Title: A prospective study comparing Itraconazole and systemic steroids as an adjunct to topical steroids in the post-operative management of Allergic fungal rhinosinusitis ABSTRACT Objectives The objective of this study was to compare the efficacy of Itraconazole and systemic steroids as an adjuvant to topical steroids in post-operative patients with Allergic Fungal Rhinosinusitis (AFRS) using both subjective and objective outcome measurements. Methods A prospective comparative study was conducted in a tertiary care center on 60 patients diagnosed with AFRS. Patients with chronic systemic illness and those undergoing revision surgery were excluded. Post-operative patients were divided into two groups of 30 each which received Itraconazole 400 mg OD or Methylprednisolone in tapering doses over six weeks. The outcomes were measured at the end of 6 weeks -Kupferberg endoscopic staging, Absolute Eosinophilic Count (AEC), Serum Immunoglobulin (IgE), and Sino Nasal Outcome Test - 20 scores. Results Our study showed no statistical significance in outcomes between the two groups treated with Itraconazole and Methylprednisolone regarding recurrence, AEC, IgE, and Quality of Life Assessment (p<0.01). Conclusion Itraconazole was comparable to Methylprednisolone in preventing disease recurrence in the post-operative management of AFRS. It may be a viable alternative to replacing systemic steroids where the latter may be contraindicated. Itraconazole given at a dose of 400 mg once daily for six weeks was a safe dose. Keywords: Allergic Fungal Rhinosinusitis, Itraconazole, endoscopy, Quality of Life, Methylprednisolone Key points: • Itraconazole was comparable to systemic steroid (Methylprednisolone) in preventing disease recurrence in the post-operative management of AFRS. • It may be a viable alternative to replacing systemic steroids where the latter may be contraindicated. • Itraconazole given at a dose of 400 mg once daily for six weeks was a safe dose. • Recurrence may be treated safely with Itraconazole than with steroids. • The course may be repeated in case of recurrence with close monitoring.

We shall investigate the asymptotic behavior of solutions to the Cauchy problem for the one-dimensional bipolar quantum Euler-Poisson system with time-dependent damping effects $\frac{J_i}{(1+t)^{\lambda}}(i=1,2)$ for $-1<\lambda<1$. Applying the technical time-weighted energy method, we prove that the classical solutions to the Cauchy problem exist uniquely and globally, and time-algebraically converge to the nonlinear diffusion waves. This study generalizes the results in [Y.-P. Li, Nonlinear Anal., 74(2011), 1501-1512] which considered the bipolar quantum Euler-Poisson system with constant coefficient damping.

Arterial bleeding can take a dramatic course with severe bleeding, therefore it requires an immediate diagnosis and treatment. In this case series, we present 2 cases of arterial injury during pacemaker implantation.

Intracerebral hemorrhage should be considered as a possible adverse event in patients with anaphylactic shock who are treated with adrenaline administration, especially those on dialysis.

This article reported two cases of adult patients diagnosed as severe obstructive sleep apnea (OSA) in the Therapy Center of Sleep-disordered Breathing of the Eye, Ear Nose & Throat (ENT) Hospital of Fudan University. Both patients were found with invisible cervical spine structural abnormality. The unknown correlation between the development.

This study reports a patient developing TEN after the first dose of (BBIBP-CorV). He developed numerous purpuric and dusky patches with flaccid bullae and areas of epidermal detachment covered more than 30% of the body area within 6 days. After treatment with dexamethasone and cyclosporin, he recovered within 14 days.

This study aimed to investigate epidemiological, clinical, and laboratory features of children with COVID-19 to identify predictors for pulmonary involvement. We conducted a retrospective, single-center study of pediatric COVID-19 at a tertiary care hospital in Turkey between December 2020 and June 2021. A total of 126 children (70 males, 55.6%) were examined during the study period. Their mean age was 74.73 ± 81.11 months (range, 1–216 months). The most frequent COVID-19 symptoms were fever (65.9%), cough (52.4%), and shortness of breath (18.3%). Ten patients required noninvasive mechanical ventilation. Sixty-nine patients (54.8%) had pneumonia. Longer duration of fever and the presence of cough were significantly associated with pulmonary involvement. In children with pneumonia, the C-reactive protein (CRP), procalcitonin levels, erythrocyte sedimentation rate (ESR), and viral load were significantly higher and lymphocyte and thrombocyte counts were significantly lower than in children without pneumonia. The cutoff viral load, CRP, and procalcitonin values for predicting pulmonary involvement were 26.5 cycle threshold (Ct; 95% confidence interval [CI], 0.54–0.74; sensitivity, 0.65; specificity, 0.56; area under curve [AUC]: 0.647, p = 0.005), 7.85 mg/L (95% CI, 0.56–0.75; sensitivity, 0.66; specificity, 0.64; AUC = 0.656; p = 0.003) and 0.105 ng/mL (95% CI, 0.52–0.72; sensitivity, 0.55; specificity, 0.58; AUC = 0.626; p = 0.02), respectively. High CRP, procalcitonin levels, ESR, and viral load and low lymphocyte and thrombocyte counts can predict pulmonary involvement in children with COVID-19, so better management may be provided for good prognosis.

The rustrela virus (RusV) was recently described as a novel pathogen in a circumscribed area of northern Germany close to the Baltic Sea. Up to now, the virus has been detected in cases of fatal non-suppurative meningoencephalitis in zoo animals of different species and a single wild carnivore as well as in apparently healthy yellow-necked field mice ( Apodemus flavicollis). Data regarding the background of this previously undiscovered pathogen, including clinical presentation of the disease, host range, and distribution of the virus, are still limited. Here, three euthanized red-necked wallabies ( Macropus rufogriseus) from zoos of different areas in northeastern Germany were submitted for necropsy after presenting with apathy and therapeutically unresponsive neurological symptoms. A moderate to severe, non-suppurative meningoencephalitis was diagnosed in all three cases. RusV was consistently detected via RT-qPCR and RNA in situ hybridization in the brains of all wallabies. Other, commonly known neuropathogens could not be detected. Overall, red-necked wallabies appear to be highly susceptible to RusV as novel neuropathogen, which is broader distributed in northeastern Germany.

The measurement of biodiversity is an integral aspect of life science research. With the establishment of second- and third-generation sequencing technologies, an increasing amount of metabarcoding data is being generated as we seek to describe the extent and patterns of biodiversity in multiple contexts. The reliability and accuracy of taxonomically assigning metabarcoding sequencing data has been shown to be critically influenced by the quality and completeness of reference databases. Custom, curated, eukaryotic reference databases, however, are scarce, as are the software programs for generating them. Here, we present CRABS (Creating Reference databases for Amplicon-Based Sequencing), a software package to create custom reference databases for metabarcoding studies. CRABS includes tools to download sequences from multiple online repositories (i.e., NCBI, BOLD, EMBL, MitoFish), retrieve amplicon regions through in silico PCR analysis and pairwise global alignments, curate the database through multiple filtering parameters (e.g., dereplication, sequence length, sequence quality, unresolved taxonomy), export the reference database in multiple formats for the immediate use in taxonomy assignment software, and investigate the reference database through implemented visualizations for diversity, primer efficiency, reference sequence length, and taxonomic resolution. CRABS is a versatile tool for generating curated reference databases of user-specified genetic markers to aid taxonomy assignment from metabarcoding sequencing data. CRABS is available for download as a conda package and via GitHub (https://github.com/gjeunen/reference_database_creator).

Despite recent advances in high-throughput DNA sequencing technologies, a lack of locally relevant DNA reference databases may limit the potential for DNA-based monitoring of biodiversity for conservation and biosecurity applications. Museums and national collections represent a compelling source of authoritatively identified genetic material for DNA database development yet obtaining DNA barcodes from long-stored specimens may be difficult due to sample degradation. We demonstrate a sensitive and efficient laboratory and bioinformatic process for generating DNA barcodes from hundreds of invertebrate specimens simultaneously via the Illumina MiSeq system. Using this process, we recovered full-length (334) or partial (105) COI barcodes from 439 of 450 (98 %) national collection-held invertebrate specimens. This included full-length barcodes from 146 specimens which produced low-yield DNA and no visible PCR bands, and which produced as little as a single sequence per specimen, demonstrating high sensitivity of the process. In many cases, the identity of the most abundant sequences per specimen were not the correct barcodes, necessitating the development of a taxonomy-informed process for identifying correct sequences among the sequencing output. The recovery of only partial barcodes for some taxa indicates a need to refine certain PCR primers. Nonetheless, our approach represents a highly sensitive, accurate, and efficient method for targeted reference database generation, providing a foundation for DNA-based assessments and monitoring of biodiversity.

Microbe associated molecular pattern (MAMP) triggered immunity research has traditionally centred around signal transduction pathways originating from activated membrane localised pattern recognition receptors (PRRs), culminating in nuclear transcription and post translational modifications. More recently, chloroplasts have emerged as key immune signalling hubs. Chloroplasts play a central role in integrating environmental signals. Notably MAMP recognition induces chloroplastic ROS (cROS) which is suppressed by pathogens effectors, which also modify the balance of defence hormone precursors, jasmonic acid (JA), salicylic acid (SA) and abscisic acid (ABA), whose precursors are chloroplast synthesised. This study focuses on how well characterised PRRs and co-receptors modulate chloroplast physiology, examining whether diverse signalling pathways converge to similarly modulate chloroplast function. Pre-treatment of receptor mutant plants with MAMP and D(Damage)AMP peptides usually protect against effector modulation of chlorophyll fluorescence and prevent Pseudomonas syringae effector mediated quenching of cROS and suppression of Fv/Fm. The MAMP-triggered immunity (MTI) co-receptor double mutant, bak1-5/bkk1-1, exhibits a remarkable decrease in Fv/Fm compared to control plants during infection, underlining the importance of MTI mediated signalling in chloroplast immunity. Further probing the role of the chloroplast in immunity we unexpectedly found that high light uncouples plant immune signalling.

Abstract text is in the manuscript due to problem with words limit

The potential benefit of concomitant surgical revascularization represents a controversial topic of the surgical treatment of post-infarction ventricular septal rupture (VSR). Beliaev and colleagues presented a case series interestingly focusing on this issue and showed how the possibility to perform coronary artery bypass grafting at time of VSR repair was associatd with better early and late mortality and improved cardiac function. However, a few more aspects deserve further comments in this controversial topic, especially considering late survival and postoperative cardiac function, although it seems reasonable to conclude that the presence of coronary artery disease not amenable to revascularization represents a strong negative prognostic factor in surgically treated VSR patients.

Here we show that substituting the ten protons in the dianion of a bispentalene derivative (C18H102-) by six Si2+ dications produces a minimum energy structure with two planar tetracoordinate carbons (ptC). In Si6C18, the ptCs are embedded in the terminal C5 pentagonal rings and participate in a three-center, two-electron (3c-2e) Si-ptC-Si σ-bond. Our exploration of the potential energy surface identifies a triphenylene derivative as the putative global minimum. But robustness to Born-Oppenheimer molecular dynamics (BOMD) simulations at 900 and 1500 K supports bispentalene derivative kinetic stability. Chemical bonding analysis reveals ten delocalized π-bonds, which, according to Hückel’s 4n+2 π-electron rule, would classify it as an aromatic system. Magnetically induced current density analysis reveals the presence of intense local paratropic currents and a weakly global diatropic current, the latter agreeing with the possible global aromatic character of this specie.

Background: Although Doppler evaluation using a multiplanar method is recommended to assess the severity of aortic stenosis (AS) with transthoracic echocardiography, evidence on the diagnostic significance of a non-apical method is limited. This study aimed to compare the use of the apical window (AW) with use of the right parasternal window (RW) method to evaluate AS severity and to examine the diagnostic significance of performing the RW method in addition to the AW method during the evaluation. Methods: This retrospective observational study included 287 consecutive patients (mean age: 79 ± 10 years; women, 56%) with severe AS (aortic valve area [AVA] ≤1.0cm 2). The severity of AS according to the AW method and that according to the RW for all subjects were compared, and the significance of performing the RW method in addition to the AW method was examined. Furthermore, we compared the concordance group, in which the AW and RW methods indicated matching in severity, and the discordant group, in which the AW and RW methods did not indicate matching severity. Results: Peak velocity (PV), mean pressure gradient (PG), and AVA were not significantly different between the AW and RW methods. Performing the RW method in addition to the AW method significantly decreased the number of low PG AS cases (mean PG <40 mmHg) from 71.1% to 65.0% and it increased the number of very severe AS cases (PV ≥5m/s) from 8.7% to 14.5%. Although, there was no significant difference in the Doppler angle (DA) observed using the AW method for the discordant group and the concordant group, the DA observed using the RW method was significantly smaller in the discordant group (8.8±8.2, 16.3±12.3 °, p<0.01). In the receiver-operating characteristic analysis, with the RW method, a DA of 8° was the cutoff value for discrepancies between the two groups. Conclusions: By performing the RW method in addition to the AW method to determine AS severity, different severity is observed in approximately 10% of cases. These results suggest that AS severity may be underestimated by using the AW method alone.

Pediatric Pulmonology strives to uphold the strongest ethical standards in publishing and to serve our diverse, international community of authors and readers with respect. We will be vigilant to prevent recurrence of this and other out-of-date, harmful terminology.

To report a case of Vogt-Koyanagi-Harada disease (VKH) in a 27-year-old male two weeks proceeding COVID-19 infection onset. Severe complications of VKH can be avoided by early diagnosis and adequate treatment with corticosteroids and immunosuppressants. It is possible that COVID-19 was a potential immunological trigger of VKH in our patient.

The effectiveness of patent foramen ovale closure for migraine has been previously discussed. By contrast, very few studies have reported the association between migraine and atrial septal defect closure. Here we report a case in which atrial septal defect closure effectively relieved migraine headaches.