摘要： The transfemoral (TF) approach in transcatheter aortic valve replacement is the first choice because of its superiority in terms of procedural outcomes with lower procedural mortality and higher success rate. Among the other access sites, the transcarotid (TC) approach has proven to be a promising alternative with comparable results and low complications. Future randomized controlled trials are needed to establish the safety and efficacy of TC access versus TF access.

关键词： Cardiac involvement   Multisystem inflammatory syndrome in children   Outcomes   Symptoms   Treatment  

摘要： Background Multisystem inflammatory syndrome in children (MIS-C) is a new clinical condition characterized by signs of inflammation and multiorgan dysfunction due to cytokine storm associated with SARS-CoV-2. The clinical spectrum of MIS-C ranges from mild to severe, and even to mortal multisystem involvement. To guide clinicians, we evaluated detailed demographic characteristics, clinical features, laboratory findings, and outcomes of MIS-C cases. Methods We performed a retrospective study of patients with MIS-C who were managed in the Department of Pediatric Infectious Disease in the Selcuk University Faculty of Medicine, Konya, Turkey. MIS-C patients were divided into three clinical severity groups (mild, moderate, and severe) and separated into three age groups (< 5 years, 5-10 years, > 10 years). We compared the characteristics of MIS-C cases according to the severity of the disease and by age groups. Result Thirty-six children with MIS-C were evaluated (52.8% male, median age of 7.8 years). A clinical spectrum overlapping with Kawasaki disease (KD) was the most common presentation (69.4%) in all age groups. The most common clinical symptoms were fever (100%), mucocutaneous rash (69.4%), and gastrointestinal symptoms (66.6%). There was no statistically significant difference in echocardiographic abnormality between KD-like and the other clinical spectra (p > 0.05). All life-threatening rhythm disturbances were observed in severe cases. No patients died. Conclusion It is important to increase the awareness of physicians about the MIS-C disease, which can present with different combinations of different systemic findings, so that patients can be diagnosed and treated in a timely manner.

关键词： Alternative fuel   Marine engine   Emissions   Waste plastic   Tyre pyrolysis   Waste lubricant oil  

摘要： The increasingly stringent shipping emissions regulations and global decarbonisation movement have prompted the adoption of alternative fuels in the shipping industry. This review presents the performance results and evaluation of alternative fuel engines under low-medium speed operation that has not been considered by existing reviews. This operating regime is typically used in marine propulsion. Relevant articles published by reputable journals were retrieved from scholarly databases and analysed. The evaluated alternative fuels were waste plastic oil (WPO), tyre pyrolysis oil (TPO), biodiesel, ammonia, vegetable oil (VO), and waste lubricant oil (WLO). Neat WPO and TPO demonstrated poorer emissions performances than diesel;alternatively, retarding the fuel injection timing of the WPO engine and blending the TPO with biodiesel had elevated engine performances substantially. As compared to VO degum and blending VO with diesel, VO preheating was a more promising approach to augment engine performance. Ammonia is an attractive candidate owing to its carbon-free chemical composition, but novel technologies are needed to address its terribly high NOx emission. Diesel-like fuel (DLF) derived from WLO produced notably better engine performance than fossil diesel. This review provides insight into liquid alternative fuels performances for low-medium speed engine operation, whose combustion physics is considerably different from high-speed operation. Such understandings are vital to address the current issues regarding marine engine systems, promoting the development of combustion technologies and alternative fuels uptake in marine propulsion.

关键词： Endodontic disinfection   Atmosphere pressure nonequilibrium plasma   2% chlorhexidine irrigation   Infected dentine tubules   Apical periodontitis  

摘要： Objective To investigate an intracanal disinfection methodology of APNPs (atmosphere pressure nonequilibrium plasmas) or modified APNPs in root canal treatment and evaluate the antimicrobial efficiency against in vitro infected dentinal tubules and in vivo experimental apical periodontitis. Materials and methods Dentine specimens were centrifugated with Enterococcus faecalis to generate 1-day-old and 3-week-old biofilms, and were treated with 2% chlorhexidine (Chx), APNP or modified APNP for 3 and 10 min (n=4). LIVE/DEAD staining was employed to analyze the ratio of deactivated bacteria. Experimental apical periodontitis in beagles was induced. Root canal therapy with APNPs or modified APNPs was performed and the antimicrobial effect was evaluated by histological and radiographical analyses. Results APNP deactivated 1-day-old and 3-week-old E. feacalis in dentinal tubules as much as 2% Chx irrigating. Modified APNP significantly deactivated more E. faecalis biofilms in dentinal tubules for 3-min and 10-min treatments, without thermal damage or dentinal destruction being observed. In beagles' apical periodontitis, significantly increased BV/TV and decreased lesion volume of apical bone were found in modified APNP group than 2% Chx irrigation group according to mu CT. Fewer inflammatory cells and bacterial residual in dentine were observed in modified APNP-treated apical tissue by histology staining compared with those in the 2% Chx irrigation group. Conclusion The antimicrobial effect of APNP jet irradiation was comparable to that of 2% Chx irrigation. No structural damage in dentine or tissue necrosis at the periapical region was induced upon treatment. The modified APNP demonstrated an increased antimicrobial efficacy compared with 2% Chx irrigation both in vitro and in vivo.

关键词： splicing   alternative splicing   introns   fungi   protein localization   drug resistance   virulence  

摘要： Spliceosomal introns are noncoding sequences that are spliced from pre-mRNA. They are ubiquitous in eukaryotic genomes, although the average number of introns per gene varies considerably between different eukaryotic species. Fungi are diverse in terms of intron numbers ranging from 4% to 99% genes with introns. Alternative splicing is one of the most common modes of posttranscriptional regulation in eukaryotes, giving rise to multiple transcripts from a single pre-mRNA and is widespread in metazoans and drives extensive proteome diversity. Earlier, alternative splicing was considered to be rare in fungi, but recently, increasing numbers of studies have revealed that alternative splicing is also widespread in fungi and has been implicated in the regulation of fungal growth and development, protein localization and the improvement of survivability, likely underlying their unique capacity to adapt to changing environmental conditions. However, the role of alternative splicing in pathogenicity and development of drug resistance is only recently gaining attention. In this review, we describe the intronic landscape in fungi. We also present in detail the newly discovered functions of alternative splicing in various cellular processes and outline areas particularly in pathogenesis and clinical drug resistance for future studies that could lead to the development of much needed new therapeutics.

关键词： Raw waste animal fats   Free acidity reduction   Animal fats refining   Bioliquids production   Liquid biofuels  

摘要： Three different waste animal fats (bone, chicken, and tallow) have been studied to evaluate whether they could be used as bioliquids according to the European Regulation (EC) No.1069/2009. The analyses showed that they contained an unsuitable amount of free fatty acids (FFA) and impurities content (total sediment) if compared with the standards for power generation (set by UNI 6579:2009), with the exception of tallow fat (class C, UNI/TS 11163:2018). A series of physical-chemical processes already applied at industrial scale have been considered to manage the acid value and the impurities content. The FFA esterification was carried out with methanol, comparing two acid catalysts (sulfuric acid or Amberlyst - 15), followed by neutralization of the residual acidity with two different bases (ammonia solution or solid sodium carbonate monohydrate) when necessary. The final purification has been achieved by treatment with powdered activated carbon. In particular, the bone fat was studied as reference material, having the worst initial physical-chemical characteristics. The UNI/TS 11163:2018 standard would allow to classify the bioliquid from bone fat belonging to class B, while the one from chicken would require further degumming and purification processes to reduce the metals, sulfur, and phosphorus content.

关键词： Nocardia   immunocompromised   trimethoprim/sulfamethoxazole   sulfa   drug allergy   bacteria   fungi   Pneumocystis jirovecii   respiratory infections  

摘要： Prophylactic trimethoprim/sulfamethoxazole (TMP/SMX) prevents Pneumocystis jirovecii pneumonia and nocardiosis in immunocompromised patients but sometimes is avoided because of purported allergies or side effects. Of 25 immunocompromised patients receiving alternative prophylaxis in whom nocardiosis developed, 16 subsequently tolerated TMP/SMX treatment. Clinicians should consider TMP/SMX allergy evaluation and rechallenging to assess patient tolerance.

关键词： Clay smear   SGR   Footwall   Mudstone distribution   ASGR  

摘要： Clay smear is an important formation mechanism of fault lateral sealing. The Shale Gouge Ratio (SGR) is often used to quantitatively predict clay smear, but the SGR mechanism only considers the clay smear of the hanging wall, ignoring the clay smear of the footwall and the influence of the mudstone distribution. Thus, the application of SGR is not effective in certain cases. In this paper, based on a dynamic evolution model of clay smear in shallow siliciclastic rocks, the problems of SGR application are analyzed and ameliorated, and the Advanced Shale Gouge Ratio (ASGR) index for evaluating clay smears is proposed. We add two factors, the clay smear of the footwall and the mudstone distribution, to the clay smear evaluation and propose two ASGR algorithms, which differ according to whether each interior point in an individual mudstone is regarded as an independent calculation unit or all interior points are taken as a whole. The ASGR index is applied to an exploration case study of the Kendong uplift of the Bohai Bay Basin. The ASGR results of fault F1 show that, the clay smear effect of the footwall is superior to that of the hanging wall in most cases, and sometimes only the footwall plays a key role in clay smear, which illustrates the importance of the clay smear of the footwall. This study reveals the ASGR as an alternative method for the fault sealing evaluation of shallow siliciclastic rocks and can serve as a helpful reference for further research in this area.