Search for Subsolar-Mass Binaries in the First Half of Advanced LIGO's and Advanced Virgo's Third Observing Run

We report on a search for compact binary coalescences where at least one binary component has a mass between 0.2  M_{⊙} and 1.0  M_{⊙} in Advanced LIGO and Advanced Virgo data collected between 1 April 2019 1500 UTC and 1 October 2019 1500 UTC. We extend our previous analyses in two main ways: we include data from the Virgo detector and we allow for more unequal mass systems, with mass ratio q≥0.1. We do not report any gravitational-wave candidates. The most significant trigger has a false alarm rate of 0.14  yr^{-1}. This implies an upper limit on the merger rate of subsolar binaries in the range [220-24200]  Gpc^{-3} yr^{-1}, depending on the chirp mass of the binary. We use this upper limit to derive astrophysical constraints on two phenomenological models that could produce subsolar-mass compact objects. One is an isotropic distribution of equal-mass primordial black holes. Using this model, we find that the fraction of dark matter in primordial black holes in the mass range 0.2  M_{⊙}<m_{PBH}<1.0  M_{⊙} is f_{PBH}≡Ω_{PBH}/Ω_{DM}≲6%. This improves existing constraints on primordial black hole abundance by a factor of ∼3. The other is a dissipative dark matter model, in which fermionic dark matter can collapse and form black holes. The upper limit on the fraction of dark matter black holes depends on the minimum mass of the black holes that can be formed: the most constraining result is obtained at M_{min}=1  M_{⊙}, where f_{DBH}≡Ω_{DBH}/Ω_{DM}≲0.003%. These are the first constraints placed on dissipative dark models by subsolar-mass analyses.

The fluctuation-dissipation measurement instrument at the Linac Coherent Light Source

The development of new modes at x-ray free electron lasers has inspired novel methods for studying fluctuations at different energies and timescales. For closely spaced x-ray pulses that can be varied on ultrafast time scales, we have constructed a pair of advanced instruments to conduct studies targeting quantum materials. We first describe a prototype instrument built to test the proof-of-principle of resonant magnetic scattering using ultrafast pulse pairs. This is followed by a description of a new endstation, the so-called fluctuation-dissipation measurement instrument, which was used to carry out studies with a fast area detector. In addition, we describe various types of diagnostics for single-shot contrast measurements, which can be used to normalize data on a pulse-by-pulse basis and calibrate pulse amplitude ratios, both of which are important for the study of fluctuations in materials. Furthermore, we present some new results using the instrument that demonstrates access to higher momentum resolution.

Analysis of entropy production in a bi-convective magnetized and radiative hybrid nanofluid flow using temperature-sensitive base fluid (water) properties

The heat transport characteristics, flow features, and entropy-production of bi-convection buoyancy induced, radiation-assisted hydro-magnetic hybrid nanofluid flow with thermal sink/source effects are inspected in this study. The physical characteristics of hybrid nanofluids (water-hosted) are inherited from the base liquid (water) and none has considered the physical characteristics of base liquid (water) in the study of temperature-sensorial hybrid nanofluid investigations, though the water physical characteristics are not constants in temperature variations. So, the temperature-sensorial attributes of base liquid (water) are taken into account for this hybrid nanofluid ([Formula: see text]) flow analysis. The mathematical forms of the flow configuration (i.e., the set of coupled, nonlinear PDE form of governing equations) are solved by utilizing the subsequent tasks: (i) congenial transformation; (ii) quasilinearization; (iii) methods of finite differences to form block matrix system, and (iv) Varga's iterative algorithm. The preciseness of the whole numerical procedure is ensured by restricting the computation to follow strict convergence conditions. Finally, the numerically extracted results representing the impacts of various salient parameters on different profiles ([Formula: see text]), gradients, and entropy production are exhibited in physical figures for better perception. A few noticeable results are highlighted as: velocity graph shows contrast behaviour under assisting and opposing buoyancy; temperature ([Formula: see text]) is dropping for heightening heat source ([Formula: see text]) surface friction remarkably declines with the outlying magnetic field ([Formula: see text]); thermal transport confronts drastic abatement under radiation ([Formula: see text]), and [Formula: see text]; the characteristics Reynolds and Brinkman numbers promote entropy. Furthermore, the bounding surface acts as a strong source of [Formula: see text]-production. Summarizations are listed at the end to quantify percentage variations.

Role of animal models in biomedical research: a review

The animal model deals with the species other than the human, as it can imitate the disease progression, its’ diagnosis as well as a treatment similar to human. Discovery of a drug and/or component, equipment, their toxicological studies, dose, side effects are in vivo studied for future use in humans considering its’ ethical issues. Here lies the importance of the animal model for its enormous use in biomedical research. Animal models have many facets that mimic various disease conditions in humans like systemic autoimmune diseases, rheumatoid arthritis, epilepsy, Alzheimer’s disease, cardiovascular diseases, Atherosclerosis, diabetes, etc., and many more. Besides, the model has tremendous importance in drug development, development of medical devices, tissue engineering, wound healing, and bone and cartilage regeneration studies, as a model in vascular surgeries as well as the model for vertebral disc regeneration surgery. Though, all the models have some advantages as well as challenges, but, present review has emphasized the importance of various small and large animal models in pharmaceutical drug development, transgenic animal models, models for medical device developments, studies for various human diseases, bone and cartilage regeneration model, diabetic and burn wound model as well as surgical models like vascular surgeries and surgeries for intervertebral disc degeneration considering all the ethical issues of that specific animal model. Despite, the process of using the animal model has facilitated researchers to carry out the researches that would have been impossible to accomplish in human considering the ethical prohibitions.

Hypertriton Production in p-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

The study of nuclei and antinuclei production has proven to be a powerful tool to investigate the formation mechanism of loosely bound states in high-energy hadronic collisions. The first measurement of the production of _{Λ}^{3}H in p-Pb collisions at sqrt[s_{NN}]=5.02  TeV is presented in this Letter. Its production yield measured in the rapidity interval -1<y<0 for the 40% highest-multiplicity p-Pb collisions is dN/dy=[6.3±1.8(stat)±1.2(syst)]×10^{-7}. The measurement is compared with the expectations of statistical hadronization and coalescence models, which describe the nucleosynthesis in hadronic collisions. These two models predict very different yields of the hypertriton in charged particle multiplicity environments relevant to small collision systems such as p-Pb, and therefore the measurement of dN/dy is crucial to distinguish between them. The precision of this measurement leads to the exclusion with a significance larger than 6.9σ of some configurations of the statistical hadronization model, thus constraining the theory behind the production of loosely bound states at hadron colliders.

AB0444 ENPATORAN: PRECLINICAL EVIDENCE SUPPORTING GLUCOCORTICOID DOSE REDUCTION AND PHASE II STUDY DESIGN IN PATIENTS WITH SLE AND/OR CLE (WILLOW)

Background

Enpatoran is a potent selective dual inhibitor of toll-like receptor (TLR) 7 and TLR8, aberrant activation of which may be involved in systemic lupus erythematosus (SLE) pathogenesis and glucocorticoid resistance.1,2,3 Enpatoran suppressed disease development in lupus mouse models, improving survival and reducing proteinuria, autoantibodies, and the interferon (IFN) gene signature.1 In healthy participants and patients hospitalized with COVID-19 pneumonia, enpatoran was well tolerated and demonstrated effective TLR7/8 engagement.4 Enpatoran is potentially glucocorticoid sparing and may help avoid the detrimental effects of long-term corticosteroid use in SLE management.5,6

Objectives

To evaluate the glucocorticoid-sparing effect of enpatoran and design a basket trial to assess its efficacy and safety in patients with SLE and/or cutaneous lupus erythematosus (CLE).

Methods

Cytokine concentrations and gene expression changes were measured in stimulated human peripheral blood mononuclear cells (PBMCs) from healthy donors after treatment with dexamethasone, TLR7/8 inhibitor, or both. A Phase II, basket design proof-of-concept, dose-finding study in patients with SLE and/or CLE (WILLOW) was designed.

Results

In healthy donor PBMCs, synergy was observed between TLR7/8 inhibitor and dexamethasone. Combination treatment inhibited cytokine release (IL-6) with greater potency than either treatment alone and reduced the expression of nuclear factor-kappa B and IFN-regulated genes. WILLOW is a Phase II, basket proof-of-concept, dose-finding, randomized, double-blind, placebo (PBO)-controlled 24-week study with two cohorts (NCT05162586, Figure 1). The primary objectives of WILLOW are to evaluate the dose–response relationship of enpatoran in reducing disease activity based on Cutaneous Lupus Erythematosus Disease Area and Severity Index-A (CLASI-A) or BILAG-Based Composite Lupus Assessment (BICLA) response rate. The secondary objectives are to investigate effects on both BICLA response and clinically meaningful corticosteroid reduction and evaluate disease control (including clinically meaningful corticosteroid reduction) in patients with predominantly active CLE or SLE. Cohort A will enroll patients with CLE (active subacute CLE and/or discoid LE) or SLE with predominantly active lupus rash. Cohort B, in two parts, will enroll SLE patients with moderate to severe systemic disease activity. Part 1 will assess clinical signal and Part 2 may be adapted to improve dose finding. Glucocorticoid-sparing will be evaluated by mandatory tapering to a prednisone-equivalent dose of ≤5 mg/day.

Figure 1.

WILLOW study design.

Cohort A and Cohort B Part 1 will start in parallel.

*Part 2 will be initiated after a pre-specified number of patients are enrolled in Part 1; enpatoran doses in Part 2 may be adapted to improve dose finding (dashed boxes).

BILAG, British Isles Lupus Assessment Group; CLASI-A, Cutaneous Lupus Erythematosus Disease Area and Severity Index-A; CLE, cutaneous lupus erythematosus; CS, corticosteroid; DBPC, double-blind placebo-controlled; DLE, discoid lupus erythematosus; PBO, placebo; SCLE, Subacute cutaneous lupus erythematosus; SLE, systemic lupus erythematosus; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index.

Conclusion

Enpatoran is a novel TLR7/8 inhibitor and may enable glucocorticoid dose reduction in patients with SLE and CLE. The WILLOW study incorporates multiple novel elements including a basket design and evaluation of glucocorticoid-sparing.

References

[1]Vlach, et al. J Pharmacol Exp Ther. 2021;376:397–409;

[2]Northcott, et al. Lancet Rheumatol. 2021;5:e357–e370;

[3]Guiducci, et al. Nature. 2010;465:937–941;

[4]Port, et al. Pharmacol Res Perspect. 2021;9:e00842;

[5]Thamer, et al. J Rheumatol. 2009;36:560–564;

[6]Ruiz-Irastorza, et al. Rheumatology. 2012;51:1145–1153.

Acknowledgements

This study was sponsored by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945), who funded medical writing support by Bioscript Stirling Ltd.

Disclosure of Interests

Eric F. Morand: None declared, Andrew Bender Shareholder of: Shares in Merck KGaA, Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Aditee Deshpande Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Bharat Vaidyanathan Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), cristina vazquez mateo Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Melinda Przetak Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Flavie Moreau Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Mukhy Khursheed Employee of: Merck Serono Ltd (an affiliate of Merck KGaA), Sanjeev Roy Employee of: Ares Trading SA (an affiliate of Merck KGaA), David Pearson Consultant of: Biogen Inc.

Expression profile, transcriptional and post-transcriptional regulation of genes involved in hydrogen sulphide metabolism connecting the balance between development and stress adaptation in plants: a data-mining bioinformatics approach

Recent research focused on novel aspects of sulphur and sulphur-containing molecules in fundamental plant processes has highlighted the importance of these compounds. Currently, the focus has shifted to the efficacy of hydrogen sulphide (H₂ S) as signalling compounds that regulate different development and stress mitigation in plants. Accordingly, we used an in silico approach to study the differential expression patterns of H₂ S metabolic genes at different growth/development stages and their tissue-specific expression patterns under a range of abiotic stresses. Moreover, to understand the multilevel regulation of genes involved in H₂ S metabolism, we performed computation-based promoter analysis, alternative splice variant analysis, prediction of putative miRNA targets and co-expression network analysis. Gene expression analysis suggests that H₂ S biosynthesis is highly influenced by developmental and stress stimuli. The functional annotation of promoter structures reveales a wide range of plant hormone and stress responsive cis-regulatory elements (CREs) that regulate H₂ S metabolism. Co-expression analysis suggested that genes involved in H₂ S metabolism are also associated with different metabolic processes. In this data-mining study, the primary focus was to understand the genetic architecture governing pathways of H₂ S metabolism in different cell compartments under various developmental and stress signalling cascades. The present study will help to understand the genetic architecture of H₂ S metabolism via cysteine metabolism and the functional roles of these genes in development and stress tolerance mechanisms.

POS1268 PHASE II TRIAL OF ENPATORAN IN PATIENTS HOSPITALIZED WITH COVID-19 PNEUMONIA

Background

Enpatoran is a selective and potent dual toll-like receptor (TLR) 7/8 inhibitor in development for the treatment of cutaneous and systemic lupus erythematosus (CLE/SLE). Enpatoran inhibits TLR7/8 activation in vitro and suppresses disease activity in lupus mouse models.1 Enpatoran was well tolerated and had linear pharmacokinetic (PK) parameters in healthy volunteers.2 As TLR7/8 mediate immune responses to single-stranded RNA viruses, including SARS-CoV-2, it was postulated that enpatoran may prevent hyperinflammation and cytokine storm in COVID-19.

Objectives

In response to the COVID-19 pandemic, we conducted an exploratory Phase II trial to assess safety and determine whether enpatoran prevents clinical deterioration in patients (pts) hospitalized with COVID-19 pneumonia. PK and pharmacodynamics (PD) of enpatoran were also evaluated.

Methods

ANEMONE was a randomized, double-blind, placebo (PBO)-controlled study conducted in Brazil, the Philippines, and the USA (NCT04448756). Pts aged 18–75 years, hospitalized with COVID-19 pneumonia (WHO 9-point scale score =4) but not mechanically ventilated, with SpO2 <94% and PaO2/FiO2 ≥150 (FiO2 maximum 0.4) were eligible. Those with a history of uncontrolled illness, active/unstable cardiovascular disease and SARS-CoV-2 vaccination were excluded. Pts received PBO or enpatoran (50 or 100 mg twice daily [BID]) for 14 days, with monitoring to Day 28 and safety follow-up to Day 60. Primary outcomes were safety and time to recovery (WHO 9-point scale ≤3). Clinical deterioration (time to clinical status >4, WHO 9-point scale) was a secondary outcome. Exploratory endpoints were enpatoran and biomarker concentrations (cytokines, C-reactive protein [CRP], D-dimer and interferon gene signature [IFN-GS] scores) assessed over time.

Results

149 pts received either PBO (n=49), or enpatoran 50 mg (n=54) or 100 mg (n=46) BID; 88% completed treatment and 86% received concomitant steroids. Median age was 50 years (77% <60 years old), 66% were male, and 50% had ≥1 comorbidity (40% hypertension, 24% diabetes). Overall, 59% pts reported a treatment-emergent adverse event (TEAE) with three non-treatment-related deaths; 11% reported a treatment-related TEAE. The proportion of pts in the enpatoran group reporting serious TEAEs was low (50 mg BID 9%; 100 mg BID 2%) vs PBO (18%). Gastrointestinal disorders were most common (PBO 8%; 50 mg BID 28%; 100 mg BID 9%). The primary outcome of time to recovery with enpatoran vs PBO was not met; medians were 3.4–3.9 days. A positive signal in time to clinical deterioration from Day 1 through Day 28 was observed; hazard ratios [95% CI] for enpatoran vs PBO were 0.39 [0.13, 1.15] (50 mg BID) and 0.30 [0.08, 1.08] (100 mg BID). Mean enpatoran exposure was dose-proportional, and PK properties were within expectations. The median (quartile [Q]1– Q3) interleukin 6 (IL-6), CRP and D-dimer baseline concentration across the groups were 5.7 (4.0–13.5) pg/mL, 30.04 (11.40–98.02) and 0.62 (0.39–1.01) mg/L, respectively. Baseline IFN-GS scores were similar across groups.

Conclusion

The ANEMONE trial was the first to evaluate the safety and efficacy of a TLR7/8 inhibitor in an infectious disease for preventing cytokine storm. Enpatoran up to 100 mg BID for 14 days was well tolerated by patients acutely ill with COVID-19 pneumonia. Time to recovery was not improved with enpatoran, perhaps due to the younger age of patients who had fewer comorbidities compared to those in similar COVID-19 trials. However, there was less likelihood for clinical deterioration with enpatoran than placebo. This trial provides important safety, tolerability, PK and PD data supporting continued development of enpatoran in SLE and CLE (NCT04647708, NCT05162586).

References

[1]Vlach, et al. J Pharmacol Exp Ther 2021;376:397–409;

[2]Port, et al. Pharmacol Res Perspect 2021;9:e00842.

Acknowledgements

We would like to thank those who took part in the the ANEMONE trial. This study was sponsored by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945), who funded medical writing support by Bioscript Stirling Ltd.

Disclosure of Interests

John E. McKinnon Consultant of: EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA, Joel Santiaguel Speakers bureau: Merck Healthcare KGaA, Claudia Murta Speakers bureau: Pfizer/Wyeth, Dongzi Yu Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Mukhy Khursheed Employee of: Merck Serono Ltd (an affiliate of Merck KGaA), Flavie Moreau Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Lena Klopp-Schulze Employee of: Merck Healthcare KGaA, Jamie Shaw Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Sanjeev Roy Employee of: Ares Trading SA (an affiliate of Merck KGaA), Amy Kao Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA)

POS1411 ARTIFICIAL INTELLIGENCE FOR IDENTIFYING NEW DISEASE CLUSTERS IN PATIENTS WITH PSORIATIC ARTHRITIS/PSORIASIS: A PROOF-OF-CONCEPT STUDY

Background

Psoriatic arthritis (PsA)/Psoriasis (PsO) patients present with multiple long-term conditions (MLTCs), and more than half of PsA patients have ≥1 LTC, which have an impact on the quality of life. We used the Clinical Practice Research Datalink (CPRD) in the UK to determine multimorbidity in patients with PsA/PsO. CPRD is a database of routinely collected UK patient data that can be used to examine multimorbidity over the life course of the disease. A understanding of clusters and timing may allow the development of tailored programmes for surveillance and early interventions to reduce MLTcs in PSA/PO.

Objectives

The overall objective of our study was to use CPRD to identify and interpret new and frequently-occurring disease clusters in the PsA/PsO population.

Methods

We identified PsA/PsO patients from the CPRD GOLD for the UK from 2009 to 2018 with at least one year of follow up but excluded patients in practices that had migrated to Aurum, a different electronic health record system held by CPRD. All patients were matched to controls at a 1: 4 ratio by age, sex, practice. We analysed 40 common MLTCs outlined by Barnett et al. to identify and interpret multimorbidity clusters. Multimorbidity clusters were identified using the network bi-clustering. Our methodology can be divided into three steps- (a) Separate the “case” and the “control” population, (b) Create a patient-condition matrix for each of “case” and “control” population and (c) From the patient-condition matrix in each case use a the Euclidean distance criterion to compute a similarity matrix of all the possible conditions among those patients.

Results

We identified 67,827 incident or prevalent PsA/PsO patients aged 20 years and above who were matched to 271,308 controls by age, sex and practice (Table 1). The median number of long-term conditions (LTCs) was higher in the cases than in the controls.

Table 1.CharacteristicCASE, N = 67,827CONTROL, N = 271,308Age Group, n (%)<206,491 (9.6%)27,897 (10%)20-5442,357 (62.4%)169,008(62.3%)55 and above19,148 (28.2%)74,403 (27.4%)Ethnicity, n (%)White28,200 (41.6%)93,485 (34.5%)Black, S.Asian and other956 (1.4%)3,735 (1.4%)Unknown38,671 (57%)174,088(64.2%)Sex, n (%)F35,431 (52%)141,724 (52%)BMI category, n (%)20 to <2511,183 (16.5%)43,240 (15.9%)25 to <3013,565 (20%)45,783 (16.9%)30 to <357,584 (11.2%)22,690 (8.4%)35 to 403,048 (4.5%)8,172 (3.0%)Alcohol status, n (%)Non-drinker/ Ex-drinker8,649/2,159 (15.9%)33,983/7,579 (15.3%)Drinker/Heavy drinker47,316/3,030 (74.2%)180,888/8,831 (69.9%)Smoking status, n (%)Ex-smoker/Non-smoker14,137/29,289 (64%)48,110/142,295 (70.2%)Smoker24,018 (35%)71,779 (26%)Long term condition, Median (IQR)1.00 (0.00, 3.00)1.00 (0.00, 2.00)

We present the results obtained via spectral clustering on the similarity matrix obtained in each “case” and “control” population via Euclidean distance. There are 40 LTCs which are represented via two clusters in the “case” and the “control” population network (Figure 1). The LTCs in the same cluster are strongly connected within themselves compared to those in the other cluster. The noticeable part was clustering of diabetes, hypertension and chronic heart diseases in one group, especially in the “case” population over the “control” population. Interestingly depression, dementia and chronic heart diseases were in the same group in the clustering results for both the “case” and the “control” population. There are a central group of diseases (HYP, DEM, DIV, CHD etc.) in Figure 1, which seems to be connected with both sets of clusters. As mentioned earlier, diabetes has connections with these central groups of diseases, and it tends to be more pronounced in the “case” population.

Figure 1.

Conclusion

MLTCs including diabetes, hypertension, chronic kidney disease and heart disease occurred together more commonly in patients with PsA/PsO than those without PsA/PsO.

The future goal is to identify frequently occurring clusters of MLTCs in the immune-mediated inflammatory disease population.

Disclosure of Interests

Prasad Nishtala: None declared, Neil McHugh: None declared, William Tillett Speakers bureau: Abbvie, Amgen, Celgene, Eli-Lilly, Janssen, MSD, Novartis, Pfizer and UCB, Consultant of: Abbvie, Amgen, Celgene, Eli-Lilly, Janssen, MSD, Novartis, Pfizer and UCB, Grant/research support from: Abbvie, Celgene, Eli-Lilly, Janssen, and UCB, Sarah Skeoch: None declared, Jenny Humphreys: None declared, John Pauling: None declared, Olga Isupova: None declared, Anita McGROGAN: None declared, Julia Snowball: None declared, Sandipan Roy: None declared

Hydrogen sulphide (H2 S) in the hidden half: Role in root growth, stress signalling and rhizospheric interactions

Apart from nitric oxide (NO) and carbon monoxide (CO), hydrogen sulphide (H₂ S) has emerged as a potential gasotransmitter that has regulatory roles in root differentiation, proliferation and stress signalling. H₂ S metabolism in plants exhibits spatio-temporal differences that are intimately associated with sulphide signalling in the cytosol and other subcellular components, e.g. chloroplast and mitochondria. H₂ S biosynthesis in plant organs uses both enzymatic and non-enzymatic pathways. H₂ S generation in roots and aerial organs is modulated by developmental phase and changes in environmental stimuli. H₂ S has an influential role in root development and in the nodulation process. Studies have revealed that H₂ S is a part of the auxin and NO signalling pathways in roots, which induce lateral root formation. At the molecular level, exogenous application of H₂ S regulates expression of several transcription factors, viz. LBD (Lateral organ Boundaries Domain), MYB (myeloblastosis) and AP2/ERF (Apetala 2/ Ethylene Response Factor), which stimulate upregulation of PpLBD16 (Lateral organ boundaries domain 16), thereby significantly increasing the number of lateral roots. Concomitantly, H₂ S acts as a crucial signalling molecule in roots during various abiotic stresses, e.g. drought, salinity heavy metals (HMs), etc., and augments stress tolerance in plants. Interestingly, extensive crosstalk exists between H₂ S, NO, ABA, calcium and ethylene during stress, which escalate plant defence and regulate plant growth and productivity. Hence, the present review will elaborate the role of H₂ S in root development, stress alleviation, legume-Rhizobium symbiosis and rhizosphere signalling. The review also examines the mechanism of H₂ S-mediated abiotic stress mitigation and cross-talk with other signaling molecules.

Polarization of Λ and Λ[over ¯] Hyperons along the Beam Direction in Pb-Pb Collisions at sqrt[s]_{NN}=5.02 TeV

The polarization of the Λ and Λ[over ¯] hyperons along the beam (z) direction, P_{z}, has been measured in Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV recorded with ALICE at the Large Hadron Collider (LHC). The main contribution to P_{z} comes from elliptic flow-induced vorticity and can be characterized by the second Fourier sine coefficient P_{z,s2}=⟨P_{z}sin(2φ-2Ψ_{2})⟩, where φ is the hyperon azimuthal emission angle and Ψ_{2} is the elliptic flow plane angle. We report the measurement of P_{z,s2} for different collision centralities and in the 30%-50% centrality interval as a function of the hyperon transverse momentum and rapidity. The P_{z,s2} is positive similarly as measured by the STAR Collaboration in Au-Au collisions at sqrt[s_{NN}]=200  GeV, with somewhat smaller amplitude in the semicentral collisions. This is the first experimental evidence of a nonzero hyperon P_{z} in Pb-Pb collisions at the LHC. The comparison of the measured P_{z,s2} with the hydrodynamic model calculations shows sensitivity to the competing contributions from thermal and the recently found shear-induced vorticity, as well as to whether the polarization is acquired at the quark-gluon plasma or the hadronic phase.

Post-Acute Covid Neurological Symptoms among Doctors and Nurses in A Tertiary Care Hospital: An Observational Study from Bangladesh

A good number of patients experience post-Covid complications. Doctors and nurses are the front liners who are at greater risk of having this disease. Neurological symptoms are frequent in patients with post-COVID-19 infection. The study aims to observe the post-acute neurological symptoms among doctors and nurses of Mymensingh Medical College Hospital, a tertiary care hospital in Bangladesh, after they recover from initial infection or among the asymptomatic cases. It was a retrospective observational study among the doctors and nurses who became RT PCR positive from late April to mid-September 2020. A total of 100 subjects were interviewed over the phone for the presence or absence of neurological symptoms four weeks post Covid-19 infection. Total 54 doctors and 46 nurses were evaluated; the male-female ratio was 1:1.77, the mean age was 35.6±7.6 years. Post-acute COVID neurological symptoms (PACNS) were present in 60% of respondents. Fatigue (51%) was the most common symptom, followed by sleep disturbance, headache, myalgia, loss of taste and smell. PACNS were more in symptomatic patients at the initial Covid infection than asymptomatic cases.

Measurement of the Groomed Jet Radius and Momentum Splitting Fraction in pp and Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

This article presents groomed jet substructure measurements in pp and Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV with the ALICE detector. The soft drop grooming algorithm provides access to the hard parton splittings inside a jet by removing soft wide-angle radiation. We report the groomed jet momentum splitting fraction, z_{g}, and the (scaled) groomed jet radius, θ_{g}. Charged-particle jets are reconstructed at midrapidity using the anti-k_{T} algorithm with resolution parameters R=0.2 and R=0.4. In heavy-ion collisions, the large underlying event poses a challenge for the reconstruction of groomed jet observables, since fluctuations in the background can cause groomed parton splittings to be misidentified. By using strong grooming conditions to reduce this background, we report these observables fully corrected for detector effects and background fluctuations for the first time. A narrowing of the θ_{g} distribution in Pb-Pb collisions compared to pp collisions is seen, which provides direct evidence of the modification of the angular structure of jets in the quark-gluon plasma. No significant modification of the z_{g} distribution in Pb-Pb collisions compared to pp collisions is observed. These results are compared with a variety of theoretical models of jet quenching, and provide constraints on jet energy-loss mechanisms and coherence effects in the quark-gluon plasma.

Optical coherence tomography versus angiography to guide percutaneous intervention: a real-world single center propensity-matched analysis

Funding Acknowledgements

Type of funding sources: None.

Background

Optical coherence tomography (OCT) with its superior resolution has several benefits over coronary angiography (CA) to guide percutaneous coronary intervention (PCI).  Despite the benefits of OCT in comparison with angiography, it is not widely used in developing countries like India data is limited in India specifically in all comer population to meet unmet need.

Objective

Here we aim to determine the clinical efficacy and safety outcomes of OCT versus CA alone in guiding PCI in all-comer patients.

Methods

This was a retrospective study which included 434 all comer patients which were propensity matched. These patients underwent PCI at our center between December 2018 and June 2020.  The primary endpoint was MACE, a composite of cardiovascular death, repeat revascularization, stent thrombosis, recurrent ischemia and target vessel myocardial infarction (TV-MI) at 6 months. Secondary endpoint was target lesion failure (TLF), composite of stent thrombosis and in-stent restenosis. Safety endpoints were post-PCI s. creatinine and hospital stay and other outcome includes post PCI rise in CK-MB.

Results

A total of 217 patients were included in each group: the OCT group and conventional angiography guided PCI (angio group) after propensity matching. Compared to angio group, patients presenting with unstable angina, NSTEMI were significantly higher in the OCT group (55.7% vs 43.3%, p = 0.0095; 17.5% vs 10%, p = 0.02, respectively) while patients with STEMI were significantly low in the OCT (23.5% vs 41.5%, p = 0.00005). Number of balloons, maximum balloon size and left main interventions and contrast volume were more in OCT group than angio group (4.21 ± 1.67 vs 3.86 ± 1.76, P= 0.0034; 3.77 ± 0.63 mm vs 3.51 ± 0.52 mm,P &lt; 0.0001; 24.52% vs 13.36 %,P = 0.003 and 202.53 ± 73.15 ml vs 161.91 ± 69.23 ml, P&lt; 0.0001 respectively). The incidence of MACE at 6 months was numerically lower in the OCT group vs angio group but the difference was not statistically significant (15 [6.9%] vs 21 [9.7%]; p = 0.2964). No cases of TV-MI, TLF (stent thrombosis or in-stent restenosis) is observed in both the groups. Post procedure rise in CKMB was more in Angio group in comparison to OCT group (6.16 ± 31.28 ng/ml vs 39.5 ± 108.71 ng/ml, p &lt; 0.001). Optimal stent expansion (&gt;80%) was seen in 71.5% patients in post OCT-guided PCI. In OCT guided PCI group, OCT identified stent underexpansion in 28.5%, stent malapposition in 3.7%, stent edge dissection in 4.1%, and tissue prolapse in 10% of the patients.

Conclusion

In this large retrospective study, OCT guided PCI is feasible and OCT-guided PCI has tendency to improve clinical outcomes at six months follow up compared to conventional angiography guided PCI in all comer patients. Abstract Figure. central illustration  Abstract Figure. Identification of PCI complications

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background

Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies.

Methods

In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality.

Findings

Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference –1·69 [–9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5–8] vs 6 [5–8] cm H₂O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52–23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75–0·86]; p<0·0001).

Interpretation

Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status.

Funding

No funding.

A Bi-Convective Magnetized Hybrid Nanofluid Flow Along with Thermal Radiation in an Adverse Pressure Field Using Temperature-Sensitive Base Fluid (Water) Properties

This investigation considers the temperature-sensitive characteristics of water (base fluid) to scrutinize the flow mechanism, various essential gradients and energy distribution (by means of entropy production) in a magnetized hybrid nanofluid (Cu+Al2O3+H2O) flow with exponentially increasing pressure. For more mechanically realistic results, the analysis includes radiation and heat generation/absorption along with surface mass disposal. Thermophoretic diffusion and Brownian diffusion (Nt, Nb) are incorporated into this study as essential slip mechanisms. The governing physical principles in mathematical form are solved utilizing a robust numerical method with Varga’s block matrix method. The graphical demonstrations of numerical results show that velocity heightens with mixed convection (λ) and Reynolds number (Re) whereas temperature enhances for heat source (Q > 0) and injection (A < 0). Stuart Number (St) reduce the heat transfer performance while mixed convection (λ) enhances the frictional coefficient. This study further found that improving estimations of nanoparticles’ percentage (Φ), Re, Eckert number (Ec) and suction (A > 0) significantly generating more entropy.

Factors associated with hospital admission and adverse outcome for COVID-19: role of social factors and medical care

Background

Beyond sex, age, and various comorbidities, geographical origin and socioeconomic deprivation are associated with Coronavirus Disease (COVID-19) morbidity and mortality in the general population. We aimed to assess factors associated with severe forms of COVID-19 after a hospital emergency department visit, focusing on socioeconomic factors.

Methods

Patients with laboratory-confirmed COVID-19 attending the emergency department of Béclère Hospital (France) in March–April 2020 were included. Postal addresses were used to obtain two geographical deprivation indices at the neighborhood level. Factors associated with hospitalization and factors associated with adverse outcomes, i.e. mechanical ventilation or death, were studied using logistic and Cox analyses, respectively.

Results

Among 399 included patients, 321 were hospitalized. Neither geographical origin nor socioeconomic deprivation was associated with any of the outcomes. Being male, older, overweight or obese, diabetic, or having a neuropsychiatric disorder were independent risk factors for hospitalization. Among 296 patients hospitalized at Béclère Hospital, 91 experienced an adverse outcome. Older age, being overweight or obese, desaturation and extent of chest CT scan lesions > 25% at admission (aHR: 2.2 [95% CI: 1.3–3.5]) and higher peak CRP levels and acute kidney failure (aHR: 2.0 [1.2–3.3]) during follow-up were independently associated with adverse outcomes, whereas treatment with hydrocortisone reduced the risk of mechanical ventilation or death by half (aHR: 0.5 [0.3–0.8]).

Conclusion

No association between geographical origin or socioeconomic deprivation and the occurrence of a severe form of COVID-19 was observed in our population after arrival to the emergency department. Empirical corticosteroid use with hydrocortisone had a strong protective impact.

Measurement of Prompt D^{0}, Λ_{c}^{+}, and Σ_{c}^{0,++}(2455) Production in Proton-Proton Collisions at sqrt[s]=13 TeV

The p_{T}-differential production cross sections of prompt D^{0}, Λ_{c}^{+}, and Σ_{c}^{0,++}(2455) charmed hadrons are measured at midrapidity (|y|<0.5) in pp collisions at sqrt[s]=13  TeV. This is the first measurement of Σ_{c}^{0,++} production in hadronic collisions. Assuming the same production yield for the three Σ_{c}^{0,+,++} isospin states, the baryon-to-meson cross section ratios Σ_{c}^{0,+,++}/D^{0} and Λ_{c}^{+}/D^{0} are calculated in the transverse momentum (p_{T}) intervals 2<p_{T}<12 and 1<p_{T}<24  GeV/c. Values significantly larger than in e^{+}e^{-} collisions are observed, indicating for the first time that baryon enhancement in hadronic collisions also extends to the Σ_{c}. The feed-down contribution to Λ_{c}^{+} production from Σ_{c}^{0,+,++} is also reported and is found to be larger than in e^{+}e^{-} collisions. The data are compared with predictions from event generators and other phenomenological models, providing a sensitive test of the different charm-hadronization mechanisms implemented in the models.

Chronic pancreatitis in a caerulein-induced mouse model is associated with an altered gut microbiome

BACKGROUND

Chronic pancreatitis (CP) is an inflammatory disease of the pancreas with loss of exocrine/endocrine functions as well as development of fibrosis. Dysbiosis of gut microbiome has been shown to be involved in the pathogenesis of many disease processes. Therefore, we aim to investigate the alteration in gut microbiome associated with CP in caerulein-induced mouse model.

METHODS

CP was induced in C57Bl/6 by using caerulein injections (50 μg/kg/h, i.p., x7, twice weekly for 10 weeks). Stool samples were collected either one week after end of injection (10-week CP) or 6 weeks (16-week CP). DNA was extracted from stool samples and V4 region of 16S rDNA was sequenced for microbiome analysis.

RESULTS

CP was strongly associated with the alteration in the composition of the gut microbiome, evidenced by differences in α and β diversity. When β diversity was measured using both weighted and unweighted UniFrac distances, stool from control mice is significantly different from mice on 10-week or 16-week CP (q < 0.01). The α-diversity measured by Faith's phylogenetic diversity was lowest in stool from healthy control and highest in stool from mice with 16-week CP (p < 0.001). Bacteria taxa differentially enriched in CP samples were detected using linear discriminant analysis. Bacteria from genera Bifidobacterium, Akkermansia, and Desulfovibrio were enriched in samples from 10-week CP mice. Bacteria from genera Allobaculum, Prevotella, and Bacteroides were enriched in samples from 16-week CP mice.

CONCLUSION

Together, these analyses reveal pronounced alteration in the gut microbiome composition, diversity, and function when mice develop CP.

Measurement of the Cross Sections of Ξ_{c}^{0} and Ξ_{c}^{+} Baryons and of the Branching-Fraction Ratio BR(Ξ_{c}^{0}→Ξ^{-}e^{+}ν_{e})/BR(Ξ_{c}^{0}→Ξ^{-}π^{+}) in pp Collisions at sqrt[s]=13 TeV

The p_{T}-differential cross sections of prompt charm-strange baryons Ξ_{c}^{0} and Ξ_{c}^{+} were measured at midrapidity (|y|<0.5) in proton-proton (pp) collisions at a center-of-mass energy sqrt[s]=13  TeV with the ALICE detector at the LHC. The Ξ_{c}^{0} baryon was reconstructed via both the semileptonic decay (Ξ^{-}e^{+}ν_{e}) and the hadronic decay (Ξ^{-}π^{+}) channels. The Ξ_{c}^{+} baryon was reconstructed via the hadronic decay (Ξ^{-}π^{+}π^{+}) channel. The branching-fraction ratio BR(Ξ_{c}^{0}→Ξ^{-}e^{+}ν_{e})/BR(Ξ_{c}^{0}→Ξ^{-}π^{+})=1.38±0.14(stat)±0.22(syst) was measured with a total uncertainty reduced by a factor of about 3 with respect to the current world average reported by the Particle Data Group. The transverse momentum (p_{T}) dependence of the Ξ_{c}^{0}- and Ξ_{c}^{+}-baryon production relative to the D^{0} meson and to the Σ_{c}^{0,+,++}- and Λ_{c}^{+}-baryon production are reported. The baryon-to-meson ratio increases toward low p_{T} up to a value of approximately 0.3. The measurements are compared with various models that take different hadronization mechanisms into consideration. The results provide stringent constraints to these theoretical calculations and additional evidence that different processes are involved in charm hadronization in electron-positron (e^{+}e^{-}) and hadronic collisions.

Experimental Evidence for an Attractive p-ϕ Interaction

This Letter presents the first experimental evidence of the attractive strong interaction between a proton and a ϕ meson. The result is obtained from two-particle correlations of combined p-ϕ⊕ p[over ¯]-ϕ pairs measured in high-multiplicity pp collisions at sqrt[s]=13  TeV by the ALICE Collaboration. The spin-averaged scattering length and effective range of the p-ϕ interaction are extracted from the fully corrected correlation function employing the Lednický-Lyuboshits approach. In particular, the imaginary part of the scattering length vanishes within uncertainties, indicating that inelastic processes do not play a prominent role for the p-ϕ interaction. These data demonstrate that the interaction is dominated by elastic p-ϕ scattering. Furthermore, an analysis employing phenomenological Gaussian- and Yukawa-type potentials is conducted. Under the assumption of the latter, the N-ϕ coupling constant is found to be g_{N-ϕ}=0.14±0.03(stat)±0.02(syst). This work provides valuable experimental input to accomplish a self-consistent description of the N-ϕ interaction, which is particularly relevant for the more fundamental studies on partial restoration of chiral symmetry in nuclear medium.

Rapid Serologic and Molecular Diagnosis of Scrub Typhus among Suspected Febrile Patients Visiting Mymensingh Medical College Hospital

Scrub typhus, caused by the bacterium- Orientia tsutsugamushi is one of the leading causes of undifferentiated treatable febrile illness in Asia pacific region. It is grossly under diagnosed in many tropical countries of South Asia including Bangladesh, due to wide range of non-specific clinical presentations, low index of suspicion among clinicians, limited awareness and lack of accurate diagnostic facilities. This cross-sectional descriptive study was conducted at Department of Microbiology, Mymensingh Medical College to diagnose scrub typhus by rapid Immunochromatographic test (ICT) as well as molecular detection of O. tsutsugamushi by Nested PCR and automated nucleotide sequencing among suspected febrile patients in Mymensingh, Bangladesh during 2019-20. Blood samples were collected from 402 febrile patients of suspected Rickettsial illness, referred from inpatient and outpatient departments of Medicine and Pediatrics, Mymensingh Medical College Hospital (MMCH). Among the enrolled 402 patients, 89 samples (22.13%) were seropositive by Immunochromatographic test (ICT) and 65 samples (16.16%) were positive for O. tsutsugamushi DNA by Nested PCR, targeting 47KDa gene. Therefore, 113/402 (28.10%) samples were positive for scrub typhus by PCR and/ or ICT. Highest number of patients was detected positive by nested PCR during the first 5-10 days of fever but only 2 cases were positive after 20 days. In case of ICT, highest positivity for only IgM (8.13%) and both antibodies (2.43%) were documented in first 5-10 days of fever, but IgG positivity was highest (41.66) in >20 days of fever. From 65 PCR positive samples, automated nucleotide sequencing was performed on 20 randomly selected samples and all were genetically confirmed to be O. tsutsugamushi.

Detection of Biocide Resistance Genes (qacE and qacΔE1) in Pseudomonas spp Isolated from Patients with CSOM at Mymensingh Medical College Hospital, Bangladesh

Biocides, including disinfectants and antiseptics, are used for a variety of topical and hard surface applications in health care facilities. Biocides play a significant role for preventing and controlling nosocomial infections. However, failures in the antimicrobial activities of biocides have been reported. The resistance mechanism to disinfectants is usually determined by genes which are related to resistance to quaternary ammonium compounds, namely, qacE, qacΔE1 that are found in Gram-negative bacteria. The aim of this study is to detect the prevalence of Biocides resistance genes, qacE and qacΔE1, in clinical isolates of Pseudomonas spp. It was carried out from March 2017 to July 2018 in the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Samples were collected from Outpatient of ENT department, MMCH. In this study, 300 clinical samples of CSOM cases were tested by the PCR method. The present study shows detection of biocide resistance genes (qacE, qacΔE1) among 87 isolated Pseudomonas spp by uniplex PCR. Among 72 clinical isolates of Pseudomonas aeruginosa 67(93.05%) had the gene qacEΔ1 and 25(34.72%) had the gene qacE. In addition other 15 Pseudomonas spp 3(20%) isolates had the qacEΔ1 gene and 2(13.33%) isolates had the qacE gene. In this study there is a marked difference in detection of the qacEΔ1 gene between the MDR and non MDR P. aeruginosa isolates. The qacEΔ1 was identified in 50 of 54(92.59%) MDR isolates and 7 of 18(38.89%) non MDR strains respectively. While gene qacE was detect 25(46.29%) MDR isolates and did not show any qacEΔ1gene in non MDR isolates. This study shows that the genes, qacE, qacΔE1 are widespread among Pseudomonas aeruginosa, they are higher in MDR strains than non MDR strains.

Microsphere embedded hydrogel construct - binary delivery of alendronate and BMP-2 for superior bone regeneration

Biomimetic delivery of osteoinductive growth factors via an osteoconductive matrix is an interesting approach for stimulating bone regeneration. In this context, the bone extracellular matrix (ECM) has been explored as an optimal delivery system, since it releases growth factors in a spatiotemporal manner from the matrix. However, a bone ECM hydrogel alone is weak, unstable, and prone to microbial contamination and also has been reported to have significantly reduced bone morphogenic protein-2 (BMP-2) post decellularization. In the present work, a microsphere embedded osteoinductive decellularized bone ECM/oleoyl chitosan based hydrogel construct (BOC) was developed as a matrix allowing dual delivery of an anti-resorptive drug (alendronate, ALN, via the microspheres) and BMP-2 (via the hydrogel) for a focal tibial defect in a rabbit model. The synthesized gelatin microspheres (GMs) were spherical in shape with diameter ∼32 μm as assessed by SEM analysis. The BOC construct showed sustained release of ALN and BMP-2 under the studied conditions. Interestingly, amniotic membrane-derived stem cells (HAMSCs) cultivated on the hydrogel construct demonstrated excellent biocompatibility, cell viability, and active proliferation potential. Additionally, cell differentiation on the constructs showed an elevated expression of osteogenic genes in an RT-PCR study along with enhanced mineralized matrix deposition as demonstrated by alkaline phosphatase (ALP) assay and alizarin red assay. The hydrogel construct was witnessed to have improved neo-vascularization potential in a chick chorioalantoic membrane (CAM) assay. Also, histological and computed tomographic findings evidenced enhanced bone regeneration in the group treated with the BOC/ALN/BMP hydrogel construct in a rabbit tibial defect model. To conclude, the developed multifunctional hydrogel construct acts as an osteoinductive and osteoconductive platform facilitating controlled delivery of ALN and BMP-2, essential for stimulating bone tissue regeneration.

Forme sévère de COVID-19 pendant la première vague épidémique en France : rôle des facteurs sociaux et des traitements empiriques

Introduction

La COVID-19 est une maladie multiforme, allant d’un rhume banal au syndrome de détresse respiratoire aiguë. L’identification précoce des patients à risque de forme sévère est cruciale. Le sexe masculin, l’âge, l’obésité et diverses comorbidités sont maintenant clairement reconnus comme associés à une évolution défavorable. La vaste étude britannique OpenSafely suggère qu’au-delà de l’état de santé individuel, l’ethnicité et le désavantage social sont associés significativement avec la mortalité hospitalière au cours des infections par le SARS-CoV-2, mais très peu de données sont disponibles en France à ce sujet.

L’objectif principal de ce travail était d’étudier les facteurs, notamment socioéconomiques, associés à la survenue d’une forme grave. L’objectif secondaire était d’étudier le rôle des traitements empiriques utilisés par les praticiens.

Matériels et méthodes

Tous les patients adultes ayant eu un diagnostic par PCR d’infection à SARS-CoV-2 de mars à mai 2020 dans un hôpital français ont été inclus. Les femmes enceintes et les cas nosocomiaux ont été exclus. Les données des dossiers médicaux ont été recueillies de manière anonymisée via un e-CRF. L’adresse du patient a été utilisée pour obtenir l’IRIS du domicile et la correspondance avec deux indicateurs socioéconomiques validés : FDEP et French EDI. Les traitements empiriques utilisés par les praticiens ont été recueillis. Les facteurs associés à une forme grave, définie par la survenue du décès ou la nécessité d’une ventilation mécanique, ont été étudiés à l’aide de modèles de Cox.

Résultats

Parmi 399 patients inclus à partir des urgences, 78 patients sont retournés au domicile et 25 ont été transférés dans un autre hôpital. Parmi les 296 patients hospitalisés, 91 ont présenté une forme sévère (68 décès). L’origine ethnique, le FDEP et le FEDI n’étaient pas associés à la survenue d’une forme grave. Parmi les différentes comorbidités, un IMC > 25, un antécédent cardiovasculaire, au moins deux comorbidités étaient associés à la survenue d’une forme grave en analyse univariée. Les facteurs associés à la survenue d’une forme grave lors de l’analyse multivariée étaient : âge > 80 ans (HR : 2,2 [1,3–3,5]), surpoids (HR : 2,3 [1,4–3,7]), lésions sévères au TDM thoracique (HR : 3,3 [2,0–5,3]). La prescription d’une corticothérapie pendant au moins 48 h était un facteur protecteur (HR : 0,4 [0,2–0,6]).

Conclusion

Aucune association entre ethnicité ou désavantage social et survenue d’une forme sévère de COVID-19 n’a été retrouvée dans notre population. La prescription d’une corticothérapie était un facteur protecteur.

Direct 3D Printing of Seashell Precursor toward Engineering a Multiphasic Calcium Phosphate Bone Graft

Multiphasic calcium phosphate (Ca-P) has widely been explored for bone graft replacement. This study represents a simple method of developing osteoinductive scaffolds by direct printing of seashell resources. The process demonstrates a coagulation-assisted extrusion-based three-dimensional (3D) printing process for rapid fabrication of multiphasic calcium phosphate-incorporated 3D scaffolds. These scaffolds demonstrated an interconnected open porous architecture with improved compressive strength and higher surface area. Multiphasic calcium phosphate (Ca-P) and hydroxyapatite present in the multi-scalar naturally resourced scaffold displayed differential protein adsorption, thus facilitating cell adhesion, migration, and differentiation, resulting in enhanced deposition of the extracellular matrix. The microstructural and physicochemical attributes of the scaffolds also lead to enhanced stem cell differentiation as witnessed from gene and protein expression analysis. Furthermore, the histological study of subcutaneous implantation evidently portrays promising biocompatibility without foreign body reaction. Neo-tissue in-growth was manifested with abundant blood vessels, thus indicative of excellent vascularization. Notably, cartilaginous and proteoglycan-rich tissue deposition indicated ectopic bone formation via an endochondral ossification pathway. The hierarchical interconnected porous architectural tribology accompanied with multiphasic calcium phosphate composition manifests its successful implication in enhancing stem cell differentiation and promoting excellent tissue in-growth, thus making it a plausible alternative in bone tissue engineering applications.

Prevalence of ESBL Encoding Genes in Acinetobacter baumannii Strains Isolated from Various Samples of a Tertiary Care Hospital in Mymensingh

The aim of this study was to find the prevalence of ESBL genes among A. baumannii isolates. In this cross sectional study, 49 Acinetobacter spp. were isolated from various clinical samples from March 2019 to February 2020 conducted in the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Clinical samples including endotracheal aspirates, wound swab/pus, urine and blood. A total of 380 samples were analyzed. Growth was obtained in 34.21% of the samples yielding 130 organisms. Out of 130 organisms, 49(37.69%) were Acinetobacter spp. Among 49 Acinetobacter spp, 39(79.59%) were Acinetobacter baumannii which was identified by PCR targeting OXA-51 like gene. Amplification of the ESBL encoding genes, namely CTX-M, TEM, SHV done by molecular technique PCR. The most antibacterial resistance was against ceftriaxone (79.48%) and lower resistance only showed in colistin (12.82%). All the isolates were sensitive to tigecycline. The distribution of ESBLs genes such as TEM 20(51.28%), CTX-M 16(41.02%) and SHV 0(0%). The high resistance to most of the antibiotics among the studied strains and also a high prevalence of TEM gene in A. baumannii strains found in our study gives alarming sign towards the treatment complexity of these strains.

Clinical Features of Covid-19 Infection: a Study of SARS-CoV-2 Positive Patients from Mymensingh Region, in Bangladesh

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to almost every country on the globe and it is considered by World Health Organization as a pandemic. SARS-CoV-2 causes the Coronavirus disease 2019 (COVID-19). Many of country are reporting the symptomatic characteristics of their cases to give better observations into the various clinical presentations of SARS-CoV-2 infection. However, the symptomatic literature is limited in Bangladesh. The aim of the study is to analyze the symptomatic characteristics of patients having the SARS-CoV-2 positive by real time reverse transcription polymerase chain reaction (rRT -PCR) test. Here, the data of 146 patients who were positive for the SARS-CoV-2 virus and were residents of different districts of Mymensingh region were analyzed. Patients' demographics, symptoms, history of co-morbidities condition like DM, HTN, Hypothyroid etc, travel and contact were collected from MMC Daily Reported data from April 1, 2020 to April 30, 2020. Among the total 3184 patients' nasopharyngeal samples, we have got 146 (4.58%) positive for SARS-CoV-2. Of the 146 positive patients most of the patients were male 95(65%), the majority 80(54.8%) were the 21 to 40year age group. Most of the patients 61(41.78%) were residents of Mymensingh include Mymensingh Sadar, Valuka, Trishal and Ishhorganj. Among the patients 94(64.4%) were symptomatic and 52(35.6%) were asymptomatic. The symptomatic patients presented mostly were with fever 45(30.82%), cough 33(22.6%) and breathlessness 9(6.16%). The majority of patients 54(36.9%) had a history of contact with SARS-CoV-2 patients and 16(11%) had a travel history within 14 days of their rRT-PCR test positive. The only 3(2%) patients had history of comorbidities condition like DM, HTN, Hypothyroid etc. The number of SARS-CoV-2 cases is rapidly increasing in our country. The education of the population about the most common symptoms of the virus infection is needed mostly; therefore, individuals may able to recognize these symptoms. So, that people might get themselves tested.