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A 49-year-old Japanese male was managed by mechanical ventilation due to coronavirus disease 2019 (COVID-19) pneumonia. Favipiravir as an antiviral therapy, and anti-inflammatory treatment were administered. SARS-CoV-2 RNA was detected in serum by the loop-mediated isothermal amplification (LAMP) method on Day 9; favipiravir treatment was continued. On Day 13, negative serum RNA was confirmed, followed by mechanical ventilation was removed. On Day 23, LAMP negative was confirmed in nasopharynx, after that the patient discharged on Day 27. We could treat successfully for severe COVID-19 pneumonia based on the LAMP method. We consider this method will be useful in COVID-19 treatment.

To investigate the repeatability of waveform signal parameters, measured with the Ocular Response Analyzer (ORA), in children.

Two sets of ORA measurements, with a 10-min break between them, were performed on children, aged six to <11 years old, either wearing single-vision spectacles (SVS) or orthokeratology (ortho-k) lenses. Intraclass correlation coefficients (ICCs) were used to assess agreements between two sets of measurements (37 waveform signal parameters). Bland-Altman (BA) plots were used to further analyse waveform signal parameters which had ICC 95 % confidence interval (95 % CI) between 0.50 to >0.90 (regarded as moderate to excellent agreement).

A total of 30 participants [15 SVS, 15 ortho-k (3.6 ± 2.4 months)] completed the study. Since no significant between-group differences were detected in demographic data (p > 0.28) and all waveform signal parameters (p > 0.05), data from the two groups of participants were pooled for the analysis of repeatability. Six parameters, h2, h21,form at the peaks in the signal, had moderate to excellent agreement in children. Results of the current study provides fundamental information for further studies on the potential clinical application of these waveform signal parameters in children.

The clinical relevance of subdivision of non-metastatic pancreatic ductal adenocarcinoma (PDAC) into locally advanced borderline resectable (LA-BR) and locally advanced unresectable (LA-UR) has been questioned. We assessed equivalence of overall survival (OS) in patients with LA-BR and LA-UR PDAC.

A systematic review was performed of studies published January 1, 2009 to August 21, 2019, reporting OS for LA-BR and LA-UR patients treated with or without neoadjuvant therapy (NAT), with or without surgical resection. A frequentist network meta-analysis was used to assess the primary outcome (hazard ratio for OS) and secondary outcomes (OS in LA-BR, LA-UR, and upfront resectable (UFR) PDAC).

Thirty-nine studies, comprising 14,065 patients in a network of eight unique treatment subgroups were analysed. Overall survival was better for LA-BR than LA-UR patients following surgery both with and without NAT. Neoadjuvant therapy prior to surgery was associated with longer OS for UFR, LA-BR, and LA-UR tumours, compared to upfront surgery.

Survival between the LA-BR and LA-UR subgroups was not equivalent. This subdivision is useful for prognostication, but likely unhelpful in treatment decision making. Our data supports NAT regardless of initial disease extent. Individual patient data assessment is needed to accurately estimate the benefit of NAT.

Survival between the LA-BR and LA-UR subgroups was not equivalent. This subdivision is useful for prognostication, but likely unhelpful in treatment decision making. Our data supports NAT regardless of initial disease extent. Individual patient data assessment is needed to accurately estimate the benefit of NAT.

To ascertain the opinion of physicians about diagnostic criteria, control targets, control rates, and therapeutic approach of patients with dyslipidaemia in Spain.

A specific questionnaire was created about diagnostic criteria, control targets, control rates, lipid lowering therapies, and therapeutic inertia in patients with dyslipidaemia. Physicians completed the questionnaire online during a 4-month period.

A total of 959 questionnaires were collected from all over Spain. The most frequent scale to stratify cardiovascular risk is SCORE (54.9%), and guidelines from the European Society of Cardiology are the most common guidelines used (50.5%). The majority of patients are on primary prevention (57.7%), and 31.4% have a high-very high cardiovascular risk. More than 70% of investigators considered that the target among patients at very high risk and those in secondary prevention is an LDL cholesterol < 70 mg/dL. It is considered by 60.0% and 66.4% of investigators that their patients on primary and secondary prevention, respectively, achieve control targets. Statins are the most common lipid lowering drugs used, followed by ezetimibe. In the majority of cases, when a patient is not adequately controlled with statins, there is an increase in the dose or a change to another statin. Poor adherence to treatment and therapeutic inertia are the main reasons for poor LDL cholesterol control.

The Cardio Right Care CVR Control project allows those aspects to be identified, as well as areas of improvement in patients with dyslipidaemia in Spain.

The Cardio Right Care CVR Control project allows those aspects to be identified, as well as areas of improvement in patients with dyslipidaemia in Spain.

Minor Surgery (MS) is an ever-increasing programmed activity in Primary Health Care Centres (PHC). The aim of this study is to establish the clinical and histopathology diagnostic agreement between PHC and MS and evaluating the efficacy of this activity.

A retrospective, observational, and reliability study was performed. A total of 234 patient specimens were sent to Histopathology between January 2014 and December 2018 in basic health area of San Benito-La Laguna, Santa Cruz de Tenerife. Of these, 203 specimens met criteria, with 31 being excluded due to death or absence of diagnosis. Sociodemographic and diagnostic variables were analysed, and 10 possible diagnoses were grouped into 3 categories according to their nature. Cohen kappa coefficient was used as the main evaluation measure.

The majority of specimens were obtained from women (51.2%), and the mean age was 52.82±17.82 years. The most frequently referred lesion was the epidermoid cyst (20.2-21.67%). A clinical-pathological agreement of 60% was obtained in Minor Surgery, with a specificity of 98.3% and a sensitivity of 61.9%. In Primary Care agreement was 36.1%, with a specificity of 98.4% and a sensitivity of 42.8%. Infectious lesions represented the largest concordance difference obtained, with 27% less in Primary Care compared to Minor Surgery.

Minor Surgery is an effective support in the initial diagnosis of lesions referred for evaluation at Primary Care. However, it is necessary to implement improvements in diagnostic efficacy of Primary Care.

Minor Surgery is an effective support in the initial diagnosis of lesions referred for evaluation at Primary Care. However, it is necessary to implement improvements in diagnostic efficacy of Primary Care.High amounts of deposited nitrogen (N) dramatically influence the stability and functions of alpine ecosystems by changing soil microbial community functions, but the mechanism is still unclear. To investigate the impacts of increased N deposition on microbial community functions, a 2-year multilevel N addition (0, 10, 20, 40, 80 and 160 kg N ha-1 year-1) field experiment was set up in an alpine steppe on the Tibetan Plateau. Soil microbial functional genes (GeoChip 4.6), together with soil enzyme activity, soil organic compounds and environmental variables, were used to explore the response of microbial community functions to N additions. The results showed that the N addition rate of 40 kg N ha-1 year-1 was the critical value for soil microbial functional genes in this alpine steppe. A small amount of added N (≤40 kg N ha-1 year-1) had no significant effects on the abundance of microbial functional genes, while high amounts of added N (>40 kg N ha-1 year-1) significantly increased the abundance of soil organic carbon degradation genes. Additionally, the abundance of microbial functional genes associated with NH4+, including ammonification, N fixation and assimilatory nitrate reduction pathways, was significantly increased under high N additions. Further, high N additions also increased soil organic phosphorus utilization, which was indicated by the increase in the abundance of phytase genes and alkaline phosphatase activity. Plant richness, soil NO2-/NH4+ and WSOC/WSON were significantly correlated with the abundance of microbial functional genes, which drove the changes in microbial community functions under N additions. These findings help us to predict that increased N deposition in the future may alter soil microbial functional structure, which will lead to changes in microbially-mediated biogeochemical dynamics in alpine steppes on the Tibetan Plateau and will have extraordinary impacts on microbial C, N and P cycles.Climate change is expected to increase the prevalence of water-borne diseases especially in developing countries. Climate-resilient drinking water supplies are critical to protect communities from faecal contamination and thus against increasing disease risks. However, no quantitative assessment exists for the impacts of short-term climate variability on faecal contamination at different drinking water sources in developing countries, while existing understanding remains largely conceptual. Selleckchem ML198 This critical gap limits the ability to predict drinking water quality under climate change or to recommend climate-resilient water sources for vulnerable communities. This study aims to provide such quantitative understanding by investigating the relationships between faecal contamination and short-term climate variability across different types of water sources. We collected a novel dataset with over 20 months' monitoring of weather, Escherichia coli (E. coli) and total coliforms, at 233 different water sources in three hich highlight the urgent need of protecting vulnerable communities from the severe climate impacts.Tropical peatlands are areas of high carbon density that are important in biosphere-atmosphere interactions. Drainage and burning of tropical peatlands releases about 5% of global greenhouse gas (GHG) emissions, yet there is great uncertainty in these estimates. Our comprehensive literature review of parameters required to calculate GHG emissions from burnt peat forests, following the international guidelines, revealed many gaps in knowledge of carbon pools and few recent supporting studies. To improve future estimates of the total ecosystem carbon balance and peatfire emissions this study aimed to account for all carbon pools aboveground, deadwood, pyrogenic carbon (PyC) and peat of single and repeatedly burnt peat forests. A further aim was to identify the minimum sampling intensity required to detect with 80% power significant differences in these carbon pools among long unburnt, recently burnt and repeatedly burnt peat swamp forests. About 90 Mg C ha-1 remains aboveground as deadwood after a single fire and half of this remains after a second fire. One fire produces 4.5 ± 0.6 Mg C ha-1 of PyC, with a second fire increasing this to 7.1 ± 0.8 Mg C ha-1. For peat swamp forests these aboveground carbon pools are rarely accounted in estimates of emissions following multiple fires, while PyC has not been included in the total peat carbon mass balance. Peat bulk density and peat carbon content change with fire frequency, yet these parameters often remain constant in the published emission estimates following a single and multiple fires. Our power analysis indicated that as few as 12 plots are required to detect meaningful differences between fire treatments for the major carbon pools. Further field studies directed at improving the parameters for calculating carbon balance of disturbed peat forest ecosystems are required to better constrain peatfire GHG emission estimates.