Placental inflammation in a fetal demise of a SARS-CoV-2-asymptomatic, COVID-19-unvaccinated pregnant woman: a case-report.

BACKGROUND: Intrauterine fetal demise is a recognized complication of coronavirus disease 2019 in pregnant women and is associated with histopathological placental lesions. The pathological mechanism and virus-induced immune response in the placenta are not fully understood. A detailed description of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced inflammation in the placenta during fetal demise is crucial for improved clinical management. CASE PRESENTATION: We report the case of a 27-week gestation SARS-CoV-2-asymptomatic unvaccinated pregnant woman without comorbidities or other risk factors for negative pregnancy outcomes with a diagnosis of intrauterine fetal demise. Histopathological findings corresponded to patterns of subacute inflammation throughout the anatomic compartments of the placenta, showing severe chorioamnionitis, chronic villitis and deciduitis, accompanied by maternal and fetal vascular malperfusion. Our immunohistochemistry results revealed infiltration of CD68+ macrophages, CD56+ Natural Killer cells and scarce CD8+ T cytotoxic lymphocytes at the site of placental inflammation, with the SARS-CoV-2 nucleocapsid located in stromal cells of the chorion and chorionic villi, and in decidual cells. CONCLUSION: This case describes novel histopathological lesions of inflammation with infiltration of plasma cells, neutrophils, macrophages, and natural killer cells associated with malperfusion in the placenta of a SARS-CoV-2-infected asymptomatic woman with intrauterine fetal demise. A better understanding of the inflammatory effects exerted by SARS-CoV-2 in the placenta will enable strategies for better clinical management of pregnant women unvaccinated for SARS-CoV-2 to avoid fatal fetal outcomes during future transmission waves.

Percutaneous cholecystostomy: an unusual route of dissemination of gallbladder carcinoma.

A 78-year-old male with high-risk surgical presented severe acute cholecystitis and required cholecystostomy. The patient was referred later for assessment of the surgical treatment. A cholangio-MRI revealed a lesion on the gallbladder fundus with hepatic lesions suggestive of metastatic gallbladder carcinoma, which was confirmed in the histological analysis. The tumor progressed despite the chemotherapy through the cholecystostomy tract and developed peritoneal carcinomatosis. The patient did not respond to chemotherapy and he died 12 months later.

Better than the real thing? Success of a virtual platform for an established "Train the Trainer" course.

BACKGROUND: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) uses the Laparoscopic colectomy Train the Trainer (Lapco TT) framework for standardization of instructor training for Hands-On surgical skills courses. The curriculum focuses on teaching structure, skills deconstruction, trainer intervention framework, and performance enhancing feedback. A halt in the in-person Lapco TT courses due to the Coronavirus Disease 2019 (COVID-19) pandemic necessitated creation of a virtual alternative. We investigated the effectiveness of this virtual course. METHODS: Adaptation of the in-person Lapco TT course to the virtual format retained the majority of content as well as the 4:6 instructor-to-participant ratio. The virtual platform and simulators chosen allowed maximal interactivity and ease of use. After participating in the day and one half course, participants completed an 8-item post-course survey using a 5-point Likert scale related to the training experience. In addition, they had the opportunity to provide answers to several open-ended questions regarding the course. For the survey, frequency counts provided an assessment of each item. For the open questions, qualitative analysis included determination of themes for each question. Frequency counts of each theme provided quantitative analysis. RESULTS: Thirty-six total participants completed a Lapco TT virtual course (six sessions of six participants). Of this number, 32 participants completed post-course surveys and questions. All the participants completing the survey would very likely or definitely (Likert scale 4, 5) recommend the course to a colleague and incorporate the teaching in their practice. The majority of participants completing open-ended questions felt the virtual course format was effective; half thought that post-course follow-up would be useful. Technical concerns were an issue using the virtual format. CONCLUSION: A virtual Lapco TT course is feasible and well received by participants. It presents a potentially more cost effective option to faculty development.

Lighting up Nobel Prize-winning studies with protein intrinsic disorder.

Intrinsically disordered proteins and regions (IDPs and IDRs) and their importance in biology are becoming increasingly recognized in biology, biochemistry, molecular biology and chemistry textbooks, as well as in current protein science and structural biology curricula. We argue that the sequence → dynamic conformational ensemble → function principle is of equal importance as the classical sequence → structure → function paradigm. To highlight this point, we describe the IDPs and/or IDRs behind the discoveries associated with 17 Nobel Prizes, 11 in Physiology or Medicine and 6 in Chemistry. The Nobel Laureates themselves did not always mention that the proteins underlying the phenomena investigated in their award-winning studies are in fact IDPs or contain IDRs. In several cases, IDP- or IDR-based molecular functions have been elucidated, while in other instances, it is recognized that the respective protein(s) contain IDRs, but the specific IDR-based molecular functions have yet to be determined. To highlight the importance of IDPs and IDRs as general principle in biology, we present here illustrative examples of IDPs/IDRs in Nobel Prize-winning mechanisms and processes.

Effect of Vagus Nerve Stimulation on the GASH/Sal Audiogenic-Seizure-Prone Hamster.

Vagus nerve stimulation (VNS) is an adjuvant neuromodulation therapy for the treatment of refractory epilepsy. However, the mechanisms behind its effectiveness are not fully understood. Our aim was to develop a VNS protocol for the Genetic Audiogenic Seizure Hamster from Salamanca (GASH/Sal) in order to evaluate the mechanisms of action of the therapy. The rodents were subject to VNS for 14 days using clinical stimulation parameters by implanting a clinically available neurostimulation device or our own prototype for laboratory animals. The neuroethological assessment of seizures and general behavior were performed before surgery, and after 7, 10, and 14 days of VNS. Moreover, potential side effects were examined. Finally, the expression of 23 inflammatory markers in plasma and the left-brain hemisphere was evaluated. VNS significantly reduced seizure severity in GASH/Sal without side effects. No differences were observed between the neurostimulation devices. GASH/Sal treated with VNS showed statistically significant reduced levels of interleukin IL-1ß, monocyte chemoattractant protein MCP-1, matrix metalloproteinases (MMP-2, MMP-3), and tumor necrosis factor TNF-α in the brain. The described experimental design allows for the study of VNS effects and mechanisms of action using an implantable device. This was achieved in a model of convulsive seizures in which VNS is effective and shows an anti-inflammatory effect.

Combined use of biochar and alternative management systems for imazamox induced pollution control in rice growing environments.

Imazamox (IMZX) is a persistent herbicide having probable risks for non-target organisms in the environment and water contamination. Alternatives to conventional flooding rice production, including biochar amendment, may induce changes in soil properties which can greatly modify the environmental fate of IMZX. This two-year study is the first to evaluate how tillage and irrigation practices, with or without fresh or aged biochar (Bc), that are alternatives to conventional rice production impact IMZX's environmental fate. The treatments were: conventional tillage and flooding irrigation (CTFI), conventional tillage and sprinkler irrigation (CTSI), no-tillage and sprinkler irrigation (NTSI), and the corresponding Bc-amendment treatments (CTFI-Bc, CTSI-Bc, and NTSI-Bc). Fresh and aged Bc amendment decreased IMZX's sorption onto the soil in tillage treatments, with Kf values decreasing 3.7 and 4.2-fold (fresh case) and 1.5 and 2.6-fold (aged case) for CTSI-Bc and CTFI-Bc, respectively. The transition to sprinkler irrigation reduced IMZX persistence. Overall, Bc amendment also reduced chemical persistence with half-life values decreasing 1.6 and 1.5-fold for CTFI and CTSI (fresh year) and 1.1, 1.1, and 1.3-fold for CTFI, CTSI, and NTSI (aged year), respectively. Sprinkler irrigation reduced IMZX leaching by up to a factor of 2.2. The use of Bc as amendment led to a significant decrease in IMZX leaching only under tillage conditions, but notable in particular for the CTFI case where leaching losses were reduced in the fresh year from 80% to 34% and, in the aged year, from 74% to 50%. Hence the change in irrigation from flooding to sprinkler either alone or in combination with the use of Bc (fresh or aged) amendment could be considered an effective way to sharply mitigate IMZX contamination of water in environments where rice is grown, particularly in those managed with tillage.

An unusual finding in gastroesophageal surgery: gastric anthracosis.

We present the case of a patient with an unusual finding of gastric anthracosis during oncological surgery for gastric adenocarcinoma.

All-Electrochemical Nanofabrication of Stacked Ternary Metal Sulfide/Graphene Electrodes for High-Performance Alkaline Batteries.

Energy-storage materials can be assembled directly on the electrodes of a battery using electrochemical methods, this allowing sequential deposition, high structural control, and low cost. Here, a two-step approach combining electrophoretic deposition (EPD) and cathodic electrodeposition (CED) is demonstrated to fabricate multilayer hierarchical electrodes of reduced graphene oxide (rGO) and mixed transition metal sulfides (NiCoMnSx ). The process is performed directly on conductive electrodes applying a small electric bias to electro-deposit rGO and NiCoMnSx in alternated cycles, yielding an ideal porous network and a continuous path for transport of ions and electrons. A fully rechargeable alkaline battery (RAB) assembled with such electrodes gives maximum energy density of 97.2 Wh kg-1 and maximum power density of 3.1 kW kg-1 , calculated on the total mass of active materials, and outstanding cycling stability (retention 72% after 7000 charge/discharge cycles at 10 A g-1 ). When the total electrode mass of the cell is considered, the authors achieve an unprecedented gravimetric energy density of 68.5 Wh kg-1 , sevenfold higher than that of typical commercial supercapacitors, higher than that of Ni/Cd or lead-acid Batteries and similar to Ni-MH Batteries. The approach can be used to assemble multilayer composite structures on arbitrary electrode shapes.

Intra-abdominal epithelioid angiosarcoma.

The epithelioid angiosarcoma is a type of sarcoma is very rare (<1 % of all sarcomas). The most frequent location is in extremities, therefore is the axial region less common.Differential diagnosis with other histologic variants of intra-abdominal hepatic and splenic angiosarcomas is essential. Surgery is the treatment of choice, and there is no current evidence on the management of cases with locoregional or distant involvement.

Critical Role of Functional Groups Containing N, S, and O on Graphene Surface for Stable and Fast Charging Li-S Batteries.

Lithium-sulfur (Li-S) batteries are considered one of the most promising energy storage technologies, possibly replacing the state-of-the-art lithium-ion (Li-ion) batteries owing to their high energy density, low cost, and eco-compatibility. However, the migration of high-order lithium polysulfides (LiPs) to the lithium surface and the sluggish electrochemical kinetics pose challenges to their commercialization. The interactions between the cathode and LiPs can be enhanced by the doping of the carbon host with heteroatoms, however with relatively low doping content (<10%) in the bulk of the carbon, which can hardly interact with LiPs at the host surface. In this study, the grafting of versatile functional groups with designable properties (e.g., catalytic effects) directly on the surface of the carbon host is proposed to enhance interactions with LiPs. As model systems, benzene groups containing N/O and S/O atoms are vertically grafted and uniformly distributed on the surface of expanded reduced graphene oxide, fostering a stable interface between the cathode and LiPs. The combination of experiments and density functional theory calculations demonstrate improvements in chemical interactions between graphene and LiPs, with an enhancement in the electrochemical kinetics, power, and energy densities.

Factors affecting diabetic patient's long-term quality of life after simultaneous pancreas-kidney transplantation: a single-center analysis.

PURPOSE: Pancreas transplantation (PT) is one of the few ways to restore euglycemia within diabetic patients; however, the high morbidity caused by surgical complications and the need for immunosuppressive therapy has raised controversy about PT improving the health-related quality-of-life (HRQoL). The aim of this study is to assess the long-term (≥ 5 years after PT) HRQoL and to identify the factors affecting it. METHODS: A single-center, cross-sectional study of 49 sequential PT was performed. All patients conducted a telephone interview to fulfill the modification of Medical Outcome Health Survey Short Form questionnaire (SF-36v2) and were compared to similar post-PT studies from the literature. RESULTS: Patients with a history of replacement renal therapy (RRT) or neuropathy undergoing a PT were associated to a worse bodily pain (P = 0.03) and physical function (P = 0.04), respectively, whereas those with retinopathy showed an improved Role Emotional (P = 0.04). Multivariate analysis revealed the presence of RRT as the only independent prognostic factor for a worse bodily pain [relative risk = 3.9; 95% confidence interval (1.1-14.6)], (P = 0.04). Furthermore, nearly all PT recipients (91.8%) claimed an overall better health than prior to PT. CONCLUSION: Our study confirms that PT recipients' HRQoL improves after PT, showing similar HRQoL scores across different populations and suggests that patients in predialysis could benefit from an improved HRQoL if transplanted on the early stages of the disease.

A mycotic hepatic artery aneurysm, a rare complication of aortic valve endocarditis.

A 58-year-old male underwent an aortic valve replacement due to an acute aortic regurgitation for aortic valve endocarditis. The patient maintained febrile syndrome during the postoperative period, in spite of broad-spectrum antibiotics. The CT scan showed an aneurysmal dilatation (45 mm in diameter) on the right hepatic artery. The appearance of a rapidly growing aneurysmal lesion, which was observed in previous radiologic examinations, suggested a diagnosis of a mycotic aneurysm secondary to infective endocarditis. A selected angiography of the celiac trunk was performed, which confirmed the diagnosis. An endovascular approach was applied and an aneurysm coil embolization was performed. Targeted antibiotic therapy was applied during 6 weeks and the patient showed an improvement and was discharged. He is currently asymptomatic. Discussion Mycotic hepatic artery aneurysms (MHAAs) are uncommon (less than 0.1%) and mainly affect the extrahepatic region (1). In most cases, MHAAs are asymptomatic and a high clinical suspicion is needed. Arteriography is the gold standard and it can be used as a diagnostic and therapeutic tool (2). MHAAs are associated with a high risk of rupture, even in patients without symptoms suggestive of MHAA or previous endocarditis (3). Thus, an early diagnosis and treatment is necessary. Surgery or endovascular techniques may be performed. The endovascular approach is accepted in intrahepatic MHAAs or in high risk patients (1,3). In our patient, a radiological exam was needed due to the persistent febrile syndrome. An endovascular approach was performed after a multidisciplinary team decision.

Influence of FecGE mutation on the reproductive variables of Pelibuey ewes in the anestrus period.

The growth and differentiation factor 9 (GDF9) intervenes in the fecundity and prolificacy of the ewe, which are important variables that participate in the reproductive efficiency of a flock. The objective of this study was to evaluate the influence of FecGE mutation of the gene GDF9 in the natural response of the manifestation to estrus, return to estrus, ovulation rate, pregnancy, lambing, prolificacy, and fecundity rate in Pelibuey ewes, during the anestrus period. The sequences of the exon 2 of the gene GDF9 were obtained from blood samples collected in Whatman™ FTA™ cards from 42 multiparous Pelibuey ewes with reproductive records. For this purpose, the quality of the sequences was analyzed and the polymorphisms and genotypes were searched for. The ewes were grouped according to their group: (a) homozygous or Embrapa (GG), (b) wild (AA), and (c) group without gene (sG). All the ewes studied manifested estrus behavior, but none showed signs of return to estrus after natural mating (p > 0.05); likewise, the pregnancy and lambing rates (p > 0.05) did not show differences between groups. However, the group GG presented higher ovulation rate, prolificacy, and fecundity rate (p < 0.05), compared to groups AA and sG. Although no differences were found in the manifestation of estrus, return to estrus, and percentage of pregnancy and lambing in females from the genotypes studied, the homozygous ewes GG presented 1.22 and 1.72 more corpus luteum (CL, p < 0.05), prolificacy of 0.7 and 0.7, and fecundity rate of 0.8 and 1.0 more lambs per ewe (p < 0.05) than the ones produced by the wild-type AA and sG groups, respectively.

Curve Sprinting in Soccer: Kinematic and Neuromuscular Analysis.

Sprinting in curvilinear trajectories is an important soccer ability, corresponding to ~85% of the actions performed at maximum velocity in a soccer league. We compared the neuromuscular behavior and foot contact-time between outside leg and inside leg during curve sprinting to both sides in soccer players. Nine soccer players (age=23±4.12 years) performed: 3×Sprint linear, 3×Sprint right curve, and 3×Sprint left curve. An ANOVA with repeated measures was used to compare the differences between inside and outside leg, and Cohen's d was used to calculate the effect-size. Considering the average data, the performance classification (from best to worst) was as follows: 1. Curve "good" side (2.45±0.11 s), 2. Linear (2.47±0.13 s), and 3. Curve "weak" side (2.56±0.17 s). Comparing linear with curve sprinting, inside leg recorded significant differences ("good" and "weak"; effect size=1.20 and 2, respectively); in contrast, for outside leg, there were no significant differences ("good" and "weak"; effect size=0.30 and 0.49, respectively). Electromyography activity showed significant differences (p≤0.05) during curve sprinting between outside (higher in biceps femoris and gluteus medius) and inside leg (higher activity in semitendinosus and adductor). In summary, inside and outside leg play different roles during curved sprints, but inside leg is more affected by the change from straight to curve sprint.

Relation of the maximum temperature and relative humidity close to the insemination with the tropical milking criollo heifer's gestation in three seasons.

The high climatic variability of hot climates of the intertropical zone reduces cattle fertility. In dairy cows in temperates zones, the THI has been used to evaluate the temperature and relative humidity (RH) joint effect in reproduction, but its use is not recommended in all geographic zones; in hot climates, the maximum temperature (Tmax) can provide more convenient information than THI. The objective of this study was to determine the artificial insemination (AI) service seasons and their joint effect with the maximum temperature and relative humidity of the previous seven days, the service day, and posterior seven days to the AI in the tropical milking criollo (LT) heifer's gestation. Climatic data was used to define three seasons: hot-dry (HD), hot-humid (HH), and fresh-dry (FD), and 313 artificial insemination services from 176 heifers were analyzed over fourteen years. The seasons were determined by cluster analysis. Gestation at first service (GF) was analyzed with a logistic regression model and global gestation (GG) with a mixed linear generalized model. The Tmax of previous seven days insemination [Formula: see text] - 0.20 ± 0.09 (p ≤ 0.02) in HD (p ≤ 0.02) and RH of seven days posterior insemination [Formula: see text]= - 0.08 ± 0.04 (p ≤ 0.04) in HD (p ≤ 0.01) affected GF. No effect of the Tmax and RH on the service day was observed (p > 0.05). The highest GG probabilities were higher than 0.70 in HH and FD, making those seasons the most suitable for inseminating LT heifers.

Effect of Incorporating White, Red or Black Quinoa Flours on Free and Bound Polyphenol Content, Antioxidant Activity and Colour of Bread.

Interest in quinoa as a functional food ingredient is currently emerging. The flours from white, red and black quinoa seeds were analysed in terms of total polyphenol content and antioxidant activity. They were incorporated at 25% on flour basis into the bread dough formula to evaluate their potential to improve the functional properties of wheat breads. The contribution of extractable polyphenols (soluble forms) and the largely unexplored hydrolysable polyphenols (bound forms that can be found in the residues of the former) were taken into account to reflect a realistic health-promoting potential of breads. The red and black quinoa varieties stood out compared to wheat flour, with about double the polyphenol content and up to 4.7-fold increments in antioxidant activity when considering the sum of extractable and hydrolysable polyphenols. The red and black flours were equally effective in intensifying the antioxidant properties of bread despite the baking process (between 2- and 3-fold). They produced significant changes in the parameters that describe crust and crumb colour (L*, a*, b*). A clear darkening was observed compared to the control bread, an appealing attribute for lovers of unconventional and natural products. According to our results, the flours from the coloured quinoa seeds could be considered interesting antioxidant sources and be applied as natural ingredients in bread-making; new, promising and valuable unconventional products for consumers and producers could be developed.

Knowledge, attitudes and beliefs of technical staff towards doping in Spanish football.

The aim of this study was to understand the attitudes, beliefs and knowledge among technical staff members of Spanish football teams regarding doping. The sample was drawn from 88 football teams that ranged from elite to under-18 categories. The 237 stakeholders (34.45 ± 8.59 years) were categorised as follows: coaches (COA) (n = 101), physical trainers (PT) (n = 68) and rest of technical staff (RTS) (n = 68). The descriptive exploratory design used an instrument that combined a validated questionnaire (Performance Enhancement Attitude Scale; PEAS) with specific, qualitative open-ended questions. The overall mean score from the PEAS (range, 17-102, with higher scores representing more permissive attitudes towards doping) was 31.64 ± 10.77; for COA, 31.91 ± 11.42; for PT, 31.28 ± 9.44; and for RTS, 31.58 ± 11.18. Regarding participants' knowledge and beliefs, most respondents (57.6%) did not know the meaning of WADA (World Anti-Doping Agency); 84.9% did not know the prohibited list; and 39.2% had used/recommended supplements. In addition, 87.2% recognised "differential treatment of doping among sports," with cycling considered most affected (62.6%) and team sports least (27.2%, with football at 15%). The dangerous lack of knowledge highlights the necessity for anti-doping education and prevention programs for all football stakeholders, not just athletes.