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World-class expertise: a new educational style.
Subtractive microarray analysis showed that one of the earliest events resulting from MALT1 inhibition is increased susceptibility to endoplasmic reticulum stress-induced apoptosis. The BMA19 cell line is considered to conserve the biological properties of MALT lymphoma and is expected to be a valuable tool for research into the pathogenesis of MALT lymphoma with an API2-MALT1 translocation. © 2020 Wiley Periodicals, Inc.The global pandemic of 2019 novel coronavirus disease (COVID-19) has tremendously altered routine medical service provision and imposed unprecedented challenges to the health care system. This impacts patients with dysphagia complications caused by head and neck cancers. As this pandemic of COVID-19 may last longer than severe acute respiratory syndrome (SARS) in 2003, a practical workflow for managing dysphagia is crucial to ensure a safe and efficient practice to patients and health care personnel. This document provides clinical practice guidelines based on available evidence to date to balance the risks of SARS-CoV-2 exposure with the risks associated with dysphagia. Critical considerations include reserving instrumental assessments for urgent cases only, optimizing the noninstrumental swallowing evaluation, appropriate use of personal protective equipment (PPE), and use of telehealth when appropriate. Despite significant limitations in clinical service provision during the pandemic of COVID-19, a safe and reasonable dysphagia care pathway can still be implemented with modifications of setup and application of newer technologies. © 2020 Wiley Periodicals, Inc.Neonicotinoid pesticides are highly hydrophilic systemic insecticides that have been extensively used worldwide. To evaluate their environmental risks, the concentrations of these pesticides in the aquatic environment must be monitored. While Polar Organic Chemical Integrative Sampler (POCIS) has been proven to be a suitable passive sampler for many highly hydrophilic compounds, HLB POCIS showed limitations such as short linear uptake ranges in the monitoring of neonicotinoid pesticides. Here, POCIS was optimized for neonicotinoid pesticides by selecting a suitable adsorbent and filter. The ENVI-Carb nonporous carbon-based adsorbent demonstrated a good balance between strong sorption and high recovery. Static renewal experiments showed that the new POCIS device using ENVI-Carb with a polyethersulfone (PES) membrane filter had a 3 d (dinotefuran) to 28 d (clothianidin, imidacloprid, acetamiprid, and thiacloprid) linear range, which is longer than that of HLB POCIS (≤ 1 (dinotefuran) to 14 d). The POCIS using ENVI-carb with a polytetrafluoroethylene membrane had higher sampling rates (0.270 (clothianidin) to 0.686 (imidacloprid) L/d) than those of the HLB POCIS for short-term deployment. The time-weighted average concentrations in actual river water measured by the new POCIS were in good agreement with those obtained by repeated grab sampling, within 30 %. Moreover, POCIS detected two neonicotinoid pesticides that were not detected by grab sampling. Thus, the proposed POCIS is a promising tool for the monitoring of neonicotinoid pesticides. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Vascularized Composite Allotransplants (VCA) including hand, face and most recently transplants of reproductive organs represent unique, life changing procedures that have been established in centers around the world, albeit in small numbers [1]. One of the major impediments in moving VCA transplants forward has been the necessity of immunosuppression for a procedure that is life-enhancing rather than lifesaving. Indeed, side-effects of immunosuppression have been broad in VCA, just like in solid organ transplant recipients. Of additional relevance, unwanted effects of immunosuppressants may also reach a different level of concern for a life-long immunosuppression in face and hand transplantation compared to short-term treatments in temporary grafts such as uterine transplants. This article is protected by copyright. All rights reserved.Severe acute respiratory syndrome coronavirus (SARS-CoV)-2, a novel coronavirus from the same family as SARS-CoV and Middle East respiratory syndrome coronavirus, has spread worldwide leading the World Health Organization to declare a pandemic. The disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19), presents flu-like symptoms which can become serious in high-risk individuals. Here, we provide an overview of the known clinical features and treatment options for COVID-19. We carried out a systematic literature search using the main online databases (PubMed, Google Scholar, MEDLINE, UpToDate, Embase and Web of Science) with the following keywords 'COVID-19', '2019-nCoV', 'coronavirus' and 'SARS-CoV-2'. We included publications from 1 January 2019 to 3 April 2020 which focused on clinical features and treatments. We found that infection is transmitted from human to human and through contact with contaminated environmental surfaces. Hand hygiene is fundamental to prevent contamination. Wearing personal protective equipment is recommended in specific environments. The main symptoms of COVID-19 are fever, cough, fatigue, slight dyspnoea, sore throat, headache, conjunctivitis and gastrointestinal issues. Real-time PCR is used as a diagnostic tool using nasal swab, tracheal aspirate or bronchoalveolar lavage samples. Computed tomography findings are important for both diagnosis and follow-up. To date, there is no evidence of any effective treatment for COVID-19. The main therapies being used to treat the disease are antiviral drugs, chloroquine/hydroxychloroquine and respiratory therapy. In conclusion, although many therapies have been proposed, quarantine is the only intervention that appears to be effective in decreasing the contagion rate. Specifically designed randomized clinical trials are needed to determine the most appropriate evidence-based treatment modality. © 2020 The Association for the Publication of the Journal of Internal Medicine.Fusarium is a geophilic fungus, widely distributed in soil all around the world. Pathogenic subtypes may cause opportunistic infections in humans, particularly in patients with underlying immunosuppression. This article is protected by copyright. All rights reserved.The impact on the Italian national healthcare service of the COVID-19 pandemic has already been reported (1). To date, measures have been taken to adapt our healthcare systems (2). The number of patients infected in Italy since 20 February 2020 has closely followed an exponential trend, challenging our universal-coverage public healthcare system especially in terms of the availability of intensive care unit (ICU) beds, healthcare providers, and blood products (1,2). This article is protected by copyright. All rights reserved.The COVID-19 pandemic has spread to 185 countries with over 2.1 million confirmed cases and 145,000 deaths, as per the Johns Hopkins University COVID-19 dashboard provided at https//coronavirus.jhu.edu/map.html. Imaging modalities such as chest radiography, thoracic and cardiovascular ultrasound, and computed tomography have roles in the diagnosis, prognosis, monitoring, and therapy of COVID-19. However, the potential benefits of imaging need to be balanced against resource utilization and infectious risk. This article is protected by copyright. All rights reserved.Hidradenitis suppurativa (HS) is known to have a profound impact on the quality of life (QoL) of patients.1 Only a few small studies have assessed the Short Form-36 (SF-36) questionnaire in HS patients.2-5 The relation between patient characteristics, patient reported outcome measures (PROMs) and SF-36 scores has never been evaluated, even though younger age of onset, higher pain and pruritus scores are known to affect other QoL scores among HS patients.5, 6 The aim of this study was to assess the relation between patient characteristics, PROMs, and objective severity scores and SF-36 scores among HS patients. This article is protected by copyright. PI3K inhibitor All rights reserved.Total Artificial Heart (TAH) represents the only valid alternative to heart transplantation, which number is continuously increasing in recent years. The Carmat-TAH, example of a modern generation of TAH, is a biventricular pulsatile, electrically powered, hydraulically actuated flow pump with all components embodied in a single device. One of the major issues for TAHs is the washout capability of the device, strictly correlated to the presence of blood stagnation sites. The aim of this work is to develop a numerical methodology to study the washout coupled with the fluid dynamics evaluation of the Carmat-TAH during nominal working conditions. The first part of this study, focussed on the CT scan analysis of the hybrid membrane kinematics during TAH operation which was replicated with a fluid-structure interaction simulation in the second part. The difference in percentage between the in-vitro and in-silico flow rates and stroke volume is 9.7% and 6.3%, respectively. An injection of contrast blood was simulated, and its washout was observed and quantified with the volume fraction of the contrast blood still in the ventricle. The left chamber of the device showed a superior washout performance, with a contrast volume still inside the device after four washout cycles of 6.2%, respect to the right chamber with 15%. This article is protected by copyright. All rights reserved.As this ever-evolving pandemic lays itself, more of its impact is being understood. Until recently, most guidelines were reported to aid in managing and treating suspected or confirmed cases. Research institutions around the world are responding with a sense of confusion. Some are continuing routinely, especially those who are overseeing clinical trials that could offer life-saving therapies, particularly against the novel coronavirus. Since research must continue even in the face of a shutdown, we aim to collate the currently available recommendations from various organizations and provide guidance to head and neck researchers across the world during these trying times. © 2020 Wiley Periodicals, Inc.BACKGROUND The global COVID-19 pandemic brings new challenges to otolaryngology resident education. Surgical volume and clinic visits are curtailed, personal protective equipment for operating room participation is restricted, and the risk of COVID-19 disease transmission during heretofore routine patient care is the new norm. METHODS We describe a small-team "cohorting" protocol including guidelines for faculty and resident in common clinical scenarios with attention paid to the risk of common otolaryngologic procedures. RESULTS A rotating small-team approach was implemented at each clinical site, limiting interaction between department members but providing comprehensive coverage. Faculty were involved at the earliest phase of clinical interactions. Guidelines delineated faculty and resident roles based on risk stratification by patient COVID status and anticipated procedures. Special consideration was given to high-risk procedures such as endoscopy and tracheotomy. CONCLUSIONS A small-team-based approach with guidelines for faculty/resident roles may mitigate risk while optimizing patient care and maximizing education.
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