Hanan Hassan Fouad

Raw data on exopodite beating in the first three developmental stages of the lobster Homarus gammarus were collected and analysed for key beating parameters. The analysis was computer assisted and the main procedures used are described. Beating patterns are the same in all three stages and are usually very regular although perturbations do occur (figures 1, 2). When beating stops the deceleration and subsequent re-acceleration is very rapid (figure 1) and limb movement sequences usually start posteriorly and move forwards (figures 1, 2d). Ipsilateral phase relations are generally maintained at 0.4-0.6 (figures, 3,4) and while the coupling between adjacent exopodites is usually stronger than for those further apart various deviations from this are occasionally seen (figure 5). No significant correlation between the ipsilateral phase relations of adjacent exopodites and base cycle duration was detected for any of the stages (figure 6). Contralateral phase relations undergo a constant progression (figures 7, 9) and this was found to be due to a heterodyne effect (figure 8) also described as gliding coordination. The powerstroke/returnstroke ratio for all stages was approximately 0.5 (figure 10) and no significant correlation was found with cycle duration (figure 11). The only substantial difference between the three larval stages which was noted was that of cycle duration, the cycles of stage III being shorter than those of the first two stages. The exopodite beating pattern was discussed in context with other metachronously cycling systems in arthropods and the implications of the present study discussed.

Background & Aims: Coronavirus disease - 2019 ({COVID}-19) is a major pandemic that causes high morbidity and mortality rates. Aim of this study: to detect the relations between many risk factors, {ACE}-2, {MCP}-1, Micro {RNA} 146 gene expression, and {COVID}-19 infection and disease severity. Methods: This study was carried out on 165 cases of {COVID}-19 and 138 controls. {ACE}2 and {MCP}1 levels were measured in {COVID}-19 cases and control by {ELISA} and micro-{RNA}-146 expression by {PCR}. Results: We found an increased blood level of {ACE}2 and {MCP}1 in {COVID}- 19 patients than in healthy persons and a significant down-regulation of micro-{RNA} 146 gene expression in cases than in controls. There was a significant correlation between increased blood level of {ACE}2, regulation of micro-{RNA} 146 gene expression and severity of lung affection, a significant correlation was found between increased blood level of {MCP}1 and thrombosis in {COVID}-19 patients. Neurological complications were significantly correlated with more viral load, more {ACE}2 blood level, and down regulation of micro {RNA}146 expression. Conclusion: High viral load, increased blood level of {ACE}2, and down-regulation of micro-{RNA} 146 expression are associated with more severe lung injury and the presence of neurologic complications like convulsions and coma in {COVID}-19 Egyptian patients.

INTRODUCTION: Postcardiotomy veno-arterial extracorporeal membrane oxygenation (V-A-ECMO) is associated with significant mortality. Identification of patients at very high risk for death is elusive and the decision to initiate V-A-ECMO is based on clinical judgment. The prognostic impact of pre-V-A-ECMO arterial lactate level in these critically ill patients has been herein evaluated.

METHODS: A systematic review was conducted to identify studies on postcardiotomy VA-ECMO for the present individual patient data meta-analysis.

RESULTS: Overall, 1269 patients selected from 10 studies were included in this analysis. Arterial lactate level at V-A-ECMO initiation was increased in patients who died during the index hospitalization compared to those who survived (9.3 vs 6.6 mmol/L, < 0.0001). Accordingly, in hospital mortality increased along quintiles of pre-V-A-ECMO arterial lactate level (quintiles: 1, 54.9%; 2, 54.9%; 3, 67.3%; 4, 74.2%; 5, 82.2%, < 0.0001). The best cut-off for arterial lactate was 6.8 mmol/L (in-hospital mortality, 76.7% vs. 55.7%, < 0.0001). Multivariable multilevel mixed-effect logistic regression model including arterial lactate level significantly increased the area under the receiver operating characteristics curve (0.731, 95% CI 0.702-0.760 vs 0.679, 95% CI 0.648-0.711, DeLong test < 0.0001). Classification and regression tree analysis showed the in-hospital mortality was 85.2% in patients aged more than 70 years with pre-V-A-ECMO arterial lactate level ≥6.8 mmol/L.

CONCLUSIONS: Among patients requiring postcardiotomy V-A-ECMO, hyperlactatemia was associated with a marked increase of in-hospital mortality. Arterial lactate may be useful in guiding the decision-making process and the timing of initiation of postcardiotomy V-A-ECMO.

Hypervirulent Klebsiella pneumoniae (hvKp) is an emerging pathogen and it has more virulence factors than classical Klebsiella pneumoniae strains. Carbapenem-resistant hvKp (CR-hvKp) is a dangerous bacteria that has both high virulence and antibiotic resistance and poses a global public health problem worldwide. The current study was carried out to investigate the occurrence of hvKp as well as carbapenem-resistant Klebsiella pneumoniae (CRKP) and CR-hvKp among diarrheic farm animals. For this purpose, rectal swabs from 165 farm animals (45 cattle, 66 sheep, and 54 goats) were collected. Samples were processed for the isolation and identification of Klebsiella pneumoniae. Moreover, hvKp was detected using molecular techniques by amplification of biomarker virulence genes (rmpA, rmpA2, iucA, iroB, and peg-344), followed by a string test. On the other hand, all K. pneumoniae isolates were examined for carbapenem resistance by both phenotypic and molecular methods. The phylogenetic analysis of peg-344 sequences was carried out. The overall prevalence rates of K. pneumoniae, hvKp, CRKP, and CR-hvKp were 24.2%, 7.9%, 16.4%, and 6.1% respectively. HvKp and CR-hvKp were detected among all examined farm animal species. On a Molecular basis, all biomarker virulence genes were identified except iroB, but rmpA is the most prevalent one. The phylogenetic analysis of peg-344 sequences obtained from the study points out their genetic relatedness to those circulated among humans. In conclusion, the emergence of hvKp and CR-hvKp among diarrheic farm animals confers a great public health implication and thus, the possible animal reservoirs for such hypervirulent-antimicrobial resistant strains cannot be ruled out.