Echocardiographic phenotype and prognostic value of relative apical sparing of longitudinal strain pattern in severe aortic stenosis with and without cardiac amyloidosis. The AMYTAVI study

Introduction: It is estimated that 15% of patients with AS have concomitant cardiac amyloidosis (CA). Left ventricular (LV) longitudinal strain (LS) pattern with relative apical sparing (RELAPS>1), shown as bright red in the apical segments on the polar map, has been strongly associated with CA. Its presence and its significance in AS is yet to be determined. Purpose(s): To determine the prevalence of the RELAPS>1 pattern in patients with severe AS with and without concomitant CA, and to analyze the echocardiographic phenotype associated with this strain pattern and its prognostic value. Method(s): Patients with severe symptomatic AS undergoing TAVI were prospectively and consecutively included between Jan-19 and Dec-20. Pre-procedure, a complete echocardiogram was performed that included deformation parameters using Speckle-Tracking. Strain derived Indices accepted for CA screening were calculated: RELAPS: Relative apical LS (average apical LS/average basal+mid LS);SAB: (apical-septal/basal-septal LS);EFSR: (LVEF/GLS). After TAVI, a 99Tc-PYP scintigraphy and a proteinogram were performed to screen for CA. Result(s): 324 patients were included. The mean age was 81 yo, 52% women. Strain analysis could be performed in 243 patients due to acoustic window and covid19 pandemic restrictions. Among those, 111 (46%) presented relative apical sparing (RELAPS>1). There were no differences in clinical characteristics between patients with RELAPS <1 and >1: Similar age, sex, cardiovascular risk factors and funcional class, renal function or NT-proBNP. Among patients with RELAPS>1 there was more frecuently CA with uptake grade 2 and 3 on scintigraphy (15% vs. 4.5%, P=0.006) (Figure 1). RELAPS>1 group showed greater LV hypertrophic remodeling: Thicker myocardial wall with smaller ventricular cavity, especially concentric hypertrophy;LVEF and GLS was similar, however, MAPSE and myocardial contraction fraction (MCF) were worse in RELAPS >1 group, and EFSR was significantly higher (4.2 vs 3.9, p=0.002). RELAPS >1 group had smaller aortic valve area (AVA: 0.6 vs 0.7 cm2, p=0.045), but similar transvalvular gradients due to lower stroke volume. It had larger atria and less left atrial (LA) fractional emptying, as well as higher prevalence of atrial fibrillation (AF: 41% vs 27%, p=0.03). Right ventricle (RV) size were similar, however, RV function was worse in RELAPS >1 group (TAPSE: 19 vs 21 mm, p=0.003;free Wall LS: -24 vs -27%, p=0.008). There was no difference in all-cause mortality at 1 year of follow-up between groups (6.4% vs. 6.3%, p=1). Figure 2 represents the morphological characteristics according to the LS phenotype. Conclusion(s): In severe AS, RELAPS >1 is present in almost half of the patients. It is associated with worse cardiac remodeling, as well as higher prevalence of AF. However, it wasn't associated with higher mortality at 1 year. 1 in 7 patients with AS and RELAPS >1 have concomitant ATTR CA grade 2/3.

Multidisciplinary management of a quickly growing pediatric atypical Spitz nevus, mimicking melanoma, during the COVID-19 pandemic

Spitzoid melanoma is very rare tumour in the pediatric population, with clinical and non-uniform behaviour, different from adult melanoma [1]. It can be difficult to differentiate an atypical Spitz nevus from a Spitzoid melanoma, resulting in diagnostic problems. In addition, in our clinical case, the COVID-19pandemiccaused significant delays both in the diagnosis and in the surgical treatment of our patient. We present the clinical case of a 4-year-old child suffering from a localized polypoid cutaneous neoformation on the dorsum of the left hand, which started immediately before the lockdown and steadily increased during the COVID-19 pandemic. After a general clinical framing, the child underwent an excisional biopsy at our Department of Plastic and Reconstructive Surgery, at the Policlinico of Foggia. Subsequently, two independent anatomic pathology groups examined the specimen. Definitive diagnosis was made only after careful genetic analysis in combination with supporting histological and immunohistochemical examinations. This clinical case shows how during the pandemic we have been facing advanced forms of tumours, compared to the previous period and highlight show an interdisciplinary and multicenter collaboration allowed a quick diagnosis of certainty, demonstrating the utility of molecular pathology as a fundamental aid in clinical/surgical practice. © 2022 The Authors

Development of reusable cloth mask with nanoparticle filtration efficiency greater than 95%

ABSRACT: After the rapid spread of SARS-Cov-2 virus, the use of masks was suggested by the world health organization (WHO) to reduce the virus transmission, whose primary mode of transmission was suggested to be through respiratory droplets. The recommended face coverings were single use surgical and respirator masks made of non-woven materials. With the increased demand for masks worldwide, the environmental impacts of mask disposal and the pollution caused by microplastic fibers of the non-woven materials were presented. This challenge necessitates the need for the development of a novel reusable mask reducing the environmental effects, while providing the necessary personal protective properties. Based on the ASTM F2299 standard test method, the performance, i.e., particle-size dependent filtration efficiency and pressure drop were studied for 20 samples with multilayer knit fabrics of natural and synthetic fibers (inner layer of pure cotton, cotton-nylon and cotton-polyester, middle layer of Lycra, and outer layer of superhydrophobic polyester). The results show that all the samples had an efficiency of >94% and 87–99% for large (250 (Formula presented.) –1 (Formula presented.) m) and small (100–250 nm) particles, respectively. The best performing structure has a material composition of 41% superhydrophobic polyester, 26% natural cotton, 24% nylon and 9% Lycra. The filtration efficiency, pressure drop, and quality factor for this sample are 97.8% (for 100 nm particles), 4.04 mmH2O/cm2 and 4.77 kPa−1, respectively. It was also demonstrated that the developed mask maintains its performance after 50 wash/dry cycles, verifying its reusability. It should be noted that charge neutralizer was not used in the experimental setup of this study which might have led to enhanced results for the filtration efficiency of small (100–250 nm) particles due to the dominance of electrostatic attraction. However, several samples were tested by the third-party company who uses a certified testing equipment based on ASTM F2299, and similar results were obtained. Copyright © 2022 American Association for Aerosol Research.

An investigation into the aging of disposable face masks in landfill leachate

Due to the excessive use of disposable face masks during the COVID-19 pandemic, their accumulation has posed a great threat to the environment. In this study, we explored the fate of masks after being disposed in landfill. We simulated the possible process that masks would experience, including the exposure to sunlight before being covered and the contact with landfill leachate. After exposure to UV radiation, all three mask layers exhibited abrasions and fractures on the surface and became unstable with the increased UV radiation duration showed aging process. The alterations in chemical groups of masks as well as the lower mechanical strength of masks after UV weathering were detected to prove the happened aging process. Then it was found that the aging of masks in landfill leachate was further accelerated compared to these processes occurring in deionized water. Furthermore, the carbonyl index and isotacticity of the mask samples after aging for 30 days in leachate were higher than those of pristine materials, especially for those endured longer UV radiation. Similarly, the weight and tensile strength of the aged masks were also found lower than the original samples. Masks were likely to release more microparticles and high concentration of metal elements into leachate than deionized water after UV radiation and aging. After being exposed to UV radiation for 48 h, the concentration of released particles in leachate was 39.45 muL/L after 1 day and then grew to 309.45 muL/L after 30 days of aging. Seven elements (Al, Cr, Cu, Zn, Cd, Sb and Pb) were detected in leachate and the concentration of this metal elements increased with the longer aging time. The findings of this study can advance our understanding of the fate of disposable masks in the landfill and develop the strategy to address this challenge in waste management. Copyright © 2023 Elsevier B.V.

Persistent morphological alterations of endothelial colony-forming cells after 9 months in patients recovered from COVID-19

Background: Patients who have had the disease Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV- 2) COVID-19, mild, moderate or severe, has persisting symptoms weeks to moths after recovery of infection, with the risk of developing long-terms effects. Some alterations are related to damage of the vascular endothelium, generating thrombosis, a direct relation of the endothelial dysfunction. There are not data related on frequency of endothelial colony-forming cells (ECFCs) at 9 months of patients recovered from mild-moderate COVID-19 disease. Aim(s): We analyzed the frequency and morphology of ECFCs from recovered COVID-19 patients at 9 months post-infection. Method(s): Human mononuclear cells (MNCs) were obtained from peripheral blood from 15 recovered COVID-19 patients 9 months after disease, 10 healthy human volunteers with schedule of 2 vaccines (controls 1) and 10 healthy human volunteers without vaccines (controls 2), matched by age. All were men (25-50 years) without a history of major comorbidities. We assayed the frequency, morphological characteristics and proliferation of the ECFCs. The study was approved by the Scientific and Ethical Committee of the IMSS (number IMSS-R- 2020- 785- 167). Informed written consent was obtained from all subjects before enrollment. Result(s): ECFCs were detected in average on day 18 of culture in recovered COVID-19 patients, on day 14 in controls 1 and day 21 in controls 2, respectively. In recovered COVID-19 patients, ECFCs show abnormalities in size with elongations, large cytoplasm with prominent nuclei, similar to senescent state with no proliferative capacity when they were sub-cultured. These findings were different from those observed in controls 1 and 2 respectively. Conclusion(s): We demonstrate for the first time that ECFCs from patients recovered from COVID-19 at 9 months has characteristics of dysfunctional endothelial similar to those observed in patients recovered after 30 days after infection. This finding may support our understanding of the physiology of dysfunctional endothelium from COVID-19 disease at long term.

Ultrastructural analysis of the late stages of SARS-CoV-2 infection in Vero cells

Since 2019, the world is experiencing a COVID-19 pandemic period caused by the new betacoronavirus SARS-CoV-2. This pathogen has led more than millions of people to death and many questions about the molecular mechanisms of interactions with the host cell are still unanswered. Viral entry and egress are important steps for the virus cycle. Although SARS-CoV-2 internalization has been largely studied, the egress steps of SARS-CoV-2 are still not fully described. In this study, we address the morphological characteristics of SARS-CoV-2 morphogenesis and egress by transmission and high-resolution scanning microscopy, with the aim of adding more information about the route of nascent virions towards the extracellular medium. Our results reinforce the role of small secretory vesicles as a vehicle to the individual egress, which could be the predominant via to the SARS-CoV-2 egress in Vero cells.

BIODEGRADATION of BIOPLASTICS, INJECTED MOLDED POLYHYDROXYALKANOATES, by A BACTERIUM ISOLATED from VERMICOMPOST

According to the Argentinian Wildlife Foundation census on the coast of Buenos Aires province, 80% of the wastes were petrochemicals plastics and microplastics. Since last year, due to the influence of the COVID-19 pandemic, the use of plastics has increased, especially in containers for prepared food and single-use plastics. For this reason, the world market for bioplastics is growing steadily. The aim of this work was to evaluate the biodegradation of injected molded bioplastics in vermicompost using a bacterium isolated with extracellular enzymatic activity for the depolymerization of polyhydroxyalkanoates (PHAs). Vermicompost (Californian red worm) was sieved through 5 mm opening size. Phylogenetic analysis: the sequence of the 16S rDNA from the isolated Actinomycetes was compared with the EMBL and GenBank databases. The phylogenetic tree was constructed. The morphological characteristics were performed in ISP media and the biochemical tests were carried out according to the Bergeýs manual. Biodegradation analysis: injected molded PHAs samples consisted in rectangular (1.00 ± 0.05 cm width and 3.00 ± 0.05 cm length, thickness: 200 μm) and circular samples (diameter 2 cm, thickness 0.2 cm). Biodegradation by extracellular depolymerase activity was measured at 650 nm by turbidity decrease and by halo formation around colonies (ISP media, 12 days, 30 °C). PHAs surfaces were observed using a microscope. 28 Actinomycetes were isolated with PHAs biodegradation capacity, with different types of growth, colony morphology and extracellular enzyme production. Based on the biodegradation halo area, isolates were classified into three groups: low, medium and high enzymatic activity. From the last group, the one with the highest degradative activity under different environmental conditions was selected. The bacterium was identified as Streptomyces omiyaensis by phylogenetic studies, 16S rDNA sequencing, morphological characterization and biochemical tests and it was determined as GRAS. The strain was deposited in the AGRAL FAUBA culture collection as S. omiyaensis SSM5670. The PHAs samples in vermicompost inoculated with S. omiyaensis SSM5670 showed the deterioration of their surfaces, with the presence of surface irregularities and roughness, until the total biodegradation of the samples. The inoculation of vermicompost with an Actinomycetes isolate with extracellular PHAs degradation activity, would improve the bioplastics degradation, which would be critical given that the global production capacity of bioplastics has been estimated to increase to approximately 2.44 million tonnes in 2022.

Clinical and morphological characteristics of COVID-19-associated myocarditis

Background: COVID-19 is accompanied by the development of a wide range of cardiovascular lesions. The goal: to study the clinical and morphological features of SARS-CoV-2-associated myocarditis (SCM), determining the presence of viral RNA and proteins in myocardial tissue. Methods: The study was based on 32 autopsies with a confirmed diagnosis of myocarditis. The average age of the patients was 72.7±15.5 years. Men predominated in the group (53%). The immunohistochemical determination of the surface markers of CD45, CD3, CD20, CD 68 inflammatory infiltrates and SARS-CoV-2 nucleocapsid and spike protein has been done. Detection of coronavirus RNA was performed. Results: The clinical manifestations SCM included heart failure and variety of rhythm disturbances. Increased level of anticardiac antibodies was detected. Lymphomacrophage infiltrates (more than 7 CD3+ T-lymphocytes, more than 14 CD45+ lymphocytes and more than 7 CD68+ macrophages per 1 mm2) were found in 100% of cases. RNA of the virus was detected in myocardial tissue. Virus proteins were identified in macrophages of the inflammatory infiltrate and cardiomyocytes. Conclusion: The results suggest persistence of the virus.