Biochemical, Hematological, Inflammatory, and Gut Permeability Biomarkers in Patients with Alcohol Withdrawal Syndrome with and without Delirium Tremens.

Background: Delirium Tremens (DT) is known to be a serious complication of alcohol withdrawal syndrome (AWS). Neurotransmitter abnormalities, inflammation, and increased permeability are associated with the pathogenesis of AWS and DT. However, the biomarkers of these conditions are still poorly understood. Methods: In this work, biochemical, hematologic, inflammatory, and gut permeability biomarkers were investigated in the following three groups: healthy controls (n = 75), severe AWS patients with DT (n = 28), and mild/moderate AWS without DT (n = 97). Blood sampling was performed after resolution of the acute condition (on 5 ± 1 day after admission) to collect clinical information from patients and to investigate associations with clinical scales. Biomarker analysis was performed using automated analyzers and ELISA. Inflammatory biomarkers included the erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hsCRP), and platelet-to-lymphocyte ratio (PLR). Results: Among the biochemical biomarkers, only glucose, total cholesterol, and alanine aminotransferase (ALT) changed significantly in the analyzed groups. A multiple regression analysis showed that age and ALT were independent predictors of the CIWA-Ar score. Hematologic biomarker analysis showed an increased white blood cell count, and the elevated size and greater size variability of red blood cells and platelets (MCV, RDWc, and PDWc) in two groups of patients. Gut permeability biomarkers (FABP2, LBP, and zonulin) did not change, but were associated with comorbid pathologies (alcohol liver disease and pancreatitis). The increase in inflammatory biomarkers (ESR and PLR) was more evident in AWS patients with DT. Cluster analysis confirmed the existence of a subgroup of patients with evidence of high inflammation, and such a subgroup was more frequent in DT patients. Conclusions: These findings contribute to the understanding of biomarker variability in AWS patients with and without DT and support the heterogeneity of patients by the level of inflammation.

Deep learning modeling of rare noncoding genetic variants in human motor neurons defines CCDC146 as a therapeutic target for ALS.

Amyotrophic lateral sclerosis (ALS) is a fatal and incurable neurodegenerative disease caused by the selective and progressive death of motor neurons (MNs). Understanding the genetic and molecular factors influencing ALS survival is crucial for disease management and therapeutics. In this study, we introduce a deep learning-powered genetic analysis framework to link rare noncoding genetic variants to ALS survival. Using data from human induced pluripotent stem cell (iPSC)-derived MNs, this method prioritizes functional noncoding variants using deep learning, links cis-regulatory elements (CREs) to target genes using epigenomics data, and integrates these data through gene-level burden tests to identify survival-modifying variants, CREs, and genes. We apply this approach to analyze 6,715 ALS genomes, and pinpoint four novel rare noncoding variants associated with survival, including chr7:76,009,472:C>T linked to CCDC146. CRISPR-Cas9 editing of this variant increases CCDC146 expression in iPSC-derived MNs and exacerbates ALS-specific phenotypes, including TDP-43 mislocalization. Suppressing CCDC146 with an antisense oligonucleotide (ASO), showing no toxicity, completely rescues ALS-associated survival defects in neurons derived from sporadic ALS patients and from carriers of the ALS-associated G4C2-repeat expansion within C9ORF72. ASO targeting of CCDC146 may be a broadly effective therapeutic approach for ALS. Our framework provides a generic and powerful approach for studying noncoding genetics of complex human diseases.

Chitin nanocrystals/alginate complex for tuning stability, rheology and bioavailability of cholecalciferol in Pickering emulsions.

In this paper we investigate polyelectrolyte complexes of sodium alginate (Alg) and chitin nanocrystals (ChNC). Formation, stability and transport properties of sunflower oil-in-water emulsions stabilized by ChNC-Alg complex were studied using dynamic light scattering (DLS), laser Doppler electrophoresis, optical microscopy, potentiometric titration, rheology and simulated digestion. It has been established that during emulsions formation, the ChNC-Alg complex is rearranged at the interface and the formation of a two-layer coating of the droplet occurs. Stabilized O/W emulsions are stable during storage, in the pH range 2-9 and centrifugal acceleration up to 2000 RCF. Presence of Ca2+ and Na+ ions in the range up to 150 mM has virtually no effect on the droplet size. Inclusion of 5 wt% Alg in the ChNC-based emulsion stabilizer system leads to a drop in Gibbs adsorption >16 times compared to the ChNC-stabilized emulsion, increase in viscosity and rheopexy index of the systems. We found that chemical properties of colloidal phase surface and rheological properties of emulsions stabilized by ChNC-Alg are mostly dependent on the droplet size, not the type of oil as a result of a comparative study of sunflower oil/liquid paraffin oil. Emulsion drops of an optimized composition are stable in the upper parts of the model gastrointestinal tract system and transport vitamin D3 to the small intestine without significant losses. The bioavailability of vitamin D3 in emulsions stabilized with the ChNC-Alg complex is higher than for emulsions stabilized with ChNC alone.

Using HScore for Evaluation of Hemophagocytosis in Multisystem Inflammatory Syndrome Associated with COVID-19 in Children.

Hemophagocytic syndrome is a key point in the pathogenesis of severe forms of multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C). The factors associated with hemophagocytosis in patients with MIS-C were assessed in the present study of 94 boys and 64 girls ranging in age from 4 months to 17 years, each of whose HScore was calculated. In accordance with a previous analysis, patients with HScore ≤ 91 (n = 79) and HScore > 91 (n = 79) were compared. Patients with HScore > 91 had a higher frequency of symptoms such as cervical lymphadenopathy, dry cracked lips, bright mucous, erythema/swelling of hands and feet, peeling of fingers, edematous syndrome, hepatomegaly, splenomegaly, and hypotension/shock. They also had a higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and D-dimer levels, and a tendency to anemia, thrombocytopenia, and hypofibrinogenemia. They more often needed acetylsalicylic acid and biological treatment and were admitted to ICU in 70.9% of cases. Conclusion: The following signs of severe MIS-C were associated with HScore > 91: myocardial involvement, pericarditis, hypotension/shock, and ICU admission.

Tunable Sieving of Ions Using Graphene Oxide: Swelling Peculiarities in Free-Standing and Confined States.

The paper describes a comparative study of swelling processes in free-standing graphene oxide (GO) membranes and GO laminates encapsulated with epoxy glue. For free-standing graphene oxide membranes, a huge variation in d-spacing in the range of 8-12 Å depending on the ambient humidity and from 12 to >30 Å depending on the electrolyte type and its concentration was revealed using direct in situ and in operando XRD studies. Limited swelling at various humidity levels as well as in electrolyte solution with low constriction/expansion of epoxy-encapsulated GO is counterposed to that of free-standing graphene oxides. The swelling suppression was explained by both physical constriction and the intercalation of amines into GO laminates, which was proved by local EDX studies. This results in ion diffusivity variation for over 2 orders of magnitude in free-standing and constrained graphene oxide membranes and provides factual evidence for tunable sieving of ions with confined graphene oxides.

Synthesis and properties of thiol-modified CNC via surface tosylation.

SH-containing polymers and nanoparticles are a significant direction in the creation of novel materials. The aim of this work is the synthesis of cellulose nanocrystals (CNC) with a surface modified by tosyl functions (CNC-Ts) and their further modification into SH-containing nanocrystals (CNC-SH). CNC-Ts were synthesized in an aqueous-organic emulsion from never-dried particles, while maintaining the size and supramolecular structure of CNC; the content of Ts-functions is up to 2.5 mmol·g-1. Structure of the derivatives was analyzed by TEM, XRD, CP/MAS 13C NMR and FTIR spectroscopies. Nucleophilic substitution and hydrolysis of the obtained thioisouronium salts leads to the production of CNC-SH. To quantify SH-groups we used elemental analysis, potentiometric titration and Folin-Ciocalteu and Ellman's reagents. It is shown that SH-groups on the surface are partially oxidized and are involved in a dense network of hydrogen bonds. Rheological properties of CNC-SH hydrosols are close to those of CNC, addition of H2O2 at acidic pH leads to an increase in viscosity of the system; H2O2 added at neutral pH causes opposite effect - viscosity decreases. CNC-SH have a high capacity for sorption of Cr(VI) in acidic environments and exhibit photoreductive properties under UV irradiation.

Anti-Alzheimer Drug Delivery via Pickering Emulsions Stabilized by Plate-like Cellulose Nanocrystals.

In this work, we studied for the first time the formation of olive oil emulsions in water stabilized by plate-like nanocrystals with the supramolecular structure of cellulose II (pCNC). Effects of storage, pCNC concentration, and NaCl on the stability and properties of Pickering emulsions, including the creaming index, droplet size, zeta potential, acid-base surface properties, and rheology, were studied. A significant influence of the shape of nanoparticles (compared to the classical rod-like shape) on the stability parameters and rheological characteristics of emulsions is shown. Plate-like cellulose nanocrystals at a concentration of 16 g/L are able to form delamination-resistant emulsions without added electrolytes. The viscosity of pCNC-stabilized emulsions tends to decrease with increasing electrolyte concentration in the system, which is not characteristic of rod-like CNC-stabilized emulsions. This effect in pCNC-stabilized emulsions assumedly can be associated both with weak mechanical engagement between drops due to the shape of stabilizer particles and with an insignificant participation of background electrolyte cations in the formation of interdroplet interactions. Therefore, the resulting aggregates are unstable and easily destroyed, even under weak mechanical stress. As a consequence, the acid-base properties of the pCNC surface are practically independent of the emulsion preparation method (with or without electrolyte) as well as the concentration of the background electrolyte. The reduced viscosity of pCNC-stabilized emulsions in the presence of an electrolyte, coupled with the absence of acute toxicity, allows us to recommend them as a convenient oral delivery system for fat-soluble, biologically active substances. Our emulsions carrying donepezil (an anti-Alzheimer drug) showed better performance than a solution of donepezil hydrochloride in preventing memory impairment tested on laboratory mice.

Determination of Risk Factors for Severe Life-Threatening Course of Multisystem Inflammatory Syndrome Associated with COVID-19 in Children.

Multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a life-threatening condition that often requires intensive care unit (ICU) admission. The aim of this study was to determine risk factors for severe/life-threatening course of MIS-C. The study included 166 patients (99 boys, 67 girls) aged 4 months-17 years (median 8.2 years). The criterion of severity was the fact of ICU admission. To conduct a comparative analysis, MIS-C patients were divided into two groups: patients hospitalized in the ICU (n = 84, 50.6%) and those who did not need ICU admission (n = 82, 49.4%). Patients with a more severe course of MIS-C were significantly older. They had a higher frequency of signs such as rash, swelling, hepatomegaly, splenomegaly, and neurological and respiratory symptoms. Hypotension/shock and myocardial involvement were much more common in patients with severe MIS-C. These patients had a more significant increase in CRP, creatinine, troponin, and D-dimer levels. Additionally, the presence of macrophage activation syndrome was higher in patients admitted to the ICU. Conclusion: Nineteen predictors of severe course of MIS-C were found, out of which hepatomegaly, splenomegaly, D-dimer > 2568 ng/mL, troponin > 10 pg/mL were mainly associated with the probability of being classified as early predictors of severe MIS-C requiring ICU admission.

Stokes and Anti-Stokes Luminescent Rare-Earth-Doped Tantalum Oxide Nanoparticles.

Doping of nano- and microparticles of oxides with rare earth elements (REEs) is used to fine-tune their structural, optical, and electrochemical properties. On the way to establish the structure-property relationship, we dope tantalum oxide (Ta2O5) particles with REEs to study their effect on the oxide structure and luminescence. Ta2O5 is highly perspective in medicine, catalysis, and optics, but its crystal structure is insufficiently studied. Two synthesis approaches (sol-gel and solvothermal) were used to obtain powders with different textures. Experimental and theoretical studies of amorphous and crystallized tantalum oxide NPs by means of X-ray powder diffraction, Rietveld analysis, EXAFS/XANES spectroscopy, and density functional theory calculations were performed. All samples (doped and undoped) crystallized in orthorhombic phase with no admixtures. It was demonstrated that Ta2O5 is a promising wide-spectrum luminescent material: by combining REEs, both Stokes and anti-Stokes luminescence in the visible region were obtained. By means of optical absorption spectroscopy, it was shown that the prepared samples could be classified as wide band gap semiconductors.

The significance of upfront autologous stem cell transplantation for high-intermediate/high-risk stage IV diffuse large B-cell lymphoma.

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most common (30%-35%) type of B-cell lymphoma. Only about 60% of all newly diagnosed advanced-stage DLBCL can be completely treated with x6 R-CHOP. High-dose chemotherapy (HDCT) followed by autologous hematopoietic stem cell transplantation in the first remission (upfront auto-HSCT) can serve as an option to improve a prognosis in these patients. AIMS: This trial aimed to improve prognosis in DLBCL by upfront auto-HSCT. METHODS AND RESULTS: A group of 105 patients: DLBCL NOS, age 18-65, stage IV, IPI ≥2, CR/PR after x6 R-CHOP/DA-EPOCH-R from 2010 to 2019 at NMRC of Oncology named after N.N.Petrov of MoH of Russia was retrospectively analyzed. The HSCT group included patients with upfront HDCT followed by auto-HSCT (n = 35). The control group included patients with non-invasive follow-up after induction (n = 70). Primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), response rate and relapse rate. The 3-year OS (p = .013) and 3-year PFS (p = .033) were significantly higher in the HSCT group. The 3-year OS was decreased by the occurrence of relapse (p ≤ .001) and weight loss (B-symptom) (p = .04). DEL was the negative prognostic factor for 3-year PFS in all patients (p = .001) and control group (p = .001). DA-EPOCH-R significantly increased the 3-year PFS (p = .041). CONCLUSION: Upfront HDCT followed by auto-HSCT can increase 3-year OS and PFS and improve prognosis in DLBCL NOS, age 18-65, stage IV, IPI ≥2 patients.

COVID-19 Associated Vasculitis Confirmed by the Tissues RT-PCR: A Case Series Report.

BACKGROUND: Several cases of skin and central nervous system vasculopathy associated with COVID-19 in children have been published, but the information is rather limited. Our study aimed to describe these cases of vasculitis associated with COVID-19 in children. METHODS: In the retrospective-prospective case series study we included information regarding four children with COVID-19-associated vasculitis. In every case, we had a morphological description and the etiology was confirmed via real-time polymerase chain reaction during a tissue biopsy. RESULTS: The most involved systems were skin (4/4), respiratory (3/4), cardiovascular (2/4), nervous (1/4), eye (1/4), kidney (1/4), and inner year (1/4). All patients had increased inflammatory markers and thrombotic parameters (D-dimer). No patient met the criteria for multisystem inflammatory syndrome in children. Two patients met polyarteritis nodosa criteria, one met Henoch-Schonlein purpura criteria, and one met unclassified vasculitis criteria. All patients were treated with systemic glucocorticosteroids (two-pulse therapy). Non-biologic DMARDs were prescribed in all cases; 1/4 patients (25%) was treated with intravenous immunoglobuline, and 3/4 (75%) were treated with biologics (etanercept, tocilizumab, and adalimumab). CONCLUSIONS: Vasculitis associated with COVID-19 could be a life-threatening condition; SARS-CoV-2 might be a new trigger or etiological agent for vasculitis and other immune-mediated diseases. Further research and collection of similar cases are required.

Biocompatible Nanoparticle Heteroaggregates as Stabilizers of Pickering Emulsions for Vitamin D3 Efficient Delivery.

Vitamin D3 deficiency is a major public health problem worldwide, and standard cholecalciferol formulations provide poor absorbability of the vitamin. Several biphasic formulas have been proposed to overcome the disadvantages in which Pickering emulsions stand out in particular. This paper describes olive oil-in-water Pickering emulsions stabilized by pseudoboehmite (AlOOH), cellulose nanocrystals (CNC), and their heterocoagulates. Colloidal properties were assessed by laser Doppler microelectrophoresis, potentiometric titration, and rheology. It was shown that the heterocoagulation of CNC and AlOOH led to a drastic change in surface properties (ζ-potential, pKa, and number of active centers), which promoted the formation of more stable emulsions with the smallest size of droplets and the highest viscosity among the studied samples. Simulated digestion studies showed the targeted release in the small intestine medium where cholecalciferol should be delivered. High-performance liquid chromatography showed the efficient encapsulation of cholecalciferol in emulsions (86% of initial concentration). Oral administration to laboratory mice of initial nanoparticles and emulsions stabilized by them showed nontoxicity for all of the components, and they were estimated to be class V materials. The proposed emulsions have great potential as targeted delivery systems of lipophilic drugs.

Ruthenium(II) complexes with phosphonate-substituted phenanthroline ligands: synthesis, characterization and use in organic photocatalysis.

Ru(II) complexes with polypyridyl ligands play a central role in the development of photocatalytic organic reactions. This work is aimed at the structural modification of such complexes to increase their photocatalytic efficiency and adapt them for the preparation of reusable photocatalytic systems. Nine [Ru(phen)(bpy)2]2+-type complexes (bpy = 2,2'-bipyridine, phen = 1,10-phenanthroline) (Ru-Pcat) bearing the P(O)(OEt)2 substituent attached to the phen core directly or through a 1,4-phenylene linker were synthesized and characterized by spectroscopic and electrochemical techniques. The coordination mode of phen ligands was confirmed by single crystal X-ray analysis. The (spectro)electrochemical data show that the first electron transfer in Ru-Pcat takes place on the phen ligand. The emission maxima and quantum yields are strongly affected by the substitution pattern, reaching the far-red region (697 nm) for Ru-3,8P2. The singlet oxygen quantum yields of Ru-Pcat were evaluated using the chemical trapping method. Finally, the photocatalytic performance of Ru-Pcat in the oxidation of sulfides with molecular oxygen was investigated. Both dialkyl and alkyl aryl sulfides were quantitatively transformed into sulfoxides under irradiation with a blue LED in the acetonitrile-water mixture (10 : 1) using a low loading of 0.005-0.05 mol% Ru(II) photocatalysts. To rationalize the effect of phosphonate substituents on the photocatalytic efficiency, comparative kinetic studies of (1) 4-nitrothioanisole oxidation proceeding predominantly via the electron transfer pathway and (2) oxidation of dibutyl sulfide wherein singlet oxygen serves as an oxidant have been performed. It was demonstrated that complexes with the P(O)(OEt)2 substituent at positions 4 and 7 outperform the benchmark photocatalyst Ru-(bpy)3 and the parent complex Ru-phen in the reactions proceeding through electron transfer (reductive quenching photocatalytic cycle). The TON in the oxidation of 4-methoxythioanisole was found to be as high as 1 000 000 that is, to our knowledge, the highest among previously reported photocatalysts. In contrast, upon separating the P(O)(OEt)2 group and the phen core with the 1,4-phenylene linker, singlet oxygen quantum yields significantly increase that favors reactions proceeding through energy transfer (the oxidation of dibutyl sulfide in our case). Thus, both series of Ru(II) complexes prepared in this work are promising for the improvement of known photocatalytic reactions and the development of new transformations.

Surface, rheopexy, digestive stability and toxicity of olive oil emulsions stabilized by chitin nanocrystals for vitamin D3 delivery.

Pickering emulsions are of interest in medicament transport systems. The properties of emulsions are influenced by the type of oil and the surface structure of nanoparticles-stabilizers. The process of formation of o/w emulsions of olive oil stabilized by chitin nanocrystals was investigated, their stability under the influence of physical factors, rheological characteristics, acute toxicity after oral administration, stability under the conditions of a model of the gastrointestinal tract, and their potential for oral transport of vitamin D3 were analyzed. Physically stable emulsions were obtained at a stabilizer concentration of 3.6 g/l. The addition of electrolyte leads to a substantial reduction in the average size of microdroplets. The resulting emulsions have rheopexy properties and the rheopexy index increases at 37 °C. Emulsions are classified as non-toxic when taken orally, physically stable in the upper digestive system, and capable of efficiently transporting vitamin D3 with a full release in the small intestine.

Heart Involvement in Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children: The Retrospective Multicenter Cohort Data.

Objectives: Heart involvement in multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a new challenging problem, requiring fast and reliable diagnostics and appropriate treatment. The aim of this study is to describe heart involvement in patients with MIS-C. Study Design: In this retrospective, multicenter cohort study, data of 122 patients were included. All patients met WHO and CDC criteria of MIS-C. Results: Various types of heart involvement in MIS-C patients were observed. Patients with solely coronary artery lesions (CAL, n = 10, 8.2%) had typical features of Kawasaki disease: younger age, thrombocytosis and normal ferritin level, without giant CA aneurysms, thrombosis, myocardial infarction, shock, and ICU admission. Patients with solely myocardial involvement (MI, n = 30, 24.6%) had an older onset age, elevated ferritin, LDH, the highest D-dimer, H score, and thrombocytopenia level. The following clinical signs were associated with MI: gastrointestinal and central nervous system disorder, sore throat, swelling face, splenomegaly, shock, and treatment in the intensive care unit required. Patients with a combination of CAL and MI (n = 10, 8.2%) had symptoms similar to patients with solely MI, except for impressive thrombocytopenia. Shock and ICU admission were found in 34.7% of patients without heart involvement (n = 72, 59%). One major criterion [troponin > 32 pg/ml (52 points)] or at least two minor criteria [face swelling (32 points) and D-Dimer > 1,300 ng/ml (29 points)] were associated with MI (>32 points) with a sensitivity of 67.5% and a specificity of 88.9%. Conclusion: The above-suggested criteria can be added to routine diagnostic procedures to confirm MI in MIS-C patients.

Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study.

Objectives: Diagnostic between multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) and Kawasaki disease (KD) can make difficulties due to many similarities. Our study aimed to create a Kawasaki/MIS-C differentiation score (KMDscore) allowing discrimination of MIS-C and KD. Study design: The retrospective multicenter cohort study included clinical, laboratory, and instrumental information about MIS-C (n = 72) and KD (n = 147). The variables allowed to discriminate both conditions used to construct and validate the diagnostic score called the KMDscore. Results: Patients with MIS-C were older, had earlier admission to the hospital, had a shorter time before fever resolution, two times frequently had signs of GI and CNS involvement observed, and had more impressive thrombocytopenia, higher level of CRP, ferritin, ALT, AST, LDH, creatinine, triglycerides, troponin, and D-dimer compared to KD patients. Respiratory signs in MIS-C were presented with pleuritis, acute respiratory distress syndrome, oxygen dependency, lung infiltration, and ground-glass opacities in CT. The heart involvement with fast progression of myocarditis provided the severity of MIS-C and ICU admission due to 12 times higher arterial hypotension or shock and required cardiotonic. No differences in the frequency of CA lesions were seen in the majority of cases. Five criteria, CRP >11 mg/dl (18 points), D-dimer >607 ng/ml (27 points), age >5 years (30 points), thrombocytopenia (25 points), and GI involvement (28 points), were included in the KMDscore. The summa >55 points allowed to discriminate MIS-C from KD with a sensitivity of 87.5% and specificity of 89.1%. Conclusion: The KMDscore can be used to differentiate the diagnostic of MIS-C from KD.

Predictors of Acute Encephalopathy in Patients with COVID-19.

INTRODUCTION: The majority of patients with severe COVID-19 suffer from delirium as the main sign of encephalopathy associated with this viral infection. The aim of this study was to identify early markers of the development of this condition. MATERIALS: The prospective cohort-based study included patients with community-acquired pneumonia and confirmed pulmonary tissue infiltration based on CT data, with a lesion consisting of at least 25% of one lung. The main group included patients who have developed acute encephalopathy (10 patients, 3 (30%) women; average age, 47.9 ± 7.3 years). The control group included patients who at discharge did not have acute encephalopathy (20 patients, 11 (55%) women; average age, 51.0 ± 10.5 years). The study collected clinical examination data, comprehensive laboratory data, neurophysiological data, pulse oximetry and CT data to identify the predictors of acute encephalopathy (study ClinicalTrials.gov identifier NCT04405544). RESULTS: Data analysis showed a significant relationship between encephalopathy with the degree of lung tissue damage, arterial hypertension, and type 2 diabetes mellitus, as well as with D-dimer, LDH, and lymphopenia. CONCLUSIONS: The development of encephalopathy is secondary to the severity of the patient's condition since a more severe course of the coronavirus infection leads to hypoxic brain damage.

Hip Involvement in Juvenile Idiopathic Arthritis: A Roadmap From Arthritis to Total Hip Arthroplasty or How Can We Prevent Hip Damage?

Objectives: To describe the clinical characteristics of hip involvement in juvenile idiopathic arthritis (JIA) from arthritis to hip osteoarthritis (HOA) and total hip arthroplasty (THA). Study Design: Seven hundred fifty-three patients aged 2-17 years with JIA were included in the study. The comparison analysis was performed between the following subgroups: (i) JIA without hip involvement (n = 600; 79.7%) vs. JIA with hip involvement without HOA (n = 105; 13.9%), (ii) JIA with hip involvement with HOA, but without THA (n = 32; 4.3%) and JIA with hip involvement with HOA and with THA (n = 16; 2.1%). Clinical, laboratory characteristics and treatment regimens compared. Results: Hip involvement was present in 20.3% of patients. HOA was present in 6.4% (12*1,000 patient-years) of the entire JIA group and 31.4% of patients with hip involvement. Sixteen patients (2.1%; 4.0*1,000 patient-years) required THA. The following factors were associated with HOA: sJIA (OR = 3.6, p = 0.008; HR = 3.0, p = 0.002), delayed remission (OR = 4.2, p = 0.004; HR = 1.4, p = 0.538), delay in biologic therapy initiation (OR = 7.5, p = 0.00001; HR = 6.7, p = 0.002), alkaline phosphatase <165 U\l (OR = 4.1, p = 0.0003; HR = 5.2, p = 0.000004), treatment with corticosteroids (CS) (OR = 2.6, p = 0.008; HR = 1.2, p = 0.670), cumulative corticosteroids >2,700 mg (OR = 4.3, p = 0.032; HR = 1.4, p = 0.527). The following factors were associated with THA: delay in biologic treatment initiation (OR = 1.04, p = 0.0001; HR = 9.1, p = 0.034), delayed hip involvement (OR = 5.2, p = 0.002; HR = 3.0, p = 0.044), and methylprednisolone pulse therapy (OR = 10.8, p = 0.0000001; HR = 5.6, p = 0.002). Conclusion: Both sJIA and systemic CS, impaired calcium-phosphorus metabolism, and delayed hip arthritis are associated with HOA development in JIA. HOA is considered to be a severe adverse event of CS treatment, especially delayed hip involvement.

One-step quantitative RT-PCR assay with armored RNA controls for detection of SARS-CoV-2.

Coronavirus disease 2019 (COVID-19) has become pandemic since March 11, 2020. Thus, development and integration in clinics of fast and sensitive diagnostic tools are essential. The aim of the study is a development and evaluation of a one-step quantitative reverse transcription-polymerase chain reaction (RT-qPCR) assay (COVID-19 Amp) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection with an armored positive control and internal controls constructed from synthetic MS2-phage-based RNA particles. The COVID-19 Amp assay limit of detection was 103 copies/ml, the analytical specificity was 100%. A total of 109 biological samples were examined using COVID-19 Amp and World Health Organization (WHO)-based assay. Discordance in nine samples was observed (negative by the WHO-based assay) and discordant samples were retested as positive according to the results obtained from the Vector-PCRrv-2019-nCoV-RG assay. The developed COVID-19 Amp assay has high sensitivity and specificity, includes virus particles-based controls, provides the direct definition of the SARS-CoV-2 RdRp gene partial sequence, and is suitable for any hospital and laboratory equipped for RT-qPCR.

Hybrid cellulose nanocrystal/magnetite glucose biosensors.

There exists a high demand for simple and affordable blood glucose monitoring methods. For this purpose, new generations of biosensors are being developed for possible in vivo or dermal use. We present (non)sulphated cellulose nanocrystal/magnetite thin films to act as dermal and oral glucose biosensors. The biocompatible (N-CNC)-Fe3O4 and (S-CNC)-Fe3O4 hybrid systems exhibit peroxidase-like activity, indicated by an almost instant color change when in the presence of glucose and ABTS. Both types of biosensors detect glucose concentrations as low as 5 mM (which corresponds to the level of glucose in biological fluids), with (S-CNC)-Fe3O4 being 1.5 - 2 times as sensitive as (N-CNC)-Fe3O4. Hybrid catalytic activity is more pronounced at room temperature and in acidic environments. The hybrids can therefore be used to determine glucose levels by using sweat and saliva - non-blood bodily secretions which tend to be slightly to moderately acidic and have relatively low glucose levels.