Paravertebral compartment syndrome occurring without trauma is quite rare. We report a case of compartment syndrome that occurred after spinal exercises.A 23-year-old Japanese rower developed severe back pain and was unable to move 1 day after performing exercises for the spinal muscles. Initial evaluation at a nearby hospital revealed hematuria and elevated creatine phosphokinase levels. He was transferred to our hospital, where magnetic resonance imaging revealed no hematoma but confirmed edema in the paravertebral muscles. The compartment pressure measurements were elevated bilaterally. Despite his pain being severe, his creatine phosphokinase levels were expected to peak and decline; his urine output was normal; and surgery was undesirable. Therefore, we opted for conservative management. The next day, the patient’s compartment pressure diminished, and his pain levels decreased to 2/10. After 5 days, he was able to walk without medication.We present a rare case of compartment syndrome of the paravertebral muscles with good resolution following conservative management. We hope our case findings will help avoid unnecessary surgery in cases of paravertebral compartment syndrome. Compartment syndrome (CS) is characterized by increased compartmental pressure after trauma or surgery. CS is almost always reported in a limb; occurrence in other parts of the body, such as the paravertebral muscles, is rare. Lumbar paravertebral CS was first described in a 1985 case report of a young man with postexertional back pain , 3. The The patient was a 23-year-old Japanese man who was a medical student and belonged to a boating club. Two days before admission, he developed back pain after performing several repetitions of lifting 30-kg weight in a semicrouched position during a training session with the club. The pain was initially mild. On the day before admission, although he had mild back pain, he participated in both morning and evening training sessions. After the evening session, the pain gradually intensified. He waited to see whether the pain would resolve, but he was transported to a nearby hospital by ambulance at midnight because the back pain had worsened, and he found it difficult to move.Because of the combined symptoms of back pain at rest, hematuria, and a calculus detected in the ureter by computed tomography (CT), he was diagnosed with a urinary calculus and treated with fluids and rest. However, his pain persisted without relief. The following morning, because blood tests revealed elevated creatine kinase (CK)  and lactate dehydrogenase (LDH) (1815 U/L) levels, CS was suspected. He was then transferred to our hospital.Upon admission to our hospital, his condition was as follows: blood pressure, 131/81 mmHg; pulse, 88 beats/minute; oxygen saturation, 100% in room air; respiratory rate, 22 breaths/minute; and consciousness level on the Glasgow Coma Scale, E4V5M6. His abdomen was flat and soft, and no tenderness was observed. The erector spinae muscles were tense, with especially severe spontaneous pain and tenderness in the lumbar region. The skin in the lumbar region was free from blistering or other superficial lesions. No neurological abnormalities, such as muscle weakness or impaired sensation, were observed in the lower limbs. There were no other findings suggestive of CS in the limbs.Blood tests Table  revealedThe patient’s compartment pressure gradually decreased, and his CPK levels peaked on the first day of admission to the hospital Fig. . The infCS is frequently observed after trauma to the limbs. However, it rarely occurs in the erector spinae muscles, and the diagnosis is commonly delayed . Our patet al. [et al. [et al. [et al. [et al. [Paravertebral CS is rare and difficult to diagnose. It has been characterized by the following symptoms in previous studies: severe tenderness, swelling, and rigidity in the lumbar region along with elevated CPK levels, according to Ferreira et al. ; abnorma [et al. ; dysesth [et al.  and Nath [et al. ; and inc [et al. . Among tet al. [et al. [et al. [et al. also reported that muscle necrosis could be diagnosed on the basis of lack of gadolinium uptake [Regarding imaging findings, there are a few articles that mention CT. Plain CT is frequently performed for detailed examination of urinary calculi and the spinal canal in patients with sudden-onset back pain. In our patient, the diagnosis of paravertebral CS was delayed because a urinary calculus was detected at the previous hospital. Moreover, because there are few findings specifically suggestive of paravertebral CS, it appears to be difficult to diagnose the condition without performing contrast-enhanced CT. Regarding MRI findings, Ferreira et al. , Nathan  [et al. , and Mat [et al.  observedm uptake . In our et al. reported that the normal pressure in weightlifting players is 3.11 mmHg in the supine position and 10.8 mmHg in the sitting position [et al. reported that although muscle mass increases of 20% and compartment pressure increases from 8.5 to 14 mmHg are observed during exertional exercise, these values return to normal within 6 minutes after termination of exercise [et al., compartment pressure varied from 14 to 150 mmHg [et al., only one of their nine cases meets the criterion [Although measurement of compartment pressure facilitates the diagnosis of paravertebral CS, normal pressure in the erector spinae muscles is not well established. Peck position . Moreoveet al. [et al. [et al. [et al. indicated that follow-up MRI may reveal scarlike disuse changes in muscles affected by CS [Of the therapeutic strategies employed for CS of the limbs, fasciotomy is indicated when the difference between diastolic blood pressure, which reflects the perfusion pressure in a muscle compartment, and intramuscular compartment pressure is within 20–30 mmHg. However, because this value is associated with a high false-positive rate and low specificity, continuous measurement of intramuscular compartment pressure for 30–60 minutes is reportedly preferable , 12. Theet al. ; increas [et al. ; and unc [et al. . Our pated by CS , we assuIn conclusion, we present a rare case of paravertebral CS. Despite high compartment pressures, conservative management resulted in an uneventful recovery with pain control and maintenance of urine output.


Zeitschrift für die gesamte Neurologie und Psychiatrie. Today, he is rarely remembered, except mostly in the context of his research on the blood–brain barrier.In the first two decades of the twentieth century, there was probably no European neurologist who was not familiar with the name of Max Lewandowsky, German-Jewish neurologist, author of numerous works, including a handbook of neurology, and the editor of the neurological journal Friedrichsgymnasium in Berlin, graduating in 1893. Then he studied medicine in Marburg, Berlin and Halle. Among his teachers were Theodor Engelmann (1843–1909) and Hermann Munk (1839–1912). He defended his Ph.D. thesis in 1898 and immediately continued his scientific career, first in the physiology laboratory in Berlin. He attended courses of psychiatry led by Karl Bonhoeffer (1868–1948) and Franz Nissl (1860–1919) in Heidelberg and Theodor Ziehen in Berlin Charité clinic. In Paris he studied under Pierre Marie (1853–1940) at Bicêtre Hospital. In 1902 he became Privatdozent in Berlin, and in 1908 he was appointed extraordinary professor [Max Heinrich Lewandowsky was born on June 28, 1876 in Berlin, the son of Hermann Lewandowsky and Rose née Heymann. He attended Zeitschrift für die gesamte Neurologie und Psychiatrie. It was accompanied ‘by a publishing series “Monographs from the joint field of neurology and psychiatry” (Monographien aus dem Gesamtgebiete der Neurologie und Psychiatrie). In the same year, he began work on a multi-authored handbook of neurology, inviting dozens of renowned specialists from Germany and abroad [Lewandowsky was an efficient organizer. In 1910, together with Alois Alzheimer (1864–1915), he founded d abroad . Until 1d abroad . LewandoBluthirnschranke) [As a researcher, Lewandowsky was particularly interested in experimental work. His Ph.D. dissertation dealt with vagal control of lung function . Under tchranke) . His subchranke) . In 1907chranke) . He alsoMax Lewandowsky was married to a mezzosoprano singer Margarete (Gretchen) Gille in 1909; the marriage produced no children. After World War I broke out, Lewandowsky served as an army physician. He investigated neurological symptoms in head trauma and opposed inhuman methods of treating war neuroses . In the


Hemodynamic monitoring is essential to provide optimal hemodynamic management to patients in perioperative and intensive care medicine. The Journal of Clinical Monitoring and Computing (JCMC) welcomes research articles investigating hemodynamic monitoring technologies, cardiovascular pathophysiology, and hemodynamic treatment strategies that help advance this research field and eventually improve patient care. In this review, we highlight and summarize selected papers on hemodynamic monitoring and management published in the JCMC in 2019.In a prospective study, Nicklas et al.  comparedAn observational cohort study in cardiac surgery patients was performed by Henriques et al.  to invesThere is a risk of measurements artifacts in large data sets as measurements are saved electronically without controlling. A growing number of hospitals use electronic records in perioperative and intensive care medicine. Therefore, Du et al.  developeIn a retrospective analysis, Harrison et al.  used theIn 2019, five papers on cardiac output monitoring were published in the JCMC.Vetrugno et al.  comparedROC) for the CFI to predict a left ventricular ejection fraction ≥ 40% (AUCROC: 0.926), ≥ 50% (AUCROC: 0.924), and ≥ 60% (AUCROC: 0.875). Similar results were found for the predictive ability of the GEF (left ventricular ejection fraction ≥ 40% (AUCROC: 0.934), ≥ 50% (AUCROC: 0.938), and ≥ 60% (AUCROC: 0.887). Further studies were recommended to confirm these findings.Also using the Volume View/EV 1000/Hemosphere system, Nakwan et al.  investigMaeda et al.  comparedOne of the more recently marketed technologies to measure cardiac output is the BSM-9101 bedside monitor . It provides estimated continuous cardiac output (esCCO) based on pulse wave transit time technology measured using the electrocardiogram (ECG) and peripheral pulse oximeter. Suzuki et al. ) and at individually adjusted contacting force . Since ΔPOP seems to be a reliable indicator to predict fluid responsiveness at a certain contacting force and is measured non-invasively and relatively easy, this study is an important contribution for this methodology.Park et al.  investig2 and CS > 31 mL/cmH2O. Since the prone position is obligatory for many surgical procedures and a treatment option in patients suffering from acute respiratory distress syndrome, this study provides clinically important insights for these indications.Another interesting and clinically relevant study in 88 patients with spinal surgery investigated the ability of PPV to predict fluid responsiveness in prone compared to supine patient position and studied the effects of body mass index, intra-abdominal pressure, and respiratory system compliance (CS) on PPV . The autVistisen et al.  investigIn a pilot study, Pybus  investigSun et al.  performeThe number of published studies applying machine learning methods to clinical data is exploding these years, and for JCMC, 2019 was also mirroring this trend. Last year, we saw five original papers applying various types of machine learning techniques/algorithms to clinical data. All studies had a retrospective design and authors predominantly tried to predict hemodynamic events/derangements such as tachycardia , hypotenROC of 0.81 with their developed algorithm. The editorial discussed how to identify the data sets for cases and non-cases, a selection that is fundamentally acausal if the existence of an event is used to define the data set, i.e. if analyzing only selected temporal windows preceding events and non-events, which Yoon et al. [In line with the aspects of the review, the editorial by Vistisen et al.  accompann et al.  did. In n et al. . Also, tn et al.  chose a ROC was only in the range of 0.7, which is not as good as that reported for existing predictive monitoring [The study by Donald et al.  presentenitoring . An imponitoring  were wornitoring . Regardinitoring , it appeROC of around 0.75 10 min in advance of events. The peripheral oxygen saturation signal seemed to provide similar classification (AUCROC of 0.77), so the more advanced combination of vital signs in this group of patients for this predictive purpose may not be very beneficial. This highlights the need for reporting comparative classification of simple/existing monitoring [Matam et al.  describenitoring . After tJCMC also published a validation study that reported clinical outcome data before and after the implementation of the Continuous Monitoring of Event Trajectories (CoMET) system  in a surgical ICU . The CoMIn the study by Maheshwari et al. , the autIn summary, machine learning techniques gain widespread interest and utilization. JCMC not only publishes but also receives an increasing number of papers applying machine learning to hemodynamic and clinical data. The field is still new but exciting for authors, editors, and reviewers and we look very much forward to seeing which impact all these efforts provide in future, preferably prospective, studies. Studies need sufficient reporting  as well In an in-silico study, Rinehart et al.  evaluateA nationwide survey was conducted by Scholten et al.  to inves


A community-based, age-specific survey of skin disorders is usually necessary to characterize the true burden of skin disease among a given population and help to tailor health care personnel training and delivery towards the prevalent disorders in resource poor settings.This was a descriptive cross-sectional study among adolescents attending secondary schools in Ilorin, Kwara State, Nigeria. A thousand and three hundred students were recruited from public and private secondary schools through a multi-staged stratified random sampling method. Information was obtained via a semi-structured questionnaire and all students underwent a physical examination. Data was analysed using SPSS version 20. Information generated was presented with tables and figures.The prevalence of skin disease in the study was 66.5%. More females, mid-adolescents, students in senior class and those attending public schools had skin disorders. The most prevalent skin disease were: acne vulgaris, pityriasis versicolor, tinea capitis, pityriasis capitis and traction alopecia.Skin conditions are highly prevalent among the adolescent population. Infective and inflammatory skin conditions appear to be more prevalent than other classes. Most times, only a few skin disorders account for the bulk of dermatoses affecting this age group. Adolescent skin healthcare should be subsidized because of the high prevalence of skin disorders in this age group. Skin disorders have been estimated to affect between 30% and 70% of individuals worldwide, with even higher rates in at-risk subpopulations . In 2010 [et al. . About 1 [et al. .Adolescents make up approximately 38 million of the population of Nigeria, a number that exceeds the total population of some countries , 7. PubeThis was a descriptive cross-sectional study that was conducted in 16 secondary schools in Ilorin, Kwara State, Nigeria. Research was approved by the University of Ilorin Teaching Hospital Ethical Review Board with Ethical approval number ERC PAN 2017/03/1655. Additional approval was obtained from the Kwara State Ministry of Education. The study was carried out by 2 paediatric dermatologists with the assistance of paediatric dermatology trainees and research assistants. Sixteen schools out of the 145 secondary schools in the Ilorin metropolis were selected through a multi-staged stratified random sampling method.Study participants were recruited over a 5-month period from November 2017 to March 2018. The research team paid a first visit to the selected schools during which the school management was informed about the study and their consent sought. A second visit was made to the selected schools a week before the research commenced and students selected by simple random sampling were addressed and given detailed information about the research. They were given assent forms to sign and consent forms to take home to their parents. Only those who returned with a duly filled and signed assent and consent form were included in the study.All study participants were given semi-structured questionnaires which was administered by the researchers. Information related to socio-demographics, presence and history of skin disorder, were obtained. The social class of the subjects was determined using the Oyedeji's classification system  . ExaminaSocio-demographic characteristics of study population: a total of 1300 students were recruited from public and private secondary schools in Ilorin. The mean age of the study population was 13.8±2.1 years with an age range of 10-19 years. Male: Female ratio was 1:1.3.Prevalence of skin disorders in the study population: eight hundred and sixty-five students had at least one skin disorder following a physical examination, giving a prevalence of 66.5%. There was a higher prevalence of self-reported skin disorders with 951 (73.1%) students reporting a skin complaint compared to 865 (66.5%) who were determined to have dermatologic diseases following history and physical examination. Most students (77.9%) had one skin disease while 20.2% had 2 skin disorders and 1.8% had three or more skin disorders as depicted in Distribution of skin disorders across socio-demographic indices: skin disorders were more common in females, students attending public schools, students in the senior secondary classes and mid-adolescents (p<0.05) as shown in Spectrum of skin disorders among adolescents: a total of 48 diagnoses was made. Skin disorders affecting the skin appendages 428 (49.5%) were the most frequent followed by infective skin disorders 330 (38.2%). The top five diagnoses were acne vulgaris 347(40.1%), pityriasis versicolor 204 (23.6%), tinea capitis 80 (9.1%) pityriasis capitis 77 (8.9%) and traction alopecia 64 (7.4%) (4 (7.4%) .Occurrence of skin disorders across the different age groups: pityriasis versicolor was the most prevalent disorder among early adolescents (21.8%), while acne vulgaris was most prevalent in mid and late adolescence (33.4% and 44% respectively). Traction alopecia, tinea capitis and pityriasis capitis were the other common disorders seen. Tinea pedis was more common in late adolescence than tinea capitis  had gone to the hospital on account of the skin complaint, 69.1% had never seen a health worker for skin complaint and 8.3% were not sure if they had. The bar chart in Statement of principal findings: this study showed a high prevalence of skin disorders among adolescents attending secondary schools in Nigeria with well over half of the study population having at least one skin disorder. This high prevalence is similar to what Ogunbiyi et al. [et al. [et al. [et al. [i et al.  and Yase [et al.  found am [et al. . This is [et al. -18. Onin [et al.  also fou [et al. , 21. How [et al.  found a A study in South Africa reported similar findings although another study described traction alopecia among Sikh males and this was attributed to cultural practices , 24. TheStrength and weakness of the study: one of the strengths of this study is the large sample size and also the recruitment of the entire range of the adolescent population as defined by the World Health Organization [nization . This alnization . Our stuStrength and weakness in relation to other studies: this study had a large sample size, which is similar to the methodology other dermato-epidemiologic skin surveys done among adolescents in Nigeria employed. A large sample size ensured that the results of this study can be reliably generalized over the adolescent population. Ogunbiyi et al. [et al. [et al. [i et al.  and Hens [et al.  also rec [et al.  had a sm [et al. . The pre [et al.  in Roman [et al. . These set al. [et al. [et al. [Our study was community based and therefore the prominent disorders reported are different from what is mostly seen in hospital-based surveys. In Lagos Nigeria, Ayanlowo et al.  found inet al. , 36. Wheet al. . Classifet al. . Eshan'set al. . We did  [et al.  focused  [et al.  also looMeaning of the study: this study has shown a high burden of skin disease in school going adolescents in a typical Nigerian community. It has also been able to demonstrate that the occurrence of skin disease can be influenced by age and gender even among adolescents. It also evaluated the adolescent behavior with regards to skin and health.Unanswered questions and future research: a study on the determinants of skin disease in adolescence and the effect on quality of life will provide further insight into the burden of these disorders.In conclusion, this study has corroborated the fact that the burden of skin disease is heavy in Nigerian adolescents going by similar prevalence rates in studies from some parts of the country. Another important finding is that almost 90% of skin disorders can be accounted for by a handful and as such targeted efforts can be made to train community health workers, subsidize dermatologic care in this age group and create more awareness about skin disorders.The prevalence of skin disease is high in adolescents;There is a wide spectrum of skin disease that can affect adolescents.The prevalence of traction alopecia is high in female adolescents;A few dermatoses account for the bulk of skin disorders seen in adolescents;Skin health-seeking behavior is poor among adolescents and is largely influenced by their parents.The authors declare no competing interests.


Adolescents are at risk of obesity and caries due to various factors such as diet and poor health habits; these factors may affect their body mass index (BMI) and salivary components. Therefore, it is necessary to assess these factors and their relationship in this age group. This study aimed to evaluate the association between decayed missing filled teeth index (DMFT), salivary alpha amylase (sAA) level and age-specific BMI in adolescent girls.p< 0.05. A cross-sectional study was conducted on 81 females aged 13-15 years in 3 groups of BMI percentiles; “normal”, “at risk for overweight” and “overweight”(n=27). DMFT was calculated and unstimulated saliva samples were collected. The sAA level was measured with a spectrophotometer. Data were analyzedusing Kolmogorov-Smir-nov test, Kruskal- Wallis and Spearman correlation tests using SPSS (version 23) at p= 0.014).  The concentration of sAA and mean DMFT were estimated 1326.56±4.73 U/L and 2.77±2.36, respectively. There was no significant differencein sAA level and mean DMFT among BMI groups. A positive and significant correlation was found between sAA and DMFT in overweight group (r 0.46,  Within the limitation of this study, higher levels of sAA may be considered as an indicator for dental caries in overweight adolescent girls. Adolescence is defined as a critical developmental period of life experienced from the ages of 10 to 24 years  . Payinget al.  equation and pointed on the age-sex specific BMI percentile chart. Based on the age-sex specific BMI percentile [ p< 0.05 was consideredstatistically significant. The study variables are listed in This cross-sectional study was carried out on female students in the age range of 13 to 15 years. All cases were randomly selectedamong the grade 1 of high schools of Babol (north of Iran). Exclusion criteria were adopted as suffering from systemic diseases,consumption of medication over the past month, poor oral hygiene, unwillingness to participate in the study and having orthodonticappliances. The sample size was calculated with consideration of the effect of 4% at the level of x= 0.05 with the power of 80%.Using the software G power, 81 students was calculated (in 3 groups of 27 each one). After approving the study protocol by the Ethic Committeeof Babol University of Medical Sciences (MUBABOL. REC.1396.12) and obtaining permission from the Babol Education Department, five high schoolswere selected randomly for sampling. The height and the weight of students were measured without shoes by a scale  and a meter.BMI of students were calculated based on [weight/ (height)centile  , the secentile  . The tep< 0.05).According to Kruskal Wallis test, no significant difference was found among sAA level and DMFT of different BMI percentiles .Based on Spearman correlation coefficient test, there was a significant positive correlationbetween DMFT and sAA only in BMI percentile> 95.Additionally, the result of Fisher exact test revealed no significant difference in caries activity of different BMI percentiles (et al. [ et al. [ Considering the results of the current study, no significant difference was found between sAA levels in overweight adolescents compared to those who were in “normal” and “at risk for overweight” groups. Although the effect of sAA gene on the risk of obesity has been confirmed, its mechanism remains unclear and there are conflicting results on the association between sAA and obesity  - 21. Ret al.   revealeet al. [ et al. [ et al. [ et al. [ et al. [ et al. [ et al. [ et al. [ et al. [ et al. [ et al. [ Additionally, no considerable difference was found between mean DMFT in the 3 groups of BMIs. This finding is in conformity with the studies of Shakya et al.   and Sad et al.  . Additi et al.  , Alves  et al.  , Mojara et al.  , Sadegh et al.  , and Pi et al.  . Moreov et al.  , did no et al.   and Red et al.   showed  et al.   showed  et al.   found a et al.   investiIn the present study, a positive correlation was found between sAA level and DMFT only in overweight group. This finding may be related to the level of starch intake by the overweight subjects. As mentioned, excessive consumption of starch by people with higher levels of sAA puts them at risk of obesity  . On theet al. [ et al. [ et al. [ et al. [ et al. [ et al. [ et al. [ The available data concerning the association between dental caries and sAA are limited and inconsistent  - 36. Met al.   in a ma et al.   and Sit et al.   reveale et al.   investi et al.   conduct et al.  .The current study was carried out with some limitations such as disregarding the dietary habits and stress level of the participants which might have an impact on the level of sAA. In addition, the study was conducted on adolescent girls who were in the pubertal period and puberty may have an impact on body biochemical and lifestyle, which may subsequently influence the study variables. Moreover, because the age of puberty for girls and boys is different, the authors had to study just on girls. Further investigations on all target age groups with a larger sample size in both genders are recommended. Additionally, matching the confounding factors such as oral hygiene, food habits, salivary immunoglobulins, stress level and so on, are suggested for future studies.The concentration of sAA and DMFT were not different among overweight and non-overweight adolescent girls. There was a positive correlation between sAA level and DMFT in overweight adolescent girls.


Data collected was analysed using Statistical Package for Social Sciences . Chi square was used to test the statistical differences at a significance of p> 0.05.a total of 410 patients  participated in the study. About 73% had tertiary education while 36.3% were within the modified ISCO-08 Group 2. The respondents that were satisfied with the general dental appearance and tooth shade were 66.3% and 63.5% respectively. More males (65.1%) than females (62.7%) were satisfied with tooth colour while more females (69.1%) were satisfied with dental appearance. The older age group were more satisfied with dental appearance and tooth colour. Awareness of tooth whitening (Over 80%) and the desire to undergo tooth whitening was more among the post-secondary individuals. More of dental patients (73.1%) than medical (59.2%) were satisfied with teeth appearance (p=0.003).patients are increasingly aware of their dental appearance/tooth colour and the need to improve it with tooth bleaching and/or orthodontic treatment. Female were more dissatisfied with their tooth colour but more satisfied with their dental appearance than the male. Older people were more satisfied with their dental appearance and tooth colour compared to younger age group. Aesthetics is an important aspect of modern society because it defines one´s personality. Individuals with positive attitude towards their teeth (colour and shape), and smile may show confidence and be extroverts while individuals with discoloured, missing or fractured teeth may on the other hand be withdrawn because of their teeth appearance. Recently in dental treatment, increasing emphasis is being laid on aesthetics  with theThe arrangement of teeth, shape and form, untreated dental caries and non-aesthetic or discoloured anterior teeth restorations as well as missing anterior teeth lead to dissatisfaction with dental appearance. ,9 Thoughet al. [This was a questionnaire-based cross-sectional study, which made use of the modified version of the questionnaires used by Tin OO et al.  and Poonet al. . The selet al.  was usedEthical approval was obtained from the University of Ibadan/University College Hospital Institutional Review Board (UI/UCH IRB) with approval number: UIUCH/EC0155. The data collected was analysed using Statistical Package for Social Sciences . Descriptive statistics was employed and chi square used to test the statistical differences of some responses at a significance of p= 0.05.Four hundred and ten patients participated in the study  with a mean age of 36.8±14.03 years. Although there were more females than males generally, the M: F among the dental patients was 1: 2.5 compared to 1: 1.3 among the medical patients. The highest proportion (73%) had tertiary education while most of the participants (36.3%) were within the modified ISCO-08 Group 2 which comprised of Technicians, Clerks, Secretaries, Skilled Agricultural workers . The finIt seems the older the age, the greater is the satisfaction with either the dental appearance or tooth colour. The feeling of having protruded anterior teeth was seen more among the youngest age group studied (< 20) compared to other age groups, this was found to be statistically significant (p=0.005). The desire to undergo orthodontic treatment was equally high among the very young and the very old. However, the knowledge of tooth whitening was highest among the youngest age group . The asset al. [et al. [et al. [et al. [et al. [et al. [et al.[Dental aesthetics has increasingly become a concern among patients and clinicians. This is because physical appearance plays a key role in social interaction and the smile and teeth are important features in determining facial attractiveness . Evaluatet al.  62.7%)  [et al.  47.2%), [et al.  57.3%)  [et al.  58.1%).2.7%  [et [et al.  in Flori. [et al. in the U. [et al.. The dis7.2%, [et. [et al.. The mai%.2.7%  [%  [et al. [et al. was toot. [et al.,17. Thou. [et al.,20. Howe. [et al..et al. [et al. [It could be deduced that the higher dissatisfaction with dental appearance among males could be due to tooth arrangement problems as more males than females, felt that their front teeth were crowded, poorly set or bulging consequently, they were more willing to undergo orthodontic, restorative or any aesthetic treatment. This is not unexpected since malocclusion could also determine dental appearance. Teeth arrangement is a factor correlated to a harmonious smile and attractiveness  and diveet al.  found thet al. . This maet al. . The greet al. ,9 where  [et al.  did not This study also evaluated the correlation between occupation and the parameters studied which may not have been previously recorded. It was found that 59.2% of the executives and high-profile professionals and business tycoons were satisfied with their teeth appearance as compared to 72.7% in Group 3. One reason for this may be the caliber of people or the company of peoples those in Group I are likely to be relating with. Though the occupational group 4 had many features of unacceptable occlusion the desire to undergo orthodontic treatment was very low (38.5%) among them and this may not be unconnected to their possible low economic status. Findings in this study also show that there were significant difference in the satisfaction of dental and medical patients as more of dental patients than medical patients were satisfied with teeth appearance. More of medical patients felt they had poorly set and protruding front teeth. These observations pointed to the fact that the dental health of the dental patients appeared to be better than that of those patients that were attending the hospital for medical reasons. This is probably because the dental patients are more aware and possibly have started receiving aesthetic dental treatments that have improved their dental appearance to certain extent.Within the limitations of this study, it could be concluded that: patients are increasingly aware of their dental appearance/tooth colour and the need to improve it with tooth bleaching and/or orthodontic treatment; female are more dissatisfied with their tooth colour but more satisfied with their dental appearance than the male; older people are more satisfied with their dental appearance and tooth colour compared to the younger age group.Studies have shown that males are more satisfied with their tooth colour and appearance whereas females are more conscious and difficult to satisfy;Dental treatments that improve anterior teeth aesthetics have been found to improve the quality of life and psychosocial well-being of people.Satisfaction with dental appearance is better in patients that are aware and seek dental treatment than those that are not;In this study, medical patient showed a greater desire to have dental treatment that will improve aesthetic such as restoration and orthodontic treatment. Thus, this shows the need for more dental education and information in our environment.


In recent years, increased resistance to antibiotics and disinfectants from foodborne bacterial pathogens has become a relevant consumer health issue and a growing concern for food safety authorities. In this situation, and with an apparent stagnation in the development of broad-spectrum antibiotics, research into new antibacterial agents and strategies for the control of foodborne pathogens that have good acceptability, low toxicity levels, and high sustainability is greatly demanded at present.Special Issue on “Natural Alternatives against Bacterial Foodborne Pathogens” aims to contribute to the visibility of some of these new antibacterial agents and contains eight research articles and one review, presenting different strategies potentially applicable in the control of various foodborne pathogens.This Escherichia coli, Listeria monocytogenes, Pseudomonas putida, and Staphylococcus aureus is described by Kerekes et al. [Bifidobacterium longum subsp. infantis and Lactobacillus reuteri) with the capacity to adhere on different surfaces  forming a biofilm able to control the growth of pathogenic and food spoilage bacteria. This could be useful as a new biocontrol solution for different industrial applications. The probiotic functionality of a Bacillus subtilis strain protecting probiotic lactic acid bacteria during their exposure to unfavorable environmental conditions, such as desiccation and acid stresses, is described by Kimelman and Shemesh [B. subtilis strains have demonstrated a potent antimicrobial activity against pathogenic S. aureus. Luis et al. [The antibacterial properties of extra virgin olive oil against different foodborne pathogens and their relationship with phenolic composition of the extract are described by Nazzaro et al. . This sts et al. . These ss et al.  proposes Shemesh . In addis et al.  report ts et al.  present s et al.  report ts et al.  present


The dairy sector is facing a decisive challenge in developed countries, which could deeply influence its future and its historical status of being a pillar for human nutrition. The most challenging issue is to give suitable answers to the demand for nutritionally balanced and environmentally sustainable products, the two main aspects of the new “food paradigm” that increasingly sees foods as drugs  and imposes a stringent eco-friendly approach in their production (“green foods”) ,2. In thProduct Innovation. Abdel-Hamid et al. [Rubus suavissimus S. Lee leaves). The phenolic compounds included as a consequence of extract addition improved biological activity in terms of antioxidant and antihypertensive activity and inhibition of the Caco-2 carcinoma cell line; on the other hand, the viability of the yogurt starter cultures during refrigerated storage was not significantly affected. Finally, the sensory analysis demonstrated a high acceptability of the product and allowed for establishing the most suitable level of fortification. In the second paper, two different plant-based ingredients were used as yogurt-fortifying agents: fenugreek (Trigonella foenum-graecum) seed flour and Moringa oleifera seed flour. Moringa oleifera samples had higher values of phenolic compounds and antioxidant activity as compared to fenugreek, and exerted higher antibacterial activity against several undesired species. On the contrary, the viability of Streptococcus thermophilus and Lactobacillus bulgaricus was improved. Incorporation of the flours caused a modification of the concentration of mineral compounds, with connected increase of some valuable elements, and of the sensory characteristics. Saleh et al. [d et al.  and Dhawd et al.  developeh et al.  investigh et al.  focused h et al.  and Facch et al.  dealt wih et al.  investigh et al.  made useThe influence of rearing conditions on cheese quality. Formaggioni et al. [i et al.  comparedi et al.  dealt wii et al.  deepenedTwo further papers complete the Special Issue: an Original Article and a Review Article. The first one  is a verIn summary, the Special Issue “Chemical and Technological Characterization of Dairy Products” offers readers a series of innovative information that can be useful both for developing new research ideas and for developing new types of dairy products.


Leprosy has long-term consequences related to impairment and stigma. This includes a major impact on mental health. This study aims to consolidate current evidence regarding the mental health impact of leprosy on affected persons and their family members. In addition, determinants influencing mental health outcomes among leprosy-affected persons and effective interventions are examined. A keyword-based search was conducted in PubMed, Web of Science, Scopus, PsycINFO, Infolep and InfoNTD; additional literature was also considered. Articles presenting primary data involving leprosy-affected persons or their family members experiencing mental conditions were included. Independent extraction of articles was executed using predefined data fields. Articles were sorted according to relevance. In total, 65 studies were included in this systematic review. Multiple psychiatric morbidities have been identified among leprosy-affected persons, including depression, anxiety disorders and suicide (attempts). Additional factors were found that may impact mental health. Moreover, studies found that demographic factors, lifestyle and disease-specific factors and stigma and discrimination impact mental health. Depressive symptoms and low self-esteem were identified among children of leprosy-affected persons. In addition, interventions were identified that could improve the mental wellbeing of leprosy patients. Depressive disorders and anxiety disorders were found to be very common among persons affected by leprosy. Feelings such as fear, shame and low self-esteem are also experienced by those affected, and their children. Further research is necessary to ensure that mental health impact is included when determining the burden of disease for leprosy, and to relieve this burden. Duplicates were automatically removed. The next step consisted of title and abstract screening. Irrelevant articles were excluded. Next, screening of full text articles was done. Both the first and second screening were performed by one author (PS) and supervised by two other authors . Uncertainties regarding inclusion or relevance of data were resolved together with the second authors. The title, abstract and full-text screening were executed in Covidence, a web-based software platform that streamlines the production of systematic reviews. Inclusion and exclusion criteria were used to guide the screening process see .Table 2Data extraction was done in Excel. Relevant information including study characteristics, patient characteristics, morbidity specifics and outcomes was noted. The articles were labelled based on the relevance. The relevance of the articles was determined based on several characteristics . Specifin = 86), because they were otherwise irrelevant (n = 118), represented perspectives of others than leprosy-affected or their family members (n = 20) or articles in another language (n = 1). In addition, 20 duplicates were removed. A total of 167 studies were included for full text screening. Based on the above exclusion criteria, a further 102 articles were discarded at this stage: other subject or outcome than mental health condition and leprosy (n = 60), other language (n = 35), perspective of others (n = 5), review (n = 2). In the end, we included an analysis of 65 relevant articles regarding leprosy and mental health. Of these, 11 of 65 articles were studies describing interventions. Out of 65 studies, 62 concerned leprosy-affected persons, while three studies concerned the family members of the affected persons. The studies included and their important characteristics are presented in In total, 797 articles were found see . In addiet al., Out of the 65 articles, three articles described psychiatric morbidity in general among leprosy-affected persons. Psychiatric morbidity, or mental ill health, was measured with the general health questionnaire (GHQ). The GHQ is a tool for screening and identifying minor psychiatric conditions among adults  among this group. According to Bharath et al. , 33.3% o  and phantasmal fear (22.3%)  for persons affected by leprosy as compared with healthy controls. When leprosy patients from Mato Grosso, Brazil, were asked to rate their QoL in a study by Garbin et al. , 37% scoet al.  found th et al., . Brouwer, et al.  found thet al., Three studies described the mental health impact of leprosy on family members of leprosy-affected persons. All three studied children and adolescents whose parents were coping with leprosy. In a study by Parashar and Kumar , 100 IndThere were several determinants presented in the articles that can have an influence on mental wellbeing. In the following paragraphs these determinants will be discussed.et al., et al., et al., et al., et al., et al., et al., et al., et al. .A study by Su et al.  investiget al. , suicide (attempts) (around 33%) and anxiety disorders (10 to 20%). In addition, this study found that children of leprosy-affected persons also experience poor mental health.et al., et al.  impairments, but also demographic factors and other disease-specific factors. Further research is necessary to identify the burden of disease of leprosy, taking the mental health consequences into account, and the impact of leprosy on the mental wellbeing of family members. In order to prevent and mitigate the mental health impact of leprosy, interventions are needed to strengthen coping mechanisms of those affected, to treat mental health conditions such as depression in this population, and to change negative community attitudes towards those affected by the disease, as stigma is a key contributor to mental ill health.


Immune cell infiltration has been identified as a prognostic biomarker in several cancers. However, no immune based biomarker has yet been validated for use in pancreatic ductal adenocarcinoma (PDAC). We undertook a systematic review and meta‐analysis of immune cell infiltration, measured by immunohistochemistry (IHC), as a prognostic biomarker in PDAC. All other IHC prognostic biomarkers in PDAC were also summarised. MEDLINE, EMBASE and Web of Science were searched between 1998 and 2018. Studies investigating IHC biomarkers and prognosis in PDAC were included. REMARK score and Newcastle–Ottawa scale were used for qualitative analysis. Random‐effects meta‐analyses were used to pool results, where possible. Twenty‐six articles studied immune cell infiltration IHC biomarkers and PDAC prognosis. Meta‐analysis found high infiltration with CD4  and CD8  T‐lymphocytes associated with better disease‐free survival. Reduced overall survival was associated with high CD163 . Infiltration of CD3, CD20, FoxP3 and CD68 cells, and PD‐L1 expression was not prognostic. In total, 708 prognostic biomarkers were identified in 1101 studies. In summary, high CD4 and CD8 infiltration are associated with better disease‐free survival in PDAC. Increased CD163 is adversely prognostic. Despite the publication of 708 IHC prognostic biomarkers in PDAC, none has been validated for clinical use. Further research should focus on reproducibility of prognostic biomarkers in PDAC in order to achieve this. Pancreatic cancer remains a challenging disease, with only small improvements in overall survival rates observed in recent years . CurrentBRAF mutant colon cancer , etc.) from the articles relating to immune infiltration was performed by AJM and this was checked by a second reviewer  to ensure accuracy. The Newcastle–Ottawa scale (NOS) [AJM reviewed the abstracts for all eligible studies to record the prognostic biomarker investigated. Abstracts describing immune response or specific immune cell markers   was usedle (NOS) .P value using the method described by Altman [The association between OS, DSS or DFS in PDAC patients and the level of tumour infiltration by immune cells, identified by IHC, was determined. HRs and corresponding 95% confidence intervals (CIs) were extracted from each publication. If these results were not explicitly stated, Parmar's method  was usedy Altman  in any sI2 statistic. I2 estimates the proportion of the variance in studies included in the meta‐analysis that is due to heterogeneity between them [Random‐effects meta‐analysis was undertaken using RevMan 5.3 software   to calcueen them . Resultseen them .For comparability, we evaluated ‘high’ versus ‘low’ immune cell infiltration/expression across studies. The HR and 95% CI from any study reporting associations for ‘low’ versus ‘high’ expression were, therefore, inverted prior to inclusion in meta‐analyses or summary tables. Results reported separately for survival associated with immune cell infiltration of specific tumour areas (e.g. stroma and tumour core) were combined by meta‐analysis prior to inclusion in the main meta‐analysis for specific variables. Publication bias was determined by assessing the symmetry of a funnel plot. Subgroup analysis based on the site of tumour was planned but a lack of relevant studies precluded this.This systematic review summarises previously published data and does not include new human data or tissue that require ethical approval and consent. The authors assume that the studies reviewed were conducted after ethical approval and consent, and in accordance with the Declaration of Helsinki.This manuscript does not contain any individual person's data. All data reported are found in the literature as cited in the text.The PRISMA flowchart  of studyTwenty‐six studies , 35, 36 et al [et al [et al [et al [The majority of studies constructed a TMA using tissue cores from the PDAC tumour core or invasive front; however, the two studies by Diana et al , 22 usedl [et al  only incl [et al . All othl [et al  used patl [et al , 51, 52 l [et al  was the l [et al . Zhang el [et al  used a cet al [Inclusion of patients based on disease stage was diverse. Three studies included stage I–II , 28, 29,et al  and Sugiet al  only incet al [et al [et al [All participants in the Nejati et al  study anl [et al  and Sugil [et al  were trel [et al , 34, 36 l [et al , 20, 30 et al [et al [The REMARK criteria  were useet al  was the l [et al  and Balal [et al  addresseThe NOS was used to determine risk of bias and the results are summarised in supplementary material, p = 0.99) in their PDAC tumour specimens. Observed heterogeneity was high .Four studies , 29, 34 p = 0.28). There was moderate heterogeneity between studies . Four studies [p ≤ 0.001), with no heterogeneity between the four studies .Six studies , 25, 32  studies , 25, 28 p = 0.15) in PDAC . Six studies [p ≤ 0.001) in PDAC in comparison with low infiltration, with little evidence of heterogeneity   Figure .et al [et al [p = 0.45). Liu et al [p ≤ 0.001). There was no association between high versus low intra‐epithelial CD8 infiltration and DSS in the Liu study [p = 0.67).Castino and colleagues  and Liu et al  measuredl [et al  found noiu et al  found loiu study  in univaet al [et al [p = 0.15). Lohneis and colleagues [p = 0.01) and DFS  with high compared to low CD8 infiltration in the stromal area of PDAC tumours. The magnitude of effect estimates reported are broadly similar to that found in the meta‐analysis for DFS.Tewari et al  and Lohnet al  investigl [et al  found nop = 0.07). There was moderate heterogeneity between studies . Only two studies [et al [p = 0.70). The Liu et al study [p = 0.01) but no association between high FoxP3 in the stroma and DFS .Four studies , 24, 26  studies , 26 inves [et al  found nop = 0.93) or stromal  PDAC tumour compartments and DSS when compared to low FoxP3.Liu and colleagues  also invp = 0.46) with low heterogeneity between studies .Six studies , 35, 36 p = 0.17: islet HR 1.38, 95% CI 0.8–2.38; p = 0.25). Diana et al [et al [p = 0.91 and HR 0.83, 95% CI 0.64–1.08; p = 0.16 respectively).In univariate analysis, Hu and colleagues  found nona et al  and Mahal [et al  found noet al [P value from univariate analysis but found no difference in DSS or DFS between high and low CD68 levels at either the tumour core or periphery.Yoshikawa et al  stained p = 0.04). Heterogeneity between studies was moderate .Five studies , 30, 36 p = 0.02) but there was no difference in the levels identified in tumour islets on univariate analysis  [Hu compared high and low CD163 expression in the tumour stroma or islets with OS . Higher  = 0.13) .et al [p ≤ 0.001) and DFS  with high compared to low levels of CD204 at the periphery of PDAC tumours. Likewise, poorer OS  and DFS  was associated with high CD204 infiltration of the neural plexus in PDAC tumours when compared to low levels. Yoshikawa and colleagues [p ≤ 0.001) and DFS  in high versus low levels of CD204 infiltration at the periphery of PDAC tumours. There was, however, no difference in DSS when high and low levels of CD204 at the tumour core were compared .Two studies , 35 inveet al  found pop = 0.004). However, Wang et al [p ≤ 0.001).Two studies , 28 inveet al [p = 0.003).Kurahara et al  was the p = 0.24). Overall heterogeneity between studies was low .Five studies , 28, 34 et al [p = 0.63). When CD20 infiltration was measured in areas of aggregated immune cells (described as ‘tertiary lymphoid tissue’), improved DSS was noted in the highest quartile of CD20 infiltration when compared to the lowest . Wang et al [p = 0.18).Castino et al  investigng et al  found noet al [p = 0.87). Using CD15 as a marker, Wang et al [p = 0.01).Two studies , 28 inveet al  used chlet al [p = 0.004).Wang et al  determinp = 0.19). There was low heterogeneity between studies .Four studies , 24, 26 et al [p = 0.03).Tessier‐Cloutier et al  was the et al [p = 0.05) with high expression of programmed cell death 1 (PD‐1) when compared to low in PDAC. There was no association between PD‐1 expression and DFS .Diana et al  reportedp ≤ 0.001) and DSS  when the highest and lowest density of immune cell infiltration were compared. Wartenberg et al [p ≤ 0.001) and DFS .Tahkola and colleagues  sought trg et al  describeet al [p = 0.005: HR 3.06, 95% CI 1.26–7.44; p = 0.014 respectively) with a high compared to low FoxP3:CD8 ratio. Fukunaga et al [p = 0.03).Hwang et al  assessedga et al  reportedIn this systematic review we sought to summarise all of the existing studies of prognostic IHC biomarkers in PDAC, and to perform a meta‐analysis in relation to immune cell infiltration and prognosis. A total of 1101 articles were identified relating to the description of tissue based prognostic biomarkers in PDAC, and these investigated over 700 individual biomarkers. The vast majority were only assessed in a single paper and this is in line with previous criticisms of studies investigating prognostic biomarkers; no systematic approach to the discovery of novel markers and little external validation , 54. MetOur findings in relation to CD4 and CD8 are in keeping with the prognostic benefit of these immune cell types observed in other tumours , 55. TraPooled analysis of studies investigating the association between CD163 and prognosis found that patients with increased tumour infiltration by CD163 macrophages had shorter OS in PDAC. This is in keeping with studies which found that increased infiltration of CD163 was associated with poorer OS in hepatocellular carcinoma, triple negative breast cancer and follicular lymphoma , 59, 60.Meta‐analysis of the studies investigating FoxP3 and CD20 cell infiltration and prognosis in PDAC did not find any association with OS and this conflicts with findings in other cancers. In ovarian tumours, high FoxP3 T‐cells have been associated with a reduction in Th1 response and worse prognosis . Studiespost hoc changes of protocol were documented to ensure transparency.This review has several strengths. First, it is the most comprehensive review undertaken to date regarding tissue based prognostic biomarkers in PDAC in terms of breadth of search strategy and number of articles included. The quality and risk of bias in the studies was determined using validated tools, the REMARK guidelines  and NOS Our review was restricted to articles published between 1998 and 2018. The benefit of gemcitabine in advanced PDAC was determined in 1997  and the et al [The main weakness of this review is the variation in the patient populations and tumour analysis methods in the included studies. Results from the two studies by Diana et al , 22, usiet al . Studieset al , 71. It et al . This vaet al [Three studies included patients treated with neoadjuvant chemotherapy prior to resection , 20, 31.The majority of studies included patients and tissue from a single centre only, although two , 15 usedThe REMARK guidelines recommend the reporting of univariable and key multivariable analysis in terms of HR and 95% CIs  and we sWhilst no prognostic biomarker has yet been validated for clinical application in PDAC patients, our review has identified over 700 potential markers already investigated and the methodological variation preventing widespread applicability. This review should therefore prove a catalyst for the wider validation of the immune markers already published, to determine their utility as independent prognostic markers in PDAC and enable translation to routine clinical practice. The difficulty of reproducing results in different institutions has been highlighted , furtherWhilst this review focussed on the association between immune infiltration and prognosis, there is potential for the markers identified to be used in the selection of checkpoint inhibitors and other immunotherapies. However, to date no immunotherapies or companion diagnostics have been approved for the treatment of PDAC. Although PD‐L1 expression was not associated with prognosis in our pooled analysis, given the success of PD‐L1/PD‐1 inhibitors in other cancers we believe further study and validation of this biomarker should be a priority. The recent FDA approval of the PD‐L1 inhibitor pembrolizumab in advanced cancers with mismatch repair deficiency, regardless of site of origin, highlights the benefit of treatment stratification based on the molecular characteristics of tumours. It is, therefore, imperative that a robust, validated biomarker is developed to ensure PDAC  patientsGiven the widespread use of IHC, the identification of a validated prognostic marker using this technique is an attractive prospect which could be readily applied to current tissue analysis. The heterogeneity of PDAC tumour tissue is a challenge and any sampling protocol would have to be reproducible and enable the collection of representative tissue. ‘Cut points’ to determine ‘high’ versus ‘low’ infiltration would also need to be standardised for the marker to be used in routine clinical practice.In keeping with other tumour types, high CD4 and CD8 infiltration is associated with improved DFS in PDAC and increased expression of CD163 macrophages is adversely prognostic. Despite the publication of over 700 IHC prognostic biomarkers in PDAC, none has been sufficiently externally validated to enable use in clinical practice. Further high‐quality research is required to focus on reproducibility of prognostic IHC biomarkers, particularly CD4, CD8 and CD163, in PDAC. In order to achieve comparable results and validate these markers, we suggest a standardised, international consensus for the investigation and validation of prognostic biomarkers in PDAC is developed. In line with other cancers, optimal sampling protocols for TMA analysis of PDAC are required to mitigate the effects of morphomolecular heterogeneity , 84.AJM acquired, analysed, and interpreted the data, and drafted the manuscript. HGC designed the review, acquired and interpreted the data, and revised the manuscript. RSM and DIJ acquired the data and revised the manuscript. PJK and MAT analysed the data and revised the manuscript. RCT designed the review, acquired and interpreted the data, and reviewed the manuscript. All of the authors approved the final version for publication and agree to be accountable for all aspects of the work.Search termsFigure S1. Funnel plot of included studiesTable S1. List and frequency of prognostic biomarkers investigated in included studiesTable S2. Characteristics of included studiesTable S3. REMARK scoreTable S4. Newcastle–Ottawa scoreClick here for additional data file.


The wild giant panda in their habitat in Liziping National Nature Reserve, Shimian. The copywight belongs to Liziping National Nature Reserve, Shimian.  Clostridium and vancomycin resistance genes) when compared to the other wild and captive populations studies, which was supported by previous giant panda whole‐genome sequencing analysis. In this study, we provide an example of a potential consensus pattern regarding host population genetics, symbiotic gut microbiome and ARGs. We revealed that habitat isolation impacts the ARG structure in the gut microbiome of mammals. Therefore, the difference in ARG composition between giant panda populations will provide some basic information for their conservation and management, especially for captive populations.The rise in infections by antibiotic‐resistant bacteria poses a serious public health problem worldwide. The gut microbiome of animals is a reservoir for antibiotic resistance genes (ARGs). However, the correlation between the gut microbiome of wild animals and ARGs remains controversial. Here, based on the metagenomes of giant pandas , we investigated the potential correlation between the constitution of the gut microbiome and the composition of ARGs across the different geographic locations and living environments. We found that the types of ARGs were correlated with gut microbiome composition. The NMDS cluster analysis using Jaccard distance of the ARGs composition of the gut microbiome of wild giant pandas displayed a difference based on geographic location. Captivity also had an effect on the differences in ARGs composition. Furthermore, we found that the Qinling population exhibited profound dissimilarities of both gut microbiome composition and ARGs (the highest proportion of  For example, at the phylum level  was highest in captive giant panda populations . In wild giant pandas, the mean abundance of Clostridium (Firmicutes) was highest in the QIN population (0.42 ± 0.35), and the mean abundance of Pseudomonas (Proteobacteria) was highest in non‐QIN populations . Additionally, the mean abundance of Pseudomonas (Proteobacteria) was also highest in the XXL population of wild red pandas (0.61 ± 0.38). However, the new finding here was the dissimilarity in the ARG composition between the captive and wild giant panda gut microbiome.Based on the meta‐analysis of the giant panda metagenome data, we confirmed the previous findings (mostly using the 16S rRNA data) on the difference in the gut microbiome composition (Wei P = 0.0001). This difference in ARG composition between the groups was larger than that in the gut microbiome community, with two clear clusters for ARGs . As such, our results revealed a clear divergence between QIN and non‐QIN populations (Qionglai and XXL populations)  Fig. C,F. Notans) Fig. . In regans) Fig. , the meaium Fig. . The meaium Fig. . And thenia Fig. . We deduet al., et al., Clostridium strains , with the QIN and non‐QIN populations diverging approximately 0.3 million years ago  and vancomycin resistance (e.g. in QIN mountain population).Our study revealed that captivity might lead to a special combination of ARGs as the treatment of captive individuals during normal health management affects the composition of ARGs. Thus, the difference in the ARG structure among different mammal groups in this study would provide some basic information for their management and conservation, especially for captive populations. The normal treatment of the mammals in the zoos (e.g. CA) should consider their potential tetracycline and macrolides resistance genes of the gut microbiome. Furthermore, maintaining the health of the captive giant panda population is important for the translocation of some small and isolated wild populations. The management of the captive giant panda population should think of the antibiotics resistance by et al., et al., et al., et al., et al., et al., et al., et al., et al., et al., Considering the phylogeny position of the giant panda (belonging to Carnivora order), we collected the published metagenomes (raw data) of giant pandas and other carnivorans Table . The 49 et al., et al., et al., et al., et al., et al., Raw reads were filtered using Trimmomatic   of gut microbiome communities and ARGs per metagenome was transformed to relative abundance using STAMP   regarding the ARG types and subtypes based on the relative abundance of bacteria genus for the annotated ARGs and the relative abundance of ARG types and subtypes in all annotated ARGs.et al., The Jaccard distance for gut microbiome genus and ARGs (types and subtypes) relative abundance was used to generate non‐metric multidimensional scaling (NDMS) in PAST3  of main ARG subtypes in the gut microbiome of giant pandas.Table S4. The mean abundance (%) of the dominant putative Clostridium species in the gut microbiome of giant pandas.Fig. S1. The distributions of dominant ARG subtypes and their abundances in the total annotated ARGs subtypes in the metagenomes.Fig. S2. The distributions of ARG subtypes and their abundances in the total annotated ARGs subtypes in giant panda and red panda metagenomes.Click here for additional data file.


Stewart et al.  were amo [et al.  publishe [et al. . As ther [et al. . From a  [et al. .et al. [The recent publication by Guan et al.  from theSurgery is generally very slow to scrutinize the rapid progression of new surgical innovations until Level-1 evidence such as randomized control trials (RCTs) have shown them to be effective. However, it is challenging to evaluate a new surgical procedure in an RCT due to many potential practical problems: recruiting patients may be difficult, as they may refuse to be randomized; measuring appropriate outcomes may require years of follow-up; there may be differences in the surgical skills of the techniques being analysed; therefore, analysis should take account of how experienced each surgeon is in performing the new operation. Ideally, randomization should begin as soon as it is feasible, as this would enable the researchers to monitor the learning curve. The latter was emphasized in the recent ROLARR randomized clinical trial, which compared the effect of robotic vs laparoscopic surgery for rectal cancer. The median laparoscopic cases performed in the laparoscopic arm was 91 vs 50 in the robotic arm and, despite a recruitment of 471 patients, there was no difference in the primary endpoints of conversion to open laparotomy and positive rate of circumferential resection margin. A subsequent publication exploring and adjusting for potential learning effects showed that the initial ROLARR analysis was confounded by the learning effect and that the estimated odds ratio of conversion in the robotic arm was significantly lower after ∼70 cases were performed when compared with the laparoscopic arm with a median of 91 cases [et al. [et al. [P = 0.005). There were no other statistical differences in the other standard parameters measured. Ma et al. [To date, there have been only three Level-1 publications on NOSES for colorectal procedures—two RCTs , 7 and oet al.  performea et al.  meta-anaP = 0.639) [So, from a critical point of view, the concept of NOSES makes sense in the avoidance of incision-related morbidity as a goal of modern minimally invasive colorectal surgery. The approach also appears to offer significant short-term benefits with no immediate adverse complications. There is still the concern of the long-term oncological implications of NOSES, although, reassuringly, a large prospectively collected study of 844 patients (163 NOSE and 681 CL) who underwent curative surgery for rectal cancers showed a combined 5-year DFS rate for all stages of 89.3% in the NOSE group and 87.3% in the CL group (et al. [Surgeons who typically perform laparoscopic-assisted colectomies would be faced with a steeper learning curve when adopting NOSES. Intracorporeal anastomosis is a prerequisite skill for those adopting NOSES. Furthermore, specimen extraction via the vagina requires a posterior colpotomy, which will be a new skill for most colorectal surgeons. These technical challenges are amplified by a lack of standardization of the technique. Guan et al. , in theiet al.  standardNone declared.


Moreover, in addition to the two studies mentioned in our paper [The references in the Correction notice do not provide direct support to the points made in the text. The authors have supplied updated references. An increasing number of studies have supported the xenomiR hypothesis in recent years. Li et al.  reportedin vitro . Hou et in vitro  showed tur paper , one morur paper .Arabidopsis cells transported small RNAs into the fungal pathogen B. cinerea, which suppressed its pathogenicity by silencing fungal virulence genes [Not limited to mammals, plant-derived xenomiRs also exist and function in insects and bacteria. Zhu et al.  reportedce genes .O. basilicum miRNAs from expressed sequenced tags using computational approaches, and predicted their targets and potential functions on human. Using bioinformatics tools and databases, Ergün [H. perforatum flower dietetically absorbed to define potential biomarkers for prostate cancer. Yu et al. [A number of studies have investigated plant derived xenomiRs using computational approaches. Patel et al.  identifis, Ergün  investigu et al.  developeu et al.  analyzedThese studies not only supported the xenomiR hypothesis from different approaches and species, but also started to explore the function, mechanism and medicinal value of plant derived xenomiRs. More related researches were well-reviewed in two recent papers , 16.Arabidopsis samples (S8 Table). The authors state that they used “independent samples Student’s t-test” when comparing abundances between the plant miRNA in human samples and human miRNAs in Arabidopsis samples. Here, the denary logarithm of plant miRNA abundances of human samples and human miRNAs of Arabidopsis samples were assumed to follow Gaussian distributions.The authors would also clarify the type of t-test used in the comparison of abundance values of plant miRNAs in human samples (S5 Table) and those of human miRNAs in When the abundances of plant derived miRNAs in human samples were analyzed, only the top 24 most abundant plant miRNAs (S3 Table) with abundance more than 0.05 were used, which include most of the plant miRNAs reported by other studies. In many samples, the abundance values of these 24 types of miRNA were 0, and none of these were not excluded. For computational convenience, a very small pseudo-abundance was added to all abundance values . The au


Exergy analysis, which is based on the second law of thermodynamics, is a potential tool to identify the sources, magnitude and location of the irreversibility in energy systems. Exergy analysis can assist researchers, engineers and students for system design, analysis, assessment, optimization, and performance evaluation of various energy systems. In this Special Issue, we have tried to attract researchers to submit their interesting and novel research works related to work availability, exergy and exergo-economic analyses. 18 high quality papers after several rounds of reviews were accepted and published in this Special Issue. A brief overview and summary of the individual contributions are given in the following:The first contribution was by Hooshmand et al.  who invePérez-García et al.  studied 2 Removal Assembly in Manned Spacecraft was carried out by Pang et al. [Sciubba and Zullo  publisheg et al. . The purg et al.  studied 2O3 nanofluids as heat transfer fluids. A 1D numerical model has been extensively used to quantify the exergy performance of the system. Fontalvo et al. [An Improved System for utilizing low-temperature waste heat of flue gas from coal-fired power plants was carried out by Huang et al. . In thiso et al.  studied Energy and exergy assessment of a pilot parabolic solar dish-Stirling system was carried out by Gholamalizadeh and Chung . The locDorosz et al. studied possible liquefied natural gas (LNG) exergy recovery systems for transportation since in most LNG-fueled vehicles, exergy of LNG was destroyed during the regasification process . Their aHuang et al. compared the integration of three retrofit concepts for waste heat recovery via ORC, in-depth boiler–turbine integration, and coupling of both for maximizing the system-level heat . Their cSpanghero et al. applied the first and second laws of thermodynamics to the human body to estimate the quality of the energy conversion during muscle activity . AuthorsJing et al. investigated building cooling based on the exergo-economics through solar refrigeration, i.e., solar/natural gas-driven absorption chiller (SNGDAC), solar vapor compression–absorption integrated refrigeration system with parallel configuration (SVCAIRSPC), and solar absorption-subcooled compression hybrid cooling system (SASCHCS) . AuthorsSince ORC is known as a promising technique to exploit waste heat from Internal Combustion Engines (ICEs), Liu et al. investigated the waste heat recovery systems that could be designed based on engine rated working conditions . AuthorsThe investigation on the impact of muscle and fat percentages on the exergy behavior of the human body in different environmental conditions was conducted by Garcia et al. . The focCastro et al.  investig


The journal retracts the article “Platypnea-Orthodeoxia Syndrome: Multiple Pathophysiological Interpretations of a Clinical Picture Primarily Consisting of Orthostatic Dyspnea” by De Vecchis, R., et al. .Following publication, concerns were brought to the attention of the publisher regarding an alleged redundant publication with “Platypnea-orthodeoxia Syndrome: Orthostatic Dyspnea and Possible Pathophysiological Substrates” by De Vecchis, R., et al. . Adhering to our complaints procedure, an investigation was conducted that confirmed the existence of a redundant publication and the article is therefore retracted.This retraction was approved by the Editor-in-Chief of Journal of Clinical Medicine.The authors agreed to this retraction.


Smoking affects not only smokers themselves, but also the people around them. 700 million children are exposed tosecond hand tobacco worldwide. One of the adverse effects of being a passive smoker is oral pigmentation. This study was conducted to evaluate the association between smoking of a parent at home and oral pigmentation in children, and the characteristic factors affecting that. In this retrospective cohort study, 140 healthy children aged 4 to 10 (mean age= 6.68±1.60), 70 with smoker parentand 70 without smoker parents, were examined for oral pigmentation. Environmental factors were evaluated by asking theparents to fill a questionnaire. Data were analyzed using Chi-square test, Fisher's exact test, Logistic regression, and Spearman scale.p= 0.0001). Spearman’s correlationshowed parents' duration of cigarette smoking and the number of cigarettes per day could meaningfully affect the severity of oralpigmentation (R=0.329). The study did not find a statistical relationship between oral pigmentation in passive smoking and gender or house area.  There was a meaningful relationship between having a smoker parent and oral pigmentation ( Children exposed to secondhand tobacco are at more risk for oral pigmentation. Its severity depends on duration of cigarette smoking and the number of cigarettes per day. Smoking affects not only the smokers themselves but also the people around them. According to world health organization (WHO), 700 million children (40% of children) are exposed to second hand tobacco worldwide  . StudieThe purpose of this study was to survey the association between smoking of parents at home and oral pigmentation in children, concerning the affecting characteristic factors.et al. study (P1-P2)2A total of 70 children (4.5 to 10 years old) referred to the Pediatric Department of Yazd Dental School (from October to December 2017) whom at least one of their parents or caregivers were smoker at home were selected as the case group. In our study, a person who had consumed at least ten cigarettes during the last month in the presence of their child was considered as smoker. This data was acquired by asking the parents. Seventy children attending pediatric department of Yazd Dental School were selected as the control group from those with non-smoker parents. The control group had the same age range as the case group. The inclusion and exclusion criteria were applied to both groups as follows. All children were psychologically and physically healthy (based on questionnaires) and did not take any medications, such as Bismuth and so on, which would have effects on the pigmentation of periodontium.In this study, the inner side of arm was chosen to determine the skin color  . MY creA form was designed containing information on the study and asking about the parents' consent on participating. After the consent was given, a questionnaire including questions on demographic information (child’s age and gender), parents’ education and child’s medical history  was given to parents or caregivers. The surface area of their house was asked with the two options, below and over 100 square meters. This variable was analyzed only in the case group to see how the house area affects the children who have a smoker parent. During the sampling process, the control group was selected to be similar to cases on the distribution of age, gender, and skin color.The size of pigmentations was measured by a graded periodontal probe and was documented along with their locations in oral cavity . A classification was used to determine severity of the lesions defined as (1) mild (0.5-1cm), (2) moderate (1-2cm), and (3) severe (more than 2cm or presence of multiple sites of pigmentation).Data were collected, coded, and entered to the computer. They were analyzed using SPSS23 software. Qualitative variableswere analyzed via Chi-square test. Pigmentation severity was considered an ordinal variable; therefore, Spearman correlation was used for its analysis. A sample of 140 children with an average age of 6.68± 1.60 years was randomly selected. Out of the 140 samples examined, only two had mild allergies and did not use any medications. These two samples were excluded and replaced so that the effect of systemic diseases variable was excluded from the study. After reviewing the data, the following results were obtained:Oral mucosal pigmentation, regardless of the effect of passive smoking on children, was observed in 50.7% of the subjects. 20.7% of them had mild pigmentation, 20.7% had moderate pigmentation and 3.9% had severe pigmentation. Therefore, the least frequent type of pigmentation was severe .p= 0.280).The sample was consisted of 69 girls and 71 boys. There was no significant relationship between gender and the presence of pigmentation (p= 0.0001). Relative risk of passive smo--king for the occurrence of oral pigmentation in passive smoker children was 2.10 (C.I. = 95%: 1.45 – 3.05).The case group consisted of 70 children with a smoker parent, all of whom their fathers were the smoker. Of these 70 patients, 31.4% had no pigmentation, 34.3% had mild pigmentation, 20% had moderate pigmentation, and 14.3% had severe pigmentation. In total, 48 had oral pigmentation. The control group consisted of 70 children without a smoker parent or caregiver. A total of 67.1% had no pigmentation, 7.2% had mild pigmentation, 21.4% had moderate pigmentation, and 4.3% had severe pigmentation. In total, 23 children with oral pigmentation were detected in the control group. There was a significant statistical difference between the presence of oral pigmentation and having a smoker father . Data are presented in There was no statistically significant difference, and no meaningful relationship between house size and the occurrence of children oral pigmentation ; p= 0.2.p= 0.001). Spearman's correlation coefficient for the age variable was 0.282. The relationship between age and oral pigmentation was statistically significant . Spearman correlation coefficient of duration of smoking (the number of years the parent has been smoking) was 0.371. Therefore, duration of consumption was directly related with the pigmentation. This variable had a significant relationship with children’s oral pigmentation (p= 0.0001).Spearman's correlation coefficient in relation to this variable was 0.358. Therefore, it also had a direct relationship with the two other variables. There was a statistically significant difference and this variable was related to pigmentation (et al. [ et al. [ et al. [ et al. [ et al. [ This study aimed to examine the relationship between smoking of a parent at home and oral pigmentation in children and the characteristics affecting that. Studies on effects of passive smoking on oral pigmentation have been conducted on different target groups. Moravej-Salehi et al.   have in et al.  , Haniok et al.  , Yasear et al.  , Sridha et al.  , similaet al. [ et al. [ Hanioka et al.   and Yas et al.   also maet al. [ et al. [ As mentioned before, by using Spearman’s correlation analysis, a positive relation between oral pigmentation and the children’s exposure to second hand tobacco was found. Some studies on effects of active smoking have shown the same results  , 13 buet al.   and Han et al.   have noet al. [ et al. [ et al. [ et al. [ et al. [ Using MY cream, skin complexions were matched and subjects with darker skins were not included in the study. Haji-Fattahi et al.  , Morave et al.   and Sri et al.   employe et al.   and Yas et al.   have noet al. [ et al. [ In this study, lesions were categorized by size. Periodontal probe was used to measure the size of the lesions. The examinations were conducted by only one clinician to ensure the objectivity of study. Madani et al.   classif et al.   also me et al.  - 12. N et al.  , 11.et al. [ Despite this study, Moravej-Salehi et al.   were abet al.  . It must be mentioned that smoking has different adverse effects on the consumer’s and their families' health. This study has investigated just one of the many harmful effects of children's passive smoking.Children exposed to secondhand-tobacco regardless of their gender are at more risk to develop oral pigmentation. Investigating factors affecting the severity of pigmentations, this study found that parents' duration of cigarette smoking and the number of cigarettes per day have a meaningful relationship with their child's oral pigmentation. As for the extent of house area, this study could not find a relationship. In conclusion, prohibition of smoking in the presence of children might prevent oral pigmentation as well as other adverse effects of being a passive smoker.


The 2020 International Conference on Intelligent Biology and Medicine (ICIBM 2020) provided a multidisciplinary forum for computational scientists and experimental biologists to share recent advances on all aspects of intelligent computing, informatics and data science in biology and medicine. ICIBM 2020 was held as a virtual conference on August 9–10, 2020, including four live sessions with forty-one oral presentations over video conferencing. In this special issue, ten high-quality manuscripts were selected after peer-review from seventy-five submissions to represent the medical informatics and decision making aspect of the conference. In this editorial, we briefly summarize these ten selected manuscripts. These ten articles went through the second round of peer-review and revision in the BMC Supplement submission system before their final acceptance to this ICIBM 2020 supplement issue. Of note, eight articles [The 2020 International Conference on Intelligent Biology and Medicine (ICIBM 2020) provided a multidisciplinary forum for computational scientists and experimental biologists to share recent advances on all aspects of intelligent computing, informatics and data science in biology and medicine. It was organized and hosted by the International Association for Intelligent Biology and Medicine (IAIBM), the University of Pennsylvania, and the Temple University on August 9–10, 2020. The conference was originally scheduled to be located in Philadelphia and was eventually transformed into a virtual conference held online due to the COVID-19 pandemic. The conference received seventy-five full-length original manuscript submissions. Each manuscript went through a rigorous review process and was peer-reviewed by at least three technical program committee members. Forty-one submissions were accepted and presented in four live sessions over Zoom, and the conference attracted ~ 300 attendees. In this special issue, ten high-quality manuscripts were selected to represent the articles  are inclPredicting mortality in critically ill patients with diabetes using machine learning and clinical notes”, Ye et al. [In “e et al.  investigNatural Language Processing (NLP) tools in extracting biomedical concepts from research articles: a case study on autism spectrum disorder”, Peng et al. [In “g et al.  performeStress detection using deep neural networks”, Li et al. [In “i et al.  applied Annotation and extraction of age and temporally-related events from clinical histories”, Hong et al. [In “g et al.  reportedSURF: identifying and allocating resources during out-of-hospital cardiac arrest”, Rao et al. [In “o et al.  studied In “Utilizing deep learning and graph mining to identify drug use on twitter data”, Tassone et al.  proposedAn interpretable risk prediction model for healthcare with pattern attention”, Kamel et al. [In “l et al.  developeComparing different wavelet transform on removing electrocardiogram baseline wanders and special trends”, Chen et al. [In “n et al.  addresseUnsupervised phenotyping of sepsis using non-negative matrix factorization on temporal trends from a multivariate panel of physiological measurements”, Ding et al. [In “g et al.  performeIdentifying risk factors of preterm birth and perinatal mortality using statistical and machine learning approaches”, Kothiya et al. [In “a et al.  studied Most of the studies included here were facilitated by and conducted with the valuable data resources either available in the open science domain or accessible to the authors. In five of these articles , 9, 10, In these studies, the authors employed informatics and machine learning methods to address various health topics, including diabetes , autism In summary, we envision a growing interest of medical informatics and machine learning approaches to address the pressing problems in health applications. We anticipate that future ICIBM events will continue serving as a forum for researchers to exchange ideas, data, and software, and speed up the development of intelligent computing methods for data-driven discovery in biology and medicine.


In addition, transcriptional rewiring through various epigenetic signals has been observed in plants upon multi‐generational exposure to abiotic stresses  that, in turn, activates multiple dehydration stress‐responsive genes  light‐, salinity‐ and hypoxia‐resistance when independently adapting to the specific intertidal environments. However, such stressful conditions can activate transposable elements . This is, in fact, a more general pattern: epigenetic alterations following biotic stress are frequently observed around genomic regions containing defence‐related genes and their transcriptional activation upon stress is often mediated via neighbouring TEs , can lead to resistance to Gibberella stalk rot in maize. Additional relevant case studies of plant–animal, plant–microbe and plant–plant interactions are critically discussed in Alonso et al.  suggest that a better understanding of the epigenetic responses to environmental (i.e. both abiotic and biotic) stress is key to understanding rapid plant adaptation, plant immunity and for developing sustainable strategies for crops’ improvement in the face of global warming. Indeed, the spontaneous and fluctuating nature of epimutations was suggested to enhance the adaptation potential to varying abiotic stimuli , are prevalent in plants and, as genomic stressors, can trigger systemic alterations across the epigenetic landscape. The epigenetic remodelling triggered helps to re‐establish the functional and structural balance of the affected genomes (e.g. Song & Chen, , et al.  report aet al., et al., et al., et al., cis–trans interactions and homoeologue expression are discussed in a recent paper by Hu & Wendel (The remodelling of the epigenetic landscape can be seen as a consequence of a phenomenon long depicted as ‘genomic shock’ (McClintock, & Wendel . In addi& Wendel .et al., Epigenetic mechanisms are also major players during plant development, and have a role in shaping phenotypic plasticity (Gallusci et al., Arabidopsis (Benoit et al.,  et al. (et al., et al. (Histone modifications also appear involved in fine‐tuning different phases of plant development. They can, for example, influence flowering time (Crevillen   et al.  uncovers et al., . Startin, et al.  show tha‘Our understanding of the control and function of structural modifications to DNA has, in recent years, been complemented by developmental and ecological perspectives of epigenetics.’Finally, epigenetic mechanisms involving small RNAs, in particular siRNAs, are relevant during plant reproduction, for example during a phase of global reactivation of TEs in gametes. During this stage an intercellular movement of siRNAs between companion cells and male gametic cells has been observed, and recent studies have elucidated the function of sperm‐delivered siRNAs during early seed development (reviewed by Wu & Zheng, et al., et al., et al., et al., et al., et al., Our understanding of the control and function of structural modifications to DNA (e.g. Law & Jacobsen,


Homo sapiens across the planet  complete genomes submitted to the international Global Initiative on Sharing Avian Influenza Data (GISAID) database by early March 2020, to produce a snapshot of the beginning of the SARS-CoV-2 epidemic  differ by more than 1,000 mutations. In their view, such a distant outgroup is unlikely to provide a reliable root for the network. We argue, on the contrary, that the bat virus is surprisingly conclusive, as shown by its stable rooting in cluster A despite incrementally increasing the epsilon “fuzziness” setting in the median-joining network algorithm as described in PNAS  have gonMavian et al.  are puzzMavian et al.  refer toMavian et al.  then misMavian et al.  reproachMavian et al.  state thFinally, Mavian et al.  caution


This has not been adequately emphasized by Luyssaert et al.  contains supplementary material, which is available to authorized users. In the original version of the paper, a key premise was that “about 75% of this reduction is expected to come from emission reductions and the remaining 25% from land use, land-use change and forestry”, citing Grassi et al. [should not rely on forest management to mitigate climate change”.A recent article by Luyssaert et al.  analysesi et al.  concludeThe original premise of Luyssaert et al.  on the eIn this commentary, we discuss further several of the arguments by Luyssaert et al. , showing2/year —offsetting about 7% of total EU GHG emissions, with rather stable values in the last 25 years [Considering that the current carbon sink in the EU LULUCF sector is about 300 Mt CO25 years , 7 , it corresponds to about 1% of the EU 2030 emission reduction target. Therefore, contrary to the assumption of Luyssaert et al., almost all of the EU mitigation effort in 2030 is expected to come from emission reductions from non-LULUCF sectors and only a very small part directly from LULUCF.Furthermore, the EU climate legislation  has capp2e/year [2e/year in 1990 , the indirect contribution of EU forest-based bioenergy to the EU 2030 emission reduction target would realistically add another 3% ((150 − 90)/2250).Forests may contribute to mitigation also indirectly, especially through the utilization of wood as an energy source in place of fossil fuels. When the harvesting of forest biomass for energy purposes is increased, a decrease in carbon stock is reported in the LULUCF sector whilst GHG emission savings appear in the energy sector. For the EU, these savings are currently estimated to be about 130 MtCO2e/year , relativ2 impact. Rather than emphasizing these crucial caveats, Luyssaert et al. [We fully share with Luyssaert et al.  the viewt et al.  used theIf the aim is to encourage countries to start considering biophysical effects in their policies, more emphasis should be put on seasonal and local impact of biophysical effects of forest cover change, including synergies and trade-offs with a carbon-oriented management, rather than on the net annual biophysical climate impact at EU level. These seasonal and local impacts are less uncertain and more relevant in the context of changes in diurnal temperature excursions  and heat2 sink from forest management are counterbalanced by negative biophysical climate effects—resulting in a “zero-sum” climate outcome, could be interpreted as forest management not being important to fight climate change. We think that would be a wrong conclusion. In fact, the recent inclusion of forests into the EU 2030 economy-wide climate targets [2 sink, and no disincentive for a possible over-use of forest resources , which could drastically reduce the current CO2 sink.Irrespective of the high uncertainty of biophysical effects on climate, the argument by Luyssaert et al. , that ef targets  represen2 impact. Therefore, in our view, the conclusion of Luyssaert et al. [2 sink from forest management at EU level are counterbalanced by negative biophysical climate effects is uncertain and premature. Furthermore, we show that the GHG mitigation contribution by forests towards EU 2030 climate objectives is expected to be small, but yet strategically important. Although the original mistake by Luyssaert et al. [In conclusion we argue that, while biophysical effects are clearly important on the local and seasonal climate, the net annual biophysical climate impact of forest management in Europe remains more uncertain than the net COt et al.  that thet et al.  on the et et al. . They alt et al. —are serit et al. , and encAdditional file 1. The contribution of LULUCF to the countries' climate pledges made in Paris and, more specifically, the expected contribution of forests to meet EU 2030 the climate targets, including an analysis of forest-based bioenergy.


The study on entropy generation and exergy analysis in Nanofluid flows started in 2010 ,4,5,6. FBecause of high interest toward this area, in 2016 and 2017 we decided to serve as guest editors for two special issues on nanofluids. The total number of articles that have been published in the two special issues are 21 articles with more than 200 citations. The high number of citations shows the significance of this topic for researchers. 2O3–water nanofluid as the working fluid. It was found that total entropy generation increases with the increasing volume fraction of nanoparticles. In References [Here, we give a summary of papers published in these two issues. In the first paper, Kolsi et al.  studied ferences ,10,11,12ferences  modeled 2O3–water nanofluids in a microchannel with flow control devices including cylinder, rectangle, protrusion, and v-groove. They concluded that protrusion devices are the best option to achieve minimum entropy generation. In another work, Xie et al. [Li et al.  studied e et al.  studied 2O3–water nanofluid. Sheremet et al. [3O4–water nanofluid in a microchannel heat sink with offset fan-shaped reentrant cavities. Rashidi et al.  studied t et al.  evaluatet et al.  studied Qasim et al.  simulateIn most of the studies mentioned above, it was concluded that adding nanoparticles leads to heat transfer enhancement, and on the other hand, entropy generation reduces with an increase in the volume concentration of nanoparticles.Investigate the effects of different thermophysical models  on entropy generation rate;Use both two-phase mixture model and single-phase models and compare the results;Investigate new configurations;Investigate entropy generation in new application of nanofluids, as most of the present studies are limited to classic problems such as flow on sheets or inside cavities and ducts;Consider the prediction of entropy generation using soft computing approaches like neural network;Conduct a comparison between entropy generation rates of different nanoparticles and base fluids to recognize the optimum nanofluid from the second law of thermodynamics viewpoint.It is suggested for future studies that authors: