SARS-CoV-2 infections cause the current coronavirus disease (COVID-19) pandemic and challenge the immune system with ongoing inflammation. Several redox-relevant micronutrients are known to contribute to an adequate immune response, including the essential trace elements zinc (Zn) and selenium (Se). In this study, we tested the hypothesis that COVID-19 patients are characterised by Zn deficiency and that Zn status provides prognostic information. Serum Zn was determined in serum samples (n = 171) collected consecutively from patients surviving COVID-19 (n=29) or non-survivors (n=6). Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study were used for comparison. Zn concentrations in patient samples were low as compared to healthy subjects (mean±SD; 717.4±246.2 vs 975.7±294.0 μg/L, P <0.0001). The majority of serum samples collected at different time points from the non-survivors (25/34, i.e., 73.5%) and almost half of the samples collected from the survivors (56/137, i.e., 40.9%) were below the threshold for Zn deficiency, i.e., below 638.7 μg/L (the 2.5 th percentile in the EPIC cohort). In view that the Se status biomarker and Se transporter selenoprotein P (SELENOP) is also particularly low in COVID-19, we tested the prevalence of a combined deficit, i.e., serum Zn below 638.7 μg/L and serum SELENOP below 2.56 mg/L. This combined deficit was observed in 0.15% of samples in the EPIC cohort of healthy subjects, in 19.7% of the samples collected from the surviving COVID-19 patients and in 50.0% of samples from the non-survivors. Accordingly, the composite biomarker (SELENOP and Zn with age) proved as a reliable indicator of survival in COVID-19 by receiver operating characteristic (ROC) curve analysis, yielding an area under the curve (AUC) of 94.42%. We conclude that Zn and SELENOP status within the reference ranges indicate high survival odds in COVID-19, and assume that correcting a diagnostically proven deficit in Se and/or Zn by a personalised supplementation may support convalescence.

Three female children presented with different clinical symptoms that could be related to impaired thyroid function. They underwent an accurate pediatric-endocrinologic diagnosis. Laboratory tests revealed no pathological findings, except latent hypothyroidism and selenium deficiency. Hypothyroidism was diagnosed by elevated basal TSH and by a pathological i.v.-TRH-stimulation test. After treating the children with sodium selenite orally for 4 wk, their metabolism had returned to normal and we saw a marked improvement of all clinical symptoms. For the first time, we have been able to describe hypothyroidism caused exclusively by selenium deficiency, the pathophysiology of which may be expressed as a malfunction of human 5'-deiodinases.

Introduction Atopic diseases are global concerns in the today’s industrialized world. Allergic rhinitis is the most common allergic condition affecting 20% of individuals. This disorder is associated with remarkable morbidity and rising healthcare expenditure. Aim Considering the anti-inflammatory properties of a plant Zataria multiflora (ZM) with the common name of Shirazi thyme, a randomized clinical trial was designed to evaluate the alleviation of the symptoms of allergic rhinitis. Material and methods A total of 30 allergic rhinitis patients were randomly and equally assigned to experimental and control groups. Afterwards, the case group was treated with an extract of ZM and the control group with placebo for 2 months. Finally, the clinical signs and symptoms before and after the treatment according to the SNOT22 questionnaire were analysed. Results Comparing the symptoms of allergic rhinitis and an average score of SNOT22 questionnaire between the two groups before the intervention provided some difference, which was significantly greater after the treatment. Based on this questionnaire, our patients in the ZM syrup group had lower grades than before the treatment and experienced amelioration. Conclusions Regarding the significant effect of the ZM syrup in reducing symptoms of allergic rhinitis, its use is highly recommended. Since allergic rhinitis is a multifactorial condition, the use of herbal antioxidants along with conventional treatment would result in a more effective improvement of the disease.

because of the potential risk for occult regional lymph node metastases. This technique, widely used in the nodal staging of malignant melanoma and breast carcinoma, has been effectively employed also to detect occult nodal metastases in patients with high-risk non-melanoma skin cancers. 10 It can select patients for radical lymphadenectomy, sparing unnecessary nodal dissection, when SLN lacks of metastasis.Subsequent experiences are essential to support our options in the management of malignant PTT. R Cecchi, †* V Rapicano, ‡ C De Gaudio § †Departments of Dermatology, and ‡Pathology,

While classic control theory offers state of the art solutions in many problem scenarios, it is often desired to improve beyond the structure of such solutions and surpass their limitations. To this end, residual policy learning (RPL) offers a formulation to improve existing controllers with reinforcement learning (RL) by learning an additive "residual" to the output of a given controller. However, the applicability of such an approach highly depends on the structure of the controller. Often, internal feedback signals of the controller limit an RL algorithm to adequately change the policy and, hence, learn the task. We propose a new formulation that addresses these limitations by also modifying the feedback signals to the controller with an RL policy and show superior performance of our approach on a contact-rich peg-insertion task under position and orientation uncertainty. In addition, we use a recent Cartesian impedance control architecture as the control framework which can be available to us as a black-box while assuming no knowledge about its input/output structure, and show the difficulties of standard RPL. Furthermore, we introduce an adaptive curriculum for the given task to gradually increase the task difficulty in terms of position and orientation uncertainty. A video showing the results can be found at https://youtu.be/SAZm_Krze7U.