Seasonal changes in the environment often strongly influence biological communities. In environmental transition zones, or ecotone, the environment fluctuates over time between two different types of environments, and the seasonal change is more pronounced. Although emphasis has been placed on spatial variation of biota along environmental gradients, seasonal change has not been well studied despite the seasonal nature of many ecotones. The study was conducted on Butokamabetsu River floodplain, Hokkaido, Japan. In this study, we investigated seasonal biotic re-assembly in floodplain waterbodies characterized as transitions between lotic and lentic environments, and further investigated the biological processes behind seasonal re-assembly. We observed a clear seasonal re-assembly of biological communities in floodplain waterbodies. From the spring snowmelt season to the summer low flow season, the biological communities were largely driven by the hydrological connectivity to the river, represented as the timing of the lotic-lentic transition during the seasonal flood recession. In contrast, after a few months of summer low flow period, the effect weakened over time, and the communities were structured based more on the basis of the local environment. The seasonal re-assembly was largely explained by the re-assembly of amphibian and aquatic insect larvae, the main members of the floodplain aquatic assemblage, which metamorphose and emerge from the water during the summer period and then re-distribute in different ways more strongly influenced by local environmental factors such as water body size, temperature, and dissolved oxygen levels. Given that biota in ecotones occupy the habitat for a limited time due to the severe environmental fluctuations, such seasonal changes as we observed in this study may be widespread in ecotones. Landscape and local environmental conditions could alternately shape community structures in different seasons. Further attention to the temporal aspects of community structure is needed for community studies as well as for conservation.

Studying the coupled effects of environmental factors on the structure of phytoplankton communities can deepen our understanding of the stability of aquatic ecosystems in extreme environments. This study examined the phytoplankton community structure and environmental factors of saline a lake during spring, summer, and autumn in 2019. A total of 95 phytoplankton species (belonging to 47 genera and 7 phyla) were identified in Ebinur Lake, reflecting a species richness lower than those of freshwater lakes while being greater than the levels observed in other saltwater lakes. Bacillariophyta dominated the phytoplankton assemblage, followed by Chlorophyta and Cyanophyta, with lesser diversity in other algal species, suggesting that the species composition was similar to that observed in other saltwater lakes. There was considerable spatiotemporal variation in the structure of the phytoplankton community, with the biomass of phytoplankton displaying notable seasonal variation. In spring, the biomass of Bacillariophyta was dominant; in summer, as the climate warmed, the biomass of phytoplankton reached its peak and the biomass of Chlorophyta was dominant; in autumn, the biomass was the lowest, and Chlorophyta and Bacillariophyta shared dominance. The spatial distribution was relatively consistent, as reflected in the distribution of phytoplankton in the three seasons, with the southeastern area of the lake generally exhibiting higher biomass than other lake areas. Bacillariophyta and Chlorophyta were significantly correlated with water transparency (SD); Cyanophyta was significantly correlated with water temperature (WT), and Cryptophyta was significantly correlated with pH. The interaction effects of various environmental factors, including pH, SD, Chl. a, NH₄+-N, and salinity, jointly affect the dynamics of the phytoplankton community structure in Ebinur Lake. This study investigated the effects of physicochemical factors on the structure of the phytoplankton community in a high-salinity lake, thereby providing a basis for ecological protection and environmental management of aquatic ecosystems in extreme environments.

This paper addresses the identification of Nonlinear (NL) systems using a linearization approach, introducing a combined estimator to tackle this challenge. We assume that the unknown NL system operates around a stable, slowly varying operating point. The system trajectory is then perturbed slightly via small, typically fast, input perturbations. We demonstrate that the NL system’s response to these small perturbations can be approximated by a Linear Parameter-Varying (LPV) system model. Furthermore, we show that this LPV model represents the linearized version of the unknown NL system around the operating point. A new parametrization for the LPV model coefficients is introduced, establishing a structural relationship between the LPV coefficients. This structural relationship reduces the number of parameters to be estimated and ensures that the LPV model always corresponds to the linearized form of the NL system. Additionally, we demonstrate that this LPV model structure allows for the unique reconstruction of the NL system model through symbolic integration, resulting in a closed-form nonlinear Ordinary Differential Equation (ODE). This integration introduces a second structural relationship, linking the LPV model to the NL model. By leveraging these two structural relationships, we reformulate the problem of NL system identification via linearization as a combined estimation problem, leading to a unified LPV-NL estimation framework. This approach utilizes all available data, including perturbation data (linear response) and the varying operating point (NL response). We propose a combined estimator that jointly estimates the NL-LPV model, capturing the intrinsic structure of NL system identification through linearization. Finally, we present a numerical example to illustrate the performance of the proposed method.

Owing to the bilinear nature of robust performance conditions, it remains a challenge to effectively design a controller for parametric systems. To overcome this difficulty, we establish a metaheuristic-based design framework in this paper. This framework includes a simple initialization method, detailed search flows, and the associated objective functions for each step. In addition, this method can individually and easily shape the gain characteristics of closed-loop transfer functions, thus lowering the hurdle of control design for complex and uncertain systems. The whole design procedure is validated and illustrated through its application to a drivetrain bench. Numerous trials show that on average a success rate of 70% is achieved in the search for the controller.

Parameter uncertainty is the most frequently encountered model uncertainty. Although the research on the robust control of parametric systems has a long history, existing design tools are still either conservative or not numerically efficient, particularly for the performance problems. This paper treats polytopic systems which have good compatibility with physical systems. It is shown that less conservative robustness conditions can be derived from the well-known Lagrange method by treating the performance specification as an objective function in a dilated signal space and regarding the dynamics as a hyperplane in this space. A broad class of frequency domain specifications and regional pole-placement are analyzed in detail. Desirable multiplier structures are also revealed through numerical analysis. The results lay a solid foundation for an effective robust performance design of the polytopic systems.

The abnormal tumor vascular networks fuel the tumor growth and aggravate the tumor hypoxia. Although vascular normalization therapy (VNT) was clinically effective, the long period before vascular normalization window (VNW) initiation presents significant prognostic challenges. Here, we developed a platelet-mimetic nano-system, IA@PM, which was self-assembled by apatinib (APA) and indocyanine green and further coated with platelet membrane (PM). IA@PM accelerates the pro-angiogenic and anti-angiogenic factors balance to significantly expedite the VNW initiation of APA from the 4th day to the 2nd day post-treatment through rationally utilizing photodynamic therapy (PDT). Benefiting from this VNW initiation acceleration, the timelier and facilitated tumor drug delivery was achieved. This process further constructs a self-amplified therapeutic cycle between VNT and PDT, contributing to the excellent antitumor effects. Collectively, IA@PM breaks key limiting factors in current VNT efficacy by accelerating VNW initiation and also significantly promotes PDT antitumor efficacy with lower doses of ICG, bringing revolutionary new strategies in VNT.

In this review article, highlights about cholera and the outbreak of cholera and its effect on the health system and human beings in Sudan have been discussed. Additionally, the article contains an overview of the common risk factors and possible reasons for the outbreak of the cholera and the efforts of the government and the NGOs in controlling the outbreak. Cholera is a highly virulent disease that spreads through contaminated food or water and can cause severe diarrhea. An outbreak occurs when more cases than expected occur in a specific location over a specific time period. On 15 April 2023, clashes started between the Sudanese army and the Paramilitary Force with ongoing fighting that led to a humanitarian crisis and infrastructural collapses, severe famine, and many outbreaks, including the outbreak of cholera. This was declared in August 2024 after a wave of cases began on July 22. Between July and September, 8,457 cases and 299 deaths were reported across eight states. Between July and December 2023, 3.1 million people in Sudan were at risk, with 500,000 children under five at risk. The ministry of health and NGOs are working together to control the outbreaks by providing water and sanitation, detecting and managing cases, and vaccinating the affected population.

Key clinical message:

Little or no research has been conducted on the epidemiology of leukemias in Eritrea . In this retrospective study, we evaluated the burden and trends of acute lymphoblastic leukemia (ALL), Acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), chronic lymphocytic leukemia (CLL) and overall leukemia in Eritrea. Methods: An audit of leukemia cases recorded in laboratory logbooks at the National Health Laboratory (NHL) and Orotta Referral and Teaching Hospital (ORTH) between January 2010 and December 2021 was performed. Aside from leukemia sub-types, additional variables that were retrieved included age, sex, years of incidence, residency. Relevant estimates assessed included crude incidence rates (CIR), age-standardised rates (ASIR) and estimated annual percentage change (EAPC). Results: In total, 372 confirmed cases of leukemia were recorded between, 2010-2020. The median [interquartile range (IQR)] age, maximum – minimum age, and male/female ratio were as follows: 48 years (24.5 – 60 years), 2 - 91 years, and 210/161 (1.3: 1), respectively. Estimated all-age CIR and ASIR over the study period was 9.22 per 100 000 and 30.1 per 100 000 respectively. Analysis of cumulative (2010 - 2020) CIR per 100 000 (ASIR per 100 000) for ALL, AML, CLL, and CML were as follows: 2.01(3.87); 0.94(2.38); 2.94(15.37) and 3.61(24.03). Additionally, median (IQR) age differed significantly across different subtypes of leukemia – ALL (23.0 years, IQR: 10.0 – 39.0); AML (30 years, IQR: 20 – 56 years), CLL (59.0 years, IQR: 40.75 – 66.75 years), and CML (49 years, IQR: 39.25 – 60 years), p value (Kruskal Wallis), < 0.05). No sex specific differences were observed in median (IQR) for different types of leukemia. Unlike other leukemia sub-types evaluation of EAPC demonstrated that the incidence of leukemia has increased overtime, 21.9 (95 CI: 3.1-44.1), p-value = 0.025. Conclusions: The burden of leukemia was relatively stable . However, due to underreporting and underdiagnosis, it’s our belief that the true burden of leukemia is likely higher. Further, an upward trend in the burden of ALL was uncovered. Lastly, expansion of diagnostic services to other sub-zones, establishment of a national cancer registry and research remains a priority in Eritrea.

Due to the primary disease or chemotherapy-induced neutropenia, patients with acute myeloid leukemia (AML) become a high-risk population for infections. This article discusses the effects of AML cells and chemotherapeutic drugs on the immune function of CD4 + and CD8 + T lymphocytes, as well as the role of their quantitative changes in identifying the risk of infection during the post-chemotherapy bone marrow suppression period in AML. It summarizes the immune function of CD4 + and CD8 + T lymphocytes in the diagnosis of infections and pathogen differentiation during the post-chemotherapy bone marrow suppression period in AML.

Massive hemoptysis in a patient with Eisenmenger syndrome, polysplenia and transverse liverMohsen Shafiepour M.D 1, Behnam Dalfardi M.D2, Ali Nemati M.D 3, Sina Bakhshaei M.D 4, Elahenaz Parsimood M.D 5Assistant Professor of Pulmonology; Afzalipour Hospital Research Center‚ Kerman University of Medical Sciences‚ Kerman‚ Iran.Email: m.shafiepour@kmu.ac.irAdvanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, IranEmail: B.dalfardi@kmu.ac.irAssistant Professor of Hematology and oncology, Afzalipour Hospital Research Center‚ Kerman University of Medical Sciences‚ Kerman‚ Iran.Email: ali_nemati802002@kmu.ac.irInternal medicine resident, UHS SoCal MEC, Temecula, California, USAEmail: sina.bakhshaei@uhsinc.comcardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran (Corresponding author)Email: eliprs5@gmail.comAbstractIntroduction : Hemoptysis is defined as blood-streaked sputum from the lower parts of the respiratory tract. Hemoptysis, even in small amounts, is a frightening and an alarm sign for possible underlying conditions such as infections, pulmonary diseases, neoplastic conditions, cardiovascular alterations, vasculitis, traumatic events, hematological derangements, and iatrogenic or drug-induced events. The initial step in the evaluation of hemoptysis is to determine the source of bleeding.Case presentation : Herein, we report an unusual case of massive hemoptysis in a young patient with polysplenia and Pulmonary Artery Hypertension (PAH) in the setting of Eisenmenger syndrome. Chest radiography was suggestive of multiple lung opacities bilaterally. Chest Computed Tomography (CT) revealed a non-heterogeneous mass-like lesion measuring 4 × 5.2 × 5.6 cm in the superior segment of the inferior lobe of the left lung, concerning for accessory spleen. The patient underwent Video bronchoscopy, which showed tracheomalacia and active bleeding in the left main bronchus. The bleeding was controlled by Argon Plasma Coagulation (APC) technique. Broncho-alveolar lavage (BAL) was negative for acid-fast bacilli on staining and on culture. After stabilization, the patient was discharged home on medical management for PAH. On two-week follow-up, imaging revealed resolution of the pulmonary mass-like lesion.Conclusion : Our report highlights the importance of bronchoscopy in determining the bleeding source in patients with hemoptysis and managing it via the APC technique.Keywords: Hemoptysis; Pulmonary Hypertension; Eisenmenger syndrome; Polysplenia; Transverse liverINTRODUCTIONHemoptysis is defined as blood-streaked sputum from the lower parts of the respiratory tract. The initial step in the evaluation of hemoptysis is to determine the source of bleeding. Pseudo hemoptysis, which refers to blood expectoration via a source other than the bronchial or pulmonary system, should be ruled out by history and physical examination (1).Hemoptysis, even in small amounts, is a frightening and alarm sign. The clinical spectrum ranges from minor blood-stained sputum to major bleeding causing respiratory failure and hemodynamic instability. Underlying causes may vary from benign self-limiting conditions to severe and potentially life-threatening conditions. In terms of severity, hemoptysis is considered scant when presents with bleeding <5 mL, mild when <20 mL, and moderate when >20 ml, while massive hemoptysis is defined as bleeding amount of 100 mL/24 hours or more (2).Hemoptysis may derive from multiple underlying conditions, such as infections, pulmonary diseases, neoplastic conditions, cardiovascular alterations, vasculitis, traumatic events, hematological derangements, and iatrogenic or drug-induced events (Table 1) (3).In adults, acute respiratory tract infections (e.g., bronchitis, pneumonia), bronchiectasis, asthma, chronic obstructive pulmonary disease, and malignancy are the most common etiologies. Tuberculosis (TB) is a major cause of hemoptysis in endemic regions and in developing countries (4). However, in industrialized areas, bronchial carcinoma and bronchiectasis are more common culprits.Pulmonary artery hypertension (PAH) is a serious condition causing progressive obstruction and obliteration of the pulmonary vascular bed. PAH is a rare cause of hemoptysis, which is responsible for 0.2- 4% of the cases. Although, hemoptysis is a relatively more common finding in patients with Eisenmenger syndrome (1).In the past, depending on the severity and etiology of hemoptysis, several management strategies were recommended including supportive care, surgical resection, and lung transplant. Currently, the more commonly used strategy is bronchial artery embolization (BAE). In this technique, a particulate material is injected into angiographically identified abnormal bronchial arteries, helping in hemostasis. BAE is usually well tolerated; however recurrent bleeding is commonly associated with the procedure (6).Herein, we report a case of hemoptysis in a patient with Eisenmenger syndrome and polysplenia. We aim to portray the importance of bronchoscopy as both a diagnostic and therapeutic tool, which helped us to identify the source of bleeding and manage it via the BAE technique.CASE DESCRIPTIONHistoryA 34-year-old female with past medical history of Eisenmenger syndrome in the setting of Ventricular Septal Defect (VSD), who presented with 10 days’ history of cough, hemoptysis (about 300 ml/day), pleuritic chest pain, and exertional dyspnea. She did not report any fever, gum bleeding, or epistaxis.ExaminationOn physical examination the patient was tachypneic, tachycardic, and hypoxic with oxygen saturation of 85% in room air. Chest auscultation revealed left upper lobe crackles and holosystolic murmur in the lower sternal border. Also, she was found to have clubbing in her hands bilaterally.METHODS (DIFFERENTIAL DIAGNOSIS, INVESTIGATIONS, AND TREATMENT)Laboratory findings were significant for microcytic anemia (Hemoglobin 10.6 gm/dl), elevated erythrocyte sedimentation rate (ESR) at 23 mm/hr., and negative sputum for both Acid Fast Bacilli (AFB) stain and geneXpert. Chest radiograph revealed non-homogenous opacities in both lungs (figure 1). Computed tomography (CT) Chest showed a non-heterogeneous mass like lesion measuring 4 × 5.2 × 5.6 cm in superior segment of inferior lobe of the left lung (figure 2), in addition to a transversus liver and multiple spleens were noted (Figure 3). Echocardiography was remarkable for mild Pulmonary valve insufficiency, Pulmonary artery pressure (PAP) of 80 mmHg, abnormal septal motion, large membranous VSD, severe right ventricular (RV) enlargement, and left ventricular Ejection fraction (LVEF) of 55%.

The repeated evolution of herbicide resistance in agriculture provides an unprecedented opportunity to understand how organisms rapidly respond to strong anthropogenic-driven selection pressure. In populations of the grass species Bromus tectorum L., resistance to multiple herbicides has been recently identified. To understand the evolutionary origins and spread of resistance, we investigated the resistance mechanisms in 49 B. tectorum populations to acetolactate synthase (ALS) inhibitors and photosystem II inhibitors, two widely used herbicide modes of action. We assessed the genetic diversity, structure, and relatedness in a subset of 21 populations. Resistance to ALS inhibitors was associated with multiple types of non-synonymous mutations in ALS, the target site gene. Mechanisms not related to the target site evolved and were common in the populations studied. Resistance to photosystem II inhibitors was confirmed in two populations and was conferred by non-synonymous mutations in the plastid gene psbA. Population genetics analyses showed low levels of genetic diversity, suggesting that local selection pressure processes have shaped the populations. We also found evidence of long-distance gene flow among distinct growing regions and cropping systems. The results suggest that both gene flow via pollen and/or seed dispersal, and multiple local and independent evolutionary events were involved in the spread of herbicide-resistant B. tectorum. Our results provide an empirical example of the rapid repeated evolution of a trait under strong anthropogenic selection and elucidate the evolutionary origins of herbicide resistance in a plant species of agricultural importance.

IntroductionLeprosy, also known as Hansen’s disease, is an infamous chronic granulomatous infection caused by Mycobacterium leprae and Mycobacterium lepromatosis . These pathogens predominantly affect the skin and peripheral nerves. Although leprosy is known to have been eradicated in many parts of the world, it remains a major concern in developing countries, including India. Lepra reactions are immunological reactions that can complicate the course of the disease and can be a significant burden to the patient, irrespective of the status of multidrug therapy. That is, these reactions can occur before, during or after the completion of multidrug therapy [1].Lepra reactions can manifest in two types: type 1 and type 2 reactions. Type 1 reactions, also known as reversal reactions, are characterized by the development of acute inflammatory changes in skin lesions with or without neuritis, and it usually affects borderline forms of leprosy. Type 2 reactions, often referred to as erythema nodosum leprosum (ENL), typically present with constitutional symptoms, accompanied by crops of painful, erythematous, cutaneous nodules or plaques, with patients frequently experiencing multiple episodes. This type of reaction is commonly associated with lepromatous type of leprosy. ENL lesions are usually managed with the use of prednisone and thalidomide [2].While ENL typically presents with tender erythematous nodules, instances of atypical presentations of ENL such as vesiculo-bullous lesions (46% of atypical presentations), ulcero-necrotic lesions (41%), erythema multiforme-like lesions (28%), Sweet’s syndrome-like lesions (11%) and pustules (9%) are rarely found in the annals of medical literature [3]. Recently, we encountered an unusual case of bullous ENL. This article offers a comprehensive account of this distinctive presentation.

not-yet-known not-yet-known not-yet-known unknown A case report of a pregnancy complicated by sigmoid volvulus in the extreme preterm gestational age Authors list: Corresponding Author: Naghmeh Kian (School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. naghmeh.kian78@gmail.com) Co-author: Atefeh Moridi (Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. moridi59@gmail.com) Key Clinical Message Intestinal obstruction including sigmoid volvulus is an unusual incident during pregnancy which might be mismanaged due to the lack of clinical suspicion or delayed action. This study provides useful information in regards to timely diagnosis and practical methods of management in order to prevent gestational morbidity and mortality. 0.1 Abstract Intestinal obstruction is a rare but life-threatening incidence in pregnancy. Diagnosis can be challenging for clinicians as the symptoms might be approached as other common obstetric complications. Performing radiological and abdominal surgery are also areas of great concern in this field; since radiologic studies inevitably expose the fetus to radiation and the treatment options mostly involve surgery that is worrisome during gestation. The maternal and fetal outcomes are dependent on timely diagnosis and management; as intestinal perforation, necrosis and peritonitis can happen and lead to fetal or maternal mortality or morbidity. In this study, we present a challenging case of a 36-year-old pregnant women with severe abdominal pain and distension that emergently underwent surgery after the diagnosis of sigmoid volvulus without the gestation being discontinued. To our knowledge, our study presents one of the rarest cases of intestinal obstruction during pregnancy that was managed surgically without pregnancy termination. Further we will discuss intestinal obstruction in pregnancy based the current literature. Keywords: intestinal obstruction, volvulus, pregnancy, OB & GYN 0.2 Introduction Obstruction of the intestinal lumen is uncommon during pregnancy and is reported to happen from one in 1500 to one in 66,431 pregnancies (1). Since first described by Dr. Braun in 1885, Sigmoid volvulus is known as a common type of intestinal obstruction and is reported in 44% of pregnant cases with intestinal obstruction (2, 3). In the first, second, and third trimesters, sigmoid volvulus reportedly happened in 6%, 19%, and 54% of cases, and in 21% in the postpartum period (4). The most common causes of intestinal obstruction are adhesion, volvulus, intussusception, carcinoma, hernia and appendicitis (4). The clinical presentation during pregnancy might be obscure due to the physiological changes of maternal body, thus making quick diagnosis and timely management a challenge (5). With that being said, intestinal obstruction is a diagnosis that can be made when high amount of clinical suspicion is present or otherwise it will be missed and might lead to bowel ischemia, necrosis, perforation, peritonitis, sepsis, preterm labor and both fetal and maternal death (6). The decision to perform a radiological study (e.g. a CT scan in our case) is often not favorable during pregnancy due to the concerns for fetal radiation exposure. However, an abdominal contrast-enhanced CT scan which is available in most centers including ours, provides a definitive diagnosis in a short amount of time and determines the exact site of obstruction for further intervention (7, 8). The type of intervention and the decision to finish the pregnancy is dependent on the gestational age, clinical scenario, the extent of bowl ischemia and the viability of the fetus. In this study, we present a 36-year-old multiparous women in her 24th weeks’ gestation who was diagnosed with sigmoid volvulus after an oral contrast enhanced- abdominal CT scan and underwent a Hartman procedure emergently without the pregnancy being discontinued. 0.3 Case history/examination Our case was a 36-year-old multiparous women in her 24th weeks’ gestation who came to the emergency room of Mahdieh OB&GYN hospital, complaining of abdominal pain. The patient had an uneventful pregnancy until three days ago when she started feeling an abdominal pain and pressure which increased in severity day by day. She was unable to defecate and pass gas in the last three days. She has had visited several doctors for her constipation and received plenty of bisacodyl prescriptions which did not change her condition. She had given birth to four healthy kids and had no history of abortion or fetal death. The first two deliveries were performed vaginally but the last two children were delivered by cesarean section due to breech position and repeated cesarean, respectfully. Her last pregnancy dated back to 6 years ago. The patient did not receive any prenatal care during this pregnancy. Except for bisacodyl suppositories in the last three days, the patient was taking no medications other than routine supplements. She declared no past medical condition and no history of surgery other than the cesarean sections. 0.1 Abstract

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In eusocial insects, social parasitism - the exploitation of the host’s brood care behaviour for survival and reproduction – can occur either within or between species. Parasite queens invade host nests and aggressively replace the resident queen. While the adoption of conspecific queens is a common feature of species with multi-queen colonies (polygyny), the origin of parasitic founding is not fully understood. Functionally monogynous ants, in which nestmate queens establish social and reproductive hierarchies by biting and antennal boxing, might provide a link between peaceful adoption and social parasitism. In this study we aimed to evaluate whether alien queens might usurp colonies of the functionally monogynous ant Leptothorax gredleri. Ovary dissection of queens from 33 nests showed that multiple queens with developed ovaries can occasionally cooccur in the same nest. Genetic analysis highlighted frequent exchanges of the dominant queens. We evidenced that alien queens may take over reproduction, suggesting possible occurrences of intraspecific social parasitism in L. gredleri.

IntroductionEndometriosis was first described by Rokitansky in 1860. It refers to the appearance of endometrial tissue outside the uterine cavity. The incidence rate of endometriosis in women of childbearing age is about 10%–12%; in 5%–12% of cases, it may involve the intestines[1]. Colorectal endometriosis may lead to myriad symptoms, such as alteration in bowel habits (constipation/diarrhea), abdominal pain, dyspareunia (difficulty in sexual intercourse), and infertility [2], which have a significant impact on the quality of life of the patient. Due to the lack of specificity in clinical manifestations and related examinations (including endoscopy), the diagnosis of colorectal endometriosis poses a significant challenge to physicians [3]. This case was detected during colonoscopy examination. Previous reports have only rarely described the manifestations of this disease under colonoscopy. Here we report a case of colorectal endometriosis and review the relevant literature. By reviewing this case, we hope to increase awareness about the endoscopic manifestations of the lesion, which may improve chances of early diagnosis.

Over the past few decades, there was a remarkable attempt to broaden the technical application of natural/synthetic and cellulosic fiber-based polymer composites for modern use. These materials have received tremendous interest from engineers, manufacturers, and scientists to provide promising solutions to sophisticated engineering challenges and become the central subjects for environmentalists, researchers, and governments for great potential in various applications. The dynamic characteristics of manufactured fuel cells offer an excellent fortune in manufacturing multipurpose engineering materials for high-end use. Most researchers revolve around optimizing the properties of manufactured fuel cells, which are investigated. This work contributes to knowledge by critically highlighting the use of natural/synthetic and cellulosic materials in different applications and their recent progress in predicting their dynamic modifications for optimizing PEMFCs. The aspects of various designs, manufacturing processes, modeling, and optimization techniques employed for fuel cells are also critically reviewed. At the end, future challenges and trends in using advanced materials in fuel cell technology are illustrated. It can be argued that fuel cells made of cellulose are promising candidates for improved performance.