Surgical Management of Kartagener’s Syndrome with Bronchiectasis in a Paediatric Patient: A Case Report on Right Lower Lung Lobectomy in a 9-Year-Old Female.Pakeezah Tabasum1, Makhdooom Bilawal2, Priya Devi3, Waseem Sajjad4, Ali Raza Brohi5 , Mohammed Hammad Jaber Amin6Peoples University of Medical and Health Sciences for Women, Nawabshah, PakistanZiauddin University, Karachi, PakistanLiaqat University of Medical and Health Sciences, Jamshoro, PakistanKing Edward Medical University, Lahore, PakistanInstitute of Mother and Child Health, Nawabshah, PakistanAlzaiem Alazhari University, Khartoum, Sudan

Merging tetraphenylethylene (TPE) into cyclic skeletons endows fluorescent sensing capabilities for pillar[6]arenes aggregates, but results in losing their host–guest recognition function in dilute solutions. Inspired by natural enzymes, here we describe a series of TPE-based cyclo[6]arenes (termed TPz, TDz, and TTz) with endo-functionalized cavities containing inward-directed diazine motifs (pyrazine, pyridazine, and phthalazine) that act as hydrogen-bond acceptor sites. Combining electrostatic potential analysis and host–guest binding studies reveal that subtle variations in these diazine motifs substantially affect charge distribution and hydrogen-bond interactions within the internal microenvironment. These differences translate into disparate host–guest affinities, with TTz exhibiting the optimal performance. Unlike TPz which recognizes guests only in aggregate states, 1,2-diazine modified TDz and TTz possess dual-state recognition functionality. They enable size-selective binding for cationic guests in dilute solutions and sensitive fluorescence detection of nitrophenol pollutants in aggregate states through a photo-induced electron transfer-driven static quenching mechanism. This study underscores the potential of 1,2-diazine motifs as transformative hydrogen-bond acceptors for biomimetic host models with emergent properties.

Title: Update on H5N1 panzootic: fifty percent increase in mammal species infected over one yearRunning Title: Increasing H5N1 Infections in Mammals

This research proposes and evaluates the effectiveness of the Alpha-Logarithmic Power Transformed Exponential (ALPTE) distribution as a more general purpose, versatile lifetime distribution in comparison to conventional lifetime distributions. Bayesian and non-Bayesian estimation were studied along with some properties of the ALPTE model which were discussed. Mortality, Mobility, and Radiation datasets were analyzed and compared in a detailed manner. Data was evaluated using maximum likelihood estimation, descriptive statistics, and the goodness-of-fit tests such as AIC, BIC, CAIC, HQIC, KolmogorovâĂŞSmirnov, Anderson-Darling, CramÃľrâĂŞvon Mises and analyzed visually through model diagnostic plots such as boxplots, TTT plots, and PâĂŞP plots. The ALPTE model consistently demonstrated superior performance over the Gamma, Lognormal, Gumbel, Weibull, and Exponential models across all datasets. It is remarkable how the ALPTE model not only enhanced representation of light- and heavy-tailed phenomena but also exhibited robustness to outliers alongside multiplicity in failure patterns, including increases, decreases, or constant rates. Estimates of ALPTE remained robust and interpretable even in the presence of data heterogeneity, particularly in large sample sizes. Such claims of flexibility and versatility further highlights the adaptability of the ALPTE distribution.

Debates over whether and how populations are regulated have recently shifted away from detecting and instead towards quantifying the strength of density-dependence and its variation among systems. Yet, the degree of variation in density-dependent mortality and the factors driving this variation remain poorly understood. Here, we conducted a meta-analysis of 38 reef fish species across 56 studies, which yielded 147 estimates of intraspecific density-dependent mortality, primarily during early or small life stages. The magnitude of density-dependent mortality (the increase in the per capita mortality rate due to one fish per unit area of habitat) was surprisingly inconsistent both within and among species. Several factors emerged as drivers of variation. Predators amplified the negative effects of density, and density-dependent mortality was greater for species that typically colonize at low densities or achieve larger maximum size. However, even within a single species, the strength of density-dependent mortality varied dramatically — often by several orders of magnitude — and sometimes changed sign. This remarkable heterogeneity suggests that environmental variation might overshadow species-specific traits or that methodological variation among studies constrains our ability to perceive drivers. Our results underscore the need for future efforts to identify the factors that drive this variability in population regulation.

A document by Musie Negasi. Click on the document to view its contents.

Background: Leadless pacemakers are increasingly used due to their reduced risk of lead- and pocket-related complications. However, device dislodgment remains a rare but significant risk. Methods and Results We describe an 81-year-old man with bradycardia and atrial fibrillation who experienced intra-procedural Micra device dislodgment caused by inner shaft failure, resulting in

Staged Management of Traumatic Diaphragmatic Hernia with Open Abdomen: A Case Report on Successful Abdominal Wall Reconstruction

IntroductionPyogenic liver abscess (PLA) is a potentially life-threatening intra-abdominal infection. Although it was previously well associated with polymicrobial infections, like Escherichia coli and anaerobes, hypervirulent strains of Klebsiella pneumoniae (hvKp) have emerged in recent decades as dominant causative agents, particularly in East and Southeast Asia [1, 2]. These hypervirulent strains exhibit a hypermucoid phenotype, which is due to the capsular serotypes K1 and K2, and virulence factors such as rmpA, magA, and aerobactin. These factors allow them to enhance capsule production, assist in immune evasion, and iron acquisition, and therefore enable them to cause monomicrobial liver abscesses and disseminated infections even in healthy hosts [3].The clinical presentation of an hvKp liver abscess typically includes fever, right upper quadrant pain, nausea, and leukocytosis. Infections with this superbug are notable for their ability to cause metastatic complications such as endophthalmitis, meningitis, or septic pulmonary emboli [1, 4]. While endemic to South Asia, hvKp has increasingly been reported in Western countries and Europe, mostly in patients of Asian ethnicity or with Asian travel history. Over the past few decades, it has also been reported in non-Asian populations without travel history or identifiable risk factors [5].Diagnosis of PLA relies on abdominal imaging with an ultrasound or CT, which reveals unilocular or multiloculated liver lesions, often in the right hepatic lobe [4]. Confirmation is through blood or abscess culture, with the hypermucoid phenotype sometimes identified via the “string test,” where a colony stretched with a loop produces a viscous string >5 mm [5]. Polymerase Chain Reaction (PCR) can further detect molecular patterns of virulent genes such as rmpA and magA in specialized settings [5].Treatment requires prompt initiation of appropriate antibiotics, commonly third-generation cephalosporins, beta-lactam/beta-lactamase inhibitors, or carbapenems in severe cases [6]. Abscesses larger than 3–5 cm or with poor response to medical therapy may benefit from source control with image-guided percutaneous drainage. Based on the clinical and radiological response, treatment duration typically ranges from 4 to 6 weeks [7].Here we report two unique cases of the hypermucoid phenotype of Hypervirulent Klebsiella pneumoniae liver abscess in Caucasian individuals of American origin, in which one is a known diabetic with no history of international travel, Asian food consumption, or animal contact. These cases highlight the changing epidemiology of hvKp and the need for increased clinical vigilance even in immunocompetent populations previously considered low-risk.Case PresentationCase 1:

”Comorbidity of Attention Deficit Hyperactivity Disorder (ADHD) and Chung-Jansen Syndrome\RL: Case report and Review of Literature”Maedeh Khalili1 | Maryam Yousefi Fahadani2,3 | Reza Bidaki4| Zahra Talayi5*1Department of Biology, Faculty of Science, Arak University, Arak, Iran | 2Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | 3Department of Psychiatry, Research Development Center, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran |4Department of Psychiatry, Reserch Center of Addiction and Behavioral Sciences, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran |5Department of Biology, Faculty of Science, Arak University, Arak, Iran*Correspondence: Zahra Talayi (haniyeh9931@gmail.com)Funding: The authors received no specific funding for this work.Keywords: Chung-Jansen Syndrome, Attention Deficit Hyperactivity Disorder (ADHD), Genetic Comorbidity, PHIP Gene, CLCN4 Gene, Neurodevelopmental Disorders

This study presents a systematic investigation of the magnetic and structural properties of cerium-doped barium zirconate (BaZr₁₋ₓCeₓO₃, x = 0.005-0.04) perovskites synthesized via a microwave-assisted hydrothermal method. X-ray diffraction (XRD) confirmed the formation of a single-phase cubic perovskite structure for all doping levels. Field emission scanning electron microscopy (FE-SEM) revealed a consistent decaoctahedral morphology. Thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) indicate thermal stability and identified endothermic transitions associated with structural rearrangements. Electron paramagnetic resonance (EPR) spectroscopy was used to probe the magnetic behavior in the temperature range 90–670 K. Undoped BaZrO₃ exhibited a weak, temperature-dependent paramagnetic signal near g ≈ 2.00, attributed to oxygen vacancies. Upon cerium incorporation, notable changes in the resonance field and linewidth were observed, suggesting the emergence of defect-mediated magnetic interactions. Additional features, such as F-center-related signals and non-monotonic behavior at higher doping levels, point to the influence of cerium clustering and Ce³⁺/Ce⁴⁺ valence fluctuations. These findings highlight the role of structural defects and dopant chemistry in modulating the magnetic response of barium zirconate perovskites and support the design of new multifunctional materials through controlled doping strategies.

Melatonin has demonstrated antioxidant, anti-inflammatory, and potential antiviral properties. Its therapeutic role in critically ill COVID-19 patients admitted to intensive care was underexplored at the start of the pandemic. We conducted a quasi-experimental, pragmatic study over 4 consecutive uninterrupted time periods alternating control groups receiving standard of care (SoC) with treatment groups receiving SoC plus high-dose oral bedtime melatonin (50–200 mg) (OBM). The primary endpoint was 90-day mortality; secondary outcomes included sequential organ failure assessment (SOFA) scores at 4, 7, 14 and 30 days and pre-defined severe adverse events (SAEs). A total of 335 of 339 consecutive patients with a predicted stay >48 hours were enrolled; 202 received OBM with SoC and 133 received SoC alone. OBM was dispensed during the second (n=162) and fourth (n=40) study periods after the first (n=40) and third (n=93) control group periods, respectively. Melatonin therapy was associated with significantly lower 90-day mortality (20.8% vs 36.1%, OR 0.46, 95% CI 0.28-0.76). Subjects receiving melatonin had lower SOFA scores on day 4 and subsequent study visits. SAEs occurred in 84 (41.6%) subjects on OBM and in 80 (60.2%) receiving SoC (risk ratio 0.68, 95% CI 0.54-0.87; p=0.001). High-dose oral melatonin was safe and associated with improved clinical outcomes. Further evaluation of melatonin and its potential antiviral effects in future epidemics is warranted.

The internal volume of gastropod shells is a commonly measured metric in studies of hermit crab ecology, since it determines shell adequacy and subjective value. We developed and tested a computed tomography (CT) protocol to estimate shell volume as a method instead of water and sand. For this, we used shell gastropod species with different architectures and sizes, and compared the estimates obtained using this protocol (optimized CT = OCT) with traditional methods (water and sand) and with a CT previous setting (non-optimized CT = NOCT). Further, we compared the results obtained using proprietary software (attached to CT machine) with proprietary software (OsiriX MD). The results showed that for high-spired and highly ornamented shells, the OCT method gave equivalent estimates to the NOCT. In contrast, for low-spired and less ornamented shells, OCT provided higher estimates than NOCT, but similar to those obtained using the sand method. For specimens of varied sizes, the estimates were influenced by shell size for all methods. Large shells of the high-spired species showed high variability for all methods, while the less-spired evidenced lower variability for all size classes and methods. OsiriX MD software yielded equivalent estimates of volume to OCT for three of the five species tested and high reproducibility.

Tuberous Sclerosis Complex in association with Renal Cell Carcinoma and Extensive plaque psoriasis- A possible shared pathophysiology

Factors controlling plant photosynthesis and primary production include parameters dictating photosynthetic activity together with export and allocation properties. In fact, phloem loading activity as well as phloem sap redistribution and velocity are considered as important players in plant carbon acquisition. But surprisingly, there is almost no information about how phloem sap properties such as sugar concentration and velocity, are controlled by photosynthetic rate. Here, we carried out gas exchange experiments coupled to isotopic labelling on sunflower leaves to monitor photosynthate export rate when photosynthesis was varied with CO 2 mole fraction. We took advantage of a compartmental isotope model to obtain an experimental estimate of phloem sugar pool size and thus sap concentration and velocity. Phloem sugar concentration was found to increase relatively slowly (from very low values to about 1 mol L -1) with photosynthesis and export rate, while sap velocity remained in the same order of magnitude (0.2-0.6 mm s -1). This phenomenon could be explained using a simple one-dimensional model of phloem sap generation and movement suggesting that at fixed photosynthesis, phloem sap was in a steady-state reflecting the balance between xylem-to-phloem and sieve tube hydraulic conductance, turgor pressure and osmotic pressure due to loading. Our study also shows that phloem sap composition was not invariant with photosynthetic conditions but rather, adjusted to leaf export while maintaining sap flow even at very low CO 2.

A document by Sushmita Bhattarai. Click on the document to view its contents.

Cervical phrenic nerve schwannoma: A rare case reportKey clinical messagePhrenic nerve schwannomas in the neck are exceptionally rare and can present as asymptomatic lateral neck masses. Intraoperative nerve identification is critical for preservation of diaphragmatic function. Surgeons should include this rare entity in the differential diagnosis of cervical schwannomas to avoid misdiagnosis and inadvertent nerve injury.KeywordsNeck mass, phrenic schwannoma, Neck schwannoma

Urban environments provide a unique opportunity to investigate the impacts of novel stressors on organismal performance. Marine intertidal exist at the transition from sea to land, where they are exposed to a unique suite of stressors including those associated with wastewater outflow, sewage effluent and coastline development. While studies have shown that compounds found in wastewater, including endocrine disrupting chemicals (EDCs) can affect survival and development of marine organisms the mechanisms for those affects are relatively unknown. Our study investigates the developmental and transcriptomic responses to common EDC, nonylphenol, using the Pacific purple sea urchin (Strongylocentrotus purpuratus) as a model system. Beginning exposure prior to fertilization, we found that nonylphenol impacts only materialize 24 hours post fertilization when the embryonic transcriptome begins to be expressed. In addition, survival was lowest at the lowest concentration of nonylphenol. Transcriptomic patterns also varied by chemical concentration and developmental stage, with ribosomal genes differentially expressed among different levels of exposure at both early and later larval stages. We also find a strong parental effect survival, morphology, developmental abnormalities and gene expression vary among mate pairs despite all of the adult urchins coming from the same population. This potentially suggesting standing within-population variation, which may impact evolutionary responses to anthropogenic stress. Overall, our study finds that nonylphenol affects survival, morphology, and gene expression at early life history stages, and that more work needs to be done to understand intraspecific variation in those effects.