While protein medications are promising for treatment of cancer and autoimmune diseases, challenges persist in terms of development and injection stability of high-concentration formulations. Here, the extensional flow properties of protein-excipient solutions are examined via dripping-onto-substrate (DoS) extensional rheology, using a model ovalbumin protein (OVA) and biocompatible excipients polysorbate 20 (PS20) and 80 (PS80). Despite similar PS structures, differences in extensional flow are observed based on PS identity in two regimes: at moderate total solution concentrations where surface tension differences drive changes in extensional flow behavior, and at small PS:OVA ratios, which impacts the onset of weakly elastic behavior. Undesirable elasticity is observed in ultra-concentrated formulations, independent of PS identity; higher PS contents are required to observe these effects than with analogous polymeric excipient solutions. These studies reveal novel extensional flow behaviors in protein-excipient solutions, and provide a straightforward methodology for assessing the extensional flow stability of new protein-excipient formulations.

Evidence-based medicine has shown for many years that homozygous mutations of the HFE gene H63D are by no means negligible. Not only can it cause, usually after a second hit, rather mild classical hemochromatosis, but it can also cause numerous other disorders of iron metabolism, such as hypotransferrinemia, changes in binding capacity, and others. In addition, it may lead-among other symptoms-to damages of the heart and the substantia nigra via a causal relationship that remains to be investigated, most likely via a cascade dysfunction in iron metabolism. The clinical facts are compelling. Any physician who dismisses mutations of the HFE gene H63D as clinically irrelevant risks the health and life of his patient. Therefore all main researcher working on H63D Syndrome decided to raise awareness for the "iron brother" of Morbus Wilson by renaming H63D Syndrome.

Cardiac hypertrophy is an adaptive response to increased overload, which is induced by various physiological or pathological stimuli. It is a common pathological process of a variety of cardiovascular diseases, which eventually leads to heart failure. Several lines of evidence suggested that autophagy as a double-edged sword was involved in cardiac hypertrophy. Autophagy, with a typical feature of double-membrane vesicle called the autophagosome, is a highly conserved lysosomal degradation process and plays an important role in the regulation of diverse physiologic and pathologic processes. However, the exact mechanism underlying the role of autophagy in regulating cardiac hypertrophy remains largely unknown. Here, we comprehensively characterize the dual effects of autophagy in promoting or inhibiting cardiac hypertrophy under different conditions. Moreover, we summarize the potential therapeutic effects of autophagy modulators on pathological cardiac hypertrophy. Finally, we discuss the advantages and challenges of autophagic modulators for the therapy of pathological cardiac hypertrophy.

Background: Head and neck cancer (HNC) have a considerable mortality and morbidity rate. Surgery is one of the most effective treatments, however it may compromise the independence of patients after its performance. The Rehabilitation Nurse (RN) intervention is essential for recovery. Objective: To compare the dependence degree between patients who underwent RN intervention versus general health care after HNC surgery. Methods: Patients submitted to different types of HNC surgery, were divided into two groups intervention by the RN versus general health care, the outcome was the Barthel Index Discharge categorized as dichotomic to assess the patient independence at discharge and their differences calculated by statistical analysis. To analyze the effect of the RN intervention on dependence, a Poisson regression model was used, adjusting the confounding factors Initial Barthel Index and Age in the variable Barthel Index Discharge>91. Results: In middle/late postoperative period, in the group with RN intervention (n=79) the hospitalization time was reduced by 4.29 days versus general health care (n=72). At discharge, the Barthel Index (p<0.005) improved significantly in the RN intervention group compared to the general health care group. The intervention of the RN after surgery had a positive effect on the functional capacity of the patients, after adjusting the confounding factors (RR:1.47; 95%CI[1.02; 2.12]). Conclusion: The RN intervention is an added value in the independence of the patient submitted to HNC surgery. It is an innovative study in patient after diagnosis HNC, showing that intervention of RN through rehabilitation programs allows independence after his surgery. 5 succinct Key points: Independence of the patient submitted to HNC surgery; early rehabilitation in postoperative period; rehabilitation nursing programs; self-care optimization; regression model.

Objectives To assess the efficacy and implementation of an epistaxis symptom diary in the management of a child with de-novo HHT type 1. HHT is a cause of chronic, severe epistaxis which can lead to significant physical and psychogical morbidity. We propose that the use of symptom diaries can reduce associated patient morbidity and aid physicians in treatment planning. Participants We discuss an independently developed symptom diary for a 10-year-old girl with HHT, Patient x (“xxx”), and its subsequent impact. Including its uses for surgical and medical treatment planning. Design A patient developed epistaxis symptom diary was designed to including nosebleed timing and side of onset, estimated severity, exacerbating / trigger factors and use of medications. A phenomenological qualitative approach was taken to assessing the impact of the diary on “xxx’s” physical and psychological wellbeing. Setting “xxx’s” diary is a novel symptom diary for patients with of chronic epistaxis and HHT which can improve patient engagement with treatment, foster lifestyle changes, and aid clinicians in promoting tailored patient-centred care. Main outcome measures “xxx’s” diary has proved to be an extremely useful tool for patient xxx, her parents and her ENT team, having improved both her physical and psychological wellbeing. Results and Conclusions We would recommend detailed symptom monitoring for all patients with severe epistaxis and HHT and suggest “xxx’s” diary as a template for this.

A supravesical hernia (SH) is a rare abdominal wall hernia that develops at the supravesical fossa. Their clinical manifestation is often an intestinal obstruction. Their diagnosis is difficult but computed tomography (CT) appearance and familiarity with the anatomy of the supravesical fossa may allow the preoperative diagnosis.

A 51-year-old woman with stump pain was hospitalized in our department. After discussion with our medical team, a spinal cord stimulation treatment plan was developed. The operation went smoothly. After 12 mo of follow-up, the pain was significantly relieved and good results were achieved.

Considering that the correct quantification of fatigue damage involves two load parameters, the available load ratio data on polymeric materials are analyzed. It is shown that crack growth can be characterized by two parameters, ΔK and K max, without the need for any crack closure concept. The crack growth rates, starting from the threshold can be represented by the L-shaped curves in the ΔK-K max plane defining two limiting variables, ΔK* and K max*. Crack growth trajectory maps for various materials are developed by plotting ΔK* versus K max*, as a function of crack growth rate. The trajectory defines the crack growth resistance curve providing a measure of material resistance to increasing crack tip driving forces.

Background: Exogenous lipoid pneumonia(ELP) is a rare disease caused by the inhalation of oily materials in the alveoli with the pathological characterization by the presence of laden-lipid macrophages in the respiratory specimens. At present, the treatment norm for ELP has not well defined, and so the aim of this study is to evaluate the effect of bronchoalveolar lavage in combination with glucocorticoids on children with ELP. Methods and Materials: We retrospectively reviewed 17 children with a confirmed history of exogenous oily materials aspiration, admitted to the First Affiliated Hospital of Guangzhou Medical University from June 2012 to December 2021. Clinical features, blood investigations, tomographic evaluations, therapeutic bronchoalveolar lavage and glucocorticoids use were carried out at the beginning of therapy and throughout a follow-up period. Results: The included children are the median age of 2 years. Fever, dypnea and tachypnea were the most common symptoms. The most common radiological features were airspace consolidations(15, 93.75%). Chest CT scans showed areas of consolidation with air bronchogram(15, 93.75%), Poorly defined centrilobular nodules(13, 81.25%), areas of ground-glass attenuation(11, 68.75%), and ‘crazy-paving’ pattern(6, 37.5%) in the both lower, right middle lung lobes. Neutrophil percentage of peripheral blood and bronchoalveolar lavage fluid exhibited a significantly higher than the normal range. After treatment with multiple bronchoalveolar lavages and local administration of budesonide during the hospital stay, taken by oral prednisolone(1~2mg/kg) after discharge,all of children became asymptomatic and presented normal radiological imagings in the follow-up period. Conclusion:The most frequently findings in the CT scan of ELP were consolidations and ground-glass attenuation in the both lower and right middle lung lobes.Multiple bronchoalveolar lavages in combination with oral prednisolone for children who had a confirmed history of exogenous oily substances ingestion was an efficient and safe for the clearance of oily materials from the lung and the prevention of fibrosis. This strategy contributed to reducing the damage of ELP in children patients.

Background: Noninvasive ventilation for newborns has become the preferred mode of treatment for respiratory diseases. Objectives: This meta-analysis evaluated and compared the efficacy and safety of noninvasive high-frequency oscillatory ventilation (NHFOV) and nasal intermittent positive-pressure ventilation (NIPPV) for use with newborns. Study design: We searched the PubMed, Cochrane Library, EMBASE, Web of Science,CNKI, Wanfang and VIP databases from inception to April 1, 2022. Randomized controlled trials (RCTs) and cohort studies that evaluated and compared the effectiveness of NHFOV and NIPPV in newborns were included in the review and meta-analysis, which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Results: Twenty-three articles involving 2,924 patients were included. Compared to NIPPV, NHFOV showed a significantly greater reduction in the intubation rates in initial respiratory support and in the reintubation rate without time limit. While reintubation rates within 72 h and 7 days of post-extubation respiratory support were similar. Significant decreases in the duration of non-invasive ventilation and length of hospital stay were observed with NHOFV, which also: reduced PaCO2 levels, enhanced PaO2 levels and the SpO2/FiO2 ratio at 1 h and 24 h after non-invasive respiratory support; and significantly reduced the risk of bronchopulmonary dysplasia and apnea. Conclusions: Compared to NIPPV, NHFOV is a safer and more effective neonatal respiratory support modality. The potential benefits of NHFOV as a mode of respiratory support for very low birth weight or extremely preterm infants should be investigated in larger trials.

Recurrent respiratory papillomatosis (RRP) is the most common benign pediatric laryngeal neoplasm. Various adjuvant medical therapies have failed to reliably decrease surgical frequency in this challenging airway disease. Recently, systemic bevacizumab has shown promise in advanced, treatment-resistant papillomatosis. We describe the use of systemic bevacizumab in two children with severe RRP unresponsive to other therapies. Voice and breathing improved dramatically in both patients with minimal side effects. Both patients have not required surgery in 23 months and 15 months, respectively. Systemic bevacizumab is a promising long-term treatment for severe RRP, with oncology playing an important role in patient care.

Background: Pollen-allergy is common in Austria. The present study investigated if the use of major pollen-allergens on top of extract-based diagnosis may improve the diagnostic accuracy and if this additional knowledge helps to identify patients eligible for allergen-specific immunotherapy (AIT). Methods: In this retrospective database analysis patients sensitized to a grass, birch, ash-tree, mugwort or ragweed were investigated and results of pollen extracts compared to the respective major allergens (Phl p 1, Bet v 1, Ole e 1, Art v 1, Amb a 1) were assessed. Furthermore, extract- and MD- results of patients double-sensitized to both tree-extracts or both weed-extracts were compared. In patients with discrepant results, their charts were reviewed to define if this difference was clinically relevant in regard to their doctors´ AIT-decision. Results: 4234 patients (age 1.2-89.7yrs) could be included in the analyses. There was high agreement between extract-based IgE results and major allergens concerning single-sensitization to grass/Phl p 1+5 (94.4%), birch/Bet v 1 (94.4%), and ash-tree/Ole e 1 (82.9%), with lower agreement between mugwort/Art v 1 (64.1%) and ragweed/Amb a 1 (73.8%). Among patients double-sensitized to both tree pollen extracts only 76% were also sensitized to both major allergens (Bet v 1 and Ole e 1) and therefore suitable for AIT. In patients double-sensitized to both weeds, only 25% were also sensitized to both major allergens (Art v 1 and Amb a 1), 46.2% of mugwort extract positive patients tested negative for Art v 1. Of these patients, 41.3% were recommended a ragweed AIT as their Amb a 1 results were positive. Conclusion: MD can improve diagnostic accuracy in patients with pollen-allergy and should be implemented in standard clinical care, especially when double-sensitization to allergens of plants with overlapping pollen seasons cannot be clearly discerned by patients´ symptoms alone.

Vortex rock weirs (VRW) are often used in natural channel design applications to maintain channel form and function, provide physical channel stability, and contribute to habitat enhancement. A balanced approach is required to achieve conflicting goals of VRWs, which include providing erosion protection while allowing fish passage under various water level conditions. This research evaluated a sequence of asymmetrical rock weirs with 3-dimensional flow. Field assessments completed between June and September 2018 monitored water level, water temperature, and surveyed channel features at 10 rock weirs and 11 adjacent pools under different water level conditions. The structural dimensions and local velocity at each rock weir were compared to the swimming characteristics of local fish species to determine fish ‘passability’ and suggest best practices for rock weir design and construction. Results concluded fish passage occurs through gap and over-weir flow pathways and was most effective under low water level conditions. Further, appropriate design considerations based on rock weir gradient, rock weir width, keystone size, and pool length contributed to 100% fish passage effectiveness under all water level conditions. To address conflicting goals and the impact on fish passage for small-bodied fish species, methodology is provided for predicting local velocity and fish passage effectiveness through rock weir systems, inform best practices for rock weir design and construction while balancing the requirements for channel stability and fish passage, and contribute to fish population management strategies.

Objective Studies have shown that chronobiological factors may adversely affect glycemic control in patients with type 2 diabetes mellitus (T2DM). Our objective was to assess the association of chronobiological disorders with glycemic control and neonatal birthweight in women with GDM. Design A prospective observational study was conducted. Setting Israel Population 208 women aged 18-45 years with a singleton pregnancy who were randomly selected from among women undergoing follow-up for GDM at the Maternal-Fetal Medicine Unit of a tertiary medical center in 2016 and 2017. Methods Nutrition, sleep, and lifestyle patterns were assessed from onset of GDM until birth along with glycemic control and obstetrical outcomes. Data were collected by structured interview and from the medical files. Main outcome measures Maternal glycemic control and large for gestational age (LGA) neonate. Results Multivariate analyses on a cohort of 208 women revealed suboptimal glycemic control which was associated with a late breakfast (RR=2.26; 95% CI 1.09-4.67). Any 10-g increase in carbohydrate intake in the evening increased the risk 1.19 times for suboptimal glycemic control (RR=1.19; 95% CI 1.003-1.42), and 2.14 times for poor sleep quality (RR=2.14; 95% CI 1.04-4.41). The adjusted relative risk for birthweight above the 85th percentile was associated with excessive of 10-g increase of carbohydrate intake in the morning (RR=1.70; 95%CI 1.30-2.23) and in the evening (RR=1.39; 95% CI 1.16-1.67). Conclusions Chronobiological disorders are associated with suboptimal glycemic control and large-for-gestational-age newborn in women with GDM.

This paper highlights the impact of curved and flat vehicular plastic parts on the radiation characteristics of two dual-band antennas for C-V2X applications. The radiation patterns of the antennas are measured in SATIMO near field measurement system and are compared during the following setups: (a) antennas alone in the near field system, without the presence of a plastic part; (b) antennas mounted on the inside curved surface of a driver’s side mirror cover; (c) antennas mounted on the outside curved surface of the driver’s side mirror cover; (d) antennas mounted on a flat trunk lid; (e) antennas mounted on a curved plastic retrieved from the A-pillar of a vehicle. Comparison among the antennas radiation pattern measurements during these different setups, results in the conclusion that the inside surface of the side mirror cover is the most suitable position to mount the presented dual-band antennas. The curvature of the inside surface at the point where the antenna was mounted is less steep than the placement point at the outside surface, allowing the antenna to keep its polarization axis mostly unaffected. Moreover, the curve of the inside surface makes the antenna radiation more directional, creating an increase in the antenna gain. The side mirror cover, compared to trunk lid, is further from the ground protecting the antenna radiation from additional reflections.

A convex regularized variable-forgetting-factor recursive least squares algorithm (CR-VFFRLS) is proposed for sparse system identification, in which the variable-forgetting-factor is deduced by minimizing the convex regularized cost function via the gradient descent method. It overcomes the drawback that the fast-tracking ability with the high steady-state error or the low steady-state error with slow tracking ability, which is ineluctable in the fixed forgetting-factor RLS algorithm. Simulation results demonstrate the superiorities of the proposed algorithm to the CR-RLS and VFFRLS algorithm.

In this letter a smart parking application based on Internet of things paradigm have been demonstrated. The application that uses PlacePod sensors, LoRaWan network and an Android mobile app is implemented at University car parking to deliver real-time services to drivers. The feasibility and soundness of the theoretical concept underpinning the developed parking app is demonstrated through a set of testing experiment. The approach further contributes to mining user's behavior when dealing with car parking, providing insights to urban planners and policy-makers to adapt their strategies accordingly by taking into account user's feedback and actions.

Evaluating the feeding interaction of fishes is fundamental in understanding the impacts of introduced species on the community structure and ecosystem function of native species. In the Zambian Rivers, studies have shown that native species has been impacted upon by exotic Oreochromis niloticus, but few studies have investigated feeding interactions between exotic Oreochromis niloticus which is omnivorous and aquaculture preferred herbivorous native species (Coptodon rendalli) in the natural distribution. We analysed the stomach contents of 368 specimens of the fishes to examine the feeding interactions between O. niloticus and C. rendalli in the upper Kabompo River, northwest of Zambia. Both species were grouped into size classes of <50, 51−100 and 101−150 mm total length (TL). However, in the size classes 51-100 mm and 151-100 mm O. niloticus had a larger dietary niche because of its generalist diet than the native species, whose diet mainly comprised of diatoms and algae. There was no significant ontogenetic diet shift for both species, except for O. niloticus in size class 101-150 mm, whose diet consisted mainly of zooplanktons and micro fauna. The results showed an interspecific competition in their size classes, except for 101-150 mm size class, that indicated low dietary overlap. This poses major impacts on food web structure and may explain population decreases of some native species in the upper Kabompo River. Future studies are required to further understand feeding interaction between the exotic and other native fishes in the Kabompo River and other rivers across African where the species coexist.

It has been 60 years since the invention of the caged ball mechanical heart valve prosthesis. Since then, it has undergone modifications and transformations. Starr Edwards has been the pioneer valve, which was eliminated from the clinical practice in the late 2000s. Numerous reports of Starr Edwards reaching 50 years or near are emerging from different parts of the world. The article discusses the potential advantages, the author's observations and review of literature about the thrombogenicity, pannus formation, left ventricular outflow tract obstructions, and infective endocarditis in the Starr Edwards valves, which were reportedly higher before its clinical ending, was only an overestimation and not supported by scientific data, though it was less. The bulky size and unattractive protruding shape were the primary causes of its elimination. Numerous successful implantations in Asian countries were observed, and observations of less primary failures and sudden cardiac deaths with these valves. Hence, there is a need for large data collections and documentation about these valves for a potential revival of use, especially when long-term durability is contemplated.

The current scenario for the quest of microneedles (MNs) about the property of biodegradability and biocompatibility is the thrust area of interest. Microneedles are considered to be robust and can penetrate into the skin’s innermost layers are easy to manufacture and their applications in the clinical perspectives are still ongoing and ever-increasing day by day. This review paper clearly focuses upon some of the pivotal variants of polymeric microneedles namely the dissolvable and swelling-based MNs. It further explores into the drug dissolution kinetics, insertion behavior mechanisms with an emphasis on the need for mathematical modeling of MN. This review further evaluates on the fabrication methods with updates the advances in the fabrication of polymeric MNs, the choice of materials used for fabrication, the challenges in polymeric MN fabrication, the prospects of polymeric MNs with its applications in healthcare by exclusively focusing on the available literature over the erstwhile decade.

Well-facilitied capital farmland construction is an important measure to enhance the ability to ensure food security and accelerate new-style the modernization agriculture. Hyperspectral remote sensing can be provide data basis and technical support for realization the construction of well-facilitied capital farmland，to provide a reference for exploring the optimization of well-facilitied capital farmland construction area. Taking Xinzheng City of main grain producing areas in Henan province as the research object, using field sampling and indoor hyperspectral spectroscopy (350~2500 nm) combined, the spectral transformations such as Continuum removal（ CR） are carried out after the Savitzky-Golay（ SG） convolution smoothing, the best hyperspectral bands as the common index of the soil properties were selected by the correlation analysis and Fuzzy clustering maximum tree，focused on 405~431nm、781nm~831nm、1044~1087nm、1251~1410nm、1836~1898nm、2080nm~2201nm、2324~2395nm. The hyperspectral inversion model had been built by Panel date model of fixed effect variable coefficient based on the ordinary least squares estimation method ( OLS), that is about the panel data of PH、SOM、AN、AP、AK、Fe、Cr、Cd、Zn、Cu、Pb of 116 samples in Xinzheng City. The results showed that: The Panel date model significantly overall, the goodness of fit is higher (in the model, 2 =0.9991， F = 2195.67）. The result of precision test indicates that models performed well in modeling and predicting with a good ability of quantificational prediction, with RPD values were greater than 2.5.

Nutrients are a critical driver of ecological interactions (e.g., plant-herbivore, predator-prey and host-parasite) but are not yet integrated into ecological networks. Ecological concepts like nutrient-specific foraging and nutrient-dependent functional responses provide invaluable mechanistic context to complex ecological interactions. These concepts in turn offer an opportunity to predict dynamic network processes such as interaction rewiring and cascading extinction events. Here, we propose the concept of nutritional networks. By integrating nutritional data into ecological networks, we envisage significant advances to our understanding of ecological dynamics at every scale from individuals to ecosystems. We summarise the potential influence of nutrients on the structure and complexity of ecological networks, with specific reference to niche partitioning, predator-prey dynamics, spatiotemporal patterns and robustness. Using an empirical example of an inter-specific trophic network, we show that networks can be constructed with nutritional data to disentangle the drivers of ecological interactions in natural systems. Throughout, we identify fundamental ecological hypotheses that can be explored in a nutritional network context, and highlight methodological frameworks to facilitate their operationalisation.

Global emergence and re-emergence of Porcine epidemic diarrhea virus (PEDV), an Alphacoronavirus which causes a highly contagious enteric disease, have led to several studies addressing its variability. The aim of this study was to characterize the infection of weaned pigs with Swine enteric coronavirus (SeCoV) -a chimeric virus most likely originated from a recombination event between PEDV and Transmissible gastroenteritis virus, or its mutant Porcine respiratory coronavirus-, and two PEDV G1b variants, including a recently described recombinant PEDV-SeCoV (rPEDV-SeCoV), as well as to determine the degree of cross-protection achieved against the rPEDV-SeCoV. For this purpose, forty-eight 4-week-old weaned pigs were randomly allocated into four groups of 12 animals; piglets in groups B, C and D were orally inoculated with a PEDV variant (B and D) or SeCoV (C), while piglets in group A were mock inoculated and maintained as controls. At day 20 post-infection all groups were exposed to rPEDV-SeCoV; thus, group D was subjected to a homologous re-challenge, groups B and C to a heterologous re-challenge (PEDV/rPEDV-SeCoV and SeCoV/rPEDV-SeCoV, respectively) and group A was primary challenged (-/rPEDV-SeCoV). Clinical signs, viral shedding, microscopic lesions and specific humoral and cellular immune responses (IgG, IgA, neutralizing antibodies and IgA and IFN-γ-secreting cells) were monitored. After primo-infection all three viral strains induced an undistinguishable mild-to-moderate clinical disease with diarrhea as the main sign and villus shortening lesions in the small intestine. In homologous re-challenged pigs, no clinical signs or lesions were observed, and viral shedding was only detected in a single animal. This fact may be explained by the significant high level of rPEDV-SeCoV-specific neutralizing antibodies found in these pigs before the challenge. In contrast, prior exposition to a different PEDV G1b variant or SeCoV only provided partial cross-protection, allowing rPEDV-SeCoV replication and shedding in feces.

Xenotransplantation with porcine organs has been recognized as a promising solution to alleviate the shortage of organs for human transplantation. Porcine endogenous retrovirus (PERV), whose proviral DNAs are buried in the genome of all pig breeds, is a main microbiological risk for xenotransplantation. Over the last decades, some advances on PERVs’ study have been achieved. Here we reviewed the current progress of PERVs including the classification, molecular structure, regulation , function in immune system and potential risk in xenotransplantation. We also discussed the problem of insufficient research on PERVs as well as the questions need to be answered in the future work.