Orf is an acute and highly contracted human and animal infection caused by orf virus (ORFV), which mainly affects sheep and goats, especially young animals, who have close contact with sick animals. Clinically, in secondary infection cases of orf, opportunistic or conditional pathogens such as Staphylococcus aureus (S. aureus) are often detected. The S. aureus TRAP gene product is reportedly protective against bacterial infection. For joint control of ORFV and S. aureus, the research direction of delivering a TRAP gene vaccine against S. aureus infection using the ORFV live vector is proposed. Here, we used CRISPR/Cas9 technology to edit vascular endothelial growth factor E of ORFV (VEGF-V) and introduced the TRAP gene of S. aureus into the terminus of the ORFV genome to promote TRAP expression in infected keratinocytes. The construction and experimental verification of recombinant ORFV (ORFV-V/TRAP) will provide a reference for in-depth studies on the prevention and control of orf and S. aureus disease.

Background. A staged thoracotomy unifocalization approach has not been the dominant option over the past 20 years primarily due to the introduction of midline one-stage complete unifocalization. Methods. In this issue of the Journal of Cardiac Surgery, van de Woestijne and colleagues publish their experience over the past 30 years in 39 consecutive patients with “consistent” staged unifocalization through a lateral thoracotomy in patients with pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries (PA/VSD/MAPCA). Results. They report definitive repair completion in 76.3% of the patients and an overall survival after definitive repair of 96% at 20 years despite the study period ranging from 1989 to the present. Conclusion. Given the multiple variations one could have with PA/VSD/MPACA, a midline unifocalization approach may not always be possible. Surgeons should be familiar with the lateral thoracotomy unifocalization staged approach to PA/VSD/MAPCA.

Aim: Post-operative bleeding remains a significant risk after cardiac surgery. Despite adequate protamine reversal of heparin intraoperatively, protein-bound heparin causes anticoagulant effect, leading to bleeding in the post-operative period. The aim of this study is to whether the use of a four-hour, low dose protamine infusion in intensive care would reduce post-operative bleeding and hence, blood transfusion requirements. Methods: A retrospective cohort study of seven hundred and two patients, who underwent elective or urgent coronary artery bypass grafting from April 2014 and January 2017, were divided into two groups based on who received post-operative protamine infusion (Group A, 472 patients) versus those who did not (Group B, 230 patients). They were assessed for amount of post-operative mediastinal and pleural drainage for the first 24 hours, use of post-operative transfusion of blood products, postoperative hospital stay, and re-exploration. Results: We found no significant difference between the rate of bleeding in either of the groups. No significant difference was observed in blood product requirements as well. In the sub-group consisting of patients with high BMI (BMI ≥30), who received protamine infusion, post-operative platelets transfusion was found to be significantly less. Conclusions: Our results suggest that a low dose protamine infusion given in the immediate postoperative period does not lead to any significant clinical benefits. Both patients receiving and not receiving the infusion had similar postoperative drainage, transfusion requirements, haemorrhagic morbidity, mortality and length of hospital stay.

We provide a new lower bound for the life span of solutions to the Kirchhoff equation for which the initial data belongs to the Gevrey space. This lower bound strictly improves the classical one in the case when the frequency spectrum of the initial data is concentrated at the origin.

ABSTRACT Background: Obstetrical complications involving uteroplacental insufficiency associated disorders, such as preeclampsia, intrauterine growth restriction, and obstetric antiphospholipid syndrome, share pathophysiology and risk factors with cardiovascular diseases treated with statins. Objective: To evaluate associations of statin treatment with pregnancy prolongation, and neonatal and maternal morbidity, among women with uteroplacental insufficiency disorders. Search Strategy: Electronic databases including PubMed, Medline, Embase, Clinical Trials Registry Clinicaltrials.gov, and The Cochrane Library were searched from inception to January 2022. Selection Criteria: Cohort studies and randomized controlled trials (RCTs) Data collection and analysis: Pooled odds ratios were calculated using a random-effects model; meta-regression was utilized when applicable. Main Results: The analysis included ten studies describing 1391 women with uteroplacental insufficiency-associated disorders: 703 treated with pravastatin and 688 not treated with statins. Women who received pravastatin showed significant prolongation of pregnancy (mean difference 0.44 weeks, 95%CI:0.01-0.87, p=0.04, I2=96%) and less neonatal critical care unit admission (OR=0.42, 95%CI: 0.23-0.75, p=0.004, I2=25%). Trends were observed toward a decrease in preeclampsia diagnoses (OR=0.51, 95%CI:0.25–105, p=0.07, I=44%), and perinatal death (OR=0.32, 95%CI:0.09-1.13, p=0.08, I2=54%) and an increase in birth weight (mean difference=102 grams, 95%CI: -14–212, p=0.08, I2=96%). A meta-regression analysis revealed associations between earlier gestational age at initiation of pravastatin treatment to lower risk for development of preeclampsia (R2=1) and between longer duration of pravastatin treatment to lower rate of NICU admission (R2=0.33). No dose-response effect was demonstrated. Conclusions: Pravastatin treatment in pregnancies with high risk for developing uteroplacental insufficiency disorders may prolong pregnancy duration and improve neonatal outcomes.

Objective: Through clinical studies and animal experiments, we explored the expression of BRD4 in patients with NVAF and its role in the postoperative recurrence and occurrence of atrial fibrosis. Methods: 74 patients with NVAF and 73 patients with PSVT were included. The BRD4 levels of the patients were measured. Thirty-Six Sprague Dawley(SD) rats were randomly divided into three groups. The incidence and duration of AF in each group were recorded. Masson’s trichrome staining was performed. Western blot was used to detect the expression of BRD4, TGF-β1, P-Smad2/3, Smad2/3, Smad7, Cx43, and type III collagen in each group. Results: The BRD4 levels were significantly higher in patients with AF than those of PSVT,especially in patients with persistent AF and postoperative recurrence of AF and AF with left atrial low voltage( P < 0.05). The collagen volume fraction and average induced rate of AF and average duration of AF and levels of BRD4, TGF-β1, P-Smad2/3, Smad2/3, and type III collagen were significantly highest in the AF + CTL group than those of the CTL group and AF + JQ-1 group( P < 0.05). Conclusions: BRD4 was correlated with AF and atrial fibrosis. Inhibition of BRD4 expression significantly improved the degree of left atrial fibrosis in rats with AF and reduced the incidence of AF and the duration of AF. BRD4 may be involved in atrial fibrosis and remodeling through the TGF-β1/Smad signaling pathway, thus participating in the occurrence and maintenance of AF.

Background and Aims Land abandonment and selective farming are two common management methods to restore the soil conditions of low pollution farmland in mining areas. The soil microbial community plays an important role in farmland soil restoration, however, few studies have compared the composition and diversity of soil microorganisms between the abandoned farmlands (AFS) and selective-farming farmlands (FFS). Here, the effects of AFS and FFS on soil properties and microbial diversity were evaluated in an antimony (Sb) mining area in southern China. This study aimed to identify effective land management methods in terms of positive or negative changes in soil environment and bacterial diversity. Results Due to the influence of long-term fertilization, the nutritional properties (e.g., available N, P, and K) of soil in FFS were significantly improved and the microbial alpha diversity including Chao1 index, Simpson index, Shannon index, and Pielou-e index significantly increased, compared to AFS. At the phylum level, FFS had higher relative abundances of Chloroflexi, Acidobacteria, Gemmatimonadetes, and Rokubacteria, and lower relative abundances of Firmicutes, Actinobacteria, and Bacteroidetes. At the genus level, FFS had higher relative abundances of Acidothermus, Haliangium, and Rokubacteriales, and lower relative abundances of Bacillus, Rhodococcus, Sphingomonas, and 67-14. Redundancy analysis indicated that soil heavy metal content and soil fertility were closely correlated with the soil microbial community. Altogether, selective farming of low pollution farmland in the mining area can improve soil properties and soil microbial diversity.

Lamin A/C Mutations are important to recognized for therapeutic and prognostic reasons. We present the clinical cases of two sisters with Lamin A mutation presenting with complex atrial arrhythmias, atrioventricular block and ventricular arrhythmias, associated with ventricular noncompaction and abnormal pulmonary vein anatomy. The successful treatment of complex irregular atrial arrhythmias by the use of noncontact dipole density mapping and radiofrequency ablation (RFA) is described in both sisters with long-term follow up results.

Objectives: To design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis (COS), named CSOC and assess its reliability, validity and feasibility. Design: A prospective, multicentre, observational study Settings: Salivary Gland Disorder and Sialendoscopy Unit, University Tertiary Hospital. Participants: Patients with diagnosis of COS and indication for sialendoscopy were included in the study. Main outcome measures: The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument and the construct validity was tested in 120 patients. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed. Results: All the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5 minutes for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94 respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.6 and 7.98 for pre and postsialendoscopy Conclusions: The CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in COS. Keywords: sialadenitis, QOL, questionnaire, validation, sialendoscopy

A series of cyclometalated platinum(II) complexes with aromatic ligands, such as pyridyl, pyrimidinyl and pyrazolate, were investigated with theoretical calculations. To investigate the relationship between ligands with molecular orbital, molecular rigidity, electroluminescent properties and spectroscopic properties, the electrostatic potential (ESP), density-of-states (DOS), root mean squared displacement (RMSD) were calculated. On the basis of calculated absorption and phosphorescence data, the analysis of “hole” and “electron” have also been performed. From the RMSD calculations, complex 3 shows significant structural distortions on S1 state and it may be applied in thermal activation delayed fluorescence (TADF) materials. The electroluminescent properties calculations show that complex 1 is suitable for hole transport material and complex 4 can be applied in electron transport material.

The RV is considered “the forgotten side of the heart”; however, limited studies have focused on its evaluation . The RV helps manage various cardiovascular diseases. Its function is a strong determinant of the prognosis for patients with congenital heart defects, ischemic heart disease, pulmonary arterial hypertension, congestive heart failure, and cardiomyopathy. Therefore, its function should be assessed accurately. Although cardiac magnetic resonance imaging remains the gold standard for the noninvasive measurements of RV size and function, it is time-consuming, expensive, and sometimes not feasible in everyday clinical practice. Echocardiography is the first and the only method used frequently for RV evaluation because of its availability and cost-effectiveness. The complex anatomy of the RV and its trabeculated myocardium that impedes clear endocardial border tracing, unfavorable position within the thoracic cavity, and high dependence on the loading conditions of traditional RV systolic function indices make the echocardiographic analysis of the RV somewhat challenging. The RV primarily helps pump blood coming from the systemic venous system to the pulmonary trunk. The first parts to contract are the inlet and trabeculated myocardium, and, after 25–50 ms, the conus contracts. The RV functions as a high-volume, low-pressure pump; the contraction of predominantly longitudinal fibers as well as afterload and preload influence the RV’s performance. In addition, RV systolic synchrony, atrioventricular synchrony, and ventricular interdependence. A previous study has reported that 20%–40% of the RV volume outflow and systolic pressure is caused by the contraction of the left ventricle (LV). RV dyssynchrony potentially reduces the cardiac output or increases the filling pressure. Thus, maintaining the sinus rhythm and atrioventricular synchrony is crucial for the performance of the RV, particularly in the case of chronic RV failure and acute RV infarction. The current guidelines for cardiac chamber quantification suggest sonographers to use multiple acoustic windows to precisely observe the right heart from various perspectives. Because no single index of contractility that perfectly describes RV performance exists, various parameters need to be measured. In the clinical practice, the most common and feasible indices that can be used to evaluate the RV systolic function are Doppler tissue imaging, tricuspid annular plane systolic excursion (TAPSE), derived tricuspid lateral annular systolic velocity (S′ wave), and fractional area change (FAC).

Tetralogy of Fallot (TOF) is a common cyanotic congenital heart disease. Its surgical correction requires ventricular septal defect (VSD) closure and right ventricular outflow tract obstruction (RVOTO) relief, with transannular patch enlargement (TAPE) of the pulmonary valve. The first successful repair of TOF was reported in 1954 and consisted of closure of the VSD through a large right ventriculotomy, and RVOTO relief with TAPE of the pulmonary valve. To predict the intra-operative requirements and post-operative course of patients with this condition, various evaluation indices are available that can provide a good indication of patient prognosis. In this case report, we describe a novel pulmonary vein index (PVI) indicator that offers prognostic indications for pediatric cardiac patients who have undergone surgical correction of TOF.

Dental trauma in children are common occurences.Avulsion of anterior teeth due to trauma is seen in both primary and young permanent teeth.The standard protol for avulsion in permanent teeth is immediate replantation but many a times its not possible.Delayed replantation of avulsed permanent teeth has a poor prognosis.

Recently receiving FDA approval, the Amplatzer Amulet™ LAA occluder device (Abbott Medical Inc) provides a dual seal mechanism alternative to the commercially available Watchman FLX or Watchman 2.5 device for embolic stroke prevention in patients with non-valvular atrial fibrillation (NVAF). This Step-by-Step review will cover patient selection, pre-procedure imaging assessment, device sizing, device preparation, implant target position assessment, implant technique and troubleshooting, and immediate post implant follow-up.

A document by Matthew Hanson, written on Authorea.

This paper reports conservative treatment of a patient with stained pitted spots on her upper front teeth. Selective enamel micro- and macro- abrasion procedures were used as the primary method of treatment followed by resin composite restoration resulted in acceptable esthetic results.

Intramyocardial dissection following cardiac tumor excision is uncommon. The evidence available is limited to few case reports. 1 Herein,we report an infant with large cardiac fibrosarcoma arising from the interventricular septum and underwent surgical excision. Postoperative echocardiography revealed a cystic dissection located in the interventricular septum with residual shunts within the ventricular chambers. we performed conservative strategy due to the high surgical risk, difficulty of interventional therapy and hemodynamic stability.

A descriptive retrospective review of two Danish families with Axenfeld-Rieger Syndrome. Documenting clinical findings, treatment of the dental anomalies and dentofacial deformities is described. This article demonstrates the importance of early diagnosis, referral and treatment in highly specialized center to receive the best outcome.

Avi Hazan1, Elishai Ezra Tsur1*1 Neuro-Biomorphic Engineering Lab, Department of Mathematics and Computer Science, The Open University of Israel, Ra’anana, Israel* Correspondence: elishai@NBEL-lab.comAbstractNeuromorphic hardware designs realize neural principles in electronics to provide high-performing, energy-efficient frameworks for machine learning. Here, we propose a neuromorphic analog design for continuous real-time learning. Our hardware design realizes the underlying principles of the neural engineering framework (NEF). NEF brings forth a theoretical framework for the representation and transformation of mathematical constructs with spiking neurons. Thus, providing efficient means for neuromorphic machine learning and the design of intricate dynamical systems. Our analog circuit design implements the neuromorphic prescribed error sensitivity (PES) learning rule with OZ neurons. OZ is an analog implementation of a spiking neuron, which was shown to have complete correspondence with NEF across firing rates, encoding vectors, and intercepts. We demonstrate PES-based neuromorphic representation of mathematical constructs with varying neuron configurations, the transformation of mathematical constructs, and the construction of a dynamical system with the design of an inducible leaky oscillator. We further designed a circuit emulator, allowing the evaluation of our electrical designs on a large scale. We used the circuit emulator in conjunction with a robot simulator to demonstrate adaptive learning-based control of a robotic arm with six degrees of freedom.

Background: Uncomplicated type B aortic dissection (un-TBAD) has been managed conservatively with medical therapy in order to control the heart rate and blood pressure to limit disease progression, in addition to radiological follow-up. However, several trials and observational studies have investigated the use of thoracic endovascular aortic repair (TEVAR) in un-TBAD and suggested that TEVAR provides a survival benefit over medical therapy. Outcomes of TEVAR have also been linked with the timing of intervention. Aims: The scope of this review is to collate and summarise all the evidence in the literature on the mid- and long-term outcomes of TEVAR in un-TBAD, confirming its superiority. We also aimed to investigate the relationship between timing of TEVAR intervention and results. Methods: We carried out a comprehensive literature search on multiple electronic databases including PubMed, Scopus and EMBASE in order to collate and summarise all research evidence on the mid- and long-term outcomes of TEVAR in un-TBAD, as well as its relationship with intervention timing. Results: TEVAR has proven to be a safe and effective tool in un-TBAD, offering superior mid- and long-term outcomes including all-cause and aorta-related mortality, aortic-specific adverse events, aortic remodelling, and need for reintervention. Additionally, performing TEVAR during the subacute phase of dissection seems to yield optimal results. Conclusion: The evidence demonstrating a survival advantage in favour TEVAR over medical therapy in un-TBAD means that with further research, particular trials and observational studies, TEVAR could become the gold-standard treatment option for un-TBAD patients.

This paper provides a simplified solution of the Dirac equation for the pure rotational energy of the diatomic molecules and a discussion of the non-relativistic limit. The last works [1-2] led to a complicated form of the relativistic energy of the molecular rotation-vibrational energy with high computational cost based on Schrodinger-like equation. The present work provides a way to determine the pure rotational energy without exclusion of the wavefunction components or using the Schrodinger-like equation, where the selection rule ΔJ=±1, where J is the rotational quantum number, appears as a prerequisite for solving the equations. Based on the anti-hermitian spin-orbit operator (L∼) that been introduced in this paper, which excludes the derivatives, the computational cost expects to decrease.

Secondary contact of species that have evolved partial reproductive isolation in allopatry may result in several outcomes, which range from rampant hybridization to barrier reinforcement. Reinforcement arises from reduced hybrid fitness, which promotes assortative mating and hence speciation. In plants, self-fertilization and disjunction in reproductive phenology are often cited as evidence of reinforcement. However, local adaptation and pleiotropic effects during colonization can also lead to reproductive isolation without reinforcement. We explored these competing possibilities in a fir species complex (Abies flinckii - A. religiosa) distributed in ‘sky-islands’ along the Trans-Mexican Volcanic Belt (TMVB), in central Mexico. Despite co-occurring in two independent sympatric regions (west and center), these two taxa seem to rarely interbreed because of disjunct reproductive phenologies. We genotyped 1,147 SNPs, generated by GBS across 23 populations, and compared multiple demographic scenarios, built based on the geological history of the TMVB. The best-fitting model revealed one of the most rapid and complete speciation cases for a conifer species-pair, dating back to ~1.2 Ma, which included an early asymmetric gene flow (mostly from A. flinckii into A. religiosa) limited to the most ancient sympatric region. Coupled with the lack of support for colonization models, our demographic inferences point to an early development of reinforcement, as a putative mechanism for avoiding hybridization. Reinforcement should be considered as a key player for originating and maintaining species diversity in the tropics and subtropics and incorporated in studies with other model systems.

The dynamics of cyclic populations distributed in space result from the relative strength of synchronising influences and the limited dispersal of destabilising factors (activators and inhibitors), known to cause multi-annual population cycles. However, while each of these have been well studied in isolation, there is limited empirical evidence about how the processes of synchronisation and activation-inhibition act together, largely owing to the scarcity of datasets with sufficient spatial and temporal scale. We assessed a variety of models that could be underlying the spatio-temporal pattern, designed to capture both theoretical and empirical understandings of travelling waves using large-scale (> 35,000 km2), multi-year (2011-2017) field monitoring data on abundances of common vole (Microtus arvalis), a cyclic agricultural rodent pest. We found most support for a pattern formed from the summation of two radial travelling waves with contrasting speeds that together describe population growth rates across the region.

1) Results of ossiculoplasty via trans-canal endoscopic (TEES) route is comparable to that of the traditional microscopic approach 2) There was no difference in complications or secondary outcomes such as tympanic membrane residual perforation or ear discharge between these groups 3) Both groups achieved an air-bone gap of less that 20dB in more than 70% of the cases 4) In our experience there was no difference in outcomes based on ossiculoplasty material such as cartilage, titanium prosthesis or autologous grafts such as incus. 5) Eroded stapes superstructure is does not preclude getting improvements in ABG of less than 20dB, but larger studies with longer follow ups might be useful.