Introduction: Atrial fibrillation (AF) is the most common arrhythmia in patients undergoing hemodialysis (HD), which lowers the quality of life (QoL) and increases the risk of dialysis related complications. The present study aimed to evaluate the effectiveness of AF ablation on the QoL in patients undergoing HD. Methods and Results: Nineteen patients undergoing HD (14 men, age 68±8years, 15 paroxysmal AF) who underwent catheter ablation (CA) of drug-refractory AF were enrolled in the study. The ablation outcomes and procedural complications were evaluated and compared to 1053 consecutive patients without HD who underwent AF ablation. The Kidney Disease Quality of Life Short Form (KDQOL-SF) was assessed to evaluate the QoL of the HD patients at baseline and six months after the ablation. During the follow-up period of 17±13 months after the last procedure, the arrhythmia free rate was similar (HD patients 79% vs. non-HD patients 86%, log-rank p=0.82). There were no life-threatening complications in any patients. The KDQOL-SF of the HD patients six months after the ablation showed an improvement in the physical functioning (54±23 to 68±28, p<0.01), general health perceptions (38±17 to 48±15, p<0.01) and symptoms/problems (75±21 to 84±13, p=0.02) as compared to the baseline. Regarding the intradialytic symptoms, the dyspnea during HD significantly improved after the CA in the HD patients without AF recurrence (35% to 6%, p=0.04), while the atrial tachyarrhythmias and hypotension during HD remained unchanged. Conclusions: CA of AF improves the QoL in patients with chronic hemodialysis.

New World wood warblers (family: Parulidae) can exhibit strong phenotypic differences among species, particularly in song and plumage. However, within-species variation in these warblers—often designated as subspecies—is much more subtle and has led to significant debate over the origin, maintenance, and conservation status of populations that differ. A species that exhibits controversial subspecific status is the black-throated green warbler (Setophaga virens), a Neotropical-Nearctic migrant that breeds throughout eastern and boreal North America with several isolated populations at the margins of its range. In particular, uncertainty has lingered over the status of S. v. waynei, a disjunct population along the southeast Atlantic Coastal Plain of the United States that differs morphologically and ecologically from the nominate subspecies. Despite its unique circumstances, the subspecific status of S. v. waynei remains questionable in the absence of any population-wide genomic analyses. Here, we employ whole-genome resequencing to estimate the genetic distinctiveness among samples collected across the entirety of S. virens breeding range, including from putative S. v. waynei. Despite detecting low global differentiation (FST = 0.027) across the entire species, we observed discrete genetic clustering among S. v. waynei. Principal components analysis of genome-wide differences shows the main axis of variation separates S. v. waynei from all other S. v. virens samples. We also found that S. v. waynei is most similar to another isolated population from the Piedmont of North Carolina and detected evidence of a historical north-to-south geographic dispersal among the entire complex. Combined with previously documented ecological and morphological distinctness, our results support that S. v. waynei be considered a distinct and recognized subspecies worthy of targeted conservation efforts.

Mergers and Acquisitions operations continues to be one of the most explored growth strategies globally in all markets, and also in the Elevator Industry. Volume of investments grows year after year. It is the fastest way to grow in international and domestic markets, but the reality is that a high percentage of the operations carried out do not meet the expectations of the investors when the integration phase, called the post-acquisition phase, has been completed. There are several causes of failures on mergers and acquisitions processes, such as lack of commitment from the management, unrealistic business plan, cultural shock, etc … But the most common and the one with the highest risk in an acquisition decision, is the asymmetry of information. During the negotiation phase a large amount of data is collected, and subsequently analyzed during the Due Diligence period, but does not correspond to reality during the integration phase. That is, the information that the seller has provided, and has been studied and analyzed to take a decision of acquire by investors, has not been the real and complete one. In this article we will propose how the asymmetry information can be avoided by the application of Information and Communication Technology (ICT) through the IoT of the elevators. Same can be applied to other industries.

Remarkable progress has recently been achieved to identify the biological function and potential value of interleukin (IL)-33 as a novel therapeutic target of allergic rhinitis (AR) at the nasal epithelium level. 1-4 The nasal mucosa is constantly exposed to inhaled allergens, and insights into the microbiota of human nasal mucosa can provide fundamental information on factors contributing to related allergic inflammation. 5 However, a mechanistic consideration of immunomodulatory properties of the nasal microbiome to inhaled allergens has not been comprehensively performed in AR. The purpose of this study was to show the distinctive role of the nasal microbiome S. epidermidis, a major symbiont in healthy nasal mucus, and the potential impact on reduction of T helper (Th)2 inflammation through decreased cellular necroptosis and subsequent IL-33 release in nasal epithelium.

Background: Pediatric data on the epidemiology of acute kidney injury (AKI) in acute myeloid leukemia (AML) are limited, although the incidence of AKI appears to be very high in this patient group. The aim of this study was to assess the prevalence of and factors associated with AKI in childhood AML during chemotherapy treatment. Materials and methods: The medical records of 112 children aged under 15 years diagnosed with AML who received chemotherapy in a major tertiary care referral center in Southern Thailand were reviewed. Logistic regression was used to identify factors associated with AKI. Results: Fifty-six (50%) children had 69 AKI events. The median time from AML diagnosis to the first AKI was 29.5 days (interquartile range: 11.0-92.8). Age at diagnosis ≥ 10 years (OR 2.75, 95% CI 1.09-6.93), glomerular filtration rate < 90 mL/min/1.73 m2 at AML diagnosis (OR 7.58, 95% CI 1.89-30.5) and septic shock (OR 22.0, 95% CI 4.63-104.3) were independently associated with AKI. Conclusions: Childhood AML has a high rate of renal injury with 50% having AKI. Age ≥ 10 years at diagnosis, impaired renal function before treatment, and septic shock were strongly associated with AKI.

Fibrin-associated diffuse large B-cell lymphoma is an exceptionally rare neoplasm associated with Epstein-Barr virus. It is distinguished by an indolent growth pattern within confined spaces and has a predilection for prosthetic cardiac valves, implants, and thrombi. The case is an immunocompetent 7-year-old with complex congenital heart disease and recurrent primary cardiac FA-DLBCL in association with two bovine bioprosthetic pulmonary valves. Children with complex CHD have an increased risk of lymphoma and cardiac prosthetic devices may provide environments for FA-DLBCL to occur. Pediatric oncologists must be alerted to the risk of this incredibly rare lymphoma subtype, especially among children with CHD.

Objective To explore the incidence of pregnancy-related VTE in China and to assess the associations of maternal weight gain in different periods of pregnancy with VTE. Design Retrospective case-control study. Setting Shanghai, China Participants 151 cases (11.7 per 10000) of pregnancy-related venous thromboembolism (VTE) and 302 controls. Methods GWG was standardized into gestational age-specific z-scores stratified by body mass index (BMI) and categorized as low (< -1), normal (-1 to 1), and high (>1). The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated through log-binomial regression models. Main outcome measures Pregnancy-related VTE Results There were 65.6% of pulmonary embolus (PE) and 34.4% of deep venous thrombosis (DVT) alone or combined with PE. Among normal-weight women, there was observed protective effects of low weight gain (aOR 0.79; 95% CI 0.37–1.68) and significantly increased risks of high weight gain (aOR=1.47; 95% CI: 1.03-2.09) for PE in early pregnancy. Similarly, a tendency towards decreased risk at lower weight gain throughout pregnancy (aOR 0.79; 95% CI 0.37–1.68) and significantly increased risk at higher values (aOR=1.52; 95% CI: 1.01-2.31) for PE was observed. As for underweight and overweight women, results from the categorical model for early, late or total pregnancy weight gain indicated an increased risk in PE at both low and high weight gain, but confidence intervals were wide. Conclusion Maternal weight gain in total or early pregnancy is an important risk factor for PE. Intensive weight management that continues through pregnancy may be indispensable to effectively improve pregnant outcomes.

Worldwide, hoverflies (Syrphidae: Diptera) provide crucial ecosystem services (ES) such as pollination and biological pest control. Although many hoverfly species exhibit migratory behavior, the spatiotemporal facets of these movement dynamics and their ES implications are poorly understood. In this study, we use long-term (16 yr) trapping records, trajectory analysis and intrinsic (i.e., isotope, genetic, pollen) markers to describe migration patterns of the hoverfly Episyrphus balteatus in China. Our work reveals long-range, windborne migration with spring migrants originating in northern China and exhibiting return migration during autumn. The extensive genetic mixing and high genetic diversity of E. balteatus populations underscore its adaptive capacity to environmental disturbances e.g., climate change. Pollen markers further illuminate how E. balteatus visits min. 832 flowering plant species (38 orders) over space and time. By thus delineating E. balteatus trans-regional movements and pollination networks, we advance our understanding of its migration ecology and facilitate the design of targeted strategies to conserve and enhance its ecosystem services.

Understanding the effects of changing demographic characteristics on population resilience is one of the fundamental questions in ecology. Earlier maturation is a widely observed phenomenon among populations, especially in fish populations under exploitation. However, the effects of earlier maturation on ecological resilience of population have not been explicitly studied. A classical age structured population dynamics model (configured by empirical data of a population of American plaice Hippoglossoides platessoides) is used to demonstrate that earlier maturation increases both engineering and ecological resilience. Accordingly, changing to earlier maturation could prevent upcoming population regime shift, and management interventions to reduce disturbance after detecting earlier maturation helps to revert population collapse. This study demonstrates the potential of earlier maturation to increase ecological resilience and prevent population collapse, as well as acting as an early warning signal for management to revert upcoming population regime shift.

In the present communication, we give the converse of generalized ‘useful’ Jensen inequality and show that some recently reported inequalities are simple consequences of those results that have been established for a long time. We also include a new improvement of the proposed inequality of Jensen as well as changes to some associated outcomes, where generalized ‘useful’ converse of the Inequality of Jensen is presented and implementations related to it are given in the theory of information. Finally, it is shown with the help of numerical data that inequalities holds well both for convex and concave functions.

The paper investigated the non-collocated control strategy for the reduction of cable oscillations by the analytical studies and the experimental implementation. We researched the control with introduced points. We used the continuous model of cable-stayed beam to show the main features of the non-collocated lon- gitudinal active control strategy. Then, the suitable non-linear state-feedback controllers are introduced to represent the modal. The results show that they can capture the main previous control features and derive an implementable strategy. We used an actively controlled cable-stayed beam to present the control effectiveness of the proposed strategy, based on the large campaign of experiments, which conducted in various frequency ranges and amplitude levels including meaningful external resonance conditions. The responses predicted by the analytical model and the experimental results show good qualitative agreement with one another, in both the uncontrolled and controlled experienced cable-stayed beam dynamics.

Background and Aims Common variable immunodeficiency (CVID) can affect quality of life (QoL) which can be better assessed with validated scales. Our goal was to validate the Turkish version of the Italian CVID-QoL questionnaire. Methods International recommendations for cultural adaptation and translation process of original scale was followed. CVID patients completed Turkish CVID-QoL questionnaire between October 2019 and January 2020. The Short Form Health Survey (SF-36) was used as a comparative questionnaire. Reliability, reproducibility, factor analysis, content validity, convergent validity and discriminant validity were analysed. Results 50 CVID patients were included in the study. 64 % of patients (n=32), the mean age of the patients was 36.68 ± 13.2 years, the median duration of disease was 52.5 months. The instrument had good internal consistency in 50 patients [Cronbach’s alpha: 0.92, emotional functioning (EF): 0.91, relational functioning (RF): 0.77]. It also revealed high reproducibility in 26 patients QoL global, intraclass correlation coefficient (ICC)= 0.80 (95 % CI 0.56 - 0.91); EF, ICC = 0.78 (95 % CI 0.51- 0.90); RF, ICC = 0.82 (95 % CI 0.59-0.92); Gastrointestinal and skin symptoms (GSS), ICC = 0.89 (95 % CI 0.76-0.95); (p <0.001, p <0.001, p <0.001, p <0.001). QoL global, EF and RF scores showed good convergent validity with similar subscales of SF-36. The number of infections within last 3 months had a significant impact on QoL global, EF and RF (p=0.038, p=0.045, p=0.028). Conclusions The Turkish version of CVID QoL scale has appropriate validity and reliability among Turkish patients with CVID.

ABSTRACT Aims Pharmacists in all clinical settings are recognized drug experts and integral educators of biosimilar medicines. Therefore, the objective of this study was to assess pharmacists’ knowledge, predictors of knowledge and views toward biosimilar medicines in Jordan. Methods A cross-sectional questionnaire was conducted in Jordan using an internet-based self-administrated questionnaire via Google Forms. A descriptive statistical analysis was performed to summarize the data for the total sample as counts (percentage). Results A total of 502 pharmacists answered the survey. 52.6% were knowledgeable about biosimilar medicines and the mean number of correct answers was 6.47 ± 1.62 (range 2–10). Multivariate analysis identified that respondents who had heard about biosimilars before (OR = 1.942, 95% CI = 1.231-3.063, p <0.05) were more likely to be knowledgeable. Respondents who had not taken course or post-graduating training course about biosimilars were less likely to be knowledgeable (OR = 0.548, 95% CI =0.357-0.839, p < 0.05). A positive response was noted in pharmacist’s view regarding the implementation of biosimilar medicines in healthcare setting, biosimilar medicine prescription related to decreased costs, self-study about biosimilar medicine, and incorporating biosimilar education program at the pharmacy school curriculum universities level. Conclusions Pharmacists’ views and knowledge vary regarding the particularities and key issues on biosimilar medicines in Jordan. There is a need to improve communication between physicians and pharmacists and pledge educational initiatives to ensure safe and optimal use of biosimilar medicines. Incorporating biosimilar course in pharmacy school curriculum could improve their acceptance for future pharmacy jobs.

Acute lymphoblastic leukemia (ALL) is a malignant hematologic tumor with highly aggressive characteristics, which has few clinically effective drugs. It is meaningful to gain a better understanding of its pathogenesis in order to discover and evaluate potential therapeutic drugs and new treatment targets. However, the process of new drugs from research and development to clinical application is long and difficult. Many promising drugs were rejected by the US Food and Drug Administration (FDA) due to serious adverse drug reactions (ADR) in clinical phase I trials. Animal models provide us with an excellent tool to understand the complex pathological mechanisms of human diseases, to evaluate the potential of new targeted drugs and to assess the potential ADR they may have on healthy organs. In this article we briefly introduce the clinical status of ALL, review ALL animal models’ progression, their roles in revealing the pathogenesis of ALL and drug development.

Although late complete atrioventricular block (CAVB) is especially rare as periprocedural complication of atrioventricular nodal re-entrant tachycardia treatment, this complication can necessitate permanent pacemaker implantation. The present case is that this late CAVB can be caused only during periprocedural period by the indirect or functional effects on the fast pathway of AV node because this case has paroxysmal supra-ventricular tachycardia with pre-existing PR prolongation, and the PR prolongation improved within normal PR interval after curing of the late CAVB. Further, when the late CAVB occurs within a few weeks after ablation, such bradyarrhythmia as periprocedural complication may be reversible and indication of a permanent pacemaker implantation should be carefully considered.

Objective The aim of the present study was to develop a neural network to characterize the effect of aging on the ECG in healthy volunteers. Moreover, the impact of the various ECG features on aging was evaluated. Methods & Results A total of 6228 healthy subjects without structural heart disease were included in this study. A neural network regression model was created to predict age of the subjects based on their ECG; 577 parameters derived from a 12-lead ECG of each subject were used to develop and validate the neural network; A ten fold cross-validation was performed, using 118 subjects for validation eacht fold. Using SHapley Additive exPlanations values the impact of the individual features on the prediction of age was determined. Of 6228 subjects tested, 1808 (29%) were females and mean age was 34 years, range 18 – 75 years. Physiologic age was estimated as a continuous variable with an average error of 6.9±5.6 years (R2= 0.72 ± 0.04) . The correlation was slightly stronger for men (R2= 0.74) than for women (R2= 0.66). The most important features on the prediction of physiologic age were T wave morphology indices in leads V4 and V5, and P wave amplitude in leads AVR and II. Conclusion The application of artificial intelligence to the ECG using a neural network regression model, allows accurate estimation of physiologic cardiac age. This technique could be used to pick up subtle age-related cardiac changes, but also estimate the reversing of these age-associated effects by administered treatments.

Introduction An important proportion of asthma patients remain uncontrolled despite using inhaled corticosteroids and long-acting beta-agonists. Some add-on therapies, such as tiotropium bromide have been recommended for this subgroup of patients. The purpose of this study was to assess the cost-effectiveness of tiotropium as add-on therapies to ICS + LABA for children and adolescents with uncontrolled allergic asthma. Methods A probabilistic Markov model was created to estimate the cost and quality-adjusted life-years (QALYs) of patients with severe asthma in Colombia. Total costs and QALYS of two interventions including standard therapy (ICS + LABA), add-on therapy with tiotropium, were calculated over a time horizon from 6 to 18 years. Probability sensitivity analyses were conducted. Cost-effectiveness was evaluated at a willingness-to-pay value of $19,000. Results The model suggests a potential gain of 0.51 QALYs per patient per year on tiotropium, with a difference of US$265 per patient year with respect to standard therapy. The incremental cost-effectiveness ratio estimated was U$ 1928 in the deterministic model and US$2,017 in the probabilistic model after Monte-Carlo simulation. Our base‐case results were robust to variations in all assumptions and parameters. Conclusion Add-on therapy with tiotropium was cost-effective when added to usual care in children and adolescents with severe asthma who remained uncontrolled despite treatment with medium or high-dose ICS/LABA. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other middle-income countries.

During a routine surveillance for exotic and emerging swine viral diseases in India, five samples (four faecal, one serum) showed cytopathic effects in Vero cells. Transmission electron microscopy of infective cell supernatant revealed the presence of two types of virions. De novo metavirome sequencing enabled complete genome assembly of Mammalian orthorubulavirus 5 (MRuV5) and Mammalian orthoreovirus (MRV). The MRuV5 isolates possessed a whole genome of 15246 bp with seven genes (NP, V/P, M, F, SH, HN, L), while the MRV isolates had segmented genome with three large (L1, L2, L3), three medium (M1, M2, M3) and four small (S1, S2, S3, S4) segments. The MRuV5 isolates were genetically grouped with those from various mammalian species reported from South Korea and China. Deduced amino acid sequences of the HN, NP and F gene coding regions of MRuV5 isolates showed the substitutions of three (92L, 111R, 447H), two (86S, 121S) and two (139T, 246T) amino acids, respectively, compared to previously reported strains of the virus. However, they did not reveal any change in predicted amino acid residues at the receptor binding site in HN protein, cleavage site or HN stalk region. S1 gene of the MRV isolates showed the highest nucleotide identity (97.73%) with the MRV3 strain ZJ2013 isolated from pig in China, and these isolates were grouped into MRV type-3. Deduced amino acid sequences of MRV3 S1 gene revealed amino acid residues 198-204NLAIRLP, 249I, 340D, 419E known for sialic acid binding site and neurotropism. We report the co-infection of MRuV5 and MRV3 detected incidentally for the first time in domestic pigs in India. Although MRuV5 and MRV3 develop asymptomatic infections or mild disease in animals and humans, continuous monitoring of evolution and spread of such viruses is important in the current global scenario of increasing threats due to emerging novel pathogens.

We reported the 5 th published case of COVID-19 vaccine inducing SS and the first case to be induced by an inactivated SARS-CoV-2 vaccine « CoronaVac ». The short latency time strongly supports the pathogenic role of the vaccine as a cause of SS in our case.

This study aimed to characterize Brucella spp., and other abortigenic pathogens from aborted tissues of cattle from five selected districts of Rwanda. For cattle, aborted tissues (n=19) were collected, cultured, and Brucella spp. were detected using genus-specific 16S-23S ribosomal DNA interspacer region (ITS) assay and further speciated using AMOS and Bruce-ladder PCR assays. Brucella negative samples were screened using eight abortion pathogens PCR panel ( Anaplasma phagocytophilum, Bovine Herpesvirus 4, Campylobacter fetus, Chlamydophila spp., Coxiella burnetti, Leptospira spp., Listeria monocytogenes, and Salmonella spp.). samples from an abortion outbreak that occurred within a goat tribe in the Nyagatare district were included in this investigation. Sera of females (n=8), and males (n=2) were analysed using the Rose Bengal Test (RBT), and indirect enzyme-linked immunosorbent assay (i-ELISA), while vaginal swabs (n=3), and aborted tissues (n=1) were cultured and characterized. The ITS-PCR detected Brucella DNA in cultures from two aborted tissues of cattle [10.5%, (2/19)] which were identified as B. melitensis (n=1), and B. abortus (n=1) using AMOS and Bruce-ladder PCR assays. Campylobacter fetus (n=7) and Leptospira spp. (n=4) including co-infections (n=2) of C. fetus and Leptospira spp. were identified with the PCR panel from the Brucella negative samples of cattle. Goats (100.0%, 10/10) were brucellosis seropositive on RBT and i-ELISA. Mixed infections caused by B. melitensis and B. abortus were isolated from the vaginal swabs (n=3) and aborted tissues (n=1). The isolation of both B. abortus and B. melitensis indicated cross-infections and mixed livestock farming in Rwanda. This is the first identification of abortion-associated pathogens ( B. abortus, B. melitensis, C. fetus, and Leptospira spp.) in aborted cattle samples in Rwanda indicating the enormous financial losses to cattle owners and a threat to public health. It is therefore essential to include these identified pathogens in the surveillance scheme of veterinary and human services, and raise the awareness of caretakers, abattoir workers, and laboratory personnel.

Background and Purpose The prognosis of cardiorenal dysfunction induced by diabetes mellitus (DM), which belongs to cardiorenal syndrome type 5, is poor and its pathogenesis remains elusive. Here we attempt to clarify whether CX3CL1 might be a therapeutic target for cardiorenal dysfunction in diabetes. Experimental Approach Effects of CX3CL1 on cardiorenal function, myocardial and renal fibrosis, and apoptosis were examined using four types of cultured cardiomyocytes or renal cells and two diabetic mouse models, streptozotocin-induced DM or non-obese diabetic (NOD) mice. The effect of sodium glucose cotransporter 2 inhibitor canagliflozin on CX3CL1 expression was also investigated in vivo or in vitro. Key Results Cardiac and renal CX3CL1 protein levels were significantly increased in both STZ-induced diabetic mice and NOD mice, and that hyperglycemia led to persistent CX3CL1 expression in the heart and kidneys even after it was controlled by insulin. In cultured cardiac and renal cells, soluble CX3CL1 accelerated mitochondrial-dependent apoptosis via activation of the RhoA/ROCK1-Bax pathway and promoted fibrosis through cellular phenotypic trans-differentiation mediated by the TGFβ/Smad pathway. In the two diabetic mouse models, knockout of CX3CL1 receptor CX3CR1 or treatment with an CX3CL1 neutralizing antibody significantly improved cardiorenal dysfunction by inhibiting apoptosis, mitochondrial dysfunction, and fibrosis. Moreover, sodium glucose cotransporter 2 inhibitor canagliflozin significantly downregulated cardiac and renal CX3CL1 expression and improved cardiorenal dysfunction. Conclusions and Implications These findings indicate that CX3CL1 could be a new therapeutic target for diabetes-induced cardiorenal dysfunction.

Background: SARS-Cov2 already has over than 215 million people and more than 4.5 million fatalities. The beginning of the pandemic condition has led the health authorities in several countries to adopt no-pharmacological preventive measures, such as schools closures. The return took place at a time when the country had the highest rates of infection and mortality. In particular because of the circulation of the gamma variant (P.1) and the vaccination program were beginning in the country. Therefore, we aimed to investigate the prevalence of SARS-CoV2 in daycares after the return of educational activities. Methods The study involved seven childcare facilities. Swab samples from the nasopharynx and region were collected from each participant. This study was carried out between March 16 and September 3, 2021. Viral RNA was extracted using Invitrogen’s RNA purification kit. Viral diagnosis was obtained using RT-PCR, through the TaqMan system. Viral detection was performed with Seegene panel, Allplex TM 2019-nCoV Assay kit. Results and Conclusion: The study population included 201 participants among daycare workers and children. Only one sample (0,5%) was tested positive for the presence of SARS-CoV-2, which was an asymptomatic childcare worker, and no secondary cases were detected. Considering that the return to day care activities occurred in a period with high number of cases of deaths and lack of vaccines throughout the country, it is believed that the several preventive measures used by the day care center could be an indication of effectiveness in preventing transmission of SARS-CoV2.

Non-germinomatous germ cell tumours of the central nervous system (CNS NG-GCT) have no standardized treatment at relapse and prognosis is dismal. Additionally, limited patient numbers preclude any clinical trials in this setting. Here we report the case of an adolescent with relapsed metastatic pineal yolk sac tumour treated with induction chemotherapy, high dose chemotherapy followed by autologous stem cell transplant and radiotherapy who is alive and progression-free 5 years after end of treatment. This experience illustrates the importance of tumour marker surveillance and that multimodal treatment can salvage children with relapsed CNS NG-GCT.

Cylas formicarius is one of the most important pests of sweet potato worldwide, causing considerable ecological and economic damage. To improve the effect of comprehensive management and understanding of genetic mechanisms, the genetic functions of C. formicarius have been the subject of intensive study. Using Illumina and PacBio sequencing, we obtained a chromosome-level genome assembly of adult weevils from lines inbred for 15 generations. The high-quality assembly obtained had a size of 338.84 Mb, with contig and scaffold N50 values of 14.97 Mb and 34.23 Mb, respectively. In total, 157.51 Mb of repeat sequences and 11,907 protein-coding genes were predicted. A total of 337.06 Mb of genomic sequences was located on the 11 chromosomes, and the sequence length that could be used to determine the sequence and direction accounted for 99.03% of the total length of the associated chromosome. Comparative genomic analysis showed that C. formicarius was sister to Dendroctonus ponderosae, and C. formicarius diverged from D. ponderosae approximately 138.89 million years ago (Mya). Many important gene families that were expanded in the C. formicarius genome were involved in detoxification of pesticides, tolerance to cold stress and chemosensory system. In an in-depth study, the binding assay results indicated that CforOBP4-6 had strong binding affinities for sex pheromones and other ligands. Overall, the high-quality C. formicarius genome provides a valuable resource to reveal the molecular ecological basis, genetic mechanism, evolutionary process of major agricultural pests, new ideas and new technologies for ecologically sustainable pest control.