Objective This study aims to determine to what extent audiological test data effected on decision-making in the diagnosis process of patients who have hearing loss. Design Survey study Setting and Participants The audiological test results of six pathologies (auditory neuropathy spectrum disorder-ANSD, Menieré’s Disease-MD, superior semicircular canal dehiscence-SSCD, large vestibular aquaduct syndrome-LVA, chronic otitis media-COM, and secretory otitis media-SOM) belonging to five different patients with a definite diagnosis were presented to 87 otolaryngology (ENT) physicians. The physicians were not informed about patient histories and otoscopic findings. The breakdown of the physicians according to their specialization was as follows: 19 were residents, 53 were ENT specialists, 6 were associate professors, and 9 were professors. The participant physicians were asked to indicate possible pathologies (one or more) for each audiological outcome. The answers given were classified as “correct,” “undefined” and “incorrect.” Main outcome measures To determine how effective only audiological reports are for the diagnostic decision-making role was evaluated by analysing the percent of “correct” answers according to their work place and title. Results The mean “correct” response rate for all pathologies was 19.2%, and the ” incorrect” response rate was 38%. The ratio of “undefined” answers was 41.8. The “correct” prediction rates for each pathology, were 26% for ANSD, 32% for SOM, 19% for MD, 16% for COM and 14% for SSCD. There was no “correct” prediction for LVA. Conclusion Audiological tests are likely to support the decision-making process for the ENT physician when they are accompanied by other (case history, otoscopic examination, radiological findings etc.) The audiological report content may increase the diagnostic value of audiological tests.

cocaine and tetrahydrocannabinol (THC)-containing drugs (marijuana/hashish) are the most frequently used recreational drugs. Both these molecules exert their main function in the central nervous system (CNS), due to their capability to trespass the blood-brain barrier [1] [2]. Once in the CNS, cocaine acts by inhibiting the re-uptake of serotonin, norepinephrine and dopamine, while tetrahydrocannabinol act as partial agonist of the cannabinoid receptor CB1 [1] [2]. Aside the action on CNS little is known about the effects of these recreational drugs on the immune system. [3] [4] We describe herein a case of a 31-year old man, non-drug addict, that abused for the first time of both cocaine and THC and was admitted in the Emergency room for acute confusional state and increase in heartbeat. We stabilized the patient’s clinical condition and analyzed the changes in the immune compartment.

Uncertain delay differential equations are a class of uncertain differential equations with time delay, which are widely used in population model, disease model, biological model, etc. How to estimate uncertain delay differential equations with unknown parameters is an important problem to be solved. Based on observed data, this paper uses least square estimation method to obtain estimated value of unknown parameters in the coefficients of uncertain delay differential equations. Numerical examples are introduced to show that least squares estimation method is suitable for uncertain delay differential equations. Application of uncertain SIS epidemic model with time delay further illustrates effectiveness of the method.

Introduction: Hydroxychloroquine, with or without Azithromycin, was used as a treatment strategy for COVID-19 in March and April 2020. The use of Hydroxychloroquine (HCQ), with or without Azithromycin, may increase the risk of QT prolongation. This study was performed to assess the incidence and degree of QT prolongation in hospitalised COVID-19 patients treated with HCQ, and the association with morbidity and mortality. Methods and Results: Single centre retrospective observational study. Baseline corrected QT interval (QTc), peak QTc and change in QTc (∆QTc) were calculated for all patients. Known or suspected risk factors for QT prolongation were assessed. All patients were followed up for QT prolongation, length of stay, incidence of ICU admission and 30 day all-cause mortality. Sixty-two patients were included (mean age 67 years; 33.9% female). QT prolongation occurred in 62.9% of patients given HCQ, with ∆QTc ≥60msec or acquired QTc ≥500msec in 14.5% of patients. The mean ∆QTc was 28.4msec. QT prolongation was associated with increased mortality (OR 11.0; 95% CI 1.3 – 90.9; P=0.03). Conclusions: There was a high incidence of QT prolongation in patients who received HCQ as part of a COVID-19 treatment regimen. We observed an increased risk of death in patients with QT prolongation, as well as an increased incidence of ICU admission and longer length of stay in hospital. We recommend particular attention be paid to the risk of QT prolongation with novel treatment strategies for COVID-19. Further research is warranted on the effect of QT prolongation on clinical outcomes in COVID-19.

A document by Ines Lahouel. Click on the document to view its contents.

In this manuscript, we report four series for 1,2,4-triazine derivatives as dye-sensitized solar cells (DSSCs). Density functional theory (DFT) methods via utilizing Becke’s three-parameter functional and LeeeYangeParr functional (B3LYP) level with 6-31G (d, p) basis set to investigate their modeling molecular structures. Optimized molecular structures for studied molecular structures are obtained using DFT/B3LYP/6-31G (d, p) method. In addition to, the time-dependant density functional theory (TD-DFT) is used to study the optoelectronic properties and absorption spectra using DFT/CAM-B3LYP/ 6-31G ++ (d, p) level in the Gaussian 09 program. The highest occupied molecular orbital (HOMO), lowest unoccupied molecular orbital (LUMO), energy gap (Eg), light harvest efficiency (LHE) and open-circuit voltage (Voc) of the studied molecular structures are calculated and illustrated. These properties indicating that these molecular modeling structures as good candidates for utilize in organic DSSCs.

The first Zagreb index of graphs is defined to be the sum of squares of degrees of all the vertices of graphs. It drew a great deal of attention in the past half-century. In this paper, we study the relationship between the first Zagreb index and Roman domination number of graphs. More precisely, we characterize the trees with maximum the first Zagreb index among trees with given Roman domination number.

Abstract objectives: We aimed to report the prevalence of anatomic variations in Chinese pediatric patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and to explore the correlation between anatomic variations and the extent of chronic sinusitis in children. Design: This retrospective study conducted between January 2018 and June 2020. Setting:This study involved children from the First Affiliated Hospital, Sun Yat-sen University and Guangzhou Women and Children’s Medical Center. Participants: Participants included 50 children with CRSwNP. Main outcome measures: The diagnosis of CRSwNP was based on symptoms, endoscopy, and computed tomography examination according to European criteria on chronic rhinosinusitis. The presence of anatomical variations was determined, and its correlation with disease extension was analyzed. Results: Fifty children were included in the study. The anterior ethmoid sinus was the most commonly affected sinus in children, followed by the maxillary, posterior ethmoid, frontal, and sphenoid sinuses. Agger nasi cells were the most common anatomic variation in children sinus (96%), followed by inferior turbinate hypertrophy (60%), septal deviation (55.1%), concha bullosa (45.8%), Onodi cells (44.9%), Haller cells (38%), and paradoxical middle turbinate (4%). No significant correlation was found between anatomic variation and corresponding sinusitis hypertrophy and maxillary sinusitis (P > 0.05). Conclusions: Our results found no correlation between anatomic variations and sinusitis in pediatric CRSwNP. The occurrence of pediatric CRSwNP is as attributed more to immunological, infectious, or other factors rather than anatomic variations.

Background/aim of study: Infective endocarditis (IE) morbidity and mortality remains high. In most studies, endocarditis lesions found during surgery are not extensively described. The aim of this study was to register and describe endocarditis lesions found during surgery; find predictors of morbidity and mortality and correlate lesions found in echocardiogram vs. surgery. Methods: One hundred consecutive cases with endocarditis lesions seen during surgery were included between june 2014 and august 2018. Pathological lesions were coded prospectively using a coding form published by Pettersson et al. Other data were collected retrospectively. Results: Prosthetic endocarditis accounted for 23% of cases. Embolic events had occurred in 41% of cases, mainly to the brain (22%). The most frequent lesions found in echocardiogram were vegetations (77%). Vegetations and valve integrity anomalies were the main lesions described during surgery (70% and 71% respectively). Invasion was present in 39% of patients. In-hospital mortality was 9%. In univariable analysis, predictors of early mortality included chronic kidney disease (p= 0.005), prosthetic endocarditis (p< 0.001), Euroscore II (p< 0.001) and valve integrity anomalies (p= 0.016). Predictors of embolic events included aortic valve vegetations seen during surgery (p= 0.026). Sensitivity and specificity of echocardiogram findings for identification of vegetations were 84% and 40%, for valve integrity anomalies 42% and 97% and for invasion 54% and 95% respectively. Conclusions: Diversity of lesions found in endocarditis preclude obtaining significant predictors of morbidity or mortality with small numbers of patients. Echocardiogram lacks sensitivity for valve integrity anomalies and invasion, but is highly specific.

Down syndrome (DS) acute lymphoblastic leukemia (ALL), more frequent in pediatric age than in adulthood, still have a worse outcome compared with non-DS population, mainly due to their intrinsic susceptibility to chemotherapeutic drugs toxicity. Furthermore, in the last years, it has been shown that the overexpression of CRLF2 and a Ph-like signature are relatively more frequent in DS patients. We report a case of a DS patient who developed a Ph-like ALL, 21 years after a first diagnosis of B-ALL, successfully treated with blinatumomab after failure of conventional chemotherapy.

Objectives: In patients with bilateral asymmetrical hearing loss (AHL) where only one hearing aid is available, it is difficult to decide which ear to amplify. The aims of this study were to evaluate the outcomes of hearing-aid use for AHL patients fitted with a hearing aid in their worse ear only. Design: Retrospective study. Setting: Secondary-referral, university-based hospital. Participants: 102 adults with asymmetrical mixed or sensorineural hearing loss. AHL was classified into three subgroups: unilateral hearing loss (UHL), and asymmetrical hearing loss type 1 (AHL1) and type 2 (AHL2). Main outcome measures: (1) The time for wearing a hearing aid, (2) the hearing in noise test (HINT)), (3) sound localization test, and (4) the Korean version of the International Outcome Inventory for Hearing Aids (IOI-HA). Results: The 1 kHz-hearing threshold of the better ear was significantly better in the intermittent users than in the successful users for UHL. Among the etiologies of AHL, sudden hearing loss was associated with significantly better outcomes of hearing-aid use for AHL, UHL, and AHL1 patients. Younger age was associated with significantly better outcomes for AHL and AHL2. Conclusions: The results indicate the importance of good hearing at 1 kHz in the better ear when counseling UHL patients who will receive a monaural hearing aid in their worse ear. We also suggest that clinicians should recommend a monaural hearing aid for the worse ear to younger patients with AHL, especially in cases of sudden hearing loss.

Resternotomy for bleeding remains a significant complication with increased rates of morbidity and mortality. Right ventricular laceration from fractured sternal wires is rare cause of postoperative bleeding. A 68-year-old man presented for coronary artery bypass grafting (CABG). Postoperatively, he had a chronic obstructive pulmonary disease (COPD) exacerbation. He initially responded to treatment, and shortly after mobilizing, acutely decompensated hemodynamically. A bedside echo revealed significant pericardial effusion. The patient was taken urgently for re-exploration with a diagnosis of cardiac tamponade. All sternal wires were fractured, and a right ventricular laceration was identified. The laceration was repaired, and the patient recovered well postoperatively. Postoperative hemorrhage can occur in cardiac surgical patients, but rarely is the cause laceration secondary to sternal wire fracture. Alternative sternal closure techniques should be considered in this and other high-risk groups of patients. Patients with sternal dehiscence should be monitored closely and definitive management should not be postponed.

PVDF has special piezo/pyro/ferroelectric, flexibility, low weight, biocompatibility, economical, good chemical/thermal, and high mechanical properties such as excellent nontoxic fiber/film formation. It has polar and nonpolar phases of α, β, γ, ε, and δ that the nonpolar α phase is the most stable one, but the β phase is the best of all because it has good piezo/pyro/ferroelectric properties. Copolymers are attractive because of their low weight, nontoxic, chemical acid resistance, flexibility, and ease of processing. These aspects result in their applications in many fields. They are used for piezoelectric nanogenerators, cooling/heating sensors, electronic devices (fuel cells, lithium-ion batteries (as separators), dye sensitive solar cells), filtration, oil/water separation, and photoelectric nanodevices. This review highlights the main aspects of the last decade’s articles, and the focus is on the synthesis methods of PVDF nanofibers and their properties which results in their application in different fields of industry and especially focuses on finding ways to increase the output of PVDF nanofibers nanogenerators (weight/acoustic pressure nanogenerators).

The root-knot nematode Meloidogyne graminicola is an important parasitic nematode that causes huge economic losses to rice production in China. In the present study, 54 M. graminicola populations were collected from the major rice-growing areas of ten provinces in China. The cytochrome oxidase subunit I (COI) gene sequence of M. graminicola populations in the studied locations were PCR-amplified, sequenced, and evaluated for genetic diversity analysis. The total number of mutations, haplotypes (Hap) numbers, the average number of nucleotide differences (k), haplotype diversity (Hd), and nucleotide diversity (π) of mtCOI gene were 39, 15, 5.37, 0.646, and 0.00682, respectively. The significant differences in Fst value (0.593) and a low level of gene flow (0.333) were detected between the 54 M. graminicola populations. High genetic diversity was observed within each population and a small genetic distance was found between them. The phylogenetic analyses showed that 54 M. graminicola populations were divided into three large groups corresponding to the Central Region (CR), Southern China (SC) and the Yangtze Valley (YV). Hap8 was the most widely distributed and was considered to be an origin of haplotype, revealing a separate evolutionary origin in China. The high genetic differentiation of M. graminicola populations was result of variation within each of the defined geographical groups, according to an analysis of molecular variance. No significant relationship was observed between the genetic distance and geographical distance in M. graminicola populations. To the best of our knowledge, this is the first study conductedon the genetic diversity of M. graminicola infesting rice in China and provides a theoretical basis for the future management of the M. graminicola population and potential approach for increasing production of rice.

Experiments and modeling were performed to investigate the coupled hydrologic and biochemical processes that control chromium (Cr) immobilization in a low permeability groundwater zone. Bench-top flow cells were packed with a water-saturated high permeability zone (HPZ) overlying a low permeability zone (LPZ). Cr(VI) was initially flushed into the LPZ to establish a reservoir of this contaminant. Next, the electron donor acetate and the bacterium Geobacter sulfurreducens were flushed into the HPZ; they mixed with Cr(VI) in the LPZ and promoted its reduction. Experimental depth profiles show that approximately 80 % of Cr(VI) introduced to the flow cell was immobilized as Cr(III) over 180 h within a small region on either side of the HPZ-LPZ interface. Groundwater flow and reactive transport in the flow cell were simulated using MODFLOW and RT3D, respectively, with dual-Monod kinetics defined in the custom reaction module of RT3D. Modeling results adequately matched experimental data, and were extended to simulate Cr(VI) fate in a numerical flow cell with the same dimensions but with the LPZ replaced by a diffusion-controlled lower permeability clay matrix. For this scenario, approximately 99% of the Cr(VI) in the LPZ could eventually be immobilized as Cr(III); this primarily occurred in the LPZ and mitigated Cr(VI) back diffusion to the HPZ. Overall, results from this work support acetate amendment to HPZs as an effective strategy to trap Cr(III) in LPZs and mitigate back diffusion of Cr(VI) into adjacent HPZs of a groundwater aquifer.

Abstract：Structural variation (SV) is a fundamental genetic cause for cancer, with demonstrated correlation to disease progression and treatment response. Traditional sequencing method cannot provide full genomic landscape especially large-scale and complex structural variation. To overcome these limitations, we adopted a combined sequencing approaches, including optical mapping, single molecular sequencing and short reads shotgun sequencing, to evaluate the SV in thyroid cancer. Different numbers, length and types of structural variation, with genes affected by SV were scrutinized. Integrating these results could showed comprehensive scenario for thyroid cancer in a genomic view. We demonstrate that integrated approaches could provide a powerful tool for capturing a higher level of genomic SV, creating new interpretation of sequencing data of particular relevance to human cancer.

Honey DNA metabarcoding provides information of floral sources of honey and foraging plant preferences of honey bees. We evaluated the floral composition of honey from two different species of honey bees, Apis cerana (ACH) and A. mellifera (AMH) in a mixed apiary located in a semi-forest environment to understand the floral preference and level of interspecific competition on floral resource. In total, 56 plant taxa were identified across the honey samples and among them, 38 taxonomic units were found in ACH compared with a total of 33 in AMH. 23 taxonomic units were found exclusively in ACH, 18 taxonomic units were found only in AMH and 15 taxonomic units were shared between ACH and AMH indicating that 73% of the taxonomic units were present only in one type of honey. The number of major plants (>1% of reads) in the honey samples was 9 and 11 in ACH and AMH, respectively, indicating a slightly higher diversity of plant taxa in AMH. Qualitative and quantitative analyses of the shared major plants revealed the division of floral resource between these co-existing honey bee species pointing to a low level of interspecific competition. We conclude that the presence of both species in the same apiary can lead honey bees to behavioral modifications to avoid competition for floral resources and to provide pollination services to a higher number of flowering plants.

Contemporary rates of biodiversity decline emphasize the need for reliable ecological forecasting, but cur-rent methods vary in their ability to predict the declines of real-world populations. Acknowledging that stress acts at the individual level, and that it is the sum of these individual-level effects which drives popu-lations to collapse, shifts the focus of predictive ecology away from using predominantly abundance data. Doing so opens new opportunities to develop predictive frameworks which utilize increasingly available multi-dimensional data which have previously been overlooked for ecological forecasting. Using this ra-tional, we propose that stressed populations will exhibit a predictable sequence of detectable changes through time: (i) changes in individuals’ behaviour will occur as the first sign of increasing stress, followed by (ii) changes in fitness related morphological traits, (iii) shifts in the dynamics (e.g. birth rates) of popu-lations, and finally (iv) abundance declines. We discuss how monitoring the sequential appearance of these signals supplies information to discern whether a population becoming increasingly stressed risks collapse or is adapting in the face of environmental change. Such a timeline of signals provides a new framework to implement forecasting methods combining multidimensional data (e.g. behaviour, morphology, abun-dance) that may increase the ability to predict population collapse.

In this paper, the generalized coupled Sylvester matrix equations are solved using a gradient-based iterative technique over the generalized centro-symmetric matrices ( . In the case that our investigated matrix equations are consistent, with chosen initial generalized centro-symmetric matrices and , a generalized centro-symmetric solution ( can be found in a finite number of iterations in the absence of round-off errors. Numerical examples are presented in order to support the theoretical results of this paper.

Mountain climate and vegetation change rapidly with altitude therefore many plant species may be found within a narrow elevation range. In mountains of northern Mongolia, a relict shrub Prunus sibirica L. occurs within restricted upland areas. We studied 25 whole-plant and leaf traits of P. sibirica at 10 locations in the Khentei Mountains. A comparison with a global plant trait variation and a path model were used to evaluate the pattern of functional response to altitude. Intraspecific variation of pigment content found in apricot was surprisely comparable to interspecific variation of terrestrial plants over a global scale. Increasing altitude caused a dramatic increase in chlorophylls and chlorophyll/carotenoid ratio and a decrease in the chlorophyll a/b. We also found a decrease in leaf thickness contributed to transpiration and water use efficiency. Photosynthetic capacity and kinetics, plant sizes, biomass were not affected by altitude. The path modelling revealed that pigment content and leaf structure were two independent ways to maintain the plant carbon and water balance. Our results identify the important role of intraspecific variation in leaf pigments and structure in plant response to altitude and we suppose that these leaf traits could be used as predictors for the species altitudinal limits.

Since the national vaccination program was implemented with the H5/H7 bivalent vaccine in poultry in September 2017, the prevalence of H7N9 avian influenza viruses (AIVs) has been controlled effectively in China, and low pathogenic H7N9 viruses have disappeared nationwide. However, highly pathogenic H7N9 viruses still exist, causing sporadic outbreaks especially in some regions of northern China. During our routine surveillance in poultry in 2020, we isolated two strains of H7N9 subtype AIV from breeder layer farms in northern China. We found that these two chicken-origin H7N9 isolates were both highly pathogenic (HP) based on the sequence of the HA gene. Deduced amino acid sequences of the HA gene revealed that both strains had a four-amino-acid (KRTA) insertion at position 339-342 and an I335V mutation in the cleavage site to make the motif PEVPKRKRTAR↓GLF. Remarkably, both strains gained the F102V and N157D mutations (H3 numbering) in their HA genes, which have never been reported before. Solid-phase direct binding assay showed that these two isolates both had dual-receptor binding characteristics, while thermal and acid stability assays indicated that they were relatively stable in high-temperature or acidic conditions. In addition, the animal experiments demonstrated that both strains were highly pathogenic to chickens but low pathogenic to mice. These results suggested that the evolution of H7N9 subtype AIV is still continuing, and they pose a potential threat to poultry and public health. Thus, attentions should be paid to the importance of continual surveillance of the H7N9 AIVs.

Sperm whales are a cosmopolitan species only found in ice-free regions. Understanding the distribution of sperm whales in regions undergoing rapid loss of sea ice and ocean warming is important. In 2014 and 2018, sperm whales were sighted in the Pond Inlet, Baffin Bay: the first recorded uses of this region. We investigated sperm whale distribution near the Pond Inlet using visual sighting and passive acoustic data from two recording sites between 2015 and 2019. We found no records of sperm whale sightings near Pond Inlet outside of the 2014/2018 observations. However, the acoustic data revealed whale presence yearly from 2015-2019 in the late summer and fall months. Sperm whale presence increased over the 5-year study duration and was closely related to sea ice extent. Monitoring climate change-induced range expansion of sperm whales is important to understand how increasing presence of a top-predator might impact the Arctic food web.

Water use efficiency (WUE) is central to the global cycles of water and carbon. However, whether increasing tree diversity in plantation can increase WUE remain poorly understood. Here, we conduct a forest biodiversity experiment with 32 tree species spread in 14 ha in subtropical China to assess the effects of neighboring tree diversity on foliar WUE of Cunninghamia lanceolata, a widespread tree plantation species in China. We measure foliar δ13C as the proxies of changes in intrinsic WUE. Folia P concentrations of focal trees increase with trait dissimilarities between focal trees and neighbors, and the increased foliar P concentrations improve foliar WUE of focal trees. This neighborhood complementarity effect on WUE is stronger under more shaded neighborhood. However, neighborhood biodiversity did not significantly affect foliar δ18O, a surrogate for stomatal conductance. These findings suggest that tree biodiversity increases WUE through the complementary usages of soil P between neighboring tree species.

In mountain environments, populations of a species are subjected to different environmental conditions. Environmental variables impose different selection pressures that could result in a marked heterogeneity in genetic characteristics (e.g. ploidy level, genome size, population genetic diversity and structure), population features and reproductive success. Cactaceae inhabit in arid and semi-arid areas of America, from sea level to 4500 m a.s.l. and in these environments, species can present wide altitudinal ranges. The aim of this work was to analyze how genetic (cytogenetic, DNA content and AFLP genetic diversity), population features (population density and individual size) and reproductive success are related to an altitudinal gradient in five populations of Gymnocalycium monvillei. Our results showed that individuals in all studied populations are tetraploid. Analyses of the genetic structure revealed that the five altitudinal populations could be genetically two populations and that, regardless of population affiliation, all individuals analyzed are genetically very similar. The population density and individual size varied unimodally in the gradient. The population at intermediate altitude had the highest number of seeds per plant, so this population would be presenting favorable ecological conditions. Interestingly, more differences among the populations have been found in their population features and reproductive success than in genetic characters among the populations.