Inhaled bronchodilators are often given in preterm infants with evolving or established bronchopulmonary dysplasia. However, it is unclear which patients may benefit from it and when it is the best time to start treatment. The forced oscillation technique (FOT) is a noninvasive method for assessing lung mechanics that proved sensitive to airway obstruction reversibility in children and adults. FOT does not need patient cooperation, which is ideal for infants. Bedside tools for applying FOT in infants during spontaneous breathing and different respiratory support modes are becoming available. This case report illustrates for the first time that FOT has potential value in assessing airway obstruction reversibility in preterm infants, informing which infants may manifest a clinical benefit from the treatment with bronchodilators.

Green sea turtle conservation benefits from knowledge of population connectivity across different life stages. Green turtles are usually managed at the level of genetically discrete rookeries, yet individuals from different rookeries mix at foraging grounds. Rookeries may be impacted by processes at foraging grounds, hence rookery contributions to mixed foraging assemblages must be considered. Bimini, Bahamas, is an important foraging ground for juvenile green turtles, but rookery contributions to this assemblage have never been resolved. We generated mitochondrial DNA (mtDNA) sequences for 96 green turtles from Bimini and used Mixed Stock Analysis (MSA) to determine rookery contributions to this foraging assemblage using high-resolution (~817 base pair) and low-resolution (~490 base pair) rookery baseline data. The high-resolution data indicated that Quintana Roo, Mexico and Central Eastern Florida contributed most to Bimini. The low-resolution data indicated that Southwest Cuba and Central Eastern Florida contributed the most to Bimini. The results of the low-resolution MSA differ from a previous study conducted in Great Inagua, Bahamas which may reflect rookery size, rookery proximity to foraging grounds, the influence of currents, or a combination of these factors. While the presence of large credible intervals in our results does not permit explicit interpretation of individual MU contributions identified in MSAs, our results reveal substantial relative differences in rookery contributions to Bahamian foraging assemblages. Our study highlights the importance of regularly monitoring rookery contributions, resolving regional recruitment patterns to inform conservation, and the importance of using high resolution data in future MSA’s to improve rookery contribution accuracy.

Oreohelix strigosa (Rocky Mountainsnail) is a land snail found in the talus slopes of the Rocky Mountains. The University of Colorado’s Museum of Natural History has densely sampled Oreohelix for the past century; many are preserved in ethanol and available for molecular research. While microbiome compositions in other systems are not affected by short-term field season preservation, the effects of decades-long preservation have yet to be assessed. We used 16S rRNA gene amplicon sequencing to examine Oreohelix strigosa gut microbiomes from museum specimens across a 98-year range, as well as within short term preservation treatments collected in 2018. Treatment groups included samples extracted fresh, without preservation; samples starved prior to extraction; and samples preserved for 1 month, 6 months, and 9 months. General microbiome composition was similar across all years. Sample groups belonging to specific years, or specific short-term treatments, showed unique associations with select bacterial taxa. Collection year was not a significant predictor of microbial richness, though unpreserved short-term treatments showed significantly higher richness than preserved treatments. While year was a significant factor in microbiome composition, it did not explain much of the variation across samples. Other factors like location collected and drought index were also significant drivers of community composition and explained as much or more of the variability. This study is the first to examine animal host associated microbiome change across a period of nearly one century. Consistent patterns across this temporal range indicate that historic specimens can answer many ecological questions surrounding the host associated microbiome.

Aims and Objectives: We aimed to determine whether the modified bipolar cutting & coagulation system resulted in shorter operative time and less intraoperative blood loss and less postoperative complications compared to harmonic FOCUS for total thyroidectomy. Method: From September 2016 to December 2019, a total of 305 inpatients underwent total thyroidectomy in our center were randomly divided into trial group(n=155) and control group(n=150) and the surgical results were analysed prospectively. Results: The operative time, intraoperative blood loss, specimen weight, the classification of cervical lymph node dissection and the mean number of dissected lymph nodes indicated no statistical difference between two groups(P＞0.05). The rate of intraoperative parathyroid autotransplantation was 32.7%(49/150) in the control group, significantly higher than 16.1%(25/155) in the trial group (P=.001). The levels of serum PTH in the trial group at day 1,3 and 5 were significantly lower than those in the trail group(P＜0.04). The rate of transient RLN injury was 8.0%(12/150) in the control group, significantly higher than 2.6%(4/155) in the trail group(P=.041). The rate of postoperative transient hypocalcemia were 33.3% (50/150) in the control group, more than 14.8%(23/155) in the trail group statistically((P=.000). Conclusions: The modified bipolar cutting & coagulation system means safe, less damage and less complications and deserves popularizing for thyroid surgery.

Hepatic cirrhosis is a very rare complication of hematopoietic stem cell transplantation (SCT) and of neuroblastoma. We encountered two patients developing cirrhosis after SCT against neuroblastoma. A 6-year-old boy who had received allogeneic bone marrow transplantation developed cirrhosis 10 years after the SCT with the massive upper gastrointestinal hemorrhage. A 27-year-old man receiving allogeneic cord blood transplantation against recurrence of neuroblastoma, died of liver failure due to histological cirrhosis 1 year after the SCT. We could not detect the definite etiologic candidates of cirrhosis; however, careful monitoring appears warranted to avoid overlooking the onset and progression of cirrhosis after SCT.

In this article, we investigate the following delay differential equation $$ (\triangle_c \nu(z))^{2}-\tilde{A}(z)\nu(z)\nu(z+c)+\tilde{B}(z)\frac{\nu’(z)}{\nu(z)}=R(z, \nu(z)), $$ where $R(z, \nu(z))$ be an irreducible rational function in $\nu(z)$ with rational coefficients, $\tilde{A}(z)$ and $\tilde{B}(z)$ be a rational function. We give necessary conditions on the degree of $R(z, \nu)$ for the above equation to admit a transcendental entire solution $\nu(z)$ with $\sigma_{2}(\nu)<1$. In addition, for certain classes of equations, we prove the existence of rational solutions and give their forms.

Background Several articles have shown that birth weight is associated with the risk of many types of cancers. However, the results are inconsistent and whether the relationship has a casual effect remains unknown. Objectives To estimate the association between birth weight and cancer risk by dose-response meta-analysis and two-sample Mendelian randomization analysis. Search strategy PubMed and Embase library up to March 2021. Selection criteria Prospective cohort studies and case-control studies. Data collection and analysis Two reviewers collected data and the third reviewer check the accuracy. Summary relative risks (RRs) and 95% confidence intervals (CIs) were included. Main results In our dose-response meta-analysis, six cancers from 46 studies were found to had significant associations with the birth weight. (Ovarian cancer: RR: 1.21, 95%CI: 1.01-1.44; breast cancer: RR: 1.12, 95%CI: 1.08-1.16; colorectal cancer: RR: 1.20, 95%CI: 1.01-1.43; endometrial cancer: RR: 0.85, 95%CI: 0.78-0.93; prostate cancer: RR: 1.27, 95%CI: 1.01-1.61; testicular cancer: RR: 1.21, 95%CI: 1.03-1.43). As the birth weight gain, the slope of the dose-response curve of breast cancer increased continuously and the curve of testicular cancer was U-shaped. (Pnonlinearity<0.001) In the MR study, seven cancers were included. Only invasive mucinous ovarian cancer was found to have casual effect on birth weight (OR: 0.62; 95%CI: 0.39-0.97) while other cancers did not. Conclusions There is a nonlinear dose-response relationship between birth weight and breast cancer and testicular cancer. And birth weight has a casual effect on invasive mucinous ovarian cancer. Tweetable abstract Birth weight is associated with cancer risk but affects it indirectly.

Using the meshless collocation method, a scheme for solving nonlinear variable-order fractional diffusion equation with fourth-order derivative term is presented. Here approximations to fractional derivative term are obtained by weighted and shifted Gr\”unwald difference (WSGD) approximation formula. The difficulty caused by the nonlinear terms is carefully handled by quasilinearization technique. Using the radial basis functions, the solution of the problem is written in terms of the primary approximation, and the related correcting functions at each time step. Then the approximation is substituted back to the governing equations where the unknown parameters can be determined. Finally, the method is supported by several numerical experiment on irregular domains.

Hematopoietic cell transplantation corrects a hematological phenotype of Diamond-Blackfan anemia (DBA). Reduced conditioning has been recommended for patients with the cancer predisposition, but appropriate intensity is required to prevent graft failure. We conducted unrelated-donor bone marrow transplantations in six consecutive transfusion-dependent patients (median age, 5.4 years; range, 1.8–23) after targeted-busulfan (60–75 mg/L×h of cumulative AUC) and fludarabine regimen without irradiation. All obtained chronic graft-versus-host-disease-free complete donor chimerism, including one unrelated cord blood transplantation rescue. The rescued 7-year-old girl had the longest transfusion-dependency (>40 months) and highest ferritin level (>2,000 ng/mL) pretransplant. Intermediate-intensity targeted busulfan-based conditioning may cure DBA.

Fruit flies (Diptera: Tephritidae) possess high diversity and globally wide distribution, including a range of important agricultural pests. However, the origin, phylogeny and divergence history remain poorly understood. We undertook the first comprehensive mitogenomic study covering phylogenetic reconstruction, divergence time estimation and historical biogeography analyses by analyzing 147 mitochondrial genomes representing three subfamilies, seven tribes, 11 genera and 82 species. The results recovered all the three subfamilies, seven tribes and 11 genera as monophyletic group. Within Dacini subfamily, our phylogeny strongly supported the sister group relationship of (Zeugodacus + Dacus) + Bactrocera, which further supported to raise Zeugodacus as generic level of Dacini. On the other hand, our molecular phylogenetic analyses did not align well with the currently recognized subgeneric designations within Ceratitis, Dacus and Zeugodacus. Some subgenera were recovered as polyphyletic or paraphyletic, implying the incongruence between morphological characters and mitogenomic data. Neither the taxa within the Ceratitis FARQ complex nor those within the Bactrocera dorsalis complex could be clearly distinguished as distinct species corresponding to the morphospecies by mitochondrial phylogenetic tree. Divergence time estimation and historical biogeography analyses indicated that the earliest common ancestor of the Tephritidae, originated in the Palearctic realm at 138.92-71.44 Ma, with the subsequent divergence into Dacinae + Trypetinae and Tephritinae at 115.19-67.45 Ma equally in the Palearctic realm. Dacini might have originated in Laurasia rather than Gondwana and diverged into Bactrocera and Dacus + Zeugodacus at 48.43-28.70 Ma after India plate docked with Laurasia.

Background: Acute lymphoblastic leukemia (ALL) is the commonest childhood cancer globally. We described the clinical features at diagnosis and established the overall survival of children diagnosed with ALL at our Pediatric Cancer Unit. Methods: In August 2020, we retrospectively studied children <16 years diagnosed with ALL over a 4-year period (June 2016 to May 2020) at Mbarara Regional Referral Hospital (MRRH) in south west Uganda. Frequencies and proportions of baseline clinical features and treatment outcomes were described. Kaplan-Meier analysis and Cox proportional hazard regression model were performed to estimate overall survival and identify its predictors respectively. Ethical approval was obtained from Research Ethics Committee of Mbarara University of Science and Technology. Results: Within the 4-year period, 301 children were diagnosed with cancer; 51 (16.9%) with ALL. Forty-four (86.3%) presented with fever, 28 (54.9%) cough, 21(41.2%) bleeding tendencies, 20(39.4%) limb pains and 8(15.7%) abdominal distension. Forty-four (86.3%) had pallor, 39(76.5%) lymphadenopathy, 37(72.5%) hepatosplenomegaly, 18(35.3%) pyrexia, 12(23.5%) bone tenderness and 11(21.6%) petechia. Thirty (58.8%) children presented with leukocytosis (WBC>12x109/L), all the children had anemia (Hb) <11.0g/dl) and 48 (94.1%) had thrombocytopenia (<150.0x 109/L), . Thirty-three (64.7%) children completed induction chemotherapy; 27 (81.8%) with remission. Overall one year survival was 42.5%. Remission failure was associated with poor survival. Conclusions and Recommendation: Children with ALL present with non-specific clinical features that mimic common childhood infections and its outcomes are low at our unit. ALL should form part of the differential diagnosis in children with fever, pallor, bleeding, or leukocytosis, anemia and thrombocytopenia.

An extrapolation cascadic Newton multigrid (ECNMG) method is proposed for high accuracy numerical solutions of two-dimensional nonlinear Poisson equations, by incorporating the fourth-order compact difference schemes, the extrapolation techniques and the existing Newton multigrid method. A series of grid level dependent computational tolerances are discussed to distribute computational cost on different grids, and an extrapolation interpolation strategy and a bi-quartic polynomial interpolation are used for two fourth-order approximations from current and previous grids to provide an extremely accurate initial guess on the next finer grid, which can greatly reduce the iterations of the Newton multigrid computation for computing an approximation with discretization-level accuracy. Additionally, a completed Richardson extrapolation technique is adopted for the fourth-order computed solution to generate a sixth-order extrapolated solution cheaply. Numerical results of two-dimensional nonlinear Poisson-Boltzmann equations with five different fourth-order compact difference schemes are conducted to demonstrate the new ECNMG algorithm achieve sixth-order accuracy and keep less cost simultaneously, more efficient than the existing Newton-MG method.

A document by GUNJAN . Click on the document to view its contents.

Anomaly detection for the compressor systems is essential for the midstream industry. In this paper, anomaly classification and detections method based on neural network hybrid model named as Long Short-Term Memory (LSTM)-Autoencoder (AE) is proposed to detect anomalies on sequence pattern of audio data, collected by multiple sound sensors deployed at different components of each compressor system. To create a baseline for model evaluation this paper has also conducted experiments on different RNN architectures such as GRU, LSTM, Stacked LSTM and Stacked GRU with different functions. Each architecture used audio signals dataset received from the compressor system for experiments to consider the performance in each neural network model. All the network architectures and experiment results have considered with various model configuration and layers with different functions. According to performance results, optimal model for anomaly detection with best performance scores has proposed in this research. In conducted experiments, combined one-dimensional raw audio signals features using SC and Mel spectrogram features were fed to deep learning models to evaluate performance. Using SC and Mel spectrogram features achieved the best performance for anomaly detection in audio data based on the LSTM-AE in all evaluation metrics. Hence such hybrid methods can detect normal and anomaly audio signals collected from a compressor system effectively, which can increase the compressor reliability and the gas production line sustainability.

Background: Frailty is strongly associated with adverse health outcomes in older heart failure patients. Aims: We aimed to explore the effect of frailty on unplanned readmissions and death in chronic heart failure (CHF) patients aged 18 years or older. Methods: 342 chronic heart failure patients aged 18 years or older from heart centers of two tertiary care hospitals, located in north-west of China, were enrolled between July and December 2020. Frailty was assessed by the Tilburg Frailty Indicator. Patients were followed for unplanned readmissions, all-cause mortality at 30, 60, and 90 days after discharge. Multivariate cox regression models were used to analyze the effect of frailty on 90-day unplanned readmission and death in patients with CHF. Results: Frailty prevalence was 54.7% among 342 CHF patients, with a mean age of 64.65 ± 11.90 years. Compared to non-frailty CHF patients, the frailty CHF patients were older and had higher systolic blood pressure, longer duration of heart failure, more severe cognitive function, and more comorbidities ( P<0.05). Patients in the frail group had a higher incidence of unplanned readmission (73.1% vs. 26.9%, χ2 = 18.87, P < 0.01) and death (100% vs. 0%, χ2 = 6.94, P < 0.01) than those in the non-frail group. Multivariate cox regression analysis showed that frailty was an independent risk factor for 90-day unplanned readmission (HR = 1.469, 95% CI 1.318-1.637, P < 0.01) and 90-day death (HR=2.270, 95% CI 1.091-4.726, P<0.01) in patients with CHF. Discussion: Evaluation of frailty among CHF patients, include frailty in the routine evaluation of admission seems necessary to provide personalized intervention to improving their prognosis. Conclusion: Frailty is an independent predictor of unplanned readmission and death 90-day after discharge in CHF patients aged 18 years or older.

The concept of intuitionistic N-fuzzy set (INFS) has been applied to the quasi ideals of bi-ternary semigroups. The notion of intuitionistic N-fuzzy quasi ideal of bi-ternary semigroup has been introduced and characterized by using intuitionistic N-fuzzy level set and N characteristic function. The relationships between intuitionistic N-fuzzy quasi ideal and intuitionistic N-fuzzy ideals (left, right, bi) have been discussed. Finally, the idea of translations on intuitionistic N-fuzzy bi-ternary semigroup is discussed.

The general zeroth-order Randi\’c index ${^0}R_{\beta}(G)=\sum_{u\in V(G)}(d_{G}(v))^{\beta}$ is a vertex-degree-based graph invariants, where $d_{G}(v)$ denotes the degree of a vertex $v$ in $G$ and $\beta$ is an arith real number, which was defined by Li and Zheng in 2005, under the name “the first general Zagreb index”. In this paper, we explore the general zeroth-order Randi\’c index in terms of independence number. First, we give the upper and lower bounds for the general zeroth-order Randi\’{c} index of trees with given order $n$ and the independence number $\alpha$. Moreover, the corresponding extremal graphs are characterized. For unicyclic graphs, bounds for $^0R_{\beta}(G)$ are also be determined.

Corticosteroids are the most important factor to reduce the mortality in patients with moderate-severe COVID-19. The aim of the study was to analyze the impact of methylprednisolone pulse (MPP) on in-hospital mortality of patients with acute respiratory distress syndrome (ARDS) due to COVID-19. We conducted a retrospective, single-center observational study We selected adult patients admitted to the hospital with the diagnosis of COVID-19 between March and June 2020. A total of 306 patients were analyzed. In-hospital crude mortality rate was 17%. Diabetes mellitus (HR 5.5, 95% CI 1.40–4.55), dementia (HR 7.7, 95% CI 4.25-13.87) and ARDS (HR 4.2, 95% CI 2.34-7.46) were associated with in -hospital mortality. In patients diagnosed of ARDS, the only in-hospital mortality risk factor was dementia (HR 5.2, 95% CI 2.44–11.07), whereas MPP was a protective factor (HR 0.2, 95% CI 0.09–0.63)

Key pointsMeningitis is a life-threatening infection which may develop as a complication to acute otitis mediaThe most common sequela after meningitis is hearing loss, but risk factors for hearing loss have not been studied to any great extent.When all cases of meningitis (n=187) occurring in a Swedish county during 18 years (2000-2017) were investigated, 71 cases of hearing loss were identified, however 68 of the patients had not done a hearing test after recovery.Hearing loss was significantly more common in adults, occurring in 45% in patients aged 21-65 years and in 48% in patients over the age of 65 when assuming that those who had not done a hearing test had normal hearing. This corresponded to ORs of 8.0 and 9.8 compared to children.Concurrent acute otitis media and pneumococcal infection increased the odds of hearing loss by 2.1 and 3.6, respectively.

Background:This study was conducted to compare the PK characteristics, food effect and evaluate the bioequivalence between two fixed-dose combinations of lisinopril /amlodipine besylate in healthy Chinese subjects. Methods: A single center, randomized, open-label, single-dose, crossover bioequivalence study was designed in healthy Chinese subjects under both fasting and fed conditions. Cmax and AUC were used to evaluate bioequivalence. Adverse events were recorded. Results: 75 healthy subjects completed the study. The 90% confidence intervals of the ratio of geometric means of Cmax and AUC0-∞ of lisinopril and amlodipine fell within 0.80-1.25. A fat-high breakfast produced significant alteration in the Cmax and AUC of lisinopril after a dose of either reference or test drug. No severe adverse events were observed. Conclusion: The trial demonstrated that the test and the reference drug of fixed-dose combinations of lisinopril /amlodipine besylate were bioequivalent and well tolerated under fasting and fed condition

Familial neuroblastoma is an extremely rare entity with only 1 – 2% of neuroblastoma cases thought to have a familial inheritance, mainly due to PHOX2B and ALK germline mutations. 16p11.2 microdeletion syndrome has been reported to be associated with neuroblastoma. We present the first case report of a patient presenting with metastatic neuroblastoma, developmental delay, and atypical facies, in whom we identified an inherited germline 16p11.2 microdeletion.

The rise in epigenetic studies and its modifications, i.e., heritable alterations in gene expression without changes in DNA sequences, have now been confirmed in diseases. Modifications such as posttranslational histone modifications, DNA methylation and non-coding RNAs in the recent past have led to better understanding of the coaction between epigenetic alterations and human pathologies. Melatonin is a widely-produced indoleamine regulator molecule that influences numerous biological functions within many cell-types. With regard to its broad spectrum of actions, melatonin should be investigated much more with respect to its contribution in the upstream and downstream mechanistic regulation of epigenetic modifications in diseases. This review outlines the findings on melatonin's action on epigenetic regulation in human diseases including neurodegenerative disease, diabetes, cancer and cardiovascular diseases. It summarizes the ability of melatonin to act on molecules such as proteins and transcriptional factors which affects the development and progression of diseases.

Escherichia coli is one of the main pathogens that impacts swine production. Given the need for methods for its control, the in vitro effect of lactic acid bacteria (LAB) and their metabolites against E. coli F4 was evaluated through cell culture and microbiological analysis. The strains Limosilactobacillus fermentum 5.2, Lactiplantibacillus plantarum 6.2, and L. plantarum 7.1 were selected. To evaluate the action of their metabolites, lyophilized cell-free supernatants (CFS) were used. The effect of CFS was evaluated in HT-29 intestinal lineage cells; in inhibiting the growth of the pathogen in agar; and in inhibiting the formation of biofilms. The bioprotective activity of LAB was evaluated via their potential for autoaggregation and coaggregation with E. coli. The CFS did not show cytotoxicity at lower concentrations, except for L. fermentum 5.2 CFS, which is responsible for cell proliferation at doses lower than 10 mg/mL. The CFS were also not able to inhibit the growth of E. coli F4 in agar; however, the CFS of L. plantarum 7.1 resulted in a significant decrease in biofilm formation at a dose of 40 mg/mL. Regarding LAB, their direct use showed great potential for autoaggregation and coaggregation in vitro, thus suggesting possible effectiveness in animal organisms, preventing E. coli fixation and proliferation. New in vitro tests are needed to evaluate lower doses of CFS to control biofilms and confirm the bioprotective potential of LAB, and in vivo tests to assess the effect of LAB and their metabolites interacting with animal physiology.

TitleAplastic crisis in hereditary spherocytosis associated with Kawasaki disease