A previous study has reported cryptococcal meningoencephalitis in a previously healthy adult affected with H1N1 influenza. Here, we report cryptococcosis occurred in a previously healthy child with H3N2-influenza, which further suggests a potential association between cryptococcosis and influenza viral infection. In this case, a 5-year-old girl presented with fever and cough was admitted to our hospital with positive test for H3N2 influenza and pulmonary infiltration by chest CT scan. After antibiotic regimens, the clinical symptoms were not improved at all. Her bone marrow culture proved Cryptococcus infection. Following treatments with amphotericin B liposome and flucytosine, her body temperature returned to normal. Pulmonary infection was completely absorbed following oral fluconazole treatment for 6 mon.

ABSTRACT Objectives: The presence of exercise induced bronchospasm (EIB) in children with obesity and asthma is known. The measurements of fractional exhaled nitric oxide (FeNO) level in given breath are used as an indicator of airway inflammation. It can be affected by exercise and is high in patients with asthma. It is aimed to observe how much exercise what is common cause of acute airway obstruction changes FeNO in asthmatics in this study. Methods: FeNO was measured before/after exercise in the groups of obese-asthmatic children, non-asthmatic but obese children, the normal-weight children with asthma, non-asthmatic and non-obese children between the ages of 5-18. Spirometric measurements which are frequently used in asthma were compared with FeNO levels. Results: The highest average of FeNO was seen in asthmatic-obese group, the lowest mean of FeNO was found in healthy group. Non-asthmatic but obese group had respiratory parameters increasing with exercise, while FEV1/FVC was the lowest in the group with asthma-obesity and decreased with exercise. Conclusions: There is a strong relationship among FeNO and FEV1/FVC with asthma. The highest values of FeNO found in asthma-obesity combined. It was seen that obesity increased inflamation but didn’t increase EIB.

Background: Acquired angioedema due to C1-inhibitor deficiency (C1-INH-AAE) is a rare disease that can be diagnosed by complement testing. It often accompanies lymphoproliferative underlying diseases. Methods: In the last 30 years, from the 3938 patients who were sent to the Angioedema Center with angioedema symptoms, we have diagnosed C1-INH-AAE in 19 cases, and monitored them regularly. The connections between the underlying disease, its treatment, the angioedema symptoms and complement parameters were investigated. Results: The 19 C1-INH-AAE patients were followed up for 6 years on average. Underlying disease was diagnosed in case of 15 patients. Most often lymphoma (6/19 patients) and monoclonal gammopathy of undetermined significance (6/19 patients) were found. There was no difference between the sexes regarding the complement parameters. Connection was found between the presence and activity of any underlying disease, the frequency of the angioedema attacks and the decreased level of proteins of the complement system. Angioedema specific long-term prophylaxis did not make an improvement in neither the frequency of the attacks nor in the complement parameters. Rituximab treatment reduced the number of attacks or completely made them disappear, and we experienced positive changes in complement parameters. Conclusion: Complement parameters supported the long-term efficacy of rituximab treatment for C1-INH-AAE. The change in complement parameters can predict the relapse of the underlying disease, and it is a good indicator for the prediction of angioedematous attacks. In case of C1-INH-AAE, it is significantly important to examine the patients for underlying disease, and to regularly follow up the patient’s complement parameters.

Information processing is increasingly recognized as a fundamental component of life in variable environments, including the evolved use of environmental cues, biomolecular networks, and social learning. Despite this, ecology lacks a quantitative framework for understanding how population, community, and ecosystem dynamics depend on information processing. Here, we review the rationale and evidence for ‘fitness value of information’ (FVOI), and synthesize theoretical work in ecology, information theory and probability behind this general mathematical framework. The FVOI quantifies how species’ per capita population growth rates can depend on the use of information in their environment. FVOI is a breakthrough approach to linking information processing and ecological and evolutionary outcomes in a changing environment, addressing longstanding questions about how information mediates effects of environmental change and species interactions.

Pathomimia is manifested by self-induced skin lesions. It is difficult to diagnose and a challenge to treat.We report the case of a young male patient with unknown psychiatric history and self-induced skin lesions of hands and ankles.

Tuberculosis(TB) is a common disease in Sudan .Neurological consequences of TB are frequently encountered in our practice of neurology particularly tuberculosis of the spine(Pott,s disease).There are few case reports of tuberculous myelitis in literature.

Conyza blinin (C. blinii) is a traditional Chinese medicine plant grown in Sichuan, China. C. blinii is suitable for studying the tolerance mechanism of plants to iron because of its high iron content. Our results show that the growth and development of C. blinii is improved under iron at a specific concentration. Iron increased the content of endogenous auxin in C. blinii, improving the glandular trichome (GT) density and the content of blinin, the characteristic diterpene in C. blinii, which may enhance its tolerance to iron stress. We used RNA sequencing analysis to explore the differential gene transcription in C. blinii under iron stress to provide a reference for the study of other iron-sensitive plants. The results showed that most of the key enzymes in the blinin synthesis pathway were upregulated under iron stress. In addition, the process by which C. blinii responds to iron stress through IAA may be related to CbHO-1. Taken together, these results suggest that the increase in GT density and auxin-mediated blinin content improve the growth of C. blinii under iron stress.

Virus-like particles(VLPs) represent a safe and effective vaccine platform, improving assembly efficiency is necessary to reduce the cost of vaccine production, and elicit a strong immune response. In this study, CpG and Poly(I:C) were selected as scaffolds to facilitate the assembly of FMDV VLPs in vitro. The particle size, surface potential, gel retardation assay, nuclease digestion experiments, size-exclusion chromatography, transmission electron microscopy and circular dichroism analysis showed that CpG and Poly(I:C) were successfully encapsulated inside of VLPs, and have no effect on shape and sizes. The peak area of 75S of co-assembled CpG-VLPs and Poly(I:C)-VLPs were significantly increased than FMDV-VLPs(P<0.0001). With increasing the assembly efficiency of CpG-VLPs and Poly(I:C)-VLPs, higher neutralizing antibodies were elicited. Although, CpG or Poly(I:C) as adjuvant enhanced the proliferation level of spleen lymphocytes, but the proportion of CD4+ T cells and CD8+ T cells in the lymphocyte were significantly increased after stimulating by co-assembled CpG-VLPs (P<0.01) and Poly(I:C)-VLPs (P<0.001). This study demonstrated that CpG and Poly(I:C) not only improved the assembly efficiency of FMDV VLPs, also had an adjuvant activity to enhance the immune response, Furtherly, proposes a new idea and optimized strategy for improving the assembly efficiency of VLPs and contributes to the development of VLPs vaccine.

Objectives: To evaluate the management of cholesteatomas with labyrinthine fistulas (LF), as well as the clinical characteristics and postoperative hearing outcomes in a tertiary general hospital from 2011 to 2018. Design: Retrospective observational cross-sectional study using hospital electronic medical records. Setting: Mastoidectomies done for clinically suspected cholesteatomas. Participants: All patients who underwent primary middle ear mastoidectomy for cholesteatomas. Main outcome measures: Demographic data: age, gender, race, presenting complaints. Preoperative HRCT temporal bone and intraoperative findings. Change in hearing levels preoperatively and postoperatively. Results: 14 of 90 ears (15%) with middle ear cholesteatomas were complicated by LF. HRCT observed 93% sensitivity and 95% specificity in the identification of LFs. Intraoperative findings include stapes erosion in 79% ears (p<0.001), malleus erosion in 79% ears, incus erosion in 93% ears, dehiscence of tegmen tympani in 64% of ears (p=0.016) and tympanic facial canal dehiscence in 45% of ears. Matrix was removed completely in 85% (n=12) and matrix was left behind in 13% (n=2). 21.5% (n=3) had preoperative dead ears. Postoperative hearing results had a mean follow-up time of 2.1 years (1.5, 0.14-4.84). Matrix removal group (n=9) had hearing levels with 78% no change, 11.1% improvement and 11.1% decrease in hearing levels, while matrix preservation group (n=2) had decreased hearing levels. Conclusions: Preservation of hearing in labyrinthine fistulas is possible with cautious matrix removal and immediate repair of the fistula. Longer follow-up of hearing of LF with matrix preservation may show poorer hearing outcomes.

High temperature affects yield and quality of vegetable crops. Thermotolerant plants have excellent systems for identifying molecular mechanisms of heat responsive. In this paper, Various heat resistance indexes of thermotolerant (‘14’) and thermosensitive (‘02’) cucumber plants were observed at seedling stage, and the similarities and differences of regulatory genes were detected by transcriptome, so as to provide a train of thought for studying the effects of heat stress on the internal mechanism of cucumber. Leaf orientation, photosystem, water loss, ROS of ‘14’ plants displayed enhancer responsive than that of ‘02’ plants under high temperature. In corresponding, transcriptome analysis shown that genes in photosynthesis, chlorophyll metabolism and water homeostasis were upregulated in ‘14’ plants, but downregulated in ‘02’ plants. The content of ZR, BR and JA of ‘14’ plants was more than that of ‘02’ plants, GA increased in both but higher in ‘14’, IAA and GA were boosted by heat in ‘14’ and ‘02’ after high temperature stress. Further correlation and interaction analysis revealed that a small number of transcription factor family genes and the metabolic pathways corporately regulate heat responsive. Our study revealed different phenotypic and physiological mechanisms of heat response in thermotolerant and thermosensitive cucumber plants, revealed different expression profiles and preference metabolic pathways between thermotolerant and thermosensitive plants. The transcription factors and genes that involved in heat resistance were analyzed comprehensively. Those results enhanced our understanding on the molecular mechanisms of high temperature responsive in cucumber.

Background: Carboxypeptidase N (CPN) plays a major role in anaphylatoxin inactivation and is critical for bradykinin catabolism. CPN deficiency is a rare and underdiagnosed condition. Its pathophysiology has been shown as a function of anaphylatoxin and kinin accumulation, prone to mast cell and endothelium activation and sustaining inflammatory processes. We aimed to study families with homogeneous presentations for clinical and biological observations and genetics. Methods: Four families presenting with a CPN deficiency have been included. The study comprised clinical records of patients, biological parameters of anaphylatoxin/kinin metabolism, analysis of variants by next-generation sequencing and Sanger sequencing. Variants were classified as affecting splicing, benign to deleterious or disease causing according to algorithms (HSF ®, SIFT ®, Polyphen-2 ®, MutationTaster ®). Results: Patients had chronic spontaneous urticaria and swellings, mainly on face/lips, but also with abdominal pain or laryngeal symptoms. Plasma samples from affected patient displayed low CPN activity, mostly below 50% of median value. We detected 3 variants in CPN1 gene encoding the catalytic 85-kDa subunit of CPN, c.533G>A, c.582A>G and c.734C>T. The families carried these variants in combination, e.g. [c.533G>A];[c.533G>A] (n=2), [c.533G>A(;)c.582A>G] (n=1) and [c.533G>A(;)c.734C>T] (n=1). Family studies revealed that variant combinations associated with CPN deficiency segregated with both symptoms and CPN activity. Conclusions: CPN deficiency has been found associated with combinations of CPN1 variants, with c.533G>A when present on both alleles or in combination with c.582A>G or c.734C>T. It is associated with a high risk of chronic spontaneous urticaria and/or swellings, consistently with anaphylatoxin and bradykinin accumulation.

The inflammation is a response to some injury aimed at reestablishing homeostasis of the affected tissue. The in vitro model using RAW 264.7 cells has been widely used, as experimental model to assess the inflammatory response. However, there is still no consensus on which inflammatory mediators should initially be measured to screen for possible anti-inflammatory effects. To determine the rationality of measuring different inflammatory mediators together with NO, we carried out this systematic review and meta-analysis. A total of 17 studies were included, and LPS-induced cells produced high NO levels compared to non-LPS induced, and this production was not related to cell density. TNF-α, IL-1β, and IL-6, also showed high levels after cells had been stimulated with LPS; however, these effects were related to cell density. Finally, was found that measurement of NO levels alone may be sufficient to screen for possible anti-inflammatory action in the context of this model.

Congenital anomalous anatomy and course of coronary arteries are common however atresia of LMS is extremely a rare condition. Fewer than 50 cases of congenital atresia of left main stem coronary artery have been reported in the literature. The ostium or trunk of the left coronary artery is atretic, and the left coronary artery and its branches are supplied by the right coronary artery via coronary collaterals in a retrograde direction. The pattern of presentation varies depending on the age and anatomy of the patient. According to the literature these cases present at a very early age with signs of heart failure whereas adults may present with angina or shortness of breath. Its clinical signs and symptoms often resemble anomalous origin of the left coronary artery from the pulmonary artery and endomyocardial fibrosis. In literature there are only five adult cases reported with congenital atresia of LMS and an interesting fact is that one out of those five cases was diagnosed on autopsy to have atresia of LMS. That patient was a female at age of 76 years who died of reasons other than heart symptoms. Therefore it may be inferred that the range of symptoms vary from being completely asymptomatic to overt heart failure.

Abdominal Pregnancy at 38 weeks with good maternal and perinatal outcome: A Review Article An advanced abdominal pregnancy with a good fetal and maternal outcome is extraordinary occurrence because it is rare, associated with high morbidity and mortality for both fetus and mother. We present a case of abdominal pregnancy which was an emergency diagnosis on OT table while performing elective LSCS for 38 weeks with breech with previous LSCS with normal documented prenatal sonographies. Post delivery of baby by breech extraction, the torrential bleed and massive hemorrhage from placenta adhering to bowel and omentum was a big challenge.

In this study, by using the monotonicity properties of functions, several inequalities for convex functions are obtained with the help of a fractional integral operator which provides a function to be integrated in fractional order with respect to another function. It is also seen that the results obtained were generalizations of the previous results presented.

This paper discusses the problem of the adaptive control of nonlinear impulsive differential dynamical systems. First, a class of adaptive controllers are designed for the nonlinear impulsive differential equations, where the nonlinear function can be decomposed into matching condition and mismatching condition. Second, combining with Lasalle invariant set theorem, Schur complement theorem and some inequality techniques, we consider the synchronization of impulsively coupled complex networks via the general adaptive control. Moreover, this paper proposes the pining adaptive synchronization results for impulsive dynamical complex networks. Finally, some examples with simulations are given to demonstrate the effectiveness of our results.

In this article, we focus on triple weak solutions for some p-Laplacian type singular elliptic problems with two parameters and mixed boundary conditions. We show the existence of at least three distinct weak solutions by using variational methods, the Hardy inequality and a recently obtained three critical points theorem under suitable assumptions.

Background: This study aimed to determine the median effective analgesic concentration of 10mL ropivacaine in interscalene brachial plexus block for postoperative anesthesia in 50% of the patients (EC50). Method: This study was conducted on 30 patients with ASA grade I or II, who are planning to undergo proximal humerus fracture operation. A concentration of 10mL ropivacaine administered for the Interscalene brachial plexus was determined using the up-and-down sequential. The initial concentration of ropivacaine in the first patient to receive interscalene brachial plexus block(ISBPB) was 0.3%, After a successful or unsuccessful postoperative analgesia, the concentration of local anesthetic was decreased or increased, respectively, by 0.05% in the next patient. We defined successful postoperative analgesia as VAS score below 4 at rest within initial 8 hours after ISBPB. The analytic techniques of linear, linear-logarithmic, exponential regressions and centered isotonic regression were used to determine the EC50 of ropivacaine and the residual standard errors were calculated for the comparison of “goodness of fit” among the different models. Results: The concentration of ropivacaine administered ranged from 0.1% to 0.35%. The EC50 (95% confidence interval) from 4 different statistical approaches (linear, linear-logarithmic, exponential regressions and centred isotonic regression) were 0.222% (0.198%, 0.335%), 0.233% (0.215%, 0.453%), 0.223% (0.202%, 0.436%), and 0.232%, respectively. Among all of the 4 models, the linear regression had the least residual standard error (0.1676). Conclusion: The EC50 derived from four statistical models for 10ml ropivacaine in ultrasound-guided interscalene brachial plexus block for postoperative analgesia was distributed in a narrow range of 0.222%–0.233%.

Carapa guianensis Aubl., known as andiroba, is a multipurpose tree from the Amazon. Planted under environmental conditions, there is still no conclusive data on the light preferences of this species. Thus, the aim of this study was to evaluate growth and physio- logical variables at four shading levels (0%, 30%, 50% and 70%). In the first observation period (≤ 15 months), the relative chlorophyll content (SPAD index) indicated more efficient carbon gain by photosynthesis under shade conditions. Gas exchange measurements (20 months) allowed to conclude that the conditions of exposure to the sun caused photoinhibition. Dry matter evaluation (24 months) confirmed: 50% shade resulted in the greatest increase in dry matter for all plant parts (leaves, stems and roots). This study indicates that this species can give a greater return in relation to biomass under shading conditions, such as in secondary forest enrichment or agroforestry systems, at least in the initial phase of establishment.

Migrating animals respond to seasonal changes in the environment, and therefore they should time migration to coincide with peaks in resource abundance. However, it is unclear if and how frugivorous animals use phenological events to time migration, especially in the tropics. The straw-colored fruit bat (Eidolon helvum), Africa’s most gregarious fruit bat and a key seed disperser, forms large seasonal colonies through much of sub-Saharan Africa. We hypothesized that aggregations of straw-colored fruit bats match the timing of their migration with some landscape phenologies. Using monthly colony counts from seventeen sites across much of their range, we matched peak colony size to peaks in remote sensing measures of enhanced vegetation index (EVI), instantaneous rate of green up (IRG), precipitation (PRP), and the instantaneous rate of change of precipitation (IRP). Peak colony size was closest to peak IRG (60% of peak sizes occur within 1 month of peak IRG), while IRP was a close second. Sites with closer temporal matching by colonies typically had higher maximum EVI, high seasonal variation, or a short growing season, and larger peak colony size. E. helvum seem to time their migrations to move into highly seasonal landscapes and away from their core distributional range in the tropical forest belt to exploit short-lived explosions of food. The link between rapid changes in colony size and phenological match may also imply a potential collective sensing of the environment, which could be threatened by overall decreasing bat numbers along with various threats faced by large colonies.

Land use and climate change interact to impact functional and phylogenetic diversity globally, but this pattern is largely unknown in Eastern Himalayas. Using data comprising 45 mammal species and 336 bird species, we investigated the response of taxonomic, functional, and phylogenetic diversity and structure to land use and climate variables in the Himalayan biodiversity hotspot of Bhutan. Community diversity and structure in both groups were lower than expected by chance and decreased with land-use change resulting in clustering of distinct assemblages in different land-use settings, but climate produced mixed results. Functional and phylogenetic overdispersion for mammals were best explained by precipitation while temperature did so in birds. Overall, the mammal community better tolerated extreme climates than did birds. However, the nuances in individual responses were variable across the phylogenetic tree. Our results highlight the importance of land use and climate gradients in shaping the regional terrestrial biodiversity in a fragile and dynamic conservation landscape.

A central and fundamental issue in ecology is to understand the relationship between complexity and stability. Increased empirical evidences demonstrated no clear relationships between complexity metrics and stability, and recent food web loop analyses suggested that maximum loop weight as well as the summation ratio between 3 and 2-link feedback loop weights could be better estimators of system stability. However, the importance of longer loops than 3-link on the stability remains unclear. Here we use 127 marine food webs and the matrix product and trace method to investigate the relationship between loops with maximum of 7 links and food web stability. We found that feedback metrics |a2n+1/a2n|α, i.e., the ratio of the sums of (2n + 1)-link and 2n-link loop weights, are strongly related with stability. These sum weight ratios can be regarded as the coupling strength between omnivory loops and their one-species-delete subloops, including the smallest three species and high-level omnivory ones. Further theoretical simulations of bioenergetic consumer-resource models with allometric constraints strengthen this finding. These results suggest that both longer loops and omnivory are important drivers of the food web stability.

Background:T wave positivity in the lead aVR is a marker of ventricular repolarization abnormality and provides information on short and long-term cardiovascular mortality in patients who have heart failure, anterior myocardial infarction, and receive hemodialysis for various reasons. The aim of this study was to investigate the relationship between T wave positivity in the lead aVR on superficial ECG and mortality from COVID-19 pneumonia. Methods: This study retrospectively included 130 patients who were diagnosed with COVID-19 and treated as an outpatient or in the thoracic diseases ward in a single center between January 2021 and June 2021. All patients included in the study had clinical and radiological features and signs of COVID-19 pneumonia. The COVID-19 diagnosis of all patients was confirmed by polymerase chain reaction (PCR) studied from an oropharyngeal swab Results: A total of 130 patients were included in this study. Patients were divided into 2 groups: survived and deceased. There were 55 patients (with a mean age of 64.76-14.93 years, 58.18% male, 41.12% female) in the survived group, while there were 75 patients (with a mean age of 65-15 years, 58.67% male, 41.33% female) in the deceased group. The univariate and multivariate regression analyses showed that positive TAVR (OR: 5.151, 95% CI: 1.001-26.504, p: 0.0012), lactate dehydrogenase (LDH) (OR: 1.006, 95% CI: 1.001-1.010, p: 0.012) and D-dimer (OR:1.436, 95% CI: 1.115-1.848, p: 0.005) were independent risk factors for mortality Conclusions: positive TAaVR is useful in risk stratification for COVID-19 pneumonia mortality. KEY WORLD:Electrocardıographıa, positive TAaVR, COVID-19 pneumonia, mortality

Atrial fibrillation(AF) is a common clinical finding and associated with a poor outcome, which imposes a major health concern. The management for AF predominantly consists of pharmacotherapy and catheter ablation. Despite medical advances in recent years, treatment remains suboptimal. In the current article, we review and discuss therapies for AF, and elucidate rationale and procedures of a potentially novel treatment option.