We present the case of a male adolescent with a haemothorax caused by pericardial rupture secondary to costal exostosis. The patient was affected by multiple congenital exostosis and six years earlier he underwent a bone spur resection of the right femur. An X-ray performed at presentation was interpreted as suggestive of pneumonia and the patient was therefore treated with antibiotics without any clinical improvement. A thoracic ultrasonography performed 7 days later showed a massive haemothorax, confirmed by a CT scan on which a pericardial lesion caused by the growth of three osteo-cartilagineous spurs originating from the 5th, 7th and 8th rib was detected. The boy underwent surgery and recovered completely. The thoracic ultrasound and the subsequent CT-scan performed on the patient due to his lack of clinical improvement directed us towards a rare disease that the X-ray had not helped diagnose; this entailed the prompt surgical resolution of a possibly severe, maybe even fatal, condition.

Background: Cornual (interstitial) ectopic pregnancy is an uncommon type of ectopic pregnancy which accounts for 2%-4% of all ectopic pregnancies. It often poses a diagnostic and therapeutic challenge with a high mortality risk as a result of massive intraperitoneal bleeding. We report review of three cases of cornual ectopic pregnancy. Objective: To describe clinical presentation and management of cornual ectopic pregnancy cases Methods: Three cases of cornual ectopic pregnancy were retrospectively analyzed Results: Successful cornual wedge resection and removal of products of conception was performed in two cases (one ruptured and the other unruptured), while the 3rd case (ruptured with massive hemorrhage) was managed with hysterectomy. Conclusion: Early diagnosis of cornual ectopic pregnancy gives patients a wider opportunity to have conservative management either with MTX or laparascopic surgery. However; whenever there is hemodynamic instability, laparotomy with either cornual resection or hysterectomy is advisable.

As an excellent source of abundant and renewable industrial and agricultural raw materials, the Moso bamboo stem has excellent mechanical properties, which are closely related to the cell wall composition and structure. However, the molecular regulation of cell wall biosynthesis (CWB) in Moso bamboo remains unclear. We used Moso bamboo protoplasts to investigate CWB. Transcriptome and proteome of embryogenic calli and protoplasts at four time-points (0, 24, 72, and 120 h) were comprehensively analyzed to clarify the transcriptional and translational changes mediating CWB. In total, 41,014 unigenes and 7,454 proteins were identified. There were significant differences between the differentially expressed genes and differentially abundant proteins regarding the enriched GO terms and KEGG pathways, reflecting the temporal and spatial specificities of the samples at the transcript and protein levels. Transcriptomic and proteomic analyses indicated that protoplast cell wall regeneration requires the regulation of gene expression, the guidance of the cytoskeleton system, and sufficient base materials. Furthermore, the new cell wall is more acetylated than methylated, and it may contain a small amount of lignin. Overall, we provide new insights into Moso bamboo protoplast cell wall reconstruction that may be relevant for further characterizing the molecular mechanism controlling CWB in monocotyledons.

Sensitivity to treatment-related changes in tinnitus severity using the Chinese version of Tinnitus Functional Index (TFI-CH) should be further investigated in the mainland Chinese population and for a fixed, well-controlled intervention (repetitive transcranial magnetic stimulation). Good agreement was observed between visual analog scale (VAS) and TFI-CH total scores before and after treatment, with both measures showing significantly reduced after treatment (both p < 0.001). There was good agreement between the response rates to the intervention between the VAS and TFI-CH total scores. The TFI-CH emotional subscale contributed most strongly to overall tinnitus severity, and the reduction in severity was best predicted by emotional benefit. The TFI-CH is suitable to evaluate treatment-related changes in Chinese tinnitus patients.

Objective: To evaluate the effect of different connection modes of ECMO and CRRT on patients with acute kidney injury (AKI). Methods: Twenty-one patients received ECMO with AKI who were admitted to our center from December 2018 to February 2021 were selected and were all treated with both ECMO and CRRT. They were divided into A connection mode (pre-membrane–pre-pump connection) and B connection mode (post-membrane–post-pump connection). We compared clinical indicators and outcomes between two connection modes. Results: There were 8 cases (38.91%) in A connection mode and 13 cases (61.09%) in B connection mode, with median durations of ECMO assistance of 5 days and 7 days, respectively; median flow rates of ECMO of 3.0 L/min and 2.5 L/min, respectively; and CRRT flow rates of 200 mL/min and 180 mL/min, respectively. CRRT filter lifetime was over 48h in both two connection modes. Except for NT-pro BNP, no significant differences in clinical indicators were observed between the two groups before or after the treatment (P > 0.05). Conclusion: Both two connection modes could achieve the therapeutical purpose and need not higher level of anticoagulation who are simultaneously treated with ECMO and CRRT. Two modes had no impact on treatment effect and clinical indicators in patients. It had no effect on length of ICU stay and prognostic.

Background: ABVD regimen for Hodgkin lymphoma (HL), disfavoured in high-income countries, is popular in low-middle-income countries (LMIC). The feasibility/safety data for ‘non-ABVD’ protocols from LMIC is limited. Procedure: The retrospective study was conducted in a single center in India. Euronet-PHL-C1-based protocol was administered during 2010-19. A PET-CT was performed at diagnosis and following OEPA-course-2. Radiotherapy was administered for inadequate PET-response. Results: During the 10-year-period, 143 patients with HL were treated. The mean-age was 7.8±2.5 years. Bulky-disease was observed in 82 (59%). Treatment-abandonment was recorded in 13 (9.1%). The median follow-up duration was 46.4 months. An inadequate PET-response was observed in 41/118 (34.7%). Radiotherapy was administered to 23/41 (56.1%). There was a protocol violation of replacing radiotherapy in 12 (29.3%) patients with 2-courses of COPDAC. Sixty-nine episodes of febrile-neutropenia were observed in 54 patients. TRM was observed in 7 (5.3%). The majority of episodes of febrile-neutropenia (61%) and TRM (86%) were following OEPA-course-1. The 4-year overall-survival (OS) and event-free survival (EFS) were 93.5±2.2% and 86.2±3.4%, respectively. Nine (6.3%) patients relapsed. The survival compared favorably with 5-year-EFS (77.7%) of patients who received ABVD/COPP in the center in the past. Bulky-disease lacked association with inadequate PET-response (p=0.800) or relapse (p=1.000). Conclusions: OEPA/COPDAC regimen and response assessment by PET-CT permitted therapy reduction, including radiotherapy. The survival (4-year OS: 93.5±2.2%) was excellent, with a low relapse (6.3%). Febrile neutropenia and resultant TRM (5.3%) are concerning and occurred frequently following OEPA-course-1. The support system for managing febrile neutropenia should be optimized for administering OEPA in LMIC.

MicroRNAs (miRNAs) can efficiently regulate gene expression at intracellular and extracellular levels. Plant/food-derived miRNAs of the bio-environment are highly enriched in human serum or serum from phytophagous animals and play roles in the regulation of mammalian gene expression. However, the presence of food-derived miRNAs in Mollusca species is lacking evidence. In this study, we used the microalga Nannochloropsis oculata to feed the pearl oyster Pinctada fucata martensii, a bivalve species, and isolated exosomes from the serum to detect endogenous and food-derived miRNAs by RNA-seq. A total of 273 endogenous miRNAs were identified in all duplicate samples, and these participated in regulating cell proliferation and death, stress, energy metabolism, synthesis of unsaturated fatty acid, and protein synthesis and transport. Through the miRNA sequencing of the feeding N. oculata, we identified 23 microalga-derived miRNAs in the exosomes in the pearl oyster blood. Compared with endogenous miRNAs, most microalga-derived miRNAs showed high expression levels in both exosome and microalga cells and also exhibited apparent individual differences. These food-derived miRNAs were predicted to participate in endocytosis, apoptosis, signal transduction, energy metabolism, and biomineralization by targeting multiple genes. They were also closely related to energy metabolism and epigenetic regulation in N. oculata cells. These findings showed the phenomenon of cross-kingdom transport of miRNAs between a bivalve and feeding microalga and provided insights into functional molecule transmission through the food chain in an ecosystem.

Introduction: Health literacy is a main factor in health for its improvement, allowing the individuals to have a greater capacity to engage and participate in collective health promotion actions. The assessment of functional health literacy to determine the ability that each individual has to understand basic health information is essential. The aim of the present study was to translate and perform the cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry (REALD-30) to Portuguese language and test the reliability and validity of this version. Methods: The REALD-30 in the Portuguese language (REALD-29 PT) was applied to a group of individuals that participate in the program Atividade Senior, developed by the municipality of Viseu, Portugal. The final sample was composed by 206 participants that accepted responding to the questionnaire and to the REALD-30 Portuguese version (REALD-29 PT). Translation and cultural adaptation of the questionnaire and the statistical validation was accomplished in order to complete the process and obtain the REALD-29 PT. Results: The REALD-29 PT presented good internal reliability. Cronbach’s alpha ranged from 0.89 to 0.90 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility. We can verify that the REALD-30 scale for assessment of oral health literacy among older adults presents an acceptable internal consistency, with a global Cronbach´s alpha of 0.894. Conclusions: The REALD-29 PT scale can be applied to assess oral health literacy among older Portuguese adults, presenting an acceptable internal consistency and is validated to assess oral health literacy and is crucial in epidemiological studies.

Moyamoya is a progressive cerebrovascular disease associated with stenosis or occlusion of the arteries of the Circle of Willis, especially the supraclinoid internal carotid arteries (ICA), with consequent multiple collaterals. While it is common in sickle cell disease, it is rare in thalassemia. We present a 9-year-old, with HbEβ-thalassemia, who presented with headache, vomiting and episodes of transient hemiparesis. Initial imaging studies showed bilateral frontal old lacunar infarcts and narrowing of the ICA, which progressed to complete occlusion with compensatory dilatation of the basilar and vertebral arteries. She is maintained on anti-platelet therapy and is being evaluated for bypass surgery.

For $00$, we consider a class of Schr\”{o}dinger-Kirchhoff equations of fractional $p$-Laplacian involving logarithmic nonlinearity and critical exponential growth: \begin{equation*} m\left( \left\Vert u\right\Vert ^{p}\right) \left( \left( -\Delta \right) _{p}^{s}u+\lambda V\left( x\right) \left\vert u\right\vert ^{p-2}u\right) =\lambda h\left( x\right) \left\vert u\right\vert ^{\theta p-2}u\ln \left\vert u\right\vert +\sigma \left\vert u\right\vert ^{p_{s}^{\ast }-2}u\quad \mbox{in}\ \mathbb{R}^{n} \end{equation*}% with \begin{equation*} \left\Vert u\right\Vert =\left( \int_{\mathbb{R}^{2n}}\frac{\left\vert u\left( x\right) -u\left( y\right) \right\vert ^{p}}{\left\vert x-y\right\vert ^{n+sp}}dxdy+\lambda \int_{\mathbb{R}^{n}}V\left( x\right) \left\vert u\right\vert ^{p}dx\right) ^{1/p}, \end{equation*}% where $p_{s}^{\ast }=np/\left( n-sp\right) $, $1\leq \theta

An atrial septal defect is a commonly seen congenital heart defect of which secundum atrial septal defect is the most common. In a patient with evidence of right ventricular failure or significant shunt, operative repair is the treatment of choice to achieve hemodynamic stability. The use of a pericardial patch is required for the closure of large atrial septal defects. Case presentation: Here we present a case of a 50-year-old male who underwent surgical closure of secundum atrial septal defect who subsequently found to have part of the pericardial patch used for repair degraded in less than a month. Conclusion: There is a paucity of long-term outcomes data following the use of the CardioCel for septal defects, with no reports of such degradation within a month to the best of our knowledge. Further study is required to identify the incidence and implications of such findings.

Reaction kinetics of peracetic acid from acetic acid and hydrogen peroxide in a helical capillary microreactor was investigated and modelled via regression of the measured conversion rate of hydrogen peroxide. It was found that the activity of the proton in the sulphuric acid solution played a significant role in the synthesis as a catalyst. The activities of the proton were calculated with the ELECNRTL equation and used to obtain a kinetic model with the apparent activation energy of peracetic acid synthesis and hydrolysis of 53.63 and 54.45 kJ/mol, respectively. A new continuous process for industrial manufacture of peracetic acid solution (30 wt. %) was proposed, where the reacted solution from the microreactor is distilled to separate unreacted reactants and sulfuric acid which are recycled as feed. The feasibility of the new process was validated by economic assessment.

Background Thymomas are very rare neoplasms in children and they represent less than 1% of mediastinal tumours in a paediatric population. The aim of our study was to assess the long term treatment results of children with thymic tumours. Material and methods A total number of 8 children (4 boys and 4 girls) with thymic tumours were identified. Median age at diagnosis was 7 years. In 7 of them thymoma was diagnosed, in 1 thymic carcinoma. In 5 of them WHO type was assessed – in two of them B1 type was found, in one B2, in one AB and in one C. In all but one surgery was the first-line treatment, but 6 patients had only partial resection. One patient started treatment with chemotherapy and four others received chemotherapy after the surgery. Radiotherapy was applied in 6 patients with median total dose of 37.5Gy. Results Follow-up ranged from 8.5 to 273.5 months with median of 6.1 years. During that time 4 patients died – 1 due to progression of the disease, in 3 others reason of death was unknown. In all evaluated patients complete regression was observed (100% local control). Two-, 5- and 10-years OS and PFS were 85% and 72%, 51% and 54%, 51% and 54%, respectively. Conclusions Combined treatment could provide satisfactory results in thymoma patients. There is need for further larger studies which can help establish optimal management strategies.

In this paper, by using semi-cycle analysis method we examine the behavior of positive solutions of the system of difference equations \begin{equation*} x_{n+1}=\alpha+\dfrac{y_{n}^p}{y_{n-2}^p},\ y_{n+1}=\alpha+ \dfrac{x_{n}^q}{x_{n-2}^q}, \ n=0, 1, 2, … \end{equation*} where parameters $\alpha, p, q \in (0, \infty)$ and the initial values $x_{i}$, $y_{i}$ are arbitrary positive numbers for $ i= -2,-1, 0$. We also study the boundedness of positive solutions, the global asymptotic stability of the equilibrium point of above system in the case of $\alpha>1$, $0

In this paper, we study the existence and concentration of positive solutions for the following fractional Schr\”odinger logarithmic equation: \begin{equation*} \left\{ \begin{aligned} & \varepsilon^{2s} (-\Delta)^{s} u+V(x)u =u\log u^2,\ x\in \mathbb{R}^N,\\ &u\in H^s(\mathbb{R}^N), \end{aligned} \right. \end{equation*} where $\varepsilon > 0$ is a small parameter, $N>2s,$ $s \in ( 0 ,1), (-\Delta)^{s}$ is the fractional Laplacian, the potential $V$ is a continuous function having a global minimum. Using variational method to modify the nonlinearity with the sum of a $C^1 $ functional and a convex lower semicontinuous functional, we prove the existence of positive solutions and concentration around of a minimum point of $V$ when $\varepsilon$ tends to zero.

Plantlets grown in vitro with a mixed nitrogen source utilize sucrose and CO2 as carbon sources for growth. However, it is very difficult to obtain the correct proportion of assimilated nitrate, ammonium, sucrose and CO2 for plantlets. Consequently, the NH4+/NO3- use efficiency for carbon fixation derived from the assimilation of sucrose/CO2 is still unclear for plantlets. To reveal the coupled relationship of carbon and nitrogen assimilation in plantlets, the bidirectional stable nitrogen isotope tracer technique was employed to quantify the proportions of nitrate and ammonium utilized at different NH4+/ NO3- ratios, and the proportions of sucrose and CO2 assimilation were quantified by the foliar δ13C values of plantlets. There was an obvious difference in the assimilation of nitrate and ammonium under different NH4+/NO3- ratios for Brassica napus (Bn) plantlets. The proportion of sucrose/CO2 assimilation depended on the NH4+/NO3- ratios of the Bn plantlets. Both nitrate and ammonium assimilation were independent of sucrose/CO2 assimilation. Based on the proportion of CO2, sucrose, nitrate and ammonium utilization, the efficiency of nitrate/ammonium use (as indicated by the C/N ratio) for carbon fixation derived from the assimilation of sucrose/CO2 can be quantified for Bn plantlets.

Congenital sideroblastic anemia (CSA) is a rare genetic disease. SLC25A38 encodes a member of the mitochondrial membrane carrier protein family. Mutations in SLC25A38 have been found to be an important cause of transfusion-dependent CSA. Evidence-based medical treatment guidelines for CSA remain lacking, and hematopoietic stem cell transplantation (HSCT) is currently the only proven curative therapy for this disease. In this report, we successfully cure a 6-year-old patient with SLC25A38 mutation. Our patient underwent HSCT from a human leukocyte antigen (HLA)-identical unrelated donor, his hematopoiesis was reconstructed, anemia was corrected, and thereby the patient achieved long-term survival.

In this paper, we consider the Fourier spectral method and numerical investigation for a class of modified Zakharov systems with high-order space fractional quantum correction. First, the Fourier spectral scheme of the system is developed with periodic boundary condition based on the Crank-Nicolson/leap-frog methods in time and the Fourier spectral method in space. Moreover, it is shown that the scheme preserves simultaneously mass and energy conservation laws. Second, we analyze stability and convergence of the numerical scheme. Last, the numerical experiments are given, and the results show the correctness of theoretical results and the efficiency of the conservative scheme.

Which pathogen genotypes will develop on which crop cultivar? This is a crucial question in plant epidemiology for understanding the link between the host population structure and its susceptibility to disease. In the present work, we develop a theoretical approach to investigate the conditions of emergence and establishment of a mutant pathogen with generalist features in an agricultural landscape, then we determine the conditions of co-existence between genotypes with specialist and generalist features. We found that the spatial structure of landscape heterogeneity had a strong effect on the genetic structure of the pathogen population. In particular, the geometry and size of the host genotype aggregates interacted with the initial position of inoculums to determine the ability of the generalist pathogen to establish locally. In addition, coexistence among generalist and specialist pathogen genotypes occurred rather easily while only two hosts are cultivated. We finally discuss the implication of ours findings in a management perspective.

Sorghum is known as camel among the crops, grown worldwide for food, fodder, and fuel. However, sorghum is highly susceptible to low temperature stress, which greatly affects seed germination, seedling vigor, root architecture, level of cyanogenic glycosides, fertility, and grain yield. Adaptation to low temperature is very crucial for achieving desirable yields under temperate conditions. Here, an association mapping study was conducted using the large global sorghum diversity germplasm accessions to delineate the genetics of early season cold (ESC) and late season frost (LSF) tolerance in sorghum. A total of 10 single nucleotide polymorphisms (SNPs) and 17 quantitative trait loci (QTLs) were identified for ESC and 40 SNPs were identified for LSF. Two ESC tolerance QTLs identified from our study were co-localized with the classical tannin genes Tan1 and Tan2. This study identified probable candidate genes: Sobic.001G157100 (NPH3), Sobic.001G156600 (Lectin receptor-like serine/threonine kinase), and Sobic.006G061100 (SnRK1 gamma sub-unit) as for ESC tolerance and Sobic.006G139900 (UDP-glucoronosyl and UDP-glucosyl transferase), Sobic.002G187400 (Serine/threonine protein kinase), and Sobic.004G333700 (Ca2+/calmodulin-dependent protein phosphatase) for LSF tolerance in sorghum. The identified candidate genes were known to play a major role in seed germinability under cold stress and involved in plant signal transduction and regulation of cold and other biotic and abiotic stresses in crop plants.

There were many previous examples of disease-modifying expensive agents accelerated approval by The US Food and Drug Administration (FDA), which have been failed to show any clinical effectiveness in confirmatory trials in patients, subsequently withdrawn from the market. Recently on June 7th 2021, The FDA has issued an accelerated approval to a highly expensive disease-modifying agent aducanumab. In the present study, we will explore the challenges to address and lessons to learn from the approval of aducanumab another highly expensive only disease-modifying agent for Alzheimer’s disease.

In this paper, an initial boundary value problem for a hyperbolic type Kirchhoff equation with a strong dissipation and a general nonlinearity is considered. First, local existence and uniqueness of weak solutions are obtained with the help of Banach fixed point theorem. Then, by constructing an auxiliary functional and adopting the concavity argument, we give a new finite time blow-up criterion for this problem, which in particular implies that the problem admits blow-up solutions with arbitrarily high initial energy. Meanwhile, a bound for the blow-up time is derived from above. Further, we obtain a lower bound for the blow-up time when blow-up occurs. From methods to results, we partially extend the ones obtained in earlier literature.

In this paper, we continue the study of the Davey-Stewartson system which is one of the most important ( 2 + 1 ) dimensional integrable models. As we showed in the previous paper, the dDS (dispersionless Davey-Stewartson) system arises from Hamiltonian vector fields Lax pair. A new hierarchy of compatible PDEs defining infinitely many symmetries, which is associated with the dDS system, is defined in this paper. We show that this hierarchy arises from the commutation condition of a particular series of one-parameter Hamiltonian vector fields.

Revealing the mechanisms governing the complex microbial community assembly is a central issue in microbial ecology. Null models are commonly used to quantitatively disentangle the relative importance of deterministic vs. stochastic processes in structuring the compositional variations. However, microbial profiling is influenced by random sampling issues, which lead to overestimated -diversity of microbial communities and may further affect stochasticity inference. By implementing simulated datasets, we investigated whether and how microbial stochasticity inference is affected by random sampling issues. Our results demonstrated solid evidences that random sampling dramatically overestimated the -diversity of microbial communities, which further led to overestimated community stochasticity inference. The effects of random sampling issues on stochasticity inference for the whole community and the abundant subcommunities were different using different null models. The stochasticity of rare subcommunities, however, was persistently overestimated no matter which null model was used. Such effects of random sampling issues on community stochasticity inference were constantly observed for communities with different -diversity. As more studies begin to focus on the different mechanisms governing abundant and rare subcommunities, we urge cautions be taken for microbial stochasticity inference based on -diversity (e.g. null models), especially for rare subcommunities with stochastic ratio slightly higher than 0.5. When necessary, the cutoff used for judging the relative importance of deterministic vs. stochastic processes shall be redefined.