The apical hook is indispensable for protecting the delicate shoot apical meristem while dicot seedlings emerging from soil after germination in darkness. The development of apical hook is coordinately regulated by multiple phytohormones and environmental factors. Yet, a holistic understanding of the spatial-temporal interactions between different phytohormones and environmental factors remains to be achieved. By a chemical genetics method, we identified kinetin riboside, as a proxy of kinetin, that promotes apical hook development of Arabidopsis thaliana in a partially ethylene-signaling independent pathway. Further genetic and biochemical analysis revealed that cytokinin is able to regulate apical hook development via post-transcriptional regulation of the PHYTOCHROME INTERACTING FACTORs (PIFs), together with its canonical roles in inducing ethylene biosynthesis. Dynamic observations of apical hook development processes showed that ETHYLENE INSENSITVE3 (EIN3) and EIN3-LIKE1 (EIL1) are necessary for the exaggeration of hook curvature in response to cytokinin, while PIFs are crucial for the cytokinin-induced maintenance of hook curvature in darkness. Furthermore, these two families of transcription factors display divergent roles in light-triggered hook opening. Our findings unveil that cytokinin integrates ethylene signaling and light signaling via EIN3/EIL1 and PIFs, respectively, to dynamically regulate apical hook development during early seedling development.

Polysiloxane coatings on yttria stabilized zirconia (YSZ) microspheres of 500 µm were simulated using Multiphase Flow with Interface Exchange-Discrete Element Modelling (MFiX-DEM). Two different coater configurations were developed to study the influence of gas velocity and its distribution on particle dynamics. The presence of the Wurster tube not only enhances the distribution but also increases the overall residence time of the particles. For different Wurster tube positions (normal, 10% and 20% lowered from its initial position), 20% lowered Wurster tube position demonstrated the most effective coating process. The effects of gas inlet pressure on the average gas velocity and the distribution of particles were analyzed. More than 97% of the particles can be retained. The derived results, including average gas velocity, particle retention percentage, and distribution of particles with gas velocity, are being used to guide the experimental work in obtaining defect-free coatings for YSZ microspheres.

n-Butyl levulinate (n-BL) has numerous applications in biofuel and green solvents. In this paper, we have reported mechanistic accounts of sonoenzymatic synthesis of n-BL using Novozym 435. Esterification parameters were optimized with statistical design of experiments. Application of 35 kHz sonication boosted n-BL yield from 70.9% to 92.22%. Mechanistic investigation using Ping-Pong Bi-Bi kinetics model and molecular docking simulations revealed interesting influence of sonication on esterification reaction. Exposure to sonication induced significant changes in the secondary structure of enzyme, as revealed in ATR-FTIR analysis. Sonication increased α-helix content of enzyme that increased enzyme activity by opening of flapping lid and widening the catalytic cavity. Sonication also caused unfolding of secondary structural motifs with rise in random coil content that favored formation of enzyme-ligand complexes. These effects enhanced reaction velocity and substrate affinity with reduction in inhibition and unfavorable dissociation of intermediate complexes, which ultimately enhanced n-BL yield.

In this paper, we proposed a new echo state network (ESN) model, namely echo state network based on memristor (memristor-ESN). It improve the memory function of the reservoir and the prediction performance of the ESN. In the memristor-ESN, memristor is used to replace the synapses between neurons in the reservoir of echo state network. In the prediction of chaotic time series, we compare the classical echo state network with the echo state network based on memristor. Simulations are conducted to verify the prediction accuracy and prediction performance of the memristor-ESN.

In the present study, the Modified Equal Width (MEW) wave equation is going to be solved numerically by presenting a new technique based on collocation finite element method in which trigonometric cubic B-splines are used as approximate functions. In order to support the present study, three test problems; namely, the motion of a single solitary wave, interaction of two solitary waves and the birth of solitons are studied. The newly obtained results are compared with some of the other published numerical solutions available in the literature. The accuracy of the proposed method is discussed by computing the numerical conserved laws as well as the error norms L₂ and L_{∞}.

Objectives To assess how otological surgery resumed following the UK’s first wave of the COVID-19 pandemic and what challenges clinicians faced when operating. Design A multi-centre prospective audit of elective and emergency otological surgery Participants 1130 cases from 79 hospital sites across the UK (excluding Northern Ireland). Data was collected over three, 4-week audit periods from 15th June to 6th September 2020. Main outcome measures Which operations were being performed in England, Scotland and Wales? What was the use of personal protective equipment (PPE)? Were there a greater number of complications? What was the level of trainee participation? Did any patients or patients contract COVID-19? Results 85.8% of operations took place in England. 69.1% of operations were middle ear procedures and 58% of patients were adults. 83.2% were Caucasian and 93.9% of patients had minimal co-morbidities (ASA 1 or 2). 91.1% were for tested SARS-CoV-2 pre-operatively, none of whom tested positive. 70.4% isolated for 7-14 days pre-operatively. 28.2% of surgeons wore full personal protective equipment (PPE), compared with 66.6% of anaesthetists and 68.2% of scrub staff. Trainees were present in 80.3% of cases. Complications were reported in 4% of cases; surgical site infection was the most common. No patients or staff contracted SARS-CoV-2 during the audit. Conclusions Restarting otology surgery after the first wave of the SARS-CoV-2 pandemic was performed safely across the UK, with no increase in complication rates or SARS-CoV-2 transmission. However, there were challenges to operating with PPE and trainees have been affected by reduced exposure to surgical cases.

Case: We present a 2-year-old male patient who was referred to the pediatric hematology oncology clinic with left pariatotemporal mass. In computed tomography (CT) of brain; a mass lesion of approximately 8x9 cm in size extending from the left parietotemporal lobe to the inferior, extending towards the skin / subcutaneous

The influence of ABO blood type on the severity of COVID-19

The safety-efficiency trade-off (SETO) hypothesis is a common theme in plant sciences. Despite safety and efficiency are physiologically compensated for each other, they are always mathematically described into trade-off against one another. However, the compensation effect has never been defined and quantified. What remains unclear is how compensation effect has influenced the xylem water transport and subsequently photosynthesis. Here, we proposed that the compensation effect between safety and efficiency was actually a safety-efficiency tie-up strategy (SETU; a positive relationship between safety and efficiency) within xylem functions. Then we proposed a theoretical framework that integrated the compensation effect into the xylem hydraulic functional strategy to quantify SETU and SETO. Finally, we tested SETO- and SETU-photosynthetic rate relationships across different levels, based on a common garden experiment using nine conifers and published data for gymnosperms. The results demonstrated that the compensation effect in xylem functions was the dominant force in facilitating photosynthetic rates at scales from the species to the phylum. By integrating the compensation effect into the xylem hydraulic functional strategy, our study clearly indicates that the compensation effect is the evolutionary basis for the coordination of xylem hydraulic and photosynthesis physiology.

Objective：to examine the associations of COVID-19 lockdown with gestational length and preterm birth (PTB). Design: Hospital-based retrospective study. Setting: All hospitals in Foshan (n=62) and several other hospitals in Guangzhou (n=1), Shenzhen (n=1), Dongguan (n=2), and Jiangmen (n=1) in Guangdong Province, China were selected. Population and Methods: A total of 595396 singleton live infants born between 2015 and 2020 were included. The exposed group (N=101900) included women who experienced the COVID-19 Level I lockdown (1/23-2/24/2020) during pregnancy, while the unexposed group (N=493496) included women who were pregnant during the same calendar months in 2015-2019. Cumulative exposure was calculated based on days exposed to different levels of emergency responses with different weighting [1/22/2020 or earlier (no response, weighting=0), level I (weighting=3), 2/25-5/9/2020 (level II, weighting=2), and 5/10-12/31/2020 (level III, weighting=1)]. Main outcome measures: demographics, lockdown exposure, preterm birth, gestational week. Results: The exposed group had a shorter mean gestational length than the unexposed group (38.66 vs 38.74 weeks: adjusted β=-0.06 week [95%CI, -0.07, -0.05 week]). The exposed group also had a higher risk of PTB (5.7% vs 5.3%; adjusted OR=1.08 [95%CI, 1.05, 1.11]). These associations seemed to be stronger when exposure occurred before or during the 23rd gestational week (GW) than during or after the 24th GW. Conclusions: The COVID-19 lockdown measures were associated with a slightly shorter gestational length and a moderately higher risk of PTB. Early and middle pregnancy periods may be a more susceptible exposure window. Funding: National Natural Science Foundation of China.

Objectives: To characterize triglyceride (TG) changes from pregnancy to postpartum, associations between them and effects of pre-pregnancy body mass index (pre-BMI) and gestational diabetes mellitus (GDM). Design: Prospective cohort study. Setting: FUXING Hospital, Beijing, China. Population: 908 pregnant women. Methods: Serum lipids at gestational week 6-8, 16, 24, 36 and 42 days postpartum were measured. Associations between gestational and postpartum TG were analyzed by stepwise multiple liner regression, linear mixed-effect model and logistic regression. Cutoff points were calculated by receiver operating characteristic (ROC) curves. Main Outcome Measures: hypertriglyceridemia at 42 days postpartum. Results: TG increased with gestational weeks and decreased until 42 days postpartum. TGs at 6-8th, 16th, 24th, 36th gestational week and TG trend of change were positively associated with higher risk of postpartum hypertriglyceridemia [OR 4.962, 95% CI (3.007-8.189); OR 3.201, 95% CI (2.222-4.612); OR 2.484, 95% CI (1.853-3.329); OR 1.979, 95% CI (1.597-2.452); OR 11.660, 95% CI (6.018-22.591)]. Serum TG cut-offs were found as 1.12, 1.93, 2.35 and 3.08 mmol/L at studied gestational week, respectively. The risk of postpartum hypertriglyceridemia for women with normal pre-BMI and non-GDM was higher than overweight and obese group and GDM group, respectively. Conclusions: Gestational TG is a risk factor of postpartum hypertriglyceridemia, and is more significant among pregnant women with normal pre-BMI and without GDM. TG measurement and control is essential during pregnancy. Funding: National Natural Science Foundation of China (No. 81872608 and No.8207121162). Keywords: TG, Pregnancy, Postpartum, Hypertriglyceridemia, Pre-BMI, GDM. Tweetable abstract: Gestational TG increases risk of postpartum hypertriglyceridemia.

Sebaceous nevus is a congenital hemartoma. It is a known condition that benign or malignant skin tumors can develop on the sebaceous nevus especially after puberty.. In this article, we present a 61-year-old male patient with sebaceous nevus in which an ulcerated basal cell carcinoma developed on a 61 years duration of sebaceous nevus.

Objective: Neurogenic bladder is an important complication of urinary tract dysfunction after spinal cord injury. Urodynamic and urography to guide therapy remains invasive and complicated. Therefore, this research is to find potential non-invasive biomarkers from urinary exosomes to predict diagnosis and guide prognosis in patients with spinal cord injury. Methods: Urinary exosomes were isolated and proteome profile was analyzed by mass spectrometry. Transmission electron microscopy and nanoparticle tracking analysis confirmed the size and morphology characteristic of urinary exosomes. In addition, bioinformatics analysis and parallel reaction monitoring were used for screening candidate biomarkers. Selected biomarkers were validated by Western blot and ELISA. Results: Mass spectrometry identified 134 up-regulated proteins and 99 down-regulated proteins between VUR and non-VUR groups. 18 candidate proteins were selected for PRM validation, but only VTN and COL1A1 showed significant differences. In the validation experiment by western blot and ELISA, VTN was exclusively highly expressed in VUR patients compared with non-VUR patients. However, the ELISA result of COL1A1 showed no statistical difference in a bigger sample size. Furthermore, a receiver operating characteristic curve of ELISA-based VTN showed an area under the curve of 0.795, and 80% sensitivity at a threshold set to give 82.9% specificity. Conclusions: Collectively, our results suggest that VTN in urinary exosomes may be used as a biomarker to predict the progression and guide the prognosis of neurogenic bladder disease.

An accurate and efficient biological tool for various utilities is required for the structural information of biological macromolecules stored in .pdb, .cif and lately .mmtf files. Here, we present Macromolecular Analysis Toolkit (MAT) that can parse all of these files; and build a hierarchical data structure from the given input. This original program is written in C++ to ensure flexibility and performance. The novelty of the program lies in the addition of new structure-based biological algorithms and applications. This package also stands out from other similar libraries by being fast and accurate. We also provide a detailed comparison of available parsers on the whole PDB database. The same data structure is extended to accommodate information from the mmCIF and MMTF parsers. Tokenization of the data allows the extraction of information from disordered text, making it compatible for accurate identification of the entities present in the .pdb file. The parser of MAT is designed in such a way that it allows quick extraction and efficient loading of the core data structure. Additionally, we add a new approach by creating a few derived data structures, namely kD-Tree, Octree, and graphs. For certain applications that need spatial coordinate calculations, these can be subsequently constructed.

During the COVID-19 pandemic, pediatric oncology patients, caregivers, and providers were required to adapt to changes in healthcare delivery to minimize the risk of COVID-19 exposure. This study evaluated the impact of the pandemic on oncologic care and patient and caregiver distress by surveying patients actively followed for cancer treatment or on surveillance. Adherence to therapy and access to the oncology team was largely maintained with increased virtual visits. Due to concern for exposure and disruptions to work, social stressor screening and support are warranted. Continuing access to up-to-date information about COVID-19 is critical as the pandemic continues to evolve.

In this paper we present two equivalent interpretations of curvature equation for higher dimensional Seiberg-Witten equations. To achieve this we use the generalized self-duality concept of a 2-form in various dimensions.

Iron toxicity is a major constraint to rice production, particularly in highly-weathered soils of inland valleys in sub-Saharan Africa where the rice area is rapidly expanding. Although there is wide variation in tolerance in the rice germplasm, progress in introgressing tolerance traits into high-yielding germplasm has been slow owing to the complexity of tolerance mechanisms and large genotype by environment effects. We review current understanding of tolerance mechanisms, particularly those involving below-ground plant-soil interactions, which to date have been less studied than above-ground mechanisms. We cover processes in the rhizosphere linked to exclusion of toxic ferrous iron by oxidation, and resulting effects on the mobility of nutrient ions. We also cover the molecular physiology of below-ground processes controlling Fe retention in roots and root-shoot transport, and also plant Fe sensing. We conclude that future breeding programs should be based on well-characterised molecular markers for tolerance traits. To successfully identify such markers, the complex tolerance response should be broken down into its components based on understanding of tolerance mechanisms, and tailored screening methods developed for individual mechanisms.

Aims. Polycystic ovarian syndrome (PCOS) is a common endocrine disorder characterised by ovarian morphological, systemic biochemical, and menstrual changes. Women with PCOS are at significantly increased risk of raised fasting glucose, impaired glucose tolerance, and diabetes. Recognition of these complications and early intervention are key to good health outcomes. We sought to identify DNA methylation patterns that may predict future diabetes onset in this high-risk PCOS population. Patients and Methods. Peripheral blood samples from women with PCOS and women with PCOS who later developed diabetes, were analysed by Illumina HumanMethylation450 BeadChip-arrays. Bisulphite-Pyrosequencing™ was used to validate and confirm array methylation data. Results. Array analyses identified 273 differentially methylated CpG loci (≥0.2 β-value change) at initial diagnosis of PCOS, between women who did or did not later develop diabetes. 19 of these sites demonstrated differential methylation in the same direction in ≥five sample pairs. Methylation in three of the candidates (cg11897887, cg02819655, and cg25542007) showed the best concordance with corresponding array β-values, and, most clearly differentiated ‘cases’ from ‘controls’. Conclusions. We have identified novel methylation biomarkers that could predict future onset of diabetes in this high-risk population. Use of methylation analyses to identify women who are likely to develop diabetes at diagnosis of PCOS may facilitate timely lifestyle interventions to reduce future morbidity.

Rib fractures due to blunt chest trauma is a painful condition with high morbidity and mortality that is twice as high in the elderly compared to young people. If adequate analgesia treatment is not provided, respiratory complications, the need for mechanical ventilation and the length of stay in intensive care unit (ICU) may increase. Erector spinal plane (ESP) block is a regional anesthesia method that can provide effective analgesia in unilateral thoracic region. Here, ESP block, which is used successfully in pain management of a critically ill oldest-old patient with multiple rib fractures in ICU, is presented

Background: Left ventricular (LV) pacing with resynchronization therapy improves ventricular synchrony in patients with decreased LV function and Left Bundle Branch Bock (LBBB). Objective: The goal of this study is to show that LV pacing is superior to BiVentricular (BiV) pacing in patients with ventricular dysfunction and LBBB. Methods: This is a retrospective study from 2 hospitals’ registries in Lebanon. 121 patients with LVEF ≤ 35%, a QRS ≥130msec and a LBBB pattern on full medical therapy were included in 2 groups: LV pacing and BiV pacing. All patients had echocardiograms before and after device implantation. The primary endpoint was the change in ejection fraction and the secondary endpoints were decrease in pulmonary artery pressure (PAPs), in LV end diastolic diameter (LVDD) and in LV end systolic diameter (LVSD). Statistical analysis was done with SPSS. Results: The study population was mostly males (69.4%) with ischemic cardiomyopathy 74 (61.2%) & a mean age of 67 years old. Fifty (41,3%) patients were programmed as LV pacing. A statistically significant improvement in EF was seen in the LV only 9.2% compared to BiV pacing 5.5%. Similarly, we noticed a significant decrease in the LVDD and LVSD in the LV pacing compared to the second group. There was a trend in favor of more PAPs improvement in the LV pacing that did not reach significance. Conclusion: This study demonstrates that LV pacing significantly improves EF and LV size compared to BiV pacing. A large multicenter trial is needed to confirm our findings.

Background: It has been widely reported that the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) attaches human cells by using the Angiotensin Converting Enzyme 2 (ACE2) receptor, but vascular impairment described during coronavirus disease 2019 (COVID-19) infection is primarily due to the direct involvement of the endothelial cells by the virus or secondarily to the inflammatory host response is currently unknown. Methods: We therefore aimed to demonstrate in vivo the presence of endothelial dysfunction in six COVID-19 patients without cardiovascular risk factors or pre-existing cardiac condition, using the Endo-PAT 2000, a device able to measure endothelial vasodilation function in a rapid and non-invasive way. Results: Four patients were positive for endothelial dysfunction, with RHI values between 1.13-1.56 (average value 1.32, normal values >1.67); in one of the two negative patients the reported RHI value was slightly above the cutoff (1.72). Conclusion: Our findings confirm that COVID-19 patients are at higher risk of developing endothelial dysfunction. In addition, our results demonstrate that endothelial impairment may occur even in the absence of cardiovascular risk factors.

Background: Historically, infective endocarditis(IE) in South Africa was associated with the viridans group of streptococci affecting patients with underlying rheumatic heart disease(RHD). A changing IE bacteriological profile raises the question of whether the profile of underlying valvular abnormality has changed. Methods: The Tygerberg Endocarditis Cohort study prospectively enrolled patients with IE between November 2019 and April 2021. Patients underwent detailed transthoracic-and transoesophageal echocardiography to assess their underlying cardiac and valvular structure. Results: Seventy one patients were included. A predisposing endocardial abnormality was detected in 49.3% of patients, with RHD the most common single identifiable aetiology(16.9%). In-hospital mortality rate was similar in patients with and without a predisposing endocardial abnormality(20% vs 16.7%; p=0.72), as was the rate of embolic events(20% vs. 27.2%;p=0.58). Significantly more patients with a predisposing endocardial abnormality had an indication for surgery(94.3% vs 69.4%;p<0.01). The viridans group of streptococci were more prevalent in patients with a predisposing endocardial abnormality(25.7% vs 2.7%;p<0.01). Left-sided linear vegetation size more than 10mm was associated with an increased risk of in-hospital mortality(24vs.5%; p=0.05). Conclusion: We have observed a marked decrease in the prevalence of RHD in this cohort of patients with IE. The viridans group of streptococci was an uncommon cause of IE in patients where no predisposing endocardial abnormality was detected. The presence of a predisposing endocardial abnormality was not associated with an increased risk of in-hospital mortality or embolic events. Linear vegetation length more than 10mm was associated with an increased risk of in-hospital mortality in patients with left-sided IE.

Introduction: It is very rare that wide QRS complex tachycardia automatically changes to narrow QRS complex tachycardia, and it is more difficult to clarify the mechanism. Case report：A 3-month-old infant with recurrent paroxysmal supraventricular tachycardia underwent transesophageal cardiac electrophysiological examination. The wide QRS complex tachycardia was induced by atrial RS2 stimulation, and it soon changed into narrow QRS tachycardia automatically. By the accurate measurement of esophageal lead, it was found that the electrocardiogram changes completely conform to Coumel law. Conclusion: Transesophageal cardiac electrophysiological examination can reveal certain special electrophysiological phenomena, especially suitable for infants.

A massive tricyclic overdose of up to 10 grams of amitriptyline resulted in cardiovascular collapse with multiple episodes of VT and VF despite aggressive attention to current recommended therapy. 1600 mmols of sodium bicarbonate and 1000 mmols of hypertonic saline, as well as second-line anti-arrhythmic therapies failed to reduce the recurrent deteriorations to malignant ventricular rhythms. Progression to extracorporeal support was avoided by the use of an esmolol infusion. We had a physiological rationale by which esmolol prevented tachyarrhythmia and fibrillation in this severe amitriptyline toxicity.