Sinus of Valsalva aneurysm (SVA) is a relatively rare organic cardiac anomality. Here, we report a case of a ruptured SVA with tricuspid valve prolapse (TVP) and severe tricuspid regurgitation (TR). A 33-years-old man was admitted to our hospital who presented chest tightness after activity. Coronary sinus aneurysm(1.2cm*1.0cm) and tricuspid systolic prolapsed into the right atrium was detected by echocardiography. And later the patient was confirmed by surgery and pathology that the congenital aortic sinus aneurysm ruptured. Echocardiography played a vital role in the diagnosis and differential diagnosis of this case of RSVA and even the follow-up preoperative preparation.

Bluegill sunfish is an important economic fish, which originated in North America. It was introduced to China in 1987 and is now widely cultivated in Guangdong Province. In recent years, a fatal bacterial disease often occurs in cultured bluegill sunfish. The clinical manifestations of the diseased bluegill sunfish were ulceration and hyperemia. A bacterial pathogen was isolated from the viscera of diseased fish. It was identified as Vibrio cholerae by morphological, biochemical and 16S rDNA phylogenetic analysis. The regression infection experiment confirmed that the isolated strains could cause the disease of healthy bluegill sunfish. In this study, Vibrio cholerae was isolated and identified from diseased bluegill sunfish for the first time, and it provides a basis for the diagnosis, prevention and treatment of the disease. At the same time, this study proposed three ways for the transmission of Vibrio cholerae from aquatic animals to human beings, warning that we need to pay attention to the serious harm that the zoonotic bacteria in aquatic animals may cause to human beings, hoping to attract the attention of the whole society, so as to formulate effective countermeasures.

The Arctic Warbler (Phylloscopus borealis) is a cryptic songbird with an uncommon Nearctic-Paleotropical migratory strategy. Using geolocators, we provide the first documentation of the migratory routes and wintering locations of two territorial adult male Arctic Warblers from Denali National Park and Preserve, Alaska. After accounting for position estimation uncertainties and biases, we found that both individuals departed their breeding grounds in early September, stopped over in southeastern Russia and China during autumn migration, then wintered in the Philippines and the island of Palau. Our documentation of Arctic Warbler wintering on Palau suggests that additional study is needed to document their wintering range. Our results indicate that Arctic Warblers migrate further overwater than previously thought and provides hitherto unknown information on stopover and wintering locations.

In the water-limited regions, there is a limit of vegetation restoration because the short of soil water and people’s big need. However, there are few reports on the limit of vegetation restoration. In this study, non-native perennial Caragana shrublands was selected to establish experimental plots with different densities, and cover degree, basal diameter and plant height growth, soil water and precipitation was investigated, soil water supply and soil water consumption at different planting density was estimated and the relationships between planting density and soil water, soil water carrying capacity for vegetation and the potential for vegetation rehabilitation was analyzed. The results showed that the degree of cover increases with increasing density under other things being equal; the canopy interception increases with stand density and both of them is an exponential relation; the surface runoff decreases with increasing density and the relationship between them is a logarithm relationship; the sediment charge in the runoff increases with reducing density and the relationship between them can be expressed by a logistic equation. Although the canopy closure increases and the effect of the caragana forest on soil and water conservation strengthens with increasing density, but there is a limit of vegetation rehabilitation. When the cover degree of Caragana shrublands is more than the vegetation restoration limit, the water-plant relationship should be regulated based on soil water carrying capacity for vegetation to control soil drying and realize high-quality and sustainable development of soil and water conservation vegetation.

The present study investigates the effects of inclined magnetic field, heat source/sink, and concentration on the peristaltic flow of blood in an inclined asymmetric channel with variable viscosity. Mathematical analysis has been carried out in the presence of aligned magnetic field. The flow is examined in a wavy frame of references moving with the velocity of the wave. The physical problem is the first model, and then, the analytic solution is carried out under long–wavelength and low-Reynolds number approximation. The expressions for velocity, temperature, concentration, pressure gradient, tangential stress and heat transfer coefficient are obtained. The results for the pressure rise and frictional force have also been computed numerically. Numerical results are graphically discussed for various values of physical parameters of interest.

Objectives: To summarize the clinical characteristics and outcome of infantile extracranial germ cell tumors(GCTs) from four different centers in China since the last 10 years. Methods: Fifteen cases of infantile extracranial GCTs diagnosed between January 1st, 2010 to December 31st, 2019 were evaluated. Results: Nine patients were males(60%) and six were females(40%). The median age was 5.2 months(ranges:2.4-11.8months). There were six cases(40%) in retroperitoneum, six cases(40%) in sacrococcygeal, one case(6.6%) in testicular, one case(6.6%) in hip and one case(6.6%) in mediastinum. Histologically, there were 10 cases(66.6%) of immature teratoma, 3(20%) mixed GCTs and 2(13.3%) malignant GCTs. One case was stageII(6.6%), eleven stageIII(73.3%), one stageIV(6.6%) and two cases were unclear(13.3%). Nine cases(60%) had alpha-fetoprotein(AFP) level of higher than 1000ng/ml. All of the cases received adjuvant chemotherapy in which platinum-based chemotherapy regimens were mostly used. The median follow-up time was 31 months(range: 3–81 months). At the end of treatment, 12 patients got CR(80%), 1 PR(6.7%) and 2 NR(13.3%). During the follow-up period, 12 patients alive without disease and 3 patient who did not got CR at the end of treatment died of disease progression. Conclusions: Most of infantile extracranial GCTs located outside the gonads. Sacrococcygeal and retroperitoneal regions were common sites. Histologically, teratoma was more common in infantile GCTs. Early diagnosis is needed and chemotherapy regimen needs to be further standardized in China. An evaluation system is needed to figure out treatment efficacy and prognosis in the future.

At present, there are no satisfactory therapeutic drugs for the functional recovery of spinal cord injury (SCI). We previously identified a novel peptide (OM-LV20) that accelerated the regeneration of injured skin tissues of mice and exerts neuroprotective effects against cerebral ischemia/reperfusion injury in rats . Here, the intraperitoneal injection of OM-LV20 (1 μg/kg) markedly improved motor function recovery in the hind limbs of rats with traumatic SCI, and further enhanced spinal cord repair. Administration of OM-LV20 increased the number of surviving neuron bodies, as well as the expression levels of brain-derived neurotrophic factor and its receptor tyrosine receptor kinase B. In the acute stage of SCI, OM-LV20 treatment also increased superoxide dismutase and glutathione content but decreased the levels of malonaldehyde and nitric oxide. Thus, OM-LV20 significantly promoted structural and functional recovery of SCI in adult rats by increasing neuronal survival and BDNF and TrkB expression, and thereby regulating the balance of oxidative stress. Based on our knowledge, this research is the first report on the effects of amphibian-derived peptide on the recovery of SCI and our results highlight the potential of peptide OM-LV20 administration in the acceleration of the recovery of SCI.

Objective: Clinical evaluation and user experience of the Cloud DX connected HealthKit Pulsewave wrist cuff blood pressure monitor (CDXP) for home blood pressure monitoring during pregnancy (HBPM). Methods: In the first phase, an adjusted version of the European Society of Hypertension International Protocol Revision 2010 (ESH-IP 2010) was used to compare the CDXP and Omron M6 Comfort to the aneroid manometer. In the second phase, blood pressure measurement at home was compared to standard office blood pressure measurement (OBPM). Patients filled out a questionnaire regarding user experience. Results: In 34 pregnant women the blood pressure measured by the aneroid manometer did not differ from the CDXP (systolic blood pressure (SBP) difference: -0.7±6.5 mmHg (p=0.38), diastolic blood pressure (DBP) difference: 0.4±5.7 mmHg (p=0.55)), while the aneroid manometer measured SBP slightly higher (1.5±5.8 mmHg (p=0.04)) and DBP slightly lower (-2.8±5.8 mmHg (p<0.01)) as compared to the Omron M6 Comfort. In 32 patients the SBP of the office hospital measurement was significantly higher, while DBP was comparable. The mean user experience score for the CDXP was 85%, corresponding with an ‘excellent’ evaluation. Of all patients, 97% reported they liked the idea of home monitoring and would like to use it in the future. Conclusion: The CDXP is as reliable as standard office blood pressure monitors during pregnancy and gives a better representation of the blood pressure than standard hospital measurement. Pregnant women are positive and confident about HBPM and find the CDXP easy to use.

A document by Manju Chandiramani. Click on the document to view its contents.

Background: Influenza infection was a vital threat to immunosuppressed patients with longer viral shedding; however, data on these populations in China are still lacking. We analyzed clinical characteristics, risk factors and effect of antiviral therapy in these populations. Methods: We analyzed 111 immunosuppressed inpatients tested positive for influenza virus using RT-PCR during the 2015-2020 influenza season. Univariate analysis and multivariate logistics analysis were used to identify risk factors. Results: The most common immunosuppression type was malignancies with chemotherapy 87.4% (97/111), then hematopoietic stem cell transplantation 23.4% (26/111). The most common presenting symptom was fever in 92.8% (103/111) patients, then cough 50.6% (44/87). 14.4% (16/111) patients were admitted to ICU and 9.9% (11/111) patients died. Combination and double dose of neuraminidase inhibitors did not significantly reduce the admission to ICU and death. Risk factors for admission to ICU were dyspnea, co-infection with other infections and no antiviral treatment within 48 hours, and presence of dyspnea and altered mental status were independently associated with death through multivariate logistics analysis. Seasonal influenza vaccination in preceding 12 months only took up 2.7% (3/111). Conclusion: Fever and other classical symptoms of influenza may be absent in immunosuppressed recipients, and conducting influenza virus detection at the first time is a good choice for early diagnosis. Immunosuppressed patients with dyspnea, altered mental status, co-infection with other infections and no antiviral treatment within 48 hours are of note needed, because these people have high-risk to severe cases. Inactivated influenza vaccination should be taken into account in immunosuppressed patients.

Background: Stroke is a serious complication of sickle cell anemia (SCA). Transcranial Doppler (TCD) is the risk screening tool for ischemic strokes. Objective: The objective of the study was to describe the clinical progression of children with SCA who presented with high risk for stroke by TCD or relevant changes by magnetic resonance angiography (MRA) and underwent the regular transfusion program (RTP) and/or hydroxyurea (HU) treatment between 2007 and 2018. Method: This was a neonatal retrospective/prospective cohort study with children born between 1999 and 2014 with the homozygotic form (HbSS) or Sβ0-thalassemia, who underwent TCD at least once. Results: Of the 718 children screened during this period, 675 had HbSS and 43 HbSβ0-thalassemia. In 54 children (7.5%), all with HbSS, a high risk TCD (n=45) or, when the TCD was inconclusive, MRA with cerebral vasculopathy (n=9) was detected. Of these, 51 started RTP and the families of three refused treatment. Of the 43 children with high-risk TCD who initiated RTP, 29 (67.4%) reverted to low risk. In 18 of them (62%), HU was started at the maximum tolerated dose (MTD) before transfusion discontinuation. None of these 29 patients had a stroke. Eight children (18.6%) maintained a high-risk TCD even using RTP/HU, and two had a stroke. Conclusions: TCD was confirmed as a viable tool for tracking patients with a risk for stroke. The RTP was effective in preventing the primary event. New strategies are necessary to prevent stroke using HU and new drugs, besides bone marrow transplantation.

Iatrogenic chordal rupture with severe mitral regurgitation is a rare but serious complication associated with the use of Impella device. We present a case of a 47-year-old man with ischemic cardiomyopathy who presented in cardiogenic shock requiring insertion of extracorporeal membrane oxygenation which was subsequently transitioned to an Impella 5.0 device. During Impella support, he developed acute pulmonary edema secondary to newly diagnosed posterior mitral valve chordal rupture and subsequent severe mitral regurgitation. He underwent implantation of a durable left ventricular assist device with concomitant edge-to-edge mitral valve repair through the apex. Transthoracic echocardiography at three month showed mild regurgitation.

Background: Psychological stress exacerbates mast cell (MC)-dependent inflammation, including nasal allergy, but the underlying mechanisms are not well understood. Because the key stress-mediating neurohormone, corticotropin-releasing hormone (CRH), induces human skin MC degranulation, we hypothesized that CRH may be a key player in stress-aggravated nasal allergy. The current study probes this hypothesis in human nasal mucosa MCs (hM-MCs) in situ, using nasal polyp organ culture, and tests whether CRH is required for murine M-MC activation by perceived stress in vivo. Methods: Organ-cultured nasal polyps were used as a surrogate tissue for human upper airway mucosa and stimulated with CRH. In addition to quantitative immunohistomorphometry and transmission electron microscopy, we investigated whether perceived (restraint) stress activates murine M-MCs in vivo and whether this is CRH-dependent. Results: CRH stimulation significantly increased the number of hM-MCs, stimulated both their degranulation and proliferation ex vivo, and increased SCF expression in human nasal mucosa epithelium compared to controls. CRH also sensitized hM-MCs to further CRH stimulation and promoted a pro-inflammatory hM-MC phenotype. The CRH-induced increase in hM-MCs was abrogated by co-administration of CRH-R1 specific antagonist antalarmin, CRH-R1 siRNA, or SCF-neutralizing antibody. In vivo, both acute and chronic restraint stress significantly increased the number and degranulation of murine M-MCs compared to sham-stressed mice. This effect was abrogated by intranasal antalarmin. Conclusion: CRH is a major activator of hM-MC in nasal mucosa, in part via promoting SCF production, and CRH-R1 antagonists like antalarmin are promising candidate therapeutics for nasal mucosa neuroinflammation induced by perceived stress.

Background: The upper-airway microbiota may be associated with the pathogenesis of asthma and useful for predicting acute exacerbation. However, the relationship between the lower-airway microbiota and acute exacerbation in children with asthma is not well-understood. We evaluated the characteristics of the airway microbiome using induced sputum from children with asthma exacerbation and compared the microbiota-related differences of inflammatory cytokines with those in children with asthma. Methods: We analysed the microbiome using induced sputum during acute exacerbation of asthma in children. We identified microbial candidates that were prominent in children with asthma exacerbation and compared them with those in children with stable asthma using various analytical methods. The microbial candidates were analysed to determine their association with inflammatory cytokines. We also developed a predictive functional profile using PICRUSt. Results: Ninety-five children with allergic sensitisation including twenty-two with asthma exacerbation, sixty-seven with stable asthma, and six controls were evaluated. We selected 26 microbial candidates whose abundances were significantly increased, decreased, or correlated during acute exacerbation in children with asthma. Among the microbial candidates, Campylobacter, Capnocytophaga, Haemophilus, and Porphyromonas were associated with inflammatory cytokines including macrophage inflammatory protein (MIP)-1β, programmed death-ligand 1, and granzyme B. Both Campylobacter and MIP-1β levels were correlated with sputum eosinophils. Increased lipopolysaccharide biosynthesis and decreased glycan degradation were observed in children with asthma exacerbation. Conclusions: Gram-negative microbes in the lower airway were related to acute exacerbation in children with asthma. These microbes and associated cytokines may play a role in exacerbating asthma in children.

Immune Thrombocytopenia (ITP) is a relatively common hematologic disorder characterized by isolated thrombocytopenia. In children it is usually associated with a history of a preceding viral infection provoked by common viruses. During the pandemic of Coronavirus Disease-19(COVID-19) few cases have been described in literature associated with previous COVID-19 infection(1,2). We describe the case of a 2-year-old boy who presented with ITP which was attributed to previous COVID-19 infection based on positive serology and hence we aspire to highlight the importance of including Severe Acute Respiratory Syndrome Coronavirus-2(SARS-CoV-2) in routine serology tests performed in children with ITP during the current pandemic.

To move towards clinical applications, tissue engineering (TE) should be validated with human primary cells and offer easy connection to the native vascularisation. Based on a sheet-like bone substitute developed previously, we investigated a mesenchymal stem cells / endothelial cells (MSCs/ECs) coculture to enhance pre-vascularisation. Using MSCs from 6 independent donors, we focused on donor variability and cell crosstalk. Coculture was performed on calcium phosphate granules in a specific chamber (one month). MSCs were seeded first then ECs were added after two weeks, with control monocultures. Cell viability and organisation (fluorescence, electronic microscopy), differentiation (ALP staining/activity, RT-qPCR) and mechanical cohesion were analysed. Adaptation of the protocol to coculture was validated (high cell viability and proliferation). Activity and differentiation showed strong trends towards synergistic effects between cell types. MSCs reached early mineralization stage of maturation. The delayed ECs addition ECs allowed for their attachment on developed MSCs. The main impact of donor variability could be the lack of cell proliferation potential with some donors, leading to low differentiation and mechanical cohesion and therefore absence of sheet-like shape successfully obtained with others. We suggest adapting protocols to cell proliferation potentials from one batch of cells to the other in a patient-specific approach.

Background: Individuals of any age can acquire SARS-CoV-2 infection, although adults of middle age and older are most commonly affected, and older adults are more likely to have severe disease. Therefore, the management of patients with COVID-19 over the age of 50 is very important. Aims: In this study, we aimed to investigate the epidemiological, clinical, and laboratory findings of COVID-19 patients over the age of 50 in a tertiary education and research hospital. Study Design: Single-center retrospective cross-sectional study. Methods: Patients older than 50 years of age who applied to the emergency service with suspected COVID-19 and had positive nasopharyngeal PCR were included in the study. The patients were divided into 3 groups according to their ages (50-64 years, 65-79 years, and 80 years and over, respectively). Demographic characteristics of the patients such as age, gender, admission symptoms, clinical findings, laboratory results, imaging results, and hospital follow-up periods were recorded. Results: A total of 119 patients were included in the study. Seventy-five patients were 50-64 years old (63.02%), 31 patients were 65-79 years (26.05%), and 13 patients were over 80 years old (10.9%). It was observed that fever and respiratory distress gradually increased with age (p = 0.019, p = 0.029). Considering the laboratory values between the groups, statistically significant differences were found in terms of anemia (p ˂ 0.05), lymphopenia (p ˂ 0.05), and the neutrophil/lymphocyte ratio (p = 0.009). Positive computed tomography findings were detected in 88 (73.9%) cases. The rates of service and intensive care hospitalization increased with age and were highest in patients over the age of 80 (p < 0.001). Conclusion: Age is an important risk factor in COVID-19 disease. In COVID-19 disease, special protocols should be established for elderly patients and studies involving larger patient samples should be conducted.

Artificial intelligent and automation are the modern trends to industrial development. The objective of this study is to determine, model and optimize some optical properties of bulk cowpea grains varieties relevant for automation. Three varieties with five moisture levels were used. Colour properties were determined using chroma meter while the absorbance and transmittance properties were determined using spectrophotometer. Direct reflection property was calculated using Beer-Lambert equation. Quartic model was found to be the best for colour properties while quadratic model for absorbance and reflection properties. Quadratic model was not sufficient enough to describe the transmittance property. All models developed were found to be significant at p < 0.05 and were also confirmed. Optimal values for selecting sensors to identify, classify or sort cowpea seeds using the optical properties studied were developed.

Now a day’s poultry industry is moving with rapid strides in the market but respiratory diseases in poultry are sum of the most costly problem plaguing today in poultry industry due to high morbidity and mortality. Chronic respiratory disease (CRD) has major economic importance of poultry industry that caused by Mycoplasam gallispeticum (MG). CRD is highly contagious that transmit from infected birds to healthy ones by respiratory routes. Different types of antibiotics are helpful to treat it and different research use antibiotics of aminoglycoside group and supporting therapy with electrolytes. For preventing the flock from infection separates the infected birds from healthy ones. However the aim of this study is to perform the descriptive analysis to identify the respiratory poultry disease, method of prevention and their seasonal incidences.

The outbreak of African swine fever (ASF) in China in 2018, caused a huge economic loss on the pig industry. To accurately diagnose clinical infection with ASF virus (ASFV), we developed a duplex TaqMan-probe-based real-time PCR for the simultaneous detection of two discontinuous genes in the virus genome to avoid false-negative in the clinical diagnosis. Two sets of ASFV-gene specific primers, along with two TaqMan fluorescent probes were designed to target the conserved region of B646L and B438L genes, respectively. The method showed high sensitivity and specificity, with a detection limit of 10 copies/μl without cross-reactions with other pathogen genomes of CSFV, PRRSV, PEDV, PRV, PPV and PCV2. 269 clinical swine samples were tested using this method, and the results of 60 samples showed excellent consistency (95.0%) with a commercial kit. This method will greatly improve the efficiency for surveillance of ASFV and can help reduce economic losses to the swine industry, which also benefits animal and public health.

In this paper, the generalized iterative method has been successfully implemented for nding exact solutions of the non linear time fractional Klein-Gordon equations using com- posite fractional derivatives. Graphical representations also been studied. Illustrations related to Klein-Gordon equations using composite fractional derivative viz. Riemaan- Liouville fractional derivatives, Hilfer fractional derivatives, Caputo fractional derivatives has been discussed.

Background and Purpose: Mitochondrial dysfunction is essential in renal tubular damage, and mitophagy, a selective form of autophagy, specifically eliminates damaged mitochondria. Mitophagy reportedly protects against diabetic kidney disease, cisplatin-induced acute kidney injury (AKI) and other related kidney diseases, but the specific mechanism by which mitophagy protects against cisplatin-induced chronic kidney disease (CKD) remains unclear. Experimental Approach: The effects of farrerol on cisplatin-induced AKI in mice were investigated. C57BL/6 wild-type and Nrf2 knockout mice were used to evaluate the protective effect of farrerol on cisplatin-induced CKD. Key Results: we confirmed that Nrf2- and PINK1/Parkin-mediated mitophagy was significantly increased on the 3rd day of cisplatin stimulation but was reduced on the 38th day of cisplatin stimulation. Similar to previous results, farrerol, a natural compound, also activated Nrf2 on the 38th day of cisplatin administration, subsequently stimulating the Nrf2-targeted antioxidant enzymes HO-1 and NQO1. In addition, farrerol triggered PINK1/Parkin-mediated mitophagy by recruiting the receptor proteins LC3 and p62/SQSTM1, thereby eliminating damaged mitochondria. Furthermore, genetic deletion of Nrf2 reduced PINK1/Parkin-mediated mitophagy activation and led to increased renal tubular necrosis and renal fibrosis. We also found that farrerol alleviated inflammation and renal fibrosis by inhibiting p-NF-κB/NLRP3 and TGF-β/Smad signaling. Conclusions: These data indicated that farrerol effectively inhibited cisplatin-induced inflammation and renal fibrosis by activating Nrf2 and PINK1/Parkin-mediated mitophagy, which provides a potential novel therapeutic target for CKD.

\begin{abstract} {In this paper we consider the following fractional Kirchhoff equation with steep potential well \begin{align*} \renewcommand{\arraystretch}{1.25} \begin{array}{ll} \ds \left \{ \begin{array}{ll} \ds \left(a+b\int_{\R^{3}}|(-\Delta)^\frac{s}{2}u|^2\, dx\right)(-\Delta)^s u+\lambda V(x)u=|u|^{p-2}u,\,\,x\in\mathbb{R}^3, \\ u\in H^s(\R^3), \\ \end{array} \right . \end{array} \end{align*} where $a>0$ is a constant, $b$ and $\lambda$ are positive parameters. $2

A simplified micromechanical approach is used for the modelling and analysis of unidirectional (UD) composite performances. In this paper, the influence of volume fraction and constituent properties on the effective longitudinal, transverse, and shear properties of unidirectional composites are investigated. These effective properties are determined using the micromechanical approach, which is based on mathematical modelling using the rule of mixtures. Four different types of unidirectional composites such as T300/BSL914C, IM7/8511-7, T300/PR319, and S2-Glass/epoxy were used for analysis purposes. The method was validated with existing experimental results. The results are dependent on an array of parameters, such as the orientation of fibers, the volume fractions of fibers, array of fibers and the material properties of their constituents. Further, this micromechanical method might be used with other reinforcing fibers for the prediction of properties of UD, hybrid and other composites architectures.