Despite the considerable progress achieved in the field of cancer immunotherapy over the past few years, a large number of patients fail to benefit from these therapies due to insufficient alteration of the immunosuppressive tumor microenvironment (TME), which facilitates the evasion of anti-tumor immunotherapy. Metabolic reprogramming is emerging as an important hallmark of tumorigenesis and has a major effect on remodeling the tumor immune microenvironment and the response to cancer immunotherapy. However, only a limited number of studies have summarized the research trends and hotspots in metabolic reprogramming from the perspective of tumors and immune cells. Therefore, we aimed to comprehensively explore current research status and hot topics in TME-related metabolic reprogramming over a 20-year period using a bibliometric approach. Studies focusing on metabolic reprogramming and the TME were searched from the WOSCC database. Bibliometric and visual analyses of the included articles and reviews were performed using Bibliometrix (R-Tool in R-Studio), VOSviewer, and CiteSpace. A total of 4726 articles published between 2003 and 2022 were selected. The quantity of publications and citations exhibited an annual growth. Cooperation network analysis indicated that the United States holds the foremost position in the field of metabolic reprogramming and TME research, having the highest volume of publications and citations, thus exerting the greatest influence. Among the institutions, Fudan University displayed the highest level of productivity. Regarding publications in this field, Frontiers in Immunology emerged as the journal with the most extensive number of contributions. Ho Ping-Chih made the most article contributions; Pearce Edward J., was the most co-cited author. Four clusters were obtained after clustering analysis of the authors’ keywords with tumor microenvironment and immunotherapy, metabolic reprogramming and glycolysis, immunometabolism and gut microbiota, and immune and extracellular vesicles being the main topics. Immunometabolism, glycolysis, immune cells, and tumor-associated macrophages are relatively recent burst keywords that have attracted increasing attention.A comprehensive landscape of advancements in metabolic reprogramming and the TME was studied, which can provide crucial information for scholars to further advance this promising field. Further research should explore new topics related to immunometabolism in the TME using a transdisciplinary approach.

Objective We sought to determine whether patients are capable and willing to self-administer and interpret an EldonCard test to determine their Rh status. Design Cross-sectional study Setting Ambulatory obstetrics and gynecology clinic in Honolulu, HI Population English-speaking pregnancy-capable people aged 14-50 who did not know their blood type and had never used an EldonCard Methods Participants independently completed EldonCard testing, determined their Rh type and answered a survey on feasibility and acceptability. Separately, a blinded clinician recorded their interpretation of the participant’s EldonCard. When available, we obtained blood type from the electronic health record (EHR). Main Outcome Measures Rh type agreement between participant, clinician and EHR, as well as participant comfort and acceptability of testing Results Of the 330 total participants, 288 (87.3%) completed testing. Patients and clinicians had 94.0% agreement in their interpretation of the EldonCard for Rh status. Patient interpretation had 83.5% agreement with EHR while clinician and EHR had 92.3% agreement. Sensitivity of EldonCard interpretation by patient and clinician was 100%. Specificity was 83.2% for patients and 92.2% for clinicians. Two patients had Rh-negative blood type in the EHR. The vast majority of participants found the EldonCard testing easy (94.4%) and felt comfortable doing the testing (93.7%). Participants with lower education levels felt less confident (p=0.003) and less comfortable with testing (p=0.038), however, their ability to interpret results was similar to others (p=0.051). Conclusions Patient-performed Rh typing via the EldonCard is an effective and acceptable option for patients, and could be used as a primary screening test for Rh status. Funding The Society of Family Planning provided funding to the University of Hawai‘i Complex Family Planning Division to support this research. Keywords abortion; Rh immunization; Rh sensitization; Rh immunoglobulin; self-managed abortion; no-test medication abortion

Introduction: Plain language summaries (PLSs) make complex healthcare evidence accessible to patients and the public. Large language models (LLMs) may assist in generating accurate, readable PLSs. This study explored using the LLM Claude 2 to create PLSs of evidence reviews from the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program. Methods: We selected 10 evidence reviews published from 2021-2023, representing a range of methods and topics. We iteratively developed a prompt to guide Claude 2 in creating PLSs which included specifications for plain language, reading level, length, organizational structure, active voice, and inclusive language. PLSs were assessed for adherence to prompt specifications, comprehensiveness, accuracy, readability, and cultural sensitivity. Results: All PLSs met the word count. We judged one PLS as fully comprehensive; 7 mostly comprehensive. We judged 2 PLSs as fully capturing the PICO elements; 5 with minor PICO errors. We judged 3 PLSs as accurately reporting the results; 4 with minor result errors. We judged 3 PLSs as having major result errors for incorrectly reporting total participants. Five PLSs met the target 6th-8th grade reading level. Passive voice use averaged 16%. All PLSs used inclusive language. Conclusions: LLMs show promise for assisting in PLS creation but likely require human input to ensure accuracy, comprehensiveness, and the appropriate nuances of interpretation. Iterative prompt refinement may improve results and address the needs of specific reviews and audiences. As text-only summaries, the AI-generated PLSs could not meet all consumer communication criteria, such as textual design and visual representations. Further testing should explore how to best leverage LLM support in drafting PLS text for complex evidence reviews.

Despite the importance of the quality of institutions to healthcare delivery, in developing countries, the institutional role of the health sector remained less effective, affecting the population’s health status, particularly maternal and child health. This study examines the effect of institutional quality on maternal and child health in Nigeria. the main objective of the study is to find out whether or not the quality of institutions affects the health of the populace, concerning maternal and child health in Nigeria. using infant mortality, number of neonatal deaths, maternal mortality rate, and contraceptive prevalence rate to pixies maternal and child health. Democracy and Corruption were used to proxy institutional Quality with inflation, human capital and Gross domestic product as the control variables. Data were analysed using the generalised moment of method. The Result showed that two institutional quality measures (democracy and corruption) significantly impacted some maternal and child health measures, that is, IMR (β = -0.0001, p<0.01), MMR (β = -0.0001, p<0.01), and NND ((β = -0.0001, p<0.01). At the same time, corruption showed a positive and significant influence on IMR (β = 0.0004, p<0.01), MMR (β = 0.0002, p<0.01), and NND (β = 0.0005, p<0.01) and CPR (β = -0.1343, p<0.01) showing a negative and significant impact. The study concluded that the quality of the institutions, particularly the healthcare delivery institutions, impacts maternal and child health in Nigeria.

Aquatic ectotherms often attain smaller body sizes at higher temperatures. By analysing ~15,000 coastal-reef fish surveys across a 15oC spatial sea surface temperature (SST) gradient, we found that the mean length of fish length in communities decreases by ~5% for each 1oC temperature increase across space. This equated to a 50% decrease in mean length from 14 to 29oC mean annual SST. We found that trophic guild composition shifts from domination by herbivores and planktivores in the tropics, to invertivores and piscivores in cooler waters. By investigating the contribution of trophic composition to community-level mean length, we show ~25% of temperature-related changes could be attributed to trophic composition at the warmest sites, but <1% at colder temperatures. Our findings suggest that small changes in temperature will lead to large changes in fish community body sizes, driven both by community trophic composition in warm waters and mean sizes within trophic guilds.

Human activities have altered the species composition of assemblages through introductions and extinctions, but it remains unclear how those changes can affect the different facets of biodiversity. Here we assessed the impact of changes in species composition on taxonomic, functional, and phylogenetic diversity across 281 bird assemblages worldwide. To provide a more nuanced understanding of functional diversity, we distinguished morphological from life-history traits. We showed that shifts in species composition could trigger a global decline in avian biodiversity due to the high number of potential extinctions. Moreover, these extinctions were not random but unique in terms of function and phylogeny at the regional level. Our findings demonstrated that non-native species cannot compensate for these losses, as they are both morphologically and phylogenetically close to the native fauna. In the context of the ongoing biodiversity crisis, such alterations in the functional and phylogenetic structure of bird assemblages could heighten ecosystem vulnerability.

Topographic heterogeneity sets the stage for community assembly, but its effects on ecosystem functioning remain poorly understood. Here we test the hypothesis that heterogeneity underpins multiple cascading pathways that indirectly control multifunctionality. To do so, we combined experimental manipulation of topographic heterogeneity on rocky shores with comprehensive assessment of naturally assembled communities and multifunctionality. Structural equation modelling revealed that heterogeneity: i) enhanced biodiversity by supporting filter feeder richness; ii) triggered a facilitation cascade via reef-forming (polycheate) and biomass-dominant (macroalga) foundation species, which in turn broadly supported functionally diverse epibiotic and understory assemblages; and iii) inhibited a key consumer (limpet). These mechanisms exerted complementary positive effects on individual functions (e.g., water filtration, ecosystem metabolism, nutrient uptake) and, in turn, collectively enhanced multifunctionality. Topographic heterogeneity may therefore serve as a cornerstone physical attribute by initiating multiple cascades that propagate through ecological communities via foundation species, ultimately manifesting disproportionate effects on ecosystem multifunctionality.

The strong control of temperature on the timing of plant phenology is expected to cause substantial shifts in flowering times under climate change. Yet, the sensitivity of flowering phenology in dryland regions to climate change, and the potential implications for community composition, remain largely unexplored. Here, we investigate the effects of climate warming and nitrogen addition on flowering phenology of four C3 plants and two C4 plants and explore cascading effects on shifts in C3 vs C4 plant dominance in a 17-year field experiment in a desert steppe. Across the last 10 years of the experiment (2013–2022), we found that warming had a greater effect on phenological shifts in C3 than in C4 plants. Warming significantly advanced the flowering time of C3 plants by 4.3 ± 0.1 days and of C4 plants by 2.8 ± 0.1 days. Warming also reduced the duration of flowering by 1.8 ± 0.1 days and decreased the dominance of C3 plants compared to C4 plants (P＜0.05). Nitrogen addition extended the duration of flowering of C4 plants by 3.4 ± 0.2 days and increased their relative dominance, while having no effect on C3 plants. Structural equation models highlighted that these phenological responses were influenced by soil temperature and soil water availability. Our results show the divergent phenological responses between C3 and C4 plants under global changes, predicting shifts in dominance between these plant types in temperate dryland ecosystems.

Biodiversity–ecosystem functioning relationships (BEFs) have been extensively explored across ecosystems. However, these relationships may change as the forest matures, and the underlying mechanisms remain underexplored. Using large temperate forest datasets from 2,392 permanent plots in northeastern China, we examined the relationships between biodiversity and aboveground biomass (AGB) across different developmental stages from young to over-mature stands. We found the positive BEFs using both species richness and functional diversity, but these positive effects decreased with forest development. However, the effects of community-weighted mean on AGB showed two peaks in young and mature stands. Notably, the effects of community-weighted mean on AGB became larger than the effects of functional diversity after the forests developed to near-mature/mature stands, indicating that BEFs are driven by mass-ratio effects (i.e., dominant species) rather than niche complementarity in old stands. Our findings on how the developmental stage influences the effects of biodiversity on ecosystem functioning in natural forests will help identify effective strategies for maintaining or enhancing ecosystem services at different forest successional stages.

Biodiversity-function relationships in ecosystems are known to be driven by environmental conditions, including climate change. Plant functional groups (PFGs), specifically their evolutionary history, nitrogen-fixation capacity or photosynthetic-pathway likely play a critical role in shaping microbial communities and their impact on ecosystem functions, but experimental evidence is limited. Here, we simultaneously manipulated plant and microbial diversity in a microcosm study to investigate their interactions and impact on soil functions during drought. Our results highlight the dominant role of PFGs in explaining the effects of biodiversity loss on soil functions. Microbial diversity loss significantly influenced microbially-driven soil N and P pools and processes, with PFGs moderating these effects, especially under drought. Our findings offer crucial mechanistic insights for ecosystem management in the face of climate change, emphasizing the significance of PFGs in shaping soil functions and their resilience. This study underscores the importance of considering above- and belowground biodiversity, for preserving belowground functions in changing environments.

The role of trait variability in mediating plant community responses to environmental change remains poorly resolved. We conducted a 5-year study across 45 fragments in a tropical dry forest to understand shifts in trait means and variabilities of the trees classified into two functional types, drought avoiders and drought tolerators, across a soil moisture gradient, and their association with changes in site-level productivity. Trait means changed in opposite directions across the soil moisture gradient for the two functional types, especially for water safety and leaf carbon capture traits. Trait variabilities were generally greater at dry sites for drought avoiders and at wet sites for drought tolerators. Site-level growth rates were related to different sets of trait means and variabilities for the two functional types. Projected changes in precipitation will likely shift the vegetation to greater representation of drought tolerators and will be accompanied by non-linear increases in standing biomass.

A general approach is developed for discriminating strong and hereditary symmetric operators. The recursion operator of the Blaszak-Marciniak (BM) equation hierarchy is proved to be strong and hereditary symmetric. As an example of discrete soliton equations related to 3×3 matrix spectral problems, the τ-symmetries and Lie algebra structure of the BM equation are built firstly.

The heterogeneous and homogeneous combustion-based homogeneous charge compression ignition of fuel-lean methane-air mixtures over alumina-supported platinum catalysts was investigated experimentally and numerically in free-piston micro-engines without ignition sources. Single-shot experiments were carried out in the purely homogeneous and coupled heterogeneous and homogeneous combustion modes, involved temperature measurements, capturing the visible combustion image sequences, exhaust gas analysis, and the physicochemical characterization of catalysts. Simulations were performed with a two-dimensional transient model that includes detailed heterogeneous and homogeneous chemistry and transport, leakage, and free-piston motion to gain physical insight and to explore the heterogeneous and homogeneous combustion characteristics. The micro-engine performance concerning combustion efficiency, mass loss, energy density, and free-piston dynamics was investigated. The results reveal that heterogeneous reactions cause earlier ignition, which is very favourable for the micro-device. Both purely homogeneous and coupled heterogeneous and homogeneous combustion of methane-air mixtures in a narrow cylinder with a diameter of 3 mm and a height of approximately 0.3 mm are possible. Heat losses result in higher mass losses. The coupled heterogeneous and homogeneous mode can not only significantly improve the combustion efficiency, in-cylinder temperature and pressure, output power and energy density, but also reduce the mass loss because of its lower compression ratio and less time spent around the top dead centre and during the expansion stroke, indicating that this coupled mode is a promising combustion scheme for micro-engines.Keywords: Micro-engines; Homogeneous combustion; Free-piston dynamics; Power generation; Transient models; Micro-combustion

Perineural anaesthesia is a useful technique in equine surgery, providing pre-emptive targeted anaesthesia of the surgical site, reducing volatile anaesthetic requirements, improving recovery quality and providing post-operative pain relief. Surgery under standing sedation in horses has increased in popularity, mandating the need for effective locoregional anaesthesia and analgesic techniques. Nerve location techniques offer greater accuracy than blind techniques when placing injectate. These methods can help to avoid structures such as blood vessels and minimise direct nerve damage during needle placement, reducing the chance of procedure-related complications. This review will discuss the most pertinent research in the veterinary literature where objective methods of nerve location have been used to perform peripheral nerve blocks in horses. The efficacy of using objective methods to perform nerve blocks in equine anaesthesia is discussed by the authors, providing useful information to equine anaesthetists, and potentially improve the quality of anaesthesia and analgesia in horses.

EVE Clinical CommentaryThe case report by describes an interesting case of rib fracture in a race horse with an attributable hindlimb lameness. This case is the first to suggest that caudal rib fractures are a cause of hindlimb lameness and peri regional diagnostic analgesia of a rib fracture can be used to alleviate hindlimb lameness.A recent retrospective study reported 73 horses diagnosed with a rib fracture of which 56% (41/73) presented due to poor performance with a fewer number of horses presenting with lameness as a primary complaint (21/73). Undoubtedly rib fractures are painful in the acute stages of injury, with the most common site for rib fracture in a horse being dorsally (5-15cm from the costovertebral junction) on the 18th rib (Hall et. al. 2022). In this study, not all horses with caudal rib fractures were found to have lameness those that were lame had a variable pattern of lameness. All of the horses which underwent diagnostic analgesia were found to have lameness independent to the rib fracture. However only a small percentage of horses underwent diagnostic analgesia, a limitation of a retrospective study.An alternative retrospective case series of 50 rib fractures reported 5 fractures of the first rib which all occurred in racing thoroughbreds (age 2-7 years with a median age of 3), all of which had ipsilateral forelimb lameness. In the absence of a traumatic incident the authors suggested that fractures of the 1st rib may represent fatigue fracture pathology associated with training. A similar aetiology is possible for caudal rib fractures but is considered unlikely as this injury is not over represented in racing Thoroughbreds compared with a general population of horses and trauma remains the most likely cause.Ribs can be imaged in detail with nuclear scintigraphy given the relatively small amount of overlying soft tissue. Orthogonal images (lateral, dorsal and oblique) should be used to localise region, extent, pattern and origin of increased radiopharmaceutical uptake. Nuclear scintigraphy is highly sensitive in identifying osteoblastic activity but has low specificity for identifying the nature of the pathological process. Fractures show increased radiopharmaceutical uptake within 24-72 hours post injury, making nuclear scintigraphy highly sensitive in the acute stage of disease verses radiographic signs which may not be seen for around 7-10 days unless the fracture is displaced. The appearance of a fracture on nuclear scintigraphy includes 5-7 days of diffuse intense uptake, 1-4 weeks of focal intense uptake (figure 1.) and then a gradual decrease of radiopharmaceutical uptake over the next 6-12 months. This prolonged visibility on scintigraphy means that is difficult to age a fracture based on scintigraphy alone. Ultrasonography is potentially more suitable to monitor fracture healing and identify those cases which are non-healing and requiring intervention. Costochondral junctions normally have a moderate increased radiopharmaceutical uptake on nuclear scintigraphy and should not be mistaken for a rib fracture (figure 1.). The caudal ribs overly the kidney (figure 1.) but in most instances have a mild to moderate diffuse region of increased radiopharmaceutical uptake. The use of furosemide one hour before imaging has been advocated to improve soft tissue clearance and improve image count to background ratio. This was evaluated in a recent study where 1mg/kg furosemides was administered intravenously 1 h post 99m Tc-HDP administration and the image quality was assessed subjectively and semi-quantitively. There was no significant difference in image quality or radiation dose rate to handler, with a minimum distance of 30cm distance having the most effect on reducing handler dose rate by 65% .Ultrasonographic examination is highly sensitive and specific in identifying rib fractures (Hall et. al. 2022). If a rib fracture is suspected in the initial stages of examination, then survey ultrasonographic examination of the ribs is recommended, especially the caudal ribs. However, rib fractures rarely result in focal localising pain on palpation and so even a detailed clinical examination may be unrewarding. Ultrasonography of the ribs is a simple technique; clipping isn’t required and discontinuity and callus within the lateral cortex of the ribs is easy to identify (Figure 2) but should not be confused with the costochondral junction (figures 3 and 4). The costochondral junction is identified by the presence of hypoechoic cartilage and it should be noted that the margins of adjacent ribs are normally irregular at this site. In contrast, a rib fracture does not contain hypoechoic cartilage, though the rib margins are likely to be irregular and commonly periosteal new bone may be seen.In this case of hindlimb lameness due to fracture of the 18th rib , the horse took 12 months to recover and resume ridden exercise with conservative therapy. Ultrasonographic examination can monitor fracture healing and is useful in identifying non-healing fractures which may represent surgical candidates. Hall and colleagues (2022) reported six horses which underwent surgery due to failed initial conservative management which resulted in continued fracture instability, callus at the fracture site or fracture displacement causing impingement on adjacent ribs. One horse which underwent wedge ostectomy and internal fixation with a locking compression plate returned to its previous level of exercise. All other surgically managed cases (5/73) underwent partial rib resection. Most horses in this study were managed conservatively (67/73). Given the very small number of surgically managed cases it is not possible to determine if fracture healing or outcome would have been improved if surgical intervention had been performed in more cases.Peri-regional analgesia of a rib fracture is commonly used in human medicine as a therapeutic aid and is easy to perform in the horse. In this instance the ipsilateral hindlimb lameness was partially alleviated by this technique in the acute stage of lameness and completely abolished in the chronic stage of lameness. Perineural analgesia can result in increased radiopharmaceutical uptake within the soft tissues on bone phase scintigraphy, up to 7 days post blocking , with 50% of horses having uptake at the site of a tibial perineural injection one day post injection, 25% of horses at the block site 3 days post injection and 1 horse with increased radiopharmaceutical uptake 7 days post injection. An appropriate washout period is recommended prior to scintigraphy if perineural analgesia has been performed to prevent false positive results.Although rib fractures are largely under reported in adult horses this case report and recent retrospective studies confirm they should be considered a differential diagnosis for cases of poor performance and both fore and hind limb lameness. Diagnostic analgesia could be used to determine significance of the rib fracture in cases of hind limb lameness.

As a fundamental element of global carbon storage, the storage carbon in terrestrial ecosystem is significant for climate change mitigation. Land use/cover change (LUCC) is a main impact element of ecosystems’ carbon storage. Evaluating the relation between land use change and carbon storage is vital for lowering global carbon emissions. Taking Hainan Island as an example, this paper employs the InVEST as well as the CA-Markov models to assess and predict how different land use affects carbon storage in various situations from 2000 to 2020 and from 2030 to 2050 on Hainan Island. The influence factors, together with driving mechanisms of carbon storage spatial distribution are quantitatively analyzed as well in this paper. The results demonstrate that, from 2000 to 2020, Hainan Island’s net increase in built land was 605.49 km2, representing a growth rate of 77.05%. Over the last 20 years, Hainan Island’s carbon storage and density have decreased by 5.90 Tg and 1.75 Mg/hm2, respectively. The sharp rise in built land mainly makes the carbon storage decline. From 2030 to 2050, land use changes on Hainan Island are expected to result in differing degrees of carbon storage loss in various scenarios. In 2050, Hainan Island’s carbon storage will decline by 17.36 Tg in the Natural Development Scenario (NDS), 13.61 Tg in the Farmland Protection Scenario (FPS), and 8.06 Tg in the Ecological Protection Scenario (EPS) compared to 2020. The EPS can efficiently maintain carbon sequestration capability, but it cannot effectively prevent cropland area loss. Regarding the carbon storage’s spatial distribution, Hainan Island generally exhibits a pattern of high carbon storages in the low and middle carbon storages in the surrounding areas. Geographic detection presented the spatial differentiation of carbon storage in Hainan Island is mainly influenced by factors like slope, land use intensity, and DEM, as well as its interaction with other factors is significantly strengthened (p<0.05)

The popularity of electric bicycles is on the rise. These bikes are equipped with electrical components that allow them to safely navigate streets with other vehicles, by matching traffic speed. Currently, most electric bicycles use hub motors, but these can be expensive due to the complex gear systems that increase torque. Our solution is an electric bike with a non-hub BLDC motor that uses a pinion-pulley system for the motor-wheel connection. This system offers flexible gear ratios by adjusting the number of teeth in the pinion and pulley, is more cost-effective than hub motors, and generates a high torque of 70 NM.

Anthropogenic pressures on nature have been causing population declines for centuries. Intensified persecution of apex predators, like the golden eagle, resulted in population bottlenecks during the 19th-20th centuries. To study population genetics and demographic history of the golden eagle throughout its distribution, we collected museum samples from previously underrepresented regions, such as Russia and Central Asia. We used 12 microsatellite loci and a fragment of the mitochondrial DNA control region to re-evaluate phylogeography of Eurasian golden eagles and study the impacts of the population bottleneck. Our results revealed a north-south genetic gradient, expressed by the difference of Mediterranean and Holarctic lineages, as well as genetically distinct Northern Europe and Central Asia and Caucasus regions. Furthermore, Northern Europe exhibited the lowest, whereas Central Asia and Caucasus had the highest genetic diversity. Although golden eagles maintained relatively high genetic diversity, we detected genetic signatures of the recent bottleneck, including reduced genetic diversity and a decline in the effective female population size around the year 1975. Our study improves the knowledge of the genetic composition of Eurasian golden eagles and highlights the importance of understanding their historical population dynamics in the face of ongoing and future conservation efforts.

This paper solves the problem of block sparse vector recovery using the block $\ell_1-\alpha\ell_q$- minimization model. Based on the block restricted isometry property (B-RIP) condition, we obtain exact block sparse vector recovery result. We also obtain the theoretical bound for the block $\ell_1-\alpha\ell_q$- minimization model when measurements are depraved by the noises.

At this study, pore density (10PPI and 20PPI) was investigated on performance of thermal-hydraulic of MFHE. The effect of double-layers of foam with thickness ratio of 0.43, and gradient of pore density were investigated. The pore density arrangement is with either increasing or decreasing pore density towards the heated wall of the tubes bundle ((20/10 PPI) or (10/20PPI) respectively). For double layers copper foam heat exchanger, the numerical results showed that the single segment of 20PPI have pressure drop higher than specimens double layers with order increasing (10/20 PPI), or decreasing (20/10PPI), single segment with a pore density of 10PPI and finned tube with approximately (10%, 15%, 39%, and 201% ) respectively, within the range of Reynold number from 1326 to 6630. Also, it was found that gradient of pore density with decreasing PPI towards heated wall (10/20) with fixed porosity led to increase thermal hydraulic performance with 7% -10% compared with single layer of 10 PPI and 20 PPI respectively.

This study examines turbulent convective heat transfer performance (CHTP) and entropy production rate (EPR) of distilled water flowing in outwardly corrugated converging pipes (CCPs) of various diameter ratios (DR). The SST k - ω turbulence models were used to simulate the flow of H 2O inside the pipe. The effects of Reynolds number ( 5 . 0 × 10 3 ≤ Re  ≤ 5 . 0 × 10 4 ), and DR ( 1 ≤ DR  ≤ 2 ) on average Nusselt number ( Nu ), Poiseuille number (fRe) thermal performance evaluation criterion (PEC), EPR, and thermal effectiveness number ( I ) Nu were investigated parametrically. The findings revealed a significant improvement in Nu in the modified pipe compared with the straight pipe. This improvement is attributed to flow acceleration and increases in the mixing rate of hot fluid near the wall with cold fluid at the core fluid zone. Also, Nu , fRe , and EPR increase with increasing Re and DR. However, the opposite is the case for PEC and   I . Finally, the values of PEC, and I revealed that the modified pipe is advantageous compared with a straight pipe at ( 5 × 10 3 ≤ Re ≤ 1 . 0 × 10 4 ) .

Hatching plasticity allows fish and amphibians to initiate hatching in response to environmental cues including predation, flooding, and hypoxia. In species with terrestrial eggs, hatching plasticity often manifests as extended development of embryos when water is not available. Although these effects are taxonomically widespread, little attention has focused on differences in plasticity across closely related species with terrestrial and aquatic embryos. We propose that terrestrial embryonic environment that favors slower and extended development that, together, result in a more advanced stage at hatching than an aquatic embryonic environment. We test this hypothesis by comparing embryonic development between two fall-breeding mole salamanders, Ambystoma opacum and A. annulatum. Most Ambystoma lay eggs submerged in ponds but A. opacum lays its eggs on land, where hatching is triggered when eggs are submerged by rising pond levels. We compared embryonic development of A. opacum with A. annulatum, which lays eggs in water, in a common laboratory environment. Embryos of both species were reared in environments simulating either aquatic or terrestrial nests sites. We found that the A. opacum embryos exhibited slower development and took longer to hatch than A. annulatum embryos. We also found that A. opacum hatched at a more advanced stage, but only when reared in an environment that mimicked a terrestrial nest. This plasticity was absent in A. annulatum. Our results suggest that the terrestrial-laying A. opacum has evolved a developmental plasticity that allows its embryos to extend development when in terrestrial nests, while retaining the ability to hatch at a stage more typical of congeners when submerged in water.

Aims: Guidelines recommend insertable cardiac monitor (ICM) in the early phases of the evaluation of unexplained syncope (US) syncope, when an arrhythmic etiology is suspected. We examined the diagnostic yield of the last generation ICM (LG-ICM) to establish the causes of US, by assessing in the clinical practice the incidence of: relevant arrhythmia diagnosis, syncope recurrences and CM-guided cardiac electronic device (CIED) implantation. We investigated also baseline patient characteristics associated to an increased risk of relevant arrhythmias and of syncope recurrence. Methods: Data prospectively collected from consecutive patients receiving LG-ICM for investigation of US or presyncope in our institution between November 2020 and January 2023 were analyzed. Result: A total of 109 patients (mean age 64.4 ± 16.1 years, 40.4% women) with US or pre-syncope episodes underwent implantation of the LG-ICM. During a mean follow-up of 11.7 ± 8.1 months, LG-ICM diagnostic yield was 42% . In particular, LG-ICM detected cardiac arrhythmias in 29 (27%) patients (in 6 out of them during a syncope recurrence) and to exclude the arrhythmic origin of the syncope in additional 19 (17%) patients. LG-ICM guided the implantation of a CIED in 16 (15%) US patients, due to the diagnosis of asystole or severe bradycardia. Age ≥ 65 years (p=0.012) and atrial arrhythmia history (p=0.004) are significant independent predictors of arrhythmic diagnoses performed by LG-ICM, while CAD is predictor of syncope recurrence (bordering on statistical significance, p=0.056). Conclusions The diagnostic yield of LG-ICM in US syncope is comparable to those of ILR and previous generation ICM. The advantages of LG-ICM should be sought in lower hospital workload necessary to manage ICM data. Age ≥ 65 years and atrial arrhythmia history are independent predictors of significant ICM-detected arrhythmias.

Objective: Childhood spinal tumors often present with musculoskeletal symptoms, potentially causing a misdiagnosis and delays in diagnosis and treatment. This study aims to identify, characterize, and compare children with spinal tumors who had prior musculoskeletal misdiagnoses to those without, analyzing clinical presentation, diagnostic interval, and outcome. Study design: This retrospective cohort study evaluated all children aged 0-14 years diagnosed with a spinal tumor in Denmark from 1996 to 2018. The cohort was identified through the Danish Childhood Cancer Registry, and the registry data were supplemented with data from medical records. The survival was compared using the Kaplan-Meier method. Results: Among 58 patients, 57% (33/58) recieved musculoskeletal misdiagnoses before the spinal tumor diagnosis. Misdiagnoses were mostly non-specific (64%, 21/33), involving pain and accidental lesions, while 36% (12/33) were rheumatic diagnoses. The patients with prior misdiagnosis had less aggressive tumors, fewer neurological/general symptoms, and 5.5 months median diagnostic interval versus 3 months for those without a misdiagnosis. Those with prior misdiagnoses tended to have a higher 5-year survival of 83% (95% CI 63-92%) compared to 66% (95% CI 44-82%) for those without (p=0.15) Conclusion: Less aggressive spinal tumors may manifest as gradual skeletal abnormalities and musculoskeletal symptoms without neurological/general symptoms, leading to misdiagnoses and delays.