Primary breast lymphoma (PBL) is a rare form of extranodal lymphoma defined by the presence of a primary lesion within the breast with or without regional nodal involvement, but no other extra-mammary sites of involvement. Bilateral PBL is even more rare with very few cases reported in the literature. Herein, we

Background: This report describes a 48-year-old man who presented with a month history of weakness and paraesthesia associated with severe pain of all four limbs. Initially diagnosed and treated as GBS due to the severity of his extremity weakness, later discovered to be EPGA Objective: Mononeuritis multiplex should not be underestimated or overlooked in the setting of diagnosing EGPA and requires prompt treatment with biologics to limit the permanent consequences on patient’s quality of life in regards to developing limb weakness and pain. Conclusion: Although peripheral neuropathy and namely mononeuritis multiplex is not the most common feature of EGPA, it is important to consider it in order not to delay treatment with biologic agents that as seen in our patient can both halt the progress of the disease as well as give the patient a better quality of life.

Personality variation, defined as among-individual differences in behaviour that are repeatable across time and context, is widely reported across animal taxa. From an evolutionary perspective, characterising the amount and structure of this variation is useful since differences among individuals are the raw material for adaptive behavioural evolution. However, behavioural variation among-individuals also has implications for more applied areas of evolution and ecology – from invasion biology, to ecotoxicology, and selective breeding in captive systems. Here, we investigate the structure of personality variation in the red cherry shrimp, Neocaridina heteropoda, a popular ornamental species that is readily kept and bred under lab conditions and is emerging as a decapod crustacean model across these fields, but for which basic biological, ecological, and behavioural data is limited. Using two assays and a repeated measures approach, we quantify behaviours putatively indicative of shy-bold variation and test for sexual dimorphism and/or size-dependent behaviours (as predicted by some state-dependent models of personality). We find moderate to high behavioural repeatabilities across traits. Although strong individual-level correlations across behaviours are consistent with a major personality axis underlying these observed traits, the multivariate structure of personality variation does not fully match a priori expectations of a shy-bold axis. This may reflect our ecological naivety with respect to what really constitutes bolder, more risk prone, behaviour in this species. We find no evidence for sexual dimorphism and only weak support size-dependent behaviour. Our study contributes to the growing literature describing behavioural variation in aquatic invertebrates. Furthermore, it lays a foundation for further studies harnessing the potential of this emerging model system. In particular, this existing behavioural variation could be functionally linked to life-history traits, invasive success, and serve as target of artificial selection or bioassays. It thus holds significant promise in applied research across ecotoxicology, aquaculture, and invasion biology.

Maxillary molar root amputation: Case report with a 14-year follow-up and updated mini reviewKey Clinical Message : Root resection is performed to create a maintainable furcation area in teeth with advanced periodontitis. However, the long-term feasibility of this treatment remains controversial. We present a case in which distal root resection in a maxillary molar successfully preserved the form and function of the dentition for approximately 14 years.Keywords : Periodontitis, Furcation defect; long-term; Prognosis, Molar teeth

Abstract :Background: A noval radiologic sign in patients with renal failure and UE with metabolic acidosis has recently been identified as the lentiform fork sign. On magnetic resonance imaging (MRI), the ”lentiform fork sign” has been described as bilateral symmetrical hyperintensities in the basal ganglia encircled by a hyperintese rim delineating the lentiform nucleus. Changes in uremic solute retention, aberrant blood-brain barrier transport, disorderd vascular reactivity, altered electrolyte and acid-base balance, and altered hormone metabolism are the most likely causes of the condition.Case presentation : 56-year-old man with end-stage renal disease was brought to the emergency room for a progressive change in mental status and involuntary arm movements over the previous five days, which were also accompanied by mild dyspnea.A brain MRI was performed, and it revealed hyperintensity on T2/FLAIR in the white matter surrounding the basal ganglia. The haloperidol was stopped, and there more dialysis sessions were carried out.Conclusion : intensified hemodialysis and glycemic control are the cornerstones of treating DUS with likely reversible clinical symptoms and remission of imaging abnormalities.

FH mutation associated uterine leiomyomas: A Case Report and Literature Review

A document by Gordon Amponsah. Click on the document to view its contents.

A document by Meng Wang. Click on the document to view its contents.

Proton pump inhibitors (PPIs) are invaluable therapeutic options in a variety of dyspeptic diseases. In addition to their well-known risk profile, PPI consumption is related to food and environmental allergies, dysbiosis, osteoporosis, as well as immediate and delayed hypersensitivity reactions (HSRs). The latter, although a rare event, around 1-3%, due to the extraordinarily high rate of prescription and consumption of PPIs are related to a substantial risk. In this Position Paper, we provide clinicians with practical evidence-based recommendations for the diagnosis and management of HSRs to PPIs. Furthermore, the unmet needs proposed in the document aim to stimulate more in-depth investigations in the topic.

Zinc selenide (ZnSe), a metal chalcogenide, is an attractive anode material for sodium-ion batteries, exhibiting high theoretical capacity (371.4 mAhg-1) and numerous redox sites. However, volume expansion and low stability during the charge/discharge processes present challenges. This study aimed to solve these inherent problems and synthesize a high-performance anode materials by growing and synthesizing nano sized ZnSe on surface of reduced graphene oxide (rGO). ZnSe has two crystal structures, namely zinc-blende and wurtzite, and undergoes a transformation from wurtzite to the zinc-blende phase during sodium ion storage. The study conducted X-ray diffraction analysis of the electrode after the galvanostatic charge/discharge test and performed cyclic voltammetry analysis to investigate the transformation process. In addition, real-time monitoring of Nyquist plot and phase transition was performed to investigate the mechanisms of sodium ion storage. The ZnSe-rGO, exhibiting conversion reactions, shows cycle performance of 316.14 mAhg-1 at a current density of 0.5 Ag-1 after 1000 cycles. The evaluation of anode materials and analysis of their storage mechanism can facilitate sodium-ion batteries research

Aim: To examine and understand the work processes of AMS teams across two hospitals that use the same digital intervention, and to identify the challenges and enablers to effective AMS in each setting. Methods: Employing a contextual inquiry approach informed by the Systems Engineering Initiative for Patient Safety (SEIPS) model, observations and semi-structured interviews were conducted with AMS team members (n=15) in two Australian hospitals. Qualitative data analysis was conducted, mapping themes to the SEIPS framework. Results: Both hospitals utilised similar systems, however, they displayed variations in AMS processes, particularly in post-prescription review, interdepartmental AMS meetings, and the utilisation of digital tools. An antimicrobial dashboard was available at both hospitals but was utilised more at the hospital where the AMS team members were involved in the dashboard’s development, and there were user champions. At the hospital where the dashboard was utilised less, participants were unaware of key features, and interoperability issues were observed. Establishing strong relationships between the AMS team and prescribers emerged as key to effective AMS at both hospitals. However, organisational and cultural differences were found, with one hospital reporting insufficient support from executive leadership, increased prescriber autonomy, and resource constraints. Conclusion: Organisational and cultural elements, such as executive support, resource allocation, and interdepartmental relationships, played a crucial role in achieving AMS goals. System interoperability and user champions further promoted the adoption of digital tools, potentially improving AMS outcomes through increased user engagement and acceptance.

A document by Amir Hossein Farhadian. Click on the document to view its contents.

Small modular reactors (SMRs) offer a promising avenue for revolutionizing the traditional role of nuclear plants, transforming them from serving as baseload to flexible con- tributors in both power generation and ancillary services. This paper develops a steady-state model for SMRs, with a focus on incorporating constraints related to â\euro˜xenon poisoningâ\euro™. These constraints are essential to prevent issues during nuclear plant ramp-up following a ramp-down event. These â\euro˜xenon poisoningâ\euro™ constraints have been integrated into a multi-timescale power system operation framework, which also encompasses the formu- lation of inter-temporal coupling constraints. A comprehensive investigation is undertaken to evaluate the impact of integrating SMRs into a power grid with a high penetration of renewable en- ergy, specifically the NREL-118 bus system. A capacity expansion planning analysis is first conducted over multiple years to identify the optimal locations and sizes for deploying SMRs across the network. Additionally, weâ\euro™ve developed various reserve rules that adapt to the ramping status of the SMRs and include different â\euro˜hold-timeâ\euro™ for â\euro˜xenon poisoningâ\euro™ mitigation. Results obtained from a day-long simulation illustrate that the implementation of minimal â\euro˜xenon poisoningâ\euro™ hold-time, coupled with a steady- state guided reserve provision rule, yields the highest revenue â\euro“ approximately 4.14% more than the base case.Â

A document by Mark Schepperle . Click on the document to view its contents.

The goal of the current research work is to examine Palyno-morphological characteristics of Asteraceae type native to Pakistan’s District Jhelum Punjab. 8 different species were gathered, pressed, named, and studied using LM and SEM. Pollen traits that are both quantitative and qualitative were seen, including equatorial and polar diameter, number of pores and colpi, presence or absence os spines, spines length and width, exine thickness, exine sculpturing, pollen shape, P/E ratio, pollen fertility and sterility. The LM exhibited that pollens were oblate-spheroidal, prolate, and prolate in shape. Pollen is monad, the aperturation patterns vary from tricolporate, to tri-zonocolporate. Exine sculpturing was observed in echinate perforate and echinate gemmate through SEM. Our present research results shows that the minimum P/E ratio was studied in Bidens tripartite which is 0.92 and the maximum value of P/R ratio was investigated in Eclipta prostrata which is 1.2. The highest PD and ED of 41.9(37.5-44)±1.92μm and 42.9(38.5-44.5)±1.74 μm, respectively, was recorded in Sonchus oleraceous, while minimum polar and equatorial diameter 15.94(15.2-17) ±0.52 μm and 15.98(13.8-18.4) ±1.37 μm, respectively, was recorded in Parthenium hysteriophorus. Maximum exine thickness of 2.6(2-2.6) ±0.17μm was recorded in Sonchus oleraceous,and minimum of 1.74(1.5-2.0) ±0.14μm in Bidens tripartite. The morphology of pollen is significant for interpreting the taxonomy of various plant groups and is crucial for correctly identifying and classifying the asteraceous plants at the species, generic, and tribe levels.

To analyze images in various fields of science and technology, it is often necessary to count observed objects and determine their parameters. This can be quite labor-intensive and time-consuming. This article presents DLgram, a universal, user-friendly cloud service that is developed for this purpose. It is based on deep learning technologies and does not require programming skills. The user labels several objects in the image and uploads it to the cloud where the neural network is trained to recognize the objects being studied. The user receives recognition results which, if necessary, can be corrected, errors removed, or missing objects added. In addition, it is possible to carry out mathematical processing of the data obtained to get information about the sizes, areas, and coordinates of the observed objects. The article describes the service features and discusses examples of its application. The DLgram service allows to reduce significantly the time spent on quantitative image analysis, reduce subjective factor influence, and increase the accuracy of analysis.

Herbal flora has been employed to address and heal diverse health-associated predicaments since the antiquated era. Withania coagulans, a member of Solanaceae family, is a noteworthy medicinal herb commonly referred to as Rishyagandha. Predominantly located within the Eastern Mediterranean region, with its range extending as far as South Asia, is where this particular species is primarily observed. Withania coagulans has gained significant popularity in recent decades due to the recognition of its value as a medicinal product. This review offers significant new information on the phytochemistry, ethnomedical applications, and pharmacognostic characteristics of W. coagulans. The application of this substance is employed for the purpose of treating various ailments, such as dyspepsia, diabetes mellitus, hepatic disorders, purification of the bloodstream, as well as the regulation of blood pressure. In addition to the aforementioned benefits, the plant is renowned for its diverse range of pharmacological properties, encompassing hepatoprotective, free radical scavenging, hypolipidemic, antihyperglycemic, cardiovascular, central nervous system depressant, anti-inflammatory, antimicrobial, wound healing, and various other effects. Withania coagulans is chemically saturated with a special class of triterpenes called withanolides. Several formulations that are given for a wide range of disorders contain withanolides (steroidal lactones). The objective of this present article is to furnish a thorough exposition of the morphology of the plant, its ethnomedicinal applications, chemical constitution, and pharmacological traits.

Objectives: Orthodontic treatment often requires a long duration and leads to alveolar bone resorption. The effect of low-intensity pulsed ultrasound (LIPUS) on alveolar bone remodeling during orthodontic treatment is still unclear. This study aimed to investigate the impact and mechanism of LIPUS on alveolar bone remodeling during orthodontic tooth movement (OTM) to provide a foundation for clinical application. Materials and methods: We established the rat model of OTM and evaluated the tooth movement rate and alveolar bone remodeling by micro-CT and immunohistochemical staining. In vitro, we isolated human bone marrow mesenchymal stem cells (hBMSCs) and detected osteogenic differentiation ability under compression and LIPUS stimulation by qRT-PCR, Western blot, ALP staining, Alizarin red staining and immunofluorescence staining. Results: Compression force inhibited the osteogenesis of hBMSCs, and the expression of osteogenesis markers decreased, while LIPUS rescued them via modulating YAP1 expression mediated by actin cytoskeleton. In vivo, low-intensity pulsed ultrasound increased alveolar bone density and decreased vertical bone absorption while accelerating orthodontic tooth movement progress. Conclusions: Low-intensity pulsed ultrasound can accelerate tooth movement and reduce the decline of alveolar bone vertical height and bone density by modulating cytoskeleton-Lamin A/C-YAP axis, which is conducive to the stability of alveolar bone during orthodontic process.

Increasingly, in the field of communication, education and business, people are switching to video interaction, and interlocutors frequently complain that the perception of non-verbal information and concentration suffer. We investigated this issue by analyzing EEG oscillations of the sensorimotor (mu-rhythm) and visual (alpha-rhythm) cortex of the brain in an experiment with observation of identical action demonstrators live and on video. The mu-rhythm reflects the activity of the mirror neuron system, which is responsible for social perception of the actions and body language of other people, and the occipital alpha-rhythm shows the level of visual attention. We used 32-channel EEG recorded during live and video action observation in 83 healthy volunteers. The ICA infomax method was used for decomposing and selecting the components of the mu- and alpha-rhythms; the Fourier Transform was used to calculate the suppression index relative to the baseline (stationary demonstrator) of the two sub-bands (8-13 Hz and 13-24 Hz) of the mu-rhythm and the alpha-rhythm. Our work shows that the main range, 8-13 Hz, of the mu-rhythm is indeed sensitive to biological and social movement and is highly dependent on the conditions of interaction - live or video. The upper mu-range of 13-24 Hz appeared to be less sensitive to the type of demonstration, but more sensitive to different movements. The alpha-rhythm does not depend on the type of movement, however, a live performance initially causes a stronger concentration of visual attention. Thus, subtle social and nonverbal perceptions may suffer in remote video interactions.

Once batteries reach their end-of-life (EoL), they are expected to be collected, dismantled, and shredded into black mass (BM) which includes wealth amounts of critical metals. BM can be regarded as a kind of urban mines, where recyclers extract critical metals and reintroduce them into new battery manufacturing. Focusing on the BM, this article discussed the necessity of BM recovery and current recycling situations. Although the benefits of recycling are commonly agreed upon, there remain still many challenges and issues to overcome. The BM market is still in its infancy, relevant regulatory frameworks need to be updated with the widespread use and advancement of lithium-ion batteries (LIBs). Current BM-producing and processing technologies still have room for large improvements in terms of economic feasibility and sustainability that in the end requires efforts from both researchers and industrial stakeholders with growing interests and patient engagements.

Background and Purpose: Although glucose absorption in the proximal small intestine and its regulatory mechanisms have been extensively studied, the regulation of glucose absorption in the distal small intestine is poorly understood. The present study investigates the mechanisms and regulation of glucose absorption in the ileum and compares with those in the jejunum. Experimental Approach: Glucose-induced short circuit current in isolated mouse intestinal epithelia was measured by the Ussing chamber. Key Results: Glucose induced a more pronounced short circuit current in the ileum than in the jejunum, exhibiting greater sensitivity to Na+ - glucose transporter inhibitors. The extracellular Ca2+ and endoplasmic reticulum Ca2+ storage in the ileum did not regulate glucose transport like the jejunum did. Blockers of Ca2+ and K+ channels did not significantly alter glucose-induced current in the ileum. Inhibition of Na+ - Ca2+ exchange and Na+ - H+ exchange reduced ileal glucose-induced current. Moreover, 5-HT reduced ileal glucose-induced current, which could be restored by selective inhibitors of 5-HT4R, adenyl cyclase and protein kinase A. Conclusion and Implications: The ileum has more pronounced glucose absorption, and its regulatory mechanisms significantly differ from those in the jejunum. Na+ - Ca2+ exchange and Na+ - H+ exchange regulate ileal glucose absorption, whereas 5-HT inhibits it via the 5-HT4R-cAMP- protein kinase A pathway.

Steroid alkaloids are the most important active substance in medicinal plant V. nigrum, which have many pharmacological effects such as anti-hypertension, anti-tumor and anti-insect. At present, cell suspension culture is an effective method to produce secondary metabolites, but the yield of secondary metabolites cultured in ordinary cell suspension is not high. Elicitation can overcome the limitation of low metabolite yield in plant cell culture platforms in vitro, and it is an effective method to improve productivity. The purpose of this study is to explore the best elicitor combination and apply it to cell suspension of V. nigrum to improve the yield of steroidal alkaloids. In this study, several abiotic elicitors (MeJA, SA, Co 2+, Cu 2+) and a biological elicitor yeast extract (YE) were used to treat V. nigrum callus. Among various treatments applied, MeJA (100 uM concentration) improved the highest in the accumulation of two main steroid alkaloids in V. nigrum veratramine and cyclopmine. The content of veratramine has increased to 0.6689 ± 0.089 mg/g DW as compared to the content of control 0.1495 ± 0.047 mg/g DW, and the content of cyclopmine has increased to 0.3869 ± 0.040 mg/g DW as compared to the content of control 0.3032 ± 0.031 mg/g DW. The addition of YE (200 mg/L) can effectively improve biomass accumulation (Fresh weight (FW): 1.8035 ± 0.079 g) as compared to the content of control (FW: 1.1565 ± 0.081 g). Subsequently, these two elicitors were applied to suspension cell culture, and the effects of MeJA concentration, YE concentration, inoculation amount and MeJA induction time on the total contents of veratramine and cyclopmine produced by cell suspension were investigated. The experimental results show that the total yield of veratramine and cyclopmine can be increased from the initial 0.0338 ± 0.002 mg to 0.0638 ± 0.004 mg with the addition of elicitors. Through the optimization of response surface experiment and combined with the actual experimental conditions, the final optimal suspension cell culture conditions were determined as follows: MeJA concentration: 120 um/L; YE concentration: 450 mg/L; Inoculation amount: 0.45 g; MeJA induction time: the 18th day. Finally, the total yield of veratramine and cyclopmine reached 0.0827 ± 0.003 mg under this culture condition. It is possible to scale the current strategy to a bioreactor for higher productivity of steroid alkaloids of interest for various pharmaceutical industries.

This paper proposes a dynamic programming approach targeted to solve a natural resource problem of water storage management for irrigation in an environmentally and socially sustainable way. The problem we examine in our formulation, which deals with the control of water storage in tanks, incorporates assumptions that are milder compared to those previously discussed in the literature concerning similar approaches. Specifically, we consider a time periodic optimal control problem whose performance functional to be maximized merely satisfies a contraction assumption (in the sense of Boyd and Wong) weaker than the one usually considered in the pertinent literature. By using an appropriate fixed point theorem, a time periodic value function can be constructed to enable the definition of optimal feedback control strategies. After showing the insufficiency of Banach contraction frameworks, and proving the underlying auxiliary mathematical results, we show our main result under conditions that are weaker than the previous related ones. Simulation results illustrate the performance of our approach.

Recommendations for müllerian anomalies classificationSi Su1,2, Lan Zhu1*1 Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China2 Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China*Corresponding Author: Lan Zhu, MD, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China (zhu_julie@vip.sina.com)The word count for the main text: 506.In 2021, a new müllerian Anomalies Classification was proposed by American Society for Reproductive Medicine (ASRM 2021), 1 which was based on the American Fertility Society (AFS) 1988 2 and combined the benefits of existing classifications. However, mullerian anomalies is a group of complex diseases with various manifestations. And no consensus has been reached about the classification and diagnosis in clinical practice. The purpose of this study is to test the clinical application value of this new classification through the analysis of the cases from Peking Union Medical College Hospital in the past 20 years, and put forward valuable recommendations.A retrospective study was conducted using clinical data of hospitalized patients from January 2003 to December 2022 from Peking Union Medical College Hospital. Inclusion criteria included patients with 46, XX karyotype, diagnosed of müllerian anomalies, and clearly identified alterations of the uterus, cervix, and vagina. Clinical data of patients were collected through the hospital information system, and classification was performed based on the ASRM 2021. SPSS 25.0 version was used for data analysis.2671 patients were included, with an average visiting age of 28.9±10.0 years. The most common is septate uterus with 1144 cases (42.8%), followed by MRKH syndrome (20.4%), Herlyn-Werner-Wunderlich syndrome (HWWS) (10.4%), unicornuate uterus (7.4%), cervical agenesis (6.5%), uterus didelphys (5.6%), bicornuate uterus (2.9%), longitudinal vaginal septum (without uterine malformation) (2.0%), transverse vaginal septum (1.2%), complex anomalies (0.5%) and other anomalies (0.3%) (Table 1). It should be emphasized that HWWS was taken as an independent classification for statistical analysis, with reference to the clinical definition (uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis).3,4 13 cases of complex anomalies were identified and 8 cases that could not be classified were classified as other anomalies (Supplement table 1).ASRM 2021 was proposed based on the AFS 1988, which is the most widely used classification in the past 30 years. We found ASRM 2021could distinguish most clinical patients well, but there are still some shortcomings. First, the classification of patients with uterine malformations and longitudinal/transverse/oblique vaginal septum is not clear. We recommend that patients with longitudinal vaginal septum and uterine anomalies should be classified into the uterine anomalies respectively, while others without uterine anomalies should be included in longitudinal vaginal septum. All transverse vaginal septum should be included in transverse vaginal septum, because the symptoms of transverse septum are prominent. A new type of HWWS should be added. Because the obstructive symptom is prominent. Second, we found several cases of complex anomalies. For these patients, multidisciplinary and individualized treatment should be carried out. The anomalies we found that are not currently classified include T-shaped uterus, congenital vaginal stenosis, and accessory and cavitated uterine masses (ACUM). With the deeper insight into this field, there may be a better way to classify them. The limitation of this study is that as a single-center retrospective study, there could be statistical biases.In conclusion, we put forward following suggestions for ASRM 2021 classification: 1) Minimize overlaps of classification and add a type of HWWS; 2) Update complex anomalies timely; 3) Add other anomalies classification.