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Shifts in the timing of life history events, or phenology, have been recorded across many taxa and biomes in response to global change. These phenological changes are likely to have cascading effects on biotic interactions and community structure, but untangling the realized demographic consequences of these shifts is challenging. Focusing on an annual grassland plant community, we examined how experimental changes in precipitation affect flowering phenology in a community context and explore the implications of these shifts for competitive interactions and species coexistence. We found that changes in rainfall shift some species flowering phenology, but sensitivity differed among neighboring species. Four of seven species we studied started and/or peaked flowering earlier in response to reduced water availability. The idiosyncratic shifts in flowering phenology we observed have the potential to alter existing temporal dynamics that may be maintaining coexistence, such as temporal separation of resource use amongst neighbors. We show how rainfall induced phenology changes may have impacted competition outcomes between species pairs due to differences in their response to reduced water availability. More research on the effects of phenology changes on coexistence and the community level repercussions they cause due to changes in competitive interactions is essential for mitigating the impacts of climate change.

Atherosclerosis (AS) is considered to be one of the major causes of cardiovascular disease. Its pathological microenvironment is characterized by increased production of reactive oxygen species, lipid oxides, and excessive inflammatory factors, which accumulate at the monolayer endothelial cells in the vascular wall to form AS plaques. Therefore, intervention in the pathological microenvironment would be beneficial in delaying AS. Researchers have designed biomimetic nanomedicine (nanomedicine) with excellent biocompatibility and the ability to avoid being cleared by the immune system through different therapeutic strategies to achieve better therapeutic effects for the characteristics of AS. Biomimetic nanomedicine can further enhance delivery efficiency and improve treatment efficacy due to their good biocompatibility and ability to evade clearance by the immune system. Biomimetic nanomedicine based on therapeutic strategies such as neutralizing inflammatory factors, ROS scavengers, lipid clearance and integration of diagnosis and treatment are versatile approaches for effective treatment of AS. The review firstly summarizes the targeting therapeutic strategy of biomimetic nanomedicine for AS in recent 5 years. Biomimetic nanomedicine using cell membranes, proteins, and extracellular vesicles as carriers have been developed for AS.

Zooplankton undergo a vertical migration which exposes them to gradients of light, temperature, oxygen and food availability on a predictable daily schedule. Anticipating and responding to these environmental conditions, which independently are known to influence metabolic rates, likely has an appreciable effect on the delivery of waste products to the distinctly different daytime (deep) and nighttime (surface) habitats. Disentangling the co-varying and potentially synergistic interactions on metabolic rates has proven difficult, despite the importance of this migration to oceanic biogeochemical cycling. This study examines the transcriptomic and proteomic profile of the circumglobal migratory copepod, Pleuromamma xiphias, over the diel cycle. The transcriptome showed a large number of up-regulated genes during the middle of the day – the period often considered to be of lowest metabolic activity. There were proteomic and transcriptomic peaks in oxidative stress response and muscle proteins after the periods of migration, suggestive of a physiological consequence of migration. There were changes in metabolic pathways over time, with increased ammonium production signals during the evening and chitin synthesis and degradation pathways during the day. Comparisons of patterns across the paired datasets suggest that 1) estimates of physiological rates made in the laboratory in steady state conditions that don’t account for time of day may not be adequate to predict in situ phenotypes 2) use of ‘omics datasets to predict organismal phenotypes must be done cautiously as highly dynamic patterns in the transcriptome and proteome are often dampened and sometimes asynchronous at the enzyme or organismal level.

Background: Langerhans cell histiocytosis (LCH) is a great mimicker. It is a rare hematological disorder, incompletely characterised and understood, often affecting infants and young children. This disease has a wide spectrum of clinical presentations, ranging from an isolated disease with spontaneous resolution to life-threatening multisystem disease. Isolated oral presentation is rare and often occurs early in the disease process and usually gets overlooked. Some of the common oral presentations include gingivitis, periodontitis and tooth rotation. Case report: We report a case of a 1 year old male child who presented with a persistent white patch over the soft palate extending to the hard palate, initially treated as oral thrush and diphtheria by the primary paediatricians and subsequently was diagnosed with multisystem LCH (with liver as risk organ) at our centre . Conclusion: This disease requires a very high index of clinical suspicion, timely diagnosis and treatment for a favourable outcome.

Objective: To validate an intrapartum Cesarean Section Classification System (ICSCS). Design: Nationwide prospective observational study. Setting: Twenty-five Norwegian maternity units Population or Sample: Singleton cephalic pregnancies with spontaneous or induced labour at ≥ 37 weeks gestation delivering February-August 2017. Methods:. After training of all collaborators, Cesarean section (CS) after spontaneous or induced labour were classified based on fetal status, dynamic progress in labour, use of oxytocin, frequency of contractions and linked to denominator data collected and centralized by the Norwegian Medical Birth Registry. Main Outcome Measures: Cohens kappa as measure of agreement for correct application of the classification. Prevalence of the different groups using the ICSCS within the Ten Group Classification System (Robson groups). Results: Of 49 trained experts, 40 (82%) had a κ >0.6 indicating good or very good level of agreement when the classification was applied. A total of 1425 CS were classified: CS classified as fetal indication (no oxytocin) was more common in induced (Group 2a, 4a, 5b) compared to spontaneous labours (Group 1, 3, 5a). CS classified as dystocia related to inefficient uterine action and poor response to oxytocin occurred more often in induced as compared to spontaneous labours. The prevalence of CS classified as dystocia with efficient uterine action (malposition or cephalopelvic disproportion) was low in all Robson groups. Conclusions: The ICSCS was successfully validated in a national study. It may become a valuable objective tool for analyzing the management of labour and explaining differences in the prevalence of CS between different groups of women.

In this study, an eye blinking re-identification system was proposed. A fast local binary pattern was used for feature extraction because its grayscale invariance and rotational invariance allow for the effective acquisition of feature information even in the presence of noise. Finally, a recurrent neural network and long short-term memory were used for model training. The results indicated that, compared with the model trained using static data, the models based on dynamic features were less affected by environmental noise in terms of accuracy. In addition, the model trained using the recurrent neural network was highly effective in identifying unenrolled users and achieved high overall accuracy.

Cerebral toxoplasmosis in a human immunodeficiency virus (HIV) seronegative patient with liver cirrhosis.1Elroy Patrick Weledji, 2Frank Zouna1Department of Surgery, Faculty of Health sciences, University of Buea, Cameroon, W/Africa; Regional hospital Limbe, S.W. Region, Cameroon. E-mail: elroypat@yahoo.co.uk2Department of Medicine, Faculty of Health Sciences, University of Buea, Cameroon , W/Africa, Regional Hospital Limbe, S.W. Region, Cameroon. Email: zounafrank@yahoo.frCorresponding author : EP Weledji, Holy family foundation, Livanda Kongo Hill, lumpsum quarters, PO Box 126, Limbe, Cameroon. Tel 237699922144. Email: elroypat@yahoo.co.uk

Background: The role of Component Resolved Diagnostics (CRD) in the diagnosis of cow’s milk allergy (CMA) remains highly controversial. In this systematic review, we aimed to evaluate the accuracy of CRD in diagnosing CMA in children. Methods: We searched four electronic databases (EMBASE, PubMed, the Cochrane Library, and Web of Science) from January 1, 2000, to March 27, 2023, for studies that utilized milk composition and oral food challenges (OFC) as a reference standard in patients with suspected milk allergy. The quality of the included studies was assessed using QUADAS-2. Due to the heterogeneity of the studies, a meta-analysis could not be performed, and a narrative synthesis of the findings was conducted. Results: Our analysis included 5 prospective studies, 2 retrospective studies, and 2 case-control studies, with a total of 958 children. The sensitivity of Bos d 4 ranged from 0.50 to 0.82, and specificity from 0.78 to 0.98. Bos d 5 sensitivity 0.24-1.0, and specificity 0.58-0.98. Bos d 6 sensitivity 0.09, and specificity 0.94. Bos d 8 sensitivity 0.34-0.90, specificity 0.79-0.98. CONCLUSION: The specific IgE (sIgE) of the Bos d 4, Bos d 6, and Bos d 8 components of milk is highly specific but not sensitive in diagnosing cow’s milk allergy in children. The use of CRD for the diagnosis of CMA in children may reduce the need for OFC.

Frailty and Mini Dental ImplantsINTRODUCTIONMany dental implant patients are older and can have atrophic edentulous, bimaxillary jaws. Along with edentulism many are aged and may be frail. Frailty is typically diagnosed (ICD10 Code: R54) when three of the following five criteria are met: low physical activity, weak grip strength, low energy, slow walking speed, and unintentional weight loss (1).There can be ancillary diagnoses. Sarcopenia (ICD10-M62.84) is a loss of skeletal muscle that is primarily associated with aged patients with comorbidities. Frailty and sarcopenia are closely related but frailty may include cognitive and social issues (1,2,3).The baby boomer generation is aging and with that many of these people will become frail. Many will also be partially or completely edentulous with atrophic jaws. This makes adequate retention and function of dental prostheses unlikely. A denture adhesive may not be adequate for good denture stability and function, especially in the mandible. Minimally invasive mini dental implants may provide adequate to excellent retention of a complete denture for better nutrition and quality of life.Mini implants used to retain an overdenture may provide adequate function for the frail patient. Because these patients are frail and can be bimaxillary atrophic, a minimally invasive treatment may be appropriate. Minimally invasive treatment can be instituted to minimize physiologic stress and costs.CASE REPORTA 77 YO male presented for treatment with a chief complaint of “I can’t eat with these dentures”. Visual and panoramic radiographic examinations revealed bimaxillary edentulism with atrophy and an unstable mandibular complete denture. This polypharmacy patient had been diagnosed as frail and was not able to physically tolerate an extensive surgical or prosthetic procedure. The fit and flat zero-degree occlusal scheme of the existing dentures was adequate. The lower denture was well-fitting, but the residual ridge was inadequate for appropriate retention. The maxillary complete denture did not have excellent retention on the atrophic ridge. The patients primary care physician was contacted, and the procedure was explained, and medical clearance was obtained. Treatment options and a definitive treatment plan were discussed with the patient, and informed consent obtained.After local facial and lingual infiltration with1.6cc articaine (Septocaine), four mini-implants (IntraLock 2.5X13mm) were surgically placed in the anterior mandible in type 1 bone density. Proprietary drills and instrumentation were used in accordance with the manufacturer’s instructions. The implants were immediately loaded with the retainers embedded by pick-up in the existing complete mandibular denture (Fig. 1,2). The attached tissue was adequate for the mini-implants and no soft tissue flap was raised. The lower denture immediately had much better retention that impaired much better function. The maxillary complete denture increased in retention due to the stability of the mandibular denture. The patient functioned uneventfully and followed for eight years upon his death. The improved oral function may have prolonged this patient’s life.THE DIAGNOSIS OF FRAILTYMany elderly patients are diagnosed as frail. This means that these people may be seriously harmed by an extensive oral surgery. A fatality may even occur. There are several sets of criteria for a diagnosis of frailty (1,2,3).Frailty may be defined as an aging-related syndrome of physiological deterioration (2,3). This causes the patient to be vulnerable to a variety of old age disorders and diseases. Symptoms present as weakness and fatigue, complex medical issues, and relative intolerance to medical interventions. There is no standard definition of the diagnosis of frailty. There are frailty screening tests for assessing health risk assessment and epidemiology.One single parameter for the diagnosis of frailty is the TUG test, the time measured for a patient to get up of a chair walk ten feet (3 m), turn around and then return to be seated again (4, 5,6). 10 seconds or less is “normal”. 14 seconds or greater indicates a high risk for falling.A set of other parameters are: unintentional weight loss of more than 10 lbs., weak hand grip strength, self-reported exhaustion, walking speed slower than 0.8m/second, and low physical activity (2). If a patient has none of these criteria, then there is no frailty. If 1 or 2 of these are met, then there is intermediate frailty. A diagnosis of frailty is met when 3 or more of these criteria are met (2).Another set of parameters are: self-reported fatigue, inability to climb one flight of stairs, inability to walk one city block, having more than 5 illnesses, and more than 5% unintentional weight loss (5,6). Again, if 1-2 criteria are met then there is intermediate frailty and if 3 or more are met then there is a diagnosis of frailty (5,6). Women with cirrhosis have a higher frailty rate than men with similar disease severity (7Lai, 8Sheikh). There are other criteria to be used to diagnose frailty but there is no agreed upon standard.DISCUSSIONFrailty is associated with African American heritage, low education, low income, poorer general health, and comorbid chronic conditions (2,3). The frailty phenotype is predictive for incidence of falls, decreasing mobility, disability, hospitalization, and death.Patients can be frail at any age depending on their physical condition as a result of age, disease or disability. Many of these patients cannot financially afford extensive treatment. Nonetheless, they are still in need of nutrition, and a decent quality of life for appearance and speech. Mini implants are generally relatively inexpensive and easy to place in appropriate sites (9).  The bone density is important. Type 1 and 2 densities are appropriate, but any less dense site may not provide adequate resistance for immediate occlusal loading (9). Load resistance immediately depends on the mechanical resistance in dense bone until osseointegration occurs (9). Mini implants for this purpose have a processed rough surface that is intended to osseointegrate (9).Osseous site dimensional requirements for mini-implants are similar to the requirements for standard sized dental implants except that the bone width can be much less. The decreased osseous width is associated with more dense bone (9,10).Atrophic bone in the maxilla may not be dense enough to resist occlusal loading. However, there can be very dense osseous islands that can provide appropriate implant support. Thus, it is incumbent on the clinician to evaluate preoperatively the quality of the maxillary bone. Hounsfield units (HU) on cone beam computerized tomographs can give an indication of bone density but HU is not completely reliable (10). HU does provide an approximation of bone density. Intraoperative sensibility by the operator is the ultimate test for bone density. Nonetheless, density is not uniform in bone. Thus, one not so dense site may be just a millimeter or two away from a very dense osseous site (10). This means that if an implant is placed into a less dense site the surgeon may elect to relocate the osteotomy 1-2mm away and find that bone to be very dense.Bite force capacity may be an important preoperative parameter. A patient with a high bite force capacity my overload the retaining mini-implants. Since these patients are frail, the biting force they generate can be as low as 30 newtons (11). Such a low biting load would not cause a luxation of a properly placed mini-implant (11).Mini implants that retain a denture should be long as anatomically possible to prevent overload (9). A preoperative cone beam computerized tomogram is appropriate to identify anatomical landmarks to be avoided. Atrophic bone may be thin and needs to be measured so the risk of a perforation is minimized (9). Even though length does not add as much resistance to loading as width, every bit of osseous contact is required for a long-term successful outcome (9). The long length may contribute enough resistance to tolerate a happenstantial increased load such as caused by a fall or biting on a seed.There needs to be adequate attached tissue or soft tissue that is immovable or that may be augmented with a tunnel dermal allograft or porcine collagen xenograft (12). A donor site type free gingival or submucosal graft may not be tolerable for the frail patient (12). Additionally, immovable mucosa may suffice for protection for the epithelial attachment around the implant, be it a mini or standard sized (Fig. 3). The key factor is the prevention of muscle tension on the epithelial attachment (9,12).The mini-implants can be immediately loaded with retainers embedded in an existing well-fitting, occlusally correct, complete denture, by pick-up, when the ridge is composed of dense atrophic bone. As the mandibular ridge atrophies the facial and lingual cortices approach one another. After a time, the intraosseous surfaces of the cortices may be 1-2 mm apart (Fig. 4). This allows placement of a small diameter mini-implant that engages the facial and lingual dense cortices for excellent initial stability. The dense cortices provide excellent stability allowing the mini-implants to be immediately loaded.A lingualized or flat zero-degree occlusal scheme are best to prevent significant lateral or off axial loads on the retaining implants (13,14,15,16)Even though these mini-implants have small diameters they are very durable and resistant to fatigue (13). One study demonstrated that mini-implants withstand a million laterally directed load cycles without fracture (13).An overdenture retained by four mini-implants are generally not as retentive as Locator® retainers (14,15,16). Nonetheless, if there is adequate ridge length, additional implants can provide more retention that can be excellent (14,15,16). Flat zero-degree denture teeth or lingualized occlusal schemes may be most appropriate to minimize lateral loads (14,15,16).If a mini-implant fails, there is typically only minor bone loss. A larger implant failure may have a much larger volume of bone loss that may present a risk for fracture of a thin atrophic mandible (14,15,16).Progressive geriatric disorders such as dementia and Parkinson’s disease will limit the patient’s ability to cooperate and follow instructions. This may put this patient’s oral health at risk. Successful dental treatment of frail patients should include an understanding of how the patient is medically, socially, and emotionally functioning. (14,15,16,17)Frail geriatric patients are a diverse group with multiple disabilities. Their life experiences can complicate clinical dental care.  The treatment process should be based on a philosophy that addresses the best interests of the patient. (14,15,16,17)The patient and clinician working in tandem decide the treatment (17,18,19). The patient is informed of the risks and benefits. The treatment should be determined by the patient’s health, functional needs, quality of life and not their age. Elderly patients heal in the same fashion as younger patients (17,18,19). Patients older than 80 may have less bone loss and fewer implant failures than younger patients (18,19).CONCLUSIONSFrail patients need adequate nutrition and a decent quality of life. Many of these patients are edentulous and can be bimaxillary atrophic. Improved quality of life may be provided with mini-implant treatment in atrophic jaws especially in elderly patients in their waning years. A CBCT may be appropriate to identify anatomical structures to be avoided. Anatomically appropriate long-length mini-implants that are immediately loaded to retain a denture may be an appropriate treatment for the frail patient. A flat zero degree or lingualized occlusal scheme may be most appropriate. An unlikely high bite force capacity may indicate a contraindication for a denture retained with mini-implants. Post-treatment, careful follow-up is needed to insure adequate function and outcome. There are advantages for these patients with mini-implant treatment. A failed mini-implant causes much less bone loss than a standard-sized implant failure. Additionally, mini-implant treatment has a relatively low associated cost. Contemporary CBCT enables mini-implants to be placed by general dentists.The author claims no financial, commercial or political conflicts of interest.Consent: Written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy”ABBREVIATIONS: CBCT= cone beam computerized tomogramFIGURE CAPTIONSFigure 1- The patient presented with an atrophic edentulous ridge that was treated with 2.5mm diameter mini-implants and immediately loaded.Figure 2- The patient was treated with small diameter, mini, implants to retain the mandibular complete denture.Figure 3- Immovable mucosa is adequate for epithelial attachment protection.Figure 4- As the alveolar ridge atrophies, the facial and lingual cortices approach one another and provide dense facial and lingual bone which provides excellent stability the mini-implant. The flukes of the implant engage the cortices for excellent stability.REFERENCES1-     Torpy JM, Lynn C, Glass RM. Frailty in Older Adults. JAMA. 2006;296(18):2280.2-     Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146.3-     Kiely DK, Cupples LA, Lipsitz LA Validation and comparison of two frailty indexes: The MOBILIZE Boston Study. J Am Geriatr Soc. 2009;57(9):1532. Epub 2009 Jul 21.4-     Greene BR, Doheny EP, O’Halloran A, Anne Kenny R. Frailty status can be accurately assessed using inertial sensors and the TUG test. Age Ageing. 2014 May;43(3):406-411. 5-     Abellan van Kan G, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B. The I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging. 2008 Jan;12(1):29-37. 6-     Abellan van Kan G, Rolland Y, Houles M, Gillette-Guyonnet S, Soto M, Vellas B. The assessment of frailty in older adults. Clin Geriatr Med. 2010 May;26(2):275-286. 7-      Lai JC, et al Association of frailty and sex with wait list mortality in liver transplant candidates in the multicenter Functional Assessment in Liver Transplantation (FrAILT) study JAMA Surg 2020; DOI: 10.1001/jamasurg.2020.5674. 8-     Sheikh SS and Locke JE Leveraging frailty to mitigate sex-based disparities in access to liver transplant justice in allocation7 JAMA Surg 2020; DOI:10.1001/jamasurg.2020.5675. 9-     Flanagan D. Rationale for Definitive Mini Dental Implant Treatment. J Oral Implantol. 2020 Jul 14. doi: 10.1563/aaid-joi-D-19-00317. Epub ahead of print. PMID: 32663848. 10- Di Stefano DA, Arosio P, Pagnutti S, Vinci R, Gherlone EF. Distribution of Trabecular Bone Density in the Maxilla and Mandible. Implant Dent. 2019 Aug;28(4):340-348. 11- Flanagan D. Bite force and dental implant treatment: a short review. Med Devices (Auckl). 2017 Jun 27;10: 141-148. 12- Flanagan D. Stented Porcine Collagen Matrix to Treat Inadequate Facial Attached Tissue of Dental Implant Supported Fixed Partial Dentures. J Oral Implantol. 2016 Apr;42(2): 209-213. 13- Flanagan D, Ilies H, McCullough P, McQuoid S. Measurement of the fatigue life of mini dental implants: a pilot study. J Oral Implantol. 2008;34(1):7-11. 14- Fonteyne E, Van Doorne L, Becue L, Matthys C, Bronckhorst E, De Bruyn H. Speech evaluation during maxillary mini-dental implant overdenture treatment: A prospective study. J Oral Rehabil. 2019 Dec;46(12):1151-1160. QUALITY OF LIFE 15- Zygogiannis K, Aartman IH, Wismeijer D. Implant Mandibular Overdentures Retained by Immediately Loaded Implants: A 1-Year Randomized Trial Comparing Patient-Based Outcomes Between Mini Dental Implants and Standard-Sized Implants. Int J Oral Maxillofac Implants. 2018 Jan/Feb;33(1):197-205. 16- Lemos CA, Verri FR, Batista VE, Júnior JF, Mello CC, Pellizzer EP. Complete overdentures retained by mini implants: A systematic review. J Dent. 2017 Feb;57:4-13. 17- Etöz O, Bertl K, Kukla E, Ulm C, Ozmeric N, Stavropoulos A. How old is old for implant therapy in terms of implant survival and marginal bone levels after 5-11 years? Clin Oral Implants Res. 2021 Mar;32(3):337-348. 18- Marchini L, Ettinger R, Hartshorn J. Personalized Dental Caries Management for Frail Older Adults and Persons with Special Needs. Dent Clin North Am. 2019 Oct;63(4):631-651. doi: 10.1016/j.cden.2019.06.003. Epub 2019 Jul 16. PMID: 31470918. 19- Ozmeric N, Stavropoulos A. How old is old for implant therapy in terms of implant survival and marginal bone levels after 5-11 years? Clin Oral Implants Res. 2020 Dec 23. doi: 10.1111/clr.13704. Epub ahead of print. PMID: 33368735.

Pre-eclampsia and gestational diabetes mellitus are associated with an increased risk of cardiovascular diseaseDear Dr Papageorghiou,We read with great interest the article published in BJOG by Hildén et al.1, in which the authors aimed to investigate if the pre-eclampsia association with cardiovascular disease (CVD) was independent of gestational diabetes mellitus (GDM). They indicated that pre-eclampsia and GDM were independent risk factors for CVD, and after stratifying by maternal body mass index (BMI), the adjusted association of pre-eclampsia with CVD did not differ notably between BMI groups. They concluded that pre-eclampsia and GDM were independent risk factors for later CVD and having both during pregnancy was a major risk factor for later CVD. Furthermore, they indicated that the association between pre-eclampsia and CVD was not modified by BMI.We support the information provided by Hildén et al.1, and hypertension is a mediator of CVD rather than a component of the diagnostic bundle. It has been shown that pre-eclampsia and GDM can affect blood vessels, but it is not clear aetiology2. Previous studies indicated that women with GDM have an increased risk of developing preeclampsia, which in turn increases the risk of developing advanced CVD3,4. However, in these studies, there were many potential confounding factors due to the lack of adjustment for BMI. The current research just filled in this disadvantage. We thank Hildén et al.1 for their comprehensive contribution.We believe that the biggest advantage of this study is that it is a nationwide study, and the data collected prospectively has high credibility. The main disadvantage is that women with diabetes before pregnancy are excluded, which may have a great impact on the research results, leading to bias. This nested case-control study included 2639 cases and 13310 controls with complete data. So large number of study population will provide valuable guidance for clinicians to improve their understanding of pre-eclampsia and GDM related CVD, despite some limitations of this study. In addition, we are also looking forward to Hildén et al.1 developing effective CVD prevention plans for high-risk women to improve their long-term health. Therefore, we believe the research by Muraca et al.1 will greatly promote further researches on the pre-eclampsia and GDM related CVD.

Background: The need for echocardiograms among patients with long COVID is debatable. Our aim was to evaluate the prevalence of left ventricular (LV) dysfunction and identify predictors. Methods: We conducted a cross-sectional study and included all consecutive patients enrolled in our post-COVID clinic. We included patients who had an echocardiogram and had no previous known heart disease. We defined LV dysfunction as a low ejection fraction or grade II to grade III diastolic dysfunction on an echocardiogram with evidence of elevated filling pressures. We calculated the prevalence of heart disease and predictors of heart disease using logistic regression. Results: We included 217 post-COVID patients enrolled in the clinic. The prevalence of LV dysfunction is 24%;95% CI 18-30. Predictors of heart disease include older age and a previous history of hypertension and diabetes or having a intermediate or high ASCVD score. Patients with low ASCVD score did not have low ejection fraction on the screening echocardiograms. Conclusion: Our study found a considerable number of patients with LV dysfunction. Older patients with cardiovascular risk factors are at risk of long COVID associated heart disease.

Title: Castleman disease presenting as a longstanding axillary and chest wall mass: A case reportWenqing Zhou1*, Xing Liu2*, Aiming Qiu3*, Teng Ni4, Tiangeng Dong5, Lei Ding6Wenqing Zhou, Xing Liu and Aiming Qiu contributed equally to this workCorrespondence should be addressed to Tiangeng Dong; dong.tiangeng@zs-hospital.sh.cn and Lei Ding; dingleiokok@163.comAbstract: Castleman disease is a rare lymphoproliferative disorder that can present with various clinical features. We present a case of a 30-year-old female with a progressively enlarging mass in the left axilla and chest wall for ten years. After diagnostic workup, including ultrasonography, MRI, and core needle biopsy, the patient underwent surgical excision of the mass. The diagnosis of Castleman disease was confirmed through pathological and immunohistochemical examinations. The patient recovered well postoperatively with a good prognosis.Keyword: Castleman disease, axillary, chest wallIntroduction: Castleman disease, first described in 1956 by Dr. Benjamin Castleman, is a rare lymphoproliferative disorder. This disease can affect any lymphoid tissue in the body and present with localized or systemic symptoms. The diagnosis is based on pathological examination, and the disease has a varied clinical course and response to treatment[1].Case report: The patient was a 30-year-old female with a ten-year history of a progressively enlarging mass in the left axilla and chest wall (Figure 1). The mass was initially small and asymptomatic but had gradually increased in size over the years. The patient had no significant medical history or family history of lymphoproliferative disorders.Diagnostic workup, including ultrasonography(Figure 2) and MRI[Figure 3A,3B], revealed a well-circumscribed, heterogeneously enhancing mass measuring 10 x 6 x 3 cm . A core needle biopsy was performed, and pathological and immunohistochemical examinations revealed clonal lymphoid proliferation within fibrotic stroma (Figure 4A,4B). The histopathological features were consistent with the hyaline vascular variant of Castleman disease [2].After appropriate preoperative preparation, the patient underwent surgical excision of the mass. Intraoperative findings revealed a well-encapsulated mass that was adherent to the chest wall muscles. The mass was completely excised with negative margins. Postoperative recovery was uneventful, and the patient was discharged on postoperative day 5.Histopathological examination of the excised mass confirmed the diagnosis of Castleman disease. The immunohistochemical profile was consistent with the hyaline vascular variant, which is characterized by clonal proliferation of B-cells with follicular dendritic cell expansion.Discussion: Castleman disease is a rare lymphoproliferative disorder that can present with varied clinical features[3]. The disease has two major histological subtypes: hyaline vascular and plasma cell. The more common hyaline vascular subtype presents with localized lymphadenopathy, while the less common plasma cell subtype is associated with systemic symptoms and multiorgan involvement[4].Diagnosis of Castleman disease requires a combination of clinical, radiological, and pathological findings. Treatment options include surgery, radiation therapy, and chemotherapy, depending on the subtype, stage, and extent of the disease[5]. The localized hyaline vascular subtype generally has a good prognosis, while the systemic plasma cell subtype has a more variable clinical course[6].Conclusion: Castleman disease should be considered as a differential diagnosis for longstanding masses in lymphoid tissue. Appropriate diagnostic workup, including imaging and pathological examinations, is crucial for accurate diagnosis and optimal management. Surgical excision can offer a curative treatment with a good prognosis for the localized hyaline vascular subtype [7].AcknowledgmentsThis work was supported by grants from the Science and Education Foundation of Wujiang District (wwk202019).References:[1] Oksenhendler E. The Spectrum of Castleman’s Disease and its Treatment. Hematology Am Soc Hematol Educ Program. 2016;2016(1):327-334.[2] Chan KL, Tong J, Loong F, et al. Castleman’s disease: a report of 18 cases from a single institution. J Clin Oncol. 1998;16(5):1988-1995.[3] Soumerai JD, Sohani AR, Abramson JS. Diagnosis and management of Castleman disease. Cancer Control. 2014;21(4):266-278.[4] Dispenzieri A. Castleman disease. Hematology Am Soc Hematol Educ Program. 2018;2018(1):324-329. doi:10.1182/asheducation-2018.1.324[5] Liu AY, Nabel CS, Finkelman BS, et al. Idiopathic multicentric Castleman’s disease: a systematic literature review. Lancet Haematol. 2016;3(4):e163-e175. doi:10.1016/S2352-3026(16)00015-X[6] Talat N, Belgaumkar AP, Schulte KM. Surgery in Castleman’s disease: a systematic review of 404 published cases. Ann Surg. 2012;255(4):677-684. doi:10.1097/SLA.0b013e31824a57e9[7] van Rhee F, Stone K, Szmania S, Barlogie B, Singh Z. Castleman disease in the 21st century: an update on diagnosis, assessment, and therapy. Clin Adv Hematol Oncol. 2010;8(7):486-498

This study proposed a matched field source localization method based on tensor decomposition. By considering the advantages of tensors in multidimensional data processing, a three-dimensional tensor signal model of space-time-frequency is constructed, and the signal subspace is estimated using high-order singular value decomposition (HOSVD). The source position is estimated by matching the measured data tensor signal subspace with the replica field tensor signal subspace. The S5 event data of SWellEx-96 is processed by the proposed tensor-based matched-field processing (TMFP). The comparison with the results of conventional matched field processing (MFP) shows that TMFP has a better suppression effect on ambient noise under low SNR and better source localization performance.

Background and Aim By inducing oxidative stress and hindering mitochondrial activity, rotenone can cause neuronal death or cell apoptosis, which is the pathophysiological characteristic of PD. To investigate synergistic effects of levodopa (LD) and resveratrol (RES), a natural polyphenolic molecule, on rotenone-induced toxicity in PD-related cell lines and animal models. Methods The in vitro experiments were performed using the human neuroblastoma cells (SH-SY5Y) and PC-12 cell lines to investigate toxicity (MTT, LDH), cell apoptosis, ROS generation and mitochondrial membrane potential (MMP) assays. The expressions of neuroinflammatory factors (TLR-2 &TLR-4) and inflammatory cytokines was examined under qRT-PCR method. Animal behavioural analyses, neurochemical parameters and histopathological investigations were employed to study in vivo efficiency of drug molecules. Results The observed in vitro results exhibited that prepared formulation significantly inhibited ROS generation and mitochondrial malfunction. In additionally, developed formulations substantially improved motor function in a rotenone-induced SD rat model, as evidenced by rota-rod test and greater distances travelled during the spontaneous activity test. Subsequently, in vivo biochemical assays provided the evidences of LD/RES formulation effectively increased SOD activity and lowered MDA content. Conclusion Summary, our results show that the LD/RES formulation inhibits oxidative damage caused by rotenone by targeting neuroinflammation-related TLR-2 signalling pathway. Our research provided the way to an opportunity of using a combined LD/RES formulation as a neuroprotective medicinal agent in the treatment of Parkinson’s disease.

Basal amygdala (BA) neurons projecting to nucleus accumbens core/shell (NAc) are primarily glutamatergic and are integral to the circuitry of emotional processing. Several recent mouse studies have addressed whether neurons in this population(s) respond to reward, aversion, or both emotional valences. The focus has been on processing of physical emotional stimuli and here we extend this to salient social stimuli. In male mice, an iterative study was conducted into engagement of BA-NAc neurons in response to estrous female (social reward, SR) and/or aggressive-dominant male (social aversion, SA). In BL/6J mice, SR and SA activated c-Fos expression in a high and similar number/density of BA-NAc neurons in the anteroposterior intermediate BA (int-BA), whereas activation was predominantly by SA in posterior (post-)BA. In Fos-TRAP2 mice, compared with SR-SR or SA-SA controls, exposure to successive presentation of SR-SA or SA-SR, followed by assessment of tdTomato reporter and/or c-Fos expression, demonstrated that many int-BA-NAc neurons were activated by only one of SR and SA; these SR/SA monovalent neurons were similar in number and present in magnocellular and parvocellular int-BA subregions. In freely moving BL/6J mice exposed to SR, bulk GCaMP6 fibre photometry provided confirmatory in vivo evidence for engagement of int-BA-NAc neurons during social and sexual interactions. Therefore, populations of BA-NAc glutamate neurons are engaged by salient rewarding and aversive social stimuli in a topographic and valence-specific manner; this novel evidence is important to the overall understanding of the roles of this pathway in the circuitry of socio-emotional processing.

IntroductionIn a laparoscopic gastrectomy, the abdominal cavity is insufflated with CO2 to create the best possible operative view. However, laparoscopic surgery may cause severe CO2-related complications, such as pneumothorax, pneumoperitoneum, and subcutaneous emphysema. Although rare, pneumothorax is a recognized potential complication of laparoscopic surgery, with reported incidence rates of up to 2% (Mamić et al., 2016). Although tension pneumothorax is not uncommon among hospitalized patients, fatal cases of this condition are relatively rare. Tension pneumothorax can evolve during the course of a spontaneous pneumothorax or hyperbaric oxygen therapy (Light and Lee, 2016). It is caused by the entry of air into the pleural cavity, which becomes trapped and leads to increased pressure, the potential collapse of the lung, and compression of surrounding structures. Risk factors include positive-pressure ventilation, pre-existing lung disease, or accidental lung or chest wall injury during the surgery (Hillis et al., 2022). Chest radiography (CXR) and computed tomography (CT) have largely been used as lung imaging tools to diagnose abnormal lung conditions in the emergency and critical care settings but the diagnostic accuracy of lung ultrasound for conditions like pleural effusion, pneumothorax, pulmonary edema and pneumonia is superior to chest radiograph and is comparable to chest CT scan. Treatment typically involves the insertion of a chest tube to allow the trapped air to escape and restore normal pressure within the pleural cavity (Cunningham and Brull, 1993, Mehran et al., 2004, Labow and Conlon, 1999). As misdiagnoses and inadequate management of TPT can lead to severe adverse outcomes, a comprehensive description of clinical presentation and its management may improve patient care. Here, we report a case of a patient who underwent laparoscopic proximal gastrectomy but later developed tension pneumothorax during the procedure.

We employed a synergistic approach by utilizing in situ etching and phosphating techniques on trimetallic zeolitic imidazolate frameworks (ZIFs) to facilitate the conversion of CoFeNi-ZIFs into CoFeNi/Z-P NC (Nitrogen-doped graphene coating) nanocomposites. Remarkably, the resulting CoFeNi/Z-P NC materials have a large surface area and a lot of pore volume, making their active sites more accessible and makes mass transfer more effective. Additionally, the introduction of Fe and Ni guest metals into the CoP crystal lattice without phase segregation ensures a homogeneous distribution while altering the electrical characteristics. Leveraging these advantages, the CoFeNi/Z-P NC nanocomposites demonstrate a notable enhancement for the OER, 10mA cm-2 is achieved at a low overpotential with a current density of 244mV for alkaline solutions, with a low Tafel slope of 66.2mV dec-1 and has good stability.

The energy level matching of perovskites was regarded as the prerequisites for achieving high photovoltaic performance. Graphitic carbon nitride (g-C3N4) is a two-dimensional polymer semiconductor material, which has good semiconductor properties, suitable electronic band structure and excellent physical and chemical stability, and is widely used in energy and materials science fields such as photoelectric conversion. Graphene oxide (GO) is a two-dimensional π-conjugated carbon atom sheet formed by sp2 hybrid bonds. Due to its unique electronic properties, g-C3N4 is seamlessly splice with the two-dimensional domains of GO through continuous π-conjugated bonds, which not only effectively modify the electronic structure of g-C3N4, but also contribute to the unhindered separation and transfer of electrons and holes in the plane. Therefore, in this work, we can effectively passivate film trap defects and significantly reduce non-radiative recombination by constructing GO/g-C3N4 heterostructures as an ultra-thin interface modification layer between the perovskite layer and the electron transport layer (ETL). As a result, the addition of GO/g-C3N4 heterojunction modification layer exhibited a much-improved conversion efficiency, inhibited the recombination of carriers, and improved the mobility of carriers. The unpackaged device demonstrated excellent stability, maintaining an initial efficiency of more than 90% after over 1,000 hours of storage under ambient conditions.

A document by Sergey B. Yurchenko. Click on the document to view its contents.

In the context of initiatives focused on captive breeding and reintroduction of endangered animal species, it is crucial to minimize any bias in reproductive success during the reintroduction phase in order to preserve genetic diversity. One population of Tachysurus ichikawai, a critically endangered bagrid catfish endemic to Japan, faces a threat from the construction of a dam. To address this, a captive breeding program followed by translocation is being implemented. Multiple breeding families are involved in this process; however, if there is a bias in reproductive success among them after release, it will result in a decline in genetic diversity. To identify potential biases in breeding lineages, we conducted kinship analysis between individuals born at the release site and breeding individuals. Because there were no samples available from the released individuals themselves, we examined distant kinship relationships, such as grandparent–grandchild and uncle–aunt–nephew–niece relationships, using a substantial number of single-nucleotide polymorphisms obtained from the whole genome re-sequence. Our findings indicate no bias between lineages in the first year after reintroduction, but a significant bias in the second year, emphasizing the need for continuous management and monitoring of reintroduced populations. This study demonstrates that monitoring kinship after reintroduction can correct lineage bias, which is critical for the prompt restoration of genetic diversity.

The Gaoligong Mountains are a hotspot of biodiversity in China. Mid-mountain humid evergreen broad-leaved forests are the most widely distributed and best-preserved vegetation type in the region. Plant seedlings are an important stage for community regeneration. The species composition and dynamics of seedlings is of great significance for the conservation and management of local forest resources. However, there are still few studies that explore the characteristics of seedlings in the region. To solve this problem, seedlings were measured, tagged and identified in November 2020 and re-censused regularly every six months in a four-ha forest dynamic plot in a mid-mountain humid evergreen broad-leaved forest in the Gaoligong Mountains. The species composition, spatial distribution, and dynamics of the seedlings in the plot were investigated. The results showed that 977 seedlings belonging to 56 species in 44 genera and 23 families were recorded in the four censuses. The dominant species were obvious, and most of the species were rare species. The seedlings of most species were unevenly distributed in the plot, and Psychotria morindoides was the most widely distributed. The fluctuations in the number and species composition of the seedlings were small. In summary, the structure of the seedlings was stable in the mid-mountain humid evergreen broad-leaved forest in the Gaoligong Mountains.

Coastal protection is of paramount importance because erosion and flooding affect millions of people living along the coast and can largely influence countries’ economy. The implementation of nature-based solutions for coastal protection, such as sand engines, has become more popular due to these interventions’ adaptability to climate change. This study explores synergies between AI and hydro-morphodynamic models for the creation of efficient decision-making tools for the choice of optimal sand engines configurations. Specifically, we investigate the use of long-short-term memory (LSTM) models as predictive tools for the morphological evolution of sand engines. We developed different LSTM models to predict time series of bathymetric changes across the sand engine as well as the time-decline in the sand engine volume as a function of external forces and intervention size. Finally, a MATLAB framework was developed to return LSTM model results based on users’ inputs about sand engine size and external forcings.

Insulators are one of the key components in high-voltage power systems that prevent transmission lines from grounding. Since they are exposed to different kinds of harsh environments and climates, periodic inspection is indispensable for the safety and high quality of power grid. Nowadays, Unmanned Aerial Vehicle (UAV) inspection is more widely used, facilitating incorporation of CNN-based detectors in the insulator detection task. However, these methods are generally based on the assumption that the image samples are balanced among different categories and possess completely ideal annotations. The problem of sample imbalance or incomplete annotation is rarely investigated in depth for insulator defect detection. In this paper, we focus on insulator defect detection with imbalanced data and incomplete annotations. Our proposed framework, named Pi-Index, introduces Positive Unlabeled (PU) learning to solve the problem of incomplete annotation and designs a novel index the class prior, which is a key parameter in PU learning. Moreover, focal loss is integrated in our framework to alleviate the effect of sample imbalance. Experiment results demonstrate that the proposed framework achieves better performance than the baseline methods in situations of sample imbalance and missing annotation.