Catheter ablation represents nowadays a cornerstone for the treatment of atrial fibrillation. However, the benefit-risk ratio of this procedure still needs to be significantly improved. Many strategies have been proposed for this goal. Increased experience of operators and technological advances appear to be crucial points. Very important in this scenario is improving patients selection for ablation, as well. The blooming of artificial intelligence and machine learning represents a solid promise in many fields of medicine. Even in the field of atrial fibrillation cure they could prove to have a strong impact. Further prospective studies will surely help to define the real role of these techonologies in the treatment of atrial fibrillation.

Background First Few “X” (FFX) studies provide evidence to guide public health decision making and resource allocation. The adapted WHO Unity FFX protocol for COVID-19 was implemented to gain an understanding of the clinical, epidemiological, virological, and household transmission dynamics of the first cases of COVID-19 infection detected in Juba, South Sudan. Methods Laboratory-confirmed COVID-19 cases were identified through the national surveillance system, and an initial visit was conducted with eligible cases to identify all close contacts. Consenting cases and close contacts were enrolled between June 2020 and December 2020. Demographic, clinical information and biological samples were taken at enrolment and 14–21 days post-enrolment for all participants. Results Twenty-nine primary cases and 82 contacts were included in analyses. Most primary cases (n=23/29, 79.3%) and contacts (n=61/82, 74.4%) were male. Many primary cases (n=18/29, 62.1%) and contacts (n=51/82, 62.2%) were seropositive for SARS-CoV-2 at baseline. The secondary attack rate among susceptible contacts was 12.9% (4/31; 95% CI: 4.9%–29.7%). All secondary cases and most (72%) primary cases were asymptomatic. Reported symptoms included coughing (n=6/29, 20.7%), fever or history of fever (n=4/29, 13.8%), headache (n=3/29, 10.3%) and shortness of breath (n=3/29, 10.3%). Of 38 cases, two were hospitalised (5.3%) and one died (2.6%). Conclusions These findings were used to develop the South Sudanese Ministry of Health surveillance and contract tracing protocols, informing local COVID-19 case definitions, follow-up protocols and data management systems. This investigation demonstrates that rapid FFX implementation is critical in understanding the emerging disease and informing response priorities.

A document by Marouène Belkahla. Click on the document to view its contents.

CLA + memory T cells constitute a small subset of human memory T cells. Circulating skin-homing T cells participate in several aspects of atopic dermatitis, such as Staphylococcus aureus involvement in inflammation, the abnormal Th2 immune response, biomarkers, clinical aspects of the patients, pruritus, and the mechanism of action of targeted therapies. Superantigens, IL-13, IL-31, pruritus, CCL17 and early effects on dupilumab-treated patients have in common that they are related to CLA + T cell response in patients. The function of CLA + T cells is closely related to the role of T cells belonging to the skin-associated lymphoid tissue and could be a reason why they reflect different mechanisms of atopic dermatitis. The goal of this review is to gather all this translational information of atopic dermatitis pathology.

Background Unnecessary antibiotic avoidance due to allergy fears has adverse cost and health implications however, the problem is difficult to resolve because patient and provider-related factors leading to avoidance are multifactorial. The perspectives of patients can be explored using qualitative research methods to reach the heart of the problem. Objective To reveal factors leading patients to report antibiotic allergy, and determine what education is required to prevent the cycle of erroneous allergy reporting. Methods The 29 patients were a sample of convenience recruited from a tertiary public hospital in Western Australia; 18 were inpatients and 11 outpatients, with a median age of 64.2 years, and 15 (55%) were female. Semi-structured interviews assessed patients’ understanding and knowledge of three topics: (1) antibiotic allergy, (2) antibiotic allergy testing, and (3) outcomes of testing. Interview transcripts underwent thematic analysis by two researchers, independently. Results Three overlapping themes emerged as influential across topics: (1) Severity of the Index Reaction, (2) Trust in family and health care providers, and (3) Health literacy. Patients were largely unaware of the benefits of confirmatory testing, and the detrimental health consequences of unnecessary avoidance. Patients displayed trust in health care providers’ expertise, and assumed that medical records were accurate to prevent prescribing errors. Conclusions The findings provide evidence for an effective patient education strategy, and highlight failures among hospital and primary health providers to recognise the potential harm of unverified antibiotic allergy. Healthcare professionals are influential at multiple steps of a patient’s healthcare journey and addressing unconfirmed antibiotic allergy should be taken at each opportunity.

For the spacetime of 3+1 dimensions, if this can be assumed as the wormhole coordinate to be Σ where the universe for the purpose of mathematical construction satisfies the Euler-Poincare characteristics of X ≡ = 2 − 2g = 1 then there can be Σ_1 as the wormhole of g ≡ 1 in spatial dim 3 and Σ_2 as the spatial universe then: Σ_1 , Σ_2 ∈ Σ-This is easy to show that for the 3-manifolds as our mathematical universe, we can apply Heegaard splitting to split the wormhole from the mathematical universe. Comments-This shows the linkage of topology with the Einstein-Rosen Bridge in a mathematical universe.

Background: Pulmonary vein isolation (PVI) has evolved to be an integral part of ablative therapy for atrial fibrillation (AF), however, recurrence rates of AF remain high even after complete wide area circumferential PVI. In recent years adjunct posterior wall isolation (PWI) has been performed in patients with more persistent forms of AF but the benefits remain unclear. Aim: The objective of this meta-analysis was to evaluate the efficacy of adjunct posterior wall isolation in reducing recurrence rate of AF using cryoballoon ablation (CBA). Methods: We searched PubMed, Google Scholar, Clinicaltrials.gov and Cochrane CENTRAL. We included studies comparing PVI to PVI + PWI in patients with persistent AF undergoing CBA. After data extraction and quality assessment of the studies, we assessed recurrence rates of atrial tachy-arrhythmias (AF, atrial flutter, and atrial tachycardia) as well as total ablation time and procedural adverse events. Risk ratio (RR), mean difference (MD) and 95% confidence interval (CI) were calculated using Review Manager. Results: Concomitant PWI demonstrated significant decrease in recurrence risk of AF (RR 0.48; 95% CI 0.36-0.64; p < 0.00001) as well as all atrial arrhythmias (RR 0.57; 95% CI 0.47-0.70; p < 0.0001). There was no significant difference in adverse events between both groups (RR 1.05; 95% CI 0.43-2.56; p = 0.91), whereas total ablation time was significantly increased in PVI + PWI group (MD 22.67, 95% CI, 7.61-37.73, p = 0.003). Conclusion: Adjunct PWI when compared to PVI alone decreases recurrence rates of atrial tachy-arrhythmias after CBA of persistent AF.

Purpose Chemodenervation with botulinum neurotoxin type A (BoNTA) is the preferred method for focal spasticity management among various treatment options. While BoNTA injection is considered safe, its widespread use and increasing evidence raise safety concerns. Case In this paper, we present a patient with central pontine myelinolysis, a rare disease, who developed Acute Respiratory Distress Syndrome (ARDS) on the third day after BoNTA application to the spastic gastrocnemius muscle group and required intubation in the intensive care unit due to this complication. Conclusion To our knowledge, this is the first case reported in the literature to develop an acute pulmonary complication after BoNTA injection into spastic lower extremity muscles.

INTRODUCTION DIABETES MELLITUSDiabetes mellitus (DM) commonly known as diabetes, is a group of metabolic disorders characterized by a high blood sugar level over a prolonged period. Diabetes mellitus is the most common endocrine disorders affecting million people worldwide. It is a chronic condition, characterized by hyper-glycemia, due to impaired insulin secretion. It is a disease that affects the body ability to produce or use of insulin. Insulin is a hormone. When the body turns the food you eat into energy (sugar or glucose), insulin is released to help transport this energy to the cells. Its chemical message tells the cell to open and receive glucose. If the insulin produce is little or no production, leads too much sugar remains in your blood (hyper glycaemia). Blood glucose levels are higher than normal for individuals with diabetes. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels. [1]

An increasing body of research implicates inflammatory processes, including alterations in the neutrophil-lymphocyte ratio (NLR), in the pathophysiology of psychiatric illness. The deer mouse (Peromyscus maniculatus bairdii) is commonly studied for its naturalistic expression of compulsive-like behaviour. Towards future efforts to gain an understanding of how innate and adaptive immune processes might be involved this model, we set out to study the effects of pegfilgrastim, a pegylated recombinant human granulocyte colony-stimulating factor (g-CSF) analogue, on the NLR of both male and female deer mice. Briefly, 54 deer mice (equally distributed between sexes) were exposed to a single injection with either control or pegfilgrastim (0.1 or 1 mg/kg) (n = 18 per group). Six mice of each group were euthanized on days two, four and seven post-administration, blood collected and the NLR calculated. Our results showed that irrespective of dose, pegfilgrastim resulted in higher NLR values in mice of both sexes at days four and seven of testing, but that female mice exposed to the higher dose, presented with significantly higher NLR values irrespective of time, compared to male mice exposed to the same. These data highlight important dose and sex-specific areas for consideration and provide a useful basis for further study of both immunological and brain-immune crosstalk processes in deer mice.

Life sciences research improves our understanding of life on the planet, helps us to understand how environmental impacts affect organisms, and improves and saves human lives through biomedical innovation. The paradox is that, at the same time, life sciences research profoundly and negatively impacts environmental health by producing approximately 5.5 million metric tons of laboratory plastic waste annually [1] and contributing to greenhouse gas emissions with tens of thousands of labs around the world each using 5-10 times more energy per square meter than office buildings [2].

A document by Priyanka Samal. Click on the document to view its contents.

Species are not equally detectable, and this should be considered at the moment of choosing ecological indicators and considering sampling efforts. Indexes that permit ranking gilled species according to their abundance, permanency and basidiomes features were constructed. The same indexes were used to evaluate sampling effort and efficiency: more than 2 hours of continuous work affects negatively the capability of finding less detectable species. Ranking species is a practical solution to organise abundance datasets, and can be easily applied to find patterns of species relevance and detectability to better understand our findings and even to ensure optimum field work efficiency.

Bats provide us with important ecosystem services including insect population controllers in agricultural areas. Studies on bats and insect abundance in Malaysian rice fields are still lacking. Two harp traps and two mist nets were used to trap bats at the Gunung Keriang while a light trap was used to sample insects in the rice field area at three identified sites. A total of 2499 bats from 27 species were captured and for insect abundance a total of 161,539 individuals from 11 orders were captured. Rhinolophus pusillus was recorded as the dominant bat species in all seasons. In the dry season, the dominant insect pest was Chilo polychrysus (Stem borer) and in the wet season, Nilaparvata lugens (Brown planthopper) the dominant insect pest species. Insects from the Order Coleoptera (the dominant insect Order in dry season) may be eaten by bats that have a larger body size and that have a strong bite force. Due to high food availability and insect abundance, the peak time of bat foraging activity is the same as the peak time of insect emergence. We found that there is a significant relationship between bat activity with temperature and rainfall, but not with insect abundance. This study further highlights the importance of bats in regulating the insect pests population naturally in the rice field area.

As our previous study shown, the therapeutic effect of double genes (SERCA2a and Cx43) on heart failure after myocardial infarction (MI) were better than that of single gene (SERCA2a or Cx43) therapy on the basis of bone marrow stem cells (BMSCs) transplantation. Based on previous research, the aim of this study was to investigate the optimize ratio of co-delivery of SERCA2a and Cx43 genes for MI therapy after biotinylated microbubbles (BMBs) transplantation via ultrasonic-targeted microbubble destruction (UTMD). Forty rats underwent left anterior descending (LAD) ligation and BMSCs injection into the infarct and border zones. Four weeks later, double genes of SERCA2a and Cx43 with different ratios (1:1, 1:2 and 2:1) were co-delivered into the infarcted heart via the UTMD. Cardiac mechano-electrical function was determined at 4-wk after gene delivery, and the hearts of the rats were harvested for measurement of MI size and detection of SERCA2a and Cx43 expression. Q-PCR analysis of the expression of Nkx2.5 and GATA4 in the myocardial infarct zone and measurement of neovascularization in infarcted heart. After comparing the therapeutic effects of different co-gene ratios, the SERCA2a/Cx43-1:2 group shown remarkable cardiac electrical stability and strengthen the role of anti-arrhythmia. In conclusion, the optimum ratio of SERCA2a/Cx43 gene is 1:2, which take advantageous in maintaining cardiac electrophysiological stability.

A document by Hansheng Liang. Click on the document to view its contents.

Ontogenetic color change in animals is an interesting evolution-related phenomenon that has been studied by evolutionary biologists for decades. However, the performance of quantitative and continuous color measurements throughout the life cycle of animals is a challenge. To understand the rhythm of change in tail color and sexual dichromatism, we used a spectrometer to measure the tail color of blue-tailed skink (Plestiodon elegans) from birth to sexual maturity. Lab color space was selected due to its simple, fast, and accurate and depends on the visual sense of the observer for measuring the tail color of skinks. A strong relationship was observed between color indexes (values of L*, a*, b*) and growth time of skink. The luminance of tail color decreased from juveniles to adults in both sexes. Moreover, we observed differences in color rhythms between the sexes, which may be influenced by different behavioral strategies employed by them. This study provides continuous measurements of change in tail color in skinks from juveniles to adults and offers insights into their sex-based differences. Our findings explain the potential factors that drive dichromatism between the sexes of lizards and is expected to serve as a reference for future studies that explore possible mechanisms of ontogenetic color change in reptiles.

1 Gravel beaches in the Mediterranean ecoregion represent an economically important and unique habitat type. Yet, burgeoning tourism, intensive coastal development and artificial nourishment of beaches may jeopardize their ecological communities. To date, species that reside on gravel beaches and the consequences of beach alterations are poorly understood, which hampers the development of a sustainable coastal tourism industry along the region’s shorelines. 2 Using a simple collection method based on dredging buckets through the intertidal section of beaches, we quantified the microhabitat association of two sympatric clingfish species in the genus Gouania at seven natural and an artificial gravel beach based on sediment characteristics. We hypothesized that slender (G. pigra) and stout (G. adriatica) morphotypes would partition interstitial niche space based on sediment size, which may affect the vulnerability of the species to changes in gravel beach composition due to coastal development. 3 We detected substantial differences in gravel composition within and among the sampled beaches which suggests scope for microhabitat partitioning in Gouania. Indeed, we found significant relationships between species identity and the presence/absence and abundance of individuals in hauls based on their positioning on PC1. 4 Our results suggest that modifications of gravel beaches through coastal development, including beach nourishment, intensifying coastal erosion, or artificial beach creation, may have detrimental consequences for the two species if sediment types or sizes are altered. We posit that, given the simplicity and efficacy of our sampling method and the sensitivity of Gouania species to prevailing gravel composition, the genus could serve as an important indicator for gravel beach management in the Mediterranean ecoregion.

Site-occupancy modeling is widely used in ecology but its application is still limited in paleoecology, where incomplete detection is routine. Here, we make extensive expansions to an earlier multispecies occupancy model used to estimate the dynamics of relative species abundance in fossil communities. These expansions include incorporating counts of individuals at sites, explicitly allowing for the inclusion of specimens assignable to genus- but not species-level, a situation common in paleontology, and modelling regional presence/absence. We provide simulations to check the performance of this new model, as well as simulations to quantify the benefits of using individual count data versus subsample occupancy data and model estimates versus face-value (raw) estimates, respectively. We also provide an empirical case study using occupancy data from a community of marine benthic colonial animals preserved in the Pleistocene of New Zealand. We find that the new model performs well, especially when it comes to recovering relative abundance dynamics and that it is well worth the effort to both collect individual count data and to include individuals unidentified to species-level in the site-occupancy modelling framework. This extended model can be widely applied in paleoecological settings and is necessary when both the average and uncertainty values of relative abundance dynamics need to be robustly estimated.

A document by Sarbagya Manandhar. Click on the document to view its contents.

Knowledge of the breast cancer pattern and stage of diagnosis can aid in the disease’s subsequent effective management. Thus, the purpose of this study was to evaluate the clinicopathological characteristics of Sudanese women with breast carcinoma. Methodology: This analysis used Khartoum Oncology Hospital’s Pathology Laboratory to retrieve breast biopsy data from January to December 2022. Conventional histopathology confirmed the breast lesion diagnoses. Laboratory records provided all patient data. Results: With 70.2%, 12.8%, 10.6%, and 6.4%, respectively, invasive ductal carcinoma (IDC), metastatic carcinoma (MC), lobular carcinoma (LC), and papillary carcinoma (PC) were the four most prevalent types of carcinoma. The mean tumor size ± Std. Error of Mean was 8.99±2.18cm. The most common tumor sizes among patients were <3 cm, followed by >10 cm, 3-5 cm, and 5.1–10 cm, which correspond to (51%), (21.3%), (17%), and (10.7%), respectively. Conclusions: In Sudan, invasive ductal carcinoma and invasive lobular subtype are the most frequent breast cancer types. Young Sundanese are getting an increasing incidence of breast cancer. Due to the country’s poor early detection programs, many individuals arrive with advanced stages of the disease.

Cervical cancer is cancer arising from the cervix and this occurs due to abnormal growth of the cells that can invade and spread to another part of the body(1), at an early stage the patient presents asymptomatic but later on patients may present symptoms including vaginal breeding. pelvic pain or pain during sexual intercourse and finally the presence of vaginal mass may indicate the presence of malignancy sometimes in the advanced stage metastases may be present in the abdomen, lung, or elsewhere and may be accompanied by loss of appetite, weight loss, fatigue, pelvic pain, back pain, swollen legs, bone fractures and/or leakage of urine or feces from the vagina but occur very rarely. Cervical cancer is women’s fourth most common cancer It is of a public health concern as more than 569,000 cervical cancer new cases are reported annually and according to the International Agency for Research on Cancer ( IARC) global cancer observatory more than 311,000 death occur globally annually due to this cervical cancer however, in Africa the burden is well recognized where more than 119,000 new cases reported annually and 81,000 death occur annually (5) and according to current studies the burden was high observed in sub – Saharan Africa where cervical cancer contribute 20% to 25% of total cancer cases and World Health Organization report regarding the cervical cancer profile came to realize that low middle-income home countries are taking the highest burden of cervical cancer and this was due to lack effectiveness screening schedule In Tanzania, the burden of cervical cancer is well established and data declare that about 7000 women die each year due to cervical cancer the age group prone to this type of cancer is around 35 up to 44 and is uncommon for women below 20 years

There is limited and conflicting data regarding loss of immunity in childhood cancer survivors who did not undergo hematopoietic stem cell transplantation. This retrospective study included 28 childhood cancer survivors whose treatment consisted of at least 3 months of chemotherapy. Decreased seropositivity for measles, mumps, rubella, varicella, tetanus, and hepatitis B was found in patients across all categories of malignancy compared to the general population. Results were more pronounced for those with hematological malignancies. This study indicates that pediatric cancer survivors, especially those with hematological malignancies, may have greater loss of protective antibodies from primary vaccinations.

Transpressional margins are widespread, and their dynamics are relevant for plate boundary evolution globally. Though transpressional orogen evolution involves a topographic response to deformation, many studies focus only on the structural development of the system ignoring surface processes. Here, we present a new set of analog models constructed to investigate how tectonic and surface processes interact at transpressive plate boundaries and shape topography. Experiments are conducted by deforming a previously benchmarked crustal analog material in a meter-scale plexiglass box while controlling erosion through misting nozzles mounted along the transpressional wedge. We used a laser scanner to generate digital elevation models throughout the model evolution and photos for particle image velocimetry analysis. We focus on three experiments that cover a range of rainfall and convergence settings, with two end-member erosion settings and a dry reference. In all experiments, a bivergent wedge forms, and strain partitioning broadly evolves according to previously established models. Regarding drainage networks, we find that the streams in our models develop differently through feedback between fault development and drainage rearrangement processes. Differences between end-member erosional models can be explained by the varying response of streams to structure modulated by rainfall. Additionally, erosion may influence the structural evolution of transpressional topography, leading to accelerated strike-slip partitioning. From these results, we create a model for developing structures, streams, and topography where incision and valley formation along main structures localize exhumation. We apply insights from the models to natural transpressional systems, including the Transverse Ranges, CA., and the Venezuelan Andes.