Epilepsy is one of the most common neurologic diseases affecting people of all ages, races, sex, social classes, and geographic locations. Cardiac arrhythmias have been associated with patients with seizure disorders and can be a common sudden unexpected death in epilepsy. We present a case of a 74-year-old woman with altered level of consciousness and agitation who was found to have non-convulsive status epilepticus and complete AV block. She was successfully managed only with dual antiepileptic medications. Diagnosis is best made with EEG and ECG. In general, management is made by seizure medications, while pacemakers are still a point of debate.

HIV is a serious disease that threatens and affects capital stock, population composition and economic growth. This research paper aims to study the mathematical modeling and disease dynamics of HIV/AIDS with memory effect. We propose two fractional models in the Caputo sense for HIV/AIDS with and without migration. First, we prove the existence and positivity of both models and calculate the basic reproduction number R 0 using the next generation method. Then, we study the local and global stability of the obtained equilibria. In addition, numerical simulations are provided for different values of the fractional order ρ using the Adams-Bashforth-Moulton fractional scheme, to verify the theoretical results. Moreover, a sensitivity analysis of the parameters for the model with migration is carried out.

Control of plant virus diseases largely depends on the induced plant defense achieved by the external application of synthetic chemical inducers with the ability to modify defense-signaling pathways. However, most of the molecular mechanisms underlying these chemical inducers remain unknown. Here, we developed a lentinan-loaded hydrogel with a core-shell structure and discovered how it protects plants from different virus infections. The hydrogel was synthesized by adding a chitosan shell on the surface of the polyanion sodium alginate-Ca 2+-lentinan (LNT) hydrogel (SL-gel) to form a CSL-gel. CSL-gels exhibit the capacity to prolong the stable release of lentinan and promote Ca 2+ release. Application of CSL-gels on the root of plants induces broad-spectrum resistance against TMV, TRV, PVX and TuMV). RNA-seq analysis identified that the calmodulin-like protein 19 gene ( NbCML19) is upregulated by the sustained release of Ca 2+ from the CSL-gel, and silencing and overexpression of NbCML19 alter the susceptibility and resistance of tobacco to TMV. Our findings provide evidence that this novel and synthetic CSL-gel strongly inhibits the infection of plant viruses by the sustainable release of LNT and Ca 2+. This study uncovers a novel mode of action by which CSL-gels trigger NbCML19 expression through the stable and sustained release of Ca 2+.

Vegetative insecticidal proteins (Vips) are widely used in pest management, but Vip resistance is a big threat. DNA methylation plays important roles in regulating the response of biological organisms to environmental stress. In this study, DNA methylation map was developed for fall armyworm (FAW, Spodoptera frugiperda), and its function in regulating FAW Vip3Aa resistance was explored. FAW was screened by Vip3Aa for 10 generations, and bioassays indicated that Vip3Aa resistance increased trans-generationally. Based on the comparison of DNA methylation maps between Vip3Aa-resistant and -susceptible strains showed that gene body methylation was positively correlated with its expression. Moreover, the study demonstrated that a reduction in the methylation density within the gene body of a 3’5’-cyclic nucleotide phosphodiesterase gene resulted in decreased expression and increased resistance of FAW to Vip3Aa, which was validated through RNAi experiments. The mechanism of Vip3Aa resistance will improve the understanding of DNA methylation and its function in lepidoptera and provide a new perspective for making strategies to pest management.

This study aimed to investigate the relationship between personality characteristics and psychological health of hospitals’ frontline medical staff and provide a basis and reference for targeted psychological health education for frontline medical staff and for the staff of related departments to formulate relevant policies. The self-evaluation scale of symptoms (SCL-90) was used to investigate the mental health status of 150 first-line medical staff in Zhejiang Province in response to the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia.The average scores of SCL-90 and somatization, obsessive-compulsive, depression, anxiety, hostility, terror, and psychotic factors were significantly higher than those of the normal sample in the first-aid medical staff of Aihu Hubei. The degree of influence on the mental health status of the frontline medical staff in service in Hubei is as follows, from high to low: the degree of suspicion that they may have been infected when new coronavirus pneumonia-related symptoms occur, the degree of fear of being infected and thus bring the infection to their families, and whether they have received a medical check-up recently, as well as a high level of education (both P<0.05).The psychological health level of the frontline medical staff is lower than the national norm. In the context of the increasing number of confirmed cases and the new type of coronavirus pneumonia in the absence of any specific curative treatments, the frontline medical staff is under great psychological pressure. It is necessary to institute targeted mental health promotion to relieve the psychological pressure endured by the frontline medical staff, promote their physical and mental health, and better respond to the pandemic in China.

Sea ice modulates the energy exchange between the atmosphere and the ocean through its kinematics. Marginal ice zone (MIZ) dynamics are complex and are not well resolved in routine observations. Here, we investigate sea ice dynamics in the Greenland Sea MIZ using two Lagrangian drift datasets. We find evidence of tidal currents strongly affecting sub-daily sea ice motion. Velocity anomalies show abrupt transitions aligned with gradients in seafloor topography, indicating changes in ocean currents. Remote-sensed ice floe trajectories derived from moderate resolution satellite imagery provide a view of small-scale variability across the Greenland continental shelf. Ice floe trajectories reveal an west-east increasing velocity gradient imposed by the East Greenland Current, with maximum velocities aligned along the continental shelf edge. These results highlight the importance of small scale ocean variability for ice dynamics in the MIZ.

The objective of this study was to estimate the variance components and genetic parameters as well as to predict breeding values for resistance to endoparasite in Anglo Nubian goats, with repeatability model in single-trait analysis, with inclusion of genomic information. Records of body condition score (BCS), FAMACHA, eggs per gram of feces (EPG) treated by the logarithmic transformations scale L 1EPG = log (EPG + 1), and resistance to worms (RW) were used as traits associated with resistance to worms. A total of 89 animals were genotyped with Bead Chip Goats SNP50. There was little variation in variance component estimates and in heritability and repeatability values with the inclusion of the genomic information. The use of genomic information provided increased accuracy for all traits, providing gains in accuracy of up to 50% for the trait EPG. The use of genomic information improved the predictive ability of the models and, consequently, more reliable genetic parameters were estimated for traits associated with resistance to infections caused by endoparasites in Anglo Nubian goats.

Objective: Globally, early and optimal feeding practices and strategies for small and vulnerable infants are limited. We aim to share the challenges faced and implementation lessons learned from a complex, mixed methods research study on infant feeding. Design: A formative, multisite, observational cohort study using convergent parallel, mixed-methods design. Setting: 12 tertiary/secondary, public/private hospitals in India, Malawi, and Tanzania Population or Sample: Moderately low birthweight infants (MLBW; 1.50-2.49kg) Methods: We assessed infant feeding and care practices through: 1) assessment of in-facility documentation of 603 MLBW patient charts; 2) intensive observation of 148 MLBW infants during facility admission; and 3) prospective one-year follow-up of 1114 MLBW infants. Focus group discussions and in-depth interviews gathered perspectives on infant feeding among clinicians, families, and key stakeholders. Results: Hospital-level guidelines and provision of care for MLBW infants varied across and within countries. 89% of charts had missing data on time to first feed; 56% lacked discharge weights. Among 148 infants observed in-facility, 18.5% were discharged prior to meeting stated weight goals. Despite challenges during COVID, 90% of the prospective cohort was followed until 12 months of age. Conclusions: Enrolment and follow-up of this vulnerable population required additional effort from researchers and the community. Using a mixed-methods exploratory study allowed for a comprehensive understanding of MLBW health and evidence-based planning of targeted large-scale interventions. Multi-site partnerships in global health research, which require active and equal engagement, are instrumental in avoiding duplication and building a stronger, generalizable evidence base.

Background: The findings of individual epidemiological studies that suggest an association between some Persistent Organic Pollutants (POPs) and Gestational Diabetes Mellitus (GDM) are inconclusive. Objectives: To estimate the strength of the association between POPs exposure and GDM in a systematic review with meta-analysis. Search strategy: MEDLINE, Scopus, and Web of Science were searched until 2022. Selection criteria: Cohort and case-control studies analyzing the association between POPs and GDM in healthy pregnant women. Data collection and analysis: Quality was assessed using QUIPS scale and standardized mean differences (SMD) and 95% confidence intervals (CI) was pooled using random-effect model. Main results: Fourteen articles including 11,422 participants were selected. The risk of bias of included studies was high in 4 (28.6%), moderate in 9 (64.3%) and low in 1 (7.14%). Only six POPs showed a significative SMD between GDM cases and controls: Perfluorobutanesulfonic acid (PFBS) 0.33 (95% CI 0.23, 0.43; I2=0%); Perfluorodecanoic acid (PFDA) -0.11 (95% CI -0.20, -0.01, I2 = 0.0%); 2,2’,3,4,4’,5,5’-Heptachlorobiphenyl (PCB 180) 0.37 (95% CI 0.19, 0.56; I2=25.3%); 2,2’,4,4’,5-Decabromodiphenyl ether (BDE 99) 0.36 (95% CI 0.14, 0.59; I2=0%); 2,2’,4,4’,6-Decabromodiphenyl ether (BDE 100) 0.42 (95% CI 0.19, 0.38; I2=0%); and, Hexachlorobenzene (HCB) 0.22 (95% CI 0.01, 0.42, I2=39.6%). For other POPs, no statistically significant association was observed. Conclusion: The available evidence is variable on quality and results were heterogeneous making impossible to establish a clear association between POPs exposure and risk of GDM. Improve the methodology of epidemiological studies assessing the association of POPs and risk of adverse clinical outcomes are needed.

A document by Yongjun Zhang. Click on the document to view its contents.

Developing young are particularly sensitive to environmental challenges, often with life-long consequences, but the risks of climate warming during this period are not well understood. To quantify the physiological effects of increasing temperatures for developing endotherms, we measured metabolic rate, water loss, and heat dissipation behaviours between 25-45°C in nestlings of a free-living songbird. The thermoneutral zone ranged from 33.1–42.3°C – higher and narrower than adults – and metabolic rate increased sharply above and below this range. Water loss was constant below 33.5°C, above which it increased sharply, when nestlings also drooped their wings to lose heat. Despite nestlings initiating panting (p50) around 40°C, water loss was never sufficient to dissipate metabolically produced heat, indicating poor cooling capabilities. Our data show that while developing young appear relatively tolerant to higher temperatures, they are at a high risk of dehydration and hyperthermia, with limited ability to mitigate these risks of increasing temperatures.

A reliability analysis framework is constructed by combining parametric modelling methods with finite element analysis methods under fluid-thermal-solid sequential coupling. The influence of blade profile changes due to machining errors on the reliability of turbine rotor blisks in reusable rocket engines (RRE) is investigated. The effects of machining errors, material, and load variability on the cyclic life reliability of rotor blisks are effectively quantified. With the suggested method, a reliability analysis is conducted for an RRE turbine rotor blisk, and the effect of the machining error range on the analysis results is investigated. It is found that when the reliability requirements are 0.85, 0.9, and 0.95, the general tolerance grades to satisfy the reliability requirements are the coarsest grade, the medium grade, and the precise grade, respectively. The highest sensitivity coefficient in cyclic life reliability is 29.09% for the blade axial chord. This study provides valuable insights and recommendations for the reliability design and optimization of reusable turbine rotor blisks.

Antonio J. Carpio1, E. Laguna1.*, R. Pascual-Rico1,*, M. Martínez-Jauregui2, J. Guerrero-Casado3, J. Vicente1, R. C. Soriguer4, E. Delgado1, P. Acevedo1

Objectives: The treatment modalities of ependymoma in infants remains controversial. Postoperative adjuvant radiotherapy (RT) could prolong the overall survival but has the potential to affecting nervous system development in infants. The role of adjuvant chemotherapy (CT) in prolonging overall survival for infants with ependymoma is still unclear. Therefore, we designed this study to explore the effect of treatment modalities on survival time of infants with ependymoma. Methods: A total of 72 infants with ependymoma from the Surveillance, Epidemiology, and End Results (SEER) database in this retrospective analysis. Univariate and multivariate Cox proportional hazard models were adopted to determine hazard ratios and to compare overall survival. Results: Among 72 infants with ependymoma, 35 were male (48.6%) and 37 were female (51.4%). The 5-year overall survival of all patients was 67.0%. 46 infants (63.9%) received gross total resection (GTR), 20 (27.8%) received subtotal resection (STR), and 6 (8.3%) did not receive surgical resection or only autopsy. 21 infants (29.2%) received RT, and 45 (62.5%) received CT. Multivariate analysis revealed that patients accepted surgical resection (No vs GTR, P < 0.001; No vs STR, P = 0.026) and chemotherapy (No vs Yes, P = 0.024) are the independent prognostic factors for overall survival. Conclusion: Treatment modality is associated with survival time in infants with ependymoma. The extent of resection and CT were independent prognostic factors for infants with ependymoma.

We argue that a global time index may not be computable. Time and simultaneity can be computable only locally.

Background Use of continuous renal replacement therapy (CRRT) in children receiving anti-infective drugs may lead to inappropriate concentrations with risks of treatment failure, toxicity and emergence of multidrug-resistant bacteria. We aimed to describe anti-infective prescribing practices in critically ill children undergoing CRRT. Methods An online survey to assess CRRT, anti-infective prescribing and therapeutic drug monitoring (TDM) practices was sent by e-mail to physicians working in pediatric intensive care units (PICUs) through the French-speaking Group of Pediatric Intensive Care and Emergency medicine (GFRUP). Results From April 1st 2021 to May 1st 2021, 26/40 different PICUs participated in the survey, corresponding to a response rate of 65%. Twenty-one were located in France and five abroad. All PICU practiced CRRT mainly with Prismaflex™ System. Anti-infective prescriptions were adjusted to the presence of CRRT in 23 (88%) PICUs mainly according to the molecular weight in 6 (23%), the molecule protein binding in 6 (23%) and the elimination routes in 15 (58%) including the residual diuresis in 9 (35%), to the CRRT flow in 6 (23%) and to the modality of CRRT used in 15 (58%), PICUs. There was a wide variability noticed between PICUs and between physicians in the same unit. Barriers to TDM were mainly an excessive delay in obtaining results in 11 (42%) and the lack of an on-site laboratory in 8 (31%) PICUs. Conclusions Our survey reported wide variability in anti-infective prescribing practices in children undergoing CRRT highlighting the gap in the knowledge and the need for education and recommendations

The precise localization of mobile robots is of utmost importance for many industrial applications, especially when the mobile robot is part of a more complex kinematic chain, such as in a mobile manipulator. Furthermore, precise localization hugely affects the outcome of tasks that rely on an open-loop kinematic computation, such as work-station docking procedures. To achieve a repeatable and precise localization and positioning, mobile robots generally rely on onboard sensors, most commonly 2D laser scanners, whose readings are subjected to noise and numerous disturbing factors ( e.g., materials reluctance). In this work, we propose a recurrent neural network (RNN) based registration system, which uses a pair of consecutive LiDAR readings and estimates a fixed transformation. The capability of RNNs to process contiguous inputs will help neglect errors embedded in punctual laser scanner reading and output a more precise registration estimation. In such a way, the RNN can estimate a displacement error based on multiple consecutive readings and act as a sensor to be employed in a closed-loop control scheme. After a model architecture and optimization of hyperparameters, the devised model is tested in different scenarios, comparing the AMR precise positioning capability with a classical registration algorithm. The results suggest that an RNN model can greatly improve the registration precision of laser scanner signals and, consequently, the precise positioning efficiency of AMRs.

Acute Necrotizing Encephalopathy of Childhood from Eastern AfricaHilary Chipongo1, Shaffin Rajan1, Abizer Sarkar 2 Ronald Mclarty 3, Esmail Sangey1

Title of Case-A rare case of left sided obturator hernia diagnosed by Computed TomographyAuthors- Manisha Aryal, Suraj Keshari, Archana Pandey, Abhishek Pandey, Ishwor PaudelKeywords- Obturator hernia, Case report, Richter’s hernia, Obstructed hernia, Computed Tomography

Predator-prey interactions provide key information on the role of each species in the community and an overall assessment of the stability of food webs. DNA metabarcoding has the potential to provide highly informative data which substantially enhance trophic interactions analysis, by providing higher taxonomic detail compared to earlier methods. Here we show, using the Cabo Verde seabird community, that the integrated analysis of trophic networks based on DNA metabarcoding of faecal samples can increase considerably our understanding of the trophic interactions in whole communities. Results revealed that these seabird species prey mostly on fish, with most seabirds relying heavily on very few prey species, which are also targeted by fisheries. This community shows high specialization and modularity levels, i.e., is dominated by seabird species with specialized diets. Such network structure has implications for its management and conservation because specialist predators are especially vulnerable to prey depletion. The Cape Verde shearwater (Calonectris edwardsii), identified as the main network connector species, was confirmed to be a suitable sentinel species of changes in this marine food web. Our results clearly show that network analysis can be used effectively to maximize the potential of DNA metabarcoding in studying trophic interactions of complex communities.

Biatrial tachycardia (BiAT) is a rare arrhythmia, and identification of the re-entry circuit is often complicated. 1 By creating an activation map of the right atrium, left atrium, and coronary sinus as a single chamber, the Lumipoint module of the Rhythmia mapping system can be used in real time to make an accurate diagnosis. 2 Ablation of the Bachmann bundle is a feasible way to terminate BiAT, but might cause interatrial conduction delay and electrical isolation of the left atrial appendage. Chemical ablation into the vein of Marshall might be the more beneficial treatment, avoiding any potential interatrial conduction delay.

Aim: This study evaluated the effects of SHR0302 on the pharmacokinetics of cytochrome P450 (CYP) probe substrates. Methods: We performed a single-center, open-label, three-period drug-drug interaction (DDI) study in 24 healthy subjects (NCT05392127). Subjects received a single oral dose of 5 mg warfarin (CYP2C9), 20 mg omeprazole (CYP2C19), and 15 mg midazolam (CYP3A4) on day 1, 8, and 22, and received 0.5 mg repaglinide (CYP2C8) on day 7, 14, and 28. Multiple oral doses of 8 mg SHR0302 were administered once daily from day 8 to day 28. Results: The exposure of S-warfarin and repaglinide were comparable before and after SHR0302 administration. AUC of midazolam was not affected by SHR0302, whereas the administration of SHR0302 slightly decreased the Cmax of midazolam by 7.6% (single dose) and 15.7% (once daily for 14 days). The AUC0-t, AUC0-inf, and Cmax of omeprazole were slightly decreased after a single dose of SHR0302 by 19.2%, 21.8%, and 23.5%, respectively. In the presence of SHR0302 for 14 days, the AUC0-t, AUC0-inf, and Cmax of omeprazole were marginally reduced by 3.0%, 16.4%, and 8.3%, respectively. According to the induction mechanism of the CYP enzyme, for the investigation of the induction effect, the results of multiple administration of the perpetrator were more reliable than those of the single dose. Conclusion: The results demonstrated that co-administration of SHR0302 is unlikely to have a clinically meaningful effect on the exposure of drugs metabolized by CYP3A4, CYP2C8, CYP2C9, and CYP2C19 in healthy subjects.

With reference to a more compacted and less conductive upper soil layer overlying a less compacted and more conductive subsoil, a simple three-dimensional (3D) infiltration run is expected to yield more representative results of the upper layer than the subsoil. However, there is the need to quantitatively establish what is meant by more representativeness. At this aim, numerically simulated infiltration was investigated for a theoretically unconfined process under a null ponded head of water (d0H0 setup, with d = depth of ring insertion and H = ponded depth of water) and a practical beerkan run (d1H1 setup, d = H = 1 cm). The considered layered soils differed by both the layering degree (from weak to strong) and the thickness of the upper soil layer (0.5-3 cm). It was confirmed that water infiltration should be expected to be more representative of the upper soil layer when this layer is the less permeable since, for a 2-h experiment, the instantaneous infiltration rates for the layered soil were 1.0-2.1 times greater than those of the homogeneous low permeable soil and 1.3-20.7 smaller than those of the homogeneous coarser soil that constituted the subsoil. Similarity with the homogeneous fine soil increased as expected as the upper layer became thicker. For a weak layering condition, the layered soil yielded an intermediate infiltration as compared with that of the two homogeneous soils forming the layered system. For a strong layering degree, the layered soil was more similar to the homogeneous fine soil than to the homogeneous coarse soil. Using the practical setup instead of the theoretical one should have a small to moderate effect on the instantaneous infiltration rates since all the calculated percentage differences between the d1H1 and d0H0 setups fell into the relatively narrow range of -18.8% to +17.4%. A sequential analysis procedure appeared usable to detect layering conditions but with some modifications as compared with the originally proposed procedure. The practical setup enhanced the possibility to recognize the time at which the characteristics of the subsoil start to influence the infiltration process. In conclusion, this investigation contributed to better interpret both the theoretical and the practically established 3D infiltration process in a soil composed of a less conductive upper soil layer overlying a more conductive subsoil and it also demonstrated that modifying a recently proposed procedure only using infiltration data could be advisable to determine the time when layering starts to influence the process.

Habitat degradation and the associated reductions in ecosystem function can be reversed by reintroducing or ‘rewilding’ keystone species. Rewilding projects have historically targeted restoration of processes such as grazing regimes or top-down predation effects. Few projects have focussed on restoring decomposition efficiency, despite the pivotal role decomposition plays in global carbon sequestration and nutrient cycling. Here, we tested whether rewilding entire communities of detritivorous invertebrates and microbes can improve litter decomposition efficiency and restore detritivore communities during ecological restoration. Rewilding was conducted by transplanting leaf litter and soil, including associated invertebrate and microbial communities from species-rich remnant sites into species-poor, and geographically isolated, revegetated farmland sites. We sampled pre- and post-rewilding communities, comparing remnant, rewilded revegetation, and control revegetation sites for litter decomposition and the abundance and diversity of detritivorous invertebrates and microbes. We also quantified the effect of detritivores on the rate of litter decomposition using piecewise Structural Equation Modelling. Decomposition was significantly faster in rewilding sites than both control and remnant areas and was largely driven by a greater abundance of invertebrate detritivores. Similarly, the abundance of invertebrate detritivores in rewilding revegetation sites exceeded the level of remnant communities, whereas there was little difference between control and remnant sites. In contrast, saprotrophic fungi contributed little to decomposition. Areas selected for agriculture were likely more productive than remnant sites, suggesting that restoration sites have the capacity for higher decomposition rates and more abundant detritivore communities than target remnant sites. Importantly, our findings suggest that the novel and relatively simple act of transplanting leaf litter can increase functional efficiency during restoration and alter community composition. Our methods may prove important across a range of contexts where other restoration methods have failed to restore ecosystem processes to pre-degradation levels.