Background This study investigated the feasibility of a novel preformed artificial chordae tendineaes(ACTs) implantation device (Halochord) for mitral valve repair(MVP) via apical access. Methods Nine pigs were randomly divided into three groups: A, B, and C, and survived for 1, 3, and 6 months after surgery, respectively. The ACTs were anchored in the leaflet throught Halochord, adjusted to the correct length to cause moderate MR guided by echocardiography, and secured at the epicardium. Echocardiography was used to assess hemodynamic data and valve function. Surviving pigs were killed at the end of the follow-up period to confirm the deployment of ACTs. Results The modeling was successful, with no operative mortality. According to the echocardiographic and the cardiac anatomical specimen, all ACT implantation sites were found in the P2 region of MV. No rupture of the ACTs was detected during the observation period. Additionally, the ACTs gradually internalized as time passed, particularly at their extremities. Conclusions We demonstrated that off-pump ACTs implantation from the LV apex is a feasible and reproducible procedure.

This paper is concerned with the global smooth solution of the 3D generalized magneto-micropolar equations. When the velocity dissipation is logarithmically hyperdissipative and the magnetic diffusion is fractional Laplacian, based on some new observations on the nonlinear structure for the magneto-micropolar equations, it is examined the system has a unique global smooth solution ( u , w , b ) ∈ C ( [ 0 , T ] ; H s ( R 3 ) ) . AMS Subject Classification 2010: 35Q35; 35B65; 76A10; 76B03.

As part of the plant water-use process, plant nocturnal sap flow ( Q n) has been demonstrated to have important ecophysiological significance to compensate for water loss. The purpose of this study was to explore nocturnal water-use strategies to fill the knowledge gap in mangroves, by measuring three species co-occurring in a subtropical estuary. The Q n existed persistently and contributed markedly over 5.5%~24.0% of the daily sap flow ( Q) across species, which was associated with two processes, nocturnal transpiration ( E n) and nocturnal stem water refilling ( R n). The diversity of stem recharge patterns and response to sap flow to high salinity conditions were the main reasons for the differences in Q n/ Q among species. For Kandelia obovata and Aegiceras corniculatum, R n was the main contributor to Q n, which driven by the demands of stem water refilling after diurnal water depletion and high salinity. In contrast, Avicennia marina maintained a low Q n, driven by vapor pressure deficit, and the Q n mainly used for E n, which adapts to high salinity conditions by limiting water dissipation at night. We conclude that the diverse ways Q n properties act as water-compensating strategies among the co-occurring mangrove species might help the trees to overcoming water scarcity.

A document by Guangdi Zhou. Click on the document to view its contents.

An exhaustive assessment of biodiversity is a major challenge of ecological research, and molecular approaches such as the metabarcoding of environmental DNA are boosting our ability to perform biodiversity inventories. Are we actually able to assess the whole community, to unravel the intricate interactions between organisms and the impacts of global changes on the different trophic levels? The majority of metabarcoding papers published in the last years used just one or two markers and analyzed a limited number of taxonomic groups. Nevertheless, approaches are emerging that might allow “all-taxa biological inventories”. Exhaustive biodiversity assessments can be attempted by combining a large number of specific primers, by exploiting the power of universal primers, or by combining specific and universal primers to obtain good information on key taxa while limiting the overlooked biodiversity. Multiplexes of primers and shotgun sequencing may provide a better coverage of biodiversity compared to standard metabarcoding, but still require major methodological advances. We identify the strengths and limitations of different approaches, and suggest new development lines that might improve broad scale biodiversity analyses in the near future.

Mountainous regions can promote complex speciation scenarios, including hybridization leading to chloroplast capture, revealed by incongruent phylogenetic trees. Four allopatric Taxus lineages from the Hengduan Mountains, southwestern China, exhibit cytonuclear phylogenetic discordance. We use multi-omic data at the population level to investigate their historical speciation processes. Transcriptome data consistently showed that T. florinii and the Emei type, which are the focus of cytonuclear discordance, originated in the Late Miocene. Population genomic analysis based on ddRAD-seq data revealed limited contemporary inter-specific gene flow. However, neither taxon exhibited the mosaic nuclear genomes that usually characterized hybrids. Taxus florinii appears to have originated when a lineage of T. wallichiana captured the T. chinensis plastid type, whereas plastid introgression in the opposite direction generated the Emei Type. All four species have distinct ecological niches, and introgression might have contributed to, or even initiated, their ecological divergence. We propose that these speciation events represent very rare examples of chloroplast capture events despite the paternal cpDNA inheritance of Gymnosperms. These events might have been triggered by orogenic activities of the Hengduan Mountains and the intensification of the Asian monsoon in the late Miocene, and may represent a scenario more common in these mountains than presently known.

Upstream colonisations from islands to continents have played an important role in the evolution of at least two major global bird radiations – the oscine passerines and the pigeons. Here we investigate the dynamics of insular diversification and upstream dispersal of pigeons(Columbiformes) within the Indo-Australian Archipelago. Based on a supermatrix fossil-calibrated phylogeny and model-based biogeographic analyses islands of Melanesia, now centred on New Guinea and considered separately from Australia, have been centre of pigeon diversification since the Eocene-Oligocene transition (~ 34 Ma). Geological reconstructions are concordant in suggesting arc terranes and continental ribbon fragments that underpin the contemporary Melanesian region may have formed extensive archipelagos separate from the main Australian landmass for much of the Oligocene and Miocene. For most of the last 35 million years these islands are inferred to have functioned as a net source of pigeon lineages for Asia, and especially Australia. However, the probability and evolutionary outcomes of upstream colonisation vary greatly across lineages and regions. Arboreal fruit-eating pigeons have colonised nearby continents on multiple occasions yet show little evidence of subsequent radiation. In contrast, insular terrestrial pigeons have been largely unable to colonise Asia, while a single early colonisation of Australia preceded an endemic radiation.

The gas solubility in the aqueous solution surrounded the hydrate particle are important for determining hydrate growth rate and stability, which are the main concerns for marine CCUS. This work conducted a series of experiments to study the influence of temperature, pressure, and salinity on CO2 solubility in wider temperature and pressure range, ranging from liquid-gas (Lw-V) two-phase system, hydrate-liquid-gas (H-Lw-V) three-phase equilibrium system, to hydrate stability zone. The CO2 solubility curves in wider temperature and pressure range from Lw-V two-phase system to hydrate stability zone are achieved in this work. Meanwhile, the experimental results show that the CO2 solubility in brine at H-Lw-V three-phase equilibrium conditions is higher than that in deionized water, while it doesn’t linearly increase with the increase of salt concentration.

BACKGROUND: Meconium peritonitis (MP), a sterile chemical peritonitis caused by intrauterine bowel perforation, is a rare condition with high neonatal morbidity and mortality. The antenatal risk factors remain unknown. OBJECTIVES: This study aimed to explore the antenatal risk factors for MP. STUDY DESIGN: This was a retrospective case–control. The case group was enrolled upon diagnosis of MP by prenatal ultrasound screening, and the next four consecutive patients who matched all of the case-patient characteristics were included as controls. The maternal characteristics and fetal outcomes were collected from the medical record database. RESULTS: We included 92 MP cases and 368 controls. Multivariate logistic regression analyses showed that higher parity and male fetal sex were associated with higher risks of MP (odds ratio [OR]=1.36, 95% confidence interval [CI]: 1.09-1.70 and OR=1.76, 95% CI: 1.05-2.94, respectively). Mild ICP [total bile acid (TBA) 10-39µmol/L)] and severe ICP (TBA≥40 µmol/L) were associated with higher risks of MP, with ORs of 5.39 (95% CI: 2.65-10.98) and 10.55 (95% CI: 3.69-30.10), respectively, and the trend was significant. Pregnant women with mild anemia [hemoglobin (HGB) 90-109 g/L] also exhibited a higher risk of MP (OR=2.53, 95% CI: 1.35-4.72); however, there was no association between moderate anemia (HGB 60-89 g/L) and MP. CONCLUSION: Maternal ICP, mild anemia, higher parity and male fetal sex were independently associated with the risk of MP. Maternal serum TBA and fetal MP exhibited a dose-response relationship. These findings provide a novel insight into the pathogenesis underlying fetal bowel perforation.

The instability of the supercritical Taylor-Couette flows has been extensively investigated in many previous studies but only few studies focusing on shear turbulence characteristics in wide gap and large size Taylor-Couette flow (TCF) reactors have been conducted. In the present study, particle image velocimetry (PIV) technology was adopted to investigate such shear turbulence characteristics based on the measurement of the instantaneous axial and radial velocities in the meridional plane of the annulus between the rotating inner and the non-rotating outer cylinder in a large size TCF reactor. The experimental results have indicated that as the Reynolds number exceeds the critical value, the vorticity strength of the induced Taylor vortices remarkably increases, consequently causing an enhanced outward impinging jet flow. It was also found that the secondary vortices in addition to major Taylor vortices when ReT reaches a critical value significantly alter the flow and turbulent characteristics in the reactor.

Henry Cordoba-Novoa1, Isabella Chiaravalotti1 , Laura Esquivel1, Robert McGee1, Jeff Smith1, Shangpeng Sun1 and Valerio Hoyos-Villegas1

Objective To report repair of large tympanic membrane perforation using tragus cartilage ring-perichondrium grafts and factors that can affect the long-term outcomes. Methods From January 2004 to December 2013, tragus Cartilage ring perichondrium grafts were used during myringoplasty in 325 patients (375 ears). Their clinical data, including age, duration of dry ear, preoperative air conduction hearing threshold, postoperative bone conduction hearing threshold, tympanic mucosa condition, tympanosclerosis lesions, ossicular chain lesion, Eustachian tube function, intraoperative blood oozing and follow-up data (more than 3 years), were analyzed using the SPSS 16.2 software. χ2 test and multiple linear regression analysis were employed with P<0.05 being statistically significant. Results The mean age of our patients was 36±8.32 (11-62) years and the average disease duration was 21±7.62 (1-36) years. The rate of tympanic membrane healing was 94.8% at 1 year and 91.6% at 3 years. Multivariate analysis of factors influencing operation results indicated correlation to the following: tympanosclerotic plaque lesions, preoperative air conduction hearing threshold, preoperative bone conduction hearing threshold, duration of disease, eustachian tube function and intraoperative blood oozing. Conclusion Tympanosclerotic plaque lesions, preoperative air conduction hearing threshold, duration of disease, eustachian tube function and intraoperative blood oozing appear to affect the efficacy of tympanoplasty using tragus cartilage ring-perichondrium grafts. Key point 1.Tympanic membrane grafts in tympanoplasty are usually tragus perichondrium or temporomandibular fascia. 2.Some experts use cartilage-perichondrium as a graft, but it increases the quality of tympanic membrane, which will also have a certain impact on hearing recovery. 3.An expert group was convened to study how to remove the cartilage with a diameter of 5mm in the center, keep the cartilage ring with a width of 1.5mm in the periphery, and repair it into a cartilage ring-perichondrium complex, so as to reduce the influence of excessive thickness of the whole cartilage on postoperative hearing. 4.After more than 3 years’ follow-up,Multiple linear regression was used for analysis, and the factors influencing the operation effect were observed. 5.This study confirmed that in tympanoplasty, tragus cartilage ring-perichondrium is used as a graft, which is especially suitable for patients with tympanic membrane perforation.

Background Peritonsillar abscess is a common clinical problem. Management involves drainage of the abscess and administration of antibiotics. The choice of antibiotic is related to the polymicrobial growth of aspirate cultures, leading to prescriptions of co-amoxiclav, or metronidazole in addition to phenoxymethylpenicillin. However there is little evidence to support this. Objectives The aim of this review was to assess clinical effectiveness of phenoxymethylpenicillin vs phenoxymethylpenicillin plus anaerobic cover in the management of peritonsillar abscess. Design/Setting A systematic review of literature and clinical trial databases in accordance with the PRISMA 2020 statement. Studies were screened for eligibility by two independent reviewers. Main outcome measure Three studies were included, two comparing oral penicillin to oral penicillin plus metronidazole, one comparing IM/oral penicillin to IM/oral sulbactam-ampicillin. Clinical outcomes were assessed in all, including recurrence rate, symptom improvement and duration of pyrexia. Results There was no significant difference in any clinical outcome across all studies between the two groups. One study found a significant increase in diarrhoea and vomiting as a side effect in the group receiving metronidazole plus penicillin compared to penicillin alone (p=0.01). Conclusion On reviewing the literature, no significant clinical benefit has been demonstrated in the addition of either metronidazole or more broad-spectrum antibiotic cover compared to oral penicillin monotherapy for peritonsillar abscess when combined with incision and drainage protocols. Moreover, unnecessary broad-spectrum antibiotics contribute to increased side effects, costs, and antimicrobial resistance.

Liver fibrosis (LF) is a trauma repair process carried out by the liver in response to various acute and chronic liver injuries, featured by excessive proliferation as well as abnormal dismissal of extracellular matrix as the main pathological features, and its continuous development will deteriorate into cirrhosis, liver cancer as well as other illnesses. The occurrence of LF is closely related to Hepatic stellate cells (HSCs) stimulation, and intervention in HSCs proliferation is expected to reverse LF. Plant-based small molecule drugs have anti-LF effects, and their mechanisms of action are related to anti-inflammation, anti-oxidative stress, as well as inhibition of abnormal accumulation of extracellular matrix. Consequently, new agents for HSCs will be required to furnish a possible curative response. Small-molecule natural products might be attractive for LF therapy. That is because they not only have the effect against HSCs, but also have excellent qualities such as low toxic side effects and easy availability from the perspective of safety and cost. In this review, we provide an updated review of the signal transduction pathways involved in HSCs and small-molecule natural products targeting HSCs reported in the past 3 years at home and abroad, with the aim of providing new ideas for the development of plant-based small molecule drugs targeting HSCs to reverse LF.

This paper presents the development of low-cost, disposable impedance-based sensors for real-time, in-line monitoring of suspension cell culture. The sensors consist of electrical discharge machining (EDM) cut aluminum electrodes and polydimethylsiloxane (PDMS) spacers, low-cost materials that can be safely disposed of. Our work testifies the capability of the low-cost sensors for in-line, non-invasive monitoring for suspension cell growth in cell manufacturing. A hybrid equivalent circuit model extracts key features/parameters from intertwined impedance signals and feeds them to a novel physics-inspired model designed for low-frequency dielectric dispersion (LFDD) to decide viable cell count (VCC), a critical quality attribute (CQA) in cell manufacturing. Predicted VCC trends are then compared with image-based cell count data to verify their accuracy.

There is a lack of understanding of the dynamic characteristics of carbon, nitrogen, and enzyme activity of soil microbial load of Panax notoginseng in water-fertilizer intercrops. In this study , we reveal that different water and fertilizer regulations affect microbial biomass carbon, nitrogen, and enzyme activities. As the study object, we set up 3 irrigations,4 fertilization levels, and 1 control in micro-sprinkler irrigated Panax notoginseng farmland, Luxi County, Yunnan Province from 2018 to 2020. The findings demonstrated that under the same water and fertilizer management, the carbon, nitrogen, and enzyme activities of Panax notoginseng’s soil increased and then decreased with increasing fertility time, in descending order of flowering, fruiting, seedling, and rooting periods.. The maximum value is reached during the flowering period ,while the minimum value is reached during the rooting period. The soil microbial carbon and nitrogen contents ranged from 0.49 to 1.05 g.kg -1 and from 14.98 to 66.21 mg.kg -1, respectively, and soil sucrose enzyme activity was the largest, ranging from 17.12 to 68.79 mg.kg -1.d. -1. The soil microbial carbon , nitrogen and enzyme activities of Panax notoginseng increased with the rate of water and fertilizer application under different water and fertilizer management. The soil microbial carbon , nitrogen and enzyme activities of Panax notoginseng at the flowering period were the largest. The soil microbial carbon and nitrogen activities of Panax notoginseng increased with the increase of irrigation and fertilizer application, whereas the soil microbial carbon and nitrogen activities of W3F4 increased by 0.41 g.kg -1 and 39.52 mg.kg -1 respectively compared with W1F1. Soil urease, sucrase, acid phosphatase, and catalase activities were the highest in W3F4, with increases of 44.26%, 61.51%, 42.56, and 32.25% respectively compared to W1F1. There was a significant positive correlation between soil microbiomass carbon and nitrogen and enzyme activity under different water and fertilizer management. Soil microbiomass carbon and nitrogen content determined soil enzyme activity. The entropy value method combined with the TOPSIS method was used to analyze the optimal program fit Ci of soil microbial biomass carbon, nitrogen, and enzyme activity under different water and fertilizer optimization management and at different fertility periods. The results showed that the Ci values were F4, F3, F2, and F1 in descending order under the same irrigation level treatment.The Ci values decreased and then increased with increasing irrigation water under the same fertilization level treatment. The carbon, nitrogen, and enzyme activities of the soil’s microbial biomass were successfully controlled when Panax notoginseng was treated with W2F4 during the rooting period and W3F4 during the seedling, flowering, and fruiting periods. This study is an essential guideline for water and fertilizer regulation of Panax notoginseng and its yield quality improvement.

Snow avalanches are a major component of the mountain cryosphere that frequently create a menace for the road network. Deposit characteristics determine the extent of damage and disruption to communication networks, but the factors controlling snow-deposit volumes remain largely unknown. This study investigates the influence of meteorological and snowpack conditions on snow-avalanche deposits and road-network vulnerability based on 1986 deposit volumes from 182 paths located in two regions of the French Alps between 2003 and 2017: Guil and Haute-Maurienne valleys. During the period, 195 avalanches impacted the road network in these areas, leading to major disruptions. In Haute-Maurienne, correlations between deposit volumes and meteorological and snowpack conditions are high in winter. However, the relationships differ with path elevation and orientation. Results do not show any significant relationship between volumes and meteorological or snowpack conditions for the spring season. Focusing on deposits that disturbed the road network, winter and spring reveal a distinct influence of meteorological and snow variables compared to the overall data set, with snowfall intensity as the predominant control variable of deposit volumes leading to road cuts. When the same analysis is conducted by considering Guil valley separately or by aggregating Haute-Maurienne with Guil valley area data, results do not show any significant relationship, highlighting the specific regional nature of relations between deposit volumes and meteorological and snowpack conditions.

Background: Infections are common complications after stroke and associated with unfavorable outcomes. We evaluated the efficacy and safety of prophylactic antibiotics for post-acute stroke infection. Methods: We searched PubMed, Embase, the Cochrane Library, SinoMed, China National Knowledge Infrastructure, and WanFangData from inception to February 15th, 2022. We calculated the pooled risk ratio (RR) and mean differences (MDs) with 95% confidence interval (CI), evaluated the risk of bias and conducted sensitivity analysis with RevMan version 5.4.1 and Stata version 14.0 software. The overall quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results: Twelve studies (4809 participants) were included in this meta-analysis. There was no significant difference in the mortality rate [RR 1.03 (95% Cl: 0.91-1.16)], pneumonia [RR 0.94 (95% CI: 0.79-1.11)], and the incidence of adverse events between the prophylactic antibiotics and control groups. Prophylactic antibiotics significantly reduced the incidence of infections [RR 0.72 (95% Cl: 0.58-0.89)], and urinary tract infections [RR 0.39 (95% Cl: 0.3-0.49)] in patients with acute stroke. We performed a subgroup analysis and found a decreasing trend in pneumonia in patients with early prophylactic use of antibiotics within 24 hours after admission [RR 0.81 (95%CI: 0.62-1.07)] as compared with those using prophylactic use of antibiotics within 48 hours after admission [RR 0.94 (95%CI: 0.79-1.11)]. Conclusions: Prophylactic antibiotics did not significantly reduce the mortality rate and pneumonia in patients with acute stroke but reduced the incidence of infections and urinary tract infections.

Background and aim: The urgent need for breakthrough therapeutic approaches for multi-drug resistance Staphylococcus aureus (MDR) has drawn attention to potential cutting-edge tools like nanoparticles (NPs). The preparation of chitosan/alginate-encapsulated Echinacea angustifolia extract and evaluation of its effectiveness against MDR strains were the goals of this investigation. Method: Scanning electron microscopy, dynamic light scattering (DLS), and Fourier Transform Infrared spectroscopy were used to analyze the synthesized NPs. Investigations were done into the antibacterial and antibiofilm properties of E. angustifolia NPs. Also, the expression of essential genes in biofilm formation was evaluated by real-time PCR. Results: According to DLS measurements, spherical E. angustifolia NPs had a diameter of 335.3 ± 1.43 nm. The PDI was 0.681, and the entrapment effectiveness (EE%) of the E. angustifolia extract reached 83.45 %. Synthesized NPs had the highest antibacterial power. They also significantly decreased the expression of genes involved in biofilm formation. Conclusion: By releasing natural-derived medications under regulated conditions, the findings described here should help create new plant extracts with increased stability and antibacterial action, which will help minimize the usage of antibiotics.

Here we report a patient with 2q37 deletion syndrome confirmed by comparative genomic hybridization (CGH) plus single nucleotide polymorphism (SNP), who does not suffer from mental developmental abnormalities. The patient, however, does suffer from fatigue and gross motor delay, and the presence of a patent foramen ovale.

Infective endocarditis is a deadly disease, associated with high mortality and morbidity. We present a case of a 14-year-old boy with antibiotic-resistant infective endocarditis who was cured with individualized classical homeopathy. The case is analysed according to the general reactivity of the organism and the Levels of Health theory.

Internal hernias represent only 0.5 to 1% of all causes of bowel obstruction. A 59-year-old patient presented acuetly with small bowel obstruction. Laparotomy revealed a left paraduodenal hernia with most of the small bowel herniating through a space between the inferior mesenteric vein and duodenojejunal junction.

The LAmbre occluder is more convenient to operate than other left atrial appendage closures(LAAC), and it can adapt to different anatomy of left atrial appendage. However, some studies showed that Lambre occluder had a higher incidence of device-related thrombus(DRT). This meta-analysis aims to compare the safety and efficacy of the LAmbre occluder with other LAAC devices. Eligible studies were retrieved from PubMed, Embase and the Cochrane Library up to 1 July 2022 and reported the results. Five studies of a total of 607 patients were included in the meta-analysis. The LAmbre occluder was associated with higher rate of DRT(OR [95% CI] = 5.25 [1.21, 22.86], P =0.03; I2=0%). No significant differences were observed in the incidence of procedure-related death, pericardial effusion, chest pain, bleeding and vessel complication, contrast medium, fluoroscopy time ,death, stroke, bleeding events, systemic embolism and peri-device leakage. In conclusion, the LAmbre occluder had higher incidence of DRT than other LAAC devices, and there were no significant differences in stroke, bleeding events, and mortality.

A document by Jürg Thudium. Click on the document to view its contents.