1. Understanding animals’ selection of microhabitats is important in both ecology and biodiversity conservation. However, there is no generally accepted methodology for the characterisation of microhabitats, especially for vegetation structure. 2. Here we present a method that objectively characterises vegetation structure by using automated processing of images taken of the vegetation against a whiteboard under standardised conditions. We developed an R script for automatic calculation of four vegetation structure variables derived from raster data stored in the images: leaf area (LA), height of closed vegetation (HCV), maximum height of vegetation (MHC), and foliage height diversity (FHD). 3. We demonstrate the applicability of this method by testing the influence of vegetation structure on the occurrence of three viperid snakes in three grassland ecosystems: Vipera graeca in mountain meadows in Albania, V. renardi in loess steppes in Ukraine and V. ursinii in sand grasslands in Hungary. 4. We found that the variables followed normal distribution and there was minimal correlation between those. Generalized linear mixed models revealed that snake occurrence was positively related to HCV in V. graeca, to LA in V. renardi and to LA and MHC in V. ursinii, and negatively to FHD in V. renardi, and to HCV in V. ursinii. 5. Our results demonstrate that biologically meaningful vegetation structure variables can be derived from automated image processing. Our method minimises the risk of subjectivity in measuring vegetation structure, allows upscaling if neighbouring pixels are combined, and is suitable for comparison of or extrapolation across different grasslands, vegetation types or ecosystems.

Vitamin D-dependent rickets type 1 (VDDRIA) is an autosomal recessive disease caused by mutations in the Cytochrome P450 Family 27 Subfamily B Member 1 (CYP27B1) gene encoding the enzyme 1 alpha-hydroxylase. We report a known VDDRIA case presenting with hypotonia, growth and developmental disorders.

Designing appropriate management plans requires knowledge of both the dispersal ability and what has shaped the current distribution of the species under consideration. Here we investigated the evolutionary history of the endangered grey reef shark (Carcharhinus amblyrhynchos) across its range by sequencing thousands of RAD-seq loci in 173 individuals in the Indo-Pacific (IP) . We first bring evidence of the occurrence of a range expansion (RE) originating close to the Indo-Australian Archipelago (IAA) where two stepping-stone waves (east and westward) colonized almost the entire IP. Coalescent modeling additionally highlighted a homogenous connectivity (Nm~10 per generation) throughout the range, and an isolation by distance model suggested the absence of barriers to dispersal despite the affinity of C. amblyrhynchos to coral reefs. This coincides with long-distance swims previously recorded, suggesting that the strong genetic structure at the IP scale (FST ~ 0.56 between its ends) is the consequence of its broad current distribution and organization in a large number of demes. Our results strongly suggest that management plans for the grey reef shark should be designed on a range-wide rather than a local scale due to its continuous genetic structure. We further contrasted these results with those obtained previously for the sympatric but strictly lagoon-associated Carcharhinus melanopterus, known for its restricted dispersal ability. C. melanopterus exhibits similar RE dynamic, but is characterized by stronger genetic structure and a non-homogeneous connectivity largely dependent on local coral reefs availability. This sheds new light on shark evolution, emphasizing the roles of IAA as source of biodiversity and of life history traits in shaping the extent of genetic structure and diversity.

Multiple myeloma is a hematological cancer mostly located in the marrow of the vertebrae, pelvis, and thighs. Although the presence of extramedullary disease in the central nervous system is rare, herein, we report a complicated case of multiple myeloma in the spinal cord.

The effect of magnetic fields on black hole superradiance is an interesting topic with possible astrophysical applications. A dyonic RN-like black hole is not asymptotically flat, it describes a black hole immersed in an asymptotically uniform magnetic field. In this paper, we discuss the superadditive stability of a class of asymptotically flat, band-like black holes, the binary RN black holes. In this article, we introduce the above condition into dyonic RN-like black holes. If a dyonic RN-like black hole satisfies the condition of µ = yω, when µ ≥ √ 2(mΩH + qΦH),so the dyonic RN-like black hole is superradiantly stable at that time.

In this paper, we address the asymptotic stability problem for the fractional-order neural networks system with uncertainty based on sampled-data control. First, considering the influence of uncertainty and fractional-order on the system, a new sampled-data control scheme with variable sampling period is designed. According to the input delay approach, the dynamics of the considered fractional-order system is modeled by a delay system. The main purpose of the problem addressed is to design a sampled-data controller, such that the closed-loop fractional-order system can guarantee the asymptotic stability. Then, the fractional-order Razumishin theorem and linear matrix inequalities (LMIs) are used to derive the stable conditions. The new delay-dependent and order-dependent stability conditions are presented in the form of LMIs. Furthermore, the sampling controller can be obtained to ensure the stability and stabilization of fractional-order system. Finally, a numerical example is given to demonstrate the effectiveness and advantages of the proposed method.

This paper aims to introduce a patient with Chiari type 1 malformation presented with upper extremity pain and diabetes insipidus. After laboratory examinations, we confirmed central diabetes insipidus diagnosis. The patient has undergone posterior fossa decompression.in follow up patients symptoms relieved gradually.

Fuzz testing is a widely used methodology for software testing. It collects feedback of each run and uses it for generation of interesting stimuli in the future. This paper discusses the ability and process of fuzz stimuli generator for hardware verification. We chose an asynchronous FIFO and a memory (gem5[1]) coherency verification using fuzz. Our results substantiate the effectiveness of fuzz testing in the hardware verification process.

Background and aims: Transvenous lead extraction (TLE) has become a pivotal part of a comprehensive lead management strategy, dealing with a continuously increasing demand. Nonetheless, literature about the long-term impact of TLE on survivals still lacking. Given these knowledge gaps, the aim of our study was to analyse very long-term mortality in patients undergoing TLE in public health perspective. Methods: This prospective, single-centre, observational study enrolled consecutive patients with cardiac implantable electronic device (CIED) who underwent TLE, from January 2005 to January 2021. The main goal was to establish the independent predictors of very long-term mortality after TLE. We also aimed at assessing procedural and hospitalization related costs. Results: We enrolled 435 patients (mean age 70 ± 12 years, with mean lead dwelling time 6.8 ± 16.7 years), with prevalent infective indication to TLE (92%). Initial success of TLE was achieved in 98% of population. After a median follow-up of 4.5 years (range 1 month- 15.5 years),150 of the 435enrolled patients (34%) died. At multivariate analysis, death was predicted by: age (≥ 77 years, OR: 2.55, CI: 1.8-3.6, p<0.001), chronic kidney disease (CKD)defined as severe reduction of estimated glomerular filtration rate (eGFR <30 mL/min/1.73m2, OR:1.75, CI: 1.24-2.4, p=0.001), systolic dysfunction assessed before TLE defined as left ventricular ejection fraction (LVEF) <40%, OR:1.78, CI 1.26-2.5, p=0.001). Mean extraction and reimplantation-related costs were \euro5989 per procedure. Conclusions: Our study identified three predictors of long-term mortality in a high-risk cohort of patients with a cardiac device infection, undergoing successful TLE. The future development of a mortality risk score before might impact on public health strategy.

Background and Purpose Neonatal seizures are a clinical emergency. Current anti-seizure medications, however, fail to resolve seizures in ~50% of infants. The P2X7 receptor (P2X7R) is an important driver of inflammation and evidence suggest P2X7R contributing to seizures and epilepsy in adults. To date, however, no genetic proof has been provided to determine the contribution of the P2X7R to neonatal seizures, its effects on inflammatory signalling during neonatal seizures and the therapeutic potential of P2X7R-based treatments on long-lasting brain excitability. Experimental Approach Neonatal seizures were induced via global hypoxia in 7 day-old mouse pups (P7). The role of P2X7Rs during seizures was analyzed in P2X7R overexpressing and knock-out mice. Treatment of wild-type mice post-hypoxia with the P2X7R antagonist JNJ-47965567 was used to determine the effects of the P2X7R on long-lasting brain hyperexcitability. Cell type-specific P2X7R expression was analyzed via P2X7R-EGFP reporter mice. RNA sequencing was used to monitor P2X7R-dependent hippocampal down-stream signalling. Key Results P2X7R deletion reduced seizure severity whereas P2X7R overexpression exacerbated seizure severity and reduced responsiveness to anti-seizure medication. P2X7R deficiency let to an anti-inflammatory phenotype in microglia and treatment of mice with a P2X7R antagonist reduced long-lasting brain hyperexcitability. RNA sequencing identified several pathways altered in P2X7R knock-out mice after neonatal hypoxia including a down-regulation of genes implicated in inflammation and glutamatergic signalling. Conclusion and Implications Treatments based on targeting the P2X7R may represent a novel therapeutic strategy for neonatal seizures with P2X7Rs contributing to the generation of neonatal seizures, driving inflammatory processes and long-term hyperexcitability states.

Objective: The aim of this study was to compare the quality of life and complications of endoscopic sinus surgery, with and without image guidance, in patients with chronic rhinosinusitis. Design and setting: Systematic review and meta-analysis of clinical trials. PubMed, Embase, Scopus, Web of Science, SciELO, Cochrane Central Register of Controlled Trials, LILACS, and ClinicalTrials.gov were searched on April 22, 2022. Main outcome measures: A search strategy was used to retrieve clinical trials that compared the quality of life and complications of endoscopic sinus surgery with and without image guidance from the databases. The risk of bias was assessed using the Cochrane Risk of Bias tool. RevMan 5.4. was used for data synthesis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The Grading of Recommendations Assessment Development and Evaluation method was used to evaluate the strength of the evidence. Results: A total of 3281 articles were retrieved from the databases. Six studies met the inclusion criteria, and five could be combined by meta-analysis (638 patients). Image guidance showed improved efficacy in opening diseased paranasal sinuses compared with conventional endoscopic sinus surgery (risk ratio: 0.19; 95% confidence interval, 0.04-0.85; p = 0.03). There was a trend toward a reduction in complications with image-guided surgery, although it did not reach statistical significance (risk ratio: 0.53; 95% confidence interval, 0.20-1.41; p = 0.20). Conclusion: Image guidance is an important tool that helps improve surgical results and possibly increases the safety and quality of life of patients with chronic rhinosinusitis.

Objective. To discuss the presentation, evaluation, and management of congenital laryngeal webs. Methods: The Institutional approved this retrospective review of all patients who were diagnosed with laryngeal webs at our institution within the past 10 years. Results: There were 3 type I and II webs and 7 type III and IV webs; All 3 children with type I and II laryngeal webs recovered after a single endoscopic procedure, while children with type III and IV laryngeal webs usually had a record of multiple visits to the hospital with multiple treatments. In all 7 children with type III and IV webs, a tracheotomy was performed. The average age of the patients who underwent tracheotomy was 4.86 months（range，1-11mo）. Six of the seven children (85.7%) with type III and IV webs displayed subglottic stenosis. The ultimate treatment for such patients was open laryngoplasty. Conclusions: children with type III and IV laryngeal webs were more likely to have subglottic stenosis and needed to undergo tracheotomy earlier. They usually had a record of multiple visits to the hospital with multiple treatments. Open laryngoplasty combined with the implantation of a T-tube and reconstruction of the cricoid cartilage using hyoid bone may play a crucial role in the treatment of congenital laryngeal webs with subglottic stenosis.

Recent studies have highlighted associations between diseases and host microbiota. However, the role of microbe in infection process is yet to be clarified between host microbiota promoting future infections, or changes in host microbiota resulting from infections. We longitudinally surveyed, in the wild, the microbiota of individual fish hosts (Leuciscus burdigalensis) both before and after infection by a crustacean ectoparasite (Tracheliastes polycolpus). We found a striking association between parasite infection and the host microbiota composition restricted to the fins the parasite anchored. We clearly demonstrated that infections by the parasite induced a shift in (and did not result from) the host fin microbiota. Fin microbiota further got similar to that of the adult stage, and the free-living infective stage of the parasite during infection with a predominance of the Burkholderiaceae bacteria family. This suggests that Burkholderiaceae bacteria is involved in a co-infection process and possibly facilitate T. polycolpus infection.

Without the use of medicine drones, users are responsible for transporting goods at a high cost. The goal of this patient monitoring system is to identify people's health and, if necessary, administer medicine. The transportation drone is capable of finding healthcare information in a 360-degree rotation within the transportation infrastructure. Drone doctors are critical for the transportation of small gadgets such as drug treatments, blood leakages, and vaccines in the critical conditions of a heart patient, in event of failure of traffic location infrastructure, highway roads, or hospitals due to intense climate or site visitor congestion, and for the transportation of small gadgets such as drug treatments, blood leakages, and vaccines. When transmission is difficult, the self-maintaining drone is the format for quickly transporting drug treatments to the appropriate locations. The shipping drone equipped with an Ardupilot can drive in autopilot mode, which guides the drone to its destination. It has a 7-minute flying period and can deliver up to 2 kg of medicine. When the detected heartbeat is 94bpm and the fever range is 101 degree, a method has been presented in which an IoT Drone Doctor System distributes the first AID box to vulnerable patients and heart patients.

Neglecting the influence of residual stress often leads to inaccurate predictions of camshaft life. Understanding residual stress evolution (RSE) under cyclic loading is the foundation for accurately predicting the fatigue life of camshafts. Camshafts are not subjected to uniform residual stress during manufacture, nor do they experience an evenly distributed load in service. Because studying the RSE of camshafts in service using only experiments is not practical, a combination of FEA (finite element analysis) and experimental verification is used. It is difficult for FEA to accurately predict the ratchet behavior of the stress and strain of a camshaft in service. To address this issue, our study proposes an experimentally-verified cyclic-plastic constitutive model that considers mixed hardening coupled damage (CDMH). RSE that is observed during camshaft manufacture and service is discussed. The results demonstrate that the CDMH model can accurately predict the RSE of camshaft in service, with an error less than 6.23%. We noticed that the compressive residual stress generated in the manufacturing process is enhanced and redistributed during service. The first cyclic load has the greatest contribution to the stress enhancement effect; the smaller the camshaft residual stress in the manufacturing process, the larger is the increased amplitude under the same load. The residual stress on the cam profile can be increased at least 6.02% by swing grinding, when compared with cutting grinding. This study provides a method for exploring RSE in camshafts under cyclic loading.

We solve the Andô dilation problem for linear maps on vector space asked by Krishna and Johnson in [Oper. Matrices, 2022]. More precisely, we show that any commuting linear maps on vector space can be dilated to commuting injective linear maps.

In order to evaluate the thrombolytic effect of Recombinant staphylokinase for injection (r-SaK) in acute ischemic cerebral infarction, an intracranial large vessel occlusion animal model was generated by pushing an autologous thrombus to the internal carotid artery under X-ray angiography. Autologous thrombi/saline were injected into the internal carotid artery, and thrombolytic agents were then administrated. Thrombus formation and dissolution were monitored by real-time digital subtraction angiography (DSA), blood coagulation and histopathologic examinations were used as subsidiary methods. The results in the present study showed that the left cerebral vascular thrombotic occlusion model was established stably after the autologous thrombus pushed through the internal carotid artery in dogs. Administration of r-SaK (0.25, 0.5, 1.0 mg/kg) produced effective thrombus dissolution with a recovery of over 80% blood flow, as effective as alteplase (1.68 mg/kg). Correspondingly, blood coagulation was changed by r-SaK, with a dramatic elongation of prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) and reduction of fibrinogen (FIB). In contrast to the model group, pathological improvement in the two thrombolytic groups were mainly manifested in the improvement of the structural integrity of the gray matter, and the reduction of the infiltration of inflammatory cells and neuronal damage in the intracranial blood vessels. Besides, no adverse reactions related to bleeding in this model were found. The results indicate that intravenous infusion of r-SaK has a significant thrombolytic effect on intracranial large vessel occlusion model, and can prevents brain tissue and neuron damage induced by thromboembolism.

Background and Purpose: Despite their use to treat cancers with specific genetic aberrations, targeted therapies elicit heterogeneous responses. Sources of variability are critical to targeted therapy drug development, yet there exists no method to discern their relative contribution to response heterogeneity. Experimental Approach: We use HER2-amplified breast cancer and two agents, neratinib and lapatinib, to develop a platform for dissecting sources of variability in patient response. The platform comprises four components: pharmacokinetics, tumor burden and growth kinetics, clonal composition, and sensitivity to treatment. Pharmacokinetics are simulated using population models to capture variable systemic exposure. Tumor burden and growth kinetics are derived from clinical data comprising over 800,000 women. The fraction of sensitive and resistant tumor cells is informed by HER2 immunohistochemistry. Growth rate-corrected drug potency is used to predict response. We integrate these factors and simulate clinical outcomes for virtual patients. The relative contribution of these factors to response heterogeneity are compared. Key Results: The platform was verified with clinical data, including response rate and progression-free survival (PFS). For both neratinib and lapatinib, the growth rate of resistant clones influenced PFS to a higher degree than systemic drug exposure. Variability in exposure at labeled doses did not significantly influence response. Drug potency strongly influenced responses to neratinib. Variability in patient HER2 immunohistochemistry scores influenced responses to lapatinib. Exploratory twice daily dosing improved PFS for neratinib but not lapatinib. Conclusion and Implications: The platform can dissect sources of variability in response to target therapy, which may facilitate decision-making during drug development.

The present article is an attempt to highlight some of the major psychosocial issues faced by children during the pandemic through a case study. The study emphasizes upon a child's mental health care during the covid-19 pandemic. he case study can help clinicians, mental to understand the emotional, behavioral impact

Conservative flowering behaviors, such as flowering during long days in summer or late flowering at a high leaf number, are often proposed to protect against variable winter and spring temperatures which lead to frost damage if premature flowering occurs. Yet, due the many factors in natural environments relative to the number of individuals compared, assessing which climate characteristics drive these flowering traits has been difficult. We applied a multidisciplinary approach to ten winter-annual Arabidopsis thaliana populations originating along a wide climactic gradient in Norway. We paired a variable reduction strategy to assess which of 100 climate descriptors from their home sites correlated most to their behaviors when grown in common garden and assessed sequence variation of 19 known environmental-response flowering genes. We show that long-day sensitivity and late flowering may be driven not by risk of spring frosts, but by growing season temperature and length perhaps to opportunistically maximize growth.

Congenital dyserythropoietic anemia type IV (CDAIV) is a rare inherited hematological disorder presenting severe anemia due to altered erythropoiesis and hemolysis, with variable needs for recurrent transfusions. We present a case of a transfusion-dependant male newborn who required an intrauterine transfusion and presented at birth with severe hemolytic anemia. Genetic testing rapidly identified a KLF1 gene mutation, a CDAIV variant. This case highlights the advantages of next-generation sequencing testing for congenital hemolytic anemia: diagnostic speed, guidance on natural history, and optimized clinical management and anticipatory guidance for parents and clinicians. We reviewed the literature for all CDAIV cases.

Background To assess the outcomes of pediatric patients with Undifferentiated Embryonal Sarcoma of the Liver (UESL) and treatment including at least surgery and systemic chemotherapy. Methods This study included patients aged up to 21 years with a pathological diagnosis of UESL prospectively enrolled from 1995 to 2016 in three european trials focusing on the effects of surgical margins, preoperative chemotherapy, use of radiotherapy (RT) and chemotherapy. Results Out of 65 patients with a median age at diagnosis of 8.7 years (0.6-20.8), 15 had T2 tumors, and 1 had lymph node spread, 14 were Intergroup Rhabdomyosarcoma Study (IRS) I, 9 IRSII, 38 IRSIII, and 4 IRSIV. Twenty-eight upfront surgeries resulted in 5 operative spillages and 11 infiltrated surgical margins, whereas 37 delayed surgeries resulted in no spillages (P= 0.0119) and 3 infiltrated margins (P=0.0238). All patients received chemotherapy, including anthracyclines in 47. Radiotherapy was administered in 15 patients. With a median follow-up of 78.6 months, 5 year overall and event free survivals (EFS) were 90.1% (95%CI 79.2-95.5) and 89.1% (95%CI 78.4-94.6), respectively. Two out 4 local relapses had previous infiltrated margins and 2 out of 3 patients with metastatic relapses received reduced doses of alkylating agents. Infiltrated margins (P=0.1607), T2 stage (P=0.3870), use of RT (P= 0.8731), and anthracycline-based chemotherapy (P= 0.1181) were not correlated with EFS. Conclusions Neoadjuvant chemotherapy for pediatric patients with UESL increases the probability of complete surgical resection. The role of anthracyclines and radiotherapy for localized disease remains unclear. The use of alkylating agents is recommended.

We consider a billiard system consisting on an infinite rod (a straight line) and a ball (a massless point) on the plane. The rod uniformly rotates around one of its points and experiences elastic collisions with the ball. We develop a mathematical model for dynamics of such a system and study the main properties (including asymptotics) of its motions.

Macrophyte habitats exhibit remarkable heterogeneity encompasses the spatial variation of abiotic and biotic components such as water condition changes, climates and anthropogenic stressors. Environmental factors have been proposed as important drivers in shaping genetic and epigenetic variation of aquatic plants, yet the linking between genetic diversity, epigenetic variation and environmental variables remain largely unclear, especially in clonal aquatic plants. Here, we applied population genetic and epigenetic analysis, in conjunction with the habitats discriminations to detail the environmental factors of which drive intraspecies genetic and epigenetic variations of Ceratophyllum demersum from a subtropical lake. Our results demonstrated that environmental factors were highly correlated to the genetic and epigenetic variation of C. demersum, temperature was a key driver in generating the genetic variation of this aquatic herb. Genetic and epigenetic variation were positively driven by water temperature, climate temperature was defined to exert negative effects on genetic and epigenetic variation. These findings indicate that the genetic and epigenetic variations of this clonal aquatic herb could not be related to the geographic feature, but driven by environmental hierarchal, which confers new benefits of temperature to local genetic and epigenetic variation in aquatic systems.