The purpose of this paper is to give a necessary and sufficient condition for the existence and non-existence of global solutions of the following semilinear parabolic equations u t = Δ u + ψ ( t ) f ( u ) , in Ω × ( 0 , t ∗ ) , under the Dirichlet boundary condition on a bounded domain. In fact, this has remained as an open problem for a few decades, even for the case f ( u ) = u p . As a matter of fact, we prove: there is no global solution for any initial data if and only if ∫ 0 ∞ ψ ( t ) f ( ‖ S ( t ) u 0 ‖ ∞ ) ‖ S ( t ) u 0 ‖ ∞ dt = ∞ for every nonnegative nontrivial initial data u 0 ∈ C 0 ( Ω ) . Here, ( S ( t ) ) t ≥ 0 is the heat semigroup with the Dirichlet boundary condition.

Delayed but Successful T Cell Immune Reconstitution Following Umbilical Cord Blood Transplantation Conditioned with Thymoglobulin alone in IL-7Rα-mutated SCID Eman T. Al-Antary, MD1,5, Mary Caverly, CPNP2, Steve Buck3, Sharat Chandra, MD4, Süreyya Savaşan, MD1-3, 5

Background. Prior to the introduction of vaccines, COVID-19 hospitalizations of non-institutionalized persons in Connecticut disproportionately affected communities of color and individuals of low socioeconomic status (SES). Whether the magnitude of these disparities changed 7-9 months after vaccine rollout during the Delta wave is not well documented. Methods. All initially hospitalized patients with laboratory-confirmed COVID-19 during July-September 2021, were obtained from the Connecticut COVID-NET database, including patients’ geocoded residential addresses. Census tract measures of poverty and crowding were determined by linking geocoded residential addresses to the 2014-2018 American Community Survey. Age-adjusted incidence and relative rates of COVID-19 hospitalization were calculated and compared to those from July-December 2020. Vaccination levels by age and race/ethnicity at the beginning and end of the study period were obtained from Connecticut’s COVID vaccine registry and age-adjusted average values were determined. Results. There were 708 COVID-19 hospitalizations among community residents of the two counties, July-September 2021. Age-adjusted incidence was highest among non-Hispanic Blacks and Hispanic/Latinx compared to non-Hispanic Whites ((RR 4.10 (95% CI 3.41-4.94) and 3.47 (95% CI 2.89-4.16)). While RR decreased significantly among Hispanic/Latinx and among the lowest SES groups, it increased among non-Hispanic Blacks (from RR 3.1 (95% CI 2.83-3.32) to RR 4.10). Average age-adjusted vaccination rates among those >12 years were lowest among non-Hispanic Blacks compared to Hispanic/Latinx and non-Hispanic Whites (50.6% vs 64.7% and 66.6%). Conclusions. While racial/ethnic and SES disparities in COVID-19 hospitalization have mostly decreased over time, disparities among non-Hispanic Blacks increased, possibly due to differences in vaccination rates.

Loss of consciousness during delivery by cesarean section under spinal anesthesia is a rare but potentially serious complication. We report a case of a pregnant woman with unicuspid aortic valve, which was incidentally diagnosed during an aortic valve replacement after transient loss of consciousness during cesarean section.

We present a patient who has been diagnosed with Hypereosinophilic syndrome, later determined to be chronic eosinophilic leukemia, after long-term treatment with infliximab for ulcerative colitis. Follow-up immunochemistry showed that discontinuation of infliximab improved the polyclonality of eosinophils in our patient.

Initially, there was little data on the safety of immunization against COVID-19 infection in pregnant women. However, previous studies revealed no safety concerns for pregnant women or newborns who received an mRNA COVID-19 vaccine during pregnancy. Therefore, this study aimed to investigate the effects of COVID-19 vaccination on perinatal outcomes. Methods: This cross-sectional study. It started from January 2022 to June 2022. The questionnaire was developed and validated by experts. This study included all women admitted to the postpartum ward who were more than 18 years old and had received the COVID-19 vaccine. The study excluded women without proof of their vaccination status or who could not complete the questionnaire. The primary outcome was the effect of COVID-19 vaccination on gestational age and birth weight. Results: A total of 365 participants. The mean gestational age of the unvaccinated women was 38.83 ± 1.62 weeks (p < 0.001), higher than that of vaccinated women (37.69 ± 2.9 weeks). However, the average birth weight for the unvaccinated women was 2.96 ± 0.4 kg (p = 0.89) and for vaccinated women (2.97 ± 0.66 kg). Conclusion: COVID-19 vaccination, regardless of the type of vaccine received before, during, or after pregnancy, is not associated with any unfavorable perinatal outcomes.

Iatrogenic orbital emphysema from chest tube insertion is a rare but potentially serious complication due to potential optic neuropathy from orbital compartment syndrome. Herein, we present a rare case of orbital emphysema in the setting of pneumothorax and chest tube insertion.

A 53-year-old lady presented with an 18-month history of an erythematous pruritic rash 3 weeks following the COVID Moderna vaccination booster. Following this she developed a tan like colour to her skin with evidence of tiny white crystals over the superficial layer in keeping with a diagnosis of uraemic frost.

Ossified cephalhematoma (OCH) is a rare condition, especially when it presents as a skull lesion in the older pediatric population, which can managed with craniectomy and en-bloc excision of the organized hematoma.

In this letter, a novel sext-band bandpass filter (BPF) using two split-type multiple-mode resonators is proposed. The filter is composed of two sets of resonators which are respectively designed to realize Filter 1 with two passbands and Filter 2 with quad passbands. Then the two BPFs are combined by parallel coupling feed lines for sext-band responses, and each of the six centre frequencies in the proposed sext-band BPF is able to be controlled due to the design freedom. To validate the design and analysis, a prototype filter has been fabricated with six passbands centered at 1.88/2.59/3.48/5.26/5.82/6.75 GHz. The measured result of the fabricated filter agrees well with the simulation, which shows that the proposed structure is a good candidate for sext-band BPF designs and validates the proposed design flow well.

Introduction. In this prospective multicenter analysis, we aimed to investigate the predictive role of neutrophil/lymphocyte ratio (NLR) in permanent pacemaker implantation (PPI) in patients undergoing transcatheter aortic valve replacement (TAVR). Material and methods. 179 consecutive patients without previous PPI underwent TAVR from February 2017 to September 2021. Patients were further divided based on presence (n=48) and absence of conduction abnormalities (CAs) at hospital admission (n=131). Results . In patients with previous CAs, NLR values did not differ significantly between patients requiring PPI (n=16, 33%) and those not requiring it. In contrast, in patients with no CAs at hospital admission, NLR values measured at admission and on TAVR day were significantly higher in patients requiring PPI (n=17, 13%) (4.07±3.22 vs 3.01±1.47, p=0.025, and 10.81±7.81 vs 5.84±3.78, p=0.000, respectively). Multivariable analysis showed that NLR at TAVR day was an independent predictor of PPI in patients without CAs (OR 1.294; 95% CI 1.028-1.630; p=0.028), but not in those with previous CAs. ROC curve analysis showed that the cut point was a NLR value of >7.25. Time to PPI was delayed till 21 days in patients without CAs. Conclusions. In this prospective study, higher NLR values on the day of TAVR day were associated with an increased PPI rate in patients undergoing TAVR with no previous CAs. It is advisable, being inflammation part of the process, to prolong the time of observation for all patients without CAs till at least 21 days not to miss any new CA necessitating PPI.

Title pageTitle : Letter to the Editor: Percardiac closure of large apical ventricular septal defects in infants: Novel modifications and mid-term results

We report a case of redo mitral and tricuspid valve repair via right thoracotomy under hypothermia and systemic potassium administration with axillary artery cannulation in a patient after coronary artery bypass grafting (CABG) with patent bilateral internal thoracic artery (ITA) grafts crossing over the sternum. Redo mitral valve surgery is challenging through re-sternotomy as previous CABG with patent ITA poses a risk of injury due to dense adhesion. Herein, dangerous dissection around the aorta and functional ITA grafts was avoided by performing the procedure under systemic hypothermia via thoracotomy. Furthermore, considering the presence of atheroma in the aorta, the axillary artery was used as a perfusion route to prevent stroke events. Performing axillary artery cannulation and right thoracotomy under hypothermic cardiac arrest with systemic hyperkalemia without clamping the patent bilateral ITAs and aorta allowed us to execute redo mitral valve surgery after CABG without major postoperative cardiac or cerebral complications.

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Current classifications of Cor Triatriatum Sinister (CTS) do not address the associated heart defects or single ventricle pathology. Therefore, these classifications are not prognostic classifications and only describe the anatomy and the pulmonary venous drainage. The proposed classification considered the associated congenital cardiac lesions and the single ventricle pathology, therefore, it could have prognostic value. Future multicenter studies are required to measure the performance of this classification and its prognostic value in patients with CTS.

The authors conducted a prospective, observational study to evaluate the correlation of fluid responsiveness with commonly used carotid doppler-derived indices like carotid artery blood flow (CBF), carotid corrected flow time (FTc), respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak) in patients undergoing CABG. They claimed that altough only ΔVpeak demonstrated some predictive power with areas under receiver operating characteristic (AUROC) of 0.671, carotid doppler ultrasound indices were found to be not dependable as a substitute for invasive methods to assess fluid responsiveness. The presence of studies advocating quite different sentiments in the literature regarding feasibility and reliability show that there is a long way gone and a long way to go.

A document by Zaid ElHusseini. Click on the document to view its contents.

Selective oxidation at low temperatures without alkali of biomassis a promising and sustainable avenue to manufacture glycolic acid (GA), a biodegradable functional material to protect the environment. However, producing glycolic acid with high selectivity and yield using the traditional research and development approach is time-consuming and labor-intensive. To this context, a hybrid deep learning framework driven by data and reaction mechanisms for predicting sustainable glycolic acid production was proposed, considering the lack of related reaction mechanisms in the machine learning algorithms. Results showed that the fully connected residual network exhibited superior performance (average R2=0.98) for the multi-task prediction of conversion rate, GA, and by-product yields, therefore employed for the following super parameters optimization by the genetic algorithm. The L further identifies that using the optimized operating parameters, the fossil energy demand and greenhouse emissions have decreased by 2.96% and 3.00%, respectively.

Objective: To study the incidence of sinonasal mucormycosis in active and post COVID-19 patients in a district-level hospital in India. Study Design: A prospective, interventional cohort study conducted from April 2021 to January 2022. Setting: A district-level/secondary level hospital in North India. Methods: Inclusion Criteria: All COVID-19 positive patients with diabetes mellitus as co-morbidity and with at least one of the following:received steroid therapy and/or on high flow oxygen therapy and/or had prolonged hospital stay (>7 days). Exclusion Criteria: Patients already immunocompromised/having malignancy/organ transplant recipients. Clinical workup: History, examination, imaging (CECT/MRI nose and paranasal sinuses if indicated), diagnostic nasal endoscopy + Nasal scrapings for KOH mount to detect fungal elements. Results: Fourteen out of 250 patients tested positive for Mucormycosis (incidence 5.6%). Out of these 13 were symptomatic and only one patient was asymptomatic and detected on screening. No significant difference was found in mucormycosis vs. non-mucormycosis group with respect to HbA1c status, vaccination status or steroid + oxygen treatment (p>0.05 in all scenarios). Patients were treated with intravenous Liposomal Amphotericin B and surgical debridement when indicated. Two succumbed to disease (survival 85.7%). A clinical screening protocol was thus developed which can be used as an effective tool even at far-flung and remote healthcare facilities for diagnosis and timely referral of patients. Conclusion: Mucormycosis is a potentially lethal disease which needs rapid diagnosis and timely action to decrease morbidity and mortality.

The four-color problem was first posed by Francis Guthrie in 1852. It remained unsolved for over a century. Although computer-assisted proofs emerged in last 50 years, they were somewhat the "machine-checkable proof", which were hardly checked by human readers. In this paper, a novel method of rotation inspired by a rotation principle from Zhuan Falun book of Falun Dafa has been developed to prove the Four Color Theorem.

The health monitoring for disease diagnosis and prognosis in a desired smart medical structure is realized by interpreting the health data. The advances in sensor technologies and biomedical data acquisition tools have led to the new era of big data, where different sensors collect massive medical data every day. This special issue explores the latest development in emerging technologies of biomedical engineering, including big medical data, artificial intelligence, cloud/fog computing, federated learning, ubiquitous computing and communication, internet of things, wireless technologies, and, security and privacy. The biological wearable sensors can enhance the decision-making and early disease diagnosis processes by intelligently investigating and collecting large amounts of biomedical data (i.e., big health data). Hence, there is a need for scalable advanced learning, and intelligent algorithms that lead to reliable and interoperable solutions to make effective decisions in emergency medicine technologies. The optimization algorithms can be used in order to acquire the sensor data from multiple sources for fast and accurate health monitoring.

Introduction: While steerable sheaths are widely used to improve catheter stability and contact force during radiofrequency (RF) catheter ablation in patients with atrial fibrillation (AF), steerable sheaths are less commonly used during transseptal puncture. This study evaluated whether left atrial catheterization efficiency can be improved using the VersaCross combined steerable sheath and transseptal system compared to previous standard workflow. Methods: This study retrospectively analyzed AF ablation performed using the Versacross Workflow consisting of VersaCross steerable sheath and RF wire for transseptal puncture and catheter ablation (VCW) to the standard workflow using a fixed curve sheath with RF needle followed by exchange for an Agilis steerable sheath for catheter ablation (STW). Results: Thirty patients underwent RF ablation for paroxysmal or persistent AF, 15 using the VCW and 15 using the STW. Transseptal puncture time was 10.8 mins faster with the VCW compared to the standard workflow (20.9 ± 5.9 min vs. 31.7 ± 15.1 min; p=0.024). Time to left atrial catheterization was 40% faster with the VCW compared to the STW (21.3 ± 5.8 min vs. 35.2 ± 14.4 min; p=0.003). Overall procedure time was 14.2 min faster in the VCW compared to the STW (86.3 ± 16.1 min vs. 100.5 ± 19.3 min; p=0.044). Conclusions: Use of the VersaCross steerable system significantly reduced time to transseptal puncture, time to left atrial catheterization, and overall RF ablation time.

A document by Rob Salguero-Gómez. Click on the document to view its contents.

Protein folding has been one of the most difficult problems for over a half-century,The random thermal motions causing conformational changes that lead energetically downhill towards the native structure, a principle captured in funnel-shaped energy landscapes.Unfolded polypeptides have a wide range of possible conformations. The search problem becomes intractable for classical computers due to the exponential growth of potential conformations with chain length. So far, there is theoretical and experimental evidence that solving such optimization problems using Quantum Computing approaches such as Quantum Annealing, VQE, and QAOA has an advantage. Although Google's DeepMind-AlphaFold has accomplished much,But we can go even further with the quantum approach.Here we show how to predict structure of protein as well as RNA folding using the Variational Quantum Eigensolver with Conditional Value at Risk (CVaR) expectation values for the solution of the problem and for finding the minimum configuration energy and our task is to identify a protein's minimal energy structure. The protein's structure is optimized to reduce energy. Also making sure that all physical constraints are met and encoding the protein folding problem into a qubit operator.