A 52-year-old woman presented with malignant ventricular arrthythmogenesis intraoperatively during kyphoplasty for an osteoporotic fracture of a lumbar vertebra. No previous cardiovascular condition was known. Causes of arrhythmogenesis associated with the procedure were excluded. Due to her positive family history for dilated cardiomyopathy, upcoming thoughts were made for unmasking a previous asymptomatic cardiomyopathy. Nevertheless, an intracardiac cement embolism was diagnosed and, finally, the patient underwent an open heart surgery with successful removal of the cardiac cement while no new arrhythmogenic episode was recorded during follow up.

Abstract Background and purpose: 5-Hydroxytryptamine (5-HT) can enhance human ureteral contractions. However, the mediating receptors have not been clarified yet. The study sought to further characterize the mediating receptors using several more selective antagonists and agonists. Experimental approach: Human distal ureters were obtained from 88 patients undergoing cystectomy. The mRNA expression levels of 5-HT receptors were examined using RT-qPCR experiments. The phasic contractions of ureter strips, either spontaneous or evoked with neurokinin, were recorded in an organ bath. Key results: Among the 13 5-HT receptors, 5-HT2A and 5-HT2C had the highest mRNA expression levels. 5-HT (10-7–10-4 M) concentration-dependently increased the frequency and baseline tension of phasic contractions. However, a tachyphylaxis effect was observed. SB242084 (100 nM) and ketanserin (100 nM), which are 5-HT2C selective and non-selective antagonist, respectively, shifted the 5-HT concentration-response curves (frequency and baseline tension) rightward. 5-HT2C selective agonist, vabicaserin, increased contraction frequency with an Emax of 35% of 5-HT. 5-HT2A selective antagonist, volinanserin (100 nM), only reduced baseline tension. The selective antagonists of 5-HT1A,1B, 1D, 2B, 3, 4, 5, 6, and 7 had no antagonism. Blockade of voltage-gated sodium channels, α1-adrenergic receptors, adrenergic neurotransmission, and neurokinin-2 receptors using tetrodotoxin, tamsulosin, guanethidine, and Men10376, respectively, and desensitizing sensory afferents using capsaicin (100 μM), significantly reduced 5-HT effects. Conclusion and implications: 5-HT enhanced ureteral phasic contractions mainly by activating 5-HT2C. Activation of sympathetic nerve and sensory afferents partly contributed to 5-HT effects. 5-HT and 5-HT2C receptors could be promising targets for ureteral stone expulsion and ureteral colic relief.

Place recognition technology is very important for autono-mous driving. To realize the large-scale recognition task of 3D point clouds, we propose a large-scale 3D point cloud place recognition framework based on graph neural networks, which combines local and global features. In extracting features, instance segmentation is performed on the large scene point clouds first, and then the GNN network trains each segmented instance to obtain local attribute features. We construct a graph model with each object as a node and the relationship between them as edges, then obtain the global topological structure features of the scene. In calculating similar scores, we calculate the similarity vector of the global and local feature through a similarity network and cosine similarity, respectively. Finally, we fuse the similarity vectors and calculate the final similarity score. This paper uses the SemanticKitti and nuScenes datasets to verify the proposed method. Compared with the state-of-the-art deep learning-based place recognition method, the proposed method achieves the best results in the SemanticKitti and nuScenes datasets.

Anomaly detection is widely used in manufacturing and medical imaging. We propose a self-supervised defect detection method based on multi-scale feature fusion, which can effectively improve the detection and localization accuracy. The method of pseudo-defect construction was used to enhance the training data. To make the pseudo-defects more realistic, the extreme point of feature heatmap was used as the anchor point of the defect area, and the defect image was fused with the original image to construct the pseudo-defect. A multi-scale feature fusion network was proposed that utilizes the self-attention mechanism and the interaction between multi-scale features to extract semantic features containing rich contextual information to improve detection and localization accuracy further. The proposed method achieved competitive experimental results on both the MVTec AD and Chest X-ray datasets. Compared with other pseudo-defect simulation methods, the heatmap-based pseudo-defect construction method improves by at least 2%. It achieves comparable results with other state-of-the-art defect detection methods.

Congenital coronary artery fistula is a relatively rare cardiac anomaly accounting for 0.2-0.4% of all congenital heart defects, and when isolated, is commonly asymptomatic. We present a case of an asymptomatic 9-year-old boy who underwent successful surgical repair of a right coronary artery fistula to the right ventricle.

Behcet's disease is a systemic autoimmune disorder occasionally associated with otological manifestations, including sensorineural hearing loss. We are reporting a case of Behcet's disease, which was complicated by sensorineural hearing loss and managed successfully with anti-TNF agent Infliximab.

Signet ring cells consider one of the rare diagnosis that can be managed among the oncological diseases.Confined on poor prognosis and advancement of their stage.Not seems to be affected properly with the chemotherapy. And still the surgical option is the best in operable case to decrease the burden

In this study, the Zn nanoparticles was synthesized using the peel extract of Citrus aurantium. The nanoparticles was characterized by different chemical technique including UV-Vis. and FT-IR spectroscopy, and SEM technique. The results revealed a spherical shape in the average ‎size of 41.17 nm was identified for the green-synthesized nanoparticles. In the antioxidant test, the IC50 of nanoparticles and BHT against DPPH free radicals were 115 and 96 µg/mL, respectively. In the cellular and molecular part of the recent study, the treated cells with nanoparticles were assessed by MTT assay for 48h about the cytotoxicity and anti-human gastric cancer properties on normal (HUVEC) and gastric cancer cell lines i.e. NCI-N87 and MKN45. The IC50 of nanoparticles were 278 and 256 µg/mL against NCI-N87 and MKN45 cell lines, respectively. The viability of malignant gastric cell line reduced dose-dependently in the presence of Zn nanoparticles. It seems that the anti-human gastric cancer effect of recent nanoparticles is due to their antioxidant effects. After evaluating the effectiveness of this formulation in clinical trial researches, it can be a good alternative to chemotherapy drugs.

1. IntroductionMycotoxins as toxic secondary metabolites are included in over 300 chemical compounds. They are frequent contaminants of crops e. g., corn kernel, and tree nuts and fruits (1). Mycotoxins are produced by fungi species, which due to their thermo stability can remain present in food and crop commodities even after removing the fungus (2). Among mycotoxins, aflatoxin is a potent mycotoxin that is naturally produced from a number of fungi species e. g., Aspergillus species (3).The four major aflatoxins (AFs) i. e., aflatoxin B1 (AFB1), aflatoxin B2 (AFB2), aflatoxin G1 (AFG1), and aflatoxin G2 (AFG2), are of great importance owing to the pose a considerable risk to human health and widespread occurrence (4). In addition, AFB1 is considered one of the most potent naturally produced carcinogens that are labeled as group 1 of carcinogenic compounds to humans by the International Agency for Research on Cancer (IARC) (5). In a putative pathway of carcinogenicity, AFB1 in cytochrome P450 is metabolized to AFB1-8-9-epoxide, and then covalently reacts with DNA (6). Therefore, the level of aflatoxins in food is regulated in more than 100 countries. For instance, the US Food and Drug Administration (FDA) has set the maximum allowable level of 20 µg/kg of the total concentration of aflatoxins (AFT) for all foods intended for human consumption (7). Also, the Food and Drug Administration of Iran (IFDA) defined a maximum level of 5 µg/kg for AFB1 and 15 µg/kg for an AFT in crops (8).Numerous studies have reported corn and corn flour contamination with AFs in Iran. For instance, (9) monitored the amount of AFB1 in corn samples from 2006 to 2008 in different regions of Iran i. e., Fars, Khuzestan, and Ardabil province in Iran. The authors found that the average AFB1 contamination was 0.9, 2.12, and 36.39 µg/kg for Fars; 14.41, 35.93, and 1.61 µg/kg for Khuzestan; 15.63, 57.67, and 154.13 µg/kg for Ardabil province. In another study, (10) collected corn samples, aimed at animal feed and human consumption, from Kermanshah and Mazandaran provinces, Iran, which were analyzed using high-performance liquid chromatography (HPLC) for monitoring AFs contamination. In this regard, the authors reported that AFB1 was detected in 58.3% of the corn samples obtained from Kermanshah province. The maximum detected level of AFB1 and total level of AFs (AFT) contamination were 276.3 μg/kg and 316.9 μg/kg, respectively. Also, the average level of AFT from contaminated samples was 52.60 μg/kg which exceeded all the maximum permitted levels regulated for AFT.On the other hand, corn is widely used in the dry milling process to produce products for human consumption and animal feed. Corn dry milling is a four-step procedure that comprises grain handling and milling, liquefaction and saccharification, fermentation, and co-product recovery. In this regard, Ground corn is cooked and liquefied to dextrins, then dextrins are hydrolyzed into fermentable sugars using the saccharification process. During fermentation, the fermentable sugars by means of microorganisms such as saccharomyces cerevisiae are converted to ethanol and carbon dioxide (11). Also, it should be noted that the fermentation and hydrolysis process can take place separately, separate hydrolysis and fermentation (SHF), or simultaneously, known as simultaneous saccharification and fermentation (SSF) (7,12). Also, distiller’s dried grains with solubles (DDGS) are a co-product of dry-milled ethanol production and can be used as animal feed (13). Moreover, as we know, AFs are transferred and accumulated into different body parts after consumption and pose a major threat to human health as these toxins play a major role in a number of health problems e. g., cancer, blood, and nerve defects (14). Therefore, it is necessary to monitor and determine the distribution of AFs in the product of the corn dry milling.Therefore, this study aimed to contaminate a sample of corn with a high level of AFs using Aspergillus parasiticus and evaluate the fate of AFs during fermentation of corn using Saccharomyces cerevisiaeunder both enzymatic and acidic hydrolyses process of starch, based on corn dry milling process.

The steady states of an isotone electric system are described by an isotone function with respect to the componentwise order. When there are steady states, we highlight a dominant steady state and we study its domain of attraction for the fixed point iteration method.

Species distribution models (SDMs) are practical tools to assess the habitat suitability of species with numerous applications in environmental management and conservation planning. The manipulation of the input data to deal with their spatial bias is one of the advantageous methods to enhance the performance of SDMs. However, the development of a model parameterization approach covering different SDMs to achieve well-performing models has never been implemented. We integrated input data manipulation and model tuning for four commonly-used SDMs; generalized linear model (GLM), gradient boosted model (GBM), random forest (RF), and maximum entropy (MaxEnt), and compared their predictive performance to model geographically imbalanced biased data of a rare species complex of mountain vipers. Models were tuned up based on a range of model-specific parameters considering two background selection methods; random and background weighting schemes. The performance of the fine-tuned models was assessed based on a recently identified localities of the species. The results indicated that although the fine-tuned version of all models shows great performance in predicting training data (AUC > 0.9 and TSS > 0.5), they produce different results in classifying out-of-bag data. The GBM and RF with higher sensitivity of training data showed more different performances. The GLM, despite having high predictive performance for test data, showed lower specificity. It was only the MaxEnt model that showed high predictive performance and comparable results for identifying test data in both random and background weighting procedures. Our results highlight that while GBM and RF are prone to overfitting training data and GLM over-predict non-sampled areas MaxEnt is capable of producing results that are both predictable (extrapolative) and complex (interpolative). We discuss the assumptions of each model and conclude that MaxEnt could be considered as a practical method to cope with imbalanced-biased data in species distribution modeling approaches.

We present a case of erythema elevatum diutinum. A biopsy of the skin lesion showed a significant increase of neutrophils, fragmented nuclei, and fibrinoid necrosis of vascular tissue in the middle and deep layers of the dermis. The patient's condition was stabilized after treatment of IVIg.

Abstract Objective: To develop and validate a nomogram to predict severe postpartum haemorrhage (PPH) following caesarean delivery. Design: Two-centre retrospective cohort study. Setting: Third Affiliated Hospital of Guangzhou Medical University and the Dongguan Maternal and Child Health Care Hospital. Population: Cesarean delivery patients from the Third Affiliated Hospital of Guangzhou Medical University were divided into a development cohort (n=11,037) and an internal validation cohort (n=4,673). Cesarean delivery patients from the Dongguan Maternal and Child Health Care Hospital (n=13,775) were enrolled in the external validation cohort. Methods: The nomogram was based on independent risk factors for severe PPH obtained by multivariate logistic regression. We evaluated the discrimination and calibration of the nomogram in the development and validation cohorts. The area under the receiver operating characteristic curve, the Hosmer-Lemeshow test, and calibration plots were used to assess the nomogram. Main outcome measures: Postpartum haemorrhage. Results: Severe PPH occurred in 4.5%, 4.3%, and 2.0% of the patients in the development, internal validation, and external validation cohorts, respectively. The nomogram used data including previous caesarean delivery, low pre-pregnancy weight, placenta previa, and placenta accreta spectrum disorders. The area under the curves of the nomogram in the internal and external validation cohorts were 0.915 (95% confidence interval, 0.893–0.938) and 0.799 (95% confidence interval, 0.764–0.834), respectively. Consistency between the predicted and actual probabilities was observed in both validation cohorts. Conclusions: The nomogram displayed good calibration and discrimination; thus, it can be used for screening and timely intervention by clinicians, thereby reducing severe PPH incidence.

Objectives: To investigate the effect of chemotherapy cycles on survival outcomes in small cell neuroendocrine carcinoma of cervix (SCNEC). Methods: Clinical records of 103 biopsy-proven SCNEC were identified from Sun Yat-sen University Cancer Center. The cycles-dependent effect of chemotherapy on survival was estimated by restricted cubic splines (RCS) based cox regression model. Results: Through RCS analysis, we observed an inverse correlation between chemotherapy cycles and progression/death; the risks (hazard ratio [HR]) of progression/death decreased sharply until 5 cycles of chemotherapy. Long-course chemotherapy (≥5 cycles) was associated with significantly superior PFS (≥5 vs 1-4: median PFS, 58.6 months vs 25.4 months, P =0.027) and prolonged OS (≥5 vs 1-4: median OS, 65.1 months vs 37.7 months, P =0.168) than short-course chemotherapy (1-4 cycles). Subgroup analyses suggested that chemotherapy courses had significant interaction with FIGO stage; the survival benefit of long-course chemotherapy was identified in FIGO IIB-IIIC (HRPFS 0.41, 95% CI 0.18-0.92; HROS 0.41, 95% CI 0.17-0.95), rather than FIGO I-IIA (HRPFS 0.67, 95% CI 0.34-1.34; HROS 0.88, 95% CI 0.40-1.97). Additionally, chemotherapy regimen was observed to be relevant to survival outcomes; EP regimen demonstrated obvious prolonged PFS (median PFS: EP vs non-EP, 44.7 months vs 18.0 months) and OS (median OS: EP vs non-EP, 63.3 months vs 41.0 months) than those treated with non-EP regimen. Conclusion: Chemotherapy with ≥5 cycles significantly improved PFS and OS in FIGO stage IIB-IIIC SCNEC, whereas a short course of <5 cycles was adequate for FIGO I-IIA disease.

Objective Examine experiences of termination of pregnancy (TOP) in South Australia to recommend areas for service improvement following decriminalisation legislation. Design Qualitative case study. Setting Online semi-structured interview. Participants The case study was an example of the unheard, complex and distressing circumstance of TOP due to fetal anomaly diagnosis. The case was selected from larger sample (N=8) of adults who had recently had a TOP in South Australia as a subgroup from a larger study looking at the potential missed opportunities of health professionals to provide access to contraception prior to abortion. Methods Semi-structured, in depth, qualitative interview. Qualitative description using thematic content analysis identified significant aspects of the participant’s story pertaining to potential health service improvements. Results The participant experienced trauma navigating a difficult care pathway following a diagnosis of fetal anomaly. They described inadequacy of labels for pregnancy such as planned, unplanned, wanted, unwanted, the framing of abortion through the lens of ‘choice’, and confusion about service referrals and inappropriate communication by health professionals. Not being able to have a partner accompany her through the process of having a TOP due to COVID-19 restrictions resulted in extreme distress. Conclusion Abortion services need clear care pathways that are context specific, and patient centred. The language and attitudes of health professionals can result in distressing experiences of TOP. Further investigation of the relationship between infection control strategies and trauma in health service provision is warranted to improve future pandemic responses.

A document by Warda Rasool. Click on the document to view its contents.

A document by Hajira touheed. Click on the document to view its contents.

We consider the inverse coefficient problem of simultaneously determining the space dependent electric potential, the zero-th order coupling term and the first order coupling vector of a two-state Schrödinger equation in an infinite cylindrical domain of R n , n≥2, from finitely many partial boundary measurements of the solution. We prove that these n+3 unknown scalar coefficients can be Hölder stably retrieved by ( n+1)-times suitably changing the initial condition attached at the system.

Abstract Objective: To compare rates of urinary retention and postoperative urinary tract infection between women with immediate versus delayed removal of indwelling catheter following benign non-hysterectomy gynecological laparoscopic surgery. Design: This randomized clinical trial was conducted between February 2012 and December 2019, with follow-up to six weeks, in two university-affiliated hospitals in Sydney, Australia. Population: Study participants were 693 women over 18 years of age, undergoing non-hysterectomy laparoscopy for benign gynecological conditions, excluding pelvic floor or concomitant bowel surgery. Methods: 355 participants were randomized to immediate, and 338 to delayed removal of urinary catheter. Main Outcome Measures: The co-primary outcomes were urinary retention (assessed by trial of void and need to re-catheterize) and urinary tract infection. Secondary outcomes included readmission, analgesia requirements, duration of hospitalization and validated bladder function questionnaires. Results: Urinary retention for participants in the immediate removal group was statistically higher at 8.2% (95% CI: 5.7% to 11.4%) vs. 4.2% (95% CI: 2.7% to 7.2%) in the delayed removal group (p=.03). There was no statistically significant difference in the rates of urinary tract infection between the groups at 7.2% (95% CI:4.7% to 10.8%) in the delayed group vs. 4.7% (95% CI: 2.8% to 7.8%) in the immediate group. Conclusions: Rates of urinary retention and urinary tract infection following non-hysterectomy benign gynecological laparoscopy are low. There is a small increased risk of urinary retention with immediate compared with delayed removal of urinary catheter. These findings can be used to counsel patients regarding postoperative bladder care.

Phytoalexin plays an important role in plant immunity. However, the mechanism of how phytoalexin is induced by beneficial microorganisms against broad-spectrum pathogens remains elusive. This study showed that B. cereus AR156 could trigger ISR against broad-spectrum disease. RNA-seq and camalexin content assays showed that AR156-triggered ISR can induce the accumulation of phytoalexin such as camalexin synthesis and secretion-related genes. Moreover, it was found that AR156-triggered ISR elevates camalexin accumulation by increasing the expression of camalexin synthesis genes upon pathogen infection. Further studies revealed that WRKY33 was required for the induction of camalexin accumulation by AR156 during the pathogen infection. Compared to the control inoculated with Phytophthora capsici and Botrytis cinerea only, the biomass of P. capsici and B. cinerea in AR156 pretreated wrky33 mutant plants were quite similar. AR156-induced ISR resistance to Pseudomonas syringae pv. tomato DC3000 ( Pst DC3000) was significantly attenuated in the wrky33 mutant. Furthermore, the study reveals that AR156 could up-regulate the expression level of PEN3 and PDR12, which act as camalexin transporter. In addition, we found that PEN3 and PDR12 served as positive regulators involved in AR156-triggered ISR against pathogens. Specifically, PEN3 and PDR12 participated in AR156-triggered ISR against fungi and oomycetes, while PEN3 was involved in AR156-triggered ISR against Pst DC3000. In summary, B. cereus AR156 triggered induced systemic resistance against B. cinerea, Pst DC3000 and P. capsici by priming of phytoalexin synthesis and secretion. Our study first proposed that the WRKY33 as a core factor is involved in regulating AR156-induced accumulation and secretion of phytoalexin, and we deeply elucidated the mechanism of AR156-induced phytotoxin accumulation resistance to broad-spectrum pathogens.

Marine drifting animals — zooplankton — play essential ecological roles in the pelagic ecosystem, transferring energy and elements to higher trophic levels, such as fishes, cetaceans, and others. Zooplankton are generally considered passive drifting organisms homogeneously distributed throughout waters, where high dispersal is expected. Although empirical observations have demonstrated that many species possess active swimming mechanisms that generate metacommunities with high beta diversity, the role of animal sizes in the process of marine zooplankton community dynamics remains unexplored. Here, we collected a total of 48 size-fractionated zooplankton samples in the vicinity of a coral reef island with environmental gradients and performed metatranscriptome analyses. The samples were collected in two transects (from nearshore to offshore) twice a day (morning and night). Sample size fraction was the only variable that rendered apparent differences in species composition between the samples. Our results demonstrate differential dispersal through the size fractions — smaller size fraction communities had higher compositional homogeneity than larger ones. Contrary to expectation, distance to shore had no significant influence on the composition or diversity of zooplankton communities. This study offers novel insights on the use of metatranscriptomics for analyzing community structures and the role size plays for the marine zooplankton community assembly processes.

Primary malignant pericardial mesothelioma (PMPM) is a rare pericardial malignant tumor. Most of the manifestations are localized or diffuse masses surrounding the heart. Because of the difficulty of surgical resection, the prognosis of diffuse PMPM is poor, while the edge of localized PMPM is clear and easy to be resected, but it is difficult in diagnosis Timely diagnosis and proper treatment are the key to a good prognosis. Here, we report a patient with localized PMPM and describe the diagnostic method for the diagnosis of the disease.

Kawasaki Disease (KD) is a systemic vasculitis of small and medium arteries, preferably affecting coronary arteries. It is one of the most frequent causes of acquired heart disease in children. Despite being comprehensively studied, its etiopathogenesis is not totally explained. The surgical procedures usually become necessary during the late follow-up and may be coronary artery bypass grafting, cardiac defibrillator implantation with or without cardiac resynchronization therapy, or cardiac transplantation.

Background: Ovarian tumors are the second most cause of cancer-related mortality in women, with a wide range of histological diagnoses. It is responsible for 6% of all malignancies. Despite the fact that it is one of the curable tumors due to its susceptibility to anticancer medicines, it seldom causes symptoms until the disease has progressed widely. The goal of our research is to establish the type of various ovarian tumors as well as the frequency and distribution of various neoplastic lesions in the past. Methods: 201 ovarian tumors were retrospectively collected from 8691 gynecology cases seen in the outpatient clinic at the maternity and children’s hospital in Al Madinah Al Munawara, Saudi Arabia [from January 2015 to January 2019] to determine the frequency of different histological patterns of ovarian tumors in our hospital. Results: The majority of ovarian tumor cases, 186 cases, (92.54 percent) were benign, although 13 cases (6.47 percent) were malignant, and the other two cases were borderline (1%). Epithelial tumors were the most prevalent histological pattern seen in the investigation (69.8 percent). Serous cyst adenoma and teratoma were the most prevalent benign tumors, whereas serous cystadenocarcinoma and mucinous cystadenocarcinoma were the most common malignant tumors. Conclusion: Epithelial tumors are the most prevalent ovarian tumors in our study. Germ cell tumors were in second place, followed by epithelial ovarian tumors, which are more prevalent in adults and adolescents. Patients with malignant ovarian tumors frequently come in later stages of the disease, hence late reporting is prevalent.