Understanding the drivers of morphological convergence requires investigation into its relationship with behavior and niche-space, and such investigations in turn provide insights into evolutionary dynamics, functional morphology, and life history. Mygalomorph spiders (trapdoor spiders and their kin) have long been associated with high levels of homoplasy, and many convergent features can be intuitively associated with different behavioral niches. Using genus-level phylogenies based on recent genomic studies and a newly assembled matrix of discrete behavioral and somatic morphological characters, we reconstruct the evolution of burrowing behavior in the Mygalomorphae, compare the influence of behavior and evolutionary history on somatic morphology, and test hypotheses of correlated evolution between specific morphological features and behavior. Our results reveal the simplicity of the mygalomorph adaptive landscape, with opportunistic, web-building taxa at one end, and burrowing/nesting taxa with structurally-modified burrow entrances (e.g., a trapdoor) at the other. Shifts in behavioral niche, in both directions, are common across the evolutionary history of the Mygalomorphae, and several major clades include taxa inhabiting both behavioral extremes. Somatic morphology is heavily influenced by behavior, with taxa inhabiting the same behavioral niche often more similar morphologically than more closely-related but behaviorally-divergent taxa, and we were able to identify a suite of 11 somatic features that show significant correlation with particular behaviors. We discuss these findings in light of the function of particular morphological features, niche dynamics within the Mygalomorphae, and constraints on the mygalomorph adaptive landscape relative to other spiders.

Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa, usually found in denture wearers. This case history report describes an example of the dentate patients with no history of wearing maxillary prostheses and highlights the importance of professional awareness to diagnose IPH among non-denture-wearing patients.

A 68-year-old African American male who presented to the emergency department with back and abdominal pain. Imaging showed a posterior mediastinal mass interposed between the carina, the left mainstem bronchus, and the descending thoracic aorta. Biopsy of the mass favored a metastatic prostate carcinoma, which is an extremely rare presentation.

This study assessed species diversity, abundance, and habitat association of medium and large-sized mammals in the Gelama block of Arsi Mountains National Park, Southeast Ethiopia. The study covered two seasons extending between February and August 2020. Based on the vegetation cover and topographic variation, the study area was stratified into four habitat types. A total of 74 transect lines were systematically established, 14 for Afroalpine, 26 for Ericaceous, 18 for Natural forest, and 16 for Mixed plantation. The survey for mammals was done by walking on foot along each transect. A total of 25 medium and large-sized mammals were recorded, including globally threatened and endemic mammals like Canis simensis and Tragelaphus buxtoni. Results showed a significant difference in the abundance of medium and large-sized mammals among the four habitat types: dry (χ2 =126.256, df =3, P=0.000) and wet (χ2 =74.822, df =3, P=0.000) seasons. During the dry season, the highest and lowest species diversity was recorded in the natural forest (H’=2.488) and mixed plantations (H’=2.154). During the wet season, ericaceous vegetation sheltered the highest diversity of mammalian species (H’=2.224), while mixed plantation forests inhabited the lowest species diversity (H’=1.788). The presence of food, cover, and water availability were the main factors for the differences in species diversity and abundance across the habitats. Phacochoerus africanus was the most abundant species during the dry (16.89%) and wet (18.81%) seasons. However, Felis caracal (0.14 during dry) and Panthera pardus (0.36 during wet season) were the least abundant species recorded. Occurrence of abundant species was associated with their feeding habits and physiological adaptation. Although the study area is home to different species of mammals, including endangered and endemics, livestock grazing and human encroachments are evident, putting strain on flora and fauna. Hence, conservation measures should be taken to ensure long-term conservation of the area.

This research has been done for several purposes: A) Simulating the distribution of potential habitats of the medicinal and endemic plant, Artemisia Khorasanica, B) Applying MaxEnt model utilizing a set of effective soil, geomorphological, climatic, and social-ecological variables; C) Identifying spatial options for rangeland restoration under future climatic scenarios, and D) Landscape evaluating and analyzing of habitat hot patches in scenarios. Alqurat basin is one of the habitats of the study species in South Khorasan province, Iran. The present study is conducted based on field and laboratory operations along with modeling in GIS (Geographic Information System) using a multi-stage methodology. The results of the Jackknife test showed that the variables of distance from dry rivers, roads and villages, slope direction, amount of silt and sand in the soil had the most significant impact on predicting the potential habitat of the study plant, respectively. The relatively small fluctuations between the areas of high- and medium-quality simulated habitats in RCPs scenarios indicate that this plant can survive in different climatic conditions and is not highly dependent on climate change. In other words, such conservation and restoration can be considered as insurance for ecosystems of arid and semi-arid regions since the possibility of damage due to climate change as predicted in the scenarios will be minimized. This research examined two options for rangeland ecosystems management, including “mere conservation” and “conservation along with restoration”, using landscape analysis. All metrics showed the superiority of the second option, which suggests that the sustainable conservation of hot patches depends on their interconnection and the maintenance of their ecological network connectivity. The results of this study might help the in-charge organizations and departments to identify the best potential habitat for A. Khorasanica and perform restorative operations in those areas with more confidence.

Introduction. The concept of ventricular anatomy as a single muscular band was initially described by Francisco Torrent-Guasp in 1972 1 and since then, there have been multiple novel contributions to the understanding of the morphology and function of the heart. To date, this concept has been supported and denied by multiple groups of professionals reflecting both the enthusiasm and resistance to the new concept of the single muscle band model. Currently, the single muscular band is the model that meets all the requirements to explain the performance of cardiac mechanics, and its distinctive feature to determine the characteristics of the structure.

Concurrence of a Kinase-dead BRAF and an OncogenicKRAS Gain-of-function Mutation in Juvenile Xanthogranuloma

Hematological toxicity (hematotoxicity) is the most common long-term adverse effect following the use of CD19-chimeric antigen receptor (CD19-CAR) T-cell therapies. However, its management remains unclear. We present the case of a 21-year-old who received CD19-CAR T-cell therapy for relapse following a haploidentical transplant. He developed hematotoxicity and consequently multiple life-threatening infections. We administered a CD34+ hematopoietic stem cell boost (HSCB) from his transplant donor that led to hematopoietic recovery and resolution of his infections without any effect on the activity of CD19-CAR T cells. CD34+ HSCB can be a safe and effective option to treat hematotoxicity following CD19-CAR T-cell therapy.

Objective: Patent ductus arteriosus (PDA) is a common complication among premature infants, and it may be responsible for prematurity-related complications, such as bronchopulmonary dysplasia (BPD). It is unclear whether different interventional methods contribute to the severity of BPD. To date, surgical ligation and the transcatheter approach have shown equal success in premature infants with hemodynamically significant PDA after medical treatment failure. Immediate improvement in the respiratory condition after transcatheter closure has been reported. However, the short-term pulmonary outcome has not been clarified yet. Methods: This retrospective study investigated infants born with a body weight less than 1000 g and underwent either surgical ligation or transcatheter closure of PDA in a single tertiary institution. The infants were divided into groups according to the type of procedure (surgical ligation or transcatheter occlusion). The primary outcome was the severity of BPD at discharge or at post-menstrual age of 36 weeks. The outcome was analyzed with logistic regression. Results: Forty-four patients met the inclusion criteria, and of these, 14 underwent transcatheter occlusion and 30 underwent surgical ligation. The overall birth body weight and gestational age ranges were not different. The univariate model revealed an association between the procedure type and BPD severity. The multivariate model confirmed associations of BPD severity with procedure type and severe respiratory distress syndrome requiring surfactant after adjusting for confounders. Conclusion: Compared with the transcatheter approach, surgery for PDA in extremely preterm infants is associated with severe BPD at discharge. Further large-scale studies are needed to determine the exact mechanism.

Here we present a case of metastatic PNET which arose from an immature teratoma that was refractory to standard Ewing sarcoma chemotherapy. This PNET was determined to have elevated levels of ALK protein via IHC. The patient was treated with crizotinib on a palliative basis with a sustained response.

An 83-year-old-male presented with obstructive jaundice, whose imaging was consistent with the cholangiocarcinoma of the distal common bile duct. The tumor markers were within normal limits. IgG4 level was raised, therefore, IgG4-sclerosing cholangitis was made as the provisional diagnosis. Steroid therapy was started to which he responded well.

Atrial myxoma is a benign cardiac tumor found most commonly in the left atrium. They mostly present with dyspnea, fatigue or palpitations. Previously undiagnosed left atrial myxoma presenting as stroke is extremely rare. Authors describe the case of a middle aged man with LA myxoma presenting with acute embolic stroke.

We present a fetus with bilaterally enlarged and echogenic kidneys. Prenatal testing detected compound heterozygosity for a 0.676 Mb de novo deletion and an inherited pathogenic variant in PKHD1. This is the first case of autosomal recessive polycystic kidney disease (ARPKD) with a prenatally detected disease-causing PKHD1 deletion.

Omental infarction is a rare cause of acute abdomen that can present in both the pediatric and adult populations causing adhesions or abscesses. Presentation may mimic appendicitis; however, ultrasonography may not be sufficient. We discuss the importance of CT imaging for the pre-surgical diagnosis to avoid serious port-site injuries.

Study Objective: To explore the effectiveness of a modified suspension method combined with Gasless single-port laparoscopy (MS-GSPL) for the treatment of benign ovarian tumors. The aim of this approach is to provide a convenient, economical,and minimally invasive method that is suitable for widespread use, even in middle- and low-income countries or primary hospitals. Design: A retrospective comparative study. Setting: University teaching hospital. Patients: Thirty-six cases were treated with MS-GSPL, and thirty-six cases were treated with single-port laparoscopy (SPL). Interventions: Use a modified suspension method combined with Gasless single-port laparoscopy for the treatment of benign ovarian tumors. Measurements and Main Results: There are no significant differences in age, body mass index,previous pelvic surgery, tumor diameter ,and tumor pathologic outcomes between MS-GSPL group and SPL group.The median operation times were 50(Q1~Q3 , 44~62.25)min in the MS-GSPL group and 60.5(Q1~Q3 , 57.25~78)min in the SPL group with a significant difference. The median estimated blood loss were 40 (Q1~Q3 , 30~50)ml in the MS-GSPL group and 50(Q1~Q3 , 30~60) ml in the SPL group with no significant difference. Compared with SPL group, patients in MS-GSPL group had earlier postoperative exhaust times, shorter hospital stays and lower costs, and all these differences were statistically significant(P<0.05). There was a strong positive correlation between operation time and BMI in the MS-GSPL groups. Conclusion: The patients receiving MS-GSPL treatment have quick postoperative recoveries. MS-GSPL is a novel, safe and economical surgical method that is suitable for extensive clinical development in middle- and low-income countries or primary hospitals.

Unsuccessful pessary fitting is the most common reason for discontinuation of pelvic organ prolapse treatment by causing discomfort, dislodge, erosion and infection. Commercial vaginal pessaries are produced in standardized sizes, and they do not fit in or be effective in some patients who do not have the match for a specific size. The personalized pessary was produced from the biocompatible, flexible thermoplastic polyurethane filament from 3D printer with the aid of genital hiatus measurements obtained with 3D transperineal ultrasound. We present the steps of design, manufacturing and successful middle-term use of a personalized 3D--printed thermoplastic polyurethane pessary

Objective: This study aimed to evaluate the differences in maternal renal function between singleton and twin pregnancies in the second half of pregnancy. Design: Retrospective study Setting: Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital from January 2019 to June 2021. Population: This study included 1711 pregnant women with 1547 singleton pregnancies and 164 twin pregnancies. Methods: Patients underwent renal function tests (serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate [eGFR]) at least one month prior to delivery. Main Outcome Measure: Maternal renal dysfunction, defined as serum creatinine of above 0.8 mg/dL. Results: Serum creatinine level was significantly higher and eGFR was significantly lower in twin pregnancies than that in singleton pregnancies (p < 0.001). In addition, the rate of renal dysfunction was significantly higher in twin than that in singleton pregnancies (7.9% vs. 2.6%; p < 0.001). Multivariate analysis revealed that twin pregnancy (odds ratio [OR] 3.38), nulliparity (OR 2.31), and preeclampsia (OR 3.64) were significant risk factors for maternal renal dysfunction. Maternal renal dysfunction was observed in 13 twin pregnancies, all of which recovered to within normal limits during the postpartum period. Conclusions: Twin pregnancy is a significant risk factor for maternal renal dysfunction. Careful attention should be paid to maternal renal dysfunction in the management of twin pregnancies. Funding: Japanese Red Cross, Nagoya Daiichi Hospital Research Grant (grant number NFRCH22-0011). Keywords: chorionicity, renal function, serum creatinine concentration, singleton pregnancy, twin pregnancy

Objectives To evaluate pregnancy and postnatal outcomes of fetuses with NT between 95th and 99th percentile and whether they could benefit from further investigations rather that routine scans. Design Retrospective multicenter observational study. Setting Two Italian Fetal Medicine centre Population All cases with NT between 95th and 99th percentile (667) among women undergoing NT measurement between January 2015 and December 2020. Methods Unfavourable outcome was considered as: miscarriage or intrauterine fetal death (IUFD), chromosomal abnormality/genetic syndrome, major malformation or neurodevelopmental delay. Study population outcomes were compared with general population. Main Outcome Measures Unfavourable pregnancy and postnatal outcomes. Results The rate of unfavourable outcome was 25.44%. We reported: 6 (0.90%) second trimester miscarriage or IUFD, 90 (13.49%) chromosomal abnormalities/genetic syndromes, 57 (8.55%) major malformations, 13 (1.95%) cases of neurodevelopmental delay. The incidence of chromosomal abnormalities/genetic syndromes and major malformations were significantly higher (OR 6.99 (IC 95% 4.33 - 11.28), p<0.001 and OR 17.77 (IC 95%7.22 - 43.75), p<0.001 respectively) compared to the general population. The incidence of neurodevelopmental delay was not increased (OR of 0.64 CI 95% 0.33 - 1.24 p=0.185). Conclusions Fetuses with NT between 95th and 99th percentile have an increased risk of pregnancy and postnatal adverse outcomes. According to our data it is reasonable to consider a lower NT cut off (NT>95th percentile) for offering further investigations such as detailed ultrasound scan, fetal echocardiography and counselling where the option of performing fetal karyotype and CGH array should be discussed. Funding The authors have no funding to declare.

A document by Amlan Ray. Click on the document to view its contents.

Objective: To investigate whether the Antenatal Late Preterm Steroids (ALPS) trial, has been translated into clinical practice in Canada and the United States. Temporal trends in optimal and suboptimal antenatal corticosteroid (ACS) use among late preterm deliveries were also assessed. Design: A retrospective cohort study. Setting: USA and Canada, 2007 to 2020. Population: All live births in the US (n= 32,476,039) and Nova Scotia, Canada (n= 116,575). Methods and Main outcome measured: Using data from the Natality database and the Nova Scotia Atlee Perinatal Database, ACS administration within specific categories of gestational age was assessed by calculating rates per 100 live births. Temporal trends in optimal, and suboptimal ACS use were also assessed. Results: In Nova Scotia, the rate of any ACS administration increased significantly among women delivering at 35-36 weeks, from 15.2% in 2007-2016 to 19.6% in 2017-2020 (OR 1.36, 95%CI 1.14, 1.62). In the U.S., among live births at 35-36 weeks’ gestation, any ACS use increased from 4.1% in 2007–2016 to 18.5% in 2017–2020 (OR 5.33, 95% CI 5.28–5.38). Among infants between 24 and 34 weeks’ gestation in Nova Scotia, 32% received optimally timed ACS, while 47% received ACS with suboptimal timing. Of the women who received ACS in 2020, 34% in Canada and 20% in the United States delivered at ≥37 weeks. Conclusion: Publication of the ALPS trial resulted in increased ACS administration at late preterm gestation in Nova Scotia, Canada and the U.S.. However, a significant fraction of women receiving ACS prophylaxis delivered at term gestation.

Aim: Cisplatin causes acute kidney injury (AKI) in approximately one-third of patients. Serum creatinine and urinary output are poor markers of cisplatin-induced (AKI). Metabolomics was utilized to identify predictive or early diagnostic biomarkers of cisplatin-induced AKI. Methods: Thirty-one adult head and neck cancer patients receiving cisplatin (dose ≥ 70 mg m2 -1) were recruited for metabolomics analysis. Urine and serum samples were collected prior to cisplatin (pre), 24-48 hours after cisplatin (24-48h), and 5-14 days (post) after cisplatin. Based on serum creatinine concentrations measured at the post timepoint, 11/31 patients were classified with clinical AKI. Untargeted metabolomics was performed using liquid chromatography-mass spectrometry. Results: Metabolic discrimination was observed between “AKI” patients and “no AKI” patients at all timepoints. Urinary glycine, hippuric acid sulfate, 3-hydroxydecanedioc acid, and suberate were significantly different between AKI patients and no AKI patients prior to cisplatin infusion. Urinary glycine and hippuric acid sulfate were lower (-2.22-fold and -8.85-fold), whereas 3-hydroxydecanedioc acid and suberate were higher (3.62-fold and 1.91-fold) in AKI patients relative to no AKI patients. Several urine and serum metabolites were found to be altered 24-48 hours following cisplatin infusion, particularly metabolites involved with mitochondrial energetics. Conclusion: We propose glycine, hippuric acid sulfate, 3-hydroxydecanedioc acid, and suberate as predictive biomarkers of predisposition to cisplatin-induced AKI. Metabolites indicative of mitochondrial dysfunction may serve as early markers of subclinical AKI.

C 4 crops such as Zea mays (maize) and Sorghum bicolor (sorghum) are important in both food and bioenergy systems. In these crops, carbon assimilation is limited at high heat by the thermolabile protein rubisco activase (RCA). We present a comparative study of assimilation and RCA function in the C 4 grasses maize, sorghum, and the C 4 model grass Setaria viridis (setaria) during a 48 hour heat stress acclimation. Western blots and biochemical assays show that each species uses a different strategy to acclimate to heat. All grasses shift the predominant ꞵ proteoform of RCA from a 41kD to a 43kD form. In addition, sorghum expresses the ⍺ isoform, while all three grasses transiently increase expression of the ꞵ isoform. The response of RCA to magnesium ions and to ADP is also altered. After heat treatment, maize RCA is more sensitive to inhibition by magnesium but loses sensitivity to ADP. Different cultivars of maize show differences in assimilation and protein expression. Because each grass expressed and regulated RCA differently, we recommend that future study of RCA should examine each grass individually rather than relying on a model organism.

The linkage of stomatal behavior with photosynthetic processes is critical to understanding water and carbon cycles under global change. The slope ( g1) of stomatal conductance ( gs) versus CO 2 assimilation ( Anet) serves as a proxy of the marginal water cost of carbon acquisition and the trade-off between carbon gain and water loss. Here we use g1 to assess species differences in the response of stomatal behavior to experimental climate change manipulations, asking whether generalizable patterns exist across species and climate contexts. A total of 17,727 Anet- gs measurements made in a long-term open-air experiment under ambient and +3.3°C warming, and ambient and ~40% summer rainfall reduction provided > 2,700 estimates of g1 across 21 boreal and temperate tree species. All species became more conservative in their water use (lower g1) in warming and/or reduced rainfall treatments because of lower soil moisture. In contrast to these phenotypic responses, species from warmer and drier habitats tended to have slightly higher g1 and to be the least sensitive to the decrease in soil water. Overall, both warming and rainfall reduction consistently made stomatal behavior more conservative in terms of water loss per unit carbon gain across 21 species and a decade of experimental observation.

Abstract: Throughout evolutionary history, animals are finely tuned to adjust their behaviors corresponding to environmental variations. Behavioral flexibility represents an important component of a species’ adaptive capacity in the face of rapid anthropogenetic environmental change, and knowledge of animal behaviours is increasingly recognized in conservation biology. In aquatic ecosystem, variation of water depth is a key factor affecting the availability of food, thus the foraging behaviours of many waterbirds, especially piscivores. In this study, we compared the foraging behaviours of Scaly-sided Merganser (Mergus squamatus), an endangered migratory diving duck endemic to east Asia, in habitats with different water depth, using video camera records obtained from the known wintering sites during three winters from 2018-2020. Further, the energy expenditure of foraging behavior profile and energy intake based on fish sizes were calculated to study the foraging energetics. In total, 200 effective video footages that contained 1,086 minutes with 17,995 behaviours and 163 events of catching fish were recorded. Results showed that 1) time length for fishing (including eye-submerging, head-dipping, diving and food handling) of Mergus squamatus in shallow waters was significantly more than in deep waters; 2) Mergus squamatus spent significantly more time for preparing (including vigilance, preening and swimming) in deep waters than in shallow waters; 3) the mean catch rate was 0.28 fish/minute in shallow waters, which is significantly higher than the value of 0.13 fish/minute in deep waters; 4) despite the distinct foraging behaviour profiles and energy intakes, Mergus squamatus showed similar energetics in shallow and deep waters. We concluded that Mergus squamatus is a good example of behavioural flexibility that aligns with expectations of optimum foraging theory, in that it behaves in accordance to resource availability in different environments, resulting in high foraging efficiency. The behavioural flexibility can be related to its evolution history.