Alfalfa ( Medicago sativa L.) establishment is an effective strategy of managing desertification in arid regions; however, the course of artificial alfalfa grassland degradation remains poorly understood. Therefore, we investigated the dynamics of vegetation characteristics, soil edaphic factors, and rhizosphere microbial community structure in the course of artificial alfalfa grassland degradation. A space–for–time substitution approach was used to select nine alfalfa stands with different ages (1–50 years old) in the loess hilly region of northwest China. According to the plant diversity of vegetation and important value of alfalfa, the course of grassland degradation could be divided into three stages, artificial grassland (1–10 years), transitional grassland (10–30 years), and natural grassland (>30 years). With an increase in stand age, alfalfa productivity first increased, up to a maximum in the 7-year-old stand, and then decreased. Alfalfa was replaced as the dominant species by Stipa bungeana in the 50-year-old stand. Soil bulk density, total organic carbon, and major nutrient contents were the highest in the artificial grassland. Soil enzyme activity and the relative abundances of potentially beneficial microorganisms (e.g., Mortierella and Glomus) peaked in the transitional grassland. Soil water content and total porosity reached the maximum levels in the natural grassland. The species diversity indices of bacterial and fungal communities first increased and then decreased over time. Both microbial abundance and species diversity in the 0–20-cm soil layer were higher than in the 20–40-cm soil layer. Soil pH and catalase activity predominantly influenced vegetation characteristics, while total and available phosphorus contents were the major edaphic factors shaping rhizosphere microbial community structure. The results indicated that alfalfa establishment altered soil structure considerably, and improved soil fertility in the artificial grassland over the short term. Consequently, soil enzyme activity, microbial diversity, and potentially beneficial microorganisms in the rhizosphere increased during the transitional stage. Following considerable shifts in the soil environmental conditions, alfalfa was no longer the only dominant species and was eventually replaced by S. bungeana, leading to the establishment of a stable natural grassland system.

Herein we present a case of a right ventricular (RV) thrombus in a patient with arrhythmogenic cardiomyopathy (ACM). The 24-year old female patient was diagnosed with ACM after echocardiography and cardiac magnetic resonance imaging. Interestingly, at echocardiography, an unusal thrombus formation was detected at RV lateral wall. Also, CMR confirmed the thrombus and oral anticoagulant therapy was started. Even in arrhythmogenic right ventricular cardiomyopathy patients thrombi are rarely reported. However, the development of imaging techniques may enable more frequent detection and effective treatment of thrombi in these patients.

BACKGROUND Accessory cavitated uterine malformations, or mass (ACUM) is a Mullerian anomaly which increasingly recognized as a cause of severe dysmenorrhoea and pelvic pain. OBJECTIVE To know what ACUMs are and recognize their clinical presentation, able to diagnose an ACUM using ultrasound or MRI; and counsel patients with ACUMs on the different management options, including conservative, medical, and surgery. CONCLUSION AND WIDER IMPLICATION ACUMs are less rare than previously believed; hence ACUM diagnosis is essential in clinically suspicious cases via ultrasound and MRI, and intra-operative assessment of uterine morphology and laparoscopic surgical excision is the definitive treatment for ACUM.

Climate change is a public health emergency, and its global impact on women's health has been well-described. As a key tool in this arena, social prescribing enables climate-conscious, cost-effective, and holistic solutions to many patient concerns by encouraging local, environmentally friendly care that can effectively prevent carbon-heavy outpatient appointments and surgical procedures. A variety of obstetric and gynaecological issues can be tackled through this route, including menorrhagia, labour choices, and vaginal pessaries. Existing evidence suggests that there is great scope for the development of social prescribing programs that can pave the way for collective action towards greener, holistic patient care.

A document by Tahira Akram. Click on the document to view its contents.

Disturbance and environmental change may cause communities to converge to a steady state, diverge towards multiple alternative states, or remain in long-term transience. Yet, empirical tests of these successional trajectories are rare, especially in systems experiencing multiple concurrent anthropogenic drivers of change. We compared competing models of succession in grassland communities subjected to disturbance and nitrogen fertilization using data from a long-term (22-year) experiment. Regardless of disturbance, after a decade communities settled on equilibrium states largely determined by resource availability, with species turnover declining as communities approached dynamic equilibria. Species favored by the disturbance were those that eventually came to dominate the highly fertilized plots. Furthermore, disturbance made successional pathways more direct, revealing an important interaction effect between nutrients and disturbance as drivers of community change. Our results underscore the dynamical nature of grassland succession, demonstrating how community properties such as beta-diversity change through transient and equilibrium states.

BACKGROUND: Clinic pharmacists have been shown to identify and resolve medication related problems post-discharge, however, the impact on patient clinical outcomes is unclear. AIMS: To identify hospital-based post-discharge pharmacist clinics that provide medication review; report the patient clinical outcomes measured; and describe the activities of the clinical pharmacist. METHODS: Published studies evaluating a patient clinical outcome following a post-discharge hospital clinic pharmacy service were included. All studies needed a comparative design (intervention vs usual care). Pubmed, Embase, CINAHL, PsycnINFO, Web of Science, IPA and APAIS-Health databases were searched to identify studies. The type of clinic and the clinical pharmacist activities were linked to patient clinical outcomes. RESULTS: Fifty-seven studies were included in the final analysis, 14 randomised controlled trials and 43 non-randomised studies. Three key clinic types were identified: post-discharge pharmacist review alone, inpatient care plus post-discharge review and post-discharge collaborative clinics. The three main outcome metrics identified were hospital readmission and/or representation, adverse drug events, and improved disease state metrics. There was often a mix of these outcomes reported as primary and secondary outcomes. High heterogeneity of interventions and clinical pharmacist activities reported meant it was difficult to link clinical pharmacist activities with the outcomes reported. CONCLUSIONS: A post-discharge clinic pharmacist may improve patient clinical outcomes such as hospital readmission and representation rates. Future research needs to provide a clearer description of the clinical pharmacist activities provided in both arms of comparative studies.

Domen Pregeljc1, Janja Skok1, Tina Vodopivec1, Nina Mencin1, Andreja Krušič1, Jure Ličen1, Kristina Šprinzar Nemec1, Aleš Štrancar1, Rok Sekirnik1,*1BIA Separations d.o.o., a Sartorius company, Mirce 21, 5270 Ajdovščina, Slovenia*correspondence: Rok Sekirnik, BIA Separations d.o.o., Mirce 21, 5270 Ajdovščina, SloveniaTel.: +386 59 699 500; Fax: +386 59 699 599E-mail: rok.sekirnik@biaseparations.comKeywords: mRNA; in vitro transcription; HPLC; chromatography; analytics; vaccines.Abbreviations:ARCA: Anti-reverse cap analogDTT: dithiothreitolEDTA: Ethylenediaminetetraacetic acidGFP: green fluorescent proteinGTP: guanidine triphosphateHPLC: high pressure liquid chromatographyIVT: in vitro transcriptionLNP: lipid nanoparticleNTP: Nucleoside TriphosphatemRNA: messenger ribonucleic acidRNAP: RNA polymerase enzyme

Background: Hyperimmune convalescent COVID-19 plasma (CCP) containing anti-SARS-CoV-2 neutralizing antibodies (NAbs) was proposed as a therapeutic option for patients early in the new coronavirus disease pandemic. The efficacy of this therapy depends on the quantity of neutralizing antibodies (NAbs) in the CCP units, with titers > 1:160 being recommended. The standard neutralizing tests (NTs) used for determining appropriate CCP donors are technically demanding and expensive and take several days. We explored whether they could be replaced by high-throughput serology tests and a set of available clinical data. Methods: Our study included 1302 CCP donors after PCR-confirmed COVID-19 infection. To predict donors with high NAb titers, we built four (4) multiple logistic regression models evaluating the relationships of demographic data, COVID-19 symptoms, results of various serological testing, the period between disease and donation, and COVID-19 vaccination status. Results: The analysis of the four models showed that the chemiluminescent microparticle assay (CMIA) for the quantitative determination of IgG Abs to the RBD of the S1 subunit of the SARS-CoV-2 spike protein was enough to predict the CCP units with a high NAb titer. CCP donors with the respective results >6000 AU/ml SARS-CoV-2 IgG had an 80% probability of attaining high NAb titers. Including additional variables such as donor demographics, clinical symptoms, or time of donation into a particular predictive model did not significantly increase its sensitivity and specificity. Conclusion: A simple quantitative serological determination of anti-SARS-CoV-2 antibodies alone is satisfactory for efficiently predicting CCP donors with high titer NAbs.

A tipping point is a critical transition point where a system is impending to collapse under a slight disturbance. Based on sequential time-series data, such transition can be captured by early warning signals like critical slowing down. However, sequential time-series data is limited for most macro-ecosystems, which brings the challenge for practical application. Here we report that density fluctuation, a purely spatial metric, robustly indicates the tipping point of Ising-type ecosystems. Ricker model and an agroecosystem, both of which have been proved to fall in Ising universality class, are used as prototypes to illustrate how density fluctuation captures the tipping point from instantaneous spatial configurations. The agroecosystem demonstrates experimental evidence that the existence of an Ising-type tipping point depends on the dynamics properties of the system. In addition to detecting tipping points, early warning signals were able to infer ecological processes from spatial patterns of the agroecosystem. As spatially high-resolution data are becoming increasingly available, density fluctuation offers a novel perspective on anticipating tipping points and identifying ecological processes from spatial patterns.

Excessive radical induced cationic frontal polymerization lead to a decline of material propertiesAbstract: Radical induced cationic frontal polymerization (RICFP) can significantly improve the curing efficiency of epoxy resins. However, conditions such as excessive initiators lead to violent reaction of the frontal polymerization, which will adversely affect the performance of the product. Herein, the effect of the reaction degree on the tensile strength of RICFP-cured bisphenol A epoxy resin was studied, and the optimum ratio was measured by response surface methodology. Components and molecule structures of the products were analyzed by GC/MS, FTIR and XPS. The principle that overreaction affects the tensile strength of products was further explained. In addition, it was found that the epoxy value of resin may determine whether RICFP could be achieved. This could be remedied by adding ethylene glycol diglycidyl ether, which could significantly promote the reactivity. Its principle and overreaction were further studied and explained.Keywords: Radical induced cationic frontal polymerization; Rapid curing bisphenol A epoxy resin; UV initiated polymerization; Overreaction;

An endemic mammal mountain nyala has declined substantially in number and range of its distribution. Thus, Ecological monitoring is essential for conservation. Past ecological studies on mountain nyala focused more on demography, dynamics and social organization of the species but less attention was paid to the diet composition and preferences. Thus, the aim of this study was to assess diet composition and preferences of mountain nyala in Bale Mountains National Park (BMNP), Ethiopia. The study was conducted from September 2017 – January 2018 during both wet and dry seasons. Direct observation scan sampling method was employed to collect behavior data in two habitat types namely; Gaysay grassland and woodland (park head quarter) of BMNP. Scan sampling of target group selected were carried out for 10 minutes in 15 minutes interval and routine follow up were carried out (early morning and late afternoon) to identify plant species consumed by the species and the frequency of consumption of each plant species consumed. Nutrient proximate analysis of representative plant species from highly, moderately and least preferred plant species were conducted to understand governing principle that determine selective grazing and browsing. A total of 32 plant species out of 85 plant species available classified under 18 families were recorded during the study period. Mountain nyala are selective mixed feeders (mostly grazers) and predominantly folivores. Moreover, a clear seasonal dietary pattern was found in this study. In general the findings of this study imply that preference for forage species could be explained by nutritional quality. Consequently, increasing the abundance of preferred plant species is expected to benefit mountain nyala.

Pacemaker implantation via subclavian venipection is a common procedure.A patient who had a pacemaker implanted via subclavian venipection developed a massive hemothorax 21 hours after surgery.The video-assisted thoracic surgery(VATS) showed that the left subclavian artery branch ruptured and bled,and titanium clip was used to clamp and stop bleeding. For patients with difficulty in puncture process,even if it is confirmed that the device is inserted into the subclavian vein,it is important to be vigilant against damaging adjacent arteries in the process, and strict electrocardiograph monitoring should be conducted after surgery. Once hemothorax appears,VATS should be performed in conjunction with the surgeon to locate the bleeding point and stop the bleeding.

Local adaptation is a major driver of biological diversity, and related species may develop analogous (parallel evolution) or alternative (divergent evolution) solutions to similar ecological challenges. We expect these adaptive solutions between closely related organisms would culminate in both phenotypic and genotypic signals. In this study, we employ a reciprocal transplant, glasshouse experiment with two Eucalyptus species ( E. grandis and E. tereticornis) with large, overlapping distributions grown under contrasting ‘local’ temperature conditions (tropic and temperate) to investigate the independent contribution of adaptation, plasticity, and their interaction at molecular, physiological and morphological levels. We find key traits differ in their response. The link between gene expression and traits markedly differed between species. Divergent evolution was the dominant pattern driving adaptation as unique gene responses (91% of all significant genes) was the greatest factor driving differentiation; but overlapping gene (homologous) responses were dependent on the determining factor (plastic, adaptive, or genotype by environment interaction). 98% of the plastic homologs were similarly regulated, while 50% of the adaptive homologs and 100% of the interaction homologs were antagonistically regulated. Therefore, parallel evolution for the adaptive effect in homologous genes was greater than expected but not in favour of divergent evolution. Further, heat shock proteins for E. grandis were almost entirely driven by adaptive responses, while plasticity drove the response in E. tereticornis. These results suggest divergent molecular evolutionary solutions dominated the adaptive mechanisms among species, even in similar ecological circumstances. Thus, trees with overlapping distributions are unlikely to equally persist in the future, suggesting that management of future forests to changing temperature conditions must be species specific.

Patagonia is an understudied area, especially when it comes to population genomic studies with relevance to fishery management. However, the dynamic and heterogeneous landscape in this area can harbor important but cryptic genetic population structure. Once such information is revealed, it can be integrated into the management of infrequently investigated species. Eleginops maclovinus is a protandrous hermaphrodite species with economic importance for local communities that is currently managed as a single genetic unit. In this study, we sampled five locations distributed across a salinity cline from Northern Patagonia to investigate the genetic population structure of E. maclovinus. We use Restriction-site Associated DNA (RAD) sequencing and outlier tests to obtain neutral and adaptive loci, using FST and GEA approaches. We identified a spatial pattern of structuration with gene flow and spatial selection by environmental association. Neutral and adaptive loci showed two and three genetic groups, respectively. The effective population sizes estimated ranged from 572 (Chepu) to 14,454 (Chaitén) and were influenced more by locality than salinity cline. We found loci putatively associated with salinity suggesting that salinity may act as a selective driver in E. maclovinus populations. These results suggest a complex interaction between genetic drift, geneflow, and natural selection in this area. Our findings suggest several units in this area, and the information should be integrated into the management of this species. We discuss the significance of these results for fishery management and suggest future directions to improve our understanding of how E. maclovinus is adapted to the dynamic waters of Northern Patagonia.

anomalous pulmonary veins drain into the right side of the left atrium is an uncommon variety of anomalous pulmonary venous return. Rarely, anomalous pulmonary venous drainage combined with cor triatriatum and atrial septal defect. We presented the imaging findings of a male patient who had anomalous pulmonary venous drainage which has not previously been described.

Background: Influenza is a persistent public health problem associated with severe morbidity and mortality. Drug use is related to myriad health complications, but the relationship between drug use and severe influenza outcomes is not well understood. The study objective was to evaluate the relationship between drug use and severe influenza-associated outcomes. Methods: Data were collected by the Influenza Hospitalization Surveillance Network (FluSurv-NET) from the 2016-2017 through 2018-2019 influenza seasons. Among persons hospitalized with influenza, descriptive statistics and logistic regression models were used to analyze differences in demographic characteristics, risk and behavioral factors, and severe outcomes (intensive care unit [ICU] admission, mechanical ventilation, or death) between people who used drugs (PWUD), defined as having documented drug use within the past year, and non-PWUD. Results: Among 48,430 eligible hospitalized influenza cases, 2,019 were PWUD and 46,411 were non-PWUD. PWUD were younger than non-PWUD and more likely to be male, non-Hispanic Black or Hispanic/Latino, smoke tobacco, abuse alcohol, and have chronic conditions including asthma, chronic liver disease, chronic lung disease, or immunosuppressive conditions. PWUD had greater odds of ICU admission and mechanical ventilation, but not death compared with non-PWUD. Opioid use specifically was associated with increased risk of ICU admission and mechanical ventilation. Conclusion: PWUD had greater odds of ICU admission and mechanical ventilation than non-PWUD hospitalized with influenza. These results support targeted initiatives to prevent influenza and associated severe outcomes among this population.

A 50-year-old woman presented to our hospital with shortness of breath on exertion and nocturnal dyspnea. She had undergone total aortic arch replacement for Stanford type A aortic dissection 17 years previously and was taking prednisolone for systemic lupus erythematosus. Computed tomography showed that the 63-mm ascending aorta near the proximal anastomosis site compressed the superior vena cava and right atrium. Cardiac catheterization showed occlusion of the left anterior descending branch. The patient underwent urgent surgery for ascending aortic aneurysm and coronary artery occlusion. Microscopic examination revealed that the aneurysm was true. This report highlights that in patients with systemic lupus erythematosus, aortic aneurysms can reoccur even after total arch replacement.

Background: The identification of protein-protein interactions is of great challenge. Therefore, we conducted this study to fabricate a gold surface biochip with activated sophorolipids in combination with 16-amino-1-hexadecanethiol hydrochloride. Methods: We designed a direct on-chip immunological assay strategy for measuring ligand-receptor interactions in a forward or reverse manner, that is, a ligand was immobilized on the biochip surface and allowed to interact with its specific free receptor in the liquid phase and vice versa. The specificity of molecular interactions on the biochip was evaluated using an immunological blocking assay and a chemiluminescent immunoassay. To test the potential utilization of biochip, we used the serum of hemophagocytic lymphohistiocytosis (HLH) patients as an experimental entity. Results: The receptor CD25-based IL-2 and ligand IL-2-based CD25 assays revealed that the detection limits on the biochip were as low as 156pg/mL and 78pg/mL, respectively. Meanwhile, using the receptor- or ligand-based platforms, we found that the positive rates of free IL-2 and soluble CD25 (sCD25) monomers in the sera of HLH patients were 14.3% and 71.4%, respectively, like our previous specific-antibody-based biochip investigation. Also, the biochip shared a good compatibility with CLIA assay in the measurement of sCD25(r=0.77, P<0.01). Conclusions: The biochip platform can be expanded to protein-specific serological diagnosis as a potential substitute for immunoprecipitation and ELISA to understand the interactions between proteins, ligands and receptors, and enzymes and substrates.

Background: Secondary bacterial pneumonia is an important complication of seasonal influenza, but little data is available about impact on death and risk factors. This study identified risk factors for all-cause in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza. Methods: A retrospective cohort study was performed at a tertiary teaching hospital in southwest China. The study cohort included all adult hospitalized patients with a laboratory-confirmed, community-acquired influenza virus infection during three consecutive influenza seasons from 2017 to 2020. Cause-specific Cox regression was used to analyze risk factors for mortality and secondary bacterial pneumonia, respectively, accounting for competing events (discharge alive and discharge alive or death without secondary bacterial pneumonia, respectively). Results: Among 174 patients enrolled in this study, 14.4% developed secondary bacterial pneumonia and 11.5% died during hospitalization. For all-cause in-hospital mortality, time-varying secondary bacterial pneumonia was a direct risk factor of death (cause-specific hazard ratio [csHR] 3.38, 95% confidence interval [CI] 1.25-9.17); underlying disease indirectly increased death risk through decreasing the hazard of being discharged alive (csHR 0.55, 95% CI 0.39-0.77). For secondary bacterial pneumonia, the final model only confirmed direct risk factors: age ≥65 years (csHR 2.90, 95% CI 1.27-6.62), male gender (csHR 3.78, 95% CI 1.12-12.84) and mechanical ventilation on admission (csHR 2.96, 95% CI 1.32-6.64). Conclusions: Secondary bacterial pneumonia was a major risk factor for in-hospital mortality among adult hospitalized patients with community-acquired influenza. Prevention strategies for secondary bacterial pneumonia should target elderly male patients and critically ill patients under mechanical ventilation.

As a rapidly developing cell engineering technique, cell electrofusion has been increasingly applied in the field of hybridoma preparation in recent years. However, electrofusion is a certain degree of difficulty to completely replace the polyethylene glycol-mediated cell fusion. The key elements limiting electrofusion in the field of hybridoma preparation are practical complicated. This review summarizes the state of art of cell electrofusion in hybridoma preparation based on recent published literatures, mainly focusing on electrofusion instruments and their components, process control, cell treatment, and process characterization. The review provides new information and insightful commentary, critically important to the promotion of further electrofusion development in the field of hybridoma preparation.

Microinjection is a method commonly used to deliver various substances into cells. The procedure is performed on a widefield microscope stage using fine glass needle to penetrate the cell membrane. Microinjection can be carried out using a manual or semi-automatic mode. For commercially available equipment currently reported microinjection success rate and cell viability are relatively low (around 50% for both indicators). Here, for the first time, we systematically show how the microinjection effectiveness and cell viability are influenced by needle diameter and chosen microinjection mode. We found that manual mode entailed a higher injection rate, reducing cell viability at the same time. The reduction in needle diameter caused a significant increase in cell survival rate and a slight decrease in success rate for both modes. Our findings will help optimize this method in the context of cell biology research.

COVID-19 infection affects respiratory system; thus, air pollution and meteorological factors also contribute majorly to its transmission. This study is aiming to estimate and comprehend the linkages between contribution of PM 2.5 concentrations and meteorological parameters to spreading coronavirus infection in Gurugram, a badly affected city of India due to COVID-19 pandemic. We employed some statistical analysis on daily average data of PM 2.5 concentrations and meteorological constraints with daily COVID-19 cases during March 2020-February 2022. Time series analysis was conducted to optimize PM 2.5 concentrations associated with COVID-19 cases. The Pearson correlation test was applied to investigate the correlations between PM 2.5 concentrations, meteorological parameters, and COVID-19 cases. The PCA was applied to reveal the most significant factor attributable to affect the rate of COVID-19 transmission in Gurugram. The highest cases of COVID-19 (25,7375) were observed in the month of February when PM 2.5 concentration was 286.6µg/m 3, 12.64˚C temperature, 73.81% RH and 68.265 km/h wind speed; while minimum cases (3125) were found in the month of March with the 18.18µg/m3 PM 2.5 concentration, 10.62˚C temperature, 50.05% RH, and 83.295km/h wind speed. The principal component analysis revealed that the daily COVID-19 cases were significantly positively correlated with PM 2.5 concentrations, RH, and temperature. However, daily COVID-19 cases were negatively or poorly correlated with wind speed. COVID-19 pandemic is prominently affected by PM 2.5 while RH and temperature were found as important meteorological factors significantly affect its human-to-human transmission. This study may provide the useful indications to regulatory bodies to modify the environmental health policies.

Herein, we discuss a case in which L-FABP measurements were used to manage a 46-year-old male patient receiving VA-ECMO support. His mean blood pressure was ≥ 75 mmHg for the first 24 h after the initiation of VA-ECMO, and he experienced a rapid decrease in L-FABP.