IntroductionHematopoietic stem cell transplant (HSCT) is an important treatment modality for patients with both benign and malignant hematological diseases [1].Tremendous advances have occurred in the field of stem cell transplant with the use of mismatched and haploidentical donors and improved supportive care to prevent graft versus host disease enabling more patients to undergo transplant safely. Patients undergoing stem cell transplant are at an increased risk of bacterial, viral and fungal infections [2]. Patients have severe neutropenia in the immediate peri-transplant period and are at highest risk of bacterial infections [3, 4]. Infection is the most common cause of morbidity and mortality in patients undergoing transplants [5,6]. There can be several reasons for high rates of infections in these patients [7]. Bacteremia occurs in as high as 20% of patients [8].Multiorgan dysfunction and mortality ensues in complicated cases. Some studies have reported that gram-positive cocci (GPC) blood stream infections (most commonly coagulase negative staphylococcus) occur more commonly than gram-negative bacilli (GNB) infections. However, gram-negative infections contributed to as high as 45% mortality in these patients [9].Measures to decrease the incidence of infections like isolation, HEPA filter fitted rooms [10] and gut decontamination have been used in transplant patients. Antibiotic prophylaxis with fluoroquinolone has been recommended by the IDSA and ASCO for patients who are expected to have a profound (< 100 neutrophils/uL) and prolonged neutropenia (> 7 days) [11]. In a recent meta-analysis antibiotic prophylaxis significantly reduced the all-cause mortality in neutropenic patients [8]. However, it has been shown to alter the gut microbiome increasing chance of clostridium difficile infections [12]. There are concerns regarding subsequent emergence of fluroquinolone resistance increasing need for therapy with carbapenem antibiotics. Many authors have argued against using prophylactic antibiotics and advocate well-structured sepsis care bundles that focuses on timely identification and treatment of neutropenic sepsis [13]. There is also a concern around rising carbapenem resistant enterobacteracae (CRE) around the world [14]. In this study we evaluate the role of antibiotic prophylaxis in patients undergoing stem cell transplant at our center.

A man in his 50s with no significant past medical history developed subarachnoid hemorrhage due to ruptured left middle cerebral artery aneurysm. 9th hospital day, he experienced a ruptured visceral aneurysm with segmental arterial mediolysis, and we successfully treated with transarterial embolization using metallic coils.

Moisture sorption characteristics of gari sold in Ebonyi, Enugu, and Abia state were studied. The gari samples were coded thus; Abia white gari sample (ABW), Abia yellow gari sample (ABY), Ebonyi white gari sample (EBW), Ebonyi yellow gari sample (EBY), Enugu white gari sample (ENW) and Enugu yellow gari sample (ENY), accordingly. The equilibrium moisture content (EMC) was determined using a standard Gravimetric method with tetraoxosulphate (VI) salt and water mixtures providing equilibrium relative humidity (ERH) 15, 25,35, 45, 55 and 65 % to yield a water activity (aw) range of 0.0972 - 0.9811 at 30, 40 and 50 oC for adsorption and desorption isotherm arms. The sorption data generated were fitted into GAB and Handerson models. A sigmoidal behaviour ( type II) was observed which is a typical attribute of a dry carbohydrate dense food. There was a general increase in the equilibrium moisture content (%) with increasing water activity. A little difference was observed between the sorption behaviour of ABW, EBW and ENW; ABY, EBY and ENY gari sample. The equilibrium moisture content decreased with increase in temperature at constant water activity. The goodness fit of the two models were determined using four statistical parameters; coefficient of determination (r 2), root mean square error (RMSE), percentage mean relative deviation modulus (%p) and chi square (x 2). GAB model appeared as the most suitable model than Henderson model. EBW and EBY gari samples proves to be of good shelf stability.

In existing surgery process, surgeons need to manually adjust the laparoscopes to provide a better field of view during operation, which may distract surgeons and slow down the surgery process. This paper presents a data-driven control method that uses a continuum laparoscope to adjust the field of view by tracking the surgical instruments. A Koopman-based system identification method is firstly applied to linearize the nonlinear system. Shifted Chebyshev polynomials are used to construct observation functions that transfer low-dimension observations to high-dimension ones. The Koopman operator is approximated using a finite-dimensional estimation method. An optimal controller is further developed according to the trained linear model. Furthermore, a learning-based pose estimation framework is designed to detect keypoints on surgical instruments and provide visual feedback for adjusting the laparoscope. Compared with other detection methods, the proposed scheme achieves a higher detection precision and provides more optional keypoints for tracking. Simulation and experiments validate the feasibility of the proposed control method. Experiment results show that the proposed method can automatically adjust the field of continuum laparoscope through tracking surgical instruments in a timely manner and the number of surgical tools is not limited.

Infective endocarditis rarely presents with cutaneous manifestations due to earlier diagnosis and treatment. We present a case of a middle-aged male patient presenting with an erythematous papular rash in the upper extremities and left knee, further progressing into painful ulcers.

Analysis of the genetic bases of adaptation to climate changes are often conducted on natural populations. We report here on a study based on diachronic sampling (1980 & 2010) of the self-fertilising crop species, Oryza sativa (Asian rice) and Oryza glaberrima (African rice), in the tropical forest and the Sudanian savannah of West Africa. First, using historical meteorological data we confirmed changes in temperatures (+1°C on average) and rainfall regime (less predictable and reduced amount) in the target area. Second, phenotyping the populations for phenology, we observed significantly earlier heading time (up to 10 days) in the 2010 samples. Third, we implemented two genome-scan methods, one of which specially developed for selfing species, and detected 31 independent selection footprints. These loci showed significant enrichment in genes involved in reproductive processes and bore known heading time QTLs and genes, including OsGI, Hd1 and OsphyB. This rapid adaptive evolution, originated from subtle changes in the standing variation in genetic network regulating heading time, did not translate into predominance of multilocus genotypes, as it is often the case in selfing plants, and into notable selective sweeps. We argue that this high adaptive potential results from the multiline genetic structure of the rice landraces, and the rather large and imbricated genetic diversity of the rice meta-population at the farm, the village and the region levels, that hosted the adaptive variants in multiple genetic backgrounds well before the advent of the environmental selective pressure. The complex selection footprints observed in this empirical study calls for further model development on genetic bases of plant adaptation to environmental changes.

This paper is devoted to study a class of Kirchhoff type problems with variable exponent. By means of perturbation technique, variational methods and a priori estimation, the existence of nonnegative nontrivial solutions to this problem is obtain.

Glucosamine (GlcN) is a natural amino monosaccharide in which a hydroxyl group of glucose is substituted for an amino group. It belongs to functional amino sugar compounds. The traditional GlcN production method is prepared by hydrolyzing the exoskeleton of shrimp and crab. This method has many potential problems such as geographical and seasonal restrictions on raw material supply, serious environmental pollution and potential allergic reactions. The microbial fermentation method has the advantages of short fermentation time, high production intensity, wide source of raw materials, green and sustainable process, and product safety. This paper mainly summarizes the research on strain construction, metabolic pathway design, and fermentation condition optimization in microbial fermentation, which has certain guiding significance for the further production of glucosamine.

A document by Erik Wilhelm Vinnes. Click on the document to view its contents.

DNA extraction and preservation bias is a recurring topic in DNA sequencing-based microbial ecology. Different methodologies can lead to distinct outcomes, which has been demonstrated especially in studies investigating prokaryotic community composition. Eukaryotic microbes are ubiquitous, diverse, and increasingly a subject of investigation in addition to bacteria and archaea. However, little is known about how the choice of DNA preservation and extraction methodology impacts perceived eukaryotic community composition. In this study, we compared the effect of two DNA preservation protocols and 6 DNA extraction methods on the community profiles of both eukaryotes and prokaryotes in phototrophic biofilms on seagrass (Zostera marina) leaves from the Baltic Sea. We found that, whereas DNA preservation and extraction method caused significant bias in perceived community composition for both eukaryotes and prokaryotes, extraction bias was more pronounced for eukaryotes than prokaryotes. Especially soft-bodied or hard-shelled eukaryotes like nematodes and diatoms were differentially abundant depending on the extraction method. We conclude that careful consideration of DNA preservation and extraction methodology is crucial to achieving representative community profiles of eukaryotes in marine biofilms, and likely all other habitats containing diverse eukaryotic microbial communities.

Objective: To establish and externally validate nomograms to predict the risk of postoperative complications after cytoreductive surgery for advanced epithelial ovarian cancer (AEOC) patients. Design: A retrospective cohort study. Setting: Multicenter Population or Sample: Patients with FIGO stage IIIC-IV epithelial ovarian cancer who underwent cytoreductive surgery. Methods: Patient preoperative characteristics were used to predict the risk of postoperative complications by univariate and multivariate analyses. Nomograms were developed based on multivariate modeling. Main Outcome Measures: Postoperative overall and severe complications. Results: Overall, 585 AEOC patients were included for analysis (training cohort = 426, validation cohort = 159). Among the clinical variables assessed, modified frailty index (mFI) (OR 1.96 and 2.18), FIGO stage (OR 2.31 and 3.22), and Surgical Complexity Score (SCS) (OR 1.16 and 1.23) were most strongly associated with the risk of overall and severe complications, respectively. The final nomograms had superior internal discrimination with the C-index were 0.74 and 0.78 for predicting overall and severe complications, respectively, as well as good consistency and stable calibration. Additionally, the validation cohort suggested a good external discrimination with the C-index were 0.92 and 0.91 to predict overall and severe complications, respectively. Conclusions: These two nomograms can help clinicians to predict the risk of postoperative complications, and instruct clinical decision-making, as well as perioperative care to prevent adverse outcomes for AEOC patients. Funding: The Department of Science and Technology of Sichuan Province (grant number 21PJ050). Keywords: Advanced epithelial ovarian cancer, Postoperative complications, Cytoreductive surgery, Nomogram

Objective: To investigate the long-term outcomes and optimal timing of surgery for Mayer–Rokitansky–Küster–Hauser syndrome (MRKH) patients undergoing vaginoplasty using an acellular porcine small intestinal submucosa graft (SIS). Design: Observational study. Setting and Population: Seventy-eight MRKH syndrome patients, forty-eight healthy controls and a post-SIS patient who delivered a baby following the world’s first robot-assisted uterus transplantation. Methods: The outcome of sexual function and psychological were assessed through three standard questionnaires: the female sexual function index (FSFI), Self-rating scale of body image (SSBI) and self-acceptance questionnaire (SAQ). Main Outcome Measures: Sexual function and psychology outcomes. Results: A total of 89.7% patients achieved a “good” vaginal width, and the mean vaginal length was 6.92±0.80 cm. The overall FSFI score of MRKH syndrome patients was significantly lower than that of healthy controls (24.43±4.42 versus 30.28±2.61, P<0.001). Three factors (sexual arousal, orgasm and sexual satisfaction score) in the FSFI increased significantly as the postoperative time increased. The emotional impairment factor of the SSBI showed a higher score in MRKH syndrome patients (1.56±1.83 versus 1.15±2.05, P=0.030). The psychological scale score showed an improving trend as the postoperative time was prolonged in MRKH syndrome patients. Conclusions: SIS surgery is effective in improving the patient’s sexual function and psychological problems, and this effect is more pronounced in patients who have the surgery earlier. It is recommended to undergo surgery when the patient is physiologically mature and expresses the desire to proceed with therapy.

Classification of natural flow regimes of non-perennial rivers and streams (NPRS) is an incipient field of research. NPRS represent approximately 70% of the total Mediterranean rivers and are expected to increase in the next decades as a result of climate change. Due to the ecological importance of NPRS and the need to improve national ecological assessment methods within the scope of the Water Framework Directive (WFD), this paper aims to classify the hydrological regime of 69 non-regulated streams, testing several hydrological indices related to the frequency, duration, timing, and rate of change in periods of flow cessation. Using daily flow records, a total of 315 indices were calculated and their relationships were examined with Principal Component Analysis (PCA) for different thresholds used to define zero-flow condition set at 0, 1, 2, and 5 l/s. Redundancy analysis identified five indices that better describe the patterns of hydrological variability in Mediterranean NPRS: number of days per year without flow, annual percentage of months without flow, mean daily of annual flows, coefficient of variation of Julian date of the annual start of zero flow and annual rise rate. Using these indices, a self-organizing map (SOM) was trained in order to categorize the NPRS into three groups with similar hydrological features. The results of this study provide a statistically-based hydrological classification of NPRS in Mediterranean environments. We expect that this classification will provide useful insights to water authorities to improve the assessments of the ecological status in this set of water bodies.

Though some hypotheses have obtained theoretical and empirical supports, it remains largely unknown in the aspect that how deception increases orchid fitness. This study used food-deceptive Papilionanthe teres as experimental material to explore the ecological significance of orchid deceptive pollination. Deception together with obvious pollinarium bending increases P. teres fitness by means of decreasing geitonogamy under the natural conditions. The proportions of full seeds, single fruit weight and seed weight per fruit after self-pollination and nectar addition were significantly lower than that after cross-pollination and natural conditions (all p ＜ 0.05). Seed viability (seed growth and development rate) after cross-pollination and natural condition were significantly higher than that after self-pollination and nectar addition (all p ＜ 0.05). However, there was no significant difference in all the above parameter values of fruits and seeds between cross-pollination and natural conditions (all p ＞ 0.05). These results confirmed that P. teres has high level of genetic load, and self-fertilization or geitonogamy will cause serious inbreeding depression. These conclusions support the outcrossing hypothesis that ecological significance of P. teres deception is to promote outcrossing and improve the ability of the offspring to adapt to the environment.

The aim of the present study was to evaluate the functional and physicochemical characteristics of pomegranate seed protein isolate (PSPI) obtained by an isoelectric precipitation process. The extracted isolate had a desirable nutritional value as the contents of its essential amino acids (except for valine and isoleucine) exceeded those recommended by FAO/WHO for adults. The molecular weights of the protein fractions of PSPI were found to be within 15-60 kDa range. According to thermal analysis data, PSPI could be denatured at 90 °C. Surface hydrophobicity of PSPI was determined at 774 level. PSPI showed high solubility both in alkaline and acidic media with the highest solubility at pH 12 (96.6%). Solubility of PSPI at pH 7.0 was at 39.5%. Furthermore, PSPI had good oil- and water-holding capacity (3.7 and 4.3 g g-1, respectively), emulsifying and foaming properties, and in-vitro digestibility. The lowest emulsifying activity index (14.1 m2/g) and emulsion stability index (8.18%) were obtained at the isoelectric pH. Overall, PSPI as a novel protein source shows a potential for future industrial applications.

Abstract 1. Classic evolutionary theory suggests that sexual dimorphism evolves primarily via sexual and fecundity selection. However, theory and evidence is beginning to accumulate suggesting that resource competition can drive the evolution of sexual dimorphism, via ecological character displacement between sexes. A key prediction of this hypothesis is that the extent of ecological divergence between sexes will be associated with the extent of sexual dimorphism. 2. As the stable isotope ratios of animal tissues provide a quantitative measure of various aspects of ecology, we carried out a meta-analysis examining associations between the extent of isotopic divergence between sexes and the extent of body size dimorphism. Our models demonstrate that large amounts of between-study variation in isotopic (ecological) divergence between sexes is due to systematic heterogeneity, which may be associated with the traits of study subjects. We then completed meta-regressions to examine whether the extent of isotopic divergence between sexes is associated with the extent of sexual size dimorphism. 3. We found a modest but significantly positive association between size dimorphism and sex differences in trophic level. Furthermore, the strength of this positive association varied between ecological contexts, increasing in species whose diets provide the greatest scope for trophic variation and in those for which body size is of greater relevance to feeding. 4. Our results therefore provide further evidence that ecologically mediated selection, unrelated to reproduction, can contribute to the evolution of sexual dimorphism.

Abstract Objective: to find the relationship between using assisted reproductive technology (ART) and an increased risk of gestational diabetes mellitus (GDM) Design A cohort study Setting and Population singleton pregnant mothers aged 20–42 years during 2014- 2017, who conceived via ART or SC Past medical history of mothers, infant feeding, and demographic data were obtained from the mothers’ files. The children’s height and weight were collected. The children were assessed for growth and development using Age and Stages Questionnaire (ASQ) by asking the mothers. Methods: One-way ANOVA, stepwise regression, and post hoc analysis were used. Statistical analyses were made by SPSS. Main Outcome Measures GDM Results The number of children in each group separately is: 423 singleton pregnancies including 197 ART conceptions (102 subjects with and 95 without GDM diagnosis), and 226 spontaneous conceptions (116 subjects with and 110 without GDM diagnosis). Maternal variables were significant in the child’s communication development including preeclampsia, mother hypothyroidism, GDM, and previous abortion. Also, child-related variables were significantly associated with communication development consisting of neonatal weight, head and chest circumstances, LBW, preterm, neonatal Apgar 1min/ 5 min, congenital abnormality, neonatal hypoglycemia, and frequency of phototherapy to decrease hyperbilirubinemia, and finally, the significant variables. ASQ showed: The highest score mean belonged to SC). Children born via ART – GDM got the lowest score. And those means differences were all significant. Conclusions. Maternal diabetes during pregnancy is an important factor in reducing the average developmental score of the child, whether born naturally or through assisted reproduction.

Researchers' ability to accurately screen fossil and subfossil specimens for preservation of DNA and protein sequences remains limited. Thermal exposure and geologic age are usable proxies for sequence preservation on a broad scale but are of nominal use for specimens of similar depositional environments. Cell and tissue biomolecular histology is thus proposed as a novel proxy for determining sequence preservation potential of ancient specimens with improved accuracy. Biomolecular histology as a proxy is hypothesized to elucidate why fossils/subfossils of some depositional environments preserve sequences while others do not and to facilitate selection of ancient specimens for use in molecular studies.

Earth systems are nearing a global tipping point, beyond which the dynamics of biological systems will become unstable. One major driver of instability is species invasion, especially by organisms that act as “ecosystem engineers” through their modification of abiotic and biotic factors. In a mosaic landscape of non-invaded and invaded habitat, ecosystems modified through invasion may serve as “sink” habitat. To understand how native organisms respond to habitat that is becoming increasingly modified, it is essential to examine biological communities within invaded and non-invaded habitat, identifying compositional shifts between native and non-native taxa as well as measuring how modification has affected interactions among community members. Using dietary metabarcoding, our study examines the response of a native Hawaiian generalist predator to habitat modification by comparing biotic interactions across metapopulations of spiders collected in native forest and sites invaded by kahili ginger. Our study shows that, although there are shared components of the dietary community, spiders in invaded habitat are eating a less consistent and more diverse diet consisting of more non-native arthropods which are rarely or entirely undetected in spiders collected from native forest. Additionally, the frequency of novel interactions with parasites was significantly higher in invaded sites, reflected by the frequency and diversity of non-native Hymenoptera parasites and entomopathogenic fungi. The study highlights the role of habitat modification driven by an invasive plant in altering community structure and biotic interactions, appearing to serve as a “sink” for native arthropods and thereby threatening the stability of the ecosystem.

Salt-tolerant superabsorbent polymer (SAP) was synthesized to improve the water retention properties of saline-alkali soil. The Lop Nur saline-alkali soil of Xinjiang with high salinity (total dissolved salt: 18.13wt%) was the object of improvement. The good swelling capacity of SAP (69.04 g/g) under high salinity condition contributed to the superb slow-release water property and further [showed](https://www.wordhippo.com/what-is/another-word-for/build.html) [excellent](https://www.wordhippo.com/what-is/another-word-for/excellent.html) water retention property of SAP-saline-alkali soil (28 days), which showed a good application potential of SAP in saline-alkali land. The swelling mechanism under high salt condition was also explored. Notably, owe to the complexation reaction between and three hydrophilic groups of SAP, the swelling capability of SAP tended to keep steady when the concentration of CaCl 2 exceeded 0.55wt%. Interestingly, the distribution of the calcium salt in SAP was directly displayed by the maximum intensity projection of computed tomography.

Background: Science integrity initiatives require specific recommendations for randomised clinical trials (RCT). Objective: To prepare a set of statements for RCT integrity through an international multi-stakeholder consensus. Methods: Following prospective registration (https://osf.io/bhncy, https://osf.io/3ursn), the consensus was developed via: multi-country multidisciplinary stakeholder group composition and engagement; evidence synthesis of 55 systematic reviews concerning RCT integrity; anonymised two-round modified Delphi survey with consensus threshold based on the average percent of majority opinions; and, a final consensus development meeting. Results: There were 30 stakeholders representing 14 countries from 5 continents including trialists, ethicists, methodologists, statisticians, consumer representative, industry representative, systematic reviewers, funding body panel members, regulatory experts, authors, journal editors, peer-reviewers and advisors for resolving integrity concerns. Delphi survey response rate was 86.7% (26/30 stakeholders). There were 111 statements (73 stakeholder-provided, 46 systematic review-generated, 8 supported by both) in the initial long list, with 8 additional statements provided during the consensus rounds. Through consensus the final set consolidated 81 statements (49 stakeholder-provided, 41 systematic review-generated, 9 supported by both). The entire RCT life cycle was covered by the set of statements including general aspects (n=6), design and approval (n=11), conduct and monitoring (n=19), reporting of protocols and findings (n=20), post-publication concerns (n=12), and future research and development (n=13). Conclusion: Implementation of this multi-stakeholder consensus statement is expected to enhance RCT integrity.

We propose and experimentally investigate a parity-time (PT) symmetric coupled optoelectronic oscillator (COEO) based on a polarization-dependent spatial structure. In such a COEO system, the gain/loss and coupling coefficients of two orthogonal-polarization optical waves can be controlled by adjusting the polarization controller (PC) and the bias voltage of the Mach-Zehnder Modulator (MZM). The single-mode selection can be implemented by the PT symmetry breaking of a special mode. The performance of the proposed COEO is experimentally examined, and a 10.0 GHz microwave signal with a phase noise of −109.1 dBc/Hz @10 kHz and a side mode suppression ratio of 51.4 dB is generated.

Pulmonary arterial hypertension (PAH) is a rare and devastating disease of the pulmonary vasculature with a high morbidity and mortality rate in infants and children. Currently, treatment approaches are mostly based on adult guidelines and pediatrician clinical experience, focusing on specific pulmonary antihypertensive therapy and conventional supportive care. The advent of targeted drugs has led to significant advances in the treatment of PAH in children, including endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and prostacyclins, which have been studied and proven to improve hemodynamics and functional class in children PAH. A new targeted drug, riociguat, is assessing its safety and efficacy in clinical trials. However, more randomized controlled studies are needed to evaluate the combination of drugs, treatment strategies, and clinical endpoints of targeted therapy in children PAH. In this review, we summarize the research advances of PAH-targeted therapy in children over the last decade in order to provide a theoretical basis for future studies.

Abstract Background and Purpose NFEPP is a newly-designed pain killer selectively activating G-protein coupled mu opioid receptors in injured tissues, and therefore devoid of central side effects. However, the cellular mechanisms underlying NFEPP’s antinociceptive effects were not examined in sufficient detail so far. Here we investigated the effects of NFEPP on G-protein activation, on voltage gated calcium channels and on mu opioid receptor phosphorylation. Experimental Approach HEK293 cells stably transfected with mu opioid receptors were used to study [35S]-GTPγS binding and mu opioid receptor phosphorylation. Voltage dependent calcium currents and intracellular calcium signals were examined in rat sensory neurons. All experiments were performed at acidic and physiological pH values using NFEPP compared to the conventional mu opioid receptor agonist fentanyl. To investigate the role of G protein subunits, we used pertussis toxin and gallein. Key Results At low pH, NFEPP produced more efficient G-protein activation and reduction of calcium currents in depolarized sensory neurons. The latter was mediated by G protein βγ subunits and NFEPP-mediated MOR phosphorylation was pH-dependent. Fentanyl-induced signaling was not affected by pH changes. Conclusion and Implications Our study shows that, at low pH, MOR signaling induced by NFEPP is more effective and neuronal calcium channels are directly modulated by G protein βγ subunits dissociated from G protein αi/o subunits. Apparently, the enhanced efficacy of NFEPP is dependent on extra- rather than intracellular effects on opioid receptor function.