Understanding and predicting novel diseases has become very important owing to the huge global health burden. ‎Organiz‎ing and studying mathematical models ‎performs‎ an essential role in predicting the behavior of the ‎disease. ‎In this paper, a new stochastic Susceptible-Infected-Recovered-Death (SIRD) model for spreading epidemic disease is investigated. First, the deterministic SIRD model is considered, and then, by allowing randomness in the recovery and death rates that are not deterministic, the system of nonlinear stochastic differential equations is derived. For the suggested model, the existence and uniqueness of a positive global solution are demonstrated. The parameter estimation is done with the conditional least square estimator for deterministic models and the maximum likelihood estimator for stochastic ones. After that, we investigate a nonadditive state-space model for spreading epidemic disease by considering infected as the hidden process variable. The problem of the hidden process variable from noisy observations is filtered, predicted, and smoothed using a recursive Bayesian technique. For estimating the hidden number of infected variables, closed-form solutions are obtained. Finally, numerical simulations with both simulated and real data are performed to demonstrate the efficiency and accuracy of the current work.

The control of porcine reproductive and respiratory syndrome virus (PRRSV) hinges on monitoring and surveillance. The objective of this study was to assess PRRSV RNA detection by RT-PCR in tongue tips from dead suckling piglets compared to serum samples, processing fluids, and family oral fluids. Tongue tips and serum samples were collected from three PRRSV-positive breeding herd farms (farms A, B, and C) of three different age groups: newborns (<24h), processing (2 to 7 days of age), and weaning (18 to 22 days of age). Additionally, processing fluids and family oral fluids were collected from 2-7 days of age and weaning age respectively. In farms A and B, PRRSV RNA was detected in tongue tips from all age groups (100% and 95%, respectively). In addition, PRRSV RNA was detected in pooled serum samples (42% and 27%), processing fluids (100% and 50%), and family oral fluids (11% and 22%). Interestingly, the average Ct value from tongue tips was numerically lower than the average Ct value from serum samples in the newborn age. In farm C, PRRSV RNA was only detected in serum samples (60%) and family oral fluids (43%), both from the weaning age. Further, no PRRSV RNA was detected in tongue tips when pooled serum samples from the same age group tested PRRSV RNA-negative. Taken together, these results demonstrate the potential value of tongue tips for PRRSV monitoring and surveillance.

A coronavirus disease pandemic caused by the novel severe acute respiratory syndrome virus-2 or nCoV-2 has escalated to a global health emergency. In search of prospective therapeutics against the virus from the microbial treasure trove, three classes of cyclic lipopeptides produced by the bacterial genus Bacillus, namely Surfactins, Fengycins, and Iturins, were chosen as exploitative targets against the main viral protease, 3CLPro, in turn, responsible for the ordered transcription and replication of the virus. On performing molecular docking analysis using AutoDock Vina, all the annotated lipopeptides showed promising binding stability, ranging from -6.1 to -7.4 kcal/mol, compared with the control inhibitor Darunavir (-7.2 kcal/mol). The lowest binding energy was observed for Fengycin 35518574 whereas the highest was for Surfactin B, but due to the richness in forming effective interactions with the target, Surfactin C was adjudged the most potent among all others. Molecular dynamics simulation analysis using iMODs server strengthened our claim that the 3CLPro-Surfactin C complex was stable, based on Deformability, Bfactor, Eigenvalue, Covariance, and Elastic network modeling. All the lipopeptides were found to form multiple hydrogen-bonded and hydrophobic interactions with the enzyme, in-silico, due to the exposed polyhydroxyl moieties and prenyl groups in their peptide structures. As most of these lipopeptides are non-toxic to human cells, the results of this study emphasize the need for research using these wonder molecules and their derivatives as pharmaceuticals in combating notorious viruses like nCoV-2.  

A 59-year-old Afro-American woman presented with a gradual loss of hair and scalp pruritus for the last year. The complementary tests revealed a scalp thickness of 10,1mm and a punch biopsy confirmed the diagnosis of a lipedematous alopecia. This, together with lipedematous scalp, are uncommon clinicopathologic entities of unknow etiology.

Community dynamics are governed by two opposed processes: species sorting, which produces deterministic dynamics leading to an equilibrium state, and ecological drift, which produces stochastic dynamics. Despite a great deal of theoretical and empirical work aiming to demonstrate the predominance of one or the other of these processes, the importance of drift in structuring communities and maintaining species diversity remains contested. Here we present the results of a basic community dynamics experiment using floating aquatic plants, designed to measure the relative contributions of species sorting, ecological drift to community change over about a dozen generations. We found that species sorting became overwhelmingly dominant as the experiment progressed, and directed communities towards a stable equilibrium state maintained by negative frequency-dependent selection. The dynamics of any particular species depended on how far its initial frequency was from its equilibrium frequency, however, and consequently the balance of sorting and drift varied among species.

Humans have translocated thousands of species, either intentionally or not, from their native ranges to non-native ones, with many established (naturalized) and some now invasive. We report here a global database on the distributions of naturalized alien insects. Currently, 7,741 naturalized alien insect species have been reported from 222 regions, of which 47 species were reported over all six continents, 103 species over five continents, and 208 species over four continents. Naturalized alien insects are taxonomically diverse in all six continents, predominantly occurring in agroecosystems, as well as forests and grasslands. North America has accumulated the greatest number of naturalized alien insect species, while South America has the lowest number. Asia donated the greatest number of its native insect species to other continents, especially to North America and Europe. The global patterns of naturalized alien insects are correlated with transcontinental trade and the number of local scientists who study insect invasions. Most naturalized alien insects have been introduced to multiple continents, further facilitating the expansion of introduced populations through bridgehead effects. Understanding the global exchange and accumulation of alien insects helps the development of an early warning and monitoring system for insect invasions.

Aim: To summarise the effectiveness of organisational interventions on appropriate opioid use for non-cancer pain upon hospital discharge. Methods: A systematic search was conducted on six electronic databases by two independent reviewers. We included original research articles reporting on quantitative outcomes of organisational interventions targeting appropriate opioid use on hospital discharge. Quality assessment was performed by two independent reviewers. The protocol for this review was prospectively registered on PROSPERO (ID: CRD42020156104). Results: Out of 173 full texts assessed for eligibility, 43 were included in this review. The majority of studies had a moderate to serious risk of bias (33 out of 43). Most of the studies implemented a multifaceted organisational intervention (16 studies). Other interventions included guideline implementation, prescriber education and default opioid prescribing quantity changes in electronic medical records. Multiple studies found that the dissemination of patient-specific and procedure-specific guidelines reduced the quantity of opioids prescribed by 44-57%. Prescriber education provided with feedback was implemented in four studies and resulted in a 33-44% decrease in prescribing rates. Lowering the default quantities in the electronic medical records produced a 40% decrease in opioids prescribed in one study. Conclusion: Guideline implementation, prescriber education and default opioid prescribing quantity changes all appear effective in improving the appropriate use of opioids on hospital discharge. However, the extent of reduction of opioid prescribing upon hospital discharge after the implementation of multifaceted intervention strategies appears similar to that of simpler interventions which require fewer resources.

Growing body of evidence supporting the use ofBivalirudin as alternative anticoagulation during extracorporeal membrane oxygenation.

The MitraClip technique has been increasingly used for correction of mitral valve regurgitation in patients in whom surgical mitral repair is considered contraindicated or very risky, but off label use occurs often. Failure of the procedure, translated into moderate to severe rates of residual or recurrent mitral regurgitation, is observed in up to one-third of the patients, and surgery has been used to correct it in a number of cases, in what can be called an “operation for the inoperable”. That is precisely the subtitle of a paper published in this issue of the JOCS by Gerfen and colleagues, who analyse their institutional experience with a series of 17 patients. In this Editorial, I comment on this series and the possible reasons for failure of the MitraClip, and on the indications for reintervention and its constraints, which I hope can contribute to the discussion about “further exploration and refinement of patient selection criteria and identify predictors for MitraClip failure”, as the authors suggest.

The dominant method for generating Chinese hamster ovary (CHO) cell lines that produce high titers of biotherapeutic proteins utilizes selectable markers such as dihydrofolate reductase (Dhfr) or glutamine synthetase (Gs), alongside inhibitory compounds like methotrexate (MTX) or methionine sulfoximine (MSX), respectively. Recent work has shown the importance of asparaginase (Aspg) for growth in media lacking glutamine–the selection medium for Gs-based selection systems. We generated a Gs/Aspg double knockout CHO cell line and evaluated its utility as a novel dual selectable system via co-transfection of Gs-Enbrel and Aspg-Enbrel plasmids. Using the same selection conditions as the standard Gs system, the resulting cells from the Gs/Aspg dual selection showed substantially improved specific productivity and titer compared to the standard Gs selection method, however, with reduced growth rate and viability. Following adaptation in selection medium, the cells improved viability and growth while still achieving ~5-fold higher specific productivity and ~3-fold higher titer than Gs selection alone. We anticipate that with further optimization of culture medium and selection conditions this approach would serve as an effective addition to workflows for the industrial production of recombinant biotherapeutics.

Background Data on the postoperative outcomes for patients with infective endocarditis complicated by an aortic root abscess is sparse due to the condition’s low incidence and high mortality rates. This systematic review and meta-analysis aims to evaluate existing data on the impact of aortic root abscesses (ARA) on the postoperative outcomes of surgically managed infective endocarditis (IE) and to inform optimal surgical approach. Methods The online databases MEDLINE, EMBASE and Cochrane library were searched from 1990 to 2022 for studies comparing ARA with NARA (no ARA) in infective endocarditis. Data was extracted by two independent investigators and aggregated in a random-effects model (Review Manager version 5.3). Risk of bias was assessed using an adapted version of the Newcastle-Ottawa scale. Results Six clinical studies were included in the meta-analysis (n = 1982). The ARA group was associated with an increased risk of in-hospital mortality (OR = 1.74 96% CI 1.18-2.56) and late mortality (HR = 1.27 95% CI 1.03-1.58). The reoperation meta-analysis was complicated by high rates of heterogeneity (I 2 = 59%) and found no significant differences in reoperation between group ARA and NARA (no ARA) (HR = 1.48; 95% CI 0.92-2.40). Post-hoc scatter graph showed a strong linear relationship (r=0.998), suggesting hospitals with higher rates of aortic root replacement (ARR) achieve lower rates of reoperation for ARA patients compared with PR. Conclusions The presence of an ARA in aortic valve endocarditis is associated with elevated early and late mortality despite modern standards of care. Additionally, ARR should be considered to have a favourable postoperative profile for use in this context.

Objective: To evaluate the functional capacity, pulmonary function and quality of life of children and adolescents with sickle cell anemia (SCA) and to test the reproducibility of functional capacity tests in this population. Method: Cross-sectional study with  volunteers with SCA genotype Hb-SS (SCAG), aged 6 to 18 years matched in age and  gender to the control group (CG). Spirometry, 5-repetition sit-to-stand test (5STS-test),  modified shuttle walk test (MSWT), and Pediatric Quality of Life Questionnaire (PedsQL) were performed. The reproducibility of 5STS-test and MSWT was evaluated:   Results: 48 volunteers of SCAG and 48 of CG were evaluated. Pulmonary function of SCAG (FVC: 92 ± 15% pred.; FEV 1 /FVC: 84 ± 8% pred.) was worse than the CG (104 ± 15% pred.; FEV 1 /FVC: 90 ± 6% pred.) p < 0.05. SCAG had worse functional capacity registered by distance walked: 576m (515-672m) and 5STS-test: 8 seconds (7.4-8.9seconds) compared to the CG who showed distance walked: 1010m (887- 1219m) and 5STS-test: 7 seconds (7.0-8.1seconds), p < 0.001. SCAG had worse quality compared to CG, p < 0.05. The reproducibility was good of MSWT (ICC 0.99 (0.98-0.99 IC-95%)) and 5STS-test (ICC 0.80 (0.69 – 0.88), p < 0.001 . Conclusion: Children and adolescents with sickle cell anemia showed worse capacity to walk or run, and to perform sit-to-stand test. Additionally, they have poor quality of life when compared with their control peers. The MSWT and 5STS-test showed reproducible to be applied in pediatric individual with SCA.

Remdesivir can precipitate fatal acute necrotizing pancreatitis especially in patients who previously suffer from hypertriglyceridemia.

Rationale: As a result of the SARS-CoV-2 pandemic, all pediatric pulmonary fellowship programs conducted virtual interviews for the first time in the Fall of 2020. This study aimed to understand the accuracy of virtual-interview derived-impressions of fellowship programs, as well as applicant preference for future fellowship interview cycles. Methods: A group of pediatric pulmonary fellows and Program Directors designed a REDCap survey. The survey was distributed to all first-year pediatric pulmonary fellows who participated in the 2020-2021 virtual interview season. Results: 23/52 (44%) of first-year pediatric pulmonary fellows completed the survey. 96% were able to form general impressions about fellowship programs during their virtual interviews. 96% reported that generally their fellowship experience matched their virtual-interview derived-impressions. 17 of 19 factors applicants use to rank programs had no statistically significant change (p > 0.05) in impression from virtual interview to fellowship experience. The two factors with a statistically significant (p < 0.05) change in impression were patient care related – volume of ‘bread and butter’ pediatric pulmonary patients and volume of tertiary care pediatric pulmonary patients. 87% prefer some form of in-person interview option in future application cycles. A tiered interview format in which applicants are first invited to a virtual interview day followed by an optional in-person second look day was the most popular preference for future interview cycles (48%). Conclusions: Virtual interviews may provide accurate representations of pediatric pulmonary fellowship programs and applicants prefer some type of in-person interview option in future application cycles.

The file provides a rare audio-recording of typical sound of infective endocarditis (IE) in an adult with patent ductus arteriosus (PDA). It is important to consider PDA-associated IE if pan-systolic murmur is heard in the 2nd intercostal space along the left sternal border, radiating to the left subclavian region.

Squamous cell carcinoma is one of the most common head and neck types of skin cancer. This main objective of this paper is to present a case of a patient who had a moderately differentiated squamous cell carcinoma of the nose and whose tumor had an aggressive growth.

Genetic variation is described from the perspective of an individual. All the different levels of genetic information and variation are covered, ranging from whether an organism is unmixed or hybrid, has variations in genome, chromosomes and more locally in DNA regions, epigenetic variants or alterations in selfish genetic elements. Genetic constitution and heterogeneity of microbiota are highly relevant for health and wellbeing of an individual. Mutation rates vary widely for variation types e.g. due to sequence context. Genetic information guides numerous aspects in organisms. Types of inheritance, whether Mendelian or non-Mendelian, zygosity, sexual reproduction and sex determination are covered. Functions of DNA and functional effects of variations are introduced, along with mechanism that reduce and modulate functional effects, including TARAR countermeasures and intraindividual genetic conflict. TARAR countermeasures for tolerance, avoidance, repair, attenuation and resistance are essential for life, integrity of genetic information and gene expression. The genetic composition, effects of variations and their expression are considered also in diseases and personalized medicine. The text synthesizes knowledge and insight on individual genetic heterogeneity and organizes and systematizes the central concepts.

In this paper, we obtain the solutions of the difference equation \begin{equation*} x_{n+1}=\frac{x_{n-(9 t+8)}}{1+\prod_{k=0}^{6} x_{n-(t+1) k-t}}, \end{equation*} where the initials are positive real numbers.

This paper investigates stochastic differential equations (SDEs) with locally one-sided Lipschitz coefficients. Apart from the local one-sided Lipschitz condition, a more general condition is introduced to replace the monotone condition. Then, in terms of the Euler’s polygonal line method, the existence and uniqueness of solutions for SDEs is established. In the meanwhile, the $p$th moment boundedness of solutions is also provided.

In this paper, the periodicity of a class of nonautonomous fuzzy neural networks with impulses, reaction-diffusion terms and distributed time delays are investigated. Some new sufficient conditions for the existence of periodic solutions and global exponential stability of the systems are obtained using time delays integral differential inequalities, Poincaré mappings and fixed point theory. The validity and generality of the methods are illustrated by two numerical examples.

The gratings contain transmission gratings and reflective gratings. The textbook-screen in the grating experiments is a planar screen. To study the orientation-dependence of the 2-dimention diffraction patterns of the grating, we proposed the cylindrical screen. Then utilizing the cylindrical screen in both transmission grating experiments and reflective grating experiments. Experiments show the 2-dimention curved, expanded and inclined diffraction patterns. The cylindrical screen visually shows that the diffraction orders of the rotating gratings distribute in two dimensions. The CCD can be placed at the precise locations of each order to collect data. By using the cylindrical screen, two coordinates are needed to describe the curved, expanded and inclined diffraction patterns of the rotating grating. The cylindrical screen may be used to test the theories of the grating rotating around 3 axes.

Researchers have used both soil nematode data and soil multifunctionality data as indicators of soil quality. However, the relationship between soil nematodes and soil multifunctionality is poorly understood. This study explored the relationship between soil nematode properties and soil multifunctionality in different land-use types in a subtropical karst region of Southwest China. We selected the following five typical land-use types that differ in the degree of soil disturbance: cropland (maize-soybean), sugarcane, mulberry, forage grass, and forest. Soil multifunctionality was calculated based on bulk density (BD), soil pH, the ratio of soil organic carbon to total nitrogen (C: N), the contents of soil water (SWC), soil total nitrogen (TN), soil organic carbon content (SOC), calcium (Ca), magnesium (Mg), microbial biomass carbon (MBC), microbial biomass nitrogen (MBN), ammonium nitrogen (AN), and nitrate nitrogen (NN). We found that the abundance, Simpson dominance index, and metabolic footprint of soil nematodes were highest in the forest, followed by sugarcane, cropland (maize-soybean) and forage grass, and mulberry. Soil multifunctionality was significantly higher in the forest than in the other land-use types. Soil multifunctionality was positively correlated with the abundance of total nematodes and all nematode trophic groups except omnivores. A random forest model revealed that the dominant nematode genera (i.e., Coomansus and Acrobeloides) and the rare genera (i.e., Wilsonema and Heterocephalobus) were closely associated with soil multifunctionality. Our results suggest that the soil nematodes (especially keystone genera) may mediate the effects of ecosystem disturbance on soil multifunctionality. These findings increase our understanding of the relationships between soil organisms and soil multifunctionality.

The clinical application evaluation of non-invasive imaging in transcatheter aortic valve implantation has also gradually developed. The advantages of ultrasound are gradually revealed in the evaluation of cardiac function before, during and after surgery, as well as short-term and long-term follow-up. Speckle tracking echocardiography (STE) is a non-invasive and angle-dependent new ultrasound diagnostic technique, which is used to evaluate the multi-angle and multi-directional motion velocity, strain and strain rate of human myocardium. The prognosis, recovery and risk stratification have good predictive evaluation value. With the continuous development of new related technologies and parameters from STE, scholars continue to apply these new technologies and new parameters to the clinical evaluation of transcatheter aortic valve implantation. A review of the clinical application of aortic valve implantation.

Abstract Background: The misattribution of an adverse drug reaction (ADR) as a symptom or illness can lead to the prescribing of additional medication, referred to as a prescribing cascade. The aim of this systematic review is to identify published prescribing cascades in community-dwelling adults. Methods: Systematic review reported in line with the PRISMA guidelines and pre-registered with PROSPERO. Electronic databases (Medline (Ovid), EMBASE, PsycINFO, CINAHL, Cochrane Library) and grey literature sources were searched. Inclusion criteria: Community-dwelling adults; Risk-prescription medication; Outcomes-initiation of new medicine to ‘treat’ or reduce ADR risk; Study type-cohort, cross-sectional, case-control and case-series studies. Title/abstract screening, full-text screening, data extraction and methodological quality assessment was conducted independently in duplicate. A narrative synthesis was conducted. Results: A total of 101 studies (reported in 103 publications) were included. Study sample sizes ranged from 126 to 11,593,989 participants and 15 studies examined older adults specifically (≥60 years). Seventy-eight of 101 studies reported a potential prescribing cascade including calcium channel blockers to loop diuretic (n=5), amiodarone to levothyroxine (n=5), inhaled corticosteroid to topical antifungal (n=4), antipsychotic to anti-Parkinson drug (n=4), and acetylcholinesterase inhibitor to urinary incontinence drugs (n=4). Identified prescribing cascades occurred within three months to one year following initial medication. Methodological quality varied across included studies. Conclusion and implications: Prescribing cascades occur for a broad range of medications. ADRs should be included in the differential diagnosis for patients presenting with new symptoms, particularly older adults and those who started a new medication in the preceding 12 months. Word count: 245