The present study reports production, partial purification, and media optimization for alkaline protease using Bacillus cereus PW3A. A profiling study for protease production indicates maximum enzyme activity (17.22 U/ml) was observed after 48 h of incubation. The studies also showed that the enzyme activity increased with the decrease in carbon content indicating the growth associated with nature protease production. Partial purification of protease was done using ammonium sulfate precipitation and dialysis. Further studies were conducted to assess significant media ingredients influencing protease production using the one-factor-at-a-time approach and Plackett-Burman design. Fructose and yeast extract were identified as the most significant variables. Response surface methodology was applied to optimize the factors for maximizing protease production. The results showed that the production increased from 17.22 U/ml to 47.43 U/ml indicating a threefold augment in enzyme activity. Characterization of protease showed that the highest enzyme activity was shown at pH 8.0 and temperature 50°C; however, significant enzyme activity was retained till pH 10 and temperature 60°C. Using casein as substrate, the enzyme showed maximum activity V max 39 U/ml and K m 18 μM. The activity was enhanced by MgCl 2 and CuSO 4 and inhibited by HgCl 2. Since the enzyme has both pH and temperature stability with greater substrate affinity, this protease finds many useful industrial applications.

Introduction Axial spondylarthritis (axSpA) is a chronic inflammatory disease and commonly results in pain and joint stiffness. Using remote technology, such as a computer vision-aided system, has the potential to monitor functional movement and posture. Methods The validity of the remote technology measurement of functional movement and posture were tested cross-sectionally and compared to a standard clinical measurement by a physiotherapist. The feasibility of remote implementation was tested in a home environment. In addition, a cost-benefit analysis was conducted. Results Thirty-one participants with axSpA (42% female, 54(SD 13) years old and 27.4(SD 5.3) kg/m2) and 31 participants without back pain (65% female, 36(SD 10) years old and 25.9(3.7) kg/m2). In the axSpA group, the validity of assessment on cervical rotation, lumbar flexion, lumbar side flexion, shoulder flexion, hip abduction, tragus-to-wall and thoracic kyphosis showed significant moderate to strong correlation; in the non-back pain group, the same measures showed significant correlation ranging from weak to strong. Conclusions Remote technology systems in rehabilitation have the potential to reduce health inequality and improve cost and time effectiveness for both patients and the health system. Additionally, results show that using this Computer Vision-aided system in a home environment is a safe method.

An improved predictive control strategy is proposed to regulate the speed for permanent magnet synchronous motor. Firstly, the motor model is discretized by Taylor series to obtain the expected voltage vector, and a novel cost function is reconstructed with only voltage variables for predictive control, which avoids weight-adjustment. Secondly, the angle of expected voltage vector is obtained by Clark transformation to select the sector, whose voltage vectors are the candidate voltage vectors to reduce calculations. Finally, the optimal voltage vector is determined to switch the inverter by the minimum of the cost function among the candidate voltage vectors. Superior control performance is verified in experiments compared to conventional predictive speed control.

A document by Robert Verkerk. Click on the document to view its contents.

Roflumilast is a phosphodiesterase 4 inhibitor developed for COPD treatment. Roflumilast N-oxide is the major metabolite with similar mechanism of action. The exposure difference between different races have been observed, but the need for dose adjustment have been controversial. The present study compared the pharmacokinetics of a single dose of the original oral roflumilast tablets (Daliresp®) 0.5 mg in healthy Chinese and Caucasian subjects under uniform conditions. The Chinese subjects were found to have longer t1/2, higher AUC0-t, AUCinf and Cmax than the Caucasian subjects. Compared to Caucasian subjects, the point estimate on geometric mean of AUC0-t and AUCinf in Chinese subjects was respectively 22% and 25% higher for roflumilast, and 46% and 48% higher for roflumilast N-oxide. The point estimate on geometric mean of Cmax 9% higher for roflumilast, and 24% higher for its N-oxide. After body weight normalization, the difference of pharmacokinetics (PK) exposure reduced but did not eliminate. Compared to the Caucasians, tPDE4i in Chinese subjects was 44% higher. After body- weight normalization, the difference reduced to 27%. Safety analysis showed signs indicating Chinese were less tolerant to roflumilast than Caucasians, or have different pharmacodynamic response. Our study suggests a dose of roflumilast lower than 0.5 mg daily for Chinese patients or future clinical trials. More dose exploration studies are needed to determine the optimal doses of roflumilast for Chinese COPD patients.

Aims: To evaluate the potential gastric pH-dependent drug-drug interaction (DDI), safety and tolerability of famitinib co-administered with omeprazole in healthy subjects. Methods: Twenty healthy subjects were enrolled in a single-center, single-arm, open-label, fixed-sequence study. Famitinib was administered as a single oral 25 mg under a fasting condition on day 1, omeprazole (40 mg once daily) was given on days 10–14, concomitantly with famitinib on day 15, and for the follow-up 7 additional days (days 16–22). Blood samples were collected at predetermined timepoints for the pharmacokinetic analysis of both famitinib and its metabolite SHR116637 following each famitinib dose. Safety and tolerability were assessed during the whole progress via clinical laboratory tests. Results: The least-squares geometric mean ratios (GMRs) (90% CI) of Cmax, AUC0-t and AUC0-∞ for famitinib combined with omeprazole to famitinib alone were 0.989 (0.953, 1.027), 0.956 (0.907, 1.007) and 0.953(0.905, 1.005) respectively. For the metabolite SHR116637, their GMRs (90% CI) of the above parameters were 0.851 (0.786, 0.920), 0.890 (0.838, 0.946）and 0.887 (0.835, 0.943), indicating the absence of significant differences in the parameters respectively. During the treatment period, 9(45%) subjects reported 16 treatment emergent adverse events (TEAE), among which 6 subjects (30%) reported 9 TEAEs and 1 subject (5%) reported 1 TEAE during famitinib or omeprazole administered alone respectively, 5 subjects (25.0 %) reported 6 TEAEs during in the combined administration phase. Conclusion: The PPI omeprazole did not have a significant influence on the pharmacokinetics (PK) of famitinib and SHR116637, and the safety profile was good upon co-administration.

Classic ecological theory has proven that temperature, precipitation, and productivity organize ecosystems at broad scales and are generalized drivers of biodiversity within different biomes. At local scales, the strength of these predictors is not reliable across different biomes. To better translate these theories to localized scales, it is essential to determine the links between drivers of biodiversity. Here we harmonize existing ecological theories to increase the predictive power for species richness and functional diversity. We test the relative importance of three-dimensional habitat structure as a link between local and broad scale patterns of avian richness and functional diversity. Our results indicate that habitat structure is stronger than precipitation, temperature, and elevation gradients for predicting avian species richness and functional diversity across different forest ecosystems in North America. We conclude that forest structure, driven by climatic drivers, is essential for predicting the response of biodiversity with future shifts in climatic regimes.

Ecosystem functions can be amplified or dampened by species responses to biotic and abiotic factors in the environment. In a group of marine primary producers, consisting of phytoplankton and kelp species, we tested for the features indicating Jensen's Inequality and synchronous or asynchronous dynamics that would indicate a Portfolio Effect. Nonlinearities that would drive an effect through Jensen's Inequality were weak and the relationship between environmental drivers and species fluctuations were often highly variable. Asynchrony dominated the multi-species assemblage, providing evidence of Portfolio Effects. The two canopy kelp species, however, showed temporal and spatial synchrony. Canopy kelp species had strong spatial autocorrelation up to 50 km. Spatial synchrony occurred over almost 300 km, with increased strength in spatial synchrony in two recent decades compared to the early 1990s. This potential Moran Effect, where an environmental variable generates large-scale biological synchrony, may increase the vulnerability of kelp populations into the future.

The study was carried out at the White Volta stretch in the Pwalugu area to assess the fish and fisheries of the River. The catch per unit effort (CPUE) was generally low over the entire period of study, as the highest and lowest CPUE were recorded in March, 2020 and May, 2020 respectively. The River stretch was found to be rich in fish fauna as 39 fish species belonging to 27 genera and 13 families were encountered during the period of study. Three species namely, Auchenoglanis occidentalis, Marcussenius senegalensis and Heterobranchus bidorsalis were identified as the major commercial fish species in the area. The widely used fishing gears in the area included gillnet, trap, cast net, hook-and-line and spear. Fishing activities on the river stretch were unreported and unregulated. It was recommended that the Fisheries Commission in the Upper East Region, Bolgatanga should be resourced with logistics and personnel to monitor and ensure compliance with fisheries regulations on the river.

Deep-frying is a popular food preparation method although oxidized oil may be a health hazard. Minor components in frying oil including antioxidants like tocopherols and tocotrienols, fatty acid composition, triacylglycerol (TAG), and vitamins serve to protect vegetable oil from thermal deterioration. The eating habits of three ethnicity in Malaysia due to influence from the West was briefly mentioned. The importance of fats and oils, as well as the characteristics of each plant oil, were also explained in this project paper. A total of 31 studies fulfilled our inclusion criteria. Studies with humans and animals were accepted and included in this Meta-analysis. The probability of occurrence of obesity, atherosclerosis, hypertension, Type 2 diabetes, and oxidative stress were checked. The overall weighted mean differences for palm oil (PO), canola oil (CNO), corn oil (CO), extra virgin olive oil (EVOO), sunflower oil (SFO), and soybean oil (SBO) were 0.18 [95% CI: 0.11, 0.25; P < 0.00001], 5.50 [95% CI: 4.12, 6.87; P < 0.00001], 0.62 [95% CI: -4.71, 5.95; P = 0.82], 1.13 [95% CI: 0.39, 1.87; P = 0.003], -3.79 [95% CI: -5.61, -1.97; P < 0.00001], 0.46 [95% CI:0.29, 0.64; P < 0.00001] respectively. In short, this study revealed that there was no strong relationship found between a heated and/or repeated heated vegetable oil with the adverse health complications included based on current meta-analysis.

Background: Prosthetic valve endocarditis (PVE) is a rare but dangerous complication after Bentall surgery. In addition, cases of Staphylococcus epidermidis involving multiple valves simultaneously and multi-organ embolism during the early postoperative period are rarer. Case presentation: We reported a 42-year-old patient who developed PVE with systemic embolism one month after aortic valve replacement (Bentall surgery). Echocardiography suggested large, mobile vegetations on both the prosthetic aortic valve and native tricuspid valve. The patient immediately received antibiotic treatment after the presence of Staphylococcus epidermidis was revealed by multiple blood cultures. Shortly after that, the patient felt numbness in the right lower extremity and received a vascular ultrasonography examination. The Pathological exam revealed right femoral artery thromboembolism. The patient also developed cerebral and splenic infarction during follow-ups and died of cerebral infarction. Conclusions: We reported a sporadic case of Staphylococcus epidermidis infective endocarditis (IE) involving multiple valves and systemic embolisms early after Bentall surgery in a patient with Marfan’s syndrome. Fatal systemic embolism should be aware of in PVE patients with large vegetations present with dyskinesia, abdominal pain, and limb numbness. The prompt echocardiography and vascular ultrasound are primary and reliable diagnostic methods in this scenario.

In this paper, we propose a new structure-preserving algorithm for computing the singular value decomposition of a quaternion matrix $A$. We first define a quaternion-type matrix and prove that the multiplication of two quaternion-type matrices still be a quaternion-type matrix. Thus, utilizing this fact, we conduct a sequence of quaternion-type unitary transformations on a half of the elements of the complex adjoint matrix $\chi_A$ of $A$ instead of on the whole $\chi_A$. Then, we recover the resulting matrix with the help of the special structures. Compared with direct performing on the complex adjoint matrix, our algorithm needs only half of the computation and storage. This method also provides a novel proof for the existence of the singular value decomposition of a quaternion matrix. Moreover, numerical experiments are given to demonstrate the validity of our approach.

We are concerned with a Dirichlet system, involving the Monge-Ampere operator \det D^2u in a ball in \mathbb{R}^N. Based on the Leray-Schauder degree, we first obtain the existence of radial solutions for a class of differential systems with general nonlinearities. In addition, we prove that such a system admits positive solutions when nonlinearities satisfy sub- or superlinear growth near origin. Finally, by using the lower and upper solution method, and constructing the subsolution and supersolution, we show the existence and multiplicity of nontrivial radial solutions for Dirichlet systems with Monge-Ampere operator and Lane-Emden type nonlinearities with two parameters.

Objective To assess the perception, knowledge, and practices regarding maternal perception of fetal movements (FMs) among women and their healthcare providers in a low-resource setting. Design Qualitative study. Setting The maternity unit of Mnazi Mmoja Hospital, Zanzibar, Tanzania. Population Pregnant and postpartum women, and health providers. Methods Semi-structured interviews, questionnaires and focus group discussions were conducted with 45 Zanzibar women (18 antenatal, 28 postpartum) and 28 health providers. Main outcome measures Descriptive and thematic analyses were conducted to systematically extract subthemes within four main themes 1) knowledge/awareness, 2) behavior/practice, 3) barriers, and 4) improvements. Results Within the main themes it was found that 1) Women were instinctively aware of (ab)normal FM-patterns and healthcare providers had adequate knowledge about FMs. 2) Women often did not know how to monitor FMs or when to report concerns. There was inadequate assessment and management of (ab)normal FMs. 3) Women did not feel free to express concerns. Healthcare providers considered FM-awareness among women as low and unreliable; lack of staff, time and space for FM-education, and no protocol for FM-management. 4) Women and health providers recognized the need for education on assessment and management of (ab)normal FMs. Conclusion Women expressed FMs in an adequate way and perceived abnormalities of these movements better than assumed by health providers. There is a need for more evidence on the effect of improving knowledge and awareness of FMs in order to construct evidence-based guidelines for low resource settings.

Objective: To describe clinical and laboratory characteristics of term deliveries complicated by chorioamnionitis, and to assess their association with adverse neonatal outcomes. Design: Cross-sectional cohort study Setting: The study is based on data from the Swedish Pregnancy Register, enriched with clinical data extracted from medical charts. Population and Sample: A random sample of 500 term singleton deliveries in Stockholm County with registered diagnosis of chorioamnionitis in the Swedish Pregnancy Register between 2014 and 2020. Methods: Logistic regression was used to estimate odds ratios (OR) as a measurement of the association between clinical and laboratory characteristics and neonatal complications Main Outcome Measures: Neonatal infection and asphyxia-related complications. Results: Maternal fever, maternal and fetal tachycardia, and elevated inflammatory laboratory markers were frequent signs of chorioamnionitis. The prevalence of neonatal infection and asphyxia-related complications was 10 and 22%, respectively. First leukocyte count in the second tertile (OR 2.14 [95% CI 1.02-4.49]), maximum CRP level in the third tertile (OR 4.01 [95% Cl 1.66-9.68]), and positive cervical culture (OR 2.22 [95% Cl 1.10-4.48]) were associated with an increased risk of neonatal infection. Maximum level of CRP in the third tertile (OR 1.93 [95% Cl 1.09-3.41]), and fetal tachycardia (OR 1.63 [95% Cl 1.01-2.65]) were associated with increased risk of asphyxia-related complications. Conclusions: In addition to maternal intrapartum fever, maternal and fetal tachycardia, and elevated inflammatory laboratory markers were common signs of chorioamnionitis. Elevated inflammatory laboratory markers were associated with both neonatal infection and asphyxia-related complications, and fetal tachycardia was associated asphyxia-related complications.

Objective This study compares survival of four different surgical approaches including ARH, LRH, RRH and VRH for early-stage cervical cancer in order to define the best effects and survivals for patients. Design Retrospective study. Setting The First Medical Center of the PLA General Hospital. Population 238 women diagnosed early-stage cervical cancer between January 2013 and December 2017 and followed up until September 2020. Methods All patients with early-stage cervical cancer were retrospective collected in the first medical center of the PLA general hospital. Disease free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier’s method, and survival curves were compared using log-rank test. Main outcome measures Outcomes were the comparison of patients’ DFS and OS between the four different radical hysterectomy approaches. Results The intraoperative blood loss and postoperative exhaust time of LRH, RRH and VRH groups are better than that in ARH group. The total 5-year OS was significant difference among the four groups. However, the difference of 5-year DFS was not statistically significant among the four groups. Furthermore, patients with early-stage cervical cancer had a significantly better DFS and OS in ARH and RRH groups than that in LRH and VRH groups. Conclusions This retrospective study demonstrated that both ARH and RRH obtained higher rate of 5-year DFS and 5-year OS compared with LRH and VRH for early-stage cervical cancer, and the survival outcomes between ARH and RRH were similar. Keywords Cervical cancer, ARH, LRH, RRH, VRH, survival.

Variants of Severe-Acute-Respiratory-Syndrome Coronavirus-2 (SARS-CoV-2) has caused tremendous impact globally. It has been widely reported that the Omicron (B.1.1.529) variant is less deadly than the Delta (B.1.617.2) variant, presumably due to immunity from vaccination and previous infection. When measuring the severity of a variant, Case-Fatality-Rate (CFR) is often estimated. The purpose of this work is to calculate the change in CFR of different variants over time from a large number of countries/regions since the start of the pandemic in 2020.

An individual’s fitness cost associated with environmental change depends on the rate of adaptive phenotypic plasticity, and yet our understanding of plasticity rates in an ecological and evolutionary context remains limited. We provide the first quantitative synthesis of existing plasticity rate data, focusing on acclimation of temperature tolerance in ectothermic animals, where we demonstrate applicability of a recently proposed analytical approach. The analyses reveal considerable variation in plasticity rates of this trait among species, with half-times (how long it takes for the initial deviation from the acclimated phenotype to be reduced by 50% when individuals are shifted to a new environment) ranging from 3.7 to 770.2 h. Furthermore, rates differ among higher taxa, being higher for amphibians and reptiles than for crustaceans and fishes, and with insects being intermediate. We argue that a more comprehensive understanding of phenotypic plasticity will be attained through increased focus on the rate parameter.

Objectives: To compare outcomes of telephone and face-to-face consultations for new otology referrals and discuss the wider use of telemedicine in otology. Design: Retrospective cohort study. Setting: UK secondary/tertiary referral unit. Participants: New adult otology referrals to our unit, sampled consecutively between March 2021 and May 2021, reviewed in either a face-to-face or telephone clinic. Main outcome measures: Primary outcome measure was the proportion of patients with a definitive management outcome (discharged or added to waiting list for treatment) versus the proportion of patients requiring follow-up for further assessment or review. Results: 150 new patients referred for a routine otology consultation (75 telephone, 75 face-to-face) were included. 53/75 patients (71%) undergoing a face-to-face consultation received a definitive outcome following initial review, versus 22/75 (29%) telephone patients (2 <0.001, OR 5.8). 52/75 (69%) telephone patients were followed up face-to-face for examination. The mean (SD) number of appointments required to reach a definitive outcome was 1.22 (0.58) and 1.75 (0.73) in the face-to-face and telephone cohorts respectively (p<0.001). Conclusion: Telephone clinics in otology have played an important role as part of the COVID19 response. However, they are currently limited by a lack of clinical examination and audiometry. Remote assessment pathways in otology that incorporate asynchronous review of recorded examinations alongside audiometry, either conventional or boothless, may mitigate this problem, however further research is required.

Objectives: The purpose of this study was to compare the incidences of common upper airway infections and their complications, and of antibiotic prescription rates during 2020, when the COVID-19 pandemic struck, and the previous year. Study design: Retrospective national register study Setting/source population: The Swedish population in 2019 and 2020. Methods: The Swedish Board of Health and Welfare statistics data base, which includes all out- and inpatient diagnoses in specialised care was used to retrieve the number of otitis media, rhinosinusitis, pharyngotonsillitis, acute mastoiditis and peritonsillar abscess diagnoses in various age groups during 2019 and 2020. The number of prescriptions of oral antibiotics used to treat upper airway infections was collected from the Swedish E-Health Authority, which covers all prescriptions in Sweden. Population data were retrieved from Statistics Sweden. Results: There was strong evidence of a substantial decrease (approximately 40%) in otitis media, rhinosinusitis and pharyngotonsillitis cases in the population as a whole in 2020 compared to 2019. For otitis media, the decrease was most pronounced among children, whereas rhinosinusitis and pharyngotonsillitis incidence decreased to a similar extent in adults, as well. Furthermore, there was equally strong evidence that acute mastoiditis decreased by 40% in children and adolescents and that peritonsillitis in adults decreased by 24%. The decrease in infections was accompanied by a corresponding decrease in antibiotic prescriptions. Conclusion: The social distancing measures introduced during 2020 were followed by a significant decrease in upper airway infections and antibiotic prescriptions.

Species turnover is fundamental for understanding the mechanisms that influence large-scale species richness patterns. However, the large-scale spatial variation and the causes in soil animal species turnover remain elusive. In addition, the determinants of species turnover depend on the dispersal ability of guilds. In this study, we explored the large-scale patterns of meso-micro soil fauna turnover pattern and the driving factors based on fourteen sampling sites in East Asia. The patterns of soil fauna species turnover increased significantly with increasing latitude differences in East Asia. The environment explained 54.09, 50.62, and 57.34% of the total variance, and spatial factors explained 13.84, 15.91, and 21.04% of the total variance in species composition of overall, phytophage, and predacity faunas, respectively. Meanwhile, the effects of climate factors in environmental processes were stronger than that of soil factors in these three groups. Our results support the hypothesis that the effect of environment processes on soil animal species turnover is more important than the effect of the neutral. Climatic factors explained more variation for turnover of phytophage faunas, but soil and environment factors explained equally for predacity. Our results provide evidence supporting both environmental filtering and dispersal limitation hypotheses on the reginal and population scales. At last, this study has important theoretical significance and applied value in maintaining and promoting soil biodiversity and ecosystem services on the large scale.

The usual features of the acrocallosal syndrome (ACLS) are agenesis of the corpus callosum, mental retardation, prominent craniofacial deformities, and specific digital abnormalities. We discuss the case of a neonate with ACLS-consistent characteristics. The occurrence of this syndrome may have been caused by maternal exposure to cosmetics-related substances during pregnancy.

Characteristic of Sound Localisation of Unilateral Microtia and Atresia with and without a Non-surgical Bone Conduction Device

The accurate delimitation of species boundaries in non-bilaterian marine taxa is notoriously difficult, with consequences for many studies in ecology and evolution. Anthozoans are a diverse group of key structural organisms worldwide, but the lack of reliable morphological characters and informative genetic markers hampers our ability to understand species diversification. We investigated population differentiation and species limits in Atlantic (Iberian Peninsula) and Mediterranean lineages of the octocoral genus Paramuricea previously identified as P. clavata. We used a diverse set of molecular markers (microsatellites, RNA-seq derived single-copy orthologues [SCO] and mt-mutS [mitochondria]) at 49 locations. Clear segregation of Atlantic and Mediterranean lineages was found with all markers. Species-tree estimations based on SCO strongly supported these two clades as distinct, recently diverged sister species with incomplete lineage sorting, P. cf. grayi and P. clavata, respectively. Furthermore, a second putative (or ongoing) speciation event was detected in the Atlantic between two P. cf. grayi colour morphotypes (yellow and purple) using SCO and supported by microsatellites. While segregating P. cf. grayi lineages showed considerable geographic structure, dominating circalittoral communities in southern (yellow) and western (purple) Portugal, their occurrence in sympatry at some localities suggests a degree of reproductive isolation. Overall, our results show that previous molecular and morphological studies have underestimated species diversity in Paramuricea occurring in the Iberian Peninsula, which has important implications for conservation planning. Finally, our findings validate the usefulness of phylotranscriptomics for resolving evolutionary relationships in octocorals.