Ecosystems remain under enormous pressure from multiple anthropogenic stressors. Manipulative experiments evaluating stressor interactions and impacts mostly apply stressors under static conditions without considering how variable stressor intensity (i.e., fluctuations) and synchronicity (i.e., timing of fluctuations) affect biological responses. We ask how variable stressor intensity and synchronicity, and interaction type, can influence how multiple stressors affect seagrass. At the highest intensities, fluctuating stressors applied asynchronously reduced seagrass biomass 36% more than for static stressors, yet no such difference occurred for photosynthetic capacity. Testing three separate hypotheses to predict underlying drivers of differences in biological responses highlighted alternative modes of action dependent on how stressors fluctuated over time. Given that environmental conditions are constantly changing, assessing static stressors may lead to inaccurate predictions of cumulative effects. Translating multiple stressor experiments to the real-world, therefore, requires considering variability in stressor intensity and the synchronicity of fluctuations.

Background: Ischemic mitral valve regurgitation is a subgroup of secondary mitral valve insufficiency that develops due to ischemic heart disease. The aim of the study is to evaluate the patients who were operated after acute myocardial infarction for the type of interventions to be performed for the mitral valve in terms of mortality and morbidity. Methods: It is a single-centered, retrospective study. Patients who were admitted to the hospital with the diagnosis of acute myocardial infarction and operated emergently or urgently between January 2017 and December 2020 were evaluated. Patients who were found to have significant IMR (≥ moderate mitral regurgitation) in the early period and who could achieve complete revascularization were included in the study. Patients were divided into two groups whether the mitral valve was intervened or not. Results: The demographical data of the patients that were included in the study is as follows, 73.4% were male and 33% were female. The average age of the patients was 63.2 ± 8.9. Patients were compared in terms of significant (moderate or higher) postoperative residual mitral regurgitation. 62.2% (n=23) of the patients undergone isolated CABG had mild mitral regurgitation. 5 patients with mitral valve annuloplasty (17.9%) had significant residual regurgitation (p<0.001). Conlusion: Mitral valve intervention should not be considered in non-severe mitral valve insufficiencies (without papillary rupture or chorda rupture) after acute MI. Preservation of the dynamic structure of the mitral valve annulus in the acute period makes mitral ring annuloplasty not an appropriate treatment.

Redo cardiac surgery can present a unique set of challenges even to the experienced surgeon. Although outcomes have steadily improved in the modern era; if an intraoperative adverse event occurs, there is a 5% incidence of mortality and 19% incidence of myocardial infarction, stroke or death [(1)](#ref-0001). Overall, the modern incidence of mortality at reoperation varies but be segregated into low and higher risk cohorts depending on the planning computed tomography imaging and risk to substernal structures on re-entry [(2, 3)](#ref-0002). Patients with ascending aortic or root pseudoaneurysms represent a particularly difficult subset of high-risk patients requiring re-operative cardiac surgery due to the danger of exsanguination and air embolization [(4)](#ref-0004). Some surgeons advocate the use of deep hypothermic circulatory arrest (DHCA) to achieve safe re-entry in such cases however this can result in unpredictable DHCA duration depending on the degree of pericardial adhesions [(5)](#ref-0005). We report a case of aortic pseudoaneurysm in a patient with patent coronary grafts managed using an endoballoon precisely positioned relative to the proximal anastomoses resulting in a safe surgical re-entry and shorter DHCA time.

Title Page:Title: Letter To The Editor: Long-Term Renal Function After Venoarterial Extracorporeal Membrane Oxygenation.Article Type: Letter To The EditorCorrespondence: 1. Rohit KumarContact No: +923332669103 Email: rohitkella001@gmail.comInstitute: Dow Medical CollegeAddress: Baba-e-urdu road, KarachiCo-Authors: 2. Sunil KumarContact No: +923008088669. Email: dr.sunilkumar@hotmail.comInstitute: Liaquat University of Medical and Health Sciences.Word Count: 476Conflict of interest : NoneAcknowledgment : NoneDeclaration: NoneDisclosure : NoneFunding : None

We describe conservative management of a rare type IIa endoleak after frozen elephant trunk operation with hybrid Thoraflex stent graft in chronic type B aortic dissection repair.

Ecological traps occur when species choose to settle in lower quality habitats, even if this reduces their survival or productivity. This normally occurs in situations of drastic environmental changes, resulting, for example, from anthropogenic pressures. In the medium and long term, this could mean the extinction of the species. We investigated the dynamics of occurrence and distribution of three canid species (Atelocynus microtis, Cerdocyon thous, and Spheotos venaticus) related to human threats imposed on their habitats in the Amazon Rainforest. We analyzed the possible environmental thresholds for the occurrence of these species and confronted them with the future projections of climatic niches for each one. All three species will be negatively affected by climate change in the future, with losses of up to 91% of the suitable area of occurrence in the Brazilian Amazon. The occurrence of C. thous and S. venaticus has been positively influenced by anthropogenic open areas to the detriment of native environments, suggesting that these species are being attracted by ecological traps, which may put them at risk in the future in the Amazon Region. The A. microtis species is the most dependent on forest habitats, and thus the most significant threat would be forest loss. Using the canid species as a model, we could deeply investigate these ecological effects that can affect a large part of the Amazonian fauna in the current scenario. Considering the high degree of environmental degradation and deforestation in the Amazon Rainforest, the theory of ecological traps must be discussed at the same level that habitat loss is considered a decisive criterion of threat to biodiversity.

Background and purpose: Chronic inflammation may affect bone metabolism, leading to consequent bone loss and increased fracture risk. Lipopolysaccharide (LPS), a major component of Gram-negative bacteria from an infection or leaky gut, may cause chronic inflammatory bone loss. This study aims to enrich the mechanism by which LPS promotes the pathogenesis of bone loss. Experimental approach: C57BL/6 mice were treated with 1.5 mg•kg-1 of LPS or vehicle by intraperitoneal injection 3 times a week. The pharmacological effect of disulfiram, resatorvid, erlotinib were assessed in mice models of chronic inflammatory bone loss induced by LPS. Primary bone marrow-derived macrophages (BMDMs) were used to evaluate the roles of toll-like receptor (TLR) 4 and epidermal growth factor receptor (EGFR) signaling in pyroptosis. Key results: We demonstrated that TLR4 and EGFR signaling differentially regulated pyroptosis in BMDMs, mediating LPS-induced low proliferation of osteoprogenitors and inflammatory bone destruction. Pharmacological treatment of LPS-treated mice with pyroptosis inhibitor by disulfiram, TLR4 signaling inhibitor by resatorvid, or EGFR signaling inhibitor by erlotinib protected mice against loss of osteoblasts and osteoprogenitors, and rescued inflammatory bone destruction as well. Mechanistically, we found that LPS suppressed the proliferation of osteoprogenitors by activating pyroptosis in BMDMs. Further, EGFR signaling mediated the mRNA expression of IL-1β and IL-18 while TLR4 signaling mediated LPS-induced pyroptosis and release of IL-1β and IL-18. Conclusion and implications: These findings have identified TLR4 and EGFR signaling in BMDMs as a co-regulator of pyroptosis and inflammatory bone destruction, highlighting the importance of targeting pyroptosis against LPS-induced bone loss.

A child had been vomiting, convulsing, and having an abnormal sensorium for 3 days. He fell from his mother's lap 20 days back. On CT scan brain, he had traumatic subdural effusion. In the emergency room, he underwent subdural effusion needle aspiration, which resulted in an immediate improvement in GCS.

A 1-year-old girl presented with an overly enlarged head for 5 months. Ignorance of parents regarding treatment for this enlarged head is concerning. Early treatment can avoid a lot of complications. Hydrocephalus secondary to aqueductal stenosis was diagnosed after a thorough history, examination, and investigations. Endoscopic Third Ventriculostomy was performed.

A 25-year-old man came to us with a three-year-old forehead scar. There was no history of trauma, and no other signs or symptoms to go along with it. He had a non-contrast computed tomography (CT) brain scan, which revealed thickening of the inner frontal bone, indicating hyperostosis frontalis interna.

Konno-Rastan operation is the treatment of choice for relief of complex left ventricular outflow obstruction, especially in those with a small aortic annulus. In this report, we present a case of a ten-year-old boy with the diagnosis of recurrent diffuse subaortic stenosis and dextrocardia who underwent Konno-Rastan operation successfully.

During the twentieth century, scientific and technological progress has led to a sharp increase in energy consumption. Since the beginning of the XXI century, hydrocarbon raw materials have become the basis of energy generation. Scientists around the world are currently working on the development and implementation of new alternative methods of energy generation. The share of ecological generation is growing every year, but such growth does not keep up with the increase in consumption. With this in mind, the article conducted a study proposing a new approach to electricity generation. The operation of the proposed devices is based on the conversion of electric current by an anisotropic electrically conductive medium characterized by different p- and n-types of conductivity in selected crystallographic directions under ohmic contact. It is shown that in the case of an external sinusoidal electric current flowing through a device based on an anisotropic rectangular plate, vortices of electric current occur in its volume. Such electric vortices with turbulent flow are an effective mechanism that pumps energy between the environment and in our case, the anisotropic plate.

This paper presents the load-dependent power loss in a wind turbine gearbox under real-time operating wind speed for three different oil formulations. The gear power loss was determined using mathematical models from the values of gear loss factors and specific film thickness experimentally determined by other researchers. The bearing power loss was determined using the new SKF calibrated model. Wind data from Bafoussam, a town in Cameroon was used to validate the model. A back propagation neural network with different numbers of hidden neurons was designed for power loss modeling and prediction. The achieved results reveal that the load-dependent power loss in a wind turbine gearbox is greatly influenced by wind speed and oil type. Finally, it is shown that the predictive performance of the neural network is also influenced by the number of neurons in the hidden layer.

Primary abdominal ectopic pregnancy is extremely rare. This case write-up is to report a primary abdominal ectopic pregnancy managed with surgical intervention followed by medical treatment. Every gynecologist needs to have a high index of suspicion and deal promptly to obviate grievous consequences.

We present a case of a 61-years old female patient with family history of malignancy who presented with multiple nodules at the ultrasonography images. CT scan and MRI were not sufficient to pose a certain diagnosis which was later confirmed by liver biopsy.

Rust fungi are characterized by large genomes with high repeat content, and have two haploid nuclei in most life stages, which makes achieving high-quality genome assemblies challenging. Here, we describe a pipeline using HiFi reads and Hi-C data to assemble a gigabase-sized fungal pathogen, Puccinia polysora f.sp. zeae, to haplotype-phased and chromosome-scale. The final assembled genome is 1.71 Gbp, with ~850 Mbp and 18 chromosomes in each haplotype, being currently the largest fungal genome assembled to chromosome scale. Transcript-based annotation identified 47,512 genes with a similar number for each haplotype. A high level of interhaplotype variation was found with 10% haplotype-specific BUSCO genes, 5.8 SNPs/kbp, and structural variation accounting for 3% of the genome size. The P. polysora genome displayed over 85% repeat content, with genome-size expansion, gene losses and gene family expansions suggested by multiple copies of species-specific orthogroups. Interestingly, these features did not affect overall synteny with other Puccinia species with smaller genomes. Fine-time-point transcriptomics revealed seven clusters of co-expressed secreted proteins that are conserved between two haplotypes. The fact that candidate effectors interspersed with all genes indicated the absence of a “two-speed genome” evolution in P. polysora. Genome resequencing of 79 additional isolates revealed a clonal population structure of P. polysora in China with low geographic differentiation. Nevertheless, a minor population drifted from the major population by having mutations on secreted proteins including AvrRppC, indicating the ongoing evolution and population differentiation. The high-quality assembly provides valuable genomic resources for future studies on the evolution of P. polysora.

In order to interpret the degree of postmating isolation and the evolutionary relationships among Fejervarya species from Indonesia (Lesser Sunda), Bangladesh, China, and Japan, crossing experiments and molecular phylogenetic analyses were carried out using frogs of Fejervarya species from these countries. The crossing experiments revealed that the reciprocal hybrids among F. iskandari, F. verruculosa, and F. sp. Large type, and those between F. multistriata and F. kawamurai were viable through metamorphosis, but those between F. iskandari group and F. limnocharis group were completely or partially inviable at the tadpole stage, and those between Southeast -Asian and South-Asian Fejervarya groups were completely inviable at the embryonic stage. The matured reciprocal hybrids between F. iskandari and F. verruculosa from Indonesia, Lesser Sunda showed some degree of abnormality in spermatogenesis. The phylogenetic analyses using mtDNA Cytb gene sequences demonstrated that F. iskandari formed a sister clade with F. verruculosa from Lesser Sunda, Indonesia with 8.1% sequence divergence. Fejervaraya multistriata from China made a clade with Thailand, Malaysia and Indonesian (topotype) populations of F. limnocharis which showed sister relationships to F. kawamurai from Japan with 8.9% sequence divergence of Cytb gene. Fejervarya sp. small type from Bangladesh formed a clade with the other South-Asian members of Fejervarya group and made a sister clade with Southeast-Asian Fejervarya group having 23.1% sequence divergence of Cytb gene. This study showed that the degree of postmating isolation reflects the molecular phylogenetic relationships, and that the two species, F. iskandari and F. verruculosa from Indonesia (Lesser Sunda) are reproductively isolated by abnormal spermatogenesis, and genetically deviated.

Malignant hyperthermia (MH) is a lethal complication associated with general anesthesia characterized by sudden onset, rapid progression, and high mortality. Adequate preoperative assessment, attention to MH susceptibility, early identification of MH response, timely rescue, early use of dantrolene, and attention during cardiopulmonary bypass are necessary for comprehensive MH treatment.

We described a case of neural tube defect (NTDs) viz., occipital encephalomeningocele born to a mother with folic acid supplementation. A wide interplay of genetic and environmental factors exists in its causation. The folic acid confers advantage but the relationship with causation of NTDs is still not clear.

Background: In the absence of a clear clinical history of reaction, diagnosis of cashew allergy using skin prick tests (SPT) or cashew-specific IgE requires a high number of oral food challenges (OFC). By using Ana o 3 sIgE alone, or a two-step diagnostic algorithm using cashew sIgE followed by Ana o 3 sIgE, there is a reduced need for OFC. We aimed to perform a cost comparison for both of these approaches compared to cashew SPT alone. Methods: Pooled individual level data from 6 studies was used to determine diagnostic accuracy and OFC rate. Two studies used cashew SPT (n=567, 198 allergic), with 95% positive and negative predictive values of ≥12mm and <3mm. Four studies were included in the pathways for Ana o 3 sIgE alone or a 2-step algorithm incorporating cashew and Ana o 3 sIgE (n=271, 156 allergic). Cut-offs used were ≥8.5kUA/L and ≤0.1kUA/L for cashew sIgE and ≥0.35kUA/L and ≤0.1kUA/L for Ana o 3 sIgE. Costs were constructed based on unit prices from hospital inpatient admissions, expenses incurred by families, individual patient data on allergic reaction types and rates and adrenaline autoinjector carriage, applying a health system perspective. Results: Modelled data through the Ana o 3 pathway resulted in a 46.43% cost reduction (\euro307,406/1000 patients) compared to using cashew SPT alone (\euro573,854/1000 patients). The 2-step algorithm resulted in a 44.94% cost reduction compared to SPT alone (\euro315,952.82/1000 patients). Both the Ana o 3 pathway and 2-step algorithm resulted in a 79-80% reduction in OFCs compared to SPT. Conclusions: Using Ana o 3 as a standalone test for cashew allergy diagnosis or a 2-step algorithm incorporating cashew sIgE and Ana o 3 sIgE is accurate and results in a large reduction in both OFCs and health system costs compared to cashew SPT alone.

Children with congenital neutropenia frequently require hospitalization due to febrile neutropenia. Deficiency of Adenosine DeAminase -2(DADA-2) an autosomal recessive disorder caused by a mutation in CECR1 gene. It is an autoinflammatory disease presenting with autoimmunity and features of immunodeficiency. It usually presents in early childhood with recurrent stroke and vasculitis features. Here, we report a young male with CECR1 mutation presenting predominantly with neutropenia.

n this work, we present a new boundary conditions for fractional cubic spline (FCS) model for solving fractional Volterra-integral equations. We reduced the problem to a set of a linear systems by using fractional continuity conditions. Convergence analysis proved to solve fractional Volterra-integral equations by obtained linear systems, to determine fractional spline derivatives, we applied the Caputo fractional derivative. The process is detailed and computed with three computational examples, and the results show that it is both effective and simple to use. Moreover, the results are compared with the methods in [1 ], [ 2 ] and [4].

Ab initio calculations were carried out to understand the effect of electron donating groups (EDG) and electron withdrawing groups (EWG) at the C5 position of cytosine (Cyt) and saturated cytosine (H2Cyt) of the deamination reaction. Geometries of the reactants, transition states, intermediates, and products were fully optimized at the B3LYP/6-31G(d,p) level in the gas phase as this level of theory has been found to agree very well with G3 theories. Activation energies, enthalpies, and Gibbs energies of activation along with the thermodynamic properties (ΔE, ΔH, and ΔG) of each reaction were calculated. A plot of the Gibbs energies of activation (ΔG‡) for C5 substituted Cyt and H2Cyt against the Hammett σ-constants reveal a good linear relationship. In general, both EDG and EWG substituents at the C5 position in Cyt results in higher ΔG‡ and lower σ values compared to those of H2Cyt deamination reactions. C5 alkyl substituents (−H, −CH3, −CH2CH3, −CH2CH2CH3) increase ΔG‡ values for Cyt, while the same substituents decrease ΔG‡ values for H2Cyt which is likely due to steric effects. However, the Hammett σ-constants were found to decrease for both the Cyt and H2Cyt. Both ΔG‡ and σ values decrease for the substituents Cl and Br in the reaction Cyt, while ΔG‡ values increase and σ decrease in the reaction H2Cyt. This may be due to high polarizability of bromine which results in a greater stabilization of the transition state in the case of bromine compared to chlorine. Regardless of the substituent at C5, the positive charge on C4 is greater in the TS compared to the reactant complex for both the Cyt and H2Cyt. Moreover, as the charges on C4 in the TS increase compared to reactant, ΔG‡ also increase for the C5 alkyl substituents (-H, −CH3, −CH2CH3, −CH2CH2CH3) in Cyt, while ΔG‡ decrease in H2Cyt. In addition, analysis of the frontier MO energies for the transition state structures shows that there is a correlation between the energy of the HOMO‒LUMO gap and activation energies.

Rhabdomyosarcomas (RMS) are the most common pediatric soft tissue sarcomas. High-risk and metastatic disease continues to be associated with very poor prognosis. RMS model systems that faithfully recapitulate the human disease and provide rapid, cost-efficient estimates of anti-tumor efficacy of candidate drugs are needed to facilitate drug development and personalized medicine approaches. Here, we present a new zebrafish-based xenotransplant model allowing for rapid and easily accessible drug screening using low numbers of viable tumor cells and relatively small amounts of water-soluble chemicals. Under optimized temperature conditions, embryonal RMS-xenografts were established in zebrafish embryos at 3 hours post fertilization (hpf). In proof-of-principle experiments, chemotherapy drugs with established clinical anti-RMS efficacy (vincristine, dactinomycin) and the MEK inhibitor trametinib were shown to significantly reduce the cross-sectional area of the tumors by 120 hpf. RMS xenograft models in zebrafish embryos henceforth could serve as a valuable addition to cell culture and mammalian models of RMS and represent a rapid and cost-effective solution for pre-clinical candidate drug testing.