Understanding how parasite transmission is affected by ecological interactions among hosts is critical for predicting disease dynamics. For instance, theory predicts that intraguild predation (IGP) and cannibalism negatively impact parasite populations, but this is based primarily on assumptions of simple or single host life cycles. Here we investigate the effects of cannibalism on two digenean trematodes that have complex multi-host life cycles. Contrary to theory, high cannibalism among paratenic hosts produced higher parasite abundances, whereas cannibalism among obligate hosts reduced parasite abundances as predicted. We attribute this difference to trophic transfer of parasites among paratenic hosts via cannibalism. Moreover, we found evidence of indirect competitive interactions between parasites that can also increase infections at small scales. Our results show that there are multiple mechanisms through which high cannibalism environments can benefit parasites that use paratenic hosts and trophic transfer to complete their life cycles.

In order to reduce the error transfer existing in the application of knowledge distillation network in the previous knowledge question answering model, a multi-path reasoning teacher network model is proposed. The basic reasoning model is obtained according to the idea of bidirectional reasoning, and then two sets of bidirectional reasoning answer search paths are added to improve the accuracy of the intermediate supervision signal generated by the teacher network and reduce the negative effect of the teacher network on the student network. The experimental results have proved the effectiveness of this method. In addition, the multi-path reasoning method proposed in this paper can provide ideas for knowledge reasoning, knowledge question answering and other fields.

Abstract Background: The concurrent usage of herbal medicines with conventional therapies is an important concern in cancer treatment which can lead to unexpected consequences like herb-drug interactions. The aim of this study was to determine the prevalence of potential herb-drug interactions and to predict factors associated with herb-drug interactions for cancer patients. Methods: This cross-sectional study was conducted among a convenience sample of 315 cancer patients referring to the oncology clinics of Kerman in 2018. Data were collected via comprehensive face-to-face interviews and medical chart reviews. A drug interaction checker was used to determine herb-drug interactions. The information of patients was compared based on herb-drug interactions by using bivariable logistic regression models and predictors were determined by the multivariable logistic regression model. All analyses were performed by Stata software version 16. Results: Of 262 patients who used herbal medicines, 209 patients [79.8% (95% CI: 75.2 – 85.1)] had potential herb-drug interactions. Chamomile was the most popular herbal medicine (n=163, 78%), and minor and moderate herb-drug interactions were caused by green tea (n=34, 16.3%) and peppermint (n=78, 37.5%). The number of chemotherapeutic agents (OR: 1.92, 95% CI: 1.43–2.58; P-value<0.0001) and the experience of pain during chemotherapy courses (OR=2.22, 95%CI:1.00–4.94; P-value=0.04) were some of the predictors of herb-drug interactions among cancer patients. Conclusion: The majority of cancer patients used herbal medicines during chemotherapy courses and physicians could reduce the odds of herb-drug interactions with proper education, monitor the side effects of chemotherapy, and prevent patients from self-medication with herbal medicines.

Clonidine is an alpha-adrenergic receptors and used in the treatment of hypertensive. We described a 22-year-old man with end-stage renal disease and hypertension overdose use for 7 years in a peritoneal dialysis patient do not cause severe toxicity except exhilarate.

Microorganisms build fatty acids with biocatalytic assembly lines, or fatty acid synthases (FASs), that can be repurposed to produce a broad set of fuels and chemicals. Despite their versatility, the product profiles of FAS-based pathways are challenging to adjust without experimental iteration, and off-target products are common. This study uses a detailed kinetic model of the E. coli FAS as a foundation to model nine oleochemical pathways. These models provide good fits to experimental data and help explain unexpected results from in vivo studies. An analysis of pathways for alkanes and fatty acid ethyl esters, for example, suggests that reductions in titer caused by enzyme overexpression can result from shifts in pools of metabolic intermediates that are incompatible with the substrate specificities of downstream enzymes. In general, different engineering objectives (i.e., production, unsaturated fraction, and average chain length) show experimentally consistent sensitivities to pathway enzymes, and model-based compositional analyses indicate simple shifts in enzyme concentrations can alter the product profiles of pathways with promiscuous components. The study concludes by integrating all models into a graphical user interface. The models supplied by this work provide a versatile kinetic framework for studying oleochemical pathways in different biochemical contexts.

Cyberinfrastructures in ecology have coevolved alongside fields excellent at expanding the landscape of big data acquisition. Arguably, they offer better technological solutions for mobilising ‘born digital’ data (e.g. sensor technologies and citizen science), then they do for low velocity, resource intensive ecological data which are inherently tied to sociological and cultural constraints limiting sharing. Such barriers can be summarised as trust, transparency and control, fundamental properties on which blockchain technologies have been prefiguratively designed. While this nascent decentralised ledger technology (DLT) is receiving increasing attention among the sciences, focus is yet to be directed at its potential utility to bolster open ecological data. In this viewpoint we offer insight into how blockchain technology could be leveraged to help normalise and incentivize open ecological data and its potential to help culture a paradigm shift from data proprietorship towards data stewardship.

Objective The COVID-19 pandemic has had a significant impact on oncogynecologic patients worldwide, particularly with respect to delayed diagnosis and treatment. During the COVID-19 pandemic, few studies have examined the impact of delayed surgery on survival in early-stage cervical cancer patients. The purpose of this study was to determine the effect of delayed surgical time on survival in patients with early cervical cancer. Design A retrospective cohort study. Setting A single general hospital in Shaanxi, Northwest China. Population A total of 1207women with early cervical cancer were recruited between April 2013 and December 2018 in Mainland China and followed up until 29 Feb 2022. Methods This retrospective cohort study was conducted in a comprehensive tertiary hospital in Shaanxi, Xi’an, China. We used a Cox proportional hazard model with delay time in weeks as a categorical variable to analyse the effect of surgical delay time on survival. Main Outcome Measures The 5-year overall and disease-free survival were used as the primary outcome measures. Results A total of 800 participants were included in the final cohort. In the multivariate Cox regression analysis (median follow-up, 58 months), patients in the long delay time group had DFS (5-year rates, 91.5% versus 90.9%, HR 0.99, 95% CI 0.62~1.59, P=0.98) and OS (5-year rates of 92.9% versus 90.8%, HR 0.68, 95% CI 0.42~1.10, P=0.11) similar to those in the short delay time group. Conclusions Our findings indicate that a 12-week delay in surgery is not associated with long-term survival in women with early-stage cervical cancer.

A commentary on the fertility-sparing treatment for early endometrial cancer: the challenge to expand indications Sijing Chen1,2, Ying Zheng*1,2

Objective: To investigate the outcome of Laparoscopic Nerve-Sparing Ultra-Radical Hysterectomy (LNSURH), open radical hysterectomy (ORH), and concurrent platinum-based chemoradiation therapy (CCRT) on patients with locally advanced cervical carcinoma (LACC). Design：Retrospective clinical study. Population：LACC patients (74) who received ORH (29), LNSRH (20), or CCRT (25) between January 2011 and December 2019 at the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University. Methods: The age, tumor size, early and late postoperative morbidities, disease-free survival (DFS), and overall survival (OS) were recorded. A series of questions regarding urinary, bowel, and sexual functions were asked to the patients after their operation. Results: The Kaplan Meier curves revealed that the OS and DFS times in the CCRT group were comparable to the ORH or LNSURH groups (P = 0.106 for DFS and 0.190 for OS). The rates of early complications in the CCRT, ORH, and LNSURH groups, were also not statistically significant differences among the three groups (P = 0.46). Compared with CCRT groups, the rate of late complications in the ORH and LNSURH groups was significantly lower. The urinary and bowel functions were restored to the preoperative state although the resultant sexual function was not satisfactory. Main outcome measures：Postoperative prognosis and life quality of these patients. Conclusion: The CCRT, ORH, and LNSURH can be provided as options for LACC patients as they showed no statistically significant difference in the OS and DFS. LNSURH exhibited a lower rate of late complications and a high score of sexual function.

BRCA2, PALB2, RECQL4 germline mutations, and TP53 somatic mutations in endometrial cancer, with ovarian cancer and unilateral breast cancer: A triple metachronous malignancies case reportYang Liua, Xueshu Fua, Luting Zhonga, Ping Xua, Fang Fanga Ying Liua, Qing Lia, Ya’nan Yana, Shanchuang Weia, Chunhua ZhangbaHuai ’an Maternal and Child Health Care Hospital, Department of Gynaecology, Jiangsu Province, ChinabThe Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Department of Gynaecology, Jiangsu Province, ChinaCorrespondence: Chunhua Zhang, The Huai’an Maternity and Child Clinical College of Xuzhou Medical University, Department of Gynaecology, Jiangsu Province, China. Email: hafyzch@126.comAbstractMultiple primary cancer (MPC) is defined by developing more than one malignancy in a single patient. Triple primary malignancies are a relatively rare occurrence. Endometrial cancer (EC) is the most common female pelvic malignant tumor. EC patients with gene mutations such as BRCA2 mutation have a higher risk of ovarian cancer and breast cancer than normal people. Here, we present a 50-year-old postmenopausal woman diagnosed with BRCA2, PALB2, RECQL4 germline mutations, and TP53 somatic mutations in endometrial cancer, and with ovarian cancer and unilateral breast cancer. In term of diagnosis of MPC, gene testing maybe necessary for patients with endometrial cancer, even for patients with low-risk types (well differentiated, superficial muscle layer, small lesions) that meet Mayo criteria.Keywords: Multiple primary cancer; Endometrial cancer; Ovarian cancer; Breast cancer; Gene test

A method for practical realization of the inverse scattering transform method for the Korteweg-de Vries equation is proposed. It is based on analytical representations for Jost solutions and for integral kernels of transformation operators obtained recently by the authors. The representations have the form of functional series in which the first coefficient plays a crucial role both in solving the direct scattering and the inverse scattering problems. The direct scattering problem reduces to computation of a number of the coefficients following a simple recurrent integration procedure with a posterior calculation of scattering data by well known formulas. The inverse scattering problem reduces to a system of linear algebraic equations from which the first component of the solution vector leads to the recovery of the potential. We prove the applicability of the finite section method to the system of linear algebraic equations and discuss numerical aspects of the proposed method. Numerical examples are given, which reveal the accuracy and speed of the method.

The aim of current study is to establish two crucial (p, q) b -integral identities for midpoint and trapezoid type inequalities. Utilizing these identities, we developed some new variant of midpoint and trapezoid type integral inequalities of differential (α, m)-convex functions using right post quantum integral approach. Moreover, we have presented the application of derived results related to special means of positive real numbers.

We present a strange type of aortic dissection in this report. The patient's Computed tomography demonstrated a strange intima-media complex dislodgement adjacent to the cervical vessels from ascending aorta. Emergent surgery was performed to this patient successfully.

Ventricular septal rupture with dissection of the interventricular septum is an extremely rare complication following myocardial infarction, and the optimal surgical strategy remains unclear because of the limited number of surgical cases. Here we report a case of ventricular septal rupture with dissection of the interventricular septum, which we treated using a modification of the extended double patch technique via false lumen incision to close the ventricular septal rupture and exclude the dissection cavity.

Understanding the aortic annulus is important for obtaining reproducible and durable aortic valve repair and allowing advances for TAVR treatment of aortic regurgitation. Significant limitations exist when using echocardiography and CT-based imaging with feature tracking at the aortic annulus. Cardiac Magnetic Resonance is used to obtain Regional Longitudinal Strain (RLS) and can be modified to obtain circumferential annular strain at the fibrous and muscular portions of the aortic valve annulus. Holst and colleagues use a novel method to characterize and prove that adverse annular deformation occurs at the muscular portion of the aortic valve annulus in patients with aortic regurgitation. The direction of muscular annular deformation in patients with aortic regurgitation is opposite to the direction of muscular annular deformation in patients with normal aortic valves.

Background: Left ventricular assist devices have been a significant development in the treatment of patients with advanced heart failure supporting circulation as a bridge to transplant, recovery or long-term destination therapy. When ventricular recovery occurs, there are multiple described ways of proceeding. HM2 decommissions are well described with varying degrees of explant operations, less so in HM3 due to the novelty of the device. In certain situations, invasive surgery can carry high risk and so a minimally invasive decommission, leaving the LVAD essentially intact in situ can be considered. Case report In this report, we describe the case of a 35-year-old male diagnosed with an idiopathic dilated cardiomyopathy requiring an LVAD with subsequent identification of cardiac recovery with the asymptomatic thrombosis of the 2 nd HM3 device. Investigations demonstrated absent flow through the pump whilst the patient-reported NYHA I functional class symptoms. The Driveline was cut with the remaining internal pump components decommissioned and left in situ. At 1 year the patient continues to do well with continued features of cardiac recovery with an LVEF of over 40%. Conclusion LV recovery is well recognized with typical management being LVAD explant surgeries performed. Each case should be analyzed for risks and benefits to the patient and future research showed be directed towards levels of decommissioning surgery and management post-LVAD decommission patient care.

Two dimensional (2D) images of light beams reflected off the objects in space impinge on the retinal photoreceptors of our two laterally separated eyes. Nevertheless, we experience our visual percept as a single 3D entity—our visual world that we tend to identify with physical world. However, experiments point to different geometries in these two worlds. Using the binocular system with the asymmetric eyes (AEs), this article studies the global geometric aspects of visual space in the Riemannian geometry framework. The constant-depth curves in the horizontal field of binocular fixations consist of families of arcs of ellipses or hyperbolas depending on the AE parameters and the eyes’ fixation point. For a single set of AE’s parameters, there is a unique symmetric fixation at the abathic distance such that the constant-depth conics are straight frontal lines. Critically, the distribution of the constant-depth lines is independent of such fixations. In these cases, a two-parameter family of the Riemann metrics is proposed based on the retinal topography and simulated constant-depth lines. The obtained geodesics for a subset of metric parameters include the incomplete geodesics that give finite distances to the horizon. The Gaussian curvature of the phenomenal horizontal field is analyzed for all the metric parameters. The sign of the curvature can be inferred from the global behavior of the constant-depth ellipses and hyperbolas only when for the metric parameters for which the constant-depth frontal lines at the abathic distance fixations are geodesics.

We describe here the third reported case of anaphylaxis after ingestion of some leavers of Moringa oleifera, causing a widespread angioedema, a respiratory distress and an elevation of serum tryptase. Moringa oleifera leavers were confirmed as the causative allergen by prick testing with fresh leavers.

Hemolytic disease of the fetus and newborn can cause hydrops and intrauterine death due to fetal anemia. Immunoglobulin and plasmapheresis have been used to defer blood transfusions to later gestational ages and treat fetal anemia in patients who were immunized early in pregnancy, with different success.

Recombination is responsible for breaking up haplotypes, influencing genetic variability, and the efficacy of selection. Bird genomes lack the protein PRDM9, a key determinant of recombination dynamics in most metazoans. The historical recombination maps in birds show an apparent stasis in the positioning of recombination events. This highly conserved recombination pattern over long timescales should constrain the evolution of recombination in birds, but extensive variation in recombination rate across the genome and between different species has been reported. Here, we characterise a fine-scale historical recombination map of an iconic migratory songbird, the European blackcap (Sylvia atricapilla) using a LD-based approach which accounts for population demography. We found variable recombination rates among and within chromosomes, which associate positively with nucleotide diversity and GC content, and a negatively with chromosome size. The recombination rates increased significantly at regulatory regions and not necessarily at high-dense gene regions. CpG islands associated strongly with recombination rates; however, their specific position and local DNA methylation patterns likely influenced this relationship. The association with retrotransposons varied according to specific family and location. Our results also provide evidence of a heterogeneous conservation of recombination maps between the blackcap and its closest sister taxon, the garden warbler at the intra-chromosomal level. These findings highlight the considerable variability of recombination rates at different scales and the role of specific genomic features at shaping this variation. This study opens the possibility of further investigating the impact of recombination in specific population-genomic features.

Cryptogenic stroke is a complication commonly associated with patent foramen ovales (PFOs). However, current guidelines do not address PFO management in COVID-19 patients. This report describes a challenging case of an unvaccinated patient with recurrent strokes and refractory hypoxemia secondary to COVID-19 pneumonia who underwent a PFO closure using NobleStitch.

Rickettsial infections and Q fever are a common cause of acute febrile illness globally. Data on the role of climate and altitude on the prevalence of these infections in lacking from Southern India. In this study, we determined the sero-prevalence of scrub typhus (ST), spotted fever (SF), murine typhus (MT) and Q Fever (QF) in 8 eight geographical regions of North Tamil Nadu by detecting IgG antbodies using ELISA. Totally we tested 2565 people from 86 localities. Among the 27.3 % positives, approximately 5% were IgG positive for two or more infections. Seroprevalence to rickettsioses and Q fever was highest for individuals from rural areas and increased with age (>30 years). Those in the Nilgiris highlands (wetter and cooler) and Erode, which has the most land under irrigation, demonstrated the least exposure to rickettsioses and Q fever. Lowland plains (AOR: 8.4-22.9; 95% CI: 3.1-55.3) and highland areas upto 1000 metres (AOR: 6.1-10.3; 95% CI: 2.4-23.9) showed the highest risk of exposure to scrub typhus. For spotted fever, the risk of exposure was highest in Jawadhi (AOR:10.8; 95% CI: 2.6-44.3) and Kalrayan (AOR:16.6; 95% CI: 4.1–66.2). Q fever positivity was most likely to be encountered in Salem (AOR: 5.60; 95% CI: 1.01 – 31.08) and Kalrayan hills (AOR:12.3; 95% CI:2.9 – 51.6). Murine typhus risk was significant only in Thiruvannamalai (AOR:24.2; 95% CI: 3.3 – 178.6). Based on the data generated it seems that rickettsial infections and Q fever prevalence is low in areas which receive rainfall of ≥150 cm/yr, with average minimum and maximum temperatures between 15-25 oC and elevation in excess of 2000 metres. It is also low in low land and irrigated lands with dry climate. These preliminary findings need to be validated by conducting active surveillance in these areas.

Background and Purpose: In accord with ICH S7B guidelines, an in vitro human ether-a-go-go-related gene (hERG) assay is conducted to assess risk for delayed ventricular repolarization. Function of hERG could be affected by direct and acute mechanisms, or by indirect and chronic mechanisms. Oligonucleotides have unique mechanisms and time courses of action. To help frame the strategy of hERG assay for siRNA, investigation was performed to assess the time-course for siRNA-mediated inhibition of hERG function and gene expression. Experimental Approach: Commercially available siRNAs of hERG were evaluated in a stable hERG expressed cell line by whole-cell voltage clamp using automated electrophysiology and polymerase chain reaction (PCR). Key Results: In the acute hERG study, no effects were observed by applying 100 nM siRNA for 20 min. The chronic effects of 100 nM siRNAs on hERG function were evaluated by transfection and recorded over 8-48 hrs, after transfection. At 8 hrs there was no significant effect, while 81% reduction was observed at 48 hrs. Measurement of hERG mRNA levels demonstrated a 79% and 93% decrease of hERG mRNA at 8 and 48 hrs., respectively, consistent with a preceding effect on gene expression compared to protein function. Conclusion and Implications: Results presented here indicate that an anti-hERG siRNA requires a long exposure time (48 hrs.) in the hERG assay to produce a maximal effect; short exposures (20 min-8 hrs.) had no effect. These findings imply that oligonucleotides require specific and appropriate protocols to characterize their potential off-target effects on hERG channel.

Background: Realgar-Indigo naturalis formula (RIF) containing A 4S 4 as a major ingredient is an oral arsenic available in China. The efficacy of RIF on pediatric acute promyelocytic leukemia (APL) is comparable to arsenic trioxide (ATO). However, it remains to be explored that the effects of these two arsenicals on differentiation syndrome (DS) and coagulation disorder which are the two main life-threatening events in children with APL. Procedure: We analyzed 68 consecutive children with newly diagnosed APL involved in SCCLG-APL study (NCT02200978). Patients received all-trans retinoic acid (ATRA) on day 1 of induction therapy. ATO (0.16 mg/kg·d) or RIF (135 mg/kg·d) was administrated on day 5 after mitoxantrone on day 3 (non-high-risk group, NHR) or day 2-4 (high-risk group, HR). Results: The incidences of DS were 3.0% and 5.7% in ATO (n = 33) and RIF (n = 35) groups ( p = 0.590), and 10.3% and 0% in patients with and without differentiation-related hyperleukocytosis, respectively ( p = 0.04). The dynamic changes of WBC between the ATO and RIF groups were not statistically different. However, patients with high WBC counts or percentage of promyelocytes in peripheral blood tended to develop differentiation-related hyperleukocytosis. The improvement of coagulation indexes in the ATO and RIF groups had no statistical difference. Fibrinogen and prothrombin time had the quickest recovery rate. Conclusions: This study provides evidences that the incidence of DS and recovery of coagulopathy are similar whenever treating with RIF or ATO in children with APL.