Abstract Background: Currently, the most common surgical modalities used for recurrent respiratory papillomatosis resection are microdebrider, CO2 laser, and KTP laser. However, complication rates vary among different surgical modalities and have been controversial in different studies. Objective of review: This study systematically reviews the available studies which reported intraoperative and postoperative complications, aiming to compare the safety of microdebrider, CO2 laser, and KTP laser. Type of review: Meta-analysis. Search strategy: Seven electronic databases (PubMed/MEDLINE, EMBASE[Ovid], Scopus, Cochrane Library, and Web of Science) were searched from inception through April 28th,2022. Randomized controlled, prospective or retrospective observational studies that recorded the complications of three different surgical modalities for recurrent respiratory papillomatosis resection were included in the meta-analysis. Evaluation method: Outcomes of interest were intraoperative and postoperative complications, and complication rate was calculated to evaluate the safety of surgical methods. Results: Twenty different studies was included in quantitative synthesis. Only one study compared outcomes of those three kinds of treatment modalities simultaneously, two studies compared microdebrider and CO2 laser, and the remaining studies focused on only one of three treatments. The weighted average complication rate for microdebrider was 0.03(95% confidence interval [CI] 0.00-0.21), n = 6, for CO2 laser treatment was 0.16 (95% confidence interval [CI] 0.09-0.25), n = 14，and for KTP laser treatment was 0.04 (95% CI 0.00-0.14), n =4. Conclusion：The limited evidence demonstrated that CO2 lasers in the surgical treatment of RRP may lead to more surgical complications, and microdebrider and KTP lasers may be safer. However, the heterogeneous data limits any strong comparison of outcomes of different treatment of laryngeal papillomas. Future randomised controlled trials that directly compare the safety of different surgical modalities are needed.

The objective of this study is to report the complete genome sequence of a field African swine fever virus (ASFV) causing a fatal outbreak in domestic pigs in the Mekong delta, namely ASF/VN/CanTho-OM/2021 (GenBank accession number: ON402789). The complete genome sequencing detected an 18-bp nucleotide deletion in the EP402R gene (encoding for serotype-specific proteins CD2v) of ASF/VN/CanTho-OM/2021 which is determined to belong to the genotype 2 and serotype 8. This mutation pattern was confirmed as unique in the GenBank; thus, ASF/VN/CanTho-OM/2021 can be considered as a novel variant with potential change of sero-characteristics within the genotype 2. Additional unique mutation of 78-bp nucleotide insertion was also observed in the B475L gene. Besides, four copies of tandem repeats sequences were found in the intergenic gene (IGR) located between I73R and I329L that is previously assigned as the IGR III variant. This study is the first to report the complete genome of ASFV in the Mekong delta and highlights the necessity for strengthening of molecular surveillance in order to provide further knowledge on evolution and incursion of ASFV in the Mekong delta and Vietnam.

Due to its stochastic nature, wind energy imposes unprecedented challenges on the power grid, and a properly scheduled reserve is essential to accommodate wind power’s intermittency and volatility. Many power reserve scheduling studies have considered the uncertainties of the renewable energy integration but few address how different wind speed forecast techniques influence the scheduling of reserves in the congested transmission networks. In this paper, three forecasting techniques: artificial neural network, autoregressive integrated moving average, and probability distribution function-based model are adopted to forecast one day of wind speed at Taylor, TX in 2012. To evaluate the impacts of the forecast techniques on power reserve scheduling, a stochastic reserve optimization model was developed to ensure the delivery of reserve in the event of transmission congestion and ramping constraints. A modified RTS-96 test system was employed and the results claim that different forecast models significantly affect the amount of scheduled up and down reserves in a stochastic reserve optimization problem. The level of operating reserve that is induced by wind is not constant during all hours of the day. Dynamic up and down reserves will be needed with a large scale of wind farm integration.

Aim: Augmentation of antipsychotic treatment with antidepressants represents a common and beneficial treatment strategy in patients suffering from schizophrenia. Combining clozapine and the selective serotonin reuptake inhibitor (SSRI) sertraline represents a clinically important strategy, but there is limited knowledge about mutual pharmacokinetic interactions. In the present study, we assessed the impact of clozapine on sertraline plasma concentrations. Methods: Based on a therapeutic drug monitoring (TDM) database, sertraline plasma concentrations were compared between two groups: patients receiving a combined treatment with sertraline and clozapine (SERTCLZ; N=15) and a matched control group receiving sertraline but no clozapine (SERT; N=17). Group differences with respect to raw and dose-adjusted plasma concentrations were assessed using non-parametric tests. Results: No significant differences were found between the groups regarding daily dosage of sertraline, age, weight, sex distribution, and caffeine or nicotine consumption (all p-values >0.05). Co-medication with clozapine was associated with 67% lower median sertraline plasma concentrations (16 vs. 48 ng/mL; p=0.022) and 28% lower median dose-adjusted plasma concentrations (C/D; 0.21 vs. 0.29 (ng/mL) / (mg/day); p=0.049) as compared to the control group. Conclusion: When applying a combined treatment with clozapine and sertraline, clinicians should consider therapeutic drug monitoring to confirm therapeutically effective plasma concentrations of sertraline.

The auxiliary array optimization is the key to performance of interference cancellation, especially for the wide operating frequency of radio communication and unknown direction of interference. The blind area rule is established and the minimum blind area model is proposed for auxiliary array optimization. After deriving and simplifying the analytical solutions of weights and signal-to-interference-noise ratio after cancellation, the proposed rule inherits communicable index of radio and requirements of anti-jamming, greatly reducing complexity. The proposed algorithm focuses on minimizing blind area after cancellation in view of this rule. Hence, it leads to a remarkable improvement of optimization efficiency with different direction of arrival of interference and wide-band operating frequency. Experiments based on communication radio demonstrate that the minimum blind area model is much efficient and promising for auxiliary array optimization of anti-interference.

Background: Anaphylaxis following influenza vaccination is a rare but serious problem. The underlying immune responses are not well understood. This study elucidated the IgE and IgG antibody responses in healthy children and adolescents following inactivated influenza vaccines (IIVs). Methods: The efficacy and safety of quadrivalent IIV (QIV) and trivalent IIV (TIV) were compared in healthy subjects aged 0-18 years. Serum IIV-specific IgE, IgG and IgG4 levels (sIgE, sIgG, sIgG4) were measured with ImmunoCAP. Hemagglutinin inhibition (HI) assay was performed for each influenza virus subtype. Sera from earlier patients who developed anaphylaxis to different IIVs were similarly tested. Results: A total of 393 subjects were enrolled: 96 were 6 months -2 years old, 100 were 3-5 years old, 100 were 6-12 years old, and 97 were 13-18 years old. No anaphylaxis was observed. Generally, QIV and TIV induced similar antibody responses. IIV-sIgE levels rose significantly after vaccination in the 6m-2y and 3-5y groups, did not change in the 6-12y group, and decreased in the 13-18y group. In contrast, the IIV-sIgG4/sIgE ratio increased significantly after vaccination in all age groups. Sensitized subjects had significantly higher HI titers and IIV-sIgG levels in the youngest age group and higher IIV-sIgG4 levels in all age groups compared with the non-sensitized. The IIV-sIgG4/sIgE ratio in 5 patients with anaphylaxis was significantly lower than in age-matched healthy subjects. Conclusion: IIVs induce IgE sensitization in healthy children, but also robust IgG4 responses that may protect them from anaphylaxis.

Schwannomas are benign tumors which rarely arise in the soft tissues of the gastrointestinal tract. We present a case of a gastrointestinal schwannoma in a 50-years-old female with lower gastrointestinal bleeding. A colonoscopy described a 4cm ulcerated polypoid mass in the descending colon. The histopathological diagnosis was a schwannoma.

Cost-effective use of limited conservation resources requires understanding which data can most contribute to alleviating biodiversity declines. Interventions might reasonably prioritise life-cycle transitions with the greatest influence on population dynamics, yet some contributing vital rates are particularly challenging to document; such pragmatic decision-making risks suboptimal management if less is known about influential rates. We aimed to explore whether study effort aligns with demographic impact on population growth rate, λ. We parameterised a matrix population model using meta-analysis of vital rates for the common eider (Somateria mollissima), an increasingly threatened yet comparatively data-rich species of seaduck. Female common eiders exhibit intermittent breeding, with some established breeders skipping one or more years between breeding attempts. We accounted for this behaviour by building breeding propensity (= 0.72) into our model with a discrete and reversible ‘non-breeder’ stage (to which surviving adults transition with a probability of 0.28). The transitions between breeding and non-breeding states had twice the influence on λ than fertility (summed matrix-element elasticities of 24% and 11%, respectively), whereas almost 15 times as many studies document components of fertility than breeding propensity (n = 103 and n = 7, respectively). Through comparative re-analyses, we find similar results for two amphibian species, further supporting our finding that study effort does not always occur in proportion to relative influence on λ. Our workflow could form part of the toolkit informing future investment of finite resources, to avoid repeated disconnects between data needs and availability thwarting evidence-driven conservation.

Lobular endocervical glandular hyperplasia (LEGH) is characterized by clinically profuse and watery vaginal discharge. In pregnancy with LEGH, with watery fluid leakage persisting throughout pregnancy, it is often difficult to visually diagnose PROM. Adding to this difficulty, auxiliary diagnostic tests might also show positive results, complicating treatment and management.

The Synchronicity of Situs Inversus totalis (SIT) and infantile hypertrophic pyloric stenosis (IHPS) is a rare phenomenon. We have reported a case of this concurrency in a 3-day-old newborn with classic symptoms.

Endovascular embolization techniques are the preferred treatment modality for the management of direct Carotid Cavernous Fistulas (CCFs).We report two cases of patients treated with SOV approach and retrograde embolization with Precipitating hydrophobic injectable liquid (PHIL) and coils.

Background: Cancer diagnosis and its treatment may impair the long-term body image of childhood cancer survivors. This may be particularly relevant in adolescence, a critical period of psycho-social development. We compared the body image between adolescent cancer survivors and their siblings, and determined whether survivors’ body image is associated with socio-demographic characteristics, clinical characteristics, and health conditions. Procedure: As part of the nationwide Swiss Childhood Cancer Survivor Study, we sent questionnaires to adolescents (aged 16-19 years), who survived >5 years after having been diagnosed with childhood cancer between 1976-2010. Siblings received the same questionnaire. We assessed the level of agreement with three body image statements referring to body satisfaction and preferences for changes. Chronic health conditions were classified into cardiovascular, pulmonary, endocrine, musculoskeletal, renal/ digestive, neurological, and hearing or vision impairment. We used ordered logistic regression models to identify determinants of a more negative body image. Results: Our study included 504 survivors (48% female) with a median age at study of 17.7 years (IQR 16.8-18.6) and 136 siblings. Survivors and siblings reported overall comparable levels of the three body image statements (all p>0.05). Female survivors (all ORs ≥ 1.7), survivors treated with haematopoietic stem cell transplantation (all ORs ≥ 2.2), and survivors with ≥ 2 chronic health conditions (all ORs ≥ 1.4) reported a more negative body image. This was particularly pronounced for survivors suffering from musculoskeletal or endocrine conditions. Conclusion: Clinicians should address body image concerns in adolescent survivors with chronic conditions and offer psycho-social support if necessary.

The hydraulic properties of ground vegetation cover are important for high resolution hydrological modeling of permafrost regions, due to its insulating and draining role. In this study, the morphological and effective hydraulic properties of Western Siberian Lowland ground vegetation samples (lichens, Sphagnum mosses, peat) are numerically assessed based on tomography scans. After numerical pre-processing, porosity is estimated through a void voxels counting algorithm, showing the existence of representative elementary volumes (REV) of porosity for most samples. Then, two methods are used to estimate hydraulic conductivity depending on the sample’s homogeneity. For the most homogeneous samples, Direct Numerical Simulations (DNS) of a single-phase flow are performed, leading to a definition of hydraulic conductivity related to REV, which is larger than those obtained for porosity. For more heterogeneous samples, no adequate REV may be defined. To bypass this issue, a pore network representation of the whole sample is created from computerized scans. Morphological and hydraulic properties are then estimated through this simplified representation. Both methods converged on similar results for porosity. Some discrepancies are observed in the morphological properties (specific surface area). Hydraulic conductivity fluctuates by two orders of magnitude, depending on the method used, and yet this uncertainty is less than that found in experimental studies. Therefore, biological and sampling artifacts are predominant over numerical biases. Porosity values are in line with previous values found in the literature, showing that arctic cryptogamic cover can be considered as an open and well-connected porous medium (over 99% of overall porosity is open porosity). Meanwhile, digitally estimated hydraulic conductivity is higher compared to previously obtained results based on field and laboratory experiments. This could be related to compressibility effects, occurring during field or laboratory measurements. Thus, some supplementary studies are compulsory for assessing syn-sampling and syn-measurement perturbations in experimentally estimated, effective hydraulic properties of such a biological porous medium.

Karst springs are the natural outflow of karst water to the surface. These springs occur where the water table can reach the surface unimpeded. This study examines the effect of alluvial deposits with varying thickness and permeability, covering the main outlet (karst spring) of a karst network on karst drainage (e.g., development of the karst water, drainage patterns, conduit-matrix interaction) as a result of a positive base level shift. This was realized with a numerical conceptual model (FEFLOW) of a hypothetical karst aquifer with 6 model configurations (inactive vs. active conduit flow, free vs. confined spring conditions with 20 m and 50 m sediment cover, respectively, with low and high hydraulic conductivity). Conduit flow and coupled conduit-matrix interactions were incorporated into the model with one-dimensional discrete feature elements. The results show that the permeability of the sediments has a more distinctive effect on conduit discharge than their thickness. The conduit network significantly contributes to the drainage even with a fully confined spring outlet. The conduit system acts as a water collector from the matrix in the recharge zone. The buried outlet increases the hydrostatic pressure farther along the conduit, and water is pushed upwards back into the matrix in the vicinity of the stratigraphic contact. Depending on the depositional setting, this results in the evolution of one to multiple new flow systems towards new potential spring sites. The results obtained here provide insight into the likely responses of natural karst systems.

Ecohydrological investigations commonly use the stable isotopes of water (hydrogen and oxygen) as a conservative ecosystem tracer. This approach requires accessing and analyzing water constrained within plant and soil matrices. Generally, there are six steps that researchers must pass through to retrieve hydrogen and oxygen isotope values from these plant and soil matrices: (i) sampling, (ii) sample storage and transport, (iii) extraction, (iv) pre-analysis processing, (v) isotopic analysis, and (vi) post-processing and correction. At each of these steps cumulative errors can be introduced which sum to non-trivial magnitudes. These errors can impact subsequent interpretations about water cycling through the soil-plant-atmosphere continuum. But these steps in the research ‘process chain’ are just the tip of the iceberg when it comes to uncertainly in published findings. At each of these discreet steps, there are multiple possible options to select from resulting in, as we will show, tens of thousands of possible combinations used by researchers to go from plant and soil samples to isotopic data. In a newly emerging science, so many options can create interpretive confusion and major issues with data comparability. This points to the need for the development of shared standardized approaches. Here we critically examine the state of the process chain, reflecting on the issues associated with each step, and end with suggestions to move our community towards standardization. We hope that critically assessing this common approach will help us see the current problem in its entirety and facilitate community action toward agreed upon standardized approaches.

The objective of this study was to determine the causative agent of an outbreak with clinical signs similar to those of piscine streptococcosis in farmed snakeskin gourami ( Trichopodus pectoralis). Initial microscopic examination revealed the predominance of a Gram-positive, cocci bacteria in the brain and kidney of the diseased fish. This bacterium was successfully isolated and identified as Streptococcus suis based on nucleotide homology of 16S rDNA and species-specific PCR. This isolate tested negative for serotype 2, one of the major zoonotic serotypes. Experimental infection was then performed to investigate the pathogenicity of the bacterium and its histopathological manifestation. Naïve juvenile and adult snakeskin gourami were injected intraperitoneally with a low dose (1.2×10 5 CFU/fish) and a high dose (1.2×10 7 CFU/fish) of S. suis. Cumulative mortality appeared to be dose- and size-dependent. Experimentally diseased fish exhibited clinical signs consistent with naturally diseased fish. Severe histopathological changes in multiple organs were observed in both juvenile and adult fish, including meningitis, severe congestion in the brain and eyes, thickened stromal layers of the retina, severe hepatic lipidosis and tissue degeneration. Notably, numerous granulomas containing massive bacterial cells in the necrotic core were observed in the infected fish. Relatively pure colonies of S. suis were recovered from tissues of experimentally diseased fish. Taken together, this study fulfilled Koch’s postulates, indicating that S. suis is a new piscine pathogen. Although this is a case report, public awareness and biosecurity measures should be considered to prevent the spread of the disease. Further surveillance of the pathogen’s distribution and research into the underlying causes of fish-host adaptation will provide insights into the genuine impact and appropriate disease control strategies.

Ticks act as important vectors of infectious agents, and several emerging tick-borne viruses have recently been identified to be associated with human diseases in northeastern China. However, little is known about the tick virome in northeastern China. We used metatranscriptomics to investigate the virome diversity in Haemaphysalis japonica, H. concinna, Dermacentor silvarum, and Ixodes persulcatus ticks collected from northeastern China. In total, 22 RNA viruses were identified, including four each in the Nairoviridae and Phenuiviridae families, three each in the Flaviviridae, Rhabdoviridae, and Solemoviridae families, two in the Chuviridae family, and one each in the Partitiviridae, Tombusviridae families and an unclassified virus. Of these, eight viruses were novel species, belonging to the Nairoviridae (Ji’an nairovirus and Yichun nairovirus), Phenuiviridae (Mudanjiang phlebovirus), Rhabdoviridae (Tahe rhabdovirus 1-3), Chuviridae (Yichun mivirus), and Tombusviridae (Yichun tombus-like virus) families, and five members were established human pathogens, including Alongshan virus, tick-borne encephalitis virus, Songling virus, Beiji nairovirus, and Nuomin virus. I. persulcatus ticks had significant higher viral species than H. japonica, H. concinna, and D. silvarum ticks. Significant differences in tick viromes were observed among Daxing’an, Xiaoxing’an and Changbai mountains. These findings showed an extensive diversity of RNA viruses in ticks in northeastern China, revealing potential public health threats from the emerging tick-borne viruses. Further studies are needed to explain the natural circulation and pathogenicity of these viruses.

Porcine reproductive and respiratory syndrome virus 1 (PRRSV-1) is one of the main pathogens causing porcine reproductive and respiratory syndrome (PRRS). In recent years, the detection number of PRRSV-1 in China has gradually increased, and the PRRSV-1 strains reported in China belong to subtype Ⅰ (Global; Clade A-L). In the present study, a novel PRRSV-1 strain, TZJ2134, was found during epidemiological surveillance of PRRSV-1 in Shandong Province in China. We obtained two fragments of TZJ2134: TZJ2134-L12 (located at nt 1672-nt 2112 in the partial Nsp2 gene) and TZJ2134-(A+B) (located at nt 7463-nt 11272 in the partial Nsp9, complete Nsp10 and partial Nsp11 genes). Phylogenetic and recombination analyses based on the two sequences showed that TZJ2134 is a recombinant strain derived from two commercial PRRSV-1 modified live vaccine (MLV) strains (the Amervac vaccine and DV vaccine strains), forming a new recombinant subgroup of DV+Amervac-like isolates with other strains. However, PRRSV-1 MLV is not currently allowed for use in China. We speculated that TZJ2134 might have been introduced from Europe. This study is the first to provide information on two recombinant PRRSV-1 MLV strains in China and provides new data for the epidemiological study of PRRSV-1 in China.

Background Cabotegravir delivered as a long-acting intramuscular injection has shown superior efficacy to oral tenofovir-emtricitabine as pre-exposure prophylaxis (PrEP) for HIV. Cabotegravir pharmacokinetics (PK), like those of other long-acting depot preparations, exhibit variability between individuals and between injection occasions. Aim To describe the population pharmacokinetics of long-acting cabotegravir (CAB-LA). Methods Using available PK measurements from 133 participants in the HIV Prevention Trials Network (HPTN) 077 trial, we analyzed CAB-LA PK data using nonlinear mixed-effects modeling to develop a population PK model. Results A two-compartment model with first order absorption best described the CAB-LA PK. The analysis identified between-occasional variability (BOV, i.e., differences in PK within one individual from one injection to the next) as a significant covariate affecting the absorption rate. Sex and body weight were identified as significant covariates influencing the absorption rate and apparent clearance of CAB-LA after intramuscular injection at various doses and frequencies. Conclusion The public availability of this model will facilitate and enable a wide variety of future clinically relevant simulations to inform the optimal use of CAB-LA.

I am neither myself nor am I the other,I am something in-between,Pillar of the bridge of routineRunning from me towards the Other. (Mário de Sá-Carneiro)

Soil salinization is a critical environmental issue restricting agricultural production. Straw deep returning as interlayer (40 cm) has been a popularized practice to alleviate salt stress. However, the legacy effects of straw interlayer associated with the straw input amount on soil organic carbon (SOC) and total nitrogen (TN) in saline soil remain unclear. Therefore, a four-year (2015-2018) field experiment was conducted with four levels (i.e., 0, 6, 12 and 18 Mg ha -1) of straw returning as interlayer. Compared with no straw interlayer (CK), straw interlayers increased SOC content by 14-32% and 11-57% in 20-40 cm and 40-60 cm, respectively. Lower increases were for soil TN content (8-22% in 20-40 cm and 6-34% in 40-60 cm) than SOC content, which led to increase soil C:N ratio in the 20-60 cm soil depth. Compared with CK, remarkable increases of SOC and soil TN contents in 20-60 cm led to the decrease of stratification ratios (0-20: 20-60 cm), which promoted uniform distributions of SOC and TN in soil profiles. Even though soil parameters ranged widely according to the straw input, straw interlayer with 12 Mg ha -1 had higher SOC, TN, C:N ratio, and lower soil stratification ratio in 2015-2017, which contributed to salt leaching, water retention, and yield increment. These results highlighted the legacy effects of straw interlayers maintained more than four years, which led to an underestimation for previous short-term experiments, and demonstrated a great potential for subsoil fertility and salt-affected soil amelioration.

Background Right ventricular dysfunction is a major cause of heart failure and mortality in end-stage renal disease patients. Scarce data is available regarding the comparison of echocardiographic right ventricular function in end-stage renal disease patients on hemodialysis (HD) and peritoneal dialysis (PD). The aim of the study was to evaluate the long-term impacts of different dialysis modalities on right ventricular function assessed by conventional echocardiography, in end-stage renal disease patients with preserved left ventricular function. Methods The study included 120 patients grouped as follows: PD(n=40), HD with arterio-venous fistula (n=40) and healthy control subjects (n=40). Conventional echocardiography was performed in all patients. A classification of right ventricular function was defined in HD patients by using tricuspid annular plane systolic excursion (TAPSE), right ventricular myocardial performance index (RV-MPI), fractional area change (FAC) and tricuspid lateral annulus systolic velocity (Sa) values. Correlation analysis was performed by using right ventricular dysfunction score, clinical and echocardiographic parameters. Results The mean age of the study population was 51.9±13.1 years and 47.5% were females. TAPSE and Sa velocity were found to be significantly lower and RV-MPI was significantly higher in patients undergoing HD, compared with control and PD patients. Logistic regression analysis showed that HD treatment was an independent risk factor for developing right ventricular dysfunction. Conclusion RV function was impaired in patients undergoing HD compared with patients on PD.

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Host-gut microbiota interactions are complex and can have a profound impact on the ecology and evolution of both counterparts. Several host traits such as taxonomy, diet and social behavior, and external factors such as prey availability and local environment are known to influence the composition and diversity of the gut microbiota. In this study, we investigated the influence of taxonomy, sex, host size, locality/habitat on gut microbiota diversity in five lizard species from two different sites in Portugal. We also analyzed the potential levels of microbial transmission between species that live in sympatry and syntopy. We studied Podarcis bocagei and Podarcis lusitanicus from northern Portugal (Moledo); and two invasive species, Podarcis siculus and Teira dugesii, and the native Podarcis virescens from Lisbon. We used a metabarcoding approach to characterize the bacterial communities from the cloaca of lizards, sequencing the V4 region of the 16S rRNA. Habitat/locality was found to be the main driver of the differences in composition and structure of gut bacterial communities of the studied lizards, with host effects more evident at finer taxonomic scales. Additionally, lizards from urbanized environments had higher microbiome diversity than lizards from rural areas. We detected a significant positive correlation between size and gut bacterial alpha-diversity in the invasive species P. siculus, which could be due to higher exploratory behaviours. Moreover, estimates of bacterial transmission indicate that P. siculus may have acquired a high proportion of local microbiota. These findings indicate that a diverse array of host and environmental factors can influence lizards gut microbiota.