We report a complicated case of 67 years old male with end stage renal disease, with coronary artery disease and stent in situ under dual antiplatelet therapy and continuous ambulatory peritoneal dialysis with left sided loculated hemorrhagic pleural effusion. He was managed with intrapleural streptokinase therapy.

Lymphoblastic lymphoma is a group of non-Hodgkin lymphomas that account for approximately 2% of all lymphomas. We intend to report a case of a girl presenting with a solitary scalp mass which was resected. Histopathological examination of the mass along with bone marrow analysis revealed primary cutaneous B-cell lymphoblastic lymphoma

This letter focuses on the improvement in the error correction performance of the extended min-sum (EMS) decoding algorithm. Introducing factor/offset modifications in the check node update process of the EMS algorithm can improve the performance. Based on this, we propose a novel threshold-based modified EMS algorithm that introduces the factor/offset in a targeted manner by setting a threshold for the posterior probability. Simulation results show that an additional performance gain of the order of 0.08 dB is obtained with the proposed method without significantly increasing the method’s complexity.

Lime application and understory removal are two silvicultural practices commonly used to improve stand productivity in subtropical plantations. However, little is known about how the two practices, particularly in their interaction, affect soil respiration ( Rs). This knowledge gap limits our accurate assessment for the carbon balance in plantations under lime application and understory removal, which are usually applied simultaneously in practices. Here, using a field manipulation experiment, we assessed the effects of lime application, understory removal, and their interactions on Rs, soil heterotrophic respiration ( Rh), and soil autotrophic respiration ( Ra) in subtropical Eucalyptus plantations in southern China. We also examined the changes in soil pH, soil microbial communities (PLFAs), Eucalyptus fine root biomass after lime application and understory removal. Lime application inhibited Rs due to the decreased Ra and the contribution of understory root respiration ( RU) to Rs. Understory removal also reduced Rs due to the decreased soil microbial and fungal PLFAs, and the associated Rh, as well as the RU. Lime application decreased Rs by 16.48% in the presence of understory and only 4.49% when understory was removed. These results demonstrate that lime application and understory removal interact to affect Rs and highlight that understory vegetation can highly mediate the effect of lime application on Rs in subtropical Eucalyptus plantations in southern China.

This work aims to develop multi-purpose machine learning (ML)-based cyclodextrin inclusion complexes (ICs) formation predicting strategies in aqueous solution to replace traditional experimental approaches. A balanced dataset of drug relevant molecules was constructed with experimental verifications. Three ML models (artificial neural network, support vector machine, and logistic regression) were established and optimized for ICs formation prediction. In order to provide more reliable approaches for different prediction requirements, ML-based linear strategy, recall-first strategy, and precision-first strategy were further established based on the ML models to pursue the maximum recall or precision values. It has also been proved that the proposed recall-first strategy finds all positive samples as much as possible to avoid missing in prediction, and the precision-first strategy finds positive samples accurately to reduce the number of validation experiments. The ML-based prediction strategies for ICs formation were first established in this work and showed high accuracy and reliability.

This publication presents a general approach for the enhancement of packings using 3D printing. Within a joint research project of the Ulm University, the Technical University of Munich and BASF SE, the presented methodology is used to develop miniaturized, scalable distillation columns for process development and scale-up applications. Therefore, a combination of design, computational fluid dynamics, 3D printing and experiment is used to overcome current limitations in the design of structured packings. The packing to be developed should have a high, constant separation efficiency independent of the F-factor at the target diameter of 20 mm. Based on a 3D printable version of the Rombopak 9M, an improved structure is introduced using the proposed methodology. This packing is an intermediate step, but already exhibits a higher, more constant separation efficiency and an improved reproducibility. This publication acts as proof of concept for this methodology.

Test Impact Analysis is an approach to obtain a subset of tests that are impacted by the code changes. This approach is mostly applied to unit testing where the link between the code and its associated tests is easy to obtain. On the integration level, however, it is not straightfoward to find such a link programatically, especially when the integration tests are held into separate repositories. We propose an approach for selecting integration tests based on the runtime analysis of code changes to reduce the test execution overhead. We provide a set of tools and framework that can be plugged into existing CI/CD pipelines. We have evaluated the approach on a range of opensource Java programs and found ≈50% reduction in tests on average, and above 80% in a few cases. We have also applied the approach to a large-scaled system currently in production and found similar results.

Studies have shown negative impacts of increased human pressures on biodiversity at local (alpha-diversity) and regional (gamma-diversity) scales. However, the diversity between local sites (beta-diversity) has received less attention. This is an important shortcoming since beta-diversity acts as a linkage between trends at the local and regional scales. Decreased beta-diversity means that local sites lose their distinctiveness, becoming more similar to each other. This process, known as biotic homogenization, is predicted to arise through the replacement of native specialists with native and non-native generalists. However, the mechanisms causing biotic homogenization have not been fully studied nor its impacts on different facets of biodiversity. We examined if land-use change due to human actions causes biotic homogenization of taxonomic, functional and phylogenetic diversity in bird communities of forested habitats in the state of Minnesota, USA. Our aim was to study if increased human pressure, which included human population density, land transformation, transport infrastructure, and electrical power infrastructure, was associated with increased similarity among bird point count sites. Our results showed that elevated human pressure was not related with increased biotic homogenization in this study region. Interestingly, increased human pressure appeared to increase the between-site functional diversity of bird communities. This association was driven by a decrease in local diversity, which, due to the nature of beta-diversity, led to an increase in between-site diversity. We highlight the importance of considering multiple facets of biodiversity and the use of beta-diversity in a conservation setting.

Abstract: Caryopteris mongholica is a rare resource plant distributed in typical steppe, desertified steppe and desert areas. Based on field survey data sampled during the growing seasons from 2018 to 2021, combined with relevant previous literature, this study analyzed the distribution and environmental characteristics of C. mongholica population, the characteristics, classification and species diversity of C. mongholica community, and the influence of environmental factors. The results showed that: (1)The C. mongholic population was mainly distributed in the east, middle and west of Inner Mongolia Autonomous Region, the north of Loess Plateau, Hexi corridorm, Qilian Mountains and other northwest temperate desert or steppe areas in China. It was the dominant species or companion species in the community. (2) According to the survey of 40 sample plots, a total of 141 species of seed plants were recorded, belonging to 110 genera of 37 families, and families of Compositae, Leguminosae and Gramineae played crucial roles in the species composition. Among them, 42 of these species were shrubs and dwarf/semi-shrubs, 76 were perennial herbs, 23 were annuals and biennials. In the class of species presence, 88.02% were occasional species with frequency distribution smaller than 20%. Typical xerophytes occupied the main advantage(32.39%) in the water ecological types. East Palearctic elements(25.35%) were the major floristic geographic elements. (3) Based on the life form and dominance of species, the C. mongholica communities were divided into 6 major association groups,which were further divided into 23 associations. (4)Precipitation, solar radiation and other environmental factors significantly affect the distribution of C. mongholica population and the species diversity of the community. Key word: Caryopteris mongholica, population distribution, community characteristic, species diversity

As a foundation species in shallow-water ecosystems, the mussel Mytilus edulis exposed to abiotic and biotic stressors. In particular, heat stress can have detrimental effects on mussel performance and biotic interactions with parasites may exacerbate those effects. This study explores the metabolic responses of mussels to infections with the trematode Renicola roscovita, under mild and transient heat exposures. Using controlled laboratory infections, a first experiment investigated the responses of infected and uninfected small mussels (2 cm), to a 24-hour exposure to a mild temperature followed by an acute heat ramp and subsequent cooling. The results indicated that trematode infections reduced mussel filtration by, on average, 13%, and that infections exacerbated the impact of the transient heat exposure, as indicated by a larger difference (33%) between infected and uninfected mussels in the post-heat recovery phase. However, these differences were statistically not significant, owing to generally large variation among mussels and low sample sizes. In a second experiment, we further investigated how mussel size (2 and 4 cm) affected infection impacts on mussel performance under constant exposure to a mild temperature. We found that infections reduced mussel filtration at similar rates (11% and 12% for small and large mussels, respectively) compared to the first experiment, albeit statistically significant only for large mussels. In both experiments, no discernible impact on the mussel respiration rate was found. Interestingly, we found positive relationships between mussel filtration capacity and infection intensity, suggesting that mussel phenotypes with generally higher filtration capacity may be more prone to infections. Overall, our results suggest that R. roscovita metacercariae infections can lower the ability of hosts to sustain optimal energy supply, which in turn may exacerbate the negative effects of heat stress. The role of mussel phenotypic variation in filtration capacity in driving infection levels and subsequent effects warrants further investigation.

This paper aims to investigate the synergistic effects in moisturizing activity and antioxidant activity between the promising unconventional polysaccharide and flavonoids from stems of Trollius chinensis Bunge (TCS). The results showed that the mixture with the mass ratio (w/w) of 7:3 (flavonoids to polysaccharides) appeared better moisture retention (73.08 ± 2.4%) and scavenging effects on·OH radicals (85.46±0.52 %). Meanwhile, the mixture with the mass ratio (w/w) of 3:7 (flavonoids to polysaccharides) unveiled better scavenging effects on DPPH radicals (44.10±0.81%) and reducing capacity. The results confirmed that the polysaccharides and flavonoids from TCS have good synergistic effects in moisturizing activity and antioxidant activity, and have the potential to be used in the food industry as edible films or edible packaging materials.

Cracks in concrete structures can serve as pathways for aggressive chemical substances that can lead to a progressive deterioration of the cement stone as well as of the reinforcement, affecting the load capacity, service life and useability of concrete structures. However, concrete and reinforced concrete exhibit an intrinsic ability to heal cracks, defined as autogenous self-healing. This effect includes the precipitation of calcium carbonate in the presence of water and CO2 and is accompanied by continued hydration, swelling and mechanical blocking of the crack pathway. Experiments led to the inclusion of crack healing by autogenous self-healing in Eurocode 1992-3 for water retaining concrete structures. However, despite code restrictions, autogenous self-healing of concrete shows limited effectiveness in practice. This indicates the need for further research to provide engineers with reliable design rules. Therefore, this study aims for giving a broad literature review on the state-of-the-art knowledge on autogenous self-healing, the boundary conditions, consensus and controversy of processes and factors influencing the efficiency of autogenous self-healing. Regarding the transferability of laboratory results to real concrete constructions, materials, crack initiation techniques, experimental concepts and methods for assessing the effectiveness of autogenous self-healing are discussed and recommendations for future experiments are set.

Background Neoadjuvant therapy is increasingly used in the first-line setting in people with advanced endometrial cancer despite a paucity of evidence for this approach. Objective To systematically evaluate the literature in this area. Search Strategy Electronic searches of Ovid MEDLINE, Ovid Embase, Clinical trials.gov and the International clinical trials registry platform were performed for studies published between 1990 and 2021 comparing neoadjuvant therapy with upfront debulking surgery in Stage 3 or 4 endometrial cancers. Selection Criteria Studies reporting overall survival, progression free survival, adverse events and/or quality of life in those undergoing neoadjuvant therapy or upfront debulking. Data Collection and Analysis Odds ratios (OR) and log hazard ratios (HR) along with 95% confidence intervals (CI) were calculated and pooled for analysis. Risk of bias was assessed using the ROBINS-I tool. Main Results Eight non-randomised studies with a total of 50,510 patients were identified. These showed that patients undergoing primary chemotherapy had similar survival outcomes to those undergoing primary surgery (HR 1.26 (95% CI 0.95-1.69)). Fewer patients in the neoadjuvant group had surgery but those that did were less likely to be suboptimally cytoreduced (OR 0.24; 95% CI 0.21-0.28). Surgical morbidity was no different between the two approaches (OR 0.51, 95% confidence interval 0.08-3.25). However, the potential for bias in these studies is very high. Conclusion There is significant uncertainty as to whether the outcomes for those undergoing primary cytoreductive surgery or neoadjuvant chemotherapy in the presence of unresectable disease are better. Prospective reporting of outcomes is needed.

There have been significant developments in the area of bone tissue engineering since its advent in terms of biomaterials as well as techniques of scaffold fabrication. Despite all these developments, the translation of research to clinical applications is very limited. The most challenging obstacle in the road of translation of engineered tissue construct into clinical applications is the manufacturing of the designed substitutes in a scalable manner. This bottleneck could be overcome by using bioreactors for the manufacture of tissue constructs. In this review, a current scenario of bone defects and cause of translational gap between laboratory research and clinical use has been briefly discussed. Furthermore, various types of bioreactors being used in the area of bone tissue regeneration in recent studies have been highlighted along with their advantages and limitations. After literature survey, we found that bioreactors should have the following attribute: (i) A dynamic combined bioreactor providing more than one physico-mechanical cues; (ii) Support the growth of multiple tissue engineered constructs simultaneously along with homogeneous distribution of cells throughout the scaffolds; (iii) Versatile to support different types of scaffolds and cell types to produce a patient/defect specific tissue construct as well as to fulfill the adequate supply demand for clinical applications; (iv) Automated with easy to operate protocols for minimal manual handling; (v) Effectively handled and reproducible; and (vi) Commercialization aspects, quality control and safely requirements. Furthermore, computational approaches could be combined with bone tissue engineering experiments using bioreactors to simulate and optimize the cellular growth in bone tissue constructs.

The objective of this retrospective case series is to describe the clinical features of patients with primary glioblastoma multiforme and to identify the presence of the MGMT protein in the tissue. Seventeen patients were selected. Tissue samples were analyzed by the neuropathologist to confirm GBM diagnosis.

As part of the One Health European Joint Programme, the project “Biosecurity practices for pig farming across Europe” (BIOPIGEE) aims to establish an inventory of relevant biosecurity measures that reflects their effectiveness in reducing the occurrence of Salmonella spp. and hepatitis E virus (HEV) in European pig production. While the term “biosecurity” is well defined, a harmonized definition of the term ”biosecurity measure” (BSM) is missing. In consequence, there is a lack of clarity, understanding and acceptence, on which measures can be considered BSMs. Without clarity and acceptance, it is hard to achieve broad and effective implementation of BSMs along the food production chain and support at government policy level. Therefore, a BIOPIGEE task group i) collected and discussed relevant inclusion and exclusion criteria for measures to be considered in the context of biosecurity and ii) screened the scientific literature for potentially existing definitions for the term BSM. This exercise confirmed the lack of a definition of BSM, and underlined the importance of the topic. In the pool of articles considered relevant to defining the term ‘biosecurity measure’, specific research themes were identified. Based on these outcomes, we propose a definition of the term BSM: “A biosecurity measure (BSM) – is the implementation of a segregation, hygiene, or management procedure (excluding medically effective feed additives and preventive/curative treatment of animals) that specifically aims at reducing the probability of the establishment, survival, or spread of any potential pathogen to, within, or from a farm, operation or geographical area.” The definition provides a basis for further agreement on a harmonized definition of the term BSM and an advanced communication of best biosecurity practices to relevant stakeholders.

To identify candidate pathogenic genes of early-stage Crohn’s disease (CD) and predict potential roles of genetic factors in CD, we performed whole exome sequencing on a child with early-stage Crohn’s disease (CD) and her parents (core family), found that the patient carried heterozygous variants of 4 genes: NOD2 c. 2257 C>T, IL10RA c. 301 C>T, PLA2G6 c. 2029 C>T, COL7A1 c. 3190 G>A. With joint action of NOD2, IL10RA, PLA2G6 and COL7A1, excessive intestinal inflammatory response is triggered, resulting in normal intestinal wall tissue damage. Meanwhile, intestinal wall tissue repair is impaired, aggravating inflammation and injury, and leading to severe CD phenotype.

The analysis of domestic pig movements have became useful in the understanding of disease spread patterns and epidemiology, which facilitates the development of more effective animal diseases control strategies. The aim of this work was to analyse the static and spatial characteristics of the pig network, to identify its trading communities and to analyse the contribution of the network to the transmission of classical swine fever. Pig movement data were extracted from the national veterinary service database (2017-2019), using social network analysis and spatial analysis we constructed a network with registered premises as nodes and their movements as edges, and also a network of parishes as its nodes aggregating their premises movements as edges. The annual network metrics showed in average a diameter of 20.33, a number of neighbours of 2.61, a shortest path length of 4.39 and a clustering coefficient of 0.38 (small-world structure). The most frequent movements were to or from markets (57%). Backyard producers made up 89% of the network premises, and the top 2% of parishes (highest degree) contributed to 50% of the movements. The highest frequencies of movements between parishes were in the centre of the country, while the highest frequency of movements to abattoirs was in the south-west. Finally, the pattern of CSF disease outbreaks within the Ecuador network was likely the result of network transmission processes. In conclusion, our results represent the first exploratory analysis of domestic pig movements at premise and parish levels. These results could be taken into account by the surveillance system to improve its procedures and update the disease control and management policy, allowing the implementation of targeted or risk-based surveillance.

Progressive respiratory muscle weakness and ineffective cough contributes to morbidity and mortality in children with neuromuscular disorders (NMD). Inspiratory muscle training (IMT) aims to preserve or improve respiratory muscle strength and reduce respiratory morbidity. This study intended to determine the safety and efficacy of IMT in children with NMD. A randomized cross-over study compared three-month intervention (IMT) with control periods (no IMT). Children diagnosed with NMD (5-18 years) performed 30 breaths (at 30% of inspiratory muscle strength (Pimax)) with an electronic threshold device, twice daily. During the control period participants did not perform any IMT. Twenty-three children (median (IQR) age of 12.33 (10.03-14.17) years), mostly male (n=20) and non-ambulant (n=14) participated. No adverse events related to IMT were reported. No difference in median patient hospitalization and respiratory tract infection rates between control and intervention periods (p=0.60; p=0.21) was found. During IMT, Pimax and peak cough flow improved with a mean (SD) of 14.57 (±15.67) cmH 2O and 32.27 (±36.60) L/min, compared to 3.04(±11.93)cmH 2O (p=0.01) and -16.59 (±48.29) L/min (p = 0.0005) during the control period. Spirometry, functional ability and total health-related quality of life scores following intervention did not show a significant change. Patient satisfaction with IMT was high (median 8/10 (IQR 5-10)) and adherence was good. A three-month IMT programme in children with NMD appears safe and well-tolerated, with significant improvement in respiratory muscle strength and cough efficacy. The use of IMT could be considered as an adjunct to respiratory management in children with NMD.

AbstractBackground: Post-exercise hypotension has been given significant importance owing to both the acute and chronic responses and changes it has on the cardiovascular system. This study aimed to provide a comparison of the outcomes of differing intensities of exercises in terms of blood pressure (BP), Mean Arterial Pressure (MAP) and heart rate. The aim of this study was to provide a clinical update on exercise blood pressure (BP) and its relationship to cardiovascular disease (CVD). We also highlight current evidence gaps that need addressing in order to optimise the relevance of exercise BP as clinical CVD risk factor. The purpose of this study was to compare the outcomes of differing intensities of  exercises.Methods: This is a descriptive, pilot, non-experimental study which was conducted across both genders including 10 normotensive individuals of age varying between 18-30 years. Automatic verses manual means were used to determine Blood pressure. There were two main sessions; session 1 corresponding to an intensity of 60% Heart rate max (HR max) and session 2 corresponding to 80% HR max, respectively. During the sessions, participants were asked to exercise on a cycle ergometer at a specific intensity for 60 minutes and BP and HR then measured immediately at 0, 10, 20, 30, 40, 50 and 60 minutes after the exercise has been completed and then Mean Arterial Pressure (MAP) was calculated. MS Excel and IBM SPSS were used to analyse the data. Ethical Considerations were followed in all respects.Results: Among the prescribing indicators ,cycle ergometry elicit at 5% of VO2 Peak the similar decline in post exercise BP. Therefore bouts of mild to moderate intensity exercise may be beneficial in the control of hypertension. Heart rate was higher during 80% intensity (75.20007 with S.D ±7.13053) than during the 60% intensity (76.6000 with S.D ±7.79173). Pre-exercise values were re-established by 60 min post exercise. VO2 remained significantly elevated above pre-exercise values in both trials until 15 min post exercise. Participants went under the testing in a randomised trial. Repeated measures taken such that they performed 30-min bouts of cycle ergometry at a power output which elicited 60 or 80% of VO2 Peak. SBP between the two trials was fluctuating and became hypotensive through 60 min (101.8 with S.D ±9.19) and 80 min (103.8 with S.D ±9.53)post exercise. . DBP was also affected by the intensity of exercise and was lower than before exercise at 10 and 20 through 60 min (63.3000 with S.D ±6.71731)and 80 min (62.9000 with S.D ±5.64604)post exercise. Similarly, mean arterial pressure (MAP) showed significant changes at 10 and 20 through 60 min (76.1330 with S.D ±6.95274) and 80 min (76.5340 with S.D ±5.98943) post exercise .Heart rate was greater during the 60% intensity (75.20007 WITH S.D ±7.13053) than during the 80% intensity(76.6000 with S.D±7.79173) trial. Pre-exercise values were re-established by 60 min post exercise.Conclusion: This study necessitates the need to implement that moderately intense exercise may be as brief as 10 min in duration in order to elicit a decrease in resting blood pressure and may have potential benefits as a non-pharmacological aid to hypertension.Keywords: Exercise, Blood pressure, Heart rate, Mean arterial pressure, diasystolic blood pressure, sysytolic blood pressure

Ibutilide is commonly used for conversion of atrial fibrillation (AF) during catheter ablation procedure. Sinus arrest or Torsades de Pointes (TdP) is mainly complication of ibutilide, however, is recovery spontaneously after a few hours.We present a patient suffering long persistent sinus arrest and Torsades de pointes following administration of ibutilide for cardioversion of persistent AF after radiofrequency ablation.

We read, with interest, the article by Deb et al. entitled “Positive QRS complex in limb lead 2 with negative QRS in lead 3 on surface electrocardiogram: A novel predictor for anterior location of right sided accessory pathways.” 1 We would like to raise a few concerns regarding the interpretation of the electrocardiographic (ECG) sign they have highlighted.

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Background and Purpose: Corticosteroid therapy is still controversial to use for treatment of coronavirus disease-2019 (COVID-19). The results of multiple randomized clinical trials (RCTs) and observational studies are very diverse and contradictory, which arising difficulty in the clinical decision-making. The objective of this study is to investigate the effect of corticosteroids on mortality by systematic review and meta-analysis. External Approach: A systematic search was performed on different databases namely Medline/PubMed, Cochrane and Google scholar on 10 February 2022, according to PRISMA guidelines. The 28-days mortality was considered as outcome of study. A pooled estimate was calculated with random effects and fixed effects models. Cochran’s Q test and the I2 statistic were conducted for statistical heterogeneity. Key Results: 38 studies were included, having sample size of 87,781 patients. Amongst them, 16437 patients received corticosteroid therapy (intervention group) while 71344 patients were standard (noncorticosteroids) therapy (control group). 12.68% (2084) mortality observed in the intervention group while 5.93% (4227) mortality observed in the control group. The overall pooled estimate showed a significantly (OR2.305;95%CI: 2.1810 to 2.4370) increased mortality in intervention group. A pooled fold change estimation showed significantly increased in the mortality in methylprednisolone (OR 1.206;95%CI: 1.0770 to 1.3500) and dexamethasone (OR 1.388;95% CI:1.1870 to 1.6220) therapy. Conclusion and Implication: In conclusion, corticosteroid therapy produced a negative prognosis as depicted by increased mortality among COVID-19 patients. The possible reasons might be delay in virus clearance and secondary infection due to initiation of the corticosteroids at high dose in the early stage of infection.