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Blood cytometry, neutrophil-lymphocyte index and platelet-lymphocyte index in childre...
Gerardo Palacios Saucedo
Celia Herrera Rivera

Gerardo Palacios Saucedo

and 2 more

May 02, 2022
ABSTRACT Background: The emergence of new SARS-CoV-2 variants is increasing pediatric COVID-19 cases. The blood cytometry (BC) values, neutrophil-lymphocyte index (NLI), and platelet-lymphocyte index (PLI) reflect inflammatory response intensity. The aim was to evaluate if BC, NLI, and PLI are predictors of the COVID-19 severity in children with high-risk pathologies. Methods: A retrospective nested case-control study of 60 pediatric patients with COVID-19 was carried out to evaluate the relationship of BC, NLI, and PLI with clinical status at the COVID area discharge. Patients with a severe or critical condition at discharge and those who died during hospitalization were classified as cases. Asymptomatic patients or those with a mild to moderate disease at discharge were considered controls. We used absolute frequencies, percentages, medians, ranges, X2 test, Fisher’s exact test, and Odds Ratio with 95% CI for statistical analysis. Results: We included 32 male and 28 female patients, median age of 6.5 years (range 0-14). All had high-risk diseases, such as Leukemia (64.4%), Down syndrome and Leukemia (8.8%), or a solid neoplasm (13.3%). Seventeen (28.3%) were cases and 43 (71.7%) controls. Fourteen (23.3%) died. No BC value was associated with illness severity, except for thrombocytosis (OR 6.30, 95% CI 1.03-38.48, p=0.048). Erythropenia was identified as a protective factor for illness severity (OR 0.18, 95% CI 0.03-0.86, p=0.034). Conclusion: A decrease in different BC values was the most frequent abnormality. Thrombocytosis was associated with COVID-19 severity. These results may apply to children with high-risk pathologies such as those in this series.
An oversight regarding the Club cell?
Richard Parad

Richard Parad

May 02, 2022
CorrespondenceTitle: An oversight regarding the Club cell?To the Editor,I was surprised to a see a title including the outdated term “Clara Cell” protein, in reference to CC16, in the title and body of the article by Rallis et al recently published in Pediatric Pulmonology (1). It appears that there needs to be an ongoing reminder that due to the association of Dr. Max Clara with the Third Reich and his unethical medical research practices which lead to the identification of this cell type (2-4) that his name was removed in 2013.In 2012, Editorial boards of American Thoracic Society, the European Respiratory Society and the American College of Chest Physicians, based on recommendations from an expert panel assembled by the Forum of International Respiratory Societies, agreed to convert to use of the terms “club cell (Clara)” and “club cell secretory protein (Clara), and after January 1, 2013, completely transitioning out the use of the (Clara) eponym.In our day, where cancel culture is so predominant, questions have been raised about what lessons are lost when history is erased. Assuming an oversight was made by the authors, editors and reviewers in not utilizing the now accepted terms “Club cell secretory protein” or bronchiolar exocrine cells, it would only be acceptable to mention the prior term in the setting of an asterisked description explaining the context and involvement of concentration camp prisoners and their association with the prior eponym, for educational purposes.Rallis D, Baltogianni M, Dermitzaki N, Balomenou F, Papastergiou E, Maragoudaki E, Tsabouri S, Makis A, Giapros V. Clara cell protein expression amongst infants with respiratory distress syndrome. Pediatr Pulmonol. 2022 Mar 18.Woywodt A, Lefrak S, Matteson E. Tainted eponyms in medicine: the ”Clara” cell joins the list. Eur Respir J. 2010 Oct;36(4):706-8Winkelmann A, Noack T. The Clara cell: a ”Third Reich eponym”? Eur Respir J. 2010 Oct;36(4):722-7.Irwin RS, Augustyn N, French CT, Rice J, Tedeschi V, Welch SJ; Editorial Leadership Team. Spread the word about the journal in 2013: from citation manipulation to invalidation of patient-reported outcomes measures to renaming the Clara cell to new journal features. Chest. 2013 Jan;143(1):1-4.
Clinical and genetic analysis of two patients with primary ciliary dyskinesia caused...
Lili Dong
Lei Zhang

Lili Dong

and 8 more

May 02, 2022
Objective: To investigate the clinical manifestations, diagnosis and treatment processes of two siblings with PCD caused by the same compound heterozygous mutations in DNAAF2. Methods: With clinical diagnosis of PCD, the two siblings were recruited in the study. We collected their clinical histories, laboratory tests, bronchoscopy, otoscope images, and radiographic data. Whole blood of the siblings and their parents were separately harvested for whole-exome sequencing and Sanger sequencing. Results: The 7-year-old girl presented with recurrent respiratory tract infection, sinusitis and otitis media. Auxiliary examinations showed pneumonia, atelectasis, bronchiectasis, low nitric oxide concentration (nNO), and conducting hearing loss. The younger brother, 10-month boy, exhibited pneumonia, sinusitis, otitis media, intestine malrotation and with lower nNO, atelectasis in chest CT, obstructive ventilator dysfunction by pulmonary function and conductive hearing loss. Two compound heterozygous mutations in DNAAF2 were detected in both of the siblings, nonsense mutation c.156C>A and frameshift mutation c.177_178insA, and the c.177_178insA (p.E60Rfs*3) mutation is a novel mutation. Conclusion: The study enriches our knowledge of clinical manifestations and genetic information of PCD caused by DNAAF2.
Surgical Treatment of Invasive Pulmonary Fungal Infections in Immunocompromised Pedia...
Sergio Lopez-Fernandez
José Andrés Molino

Sergio Lopez-Fernandez

and 6 more

May 02, 2022
INTRODUCTION: Invasive Pulmonary Fungal Infections (IPFI) represent a diagnostic and therapeutic challenge. The exact role of surgery is not well defined. This study aims to analyze our experience with surgical treatment of IPFI in immunocompromised pediatric patients and, secondarily, to compare the IPFI caused by Aspergillus spp. with other fungal infections. METHODS: retrospective review (2000-2019) of patients with IPFI surgically treated at our pediatric institution. Statistical analysis was used to compare data between Aspergillus spp. and non-Aspergillus IPFI. RESULTS: twenty-five patients (64% females) underwent 29 surgical lung resections. Median age at surgery was 7.19 years (1.63-19.14). The most frequent underlying condition (64%) was acute leukemia. Surgical indications included persistence or worsening of symptoms and pathological image findings (52%) or asymptomatic suspicious lesions in patients scheduled for intensive cytotoxic treatments or HSCT (48%). All patients underwent atypical lung resections, except one lobectomy. Aspergillus spp. was the most frequently isolated pathogen (68%). Follow up was 4.07 years (0.07-18.07). Surgery-related mortality was 0% but 4 patients died in the 100 days following surgery (2 due to disseminated fungal infection); the remaining 21 didn’t show signs of IPFI recurrence. Non-specific consolidations on CT scan were more frequent in non-Aspergillus IPFI (p<0.05). CONCLUSIONS: surgical treatment of IPFI should be considered as part of the treatment in selected pediatric immunocompromised patients, and it may have both diagnostic and therapeutic advantages over non-surgical management. When there is clinical suspicion of IPFI but CT scan shows unspecific alterations, the possibility of a non-Aspergillus IPFI should be considered.
Mean-stress sensitivity of an ultrahigh-strength steel under uniaxial and torsional h...
Bernd Schönbauer
Sumit Ghosh

Bernd Schönbauer

and 6 more

May 02, 2022
The influence of load ratio on the high and very high cycle fatigue (VHCF) strength of Ck45M steel processed by thermomechanical rolling integrated direct quenching was investigated. Ultrasonic fatigue tests were performed under uniaxial and torsional loading at load ratios of R = −1, 0.05, 0.3 and 0.5 with smooth specimens and specimens containing artificially introduced defects. Up to 2×10 5 cycles, failure originated from surface aluminate inclusions and pits under both loading conditions. The prevailing fracture mechanisms in the VHCF regime were interior crack initiation under uniaxial loading and surface shear crack initiation under torsional loading. The mean-stress sensitivity and the fatigue strength were evaluated using fracture mechanics approaches. Equal fatigue limits for uniaxial and torsional loading were determined considering the size of crack initiating defects and the appropriate threshold condition for Mode-I crack growth. Furthermore, the mean-stress sensitivity is independent of loading condition and can be expressed by σ w R = σ w R = - 1 ∙ 1 - R 2 0.63 and τ w R = τ w R = - 1 ∙ 1 - R 2 0.63 .
Very high cycle fatigue under tension/torsion loading of mold low alloy steel
Pedro R. da Costa
Luis Reis

Pedro R. da Costa

and 2 more

May 02, 2022
Ultrasonic fatigue testing is a recent fatigue methodology that applies resonant principles to induce cyclic stresses in a modally designed specimen enabling the application of fatigue damage at very high frequencies. Its primary purpose is to study fatigue life in the Very High Cycle Fatigue regime between 10E07 and 10E09 cycles with a higher performance of time and energy wise compared to conventional servo-hydraulic fatigue testing machines. In this study, an ultrasonic fatigue testing machine was used to carry out multiaxial tension/torsion fatigue tests at a frequency of 20 kHz. The objective was to reach a reliable multiaxial fatigue testing method by modifying only the specimen, with the ability to induce different shear to axial stress ratios. The improved design/methodology of the testing ultrasonic multiaxial method focused first on the innovative design specimens and setup modal behaviour by conducting both numerical and experimental analyses. Laser displacement measurements, thermographic imaging, and rosette strain gauges applied to the specimen’s fatigue stress region were carried out to validate the new design concept and compared with the computed results obtained by finite element. A good numerical to experimental results agreement was achieved. A series of fatigue tests were carried out in tension/torsion fatigue to three different combining dimension specimens allowing three different shear/axial stress ratios. The resulting crack initiation angles and fracture surfaces were analysed and compared not only between each other but also with tension-compression and pure torsion ultrasonic tested specimens.
Research on the performance of exhaust gas temperature differential power generation...
Zhongcheng WANG
Chong  Zhao

Zhongcheng WANG

and 3 more

May 02, 2022
In order to study the influencing factors of the application of temperature difference in ship’s exhaust gas and to explore the potential of recycling waste heat from ship’s exhaust gas, an experimental system for temperature difference power generation in ship’s exhaust gas has been designed. Besides, related performance studies have been carried out about the characteristics of temperature difference power generation tablets and exhaust gas. Moreover, the theoretical calculation of the maximum output power and maximum efficiency of the individual temperature differential power generation module was carried out. Furthermore, the effects of insulation material, installation pressure, thermally conductive silicone grease, brine concentration, cooling water temperature, and heat source temperature on the performance of the individual temperature differential power generation module were thoroughly investigated. The results showed that the insulation material and the brine had a small effect on the efficiency of the differential temperature power generator. Conversely, the mounting pressure, the thermal grease, the cooling water temperature, and the heat source temperature greatly influenced the open-circuit voltage and the maximum output power. The installation pressure, the thermal grease, the cooling water temperature, and the heat source temperature increased the open-circuit voltage by 6.72%, 31.54%, 18.95%, and 26.92%, respectively, and increased the maximum output power by 15.63%, 82.05%, 51.79%, and 49.41%, respectively. The maximum output of a single temperature differential power generator reached 63.5% when using an installation pressure of 3 bar, a cooling water temperature of 20°C, double-layer aluminum insulation, a thermally conductive silicone grease, and a brine concentration of 5.5%. Finally, this study provides reference data support for the use of temperature differential power generation devices for ship exhaust gas and lays a foundation for the further research and development of this technology on ships.
CASE REPORT: Coronavirus with acute kidney injury
Asiyeh Aref

Asiyeh Aref

May 02, 2022
A document by Asiyeh Aref. Click on the document to view its contents.
A Study on The Concept of Monopolistic Competition
Khadija Akter

Khadija Akter

and 6 more

May 12, 2022
IntroductionMonopolistic competition often eliminates economic profits, thus leading to losses in the short run after entries have ventured into a particular market. However, the freedom to exit these markets could influence high prices and eliminate economic losses. Such industries in monopolistic competition could include; hairdressing, fashion enterprises, and restaurants. Usually, profits can be maximized when the marginal revenue and marginal costs are equal. Therefore, the equilibrium output is determined by the point where the marginal revenue and costs are equal (Krylovskiy, 2020). While companies in monopolistic competition could face long-term economic losses, they assess their output and price of products in the short run the same way companies in a monopoly do. However, these companies could produce at a level where the marginal revenues and costs are equal in the long run. However, the demand curve shifts to the left because of new entries into monopolistic markets or industries. The demand curve shift is usually caused by reduced demand concerning a company’s products due to increased competition. Therefore, when the magnitude of the entry of new players is high, existing monopolistic companies could experience reduced economic profits; hence companies can hardly sell their products at above-average costs.
“Case Report: A wise exception to guideline of endocarditis”
Azin alizadehasl
Ehsan Khalilipur

azin alizadehasl

and 5 more

May 02, 2022
High embolization risk is an early surgery indication in Infective endocarditis patients. current guidelines acknowledge delaying surgery for 1 to 2 weeks if ischemic stroke occur. Nevertheless, it could be conducted if required. We report a case of endocarditis with high embolization risk complicated by ischemic stroke and septic emboli.
Outcomes of Liver transplantation in children with Langerhans Cell Histiocytosis: Exp...
Jagadeesh Menon
Naresh Shanmugum

Jagadeesh Menon

and 8 more

May 02, 2022
Objective : Spectrum of hepatic presentation in Langerhans cell histiocytosis (LCH) varies from asymptomatic hepatomegaly to secondary sclerosing cholangitis leading to cirrhosis with or without decompensation. Conventional chemotherapy may be counterproductive in a patient with LCH and hepatic decompensation. We analysed the outcomes of our patients with hepatic presentation of LCH, including their post liver transplant (LT) follow up. Methods: A retrospective analysis was performed on patients with hepatic presentation of LCH referred to our unit. Their clinical profile, chemotherapy protocol, details of LT and survival were analysed. A management algorithm based on the outcomes was proposed. Results: Five of 8 patients were male. Median age of diagnosis was 25(9-48) months. 8(100%) patients had portal hypertension with 4(50%) having decompensated cirrhosis. 6 (75%) patients underwent LT of which 2 had acute decompensation and 4 had sclerosing cholangitis with portal hypertension. Of the two remaining patients, 1 did not tolerate chemotherapy and succumbed, whereas 1 patient after first cycle of chemotherapy was lost to follow up. As their liver disease was worsening during chemotherapy (after 8 & 20 weeks of chemotherapy), two patients underwent urgent LT followed by continuation of chemotherapy. After median follow-up of 30.5 (10.5-50) months, all patients were alive with stable graft function and no disease recurrence. Conclusion: As shown in our series, an algorithmic approach to patient and treatment selection for LCH patients with liver involvement combined with newer chemotherapeutic agents and an optimized immunosuppression can result in excellent outcomes for a hitherto unfamiliar disease.
Performance of the new nutritional evaluation tool for hospitalized pediatric cancer...
Danúbia Saraiva
Renata Martucci

Danúbia Saraiva

and 2 more

May 02, 2022
Background: There is a lack of specific nutritional assessment tools for the pediatric population with hospitalized cancer. The aim was to evaluate the performance of ANPEDCancer in a pediatric population with cancer, verifying its ability to detect nutritional inadequacy and predict the length of hospital stay. Methods: We evaluated 111 pediatric patients hospitalized in a cancer reference institute in 2019. Patients were classified as malnourished and well-nourished, according to the ANPEDCancer, and measures of weight, height, anthropometric indicators, body composition, laboratory parameters, length of hospital stay, and death were compared between groups. The ANPEDCancer classification was compared with the complete nutritional assessment, calculating sensitivity, specificity, and predictive values, and with prolonged hospital stay. Results: The prevalence of malnutrition was 12.6%, nutritional risk was 48.6%, risk of overweight/obesity was 6.3%, and well-nourished status was 32.4%. According to ANPEDCancer, malnourished patients showed a higher frequency of inadequacy for all anthropometric indices, percentage of weight loss, albumin, C-reactive protein (CRP), and longer hospital stay when compared to well-nourished patients. There was an association between the tool’s diagnosis and measures of body composition, CRP, and length of hospital stay. ANPEDCancer validation with the complete nutritional assessment showed a sensitivity of 81.6%, specificity of 55%, positive predictive value of 53.4%, and negative predictive value of 82.5%. The length of hospital stay was almost twice as long among malnourished patients. Conclusions: ANPEDCancer is feasible to assess nutritional status and identify the presence of nutritional risk, allowing targeted assistance in the hospitalized pediatric cancer patients pediatric.
A case study related to corporate social responsibility in Bank of Maldives      
Khadija Akter
nova.mieszkowska

Khadija Akter

and 5 more

May 12, 2022
Executive SummaryWhile it is critical for a business to earn a profit, it is also critical for it to operate in an ethical and sustainable manner, which is becoming increasingly crucial as our younger generations become more aware of the detrimental influence we have on the environment.This is where CSR (Corporate Social Responsibility) enters the picture. CSR, or corporate social responsibility, is defined as a company’s endeavour to enhance society and contribute to its long-term growth.It is concerned with the environmental and social effects that a company has on the society in which it works. Bank of Maldives management claims that they are committed to continuing to operate as a sustainable and responsible business, striving to make a positive difference for their customers, communities, and employees while achieving sustainability through their operations and maintaining strong risk management and governance. The organization’s aim to be a responsible and sustainable corporation drives the corporate social responsibility (CSR) strategy.BML adopts a holistic approach to CSR, embedding responsibility into the company’s culture and operations. The BML CSR Committee, which is made up of senior executives from several divisions, oversees the CSR projects. They actively collaborate with all sectors and demographics of the Maldivian community and contribute to national and societal development in the Maldives as one of the largest corporations in the Maldives.The goal of corporate social responsibility is to improve the long-term viability of fundamental company operations. Its dedication to being a sustainable and responsible organisation is shown in their policies, practices, and Code of Conduct. It aspires to build its business responsibly, in ways that benefit society, and to operate in an ecologically, socially, and financially responsible manner.We’ve looked at the theoretical understanding, relevance, and effect of CSR, as well as the governance of BML, in this paper. Following a description of the benefits and obstacles, recommendations for policies and procedures were made.
Grazing by semi-feral cattle and horses supports plant species richness and uniquene...
christofferbonavent
Kent Olsen

Christoffer Bonavent

and 7 more

October 31, 2022
AbstractQuestion:  How do naturalistic grazing in contrast to mowing and free succession affect plant community composition and species richness in a temperate grassland grazed by semi-feral cattle and horses?Location: Mols Laboratory, DenmarkMethods: We investigated grazing exclosures in the rewilding area of the Mols Laboratory, four years after its establishment. We focused on moist to dry grassland vegetation, i.e. excluding scrub and woodland. Each experimental block consisted of five 5 × 9 m plots, representing four fenced treatments, i.e. summer-only grazing, winter-only grazing, full exclosure with annual autumn mowing and full exclosure with passive succession. The matrix was grazed by large herbivores at close-to-natural densities, i.e. regulated bottom-up by the carrying capacity of the area. Hence, the seasonal grazing treatments were grazed at close-to-natural animal density. Quantitative plant community composition was assessed using the point-intercept method in 25 × 25 cm quadrats, supplemented with biomass calibration models based on additional quadrats, in which above-ground plant biomass was harvested after recording and the material sorted to species and weighed. Uniqueness was assessed as the sum of inverse range sizes for constituent species.Results: We found an appreciably higher plant species richness in grazing treatments than under annual mowing and full exclosure, but only minor differences between seasonal grazing treatments. Uniqueness was highest in year-round and winter-only grazing and lowest in summer-only grazing. The forb:graminoid ratio tended to be high in the winter-only grazing treatment, whereas annual mowing was associated with dominance of graminoids over forbs. Full exclosure plots had accumulation of litter and the lowest species richness. Initial heterogeneity between plots within blocks and a systematic differences between blocks in moist and dry grasslands seemed to swamp treatment effects at this early point after the establishment of the experiment. Data analysis using the biomass estimates derived from the calibration models yielded only minor differences in the patterns described above, when compared to the results obtained using the raw number of intercepts.Conclusions: Grazing under near-natural conditions is a goal in itself in ecological restoration, but also proposed as an efficient management tool to promote conservation of grassland plants and communities. We found both plant species richness and the prevalence of rarer species (unicity) to be higher with grazing than mowing/abandonment. Similarly, the tendency for forbs to prevail under grazing may translate into enhanced floral resources for anthophilous insects. Summer-only grazing at low density of large herbivores was not significantly different from winter-only and year-round grazing, but this treatment was much closer to natural grazing than intensive summer grazing typical of agri-environmental practices.Keywords: biomass estimation, disturbance regime, point-intercept method, rewilding, uniquenessIntroductionGrazing by large herbivorous mammals is a key process shaping vegetation structure and habitat conditions for plants and other organisms (Bakker et al. 2016; Malhi et al. 2016; Galetti et al. 2018). In European conservation management, there is a strong tradition of aiming at mimicking traditional practices in agriculture and livestock husbandry, e.g. extensive haymaking and summer grazing (Varga et al. 2016). In reality, however, actual conservation management is often strongly constrained by the opportunities compatible with modern high input-high output farm management and agri-environment support schemes (Newton et al. 2012). Either way, conservation management practice is not always rooted in ecological theory and often fails to deliver the desired outcomes for biodiversity (Maxwell et al. 2020; Kindvall et al. 2022). Attempts to apply first principles to grazing management can be comprised under the term “naturalistic grazing”, which may be characterized as landscape-scale conservation management, under which grazing as a natural process is seen as an aim in itself, and where human intervention therefore is reduced to a minimum and where herbivore density is not human-controlled, but left to be resource-regulated (Hodder et al. 2005). Although “naturalistic grazing” is considered open-ended with regard to effects on herbivore populations and vegetation, monitoring the effects is crucial to our understanding of how grazing as a natural process works and interacts with other natural conditions and processes.In large contiguous landscapes, habitat use by large herbivores often shows substantial variation in diurnal, seasonal and between-year patterns. Animal activity tend to be concentrated in certain areas, while large areas may be much more extensively used, e.g. wet areas may be avoided during winter, but preferred in spring and summer (Górecka-Bruzda et al. 2020). Traditional European livestock husbandry had, and continues to have, the growth and survival of domestic animals as its core purpose. Therefore, summer-only grazing on pastures and winter feeding of stabled animals was traditionally the norm in Denmark, in particular for cattle, while some horses have traditionally been left on pastures year-round (Fritzbøger 2004). The pattern of summer-only grazing is strongly reinforced in modern North-European livestock husbandry, in which standard practice is to turn livestock out at very high density (e.g. 800-1000 kg·ha-1) during a short period of intensive grazing at the peak of the growing season (typically May through September or shorter). One way of investigating the resulting impact on vegetation of the annual timing of herbivore activity is to compare areas, to which animal access is restricted to certain parts of the year  (Bullock et al. 2001). Modern European grasslands are often highly grass dominated. The relatively low prevalence of forbs may, however, be a legacy effect of past megafauna extinctions. It has been hypothesized that megafauna once sustained much higher abundance of forbs in grasslands (Bråthen et al. 2021). The shift in dominant growth form has likely been exacerbated by the more recent demise of large herbivores from European landscapes at large, and natural areas in particular. The shift has probably propagated to higher trophic levels, i.e. mega-diverse consumer taxa, e.g. arthropods and fungi  (Brunbjerg et al. 2018). Flower-visiting insects have attracted particular attention, partly because this functional group is particularly threatened by both land-use intensification and abandonment, and partly because some anthophilous insect taxa have shown dramatic declines in species richness and abundance (e.g. Hallmann et al. 2017; Warren et al. 2021). The ratio in vegetation of forbs to graminoids has therefore been particularly highlighted, as most forbs have flowers offering resources to anthophilous insects, while graminoids all have wind-pollinated flowers.The response of vegetation structure to grazing regime will likely involve changes in quantitative plant community composition, with the activities of large herbivores promoting the abundance of certain species, while limiting others. We therefore applied the point-intercept method to quantitatively recording vegetation structure (Jonasson 1988; Godínez-Alvarez et al. 2009; Bonham 2013). Non-destructivity is a virtue of the method, which was desired in the current setup of long-term monitoring plots, also surveyed for other groups of organisms. However, because of differences in plant architecture, the intercept-based abundance does not translate directly to biomass-based abundance. We therefore made calibration models per species and/or functional groups, based on an additional set of quadrats, first subjected to point-intercept recording, next to total harvest and dry-mass estimation per species.Plant community species richness, or alpha diversity, is of core interest to evaluations of vegetation under contrasted grazing regime, although results may depend on the actual quadrat size applied. From the perspective of gamma diversity in the region or country, however, community unicity - the regional rarity of constituent species - is of higher relevance. One way to evaluate the contribution of individual communities to regional gamma diversity is the ‘Sum of inverse range-sizes’ (Guerin & Lowe 2015; Ejrnæs et al. 2018), in which constituent species are given decreasing weight with increasing regional occupancy. Also, from the perspective of biodiversity conservation, community unicity may be more relevant than alpha diversity, e.g. even locally species-poor communities may be of high regional conservation value, if they tend to consist of relatively rare species.Our overarching aim was to assess differences in grassland vegetation structure, community richness and unicity (the prevalence of less widespread species) as a snapshot after four years of naturalistic year-round grazing, as compared to seasonal grazing regimes, to mechanical mowing and to free succession after grazing abandonment and mowing regimes. Specifically, we aimed at investigating:1) Does plot-scale plant species richness vary between year-round grazing, seasonal grazing (all at naturalistic herbivore density), mowing and passive succession?2) Does forb to graminoid ratio vary between year-round grazing, seasonal grazing (all at naturalistic herbivore density), mowing and passive succession?3) Does plant community unicity vary between year-round grazing, seasonal grazing (all at naturalistic herbivore density), mowing and passive succession?A subordinate aim was the methodological issue of non-destructive assessment of quantitative plant community composition and the sufficiency of the point-intercept method as compared to biomass estimation. Materials and methodsStudy siteThe Mols Laboratory is an ecological research station, owned by the Natural History Museum, Aarhus. It is 120 ha located in the glacially shaped hilly landscape of Mols Bjerge at 56.22° latitude and 10.57° longitude. The area covers wide gradients in soil moisture, nutrient status and vegetation openness. Roughly half of the area is covered by open habitats, the other half by scrub and forests, with all types in a mosaic with gradients both between open and canopy-covered habitats and dry and moist habitats. The most frequent open habitat type, as categorized under the European Habitats Directive, was Species-rich Nardus grasslands (6230). Despite all research blocks but one (block 70 was not located in a designated habitat type) being assigned to this type of grassland, quite large variation in the species composition and topography between different parts of the area is evident, foremost between hilly glacial gravelly till and sandy marine foreland shaped by the higher sea-level of the Littorina transgression (Atlantic; 6800 - 3900 BCE). This contrast is presumably particularly linked to hydrology, with the marine foreland being somewhat impacted by exfiltration of groundwater from the hills.In 2016, as part of a rewilding project, 13 heads of Galloway cattle and 12 Exmoor ponies, supplemented 6 months later by a stallion, were released. Since then, the herds have lived there under near-natural conditions, which means that population size is determined by the carrying capacity, i.e. no supplementary feeding. As population size approaches carrying capacity, food shortage is likely to kick in during the late winter months, at which time weak individuals will die. In order to minimize possible suffering of the animals and to comply with Danish animal welfare legislation, the herds have been continually evaluated, following a scoring protocol based on body condition and behaviour. Individuals failing to meet a set threshold are removed from the area. This so-called “reactive” population management has led to a dynamic development in population size, with the population of large herbivores growing to a total of 44 cattle and 25 ponies in the summer of 2019, and subsequently decreasing to the current level of 12 cattle and 26 ponies. Assuming a standard body mass for cattle of 550 kg and 350 kg for horse, this is equivalent of a drop in large herbivore density from almost 300 kg/ha to 140 kg/ha.With the purpose of monitoring the effects of the naturalistic grazing regime, 22 randomly selected blocks for permanent vegetation monitoring were established in the spring of 2017. Each block contained four treatment plots, i.e. summer-only grazing (exclosure November through April), winter-only grazing (exclosure May through October), annual autumn mowing (full exclosure with one annual cut during September-October and the thatch removed) and passive succession (full exclosure), all embedded in the matrix of year-round grazing. Animal density was regulated by forage availability of the entire area, which means close to natural levels. Shrubs (but not trees) were initially removed from the mown plots in order to allow cutting by machinery, but not from the other treatments. Fencing did not prevent access to plots by herbivores such as red deer, roe deer and hare, only horse and cattle. Vegetation recordingIn order to select grassland blocks, all monitoring blocks were initially surveyed in order to establish the dominant vegetation type. Out of the initially established 22 blocks, one was discontinued, four were located in closed-canopy forest, four were almost entirely covered by dense scrub and four had scrub-grassland mosaics with too high scrub cover for the point-intercept method to be practically applicable in all treatment plots, leaving nine blocks with mostly open grassland vegetation (Fig. 1).Field work was carried out in two periods: September 1-16, 2020 and August 2-20, 2021. In the first period, sampling quadrats in treatment plots were put in the periphery of the established circular monitoring plots (see Supplementary materials, Appendix 1) and subjected to point-intercept vegetation recording, after which the above-ground biomass was cut as close to the soil surface as possible, immediately sorted into fractions by plant species (with standing litter as a separate fraction) and dried at 55 ˚C until constant weight. The resulting data were used to create calibration models per species or functional groups for the prediction of plant species above-ground biomass from non-destructive point-intercept counts. In the second time period, sampling quadrats were located within the circular monitoring plots and surveyed using the same point-intercept method as in the first round. The resulting records were 1) used as-is, 2) subjected to prediction of species’ biomass using the regression models of the first round.Due to time constraints, only six of the nine blocks were included in first round of field work and were thus included in the construction of calibration models (i.e. block numbers 60, 62 and 70 were not sampled). Similarly, mown plots were not sampled, as they were in the process of being mown while the vegetation surveys were carried out. Including newly mown plots would have compromised the reliability of calibration models. In the second year, the field work took place one month earlier, allowing point-intercept recordings in the annually mown plots.The total sample size for the two periods of fieldwork were: 6 blocks × 4 treatment plots = 24 quadrats in the first period (in 2020) and 9 blocks × 5 treatment plots = 45 quadrats in the second period (in 2021).
L'autorizzazione integrata ambientale (AIA)
Alessia Amich
Francesca Rocco

Alessia Amich

and 1 more

August 10, 2022
L’autorizzazione integrata ambientale (AIA) è un procedimento che ha lo scopo di promuovere e perseguire uno sviluppo sostenibile attraverso le migliori tecniche disponibile (MTD) contenute nei BRef. L’autorizzazione è "integrata" perché relativa a più aspetti ambientali e alla loro interazione e persegue una prestazione ambientale ottimale. L’AIA è disciplinata dal D.L. 152/2006 (T.U. ambientale) e il procedimento per il rilascio si concentra sull’analisi della documentazione fornita dall’interessato relativa ai numerosi criteri da osservare definiti dal T.U. Il caso studio riguarda la realizzazione di un impianto di termovalorizzazione dei rifiuti indifferenziati nel rispetto dei requisiti per ottenere il rilascio dell’AIA.
The targeted exome sequencing strategy (NeoExome) for Chinese newborns with the pilot...
Lin Zou
Ziyang Cao

Lin Zou

and 22 more

May 02, 2022
Newborn screening (NBS) is an effective way for 3-step prevention of birth defects. The suitable technology and rational NBS screening diseases are critical for each country and area. High-throughput sequencing has shown high application potential in NBS. However, lack of sequencing strategy for monogenic inherited diseases NBS in China. In this study, we systematically evaluated the application efficiency of different sequencing approaches for NBS, and a gene-disease association list (NeoExome panel) for the Chinese population with 601 genes was designed based on the top rare disease list and databases. In the 1000 Genomes Project, 7.6% (23/301) were NGS positive. Among the 3249 neonates recruited, NGS positive rate was 12.0%. In the 200 conventional NBS (+) subgroup, 118 were NGS positive, with 76.3% (90/118) neonates harboring consistent results of conventional NBS and NGS; in the conventional NBS (-) subgroup, the NGS positive rate was 8.9% (271/3049). Our study designed a personal NBS targeted-sequencing NeoExome panel of monogenic inherited diseases for Chinese, which has shown acceptable performance.
Retrotransposon insertion as a novel mutational cause of spinal muscular atrophy
Pascale Saugier-Veber
Myriam Vezain

Pascale Saugier-Veber

and 11 more

May 02, 2022
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder resulting from biallelic alterations of the SMN1 gene: deletion, gene conversion or, in rare cases, intragenic variants. The disease severity is mainly influenced by the copy number of SMN2, a nearly identical gene, which produces only low amounts of full-length (FL) mRNA. Here we describe the first example of retrotransposon insertion as a pathogenic SMN1 mutational event. The 50-year-old patient is clinically affected by SMA type III with a diagnostic odyssey spanning nearly 30 years. Despite a mild disease course, he carries a single SMN2 copy. Using Exome Sequencing and Sanger sequencing, we characterized a SVA-F retrotransposon inserted in SMN1 intron 7. Using RT-PCR and RNASeq experiments on lymphoblastoid cell lines, we documented the dramatic decrease of FL transcript production in the patient compared to subjects with the same SMN1 and SMN2 copy number, thus validating the pathogenicity of this SVA insertion. We characterized the mutant FL-SMN1-SVA transcript and showed that it is subject to degradation by nonsense-mediated mRNA decay. The stability of the SMN-SVA protein may explain the mild course of the disease. This observation exemplifies the role of retrotransposons in human genetic disorders.
CRISPR/Cas12a-based SARS-CoV-2 Rapid Visual Detection and Clinical Application
Jingsong Xu
Xi  Wang

Jingsong Xu

and 6 more

May 02, 2022
Background: Currently, rapid and widespread testing is essential to promote early intervention and curb the ongoing COVID-19 pandemic. The reverse transcription-polymerase chain reaction (RT-PCR) for detecting novel coronavirus (SARS-CoV-2) is restricted to professional laboratories and well-trained personnel, thus, limiting its widespread use in in resource-limited conditions. Methods: To overcome these challenges, we developed a rapid and convenient assay using recombinase polymerase amplification (RPA) and clustered regularly interspaced short palindromic repeats (CRISPR) technology for the rapid detection SARS-CoV-2, which was named as Visual Detection of RPA-amplified Products (VDAP). The reaction conditions of the VDAP were optimized and selected using pure SARS-CoV-2 RNA standards and the sensitivity and specificity of the VDAP were further determined. Finally, the VDAP was verified on clinical specimens. Results: The VDAP was performed at 37 °C for 15 min, and the result was visible by the naked eye. The limits of detection (LODs) of the VDAP for the target ORF1ab and N genes are 70 and 500 copies, respectively. No cross-reactivity was observed with the RNA standard samples of four respiratory viruses or clinical samples of common respiratory viral infections. These results confirmed that the assay was highly specific. Thirty SARS-CoV-2 positive and 30 SARS-CoV-2 negative patient specimens were analyzed. We compared these results to RT-PCR, the overall sensitivity and specificity of the VDAP compared to RT-PCR for detection SARS-CoV-2 were 93.3% and 100.0%, respectively. Conclusions: The VDAP is a simple, highly specific, and convenient assay for the detection of SARS-CoV-2 in resource-limited conditions
Analysis of a system of Riemann-Liouville fractional differential equations with coup...
Dehong Ji
Yuan Ma

Dehong Ji

and 1 more

May 02, 2022
In this paper, we investigate the existence and uniqueness of solutions for a system of Riemann-Liouville fractional differential equations with coupled Riemann-Stieltjes integrals boundary conditions. In the proof of our main existence results, we apply the Banach contraction mapping principle and the Leray-Schauder alternative therorem.
Safety of COVID-19 vaccine challenge in patients with immediate adverse reactions to...
Joseph De Luca F
Andrew Awad

Joseph De Luca F

and 8 more

May 02, 2022
A document by Joseph De Luca F. Click on the document to view its contents.
Thyroid storm presenting as a fulminant hepatic failure and cholestasis case report
Eldosugi  Eltayeb Elsheikh
Hadeel Ali Ahmed

Eldosugi Eltayeb Elsheikh

and 4 more

May 02, 2022
We report a case of thyroid storm in a 52-years old woman who wasn't known to be thyrotoxic. She was diagnosed with congestive heart failure and atrial fibrillation one month before her presentation to the emergency department with diarrhea, features of fulminant hepatic failure, and cholestasis.
Composite Gaussian Pulsed Waveform For Robust Resonance Radar Signature
Faisal Aldhubaib

Faisal Aldhubaib

May 02, 2022
The paper assesses the feasibility of forming a composite excitation pulse with a high potential to combat the noise and onset ambiguity when estimating the target resonance behaviour in a radar target signal. The assessment investigates four composite pulse configurations of unified or adaptive setups for the fractional bandwidth and peak weight to find the best setup in enhancing the resonance signature robustness. The assessment uses the method pencil function to extract the resonance parameters of the composite time data (coherent) and then determine the degree of robustness over-extraction onset and range of noise level. Determining the robustness rate requires finding the error between the original excitation frequencies and the extractable resonant frequencies and, second, the similarity between the original and reconstructed pulse waveforms. The qualitative assessments of the robustness merit concluded that the adaptive configuration of peak weight and small adaptive fractional bandwidth outperforms the other configurations in enhancing the resonance signature robustness.
Mathematical modeling and vibration analysis of rotating functionally graded porous s...
Tian Yu Zhao
Yuxuan Wang

Tian Yu Zhao

and 2 more

May 02, 2022
This paper investigates the theoretical modeling and coupled free vibration behaviors of a rotating double-bladed shaft assembly resting on elastic supports in a spacecraft system. According to the Kirchhoff plate theory and the Euler-Bernoulli beam theory, the theoretical model is established. The studied rotor is considered to be made of porous foam metal matrix and graphene nanoplatelet (GPL) reinforcement. Non-uniform distributions of porosity and graphene nanoplatelets (GPLs) are taken into account and lead to functionally graded (FG) structures. The effective material properties of the double-bladed shaft are varying along the radius and thickness direction of the shaft and blade, respectively. Moreover, the rule of mixture, the Halpin-Tsai model, and the open-cell scheme are used to determine its material properties. Considering the gyroscopic effect, the Lagrange equation is utilized to derive the coupled equations of motion. Then the traveling wave frequencies of the double-bladed shaft assembly is obtained by employing the assumed modes method and substructure modal synthesis method. A detailed parametric analysis is conducted to examine the effects of the rotating speed, GPL weight fraction, GPL distribution pattern, GPL length-to-thickness ratio, GPL length-to-width ratio, porosity coefficient, porosity distribution pattern, shaft length-to-radius ratio, blade length-to-thickness ratio, support stiffness and support location on the free vibration behaviors of the double-bladed shaft assembly.
A fatal case of repeated ventricular fibrillation following torsade de pointes, due t...
Yusuke Watanabe
Itaru Nakamura

Yusuke Watanabe

and 3 more

May 02, 2022
Although metoclopramide has many adverse effects, Torsade de pointes (TdP) is rare. We describe a fatal case of repeated ventricular fibrillation following TdP, due to multiple administrations of metoclopramide. Multiple administrations of metoclopramide over a short time to a patient with risk factors of TdP should be reconsidered.
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