Land eco-efficiency reflects the relationship between economic development and resource utilization, studying the spatio-temporal differentiation of it is conducive to promoting the transformation of land utilization mode to low-carbon intensive direction. In this study, an efficiency index system was built by using resource-capital-labor as the input index, economic-resource-social-ecological benefits as the expected output and carbon emissions as the unexpected output; besides, Super-SBM, Exploratory Spatial Data Analysis, Trend Analysis and Standard Deviation Elliptic Model were conducted to assessed the land eco-efficiency. As results, we found that the average values of land eco-efficiency index were showing a rising trend at first and a falling trend thereafter. Spatially, the difference goes from large to small in the western, eastern, northeast and central China. From the view of spatial differentiation, the high-efficiency areas were concentrated around Chongqing and gradually extended to the northeast. The average efficiency areas mainly distributed in the Pearl River Delta and urban agglomerations around the middle reaches of the Yangtze River. Low-efficiency areas were widely distributed in the central region of China. Furthermore, the spatial autocorrelation coefficient changed from negative to positive and the spatial agglomeration gradually changed to a positive correlation. The main significant correlation types were between High-High areas and Low-Low areas. The significant HH areas formed several groups in the northeast China and Inner Mongolia, and their number increases significantly. The significant LL areas formed a continuous distribution trend in the central and eastern China.

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Picture fuzzy sets are a direct extension of fuzzy sets and intuitionistic fuzzy sets, recently developed as a mathematical tool for solving uncertainty-related problems. In this paper, a novel similarity measure and corresponding weighted similarity measure between two picture fuzzy sets are proposed after indicating some disadvantages of the current similarity measures of picture fuzzy sets through some exemplary numerical examples. Also, some of their basic properties are discussed. Further, a picture fuzzy decision making algorithm based on the similarity aggregation method is constructed and then applied to the decision making problem. It is also used to deal with a medical diagnosis problem to detect which disease a patient may be suffering from. Finally, the effectiveness of the proposed similarity measure is demonstrated by making comparison with the present picture fuzzy similarity measures.

SARS-CoV-2 variants with spike (S)-protein D614G mutations now predominate globally and increase infectivity by assembling more functional S protein into the virion. In this paper, I combine topology geometric methods for the generation of novel drug designs by using generalized k - nearest neighbors within a quantum computing chemical context targeting in a atomistic level the S proteins with aspartic acid (SD614) and glycine (SG614) at residue 614 protein apparatus. In this effort, I propose powerful enough computer - aided rational drug design strategies to achieve very high accuracy levels for the generation of AI - Quantum designed molecules of GisitorviffirnaTM, Roccustyrna_ gs1_TM, and Roccustyrna_fr1_TM ligands targeting the SARS - COV - 2 SPIKE D614G mutation by unifying Eigenvalue Statements into Shannon entropy quantities as composed on Tipping–Ogilvie driven Machine Learning potentials for nonzero Christoffel symbols. For this model, I find analytic black hole solutions relevant to address a vast variety of small molecule modeling problems essential to describe pharmacophore merging phenomena in the presence of chemical potentials among others at the locally AdS5 spacetime. A boundary solution in five-dimensional Chern-Simons supergravity is described in the form of a Quantum Circuit which can carry U(1) charge provided the spacetime torsion is non-vanishing. Thus, I analyze the most general configuration consistent with the local AdS5 generated D614G Binding Site isometries in Riemann-Cartan space. I also arrived at a new Zmatter derived finite ‐ dimensional state integral and a Schwarzschild (DFT) ℓneuron (ι) : = φ∘D∘r2∘S∘r102 /3[T] Ψ0⋮Ψ0Ψ0e [r] (F ∧ F ∧ F) (1o∑ ∑ ∑ ) improver for a Chern - Simons Topology and Euclidean symplectic ω = (i~)− 1/2 F (ab)J(ab) o1 ℓ T (a)J(a) oF T1 (dx/x) ∧ (dy/y) model by computing the analytically continued “holomorphic blocks” on an appropriate quantum Hilbert space H to put pharmacophoric elements back together.

In this article, the author provides synopses of the factors that have finally propelled healthcare education and practice to join, at times reluctantly, the overarching digital transformative process that has been swept other industries over the last few decades. The key contributors and driving forces that have energized the entry of healthcare education and practices are mentioned. The roles of major universities, large technology companies and the expanding roles of Artificial Intelligence and Machine Learning are described. The projected future developments are predicted to continue to be substantial, sweeping and forcing changes that are unprecedented. Thus, academicians and practitioners should be alerted to what the rapidly changing landscape is likely to become and accordingly take steps to manage and preserve their roles or risk be left behind or worse be forced out.

In this letter, we report the near quantum-limited performance of an end-fire millimetre-wavelength superconductor-insulator-superconductor (SIS) mixer. An important feature of this mixer is its use of a unilateral finline as the input antenna, which allows for a wide RF bandwidth, a simple waveguide structure with easy alignment and for the mixer chip to be aligned along the optical axis. Each of these factors is beneficial in the construction of large-format focal plane arrays. We tested the new finline mixer from 210 to 260 GHz and the best recorded noise temperature was approximately twice the quantum limit, which is comparable to conventional radial probe mixers. This suggests that end-fire SIS mixers can be used in large-format arrays, comprising of 100s or even 1000s of SIS mixing elements, while retaining state-of-the-art quantum mixing performance.

In naturally competent bacteria, DNA transformation through horizontal gene transfer is an evolutionary mechanism to receive extracellular DNA. Bacteria need to maintain a state of competence to accept foreign DNA and this is an energy-driven phenomenon that is tightly controlled. In Streptococcus, competence development is a complex process that is not fully understood. In this study, we used Streptococcus mutans, an oral bacterium, to determine how cell density affects competence development. We found that in S. mutans the transformation efficiency is maximum when the transforming DNA was added at low cell density and incubated for 2.5 h before selecting for transformants. We also found that S. mutans cells remain competent until the mid-logarithmic phase, after which the competence decreases drastically. Surprisingly, we observed that individual components of Clp proteolytic complexes differentially regulate competence. If the transformation is carried out at the early growth phase, both ClpP protease and ClpX ATPase are needed for competence. In contrast, we found that both ClpC and ClpE negatively affect competence. We also found that if the transformation is carried out at the mid-logarithmic growth phase ClpX is still required for competence but ClpP negatively affects competence. While the exact reason for this differential effect of ClpP and ClpX on transformation is currently unknown, we found that both ClpC and ClpE have a negative effect on transformation, which was not reported before.

Subsurface chlorophyll maxima layers (SCML) are ubiquitous features of stratified aquatic systems. Availability of the micronutrient iron is known to influence marine SCML, but iron has not been explored in detail as a factor in the development of freshwater SCML. This study investigates the relationship between dissolved iron and the SCML within the dimictic, ferruginous lake Grosses Heiliges Meer in northern Germany. The occurrence of the SCML under non-ferruginous conditions in the spring and ferruginous conditions in the fall are context to explore temporal changes in the phytoplankton community and indicators of primary productivity. Results indicate that despite more abundant chlorophyll in the spring, the SCML sits below a likely primary productivity maximum within the epilimnion, inferred based on co-located dissolved oxygen, δ13CDIC, and pH maxima. The peak amount of chlorophyll in the SCML is lower in the fall than in the spring, but in the fall the SCML is co-located with elevated dissolved iron concentrations and a local δ13CDIC maximum. Cyanobacteria and Chlorophyta have elevated abundances within the SCML in the fall. Further investigation of the relationship of iron to primary productivity within ferruginous SCML may help to understand the environmental controls on primary productivity in past ferruginous oceans.

Pervaporation is considered to have great application potential in the field of organic solvent dehydration. However, the development of pervaporation is hampered by the separation performance of current membranes. In this study, covalent organic framework pervaporation membranes were fabricated through contra-diffusion self-assembly strategy for organic solvent dehydration. The polyacrylonitrile (PAN) substrates were pretreated by oxygen plasma to control the diffusion rate and confine the reactive region. Superoxide radicals were generated on the surface of the PAN substrate to assist the growth of TpPa. Therefore, the time of contra-diffusion was shortened to obtain a TpPa membrane, which exhibited a superior separation factor of 1491 and a high permeation flux of 2530 g m-2 h-1 for 90 wt% isopropanol/water mixture. The separation performance of the TpPa membrane could be stable for over 100 h, exhibiting great potential in organic solvent dehydration.

Phenotypic plasticity in reproductive behaviour can be a strong driver of individual fitness. For example, in species with high intra-sexual competition, changes in socio-sexual context can trigger quick adaptive plastic responses in males. In particular, a recent study in the vinegar fly (Drosophila melanogaster) shows that males respond adaptively to perception of female cues in a way that increases their reproductive success, but we ignore the underlying mechanisms of this phenomenon. Here, we aimed to fill this gap by investigating the short-term effects of female perception on male pre- and post-copulatory components of reproductive success: a) mating success, b) mating latency and duration, c) sperm competitiveness, and d) ejaculate effects on female receptivity and oviposition rate. We found that brief sexual perception increased mating duration, but had no effect on the main pre- or post-copulatory fitness proxies. These results tie up with previous findings to suggest that male adaptive responses to sexual perception are not due to a short-term advantage, but rather to fitness benefits that play out across the entire male lifespan.

Anthropogenic and climatic factors affect the survival of animal species. Chinese pangolins are a critically endangered species, and identifying which variables lead to local extinction events is essential for conservation management. Local chronicles in China serve as long-term monitoring data, providing a perspective to disentangle the roles of human impacts and climate changes in local extinctions. Through a generalized additive model, extinction risk assessment model and principal component analysis, we combined information from local chronicles over a period of three hundred years (1700-2000) and reconstructed environmental data to determine the causes of local extinctions of the Chinese pangolin in China. Our results showed that the extinction probability increased with population growth and climate warming. An extinction risk assessment indicated that the population and distribution range of Chinese pangolins has been persistently shrinking in response to highly intensive human activities (main cause) and climate warming. Overall, the factors that cause local extinction, intensive human interference and drastic climatic fluctuations induced by global warming, might increase the local extinction rate of Chinese pangolins. Approximately 25% of extant Chinese pangolins are confronted with a notable extinction risk (0.36≤extinction probability≤0.93), specifically those distributed in Southeast China, including Guangdong, Jiangxi, Zhejiang, Hunan, Fujian, Jiangsu and Taiwan Provinces. To rescue this endangered species, we suggest strengthening field investigations, identifying the exact distribution range and population density of Chinese pangolins and further optimizing the network of nature reserves to improve conservation coverage on the territory scale. Conservation practices that concentrate on the viability assessment of scattered populations could lead to the successful restoration of the Chinese pangolin population.

Abstract Objective: to verify if low molecular weight heparin(LMWH) could increase pregnancy rates and/or decrease abortion rates in women with thrombophilia undergoing assisted reproduction cycles. Design: Retrospective study. 30 Setting: Private infertility clinic. Patients: Patients submitted to assisted reproduction (total n=104). Women without thrombophilia (controls, n=20), women with thrombophilia (untreated group, n=30), and women with thrombophilia, treated with daily enoxaparin from the day of embryo transfer until week 36 of gestation (treated group, n=54). Interventions: Enoxaparin treatment for diagnosed thrombophilia. All women underwent controlled ovarian hyperstimulation, in vitro fertilization was performed by intracytoplasmic sperm injection, embryos were transferred on day three. Pregnancy was detected by β-hCG (biochemical) and fetal heart beat at weeks 5-6. Ongoing pregnancy was determined by ultrasound on week 12. Main Outcome Measures: Implantation rate, ongoing pregnancy rate, live birth rate, early pregnancy loss rate, and abortion rate. Results and conclusion: Patients in the Untreated Thrombophilia group presented significantly lower ongoing pregnancy rates and live birth rates, and significantly higher early pregnancy loss and abortion rates when compared to the Control or the Treated Thrombophilia groups. In women with diagnosed coagulation disorders, use of low molecular weight heparin is important in order to avoid miscarriages.7 Keywords: female infertility; thrombophilia; enoxaparin; abortion; in vitro fertilization

Objective To investigate the clinical outcomes and toxicity in patients with locally advanced cervical cancer treated with supplementary applicator guided-intensity modulated radiation therapy (IMRT) based on conventional intracavitary brachytherapy (IC/IMRT). Population Large high risk clinical target volume (HR-CTV) volume (>40cc) at the time of brachytherapy cervical cancer patients were recruited. Methods This study is a retrospective analysis of 76 patients with locally advanced cervical cancer (FIGO IIB-IVA) treated with concurrent chemo-radiotherapy followed by IC/IMRT between June 2010 and October 2016. External radiotherapy (45 Gy in 25 fractions) with cisplatin chemotherapy treated before IC/IMRT. The prescription dose for HR-CTV and IR-CTV were 6 Gy and 5 Gy per fraction for 5 fractions respectively. Results: Mean HR-CTV was 65.8±23.6 cc at the time of brachytherapy. D90 for HR-CTV and IR-CTV were 88.7±3.6 Gy and 78.1±2.5 Gy. D2cc for bladder, rectum, sigmoid and small intestine were 71.8±3.8 Gy, 64.6±4.9 Gy, 63.9±5.3 Gy and 56.7±8.7 Gy respectively. Median follow-up was 85 months (47.9-124.2 months). Five-year local recurrence free survival rate, metastasis recurrence free survival rate, disease free survival rate and cancer special survival rate were 87.6%, 82.4%, 70.9% and 76.3%, respectively. The grade 1+2 gastrointestinal and urinary late toxicities were 15.8% and 21.1%, while grade 3 late toxicities were 3.9% and 5.2%, respectively. Neither acute nor late grade 4 gastrointestinal or urinary toxicities were seen. Conclusions: The combination of ICBT with an applicator-guided supplementary IMRT boost achieved an excellent local control and overall survival with low toxicity for bulky residual cervical tumor

Background Famitinib is an oral, small-molecule, multi-targeted tyrosine kinase inhibitor under clinical investigation for the treatment of solid tumors. As famitinib is metabolized mainly by cytochrome P450 3A4 (CYP3A4), the study was conducted to investigate the effect of potent CYP3A4 inducer rifampin on the pharmacokinetics of famitinb. Methods This single-center, single-arm and fixed-sequence drug-drug interaction study enrolled 21 healthy Chinese male subjects. Subjects received a single oral dose of famitinib 25 mg on days 1 and 16 and repeated administration of oral rifampin 600mg once daily on days 10-23. Blood samples were collected and plasma concentrations of famitinib were measured by validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Pharmacokinetic parameters were calculated using noncompartmental analysis and safety was assessed. Results In the presence of rifampin, the famitinib geometric mean maximum plasma concentration (Cmax) and area under the plasma concentration-time curve from time zero to infinity (AUC0-∞) decreased by 48% and 69%, respectively, and the mean elimination half-life was shortened from 33.9 h to 18.2 h. The GMR of famitinib Cmax and AUC0-∞ and their 90% CI were 0.52 (0.50, 0.54) and 0.31 (0.29, 0.33). Single dose of famitinib 25mg was well tolerated and 8 subjects (38.1%) reported treatment emergent adverse events. Conclusion Co-administration of rifampin considerably reduces plasma concentration of famitinb due to CYP3A4 induction. Concomitant administration of famitinib and strong CYP3A4 inducers should be avoided, whereas when simultaneous use with inducers of CYP3A4, dose adjustment of famitinb is recommended.

Objective: To determine associations of calcium-based antacid and PPI use during pregnancy with late-onset preeclampsia (≥34 weeks of gestation), taking into account dosage and timing of use. Design: Prospective cohort study. Setting: This study used data from the PRIDE Study (2012-2019) and Dutch Pregnancy Drug Register (2014-2019). Sample: A total of 9,058 pregnant Dutch women aged ≥18 years. Methods: Data were collected through web-based questionnaires and obstetric records. We estimated risk ratios (RRs) for late-onset preeclampsia for any use and trajectories of calcium-based antacid and PPI use before gestational day 238, and hazard ratios for time-varying exposures after gestational day 237. Main outcome measure: Late-onset preeclampsia. Results: Late-onset preeclampsia was diagnosed in 2.6% of pregnancies. Any use of calcium-based antacids (RR 1.2 [95% CI 0.9-1.6]) or PPIs (RR 1.4 [95% CI 0.8-2.4]) before gestational day 238 was not associated with late-onset preeclampsia. Use of low-dose calcium-based antacids in gestational weeks 0-16 (<1g/day; RR 1.8 [95% CI 1.1-2.9]) and any use of PPIs in gestational weeks 17-33 (RR 1.6 [95% CI 1.0-2.8]) seemed to increase risks of late-onset preeclampsia. We did not observe associations between late-onset preeclampsia and use of calcium-based antacids and PPIs after gestational day 237. Conclusions: In this prospective cohort study, use of calcium-based antacids and PPIs during pregnancy was not found to reduce the risk of late-onset preeclampsia. Funding: Netherlands Organisation for Health Research and Development [ZonMw; grant number 848018010].

Background. Symbioses between Geosmithia fungi and wood-boring and bark beetles seldom result in disease induction within the plant host. Yet exceptions exist such as Geosmithia morbida, the causal agent of Thousand Cankers Disease (TCD) of walnuts and wingnuts, and Geosmithia sp. 41, the causal agent of Foamy Bark Canker disease of oaks. Isolates of G. obscura were recovered from black walnut trees in eastern Tennessee and at least one isolate induced cankers following artificial inoculation. Due to the putative pathogenicity and lack of recovery of G. obscura from natural lesions, a molecular diagnostic screening tool was developed using microsatellite markers mined from the G. obscura genome. Results. A total of 3,256 candidate microsatellite markers were identified (2236, 789, 137 di-, tri-, and tetra- motifs were identified, respectively), with 2011, 703, 101 di-, tri-, and tetra- motifs containing markers with primers. From these, 75 microsatellite markers were randomly selected, screened, and optimized, resulting in 28 polymorphic markers that yielded single, consistently recovered bands which were used in downstream analyses. Five of these microsatellite markers were found to be specific to G. obscura and did not cross-amplify into other, closely related species. Although the remaining tested markers could be useful, they cross-amplified within different Geosmithia species, making them not reliable for G. obscura detection. Conclusion. Five novel microsatellite markers (GOBS9, GOBS10, GOBS41, GOBS43, GOBS50) were developed based on the G. obscura genome. These species-specific microsatellite markers are available as a tool for use in molecular diagnostics and can assist future surveillance studies.

Animal social relationships emerge from interactions in multiple ecological situations. However, we seldom ask how each situation contributes to the structure of a population or to the social position of individuals. Griffon vultures interact in multiple situations, including when roosting, flying, and feeding. These social interactions can influence population-level outcomes such as disease transmission and information sharing. We examined the contribution of each ecological situation to the social structure of the population and to individuals' social positions using GPS-tracking. We found that the number of individuals each vulture interacted with was best predicted by diurnal interactions. However, the strength of social bonds was best predicted by interactions on the ground -- both during the day and at night but not by interactions while flying. Thus, social situations differ in their impact on the relationships that individuals form. Given the conservation importance of vultures, these findings can inform wildlife management actions.

To our knowledge this is the first published case of NP associated with COVID-19 in an individual with CF and the first associated with Nocardia infection. We suspect the combination of cystic fibrosis, COVID-19 pneumonitis and co-infection with Nocardia farcinia caused this young man’s NP and ultimately his untimely death. We hope this case will highlight individuals with CF of all ages are at risk of severe COVID-19 infection.

We report an automated cell-isolation system based on fluorescence image analysis of cell aggregates cultured in a photodegradable hydrogel. The system incorporates cell culture in a humidified atmosphere with controlled CO 2 concentration and temperature, image acquisition and analysis, micropatterned light exposure, and cell collection by pipetting. Cell aggregates were cultured on hydrogels, and target cells were selected by phase contrast and fluorescence image analysis. After degradation of the hydrogel by exposure to micropatterned ultraviolet light, cell aggregates were transferred to a collection vessel by robotic pipetting. We assessed the system for hydrogel degradation, recovery of target cells, and contamination by off-target cells. We demonstrated two practical applications of our method: (i) in cell aggregates from MCF-7-RFP strains in which 18.8% of cells produced red fluorescent protein (RFP), we successfully obtained 14 proliferative fluorescence-positive cell aggregates from 31 wells, and all of the isolated strains produced a higher proportion of RFP than the original populations; (ii) after fluorescent immunostaining of human epidermal growth factor receptor 2 (HER2) in cancer cells, we successfully isolated HER2-positive cells from a mixed population of HER2-positive and -negative cells, and gene sequence analysis confirmed that the isolated cells mainly contained the target cells.

This is an integrative review with database research carried out in the electronic databases Medline, Embase, LILACs and the Virtual Health Library with the aim of investigating original and observational studies that address the body temperature defined for febrile neutropenia (FN) and its evolution in pediatric patients. The temperature value in the literature is variable, noting that the diagnosis tended from values of ≥38°C (Axillary) and ≥38.3°C (Oral) as a single measurement, without consensus in the selected studies. Regarding adverse events and outcomes, there is heterogeneity of populations and the methodology used to assess body temperature, which makes comparisons between studies difficult. More robust evidence, or studies that relate thermal curve values to clinical outcomes of can be important in the construction of pediatric cancer patient stratification.

Tartary buckwheat ( Fagopyrum tataricum) is rich in flavonoids, which not only play an important role in plant-environment interaction, but are also beneficial to human health. Rutin is a therapeutic flavonol which is massively accumulated in Tartary buckwheat. It has been demonstrated that transcription factors (TFs) control rutin biosynthesis. However, the transcriptional regulatory network of rutin is not fully clear. In this study, through transcriptome and target metabolomics profiling analysis together with homolog prediction, we identified and validated the role of FtMYB102 and FtbHLH4 TFs at the different developmental stages of Tartary buckwheat. The elevated accumulation of rutin in the sprout appears to be closely associated with the expression of FtMYB102 and FtHLH4. Yeast two-hybrid, transient luciferase activity and co-immunoprecipitation analysis demonstrated that FtMYB102 and FtbHLH4 can interact and form a transcriptional complex. Moreover, yeast one-hybrid showed that both FtMYB102 and FtbHLH4 directly bind to the promoter of chalcone isomerase ( CHI), and they can coordinately induce CHI expression as shown by transient luciferase activity assay. Finally, we transferred the FtMYB102 and FtbHLH4 into the hairy roots of Tartary buckwheat and found that they both can promote the accumulation of rutin. Our results indicate that FtMYB102 and FtbHLH4 can form a transcriptional complex by inducing CHI expression to coordinately promote the accumulation of rutin.

Grassland responses to drought are strongly mediated by leaf phenology, with greening and browning being highly sensitive to soil moisture. However, this process is represented overly simplistically in most vegetation models, limiting their capacity to predict grassland responses to global change factors. We derive functions representing grassland phenological responses to soil water content (SWC), by fitting an empirical model to greenness data. Data were obtained from fixed cameras (phenocams) monitoring phenology at several grassland experiments in Sydney, Australia. The data-model synthesis showed that the sensitivity of growth to SWC exhibited a concave-down response in most species. For senescence, we found a strong nonlinear increase in senescence rate with declining SWC. Both findings contradict common assumptions in vegetation models. Incorporating nonlinear responses in the empirical model reduced the error in cover predictions by 12%. Model evaluation against data from drought treatments indicated that differential sensitivity of phenology to SWC helps explain differences among species’ responses to variable rainfall. Our work provides a new methodology, and new evidence, to support the development of improved representations of grassland phenology for vegetation models.

Extra-gonadal mature teratoma is a rare benign tumor occurring rarely in adults. The retroperitoneal localization constitutes less than 4%. Treatment consists of surgical resection. Histological examination is essential for definitive diagnosis. We reported an unusual case of mature retroperitoneal teratoma discovered in a young man with abdominal pain.

As an approach to coronary artery (CA) ostial injury in type A aortic dissection (TAAD) and infective endocarditis, we describe a technique of coronary ostial repair using a ring-shaped bovine pericardial patch. The inner and outer rims of the patch were sutured to the involved coronary ostium (to close the ostial tear) and to the aortic wall (to cover the sinus), respectively. Four patients were successfully managed and computed tomographic coronary arteriogram at follow-up showed patent coronary ostia and arteries. The favorable preliminary results imply that this technique is a simple, safe, and effective approach to coronary ostial repair in patients with TAAD or infective endocarditis.