Leptospirosis is a bacterial zoonosis caused by pathogenic Leptospira that are maintained in the kidney lumen of infected animals acting as reservoirs and contaminating the environment via infected urine. The investigation of leptospirosis through a One Health framework has been stimulated by notable genetic diversity of pathogenic Leptospira together with a high infection prevalence in certain animal reservoirs. Studies of Madagascar’s native mammal fauna have revealed a diversity of Leptospira with high levels of host-specificity. Native rodents, tenrecids, and bats shelter several distinct lineages and species of Leptospira, some of which have also been detected in acute human cases. Specifically, Leptospira mayottensis, first discovered in humans on Mayotte, an island neighboring Madagascar, was subsequently identified in a few species of Malagasy tenrecids, an endemic family of small mammals. Distinct L. mayottensis lineages were identified in shrew tenrecs ( Microgale cowani and Nesogale dobsoni) on Madagascar, and later in spiny tenrecs ( Tenrec ecaudatus) on Mayotte. These findings suggest that L. mayottensis (i) has co-radiated with tenrecids on Madagascar, and (ii) has recently emerged in human populations on Mayotte following the introduction of T. ecaudatus from Madagascar. Hitherto, L. mayottensis has not been detected in spiny tenrecs on Madagascar. In the present study, we broaden the investigation of Malagasy tenrecids and describe the presence of L. mayottensis in Malagasy T. ecaudatus and M. thomasi. These results confirm the hypothesis that L. mayottensis was introduced to Mayotte, presumably via T. ecaudatus, and provide additional data on the co-radiation of Leptospira and Tenrecidae.

Objective: Prediction of preterm birth is currently not feasible, resulting in maternal and fetal overexposure to prenatal corticosteroids and unnecessary hospital admittance. Novel biomarkers seem to hold potential for predictive applicability, including non-invasive volatile organic compounds. In this study, we aimed to assess the potential of urinary volatile organic compound profiles (VOCs) in the identification of pregnant women at risk for preterm birth. Design, setting, population: We prospectively collected urine of women admitted for imminent preterm birth (≧ 24+0 weeks until 36+6 weeks), collected data on maternal characteristics, including urine cultures, time between admission and delivery and mode of delivery. Methods and main outcome measures: Urine samples were analyzed using gas chromatography coupled to an ion mobility spectrometer (GC-IMS). VOCs of women delivering preterm and term were compared. Results: Urinary VOCs differed between women delivering between 28+0 until 36+6 weeks compared to women admitted for imminent preterm birth but delivering at term (area under the curve: 0.70). We identified women with either chorioamnionitis (area under the curve: 0.72) and positive bacterial cultures (area under the curve: 0.97) based on their urinary VOCs. Conclusions: Urinary VOCs hold potential for non-invasive prediction of preterm birth. Furthermore, they may allow for detection of chorioamnionitis and urinary tract infections in the investigated population. These observations need to be validated in a larger population prior to clinical implementation. Funding: This study was funded by the Department of Obstetrics and Prenatal diagnosis. Keywords: preterm birth, premature delivery, volatile organic compounds, chorioamnionitis, urinary tract infection, infection

Contraception use is something that most women utilize during childbearing years. In this regard, unintentional teen pregnancies are divided in half between contraception misuse and contraception nonuse. Barriers to adolescents’ use of more effective contraception methods such as intrauterine devices (IUDs) have been found in both the patients’ and providers’ experience and knowledge of the contraceptives. Two previous surveys showed that a minority of physicians believe implants and IUDs are appropriate in adolescents as most believe abstinence is the most effective. Providers play a critical role in preventing unintended teen pregnancies.

This paper presents addition of multiple binomial series based on geometric series. In general, a finite multiple summations of a geometric series are called binomial series. Addition of multiple binomial series is a sum and summation of multiple binomial series.

Soil cracks significantly affect preferential flow; however, there are some uncertainties associated with the effect of soil cracks on preferential flow in karst areas in southwest China. In this study, ground-penetrating radar (GPR) was applied to pedons to investigate the soil crack properties (inclusion, width, and configuration). Blue dye tracing experiments were designed, based on geophysical detection results, to assess the influences of inclusions (sand grains and rock fragments), crack width (1, 1.5, and 2 cm), and configuration (I-shape, V-shape, and Λ-shape) on the preferential flow. Our results indicated that (1) GPR envelope can describe the configuration of isolated soil cracks; (2) the Brilliant Blue FCF (C.I. Food Blue 2) infiltration rate and depth were over 1.5 times slower and 1.2–3.8 times lower those of water, respectively, during infiltration; (3) soil cracks can accelerate infiltration and increase the maximum dye-penetration depth, cumulative infiltration, and wetting front depth by at least an average of 5.2% and 63.2%, respectively; and (4) the I- and Λ-shaped soil crack configurations contributed to preferential flow, while the flow was not observed along the V-shaped configuration crack pore paths. The I-shaped configurations, with a width of 1.5 cm, were filled with rock fragments and had higher preferential flow ratios (18.2%–52.3%) and length indexes (4.0%–33.8%) than those of other configurations. Inclusions, crack widths, and configurations had significant influences on preferential flow ( p < 0.05). The influence of soil crack properties on preferential flow cannot be neglected during vegetation restoration and groundwater security processes in karst areas.

Insight into the rainfall-soil moisture (SM) response to land cover is critical for soil hydrological process modeling and management. In this study, five typical land-cover types (forest, shrub, grass, crop, and bare land) and four rainfall patterns (heavy, intermediate, light, and continuous rains) were selected to assess the effects of SM response characteristics on the Loess Plateau of China. We monitored SM at five depths on each land-cover type at 1-h intervals over the growing season of 2019. The results showed that rainfall patterns and land-cover typestogether determined the SM response process and infiltration efficiency. A minimum accumulated rainfall amount of 5 mm was the threshold to trigger a 10-cm SM response. Rain events with higher intensity and smaller sum triggered a quick surface SM response, while larger amounts could percolate deeper and faster. Land-cover change significantly altered the rainfall-SM response dynamics and rainwater utilization efficiency after 20 years of ecological construction. Revegetation sites (mean values of forest, shrub, and grass) increased the soil wetting depth by 14.7%, shortened the SM response time by 27.3%, and accelerated the SM wetting front velocity by 67.2%, which promoted a 35.2% rainfall transformation rate (RTR) across the 1-m profile over all rainfall events (R 1-13). Moreover, planted forest showed the highest RTR of R 1-13 and the maximal increase in soil water storage, which did not aggravate the soil water deficit across the 1-m profile over the growing season. Therefore, we present evidence that planted forests, instead of shrubs, may be beneficial for water conservation if precipitation is greater than 550 mm. The findings of this study prove the role of revegetation on rainwater infiltration capacity and efficiency and can help improve the management of afforestation in arid and semiarid regions.

A document by Deep Bhattacharjee . Click on the document to view its contents.

The substantial increase in global population and climate change, among other factors have led to global food security and supply chain challenges. The United Nations has laid out an agenda to sustainably achieve zero hunger by 2030 as one of its sustainable development goals. However, sustainably achieving improved food yield has become a challenge as excessive use of fertilizers has also led to adverse environmental impact. To address the aforementioned challenges, WisDM Green, an artificial intelligence (AI)-based platform that aims to pinpoint and prioritize compound (e.g. biostimulants) combinations in peat moss, is harnessed to sustainably improve the yield of Amaranthus cruentus (red spinach). In this proof-of-concept study, from a pool of 8 compounds, WisDM Green-pinpointed combinations (6-Benzylaminopurine/Ethylenediaminetetraacetic Acid Iron (III) and Humic Acid/Seaweed Extract) achieve 26.34±15.80 and 33.59±14.60 increase in %Yield, respectively. The study also indicates that compound combinations may exhibit concentration-dependent synergies and thus, properly adjusting the concentration ratios of combinations may further improve plant yield in the context of sustainable farming. P. Wang and K. You contributed to this work equally.Corresponding author(s) Email:   agata.blasiak@nus.edu.sg, edwardkchow@nus.edu.sg, biedh@nus.edu.sg 

Solitary fibrous tumours (SFT) are a rare group of spindle cell neoplasm of submesothelial origin with malignant potential. Here, we are presenting a case of a 45-years-old male patient, who presented with recurrent episodes of hypoglycemia spells and later on, it was diagnosed that hypoglycemic spells were secondary to fibroma.

DERMATOFIBROSARCOMAPROTUBERANS (DFSP) is a rare recurrent fibrohistiocytic tumor. Given the limitation of available diagnostic modalities in a resource poor setting, diagnosis can be confusing. As most of the tumors recur with time, our case of complete cure was interesting phenomenon observed in our case

We present here a case of 35 year old male with spastic paraparesis for two months associated with involuntary spontaneous abdominal contractions, accompanied by involuntary jerks of his legs. MRI findings pointed C3-C4 of disc herniation.

This case report displays some of the possible complications of sumatriptan poisoning, including nephritic syndrome.

The Multiple Endocrine Neoplasia type 2 (MEN2) RET proto-oncogene database, originally published in 2008, is a comprehensive repository of all publicly available RET gene variations associated with MEN2 syndromes. The variant-specific genotype/phenotype information, age of earliest reported medullary thyroid carcinoma onset, and relevant references with a brief summary of findings are cataloged. The ACMG/AMP 2015 consensus statement on variant classification was modified specifically for MEN2 syndromes and RET variants using ClinGen sequence variant interpretation working group recommendations and ClinGen expert panel manuscripts, as well as manuscripts from the American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma and other MEN2 RET literature. The classifications for the 166 single unique variants in the MEN2 RET database were reanalyzed using the MEN2 RET specifically modified ACMG/AMP classification guidelines. Applying these guidelines added two new variant classifications to the database (likely benign and likely pathogenic) and resulted in clinically significant classification changes ( e.g. from pathogenic to uncertain) in 16.9% (28/166) of the original variants. Of those clinically significant changes, the highest percentage of changes, 46.4% (13/28), were changes from uncertain to benign or likely benign. The modified ACMG/AMP criteria with MEN2 RET specifications will optimize and standardize RET variant classifications.

The critical information for conserving endangered species is to identify how different niche dimensions affect the bottlenecks in the life history stages of populations. However, it is often difficult to quantify how each niche dimension affects different life history stages because environmental factors may affect each fitness component of organisms to various degrees. Here, we applied the recently developed hypervolume method that follows the idea of Hutchinson’s n-dimensional hypervolume. We analyzed the niche space of different life history stages of the endangered landlocked salmon Oncorhynchus masou formosanus, the most southerly distributed of all salmonoids. We found no direct effect of water pollution on adult population density but a significant negative effect on their embryo hatching rate. Surprisingly, the niche hypervolume analysis showed that the size of embryo niche hypervolume was only 42% and 45.3% of the natural redd density or adult population density, respectively. This result suggests that water quality requirements during the embryonic stage are a key bottleneck in the life history stages of O. m. formosanus. Our results suggest that understanding the behavioral and physiological mechanisms that influence crucial life history stages in the wild is critical to developing effective conservation programs, and the niche hypervolume is a valuable method to achieve this.

Background: Black-faced spoonbill (BFS) is a global endangered species, distributed only in the coastal zones of East Asia. Xinghua Bay is one of the main wintering sites and migration stopovers of BFS in mainland China. However, with the reduction and degradation of natural wetlands, it is uncertain whether the constructed wetland can provide habitat for the endangered BFS. Research on diet of BFS will help to understand their preference between natural and artificial wetlands, and also provide reference for their conservation and habitat restoration. Methods: From December 2017 to February 2020, 45 potential food samples and 199 fecal samples of BFS were collected during six sampling period, of which Cyprinidae, Mugilidae, Portunidae, Gobiidae and Palaemonidae were collected from natural wetlands and Crucian (Carassius auratus) and Whiteshrimp (Litopenaeus Vannamei) were collected from artificial wetland. Their stable isotope values (δ13C, δ15N) were measured to obtain the food composition information of BFS. Results: In the early winter, the proportion of Palaemonidae in BFS’s food was as high as 74.4%, while that of other food was only 3.0% to 6.0%. In the late winter, the food contribution of BFS was as follow: Portunidae 39.3% > Palaemonidae 26.1% > Cyprinidae 8.8% > Mugilidae 8.5% > Gobiidae 7.3% > Crucian 5.1% > Whiteshrimp 4.8%. The proportion of Portunidae exceeded that of Palaemonidae, and together with Palaemonidae, it has become the main food of BFS in late winter. Conclusion: The diet composition of BFS between the early and late winter was significantly different, which may be due to seasonal changes in food resources. Natural wetlands are the main feeding grounds of BFS, but artificial wetlands also provide them with supplementary feeding grounds and resting places. Aquaculture ponds play an important ecological function in maintaining the overwintering population of BFS in Xinghua Bay.

In this paper we prove some Liouville-type theorems for the stationary magneto-micropolar fluids under suitable conditions in three space dimensions. We first prove that the solutions are trivial under the assumption of certain growth conditions for the mean oscillations of the potentials. And then we show similar results assuming that the the solutions are contained in L^p(\R^3) with p\in[2,9/2). Finally we show the same result for lower values of p\in[1,9/4) with the further assumption that the solutions vanish at infinity.

Background Household studies are crucial for understanding the transmission of SARS-CoV-2 infection, which may be underestimated from PCR testing of respiratory samples alone. We aim to combine assessment of household mitigation measures; nasopharyngeal, saliva and stool PCR testing; along with mucosal and systemic SARS-CoV-2 specific antibodies, to comprehensively characterise SARS-CoV-2 infection and transmission in households. Methods Between March and September 2020, we obtained samples from 92 participants in 26 households in Melbourne, Australia, in a 4-week period following onset of infection with ancestral SARS-CoV-2 variants. Results The secondary attack rate was 36% (24/66) when using nasopharyngeal swab (NPS) PCR positivity alone. However, when respiratory and non-respiratory samples were combined with antibody responses in blood and saliva, the secondary attack rate was 76% (50/66). SARS-CoV-2 viral load of the index case and household isolation measures were key factors that determine secondary transmission. In 27% (7/26) of households, all family members tested positive by NPS for SARS-CoV-2 and were characterised by lower respiratory Ct-values than low transmission families (Median 22.62 vs 32.91; IQR 17.06 to 28.67 vs 30.37 to 34.24). High transmission families were associated with enhanced plasma antibody responses to multiple SARS-CoV-2 antigens and the presence of neutralising antibodies. Three distinguishing saliva SARS-CoV-2 antibody features were identified according to age (IgA1 to Spike 1, IgA1 to nucleocapsid protein (NP), suggesting that adults and children generate distinct mucosal antibody responses during the acute phase of infection. Conclusion Utilising respiratory and non-respiratory PCR testing, along with measurement of SARS-CoV-2 specific local and systemic antibodies, provides a more accurate assessment of infection within households and highlights some of the immunological differences in response between children and adults.

A 65-year-old male with history of Hashimoto's thyroiditis on Levothyroxine developed Graves' disease with ocular symptoms and was treated with teprotumumab without improvement. Total thyroidectomy was performed to control hyperthyroidism. Surgical pathology revealed multifocal papillary thyroid carcinoma. Rarely a spectrum of thyroid disorders is seen in a single patient.

Background: Mites represent the second largest group with diverse niches and feeding habits, except for insects. Scabies mites are the causative agents of highly contagious skin disease in humans and more than 100 mammals. Although several versions of Sarcoptes scabiei genome have been published, i.e. var. suis, var. canis and var. hominis, the chromosome-level genome and population divergence is still desired for the community. Besides, the molecular mechanisms that scabies mites adapt to a parasitic lifestyle remains unclear. The taxonomy and ancestral origin of the scabies mite is unknown. Results: Here, we reported the first chromosome-level reference genome of S. scabiei, which was isolated from rabbits. The genome has a contig N50 size of 5.92 Mb, a total assembled length of 57.30 Mb, and ~12.65% of repetitive sequences and 9,333 protein‑coding genes were predicted. Population genetics analysis supported that scabies mites isolated from different hosts can be subdivided by hosts, and humans are likely the primary hosts of scabies mites, followed by pigs, dogs, and rabbits. However, phylogeny results suggested that rabbit was infected with scabies long before they were domesticated by humans, contradicting previous hypothesis that humans transmitted scabies mites to animals through domestication. Comparative genomics between scabies mites and mites of other feeding habits provided clues concerning the mechanisms of adaptation to permanent parasitic life from morphology, detoxification, and metabolism. Conclusions: Together, the first chromosome-level S. scabiei genome and population genetics analysis indicated its genetic subdivisions and within-host species divergence, which also provide evidence for further control of this highly contagious skin disease.

Our study of a patient who experienced a torpid evolution in 9 months incomplete treatment with antimonials and amphotericin B, with the destruction of the eyeball, a large area of necrosis on the face and nasal bone exposure.

A document by Dr. Gowsic K. Click on the document to view its contents.

A document by Dr. Gowsic K. Click on the document to view its contents.

For a Life Beyond the CureTissy Lagun Costa11Division of Pedagogical Coordination, Nursery and Pre-kindergarten, Escolinha do Faz-de-Conta, Orlândia, São Paulo, Brasil* Correspondence to:Tissy Lagun Costa, Avenida Dois, 894, Centro, Orlândia, São Paulo, 14620-000, Brasil, Tel.: +55(16)99608-2350, Email: tlaguncosta@gmail.comText word count 1099;Abstract word count: 0;Brief running title: For a life beyond the cureKey words: palliative care, DIPG, brain, tumor, CNS tumorTables: 0Figures: 0I didn’t expect that pregnancy. I really wanted it; but after going through a fertility treatment to have my first son, I couldn’t imagine that the second would come so easily. It was only eighteen months between one birth and the next one. First a boy and then a girl. A girl we called Alice.She was a beautiful baby. Delicate. From the first sight, we knew she would have great hair. She was never bald. When her newborn hair started to fall out, strong thick hair grew immediately covering her cute round head. She had a perfect body. Slender and – believe me! – with a well-defined waist.At three months, the color of her eyes began to change. One eye changed first, followed by the other. Is that normal? I don’t know. But that is how it happened. One eye was already brown, while the other still had shades of light green.She smiled for the first time. She used to grab all the objects surrounding her crib and, several times she watched her own hand moving in awe as if there was magic about it. She sat, crawled and walked all at the proper ages. She spoke her first words and quickly expanded her vocabulary. She admired her chatty brother, and there was no shortage of stimuli.She started to go to school. She was a happy and clever student. Praised by all her teachers. She actively participated in all activities. She rehearsed for presentations and cultural events. My sole contribution was to smile filled with pride – and to sew costumes for her plays and dresses for dancing around.She made bonds. Her friends were dear. They played together all the time. Her gang consisted of two boys, the twin girls, the two other girls who loved to make mischief and her best friend. Alice was the peacemaker of the group; she didn’t like conflict.Her birthdays were celebrated with many guests. When she started to understand what a party was, she made sure to always choose a theme: Little Red Riding Hood, Enchanted Fairies and Doll Tea Party complete with a full set of porcelain tea cups and pots for the stuffed guests.One day, running to get to the door to greet her best friend, she tripped and fell, hitting her mouth on the floor. Her two front teeth blackened. I didn’t worry. They were her baby teeth. After several toothless smiles, new strong teeth would grow. My life was normal, like any other mom.Until in January 2014, when everything changed.“Unfortunately, Alice has a very aggressive tumor called Diffuse Intrinsic Pontine Glioma, a.k.a. DIPG. In ninety-five percent of cases, the child dies after a few months.”; that was her diagnosis.What?! How could a routine medical appointment end up like that? I brought to the doctor a simple question: do we have to do something about her right eye being a bit misaligned? How can a question as simple as that require several appointments, examinations and two MRIs?After a crash course in neuro-oncology, we understood that Alice’s right eye couldn’t move to the right because of the sixth cranial nerve. And that nerve was connected to a time bomb about to explode.Our first reaction was of shock and awe. There must be a mistake. The doctors weren’t considering a second opinion when interpreting the images? Couldn’t it be something else? Maybe some dirt on the lens?When reality finally struck me, I faced a storm. The picture that comes to mind is a dam bursting; my body taking all that chaotic energy to avoid complete devastation. A torrential flow of conflicting emotions compounded each other. It took from me and my family our capacity to breathe, to feel and think – it got into our bones. It made us physically crumble on top of ourselves. But, no matter what, we needed to make the most important decision of our lives, so we didn’t fall apart.And we chose life.It didn’t matter how much time Alice had to live. Her life would be worth it. Each hour, each minute and each second would have meaning.Our first reaction was to avoid medical treatment. To put our plan in motion and to wait for the inevitable outcome. But it is too hard to do nothing. So, we chose the treatment that had the least impact on quality of life. Which until then was perfect. As I said, it was only her eye…What marked that period was the sorrow for the loss of what could be. It was the death of all the dreams we once dreamt for Alice: a long life full of accomplishments. The ending would be a family picture, a big family with grandkids all around and great grandkids on her lap.With our goals reevaluated, our objective was to live intensely in her last months of life. We travel to several places. The kids learned karate. We camped in the forest. We went fishing. We played in the snow. Anything was worthy of celebration. A sunny day. A fun movie. The birth of a puppy at the farm. A shower in the rain. And, against all odds, we celebrated three more birthdays.During those three years, we held our breath and focused on the present. One day, that effort took a toll on us. We were exhausted. After several MRIs that didn’t show any change in the tumor, nobody could tell if it was really dead. But suddenly, the uncertainty became certainty; the tumor started to grow again.Without the same energy we had before, we had to start a new plan. To face the most feared challenges we had avoided until now — the devastating symptoms that would take Alice from us piece by piece.The loss of movement on the right side of her face. The loss of movement of her legs and arms. The loss of her muscular tone. The loss of her ability to swallow. And, in the end… the loss of her heartbeat.Alice left the scene at nine years old.She is deeply missed; it’s painful. It’s a void that establishes itself as a physical being that we learn to live with.Drop by drop, I began to fill this void with memories. Writing helped me to get closer to my daughter. I wrote a book. These memories are dear to me. They are forever etched in paper.And like that, whenever I sit to write, I chat with my daughter Alice.What do we talk about?We talk about the beautiful life she lived.

Growth and growth limitation are important indicators of density dependence and environmental limitation of populations. Estimating individual growth trajectories is therefore an important aspect of understanding and predicting the life history and dynamics of a population. Variation in individual growth trajectories arises due to variation in the environmental factors limiting individual growth. This environmental limitation can vary over time, between cohorts and between individuals within a cohort. For a complete and accurate understanding of individual growth in a population, it is important to include all these sources of variation. So far, statistical models only accounted for a subset of these factors or required an extensive growth history of individuals. Here we present a novel model describing the growth curves of cohorts in a population. This model is derived from a stochastic form of the Von Bertalanffy growth equation describing individual growth. The model is specifically tailored for use on length-at-age data in which the growth trajectory of an individual is unknown and every individual is only measured once. The presented method can also be used if growth limitation differs strongly between age or length classes. We demonstrate the use of the model for length-at-age data of North Sea plaice (Pleuronectes platessa) from the last thirty years. Fitting this model to length-at-age data can provide new insights in the dynamics of the environmental factors limiting individual growth and provides a useful tool for ecological research and management.