Background: There is limited data on the long-term outcomes in patients who have undergone a reoperation following a failing stentless aortic valve. Methods: Between 2006-2016, a retrospective analysis was performed on 24 patients that underwent open aortic valve replacement surgery for a failed stentless aortic valve prosthesis at Health Sciences North, Sudbury, Ontario, Canada. The primary outcome was low mortality from cardiac related deaths after 5 years. Results: All patients underwent an insertion of a Medtronic Freestyle bioprosthesis implanted in the modified subcoronary technique for their initial operation. The interval from the first operation to the stentless redo surgery ranged from 6-13 years. Aortic valve reoperation was performed for structural valve deterioration in 96% (n= 23) of the cases. Reoperations involved a removal of the stented valve leaflets and stented valve-in-valve implantation in 20% (n= 5) of the cases, with the remaining cases requiring complete removal of the stentless prosthesis and aortic valve replacement. In those where a complete removal of the stentless valve was possible (n=19), there was no disruption of the native aortic root, and a 0% conversion to a Bentall procedure. There was no intraoperative mortality. The 30-day and 10-year operative mortality was 4% and 16%, respectively. Conclusions: Redo surgery for failing stentless valves can be done with relatively low-risk and with acceptable long-term outcomes without resorting to root replacement techniques.

This paper compares the traditional combination of combinatorics with the optimized combination introduced by Chinnaraji Annamalai, Indian Institute of Technology Kharagpur. This comparison of combinatorial combinations will be useful for the researchers who are involving to solve the problems in science and management. MSC Classification codes: 05A10

The present article contains the study of fixed time synchronization of octonion valued neural networks (OVNNs) with time varying delays. Firstly, OVNNs are decomposed into eight real valued systems of equations. Using some lemmas and Lyapunov functional, sufficient criteria have been derived for the fixed time synchronization. Moreover a suitable non-linear controller was created to keep the drive response system in synchronization state. Finally, a numerical example is performed to demonstrate and validate the theoretical findings.

The letter presents a new mutually coupled circuit (MCC) based on a modified voltage differencing transconductance amplifier (MVDTA), designed using the Gorski-Popiel technique [1]. The proposed synthetic transformer (ST) circuit uses two MVDTAs as active elements, and all passive elements are grounded — two capacitors and two resistors. Thanks to the newly established coupling method-connections, it is provided with independent electronic control of primary and secondary self-inductance, as well as mutual inductance, via bias voltages of MVDTAs. In addition, it is very easy to provide the conditions by which symmetrical couplings are achieved. Thorough Pspice simulation time and frequency domain analyses have been performed in order to verify the theoretical analyses. A double-tuned band-pass (DTBP) filter application is given to show the functionality of the proposed MCC.

A compact high-sensitivity probe for sensing up tangential E-field is proposed and measured in this paper. The probe is consisted of an electric dipole with patches used to induce the tangential E-field, a resonator made up of open circuit stubs (capacitor) and short circuit stubs (inductor), for achieving a specific resonance, and a compact coupled balun for transforming the differential- mode voltage into the single output voltage and impedance matching. The probe is fabricated on five-layer dielectric lamina. Compared with the referenced broadband probe, the measured |S12|of the probe is enhanced by 18.81 dB. The proposed probe in this paper is validated with simulation and measurement.

A quasi steady-model of the dissolution of a single prolate or oblate spheroidal particle has been developed based on the exact solution of the steady-state diffusion equation for mass transfer in an unconfined media. With appropriate treatment of bulk concentration, the model can predict the detailed dissolution process of a single particle in a container of finite size. The dimensionless governing equations suggest that the dissolution process is determined by three dimensionless control parameters, initial solid particle concentration, particle aspect ratio, and the product of specific volume of solid particles and saturation concentration of the dissolved species. Using this model, the dissolution process of felodipine particles in a broad range of space of the three control parameters are analyzed and some characteristics are identified. The effects of material properties indicated by the product of specific volume and saturation concentration are also analyzed.

Enterocytozoon hepatopenaei (EHP) is a high-impact pathogen in shrimp farming, causing huge economic losses to the global shrimp farming industry every year. However, current EHP detection methods are primarily based on the development of polymerase chain reaction (PCR) techniques that rely on sophisticated and expensive instruments. Consequently, a rapid, practical, and sensitive protocol for the detection of EHP is necessary. Recombinase polymerase amplification combined with a lateral flow dipstick (LFD-RPA) assay was developed using a pair of primers and nfo-probe targeting the conserved region of the spore wall protein gene. Under optimized reaction conditions, the LFD-RPA assay can detect 10 copies/μL of standard plasmid within 20 min at 40°C. Furthermore, this assay cannot amplify DNA from other shrimp pathogens. Thirty-nine samples of Litopenaeus vannamei were collected in shrimp farms and detected using LFD-RPA and nested PCR. Thirty-two positive samples were detected by LFD-RPA. Compared with those of nested PCR (32/39), the diagnostic sensitivity and specificity of LFD-RPA were 100% and 100%, respectively. These results indicated the great application potential of the newly developed LFD-RPA assay for point-of-care diagnosis, epidemic surveillance, and epidemiological investigation of EHP.

A document by Chuang, Kuochih. Click on the document to view its contents.

Marine heatwaves (MHWs) emerge as a severe stressor in marine ecosystems. Extreme warm sea surface temperatures during MHWs are often beyond the optimal thermal range and beyond one generation of tropical coastal zooplankton. However, it is relatively unknown whether transgenerational MHW effect may shape the offspring fitness, particularly in an ecologically relevant context with biotic interactions such as predation stress. We addressed these novel research questions by quantifying the reproductive success, grazing, and survival of copepod Pseudodiaptomus incisus exposed to MHW and fish predator cues (FPC) for two generations (F1 and F2). There were four F1 treatments [(control or F1-MHW) × (no FPC or F1-FPC)] and 16 F2 treatments [(control or F1-MHW) × (no F1-FPC or F1-FPC)] × [(control or F2-MHW × no F2-FPC or F2-FPC)]. In both generations, P. incisus performance was substantially lowered in MHW, but slightly higher in FPC, particularly in control temperature. F2 reproductive success and cumulative faecals were reduced by 20-30% in F1-MHW, but increased by ~2% in F1-FPC. Strikingly, direct MHW exposure strongly reduced survival, but transgenerational MHW exposure ameliorated its lethal effect and was independent of FPC. The increased survival came with a cost of reduced reproductive success, constrained by reduced grazing. The rapid transgenerational MHW acclimation and its associated costs are likely widespread and crucial mechanisms underlying the resilience of coastal tropical zooplankton to MHWs under high predation pressure in the tropical coastal marine ecosystems.

Fractal theory provides a new strategy for the equipment design and industrial amplification. In this work we propose a novel H-like fractal (HLF) impeller to improve the distribution uniformity of hydrodynamics in stirred tanks. The impeller with two vertical blades becomes fractal impellers by designing each vertical blade as an H-shaped sub-blade (HLF-1) or uniform arrangement of H-shaped sub-blades (HLF-2). Flow characteristics including velocity and turbulent kinetic energy (TKE) distributions, vortices, power number, are predicted by large eddy simulation. Compared with Rushton turbine (RT) impeller when H/T=1 (or dual RTs when H/T=1.5, triple RTs when H/T=2), the HLF impeller can produce a flow field with more uniform distributions of larger velocities and TKE level. The HLF-2 impeller can further improve distribution uniformity of hydrodynamics in the case of high H/T. Power analysis shows that this is mainly due to the improved energy utilization efficiency by the fractal structure design.

The utilization of lignin remains a great challenge due to its complex non-repetitive structure and the lack of efficient catalyst. Herein, a single-atom catalyst Ni@N-C was designed via a facile chelation-anchored strategy. Ni atoms were immobilized on the N-doped carbon carrier by a two-stage pyrolysis of a mixture of D-glucosamine hydrochloride, nickel acetate and melamine. D-glucosamine hydrochloride as a chelating agent prevented the aggregation of Ni2+, and melamine provided enough N to anchor Ni by forming Ni-N4 structure. Ni@N-C gave a 31.2% yield of aromatic compounds from lignin hydrogenolysis, which was twice higher than that achieved by Ni cluster catalyst. Based on the experimental and DFT calculation results, the higher activity of Ni@N-C was attributed to its lower H2 dissociation energy and the reduced energy barriers of the transition states. The strategy described opens an efficient green avenue for preparing single-atom catalyst that possesses outstanding activity in lignin depolymerization.

Many engineering processes can be accurately modelled using partial differential equations (PDEs), but high dimensionality and non-convexity of the resulting systems pose limitations on their efficient optimisation. In this work, a model reduction, machine-learning methodology combining principal component analysis (PCA) and artificial neural networks (ANNs) is employed to construct a reduced surrogate model, which can then be utilised by advanced deterministic global optimisation algorithms to compute global optimal solutions with theoretical guarantees. However, such optimisation would still be time-consuming due to the high non-convexity of the activation functions inside the reduced ANN structures. To develop a computationally-efficient optimization framework, we propose two alternative strategies: The first one is a piecewise-affine reformulation of the nonlinear ANN activation functions, while the second one is based on deep rectifier neural networks with ReLU activation function. The performance of the proposed framework is demonstrated through three illustrative case studies.

Arsenic is a toxic metalloid that affects human health by causing numerous diseases and by being used in the treatment of acute promyelocytic leukemia. Saccharomyces cerevisiae (budding yeast) has been extensively utilized to elucidate the molecular mechanisms underlying arsenic toxicity and resistance in eukaryotes. In this study, we applied a genomic DNA overexpression strategy to identify yeast genes that provide arsenic resistance in wild-type and arsenic-sensitive S. cerevisiae cells. In addition to known arsenic-related genes, our genetic screen revealed novel genes, including PHO86, VBA3, UGP1, and TUL1, whose overexpression conferred resistance. To gain insights into possible resistance mechanisms, we addressed the contribution of these genes to cell growth, intracellular arsenic, and protein aggregation during arsenate exposure. Overexpression of PHO86 resulted in higher cellular arsenic levels but no additional effect on protein aggregation, indicating that these cells efficiently protect their intracellular environment. VBA3 overexpression caused resistance despite higher intracellular arsenic and protein aggregation levels. Overexpression of UGP1 led to lower intracellular arsenic and protein aggregation levels whilst TUL1 overexpression had no impact on intracellular arsenic or protein aggregation levels. Thus, the identified genes appear to confer arsenic resistance through distinct mechanisms but the molecular details remain to be elucidated.

The loss of function of the FLNA gene may result in impairment of the filamin A protein. Of the many clinical syndromes, this condition may produce lung disease. This usually presents itself and is diagnosed in the infant/toddler age group that may mimic broncho-pulmonary-dysplasia. It is part of the entities included in Childhood Interstitial Lung Disease (chILD) group of disorders. We are reporting on a patient that was diagnosed at eleven years of age. This case provides a unique insight into the long-term course of lung disease in this illness and broadens our understanding of the spectrum of its presentation. Although the patient had symptoms very early in life, the diagnosis may not have been entertained because of the rarity of the disorder, its atypical presentation, and discontinuous care due to parents moving to different cities for reasons of employment. Her initial presentation to our institution was for pneumonia. Due to the highly unusual chest x-ray images, asthenia, and early clubbing, an extensive work up was undertaken that included further imaging and a lung biopsy. The final diagnosis was confirmed by the detection of FLNA LOF gene mutation.

It is generally believed that there is only one species, Nectogale elegans in the genus Nectogale. However, the validity of the species status of Nectogale sikhimensis has been controversial, and the phylogenetic relationship of this genus has not been well resolved. In this study, the mitochondrial cytochrome b gene and eight nuclear genes were used to infer the molecular phylogenetic relationship of the genus. The results of phylogenetic trees indicated that Nectogale was divided into two large lineages—Group A from Tibet and Group B from Sichuan and Yunnan. The divergence time between the two groups was estimated to be 5.76 million years. The genetic distance of K2P between the two groups was over 14%. Some morphological differences were also found in Groups A and B, including the skull size, shape of the second upper molar (M2), first lower unicuspid (a1), and palatal suture. In consideration of the large genetic distance, divergence time, and morphological differences, we recover the species status of N. sikhimensis and support that Nectogale consists of two species.

This study investigated whether Elexacaftor-Tezacaftor-Ivacaftor (Kaftrio ®), a cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulator, could improve exercise capacity in adolescents with CF. After six weeks treatment, Kaftrio ® improved both maximal and submaximal indices of aerobic fitness. Improvements were independent of changes in ventilatory function during exercise and physical activity. Interestingly, pulmonary oxygen uptake per unit of power output was higher in two, out of three, cases who presented with more severe CF lung disease. These findings suggest improved O 2 extraction and/or consumption in the exercising muscle and demonstrate, for the first time, that short-term treatment with Kaftrio ® might improve aerobic fitness in people with CF, especially in those with more severe lung disease and deconditioning.

Our case was a pediatric patient with very extensive lung involvement who also had involvement in other organs. We believe our case demonstrates clinical features that are complementary for the case series by Mfingwana L and colleagues and thus, will be beneficial for the readers.

The patient was a 52-year-old woman with approximately 6 years' history of uncontrolled diabetes mellites and hypothyroidism, who presented with cough, sputum and dyspnea 2 months ago.

Tetralogy of Fallot is the most common cyanotic congenital heart defect and accounts for about 5% of all congenital cardiopathies. The definitive treatment modality for tetralogy of Fallot is reparative surgery, which is recommended to be performed by the time of diagnosis. Without surgical repair, most patients would die during their childhood. In the past, survival data indicated that 66% of persons with tetralogy of Fallot not surgically treated lived until the age of 1, 49% lived until the age of 3, and 24% lived until the age of 10. We present a patient with uncorrected tetralogy of Fallot who lived up to 72 years of age. The patient with a history of 4 live births presented to the emergency department with dyspnea, and in our echocardiography, we found that the patient with uncorrected tetralogy of Fallot had pericardial tamponade. When we review the current literature, she is the oldest uncorrected patient with tetralogy of Fallot in our country and the female patient with the highest number of live births among patients with uncorrected Tetralogy of Fallot in the world.

Environmental perception system is the premise of the safety and stability of the autonomous vehicle system. However, studies have shown that the on-board sensors included in the perception system are extremely vulnerable to external attacks and interference, leading to incorrect driving strategies and bringing great security threats. Aiming at the problem, this paper divides the vehicle-mounted sensors into a positioning group and an identification group according to their role in the perception system. Then, based on the information correlation between sensors in the same group and the information correlation of a single sensor on adjacent time series, the distance metric model between sensors in a group and the distance metric model for each sensor of this group on time series is established. And the normal distance intervals corresponding to the confidence interval are calculated respectively. According to the distance metric model between sensors, we can detect anomalies in the perception system in real-time. Further, according to the distance metric model for each sensor on adjacent time series, we can identify anomaly sensors. Our experimental results quantitatively show that the method achieves real-time anomaly recognition, and demonstrate the effectiveness and robustness of the method on the open-source KITTI dataset.

Acute abdomen is a life-threatening condition caused by different incidences such as perforated peptic ulcers and acute appendicitis. This critical condition needs urgent investigation and treatment. The main diagnostic ways for acute pancreatitis are clinical examination and findings. It is essential to consider these two conditions in a patient simultaneously.

Pulmonary inflammatory myo-fibroblastic tumor (IMT) is a rare condition in normal population and specifically in pediatric population. We reported a 9-year-old male child presented by cough and intermittent fever and weight-loss that was mostly suggestive for infectious process. We reviewed the consideration of diagnosis and treatment and other previous cases.

Robust estimates of demographic parameters are critical for effective wildlife conservation and management, but are difficult to obtain for elusive species. We estimated the breeding and adult population sizes, as well as the minimum population size, in a high-density brown bear population on the Shiretoko Peninsula, in Hokkaido, Japan, using DNA-based pedigree reconstruction. A total of 1,288 individuals, collected in and around the Shiretoko Peninsula between 1998 and 2020, were genotyped at 21 microsatellite loci. Among them, 499 individuals were identified by intensive genetic sampling conducted in two consecutive years (2019 and 2020) mainly by noninvasive methods (e.g., hair and fecal DNA). Among them, both parents were assigned for 330 bears, and either maternity or paternity was assigned to 47 and 76 individuals, respectively. The subsequent pedigree reconstruction indicated a range of breeding and adult (≥4 years old) population sizes: 128–173 for female breeders and 66–91 male breeders, and 155–200 for female adults and 84–109 male adults. The minimum population size was estimated to be 449 (252 females and 197 males) in 2019. Long-term continuous genetic sampling prior to a short-term intensive survey would enable parentage to be identified in a population with a high probability, thus enabling reliable estimates of breeding population size for elusive species.

Background: Anaphylaxis following influenza vaccination is a rare but serious problem. The underlying immune responses are not well understood. Objective: To elucidate IgE and IgG antibody responses in healthy children and adolescents following inactivated influenza vaccines (IIVs). Methods: The efficacy and safety of quadrivalent IIV (QIV) and trivalent IIV (TIV) were compared in healthy subjects aged 0-18 years. Serum IIV-specific IgE, IgG and IgG4 levels (sIgE, sIgG, sIgG4) were measured with ImmunoCAP. Hemagglutinin inhibition (HI) assay was performed for each influenza virus subtype. Sera from earlier patients who developed anaphylaxis to different IIVs were similarly tested. Results: A total of 393 subjects were enrolled: 96 were 6 months -2 years old, 100 were 3-5 years old, 100 were 6-12 years old, and 97 were 13-18 years old . No anaphylaxis was observed. Generally, QIV and TIV induced similar antibody responses. IIV-sIgE levels rose significantly after vaccination in the 6m-2y and 3-5y groups, did not change in the 6-12y group, and decreased in the 13-18y group. In contrast, the IIV-sIgG4/sIgE ratio increased significantly after vaccination in all age groups. Sensitized subjects had significantly higher HI titers and IIV-sIgG levels in the youngest age group and higher IIV-sIgG4 levels in all age groups compared with the non-sensitized. The IIV-sIgG4/sIgE ratio in 5 patients with anaphylaxis was significantly lower than in age-matched healthy subjects. Conclusion: IIVs induce IgE sensitization in healthy children, but also robust IgG4 responses that may protect them from anaphylaxis. (239 words)