IntroductionFetal persistent hyperplastic primary vitreous (PHPV) and retinoblastoma (Rb) is rare congenital abnormal development of the vitreous body1,2. According to related manifestations after delivery, PHPV is clinically called “white pupil.” It mainly manifests as vision loss and lens opacity and, in severe cases, as intravitreal hemorrhage and eyeball atrophy. The disease is possibly isolated or associated with congenital syndromes, such as Walker–Warburg syndrome and Norrie disease. Rb is the most common intraocular malignancy of childhood. The role of prenatal ultrasound screening for Rb has been discussed3. Here, we present a case of persistent primary hyperplasia vitreous diagnosed in the second trimester using prenatal ultrasonography. An echogenic band with an irregular surface was detected between the lens and the posterior wall of the left eye. No other system abnormalities were present in the fetus.

This study was conducted to know the various circulating lineages of SARS-CoV-2, prevalent mutations in lineages, and selective pressure analysis on the genome of SARS-CoV-2 during the first and second wave of the COVID-19 pandemic in India. For this purpose total of 1451 sequences from June 2020-June 2021 spanning from various regions of India were downloaded from NCBI and GISAID. The sequences were blasted using the Pangolin COVID-19 lineage assigner. Total, forty-one lineages were found to be circulating in India during this one year. Thirty-five lineages were circulating during the first wave and twenty lineages were circulating during the second wave out of which six were new lineages. During the first wave, in 2020 only one Variant Of Concern (Alpha) was found and during the second wave in 2021 three variants of concern (Alpha, Beta, and Delta) were in circulation. One Variant Under Monitoring was also prevalent during the second wave. The most frequent mutations observed were S: D614G, NSP3: F106F, NSP 12b: P314L, ORF3a: Q57H, M: Y71Y, NSP14:C279C, S: D294D, N: S194L. Interestingly, the ten most mutated samples belonged to Delta variant of B.1.617.2 lineage and all were found in the second wave which justifies the severity of the second wave. Five mutations L452R, T478K, E484Q, N501Y, and D614G in the spike protein responsible for increased transmissibility and reduction in neutralization by convalescent sera were majorly prevalent during second wave out of which D614G, L452R, and T478K were present at prevalence rate of 88.25%, 21.04%, and 16.80%, respectively. The major selection was purifying selection, however, few sites in the NSP2, NSP3, NSP13, S protein, ORF3a, and ORF9 evolved under positive selection. We hereby also report six novel mutations, three in NSP2 (P129A, V381A, V381F), one in NSP3 (P822S), and one in S protein (Q23R) evolving under positive selection pressure.

Conservation biology emerged as a crisis discipline in the 20th century amongst an increasing awareness of pollution and habitat loss. Since the early 2000s, societal and monetary benefits of nature were added to the narrative for biodiversity conservation. Using text mining, we show that authors now favour an ecosystem-services over a crisis framing in scientific publications on coastal habitats. This may signal a shift in conservation science from a crisis to a services discipline despite continuing habitat loss. We discuss whether authors should more critically assess what conservation narrative they deploy and what consequences this may have for conservation action.

Size-scaling relationships generated across huge variation in body mass from zooplankton to elephants offer critical insight into understanding similarities in species interactions across ecosystems. Yet to what extent ecologists can borrow from these relationships to effectively predict interactions between a single species pair remains poorly understood. Here, we combine experiments and long-term data to test how accurately published size-scaling relationships predict interactions between an economically and ecologically important predator-prey pair. We demonstrate that interaction strength is highly dependent on predator size, prey size, and prey density. We then used this relationship to predict plausible interaction strengths across ten years of data at five sites. Our analysis reveals that variation in body size accounts for up to 91% of the variation in interaction strength compared to density. However, predictions generated from even the closest size-scaling relationship from the literature underestimated the strength of interactions by a factor of 4.

Plant diversity has often been linked to increased productivity. However, this apparent diversity-productivity relationship for plants may rely on interactions with microbes. Furthermore, these relationships are likely to be context dependent in response to resource availability. We used a biodiversity-ecosystem function experiment with trees exposed to high and low water availability treatments to determine if soil fungal communities mediate the diversity-productivity relationship. We found that richness and community composition of soil fungi and the interaction between plant pathogen and ectomycorrhizal richness were significant drivers of above-ground productivity and supported indirect, positive effects of tree species richness and functional diversity on productivity. Soil fungi also mediated tree water relations, reducing the effect of water limitation on productivity. Fungal communities were important drivers of positive net diversity and complementarity effects on productivity. Our study provides evidence that soil fungi play an important role in diversity-productivity relationships under variable water availability.

Skin cancer, especially malignant melanoma, can vary greatly in appearance and usually develops very quickly. Therefore, the ABCDE rule (also known as the ABCD rule in some countries) was propagated many years ago to help medical laymen to recognize for themselves when it is time to see a dermatologist. But how effective is this rule? Our previous work clearly demonstrates that another self-monitoring protocol has a higher sensitivity and better results than the outdated ABCDE rule: the C-Rapid-H-Plus Protocol. Based on this, a simple algorithm was developed which appeared to give quite promising results. Now we can present a completely new algorithm that has proven to be more reliable than dermatoscopy in predicting the need for excisional biopsy in a collective of 421 patients. The CRHP Advanced Risk Calculator, also based on the C-Rapid-H-Plus protocol, is of great value for both, in-person and telemedicine settings.

The aortic sinuses of Valsalva are an important ablation site in non-ischemic substrates and in patients with idiopathic ventricular arrhythmias. Siontis and colleagues have demonstrated that these sites should also be considered for ablation in patients with infarct-related inferior axis VT. Low voltage in the aortic sinuses of Valsalva or in the sub-aortic region should prompt further evaluation of these regions for ablation.

Introduction: Metastasis to the spleen is rare. Case presentation: The patient was a 62-year-old woman with diagnosis of invasive ductal carcinoma of breast and hairy cell leukemia with huge splenomegaly. Discussion: This case has been reported considering the uncommonness of solitary metastasis to the spleen and synchronous hairy cell leukemia.

Aims: We aimed to further evaluate the effectiveness and safety between high-power short-duration (HPSD) radiofrequency ablation (RFA) and conventional RFA in patients with atrial fibrillation (AF). Methods: Studies comparing HPSD and conventional applications from inception through December 2021 were searched on Pubmed, Medline, Cochrane and Clinicaltrials.gov. Results: The meta-analysis included seventeen studies with a total of 4934 patients. HPSD group decreased procedure duration [mean difference (MD) -38.28 min, 95% confidence interval (CI) -47.08 to -29.49, P＜0.001], RF duration (MD -20.51 min, 95% CI -25.96 to -15.06, P＜0.001) and fluoroscopy duration (MD -5.19 min, 95% CI -8.02 to -2.37, P＜0.001), while improving the rates of first-pass isolation [Odds Ratio (OR) 8.92, 95% CI 2.40-33.09, P=0.009]. Compared with conventional group, freedom from atrial arrhythmia at 1-year-followup was higher in the HPSD group with a power setting of 40-50W (OR 1.93, 95% CI 1.27-2.91, P=0.002), nevertheless, two groups had similar effectiveness with a power setting of 50W in the HPSD RFA (OR 1.10, 95% CI 0.83-1.46, P=0.52). Acute pulmonary vein reconnection (P＜0.001) was significantly lower in the HPSD group. There was no difference in complications between the two groups (P=0.71). Conclusion: HPSD RFA was associated with shorter procedure duration, higher freedom from atrial arrhythmia and comparable safety when compared with conventional RFA.

The diversity of phytoplankton is fundamental to the health of aquatic ecosystems. Those commonly used diversity indices (e.g., Shannon-weiner diversity index, etc.) were assumed that a uniform distribution was the optimal status of phytoplankton taxa in aquatic system during the assessment of these indices. We discovered that the relative abundance of phytoplankton within an aquatic ecosystem can be fitted with exponential distribution, suggesting that the exponential distribution was the intrinsic and inherent distribution of phytoplankton communities. Through mathematical derivation, taxa capacity (N), competition coefficient (k), critical relative abundance of extinction (a), degree of monopoly, and the residual sum of squares of the phytoplankton community can be obtained to provide a greater insight into phytoplankton diversity. Our results highlight a new methodology based on the above indices has been developed to provide a better insight into the phytoplankton community diversity. It will also help to evaluate the aquatic system ecological health.

Esse conteúdo digital foi criado como parte da atividade de capacitação ”Introdução ao R e RStudio para ciência social computacional”. É uma iniciativa de formação e difusão científica do Observatório de Populações e Políticas Púbicas (ObPPP) e do Programa de Formação Complementar de Graduação em Pesquisa Social Computacional (InfoSoc), ambos vinculados ao Dept.º C. Soc. / CLCH, Universidade Estadual de Londrina (UEL), Paraná - Brasil

An 81-year-old man initially underwent right hepatic lobectomy for liver cancer and was pathologically diagnosed with combined hepatocellular and cholangiocarcinoma (CHC). At 13 months after resection, multiple lymph node metastases were observed. We started atezolizumab plus bevacizumab (Atez/Bev), achieving a 7.5-month progression-free survival. Atez/Bev might exhibit efficacy for CHC patients.

Carotid sinus hypersensitivity is one of the unexplained causes of syncope in old age. A 56-year-old male, known case of coronary artery disease (CAD) and diabetes mellitus (DM), presenting with syncope, was diagnosed as carotid sinus hypersensitivity incidentally. Hence, the rare disorder like carotid sinus hypersensitivity should also be considered.

Objectives To examine the methods and infrastructure necessary to establish a national Ménière’s disease registry Design Observational study. Four NHS Trusts and four independent hospitals or clinics, within three distinct urban and rural regions within the UK (“Blinded for review”). Participants Patients with Ménière’s disease. Main outcome measures Data related to the number of participants recruited, method of recruitment, participant demographics, completeness of data, and proportion of participants with bilateral disease. Results 411 participants were recruited into this study, 263 from NHS Trusts, and 148 from independent hospitals or clinics. Online recruitment was used for 73% participants and 27% were recruited via paper. 57% of participants were female and 96% of participants were white. There was no clear advantage to data completeness from either online or postal data collection. Around 20% of participants had audiological evidence of bilateral Ménière’s disease. Conclusion This feasibility study has demonstrated that hundreds of participants with Ménière’s disease can be successfully recruited to enter data into a large data collection platform. It is hoped that this initial feasibility study will pave the way for expansion of the registry to answer fundamental and complex questions alike, regarding the nature of Ménière’s disease.

Objectives: To explore the effect of intranasal administration of rh-bFGF on postoperative chronic rhinosinusitis with nasal polyps(CRSwNP) patients. Design: A prospective, randomized, controlled, double-blinded trial. Setting and Participants: 75 hospitalized patients who met the criteria of primary bilateral CRSwNP were enrolled from March 2020 to January 2021. Main outcome measures: Visual analogue scale, 22 item Sino-Nasal Outcome Test ,Lund-Kennedy system, and Scanning electron microscopy and Quantitative real-time PCR. Results: 75 patients with CRSwNP were randomly divided into three groups, and 72 patients completed the 1-month medication regimen and 1 year follow-up. Rh-bFGF nasal spray and drop application reduced general nasal VAS scores within two weeks after ESS compared to the control group. In contrast, only rh-bFGF nasal drops reduced SNOT-22 scores at 2 weeks and 1 year compared to the control group. A significant reduction in the endoscopic L-K score was observed in the rh-bFGF nasal spray and drop group compared to the control group. This is primarily because rh-bFGF promotes cilia growth in the nasal mucosal epithelium after the operation, as illustrated by scanning electron microscopy and expression of CP110, Tap73 and Foxj1 mRNA. For eosinophilic CRSwNP, the general VAS score of rh-bFGF nasal drops was more obviously reduced compared to the control group after ESS. A similar trend was observed for L-K score. Conclusions: Rh-bFGF nasal-drops and sprays can quickly and effectively relieve postoperative symptoms and improve long-term prognosis of patients with CRSwNP. Moreover, rh-bFGF nasal-drops are also an effective method for postoperative patients with eosinophilic CRSwNP.

We read with great interest the article by Vetrugno et al. who reported the important association of preoperative diastolic dysfunction (DD) and early liver allograft dysfunction.[1](#ref-0001) We salute the authors on this detailed and important investigation, and would like to highlight several points. First, the authors provide the cohort analysis of donors’ and recipients’ demographic variables (Table 1, Ref[1](#ref-0001)), however statistical comparative analysis of the three study groups and these variables is absent. Moreover, additional, important demographic variables (e.g., ethnicity, presence of trans jugular intrahepatic portosystemic shunt; hepato-pulmonary syndrome, porto-pulmonary hypertension, pretransplant hospitalization or vasopressors; QT interval) and intraoperative variables (e.g., hemoglobin, coagulative and thromboelastographic parameters, arrhythmias, immunosuppression, and post-reperfusion syndrome and vasopressors) were not included in the groups’ analysis (Table 4, Ref[1](#ref-0001)). These parameters are predictive of postoperative major adverse cardiac events and unfavorable transplant outcomes.[2,3](#ref-0002) Lastly, an association does not imply causation,[4](#ref-0004) and both DD and early graft dysfunction may have an independent, common origin like cirrhotic cardiomyopathy.[5](#ref-0005) An adjustment for cofounders is, therefore, mandatory; regrettably, the omission of a multivariable analysis from the study obfuscates the interpretation of the observed association. Presumably, DD results in early allograft rejection and dysfunction via the attendant elevated pro-inflammatory cytokines, or increased venous pressure and hepatic allograft congestion.[6](#ref-0006) Postoperative cardiac variables (e.g., troponins, sono- and electrocardiography, venous and pulmonary pressures) and allograft biopsies were not reported in the study, but may direct clinicians to mitigating interventions to improve outcomes in liver allograft recipients with DD.

Background and aim of the study: A regular post-cardiac surgery course does not require a prolonged stay in the cardiac surgery intensive care unit (ICU). However, a complicated postoperative period, can lead to prolonged ICU stay and prolonged ventilation, and may require a tracheostomy. Nonetheless, there is currently no consensus regarding the proper timing of tracheostomy. Data regarding long-term outcomes of early versus late tracheostomy are limited. This study represents the largest single-center experience with post-cardiac surgery tracheostomy. The aim of this study was to assess the timing of tracheostomy as a risk factor for mortality. Methods : This is a retrospective study of prospectively collected data. Patients were divided into three groups according to the timing of tracheostomy; early (4-10 days); intermediate (11-20 days) and late (≤21 days). The primary outcomes were early, intermediate, and long-term mortality. For statistical analysis we use multivariable Cox proportional hazards model. Results : Between 09.2004 and 08.2021, 12,782 patients underwent cardiac surgery at our institution, of whom 407 (3.18%) required postoperative tracheostomy. 147 (36.1%) had early, 195 (47.9%) intermediate and 65 (16%) late tracheostomy. The three groups were similar regarding their baseline characteristics and operative data. Early, 30-day and in-hospital mortality was similar for all groups. However, patients, who underwent early- and intermediate tracheostomy, demonstrating statistically significant lower mortality after 1- and 5-year (42.8%; 57.4%; 64.6%; and 55.8%; 68.7%; 75.4%, respectively; p<0.001). In our patient’s cohort Cox model show age [1.025 (1.014-1.036)] and time to tracheostomy [0.315 (0.159-0.757)] as significant factor for mortality. Conclusions : This study demonstrates a relationship between the timing of tracheostomy after cardiac surgery and mortality: early tracheostomy within 4-10 days of mechanical ventilation associated with better intermediate- and long-term survival. Short-term mortality does not seem to be affected by the timing of tracheostomy. Optimal timing of tracheostomy requires further evaluation.

Recurrence after conservative resection of pleomorphic adenoma is a rare and late phenomenon that poses a difficult management problem. All recurrences at 6 years after capsular dissection were detected clinically (recurrence rate 3.2%). Magnetic resonance imaging failed to detect early occult recurrences after conservative surgery and thus a “single shot” imaging modality for follow up is not recommended. Regular ultrasound and magnetic resonance imaging have been used after surgery for early detection of a recurrence. The pickup rate is low so the additional cost and effort of radiological surveillance is not justified. Follow up after parotid surgery for pleomorphic adenoma remains clinical. There may be a benefit in regular surveillance imaging of high risk patients (prior enucleation or resection after recurrence).

S) score, posterior ethmoid sinus (PES) score, sphenoid sinus (SS) score, ethmoid sinus score/maxillary sinus score (ES/MS) ratio and posterior ethmoid sinus score/anterior ethmoid sinus score (PES/AES) ratio were significantly higher in the B-high subgroup. Logistic regression analyses disclosed that comparing with other sinus CT parameters, OC score was an independent predictor for systemic eosinophilia. There was a moderate correlation between OC score and the level of blood eosinophil (r=0.57, P<0.001). Conclusion: Olfactory cleft opacification shown in paranasal sinus CT may be a marker for the phenotype of CRSwNP with systemic eosinophilia, which appears to be closely related to olfactory dysfunction.

Achnatherum inebrians (drunken horse grass, DHG) plants, a dominant grass species in the arid and semi-arid regions of northwest China, symbiotic with an Epichloë fungal endophyte, is well adapted to drought. However, little is known about how the presence of the foliar Epichloë endophyte enhances the tolerance of DHG to drought at the molecular level. This study explored the positive effects of the presence of the Epichloë endophyte on plant growth, biomass, and photosynthetic efficiency and processes of DHG under non-drought and two drought (moderate and severe) treatments, using RNA sequencing to compare transcriptomes. The transcriptome results showed that 32 selected unigenes involved in the photosynthesis processes within Epichloë symbiotic plants were differently expressed (DEGs) versus non-symbiotic plants. The majority of these selected DEGs were up-regulated in Epichloë symbiotic plants versus non-symbiotic plants, such as up-regulated unigenes (c51525.graph_c1, c47798.graph_c0 & c64087.graph_c0) under drought conditions. In line with the transcriptomes data, the presence of the Epichloë endophyte promoted the photosynthetic rate and biomass accumulation of DHG plants, and the relationship between photosynthetic rate and biomass is liner and significant. The presence of the endophyte only increased the biomass per tiller of DHG plants under drought. This study has provided further insights into the molecular mechanisms underlying enhanced plant growth and drought tolerance of DHG host plants of the Epichloë endophyte.

In this study paper, a comparative analysis of various image enhancements in local domain techniques was made based on three-dimensional image quality statistics namely Mean Squared Error (MSE), Peak Signal to Noise Ratio (PSNR) and Image Quality Model (SSIM) to determine image quality. especially among them so that the process of image enhancement in the local domain is carried out. The conditions for choosing the best method are to have a small number of Mean Squared Error (MSE) and a high number of Peak Signal to Noise Ratio (PSNR) and Structural Properties to measure Image Quality (SSIM).

Abstract In allergic rhinitis (AR), the epithelial barrier composed of nasal mucosal epithelial cells is the first line of defense, which is crucial to protect the host immune system from harmful stimuli. Moreover, irreversible structural changes in nasal mucosal epithelial cells can occur in response to different allergens, but the mechanism leading to such abnormal changes has not been determined. Programmed cell death is regulated by genes and interacts with multiple cell signaling pathways. To explore the regulatory mechanism and signal pathway of programmed cell death in epithelial cells of allergic rhinitis, is helpful to clarify the pathogenesis of AR and put forward treatment strategies. In this paper, the regulation mechanisms of programmed cell death such as apoptosis, pyroptosis, and autophagy occurring in epithelial cells in AR, are retrospectively summarized to better understand the pathogenesis of AR. FIG. 1 Programmed cell death in AR epithelial cells

In this study, we investigate the boundedness of B-Riesz potential and its commutators on generalized weighted B-Morrey spaces. The primary aim of this study is to investigate the boundedness of Riesz potential and its commutators generated by generalized translate operator on generalized weighted B-Morrey spaces. In particular, B-Riesz potantial, its commutators and B-Morrey spaces are related to generalized translate operators that is associated with Laplace Bessel differential operator. Then, two-weighted inequality for these operators and its commutators on generalized weighted B-Morrey spaces is also provided. As a corollary, the boundedness of B-Riesz potential and its commutators on generalized weighted B-Morrey spaces is proved.

A document by Xiu-Bin Wang. Click on the document to view its contents.