Objective To identify the ranges of gestational weight gain for Chinese women with gestational diabetes based on the different pre-pregnancy body mass index group, and to investigate the association between gestational weight gain and maternal-infant adverse outcomes. Design A single-center retrospective cohort study. Setting A tertiary public women's and children's hospital in China. Population Women with gestational diabetes. Methods Retrospective analysis of 17,216 women with gestational diabetes who delivered singleton, registered between 2013 and 2018. Main outcome measures Gestational weight gain ranges, maternal-infant adverse outcomes. Results A total of 14,517 women were included finally. In comparison to the recommended gestational weight gain ranges by the National Academy of Medicine, the Chinese women with gestational diabetes in this study had a wider weight gain ranges, and faster rate of gestational weight gain. The risk of adverse outcomes increased steadily with gestational weight gain in the four body mass index groups. The ranges of gestational weight gain that were associated with lower risks of maternal-infant adverse outcomes were 15-20kg, 14-18kg, 4-8kg, and 0-4kg for the underweight, normal weight, overweight and obese groups, respectively. Conclusions The findings from this study can be used as a guideline for Chinese women with gestational diabetes. Healthcare professionals should provide targeted advice to women based on their pre-pregnancy body mass index to reduce the risks of maternal-infant adverse outcomes. Future high-quality and multi-center prospective studies are needed to validate our findings. Keywords Gestational weight gain, body mass index, gestational diabetes mellitus, maternal-infant adverse outcomes

INTRODUCTIONPrimary endometrial squamous cell carcinomas (PESCC) are rare entities, as less than 100 such cases involving only the endometrium have been reported to date. These tumors are majorly seen in post-menopausal women and conditions leading to chronic inflammation of the endometrium as pyometra, cervical stenosis, inflammatory diseases like ichthyosis, and very rarely foreign bodies like intra-uterine contraceptive device (IUCD). Although IUCD usage has been considered protective against the development of neoplasia, still sporadic cases of IUCD-associated uterine malignancies have been reported in the literature. We present a rare case of invasive pure endometrial SCC following 32 years of IUCD retention in a 66-year-old lady. Though there have been reports of endometrial SCC, to the best of our knowledge, pure endometrial (without any evidence of cervical involvement), invasive SCC, secondary to retained IUCD, is being reported for the first time.CASE REPORTWe present the case of a 66-year-old lady, with no comorbidities who presented to us in May 2020 with complaints of postmenopausal bleeding per vagina, on and off for 3 months. She attained menopause at the age of 58 years and gave a history of an IUCD -Copper T insertion 32-years ago, which was still in situ. Her BMI was 21.6. Per abdominal examination did not reveal any abnormality. Per-vaginal examination revealed a bulky uterus (8 weeks size), with the tip of IUCD felt at the level of external os, though per speculum examination had not revealed any abnormality. Bilateral parametria were free with no adnexal mass. On evaluation, her PAP smear examination was reported negative for malignancy and endometrial aspiration also showed only inflammatory changes with no malignancy. MRI of the pelvis was suggestive of irregular lobulated mass replacing the body of the uterus, involving >50% of the myometrium (Fig 1), extending up to serosa along with a linear opacity suggestive of a retained IUCD (Fig 1).The patient underwent surgical staging (Radical abdominal hysterectomy with bilateral salpingo-oophorectomy with bilateral pelvic lymph node dissection and para-aortic lymph node sampling). Intraoperative findings revealed an enlarged uterus with the tumor in situ and breaching the uterine serosa to involve small bowel at 15cm from the ileo-caecal junction. Bilateral ovaries were atrophic. Bilateral parametrium was involved. There was no intra-abdominal metastatic disease present.On gross examination, a grey-white infiltrative tumor was identified occupying the entire uterine cavity (Fig1). The tumor measured 6.5cm in the greatest dimension and involved part of the isthmus. The tumor infiltrated the full thickness of the uterine wall to involve the adjacent small bowel segment. IUCD was found within the uterine cavity (Fig 1c). Histopathological examination from the grossly identified tumor showed invasive keratinizing SCC exhibiting moderate nuclear atypia with invading front arranged in chords and trabeculae (Fig2). The surface endometrial lining in the rest of the uterine cavity was replaced by squamous metaplasia (Fig 2) along with inflammation with no areas of dysplasia. Adequate sections studied from the uterine tumor showed no coexisting adenocarcinoma. The tumor infiltrated the isthmus, which too showed metaplastic changes in the surface epithelium. The cervix was largely unremarkable and showed only focal areas of squamous metaplasia (Fig2). Cervix and isthmus both submitted in entirety did not reveal any dysplastic squamous epithelium or invasive SCC arising from the native lining epithelium. Immunohistochemistry for p16 performed on representative sections from the tumor, isthmus, and cervix was negative.DISCUSSIONPure endometrial SCC is a rare entity. The largest series of these tumors was presented by Goodman in 1996.(1) Wherein, the majority of the patients had positive cervical smears as the involvement of the endometrial cavity by upward extension of primary SCC of the cervix is a common occurrence.(2) Glitches associated with establishing a preoperative diagnosis of PESCC are the relative rarity of these tumors and the presence of highly differentiated squamous cells in endometrial curettage specimen simulating chronic inflammatory response.(1) Though, considering the post-menopausal status of the majority of patients (98% in Goodman’s series), the probability of having pelvic inflammatory diseases decreases significantly and thus can guide the pathologist for thinking of a non-inflammatory pathology. Unlike SCC of the cervix, Human papilloma virus (HPV) has not been recognized as an important factor for PESCC pathogenesis.(3)PESCC is defined as a primary carcinoma of the endometrium composed of squamous cells with varying degrees of differentiation.(4) Fluhmann described the following strict pathological criteria to define any endometrial tumor as PESCC -(a) no evidence of a coexisting endometrial adenocarcinoma or primary cervical SCC; (b) no connection between the endometrial tumor and squamous epithelium of the cervix; or (c) no connection between any existing cervical in situ carcinoma and the independent endometrial neoplasm.(5) These criteria have been further modified by S Kay and Jeffers et al.(2)Abiding by the Fluhmann criteria, the tumor, in this case, was restricted to the endometrium with no coexisting adenocarcinoma. The cervix examined in entirety did not show any dysplasia or invasive malignancy. Intact IUCD and the total replacement of the surface endometrial lining with metaplastic squamous epithelium further indicate its temporal relationship with the invasive SCC. While the negative staining for p16 affirms the non-HPV pathway of tumorigenesis.It has been established that prolonged chronic inflammatory response can induce squamous metaplasia which later can transform to SCC.(6) Though rare, squamous metaplasia is but a known entity in the presence of IUCD for a very long time.(7) It has been also testified from population-based studies that endometrium is the main source of squamous metaplastic atypical cells in cervical smears in IUCD users, though epithelial atypia rapidly disappears upon removal of IUCD.(8) So, the progression of squamous metaplasia to dysplasia, to non-invasive and ultimately to invasive carcinoma is rare, and even in cases where it does occur, it is mostly adenocarcinomatous progression.(9) There are very few documentations of primary carcinoma in situ following the use of IUCD. (6) To the best of our knowledge, there is only one such case reported of invasive SCC of endometrium following retained IUCD. But even in this case, there was the involvement of cervical tissue (including ectocervix) by SCC in situ.(10)Considering the rarity of this pathological entity, there are no defined treatment options. In Goodman’s review of 64 cases, 48.4% were treated with surgery alone, while 39.1% of the patients were treated with surgery and radiation therapy. Very few patients were treated with surgery along with chemotherapy, radiation alone, or a trimodality treatment. The authors concluded that the early-stage tumors confined to the uterus regardless of grade and depth of invasion had a good prognosis while most of the patients with the advanced stage disease had a bad prognosis even after adjuvant treatment. Keneddy S. et al reviewed the treatment and survival pattern of all cases of primary endometrial SCC fulfilling Fluhmann’s criteria until 1995 and suggested the role of cisplatin-based chemoradiation.(4) Both Goodman and Kennedy suggested that unlike endometrial adenocarcinoma, chances of lymph nodal spread to pelvic lymph nodes are less common in PESCC while the involvement of vascular spaces (Parametrium) is more common with these tumors. Considering these facts and extrapolating the outcomes of cervical SCC, chemoradiation can be explored for locally advanced primary endometrial SCC.To date, no case of invasive PESCC has been reported in reference to retained IUCD, which fulfilled all Fluhmann’s criteria. The present case confirmed to Fluhmann’s criteria as there was no evidence of invasive or in situ SCC of the cervix or any other variant of endometrial carcinoma despite extensive sampling, though it has displayed sequential changes of squamous metaplasia. Although we were unable to perform in-situ hybridization for HPV confirmation, the negativity for its surrogate marker, p16 immunohistochemistry, affirms a non-HPV pathway in this case.CONCLUSION: Herein we present a unique case of PESCC secondary to retained IUCD. Prolonged retained IUCD may cause chronic inflammation of endometrium leading to metaplasia and carcinomatous changes.Conflict of Intrest: NilContribution to authorship:Anadi Pachaury – Conceptualization, Methodology, Investigation, Original draft writing, Review and editing.Akash Sali - Methodology, Investigation, Review and editing.Debashish Chaudhary - Conceptualization, Methodology, Investigation, Original draft writing, Review and editing.Consent for publication taken from patientFunding: NilREFERENCES1. Goodman A, Zukerberg LR, Rice LW, Fuller AF, Young RH, Scully RE. Squamous cell carcinoma of the endometrium: a report of eight cases and a review of the literature. Gynecol Oncol. 1996 Apr;61(1):54–60.2. Jeffers MD, McDonald GS, McGuinness EP. Primary squamous cell carcinoma of the endometrium. Histopathology. 1991 Aug;19(2):177–9.3. Horn L-C, Richter CE, Einenkel J, Tannapfel A, Liebert U-G, Leo C. p16, p14, p53, cyclin D1, and steroid hormone receptor expression and human papillomaviruses analysis in primary squamous cell carcinoma of the endometrium. Ann Diagn Pathol. 2006 Aug;10(4):193–6.4. Kennedy AS, DeMars LR, Flannagan LM, Varia MA. Primary squamous cell carcinoma of the endometrium: a first report of adjuvant chemoradiation. Gynecol Oncol. 1995 Oct;59(1):117–23.5. Fluhmann CF. The histogenesis of squamous cell metaplasia of the cervix and endometrium. Surg Gynecol Obstet. 1953 Jul;97(1):45–58.6. Mitchell S, Fletcher H, Williams NP, Coard K. In situ squamous cell carcinoma of the endometrium associated with long-term intrauterine device (Dalkon Shield) usage. J Obstet Gynaecol J Inst Obstet Gynaecol. 1999 Jan;19(1):88–9.7. Katsura S, Satodade R. Histological study of the endometrium of 459 intrauterine contraceptive device (IUD) users. Yokohama Med Bull. 1969 Oct;20(5):137–44.8. Risse EK, Beerthuizen RJ, Vooijs GP. Cytologic and histologic findings in women using an IUD. Obstet Gynecol. 1981 Nov;58(5):569–73.9. Lax SF. [Precursor lesions of endometrial carcinoma]. Pathol. 2019 Feb;40(1):13–20.10. Valente PT, Ahmad MM. Low grade uterine stromal sarcoma and squamous cell carcinoma associated with an IUD: a report of 2 cases. J Reprod Med. 2004 Apr;49(4):324–8.

Pineapple production is mostly constrained by unavailability of high-performance suckers. However, somatic embryogenesis (SE) have been revealed the most rapid and controllable method for Pineapple propagation than conventional sucker production methods. The aim of this study was to evaluate the responses of two cultivars of pineapple regenerated through somatic embryogenesis. Thus, calli were induced from crown leaf and plantlets leaf of Smooth Cayenne and Sugar Loaf cultivars. Murashige and Skoog base medium supplemented with vitamins B5 and different in hormonal combinations: Auxins / Cytokins. BAP and / or 2,4-D have been added to base medium for calli maturation and BAP and GA3 for plant regeneration. The results indicated a significant influence of type of explant and copper on callus induction in pineaple cultivars. Likewise, The medium MS with growth regulator combination NAA (0.5 mg/l) + BAP (1mg / l (BAP) has a highly significant influence with 8.8 mature somatic embryos. Also, the growth regulator combinations and the cultivars have significantly influenced somatic embryos regeneration with a high rate of 55.25% shoots by using the hormonal combination BAP (3 mg/l) + GA3 (2 mg/l) for the smooth Cayenne. The protocol developed is a key study for successful mass propagation of the pineapple and genetics transformation of pineapple.

An experimental system consisting of gas mixing equipment, a sensor detection system, a data acquisition device, and an electric spark ignition device was set up to investigate the effect of flame speed and explosion pressure on flame quenching performance of propane, ethylene and hydrogen/air mixtures in the in-line crimped-ribbon flame arresters. The results indicated that under the conditions of the same size of experimental pipe configuration and the same ignition distance but different pipe lengths, or the same pipe length but different ignition distances, the flame arrester successfully stopped the flames at high flame speed and low explosion pressure, but failed at low flame speed and high explosion pressure. Then the relationship between flameproof speed and explosion pressure was derived base on the physical model of heat conduction, which is proved by experiment and provide more accurate reference for design and selection of crimped-ribbon flame arrester

Alkyd resin polycondensation process has been subjected to extensive theoretical, mathematical, experimental and simulation research because of inadequate kinetic models. The analysis of the alkyd resin polycondensation process is outstandingly essential for the design and development of new resins suitable for a broad range of application. However, experimental methods do not only consume time but burdensome, clumsy and costly. Researchers have, therefore, introduced mathematical modeling to control the alkyd reactor polycondensation processes and to investigate and improve the fundamental understanding of the dynamics of the polymerization process, to design new alkyd resin in a shorter time with comparatively lower cost. The latest developments in the mathematical and simulation technologies that have been reported for the alkyd reactor polycondensation kinetics were reviewed. The scope of this review includes the modeling and simulation techniques used for alkyd resin polycondensation processes and future challenges.

Background: Sickle cell disease (SCD) is a lifelong disease characterized by both acute and chronic morbid conditions that often result in acute care utilization. There is limited data on SCD patients in medically underserved areas of the United States. Methods: We conducted a retrospective analysis of SCD patients in a mixed rural/nonrural partially medically underserved area in southwest Virginia without access to an adult comprehensive sickle cell center to describe patterns of disease-related morbidities and acute care utilization, as well as the effects of other comorbid diseases. Results: Of the 71 patients who met inclusion criteria, the majority (59.1%) were insured by Medicaid, 15.5% were insured by Medicare, 14.1% through a commercial insurer, and 11.3% were self-pay. Medicare- and Medicaid-insured patients utilized acute care services more often than those insured by other means. Medicare patients had 124% more acute pain crises than patients insured by other means. Obesity was a risk factor for direct admission to the hospital. Additionally, admissions from the ED were 18.3% lower in females than males, despite the average age of the female cohort being approximately 8 years older than males. Conclusion: For this patient cohort without access to an adult comprehensive sickle cell center, public insurance status through Medicare or Medicaid was associated with more acute care utilization. Obesity and male sex were identified as risk factors for hospitalization. Further study of and targeted interventions for SCD patients in rural and medically underserved communities is warranted.

In this study, a specific and simple method based on the dual priming oligonucleotide (DPO) system was developed to simultaneously detect transmissible gastroenteritis virus (TGEV), porcine epidemic diarrhea virus (PEDV), porcine rotavirus A (PRV-A), porcine delta coronavirus (PDCoV), and swine acute diarrhea syndrome coronavirus (SADS-CoV), associated with the major enteric RNA viruses in pigs. The multiplex RT-PCR method based on the DPO system simplified the primer design and did not require optimization of the annealing temperature. Specificity analysis revealed that the method could specifically detect TGEV, PEDV, PRV-A, PDCoV, and SADS-CoV without any cross-amplification of other circulating swine viruses. The limit of detection of the method was as low as 103–104 copies/μL plasmid of each virus. The method also had good repeatability, and obvious results were seen in three repeat experiments with an interval of 45 days. This optimized multiplex RT-PCR method was used to evaluate 181 clinical swine samples that were collected from four provinces of China between September 2016 and August 2018. The results showed that the positive detection rates of PEDV, PDCoV, SADS-CoV, PRV-A, and TGEV were 30.94% (56/181), 17.67% (32/181), 11.6% (21/181), 9.39% (17/181), and 0.55% (1/181), respectively. Mixed infection of two or more viruses was also common. The DPO system-based multiplex RT-PCR could be a useful tool for detecting enteric virus infections. This method has the advantages of easy operation, low cost, high detection efficiency, and short running time for early diagnosis in clinical cases.

Mulibrey-Nanism (Muscle-liver-brain-eye nanism= dwarfism) is a rare syndrome. The underlying TRIM37 mutation predisposes these children to develop tumors frequently. Wilms tumor has been reported to be associated with this syndrome. Here we report a 2-year-old boy with Wilms tumor and Mulibrey-Nanism and review the published similar cases. Our patient had associated atrial septal defect, atrial flutter and an episode of cardiac arrest along with other features of Mulibrey Nanism. We managed him successfully with chemotherapy and surgery. A total of 14 cases (including present case) of Wilms tumor have been reported in Mulibrey-Nanism. Longest survivor has been 15-year-old.

Japanese encephalitis (JE) is the major cause of viral encephalitis (VE) in most Asian-Pacific countries. In Vietnam, there is no nationwide surveillance system for JE due to lack of medical facilities and diagnoses. Culex tritaeniorhynchus, Culex Vishnui, and Culex quinquefasciatus have been identified as the major JE vectors in Vietnam. The main objective of this study was to forecast a risk map of Culex mosquitoes in Hanoi, which is one of the most densely populated cities in Vietnam. A total of 10,775 female adult Culex mosquitoes were collected from 513 trapping locations. We collected temperature and precipitation information during the study period and its preceding month. In addition, the other predictor variables (e.g., normalized difference vegetation index [NDVI], land use/land cover and human population density), were collected for our analysis. All the collected data was pre-processed with the same study extent and spatial resolution of 30 m. The final model selected for estimating the Culex mosquito abundance included centered rainfall, quadratic term rainfall, rice cover ratio, forest cover ratio, and human population density variables. The estimated spatial distribution of Culex mosquito abundance ranged from 0 to 200. Our model estimated that 87% of the Hanoi area had an abundance of mosquitoes from 0 to 50, whereas approximately 1.2% of the area showed more than 150 mosquitoes, which was mostly in the rural/peri-urban districts. Our findings may provide better insight into understanding the spatial distribution of Culex mosquitoes and its associated environmental risk factors. Such information can assist local clinicians and public health policymakers to identify the potential areas of risk for JE virus. Risk maps can be an efficient way of raising public awareness about the virus and further preventive measures need to be considered in order to prevent outbreaks and onwards transmission of the JE virus.

The ongoing COVID-19 pandemic has highlighted the central role of diagnostic tests in pandemic control. Although reverse transcriptase quantitative real-time PCR (RT-qPCR) is the gold standard for the diagnosis of COVID-19, several rapid antigen tests (RAT) have been commercialized as rapid point-of-care diagnostics. To the best of our knowledge, there are limited data on the effect of patient’s clinical and laboratory parameters on RAT performance and no studies exist that tested the importance of combining laboratory measurements in patient’s blood in enhancing the performance of RAT. Here we tried to fill these gaps by evaluating the diagnostic performance of the RAT “Standard ™ Q COVID-19 Ag” in participant’s subgroups studying the influence of viral load, sampling time-post symptoms, clinical and laboratory features on test performance. Eighty-three nasopharyngeal and oropharyngeal swabs were tested for sever acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) by both RT-qPCR and RAT. Diagnostic accuracy of the RAT was evaluated for participant’s subgroups that have various features. Support vector machine model was then used to investigate whether laboratory measurements in subject’s blood would enhance the predictive accuracy of this RAT. The sensitivity, specificity and accuracy of the RAT were 78.2, 64.2 and 75.9%, respectively. Samples with high viral load and those that were collected within one week post-symptom showed the highest sensitivity and accuracy. Measuring Laboratory indices did not enhance the predictive accuracy of this RAT. It is concluded that “Standard ™ Q COVID-19 Ag” should not be used alone for COVID-19 diagnosis due to its low diagnostic performance. This RAT is best used at early disease stage and in patients with high viral load.

Ewing sarcoma (ES) rarely involves acral regions as the foot. A 4-year-old white female presented with a growing and painful violaceous nodular lesion at the fourth right toe, which appeared 4 months prior to the consultation. MRI reported a nonspecific soft tissue tumor with intense homogeneous contrast uptake. Histopathological examination revealed CD99 positive, small, round, blue cells. EWS-FLI1 fusion gene translocation was detected, consistent with ES. In this report, the authors show the notable response to neoadjuvant chemotherapy of an infrequent foot phalangeal ES.

A document by Chao Chen. Click on the document to view its contents.

ABSTRACT Background: The mandible, the largest and strongest bone in the face, is the only bone in the skull that does not have a sutural joint. Before starting surgical procedures and clinical approaches, it is necessary to know the anatomy of this region well. Materials and methods: It is a radiology-based morphometric study in which retrospectively scanned images of adult individuals in the 20-50 age range, whose results are normally reported using CT (Conical Beam Computed Tomography) {n=212}. Tomographic images, photographed with Planmeca ProMax3DMid ProFace brand CBCT device, was examined using the Planmeca Romexis 4.6.2.R licensed program. Mandibular incisure angle and gonial angle of the mandible were measured from those images. Gender and age-related comparisons were performed. Results: In all groups, the relationship between the right incisure angle and the right gonial angle was determined as a weak positive relationship, but was found to be statistically significant. The Gonial angle is larger in females on both sides of the jaw than in males. In the study of changes in correlation between mandibular incisure and gonial angle depending on age groups, a statistically significant positive correlation was found in the group that we can call young adults, while a significant difference was not observed in the middle age group and the group that we can call old age. Conclusions: Age and gender-based reference values of gonial angle of mandible and mandibular incisure angle were determined. It is the first study in the literature in which the size and shape of the Incisure angle is evaluated on a cross-population and gender basis. We believe that these angles will have many benefits from a clinical point of view.

Background: Despite the high productivity in temperate regions, the olive has a poor yield, under environmental stress due to the inappropriate flower bud development and increment of staminate flowers. Objectives: In this experiment, the effect of irrigation regimes and foliar nutrition with nitrogen, calcium, zinc and boron on this complication was investigated. Methods: Two experimental factors contained irrigation regimes - irrigation to 50 percent of maximum allowable depletion (MAD) (Control) (I50) – increasing the irrigation to 25 percent of MAD during flower initiation (I25init) - increasing the irrigation to 25 percent of MAD during olive flower induction (I25ind), and I25init + I25ind; and foliar nutrition - without treatment (control), and foliar nutrition with 2% urea fertilizer; 2% Ca-EDTA chelate, 9.5% Ca; 0.2 % Zn-EDTA chelate and 0.2 % boric acid, during flower initiation (FNinit), flower induction (FNind) and FNinit + FNind. Results: The results indicated that the increment of irrigation water to 25 percent of MAD during flower initiation along with foliar nutrition at both times had the highest influence on the increment of perfect flowers with 3-4 developed ovules. This treatment had the highest water productivity and fruit oil content and can be recommended for olive groves under drought stress.

In this work, using the theory of functional density (DFT), we studied the electronic structure, elastic and the magnetic properties of quaternary full-Heusler alloys Cr2NbGe1-xSnx. The calculations of the structural parameters, electronic structure and partial density of state (PDOS) are performed using the full-potential linearized augmented plane wave method with the Generalized Gradient Approximation (GGA) as functional of exchange and correlation. Our investigations show that Cu2MnAl-type structures of the Cr2NbGe1-xSnx (x = 0, 0.25, 0.50, 0.75, 1.00) Heusler compounds are more stable than that of Hg2CuTi-type ones. The elastic constants results show that these compounds are mechanically stable. These quaternary Heusler alloys are found to be a complete half-metal with a total magnetic moment of -3.00 µB, the origin of magnetic moment is due to the exchange splitting of Nb-d and Cr-d states. The quasi-harmonic Debye model, as implemented in the Gibbs code, was used to predict the thermal properties of the Cr2NbGe1-xSnx . These alloys seem to be a potential candidate of spintronic devices.

Objective Veno-Arterial Extra Corporeal Life Support (VA ECLS) is widely used as an effective device for patients in cardiogenic shock. The need for predictive markers that daily guide physicians in the evaluation of these patients could be of great value. Our aim was to investigate the role of cholesterol value during VA ECLS in predicting the Intensive Care Unit (ICU) survival. Methods Between January 2013 and November 2019, 67 patients with VA ECLS due to cardiogenic shock were included in this study. Demographic data, laboratory values, ICU data and outcomes were collected. Cholesterol was measured during morning routine blood samples. The minimal cholesterol value during the ICU stay was registered. Groups were stratified by minimal cholesterol cut-off point of 2.0 mmol/L. Logistic regression analysis were performed to identify variables associated with ICU survival. Results The ECLS duration was not significantly different (p=0.36) between the non-survivors (median 5.0 (2.0-7.5) days) and survivors (median 6.0 (1.8-12.0) days). The minimal cholesterol level was significantly lower (p=0.04) in non-survivors group (1.54 (1.00-1.87) mmol/L) compared to survivors (1.85 (1.38-2.24) mmol/L). By using logistic regression analysis, minimal cholesterol level of ≥2.0 mmol/L was associated with a higher ICU survival (p=0.02; OR 3.77; 95% CI 1.20-11.81). Conclusion Cholesterol level could be an additional marker for ICU survival of patients with cardiogenic shock on VA ECLS. A larger cohort of patients is necessary to determine total cholesterol as a specific risk factor for survival in these patients.

1. Above- and belowground biomass allocation is an essential plant functional trait that reflects plant survival strategies and affects belowground biomass estimation in grasslands. However, due to the difficulty in distinguishing fine and living roots, field-based studies show large uncertainties in estimating the biomass allocation. In addition, how plant density regulates biomass allocation across various species remains poorly addressed. 2. To address this knowledge gap, we conducted greenhouse manipulation experiments to explore patterns of above- and belowground biomass allocation and its regulation by planting density in six common grass species of different functional types (i.e., C3 vs C4; annuals vs perennials) in China’s temperate grasslands. The six species were Chenopodium glaucum, Cleistogenes squarrosa, Leymus chinensis, Medicago sativa, Setaria viridis, and Stipa grandis. 3. We found that the mean values of root to shoot ratio (R/S) ranged from 0.04 to 0.92 across the six species, with much lower R/S values in annuals than in perennials (C. glaucum and S. viridis vs C. squarrosa, L. chinensis, M. sativa and S. grandis) and in C4 plants than in C3 plants (C. squarrosa vs L. chinensis, M. sativa and S. grandis). For C. squarrosa, increasing the planting density decreased the shoot biomass fraction (SMF) but increased the root biomass fraction (RMF) and R/S. In contrast, for the other five species, planting density had nonsignificant effects on the SMF, RMF, and R/S. In addition, the planting density significantly affected the allometric relationships between above- and belowground biomass. 4. Synthesis. Our results suggest that R/S values obtained from field investigations are severely overestimated and that the pattern and density regulation of the biomass allocation vary across species of different functional types. Our findings provide important insights into approximating difficult-to-measure belowground biomass with easier-to-measure aboveground biomass in grassland ecosystems, and also provide important theoretical foundations for grass-based livestock husbandry practices.

Keypoints: • The presence of a pharyngeal mucosal space abscesses (PMA), being confined between the pharyngeal mucosa and the pharyngeal constrictor muscle, is considered rare. However, in our series represented 14,3% of deep neck infections (DNIs), suggesting that they may not be so rare as they are considered to be. • PMAs’ symptoms and clinical findings are similar to those of other DNIs, but trismus and neck swelling seem to be significant lower in PMAs. • Imaging studies will set PMA diagnosis, while CT with contrast is the modality of choice. • PMAs seems to be less dangerous than their deep-seated counterparts, since its superficial location renders them amenable to spontaneous drainage, aspiration, incision and drainage intraorally obviating spread to deeper structures.

Malignant histiocytic neoplasm with histiocytic sarcoma phenotype is a rare malignant neoplasm, distinguished by malignant cells with phenotypical characteristics of mature tissue histiocytes. Histiocytic sarcoma typically presents as a primary malignancy, although it can also present as a secondary malignancy, and is rarely seen in the pediatric population. Due to the rarity of this condition, diagnosis of histiocytic sarcoma is difficult and considered a diagnosis of exclusion. We describe a unique case of a chronic upper eyelid lesion with biopsy findings of a highly atypical histiocytic neoplasm concerning for histiocytic sarcoma in a child treated with excision and observation alone.

Resource selection analysis (RSA) is a cornerstone approach for understanding animal distributions, yet there exists no rigorous quantification of sample sizes required to obtain reliable results. We provide closed-form mathematical expressions for both the number of animals and relocations per animal required for parameterising RSA to a given degree of precision. Required sample sizes depend on just two quantities: habitat selection strength and an index of landscape complexity, which we define rigorously. We validate our solutions using 5,678,623 GPS locations from 511 animals from 10 species (omnivores, carnivores, and herbivores from boreal, temperate, and tropical forests, montane woodlands, swamps, and tundra). Our results contradict conventional wisdom by showing that environmental effects on distributions can often be estimated with fewer animals and relocations than assumed, with far-reaching implications for ecologists, conservationists, and natural resource managers.

Objective: This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery. Method: A total of 61 infants with ARDS were eligible and were randomized to the CMV + PS group (n= 30) or the HFOV + PS group (n= 31) between January 2020 and December 2020. The primary outcomes were the improvement of the arterial blood gas analysis. The incidence of mechanical ventilation duration, length of hospitalization, and the incidence of complications were considered as secondary outcomes. Results: A total of 61 infants completed the study. In HFOV + PS group, the blood gas analysis results were significantly improved (P<0.05), while, duration of mechanical ventilation and length of hospitalization were shorter than CMV + PS group (P<0.05). But the incidences of complications had no statistical significance between the two groups (P>0.05). Conclusions: Compared with the CMV + PS group, HFOV + PS significantly improved the ABG variables and shortened the length of hospitalization and mechanical ventilation in infants with ARDS after cardiac surgery.

Morbidity and mortality due to COVID-19 is due to0 severe acute respiratory distress syndrome(SARDS). Majority of victims dies on way to hospital or in ambulance for want of oxygen and ventilator bed. Here we report A case recovered without oxygen irrespective of oxygen saturation 74%.

In this errata sheet, we comment on the definition of the kernel of the continuous fractional wavelet transform (CFrWT) studied in the article “A certain family of fractional wavelet transformations” by Srivastava, Khatterwani and Upadhyay [Mathematical Methods in the Applied Sciences, Vol 42, No. 9, 3103–3122, 2019]. We have modified the definition of the kernel so that results obtained in the paper are true for all non zero values of the dilation parameter.

A prospective study was conducted to address the combined effect of Panax Ginseng and citicoline on human psychomotor performance and visual working memory in normal healthy volunteers. Eighty healthy volunteers were randomly assigned to four groups: Group A (Control group, n=20) was placebo, Group B (Ginseng group, n=20) received Panax Ginseng, Group C (Citicoline group, n=20) received citicoline, and Group D (Combined group, n=20) received Panax Ginseng plus citicoline. Psychomotor performance, vigilance and visual working memory of normal healthy volunteers were assessed before and after 1-month therapy. Panax ginseng led to an improvement in most components of the psychomotor performance measures, arousal function and visual working memory accuracy (p<0.05), but did not significantly affected recognition reaction time (RRT) and 1-back working memory accuracy (p>0.05). Regarding citicoline treatment, it led to an improvement in psychomotor performance measures and visual working memory accuracy (p<0.05), but did not markedly changed arousal and vigilance (p>0.05). When citicoline and Panax ginseng were used in combination, a marked improvement in both psychomotor performances and visual working memory accuracy on healthy volunteers were stated (p<0.01). Panax ginseng and citicoline act synergistically on human psychomotor performance and visual working memory in normal healthy volunteers.