In this work, two generalized quantum integral identities are proved by using some parameters. By utilizing these equalities we present several parameterized quantum inequalities for convex mappings. These quantum inequalities generalize many of the important inequalities that exist in the literature, such as quantum trapezoid inequalities, quantum Simpson's inequalities and quantum Newton's inequalities. We also give some new midpoint type inequalities as special cases. The results in this work naturally generalize the results for the Riemann integral.

Objective: To evaluate the associations between fetal α-thalassemia and risk of adverse pregnancy outcomes. Design: Case control study. Setting: Forty-two hospitals in Nanning, China. Participants: Pregnant women >20 weeks of gestation. Methods: Multivariate logistic regression analyses were performed to explore associations between fetal α-thalassemia and adverse pregnancy outcomes. Receiver operating characteristic curve analyses were used to assess the use of selected factors in predicting low Apgar scores. Main Outcome and Measure: Pregnancy outcomes of thalassemic women whose fetuses had non-thalassemia, α-thalassemia trait or HbH disease. Results: With thalassemic women whose fetuses were normal as the reference, fetuses in the HbH disease group showed a higher increase in the odds of Apgar scores being <7 at 1 minute (4.74% vs 1.57%) and 5 minutes (2.84% vs 0.67%). With non-thalassemic women as the reference, this trend was more obvious; whereas the normal fetal group was more likely to be diagnosed with postpartum hemorrhage. Combining fetal HbH disease and gestational age reflected medium accuracy in Apgar predictions. Conclusions: Fetal HbH disease was associated with a higher risk of low Apgar scores. Thalassemic women with normal fetuses may also have an increased risk of postpartum hemorrhage, and should be monitored accordingly. Funding: The Key Research and Development Programs of Nanning, China (No. 20183038 and No. 20193097). Keywords: Fetal alpha-thalassemia; Low Apgar scores; Postpartum hemorrhage. Tweetable abstract: This study shows that fetal HbH disease may increase the risk of low Apgar scores, and that thalassemic women with normal fetuses are prone to postpartum hemorrhage.

We report the case of a drug-refractory paroxysmal atrial fibrillation patient without a left atrial appendage (LAA) proven by transesophageal echocardiography and cardiac computed tomography prior to catheter ablation. Absence of the LAA seems to be congenital according to existing reports. In our case, 3-dimensional electroanatomical mapping indicated that there were large areas of low-voltage electrograms and scar tissue on the anterior wall, but few remaining high-voltage potentials at the usual location of the LAA, which were replaced by just a small uplifted area. These findings suggest that the absence of the LAA in our patient was acquired.

Patients with severe hemophilia are usually diagnosed in infancy due to early onset of abnormal bleeding symptoms that characterize the disease. Affected individuals require coagulation factor routinely or prior to surgical procedures to prevent bleeding and are usually excluded from activities with a high risk of trauma. A 25-year old active-duty soldier was diagnosed with severe congenital hemophilia A after presenting with initial episode of prolonged bleeding. His case demonstrates a rare late presentation of a disease that typically presents in infancy and highlights the need for improving knowledge about bleeding disorders among health workers and the community.

Megalobrama, a genus of cyprinid fish, is an important freshwater economic fish widely distributed in major waters of China. Here, we report the genome resequencing of 180 Megalobrama fish including M. amblycephala, M. skolkovii, M. hoffmanni and M. pellegrini. The results indicated that different geographical Megalobrama populations were separated into six subgroups and M. skolkovii was more closely related to M. pellegrini than other species. Megalobrama was originally distributed in the Pearl River, some spread to Hainan Island due to sea-level fall during the glacial period and others spread to northern China. The introgression provided an important genetic variation source of M. skolkovii populations. M. amblycephala enhanced energy metabolism mainly through fatty acid degradation pathways, while M. skolkovii used cholesterol metabolism pathway to regulate lipid absorption. Taken together, our results provide a valuable genomic resource for future genetic studies to improve genome-assisted breeding of Megalobrama species.

Persistent infection and tumourigenesis by papillomaviruses (PVs) require viral manipulation of various of cellular processes, including those involved in innate immune responses. Herein, we showed that bovine PV (BPV) E5 oncoprotein interacts with a tripartite motif-containing 25 (TRIM25) but not with Riplet in spontaneous BPV infection of urothelial cells of cattle. Statistically significant reduced protein levels of TRIM25, retinoic acid-inducible gene I (RIG-I), and melanoma differentiation-associated gene 5 (MDA5) were detected by Western blot analysis. Real-time quantitative PCR revealed marked transcriptional downregulation of RIG-I and MDA5 in E5-expressing cells compared with healthy urothelial cells. Mitochondrial antiviral signalling (MAVS) protein expression did not vary significantly between diseased and healthy cells. Co-immunoprecipitation studies showed that MAVS interacted with a protein network composed of Sec13, which is a positive regulator of MAVS-mediated RLR antiviral signalling, phosphorylated TANK binding kinase 1 (TBK1), and phosphorylated interferon regulatory factor 3 (IRF3). Immunoblotting revealed significantly low expression levels of Sec13 in BPV-infected cells. Low levels of Sec13 resulted in a weaker host antiviral immune response, as it attenuates MAVS-mediated IRF3 activation. Furthermore, western blot analysis revealed significantly reduced expression levels of pTBK1, which plays an essential role in the activation and phosphorylation of IRF3, a prerequisite for the latter to enter the nucleus to activate type 1 IFN genes. Our results suggested that the innate immune signalling pathway mediated by RIG-I-like receptors (RLRs) was impaired in cells infected with BPVs. Therefore, an effective immune response is not elicited against these viruses, which facilitates persistent viral infection.

Rationale, aims, objectives: Identifying patients with musculoskeletal pain at risk for additional health care use following physical therapy is important for improving the value proposition of physical therapists. We previously identified 3 patient subgroups based on importance of improvement in specific outcomes: 1) Multiple Outcome Domains Important (MDI), 2) Pain and Function Outcomes Important (PFI), and 3) Pain Important (PI). Outcome importance subgroup membership has not been investigated as a potential predictor of future care use. The aim of this study was to determine whether patient-determined outcome importance subgroup membership predicts healthcare utilization subsequent to an episode of physical therapy for musculoskeletal pain. Methods: 246 patients seeking physical therapy that provided 12-month outcome data in the Orthopedic Physical Therapy Investigative Network’s (OPT-IN) Optimal Screening for Prediction of Referral and Outcome (OSPRO) cohort. Demographics, health-related history, numeric pain rating, region specific disability, and comorbidly were collected at baseline. Outcome importance subgroup membership was assigned based on responses to the Patient Centered Outcome Questionnaire (PCOQ). At 1 year, patients reported use of health care since discharge from physical therapy. Separate logistic regression models determined whether outcome importance subgroup membership predicted additional healthcare or use of specific services. Results: The PI subgroup had higher adjusted odds (95% CI) of at least one additional health care service [aOR = 2.40 (1.01-5.71)]; and when specific services were further evaluated there were higher odds of opioid use [aOR = 11.25, (3.50-36.20)], injection [aOR = 4.41, (1.41-13.79)] and surgery [aOR = 5.58, (1.32-23.66)]. There were no differences between the PFI and MDI group for odds of additional health care use or any specific services. Conclusions: Patients with a singular focus on improvements in pain are at higher risk for opioid use, injection, and surgery following an episode of care with a physical therapist.

The origin and dynamics of the metabolic scaling is a fundamental problem in ecology. The famous power law was queried by the notable variations of the power exponent and the non-log-linear curvature of metabolic scaling. Here, we proposed a novel enzyme-driven model of metabolic scaling based on the hypothesis that the key enzyme constrained the relative rate of both metabolism and growth based on the basic biochemical evidences. The predictions were tested by the broad range of compiled database from prokaryotes to higher animals. The results showed that: (1) both metabolism (Q) and body mass (m) were increased with the rate-limiting enzyme activity exponentially, (2) both natural logarithmic metabolism (lnQ) and body mass (lnm) were limiting resource dependent, and (3) lnQ was lnm dependent, that is the non-log-linear scaling, when Q and m had the different half-saturation constant of substrate response (KQ ≠ Km) and log-linear scaling when KQ = Km, which showed how and why the variation of scaling dynamics and the exponent. The results mean that the dynamics of metabolic scaling may be mainly originated from the enzymatic dynamics and the lnQ and lnm dependent model may be more general than the power law of metabolic scaling.

Background Allergen-specific immunotherapy (AIT) is the only disease-modifying treatment for IgE mediated disease. In china, AIT has been applied over 60 years and subcutaneous immunotherapy (SCIT) is the major route. This study analyzed the relatively comprehensive status of SCIT in our country. Methods Patients who initiated SCIT between January 1, 2015, and December 31, 2016 at Peking Union Medical College Hospital were collected and their medical records from January 1, 2015, to December 31, 2019 were obtained. The formulation and adherence of SCIT in different age groups and regions were analyzed. Results A total of 4731 patients receiving SCIT were analyzed, including 459 children (5-12 years), 624 adolescent (13-18 years) and 3648 adults. On a per-species allergen extract basis, multi-allergen SCIT were prescribed in 83% of patients. Mugwort, house dust mite and firebush were most frequently administered. On per-group allergen extract basis, 49% of SCIT were mixing formulations and weed pollen, tree pollen and house dust mite were most frequently used. The most common component of SCIT was mold in children (53%), whereas weed pollen in adolescents (59%) and adults (68%). Overall, 35% of patients completed at least 3-year SCIT. Children had the highest adherence of SCIT, followed by adolescents and adults (49%, 47% and 31%, respectively). Conclusions The majority of patients were prescribed SCIT of mixing formulation. Weed pollen was the most frequently used allergen group in SCIT, especially in Northern China. Real-life adherence in SCIT was still low which desiderate improvement of current procedure of SCIT.

Macro T Wave alternans in incessant orthodromic atrioventricular reentrant tachycardia (AVRT)Debasis Acharya MBBS, MD, DM, PDF. Debasish Das MBBS, MD, PDF.Subhas Pramanik BIAM(AM), DCLT.Department of cardiology, All India Institute of Medical Sciences, Bhubaneswar, India 751019.

To solve the fracture parameters of enamel accurately, we established computational nonhomogeneous enamel models and constructed the fracture element of enamel dumb nodes, based on enamel mineral concentration, nonhomogeneous mechanical properties, and nonhomogeneous finite element method. We constructed the user subroutines UMAT and UEL in ABAQUS to solve the energy release rates of nonhomogeneous enamel structure with cracks. The stress intensity factors of central cracks, three-point bend and compact stretched enamels, double-edge notched stretched enamels and kink notched stretched enamels were determined. By comparing with analytical solutions, we proved the fracture element of enamel dumb nodes is highly accurate, simple and convenient, and the cracks can be other elements rather than singular or special elements, and show versatility and other advantages. The stress intensity factor of dental enamel can be solved more realistically. Thus, a new numerical method for prevention and treatment of dental diseases is provided.

World-wide crop productivity is hugely impacted by diverse eco-environmental conditions. In the present investigation, activation tagged (AT) lines of rice endowed with improved agronomic attributes have been analyzed for tolerance to salinity stress besides identification of genes associated with these attributes. Under salinity stress conditions, AT lines exhibited increased seed germination rates, improved plant growth and development at vegetative and reproductive stages as compared to wild-type (WT) plants. Furthermore, AT lines disclosed enhanced plant water content, photosynthetic efficiency, stomatal conductance, water use efficiency and maximum quantum yield when compared to WT plants, leading to improved yields and delayed onset of stress symptoms. Moreover, AT lines revealed effective antioxidant systems causing decreased accumulation of reactive oxygen species and delayed salinity stress symptoms compared to WT plants. Reduced accumulation of malondialdehyde with concomitant increases in proline and soluble sugars of AT lines further endorsing their improved stress tolerance levels. TAIL and qRT-PCR analyses of AT lines revealed Ds element integrations at different loci and respective overexpression of identified candidate genes involved in various aspects of plant development and stress tolerance. Accordingly, the AT lines plausibly serve as a rare genetic resource for fortifying stress tolerance and productivity traits of elite rice cultivars.

The new coronavirus (Sars-Cov-2) appeared in China in late 2019 and with it an intense search for effective pharmacological tools in the treatment of COVID-19. This virus can cause from mild symptoms, such as dry cough, fever and tiredness, to more severe symptoms, such as respiratory failure and systemic shock. Part of this problem is due to the increase in the neutrophil/lymphocyte ratio and serum levels of several inflammatory cytokines and chemokines. Other blood markers also deflagrate the inflammatory condition, among them C-reactive protein, ferritin and D dimers. Additionally, the history of chronic and/or acute hyperglycemia is an independent predictor for morbidity and mortality in patients with severe acute respiratory syndrome. In this pandemic scenario, numerous new and other drugs already available on the market have become therapeutic tools. Biguanide class drugs, classically used in the treatment of type 2 diabetes mellitus, received great notoriety for potentially useful systemic effects in the clinic, in cardiovascular level and against cancer. Some of their properties may be useful in the fight against Sars-Cov-2, such as the reduction of mRNA expression levels of inflammatory cytokines, chemokines and by the attenuation of NF-κB activation. These actions reduce the inflammatory response in the individual and the damage from a severe inflammatory response. Given the morbidity and mortality, partly attributed to the cardiovascular damage of the COVID-19, the objective of this work was to review the systemic effects of biguanides, as well as their therapeutic potential as an adjuvant.

In this paper, the authors consider an initial boundary value problem for the heat flow of equation of surfaces with constant mean curvatures, which was investigated in [On the heat flow of equation of surfaces of constant mean curvatures, Manuscripta Mathematica, 2011, 134: 259-271] by Huang et al., where global well-posedness and finite time blow-up of regular solutions were obtained. Their results are complemented in this paper in the sense that some new conditions on the initial data are provided for the solutions to develop finite time singularity.

By choosing convenient test functions and using the method of doubling variables, we prove the uniqueness of the solution to a nonlinear evolution dam problem in an arbitrary heterogeneous porous medium of IR^n (n≥2) with an impermeable horizontal bottom.

It is the purpose of this paper to go somewhat deeper into the structure of bipolar soft topological spaces. We shall introduce the concept of bipolar soft compactness. By using bipolar soft sets, this situation it furnishes us a basic tool to investigate the compactness in a more general way. For compactness the hereditary property with respect to bipolar soft closed subsets holds. So, bipolar soft compactness is a good extension. The continuous images of bipolar soft compact sets are bipolar soft compact. If bipolar soft topological space is bipolar soft T₂-space, then it will satisfy a stronger separation axiom which will be called bipolar soft normal space in tis paper. Lately for bipolar soft compactness, the Tychonoff product theorem holds.

Background: The clinical profile of coronavirus disease (COVID-19) has a wide range of symptoms from self-limiting viral upper respiratory tract infection to death from arrest. The symptoms vary depending on the severity of the disease and countries. Experts from many parts of the world report on symptoms and onset times, but there are still many unanswered questions about the new disease, COVID-19. The prevalence of symptoms and, in particular, the relief durations are also questions that need to be answered. Moreover, there is no common algorithm for post-treatment follow-up in this disease, which can cause many organ damage. Method: The aim of this cross-sectional survey study is to find answers to these questions. A total of 185 symptomatic people, who were discharged after inpatient treatment in Elazig Fethi Sekin City Hospital in Turkey in December 2020, voluntarily participated in the study. Volunteers were asked questions about the duration of relief of symptoms after treatment. Results: According to the answers of the participants, it was concluded that the symptoms could persist for more than 1 month and therefore they repeatedly applied to the hospital. Conclusion: The uncertainty about the symptoms and duration of COVID-19 after treatment imposes serious financial burdens on health organizations. Due to this reason, it is urgently necessary to conduct large-scale randomized studies and determine follow-up algorithms after treatment.

This Perspective is intended to raise questions about the conventional interpretation of protein folding. According to the conventional interpretation, developed over many decades, a protein population can visit a vast number of conformations under unfolding conditions, but a single dominant native population emerges under folding conditions. Accordingly, folding comes with a substantial loss of conformational entropy. How is this price paid? The conventional answer is that favorable interactions between and among the side chains can compensate for entropy loss, and moreover, these interactions are responsible for the structural particulars of the native conformation. Challenging this interpretation, the Perspective introduces a proposal that high energy (i.e., unfavorable) excluding interactions winnow the accessible population substantially under physical-chemical conditions that favor folding. Both steric clash and unsatisfied hydrogen bond donors and acceptors are classified as excluding interactions, so called because conformers with such disfavored interactions will be largely excluded from the thermodynamic population. Both excluding interactions and solvent factors that induce compactness are somewhat non-specific, yet together they promote substantial chain organization. Moreover, proteins are built on a backbone scaffold consisting of a-helices and strands of b sheet, where the number of hydrogen bond donors and acceptors is exactly balanced. These repetitive secondary structural elements are the only two conformers that can be both completely hydrogen-bond satisfied and extended indefinitely without encountering a steric clash. Putting the “bottom line” at the top: it is likely that hydrogen-bond satisfaction represents a largely overlooked parameter in protein folding models.

Is it possible to identifySARS-CoV-2 reinfections caused by closely related strains using shotgun sequencing? The analysis of two cases from Ecuador.

Background: Gravity affects the distribution of lung injuries due to gravity-induced nonhomogeneous ventilation leading to lung collapse and subsequently non-uniform lung lesions. Moreover, lung injury gradients gradually develop over time. However, changes in injury distribution after birth have not been investigated in very preterm infants. Methods: Preterm infants of less than 32 weeks’ gestational age were included in this prospective observational study. Gravity-dependent lungs (DL) were defined as dorsal lungs in a supine position or ventral lungs in a prone position, and non-dependent lungs (NDL) were defined as ventral lungs in a supine position or dorsal lungs in a prone position. Infants were assessed using lung ultrasound (LUS), which was performed on days 7, 14, 21, and 28 post-birth. Each anterior and posterior lung was scanned and received an LUS score of 0–3 points. LUS scores of the DL and NDL were compared. Total LUS scores were provided using a 0–6 point scale, which was obtained by adding the scores for each region of each lung. Results: Eighty–eight patients were enrolled in this study. On days 7, 14, and 21, LUS scores between the DL and NDL groups were significantly different (day 7, P = 0.01; day 14, P < 0.001; and day 21, P = 0.003). However, on day 28, there was no significant difference between groups (P = 0.064). Conclusions: LUS can be used to detect gravity-induced lung injury gradients in very preterm infants. Moreover, LUS revealed a trend of gradient improvement over time.

In present communication irreversibility analysis in Sutterby nanofluid flow towards stretching permeable surface is analyzed. Dissipation, heat flux, heat source/sink and Joule heating impacts are scrutinized in energy expression. Physical description of irreversibility analysis is deliberated through second law of thermodynamics. Thermophoresis and random movement characteristics are also accounted. Furthermore first order binary chemical reaction is scrutinized. Ordinary differential system are obtained through similarity transformation. To get convergent series solution we employed ND-solve method. Prominent effect of involved variables on velocity filed, entropy optimization, temperature distribution, Bejan number and concentration are discussed. Skin friction coefficient, gradient of temperature and Sherwood number are numerically analyzed through tables. An increment in velocity field is noted for Reynold and Deborah number. An opposite behavior for velocity and temperature is noticed through magnetic parameter. Larger Schmidt number reduces the concentration distribution. Entropy generation is improved against Reynold and Brinkman numbers. An reverse trend is observed for Bejan number and entropy rate through magnetic parameter

Background: Polyps of the lower reproductive tract are found in 7.8-50% of women. Endometrial polyps located at the fundal and tubocornual regions mechanically affect fertility. The recent advances in TVU and hysteroscopy provide an accurate diagnosis and effective treatment of polyp in the female reproductive tract. Objective: The goal of this systematic review is to highlight updates to the epidemiology, clinical presentation and imaging modalities for gynaecological polyps providing guidance to the best clinical decisions. It also highlights prevalence of infertility in gynaecological polyps. Study Design: Systemic review Material and methods: During December 2020 we searched Google scholar, Pub med, Medscape, Web of Science, Scientific Information Database and Magiran research articles from 2010 -2020. The selected articles identified through electronic search were 60 articles and 50 were selected for the review. Results: Endometrial polyps are the most frequently diagnosed type of gynaecological polyp. They have been implicated in 50% cases of abnormal uterine bleeding and 35% patients with infertility. The developments of high-resolution 2D and 4D ultrasound, contrast sonography and hysteroscopy helps the clinicians in diagnosing polyps efficiently. Hysteroscopy is the gold standard and histology is essential for the ultimate diagnosis and malignancy exclusion. Conclusions: The review of literature suggest that the polyps are common cause of abnormal uterine bleeding and have strong association with infertility. Polyps can be confidently diagnosed on ultrasound with Doppler imaging. Hysteroscopy and histopathological evaluation is considered essential for diagnosis of gynaecological polyps. Key words: Endometrial polyp, Cervical polyp, Infertility, Ultrasonography, Sonohysterography, Hysteroscopy.

Background. In endometriosis, there is an increase in ROS levels and can cause a damage the DNA structures. Objectives. To analyze the effect of mesenchymal stem cells on the expression of BCl2 mRNA, p21 mRNA, and Survivin mRNA in mice with endometriosis models. Material and methods. This study used 42 female mice which were divided into 3 groups, the normal mice group (T0), the positive control group, the endometriosis model group that received placebo (T1) and the endometriosis model mice that received bone marrow mesenchymal stem cells (T2). The stages of this research are: endometrial biopsy, bone marrow isolation for mesenchymal stem cell production, mesenchymal stem cell production, endometriosis model making, mesenchymal stem cell therapy in endometriosis model mice, cumulus-oocyte complex (COC) sample collection. Real-time PCR and Examination of Bcl-2 mRNA expression, p21 mRNA expression, and survivin mRNA expression, using real-time PCR method. Data analysis using ANOVA. Results. There was PKH26 luminescence as a characteristic sign of homing mesenchymal stem cells in the ovaries of mice that received mesenchymal stem cells. The values of Bcl-2 mRNA, p21 mRNA, and survivin mRNA of the three groups were not significantly different (p> 0.05), although the mean Bcl-2 mRNA expression in the endometriosis model group given mesenchymal stem cells was higher than the endometriosis model group. Conclusions. There was no effect between the expression of Bcl-2 mRNA, p21 mRNA, and survivin mRNA on the decrease in apoptosis of granulosa cells in the group of endometriosis model mice that received mesenchymal stem cells.

ABSTRACT Infectious pancreatic necrosis (IPN) is a highly contagious disease causing high mortality in juvenile trouts. Since there is no effective way to treatment against IPNV, early diagnosis and prevention play an important role in combating the disease. The different types of IPNV vaccines (inactive, live, recombinant, DNA, etc) have been produced from local isolates and have been used in developed countries. In Turkey, there is no commercial licensed vaccines against IPNV. Due to this reason, IPNV vaccine is needed in Turkey. The production of recombinant VP2 subunit vaccine (IPNV-VP2) and inactivated whole particle virus vaccine (IPNV-WPV) were attempted from selected isolate belong to sp serotype. For this purpose; the virus was produced in RTG-2 cell line and RT-PCR amplification was performed by using primers with restriction enzymes. The whole VP2 gene was cloned into a plasmid vector and VP2 was expressed by using E. coli expression system. A trial was conducted to determine the immunity ability of IPNV-VP2 and IPNV-WPV in rainbow trout. Relative percent of Survive (RPS) was detected as 79% in fish vaccinated with IPNV-WPV and 70% in fish vaccinated with IPNV-VP2. Thus, we can say that the recombinant vaccine of IPNV-VP2 is almost protected against IPNV infection as well as the inactive vaccine.