Background Lung ultrasound (LUS) is widely used to diagnose neonatal respiratory diseases. However, to our knowledge, few straightforward method was reported to predict respiratory support need precisely. Our aim is to determine the diagnostic accuracy of a semiquantitative LUS assessent method predicting the need for respiratory support.  Methods We conducted a prospective diagnostic accuracy study following STARD (Standards for the Reporting of Diagnostic Accuracy Studies) guidelines at a tertiary level academic hospital between 2019 to 2020. 310 late preterm and term infants enrolled. They were delivered in the obstetric department and transferred to a monitoring room to determine whether they need NICU treatment. The LUS assessment was performed for each participant at one of following timings–0.5h, 1h, 2h, 4h, 6h after birth. Reliability was tested by ROC analysis. Surfactant administration and other respiratory support were based on 2019 European guidelines as well as their clinical condition. Results 74 were confirmed to need respiratory support and 236 were healthy according to a 3-day follow up. Six LUS image patterns can be seen in these infants right after birth. Two “high-risk” patterns well relate to respiratory support need(area under the curve(AUC) = 0.95; 95% CI, 0.92-0.98, p<0.001). This reliability can be supported by AUC of “low-risk” patterns(AUC = 0.89, 95%CI, 0.85-0.93, p<0.001). Predictive value of LUS is much greater than that of using respiratory symptoms(e.g.respiratory rate)(AUC of LUS vs AUC of respiratory rate, p<0.01). Conclusions LUS can predict respiratory support need and is more reliable than the assessment based on respiratory symptoms.

Ecologists have long sought to understand the controls of species’ geographic distributions. Two important hypotheses have been that range limits are determined 1) predominantly by climate or 2) by competition in addition to climate, with competitive interactions dominating where climate is benign. If the first hypothesis is correct, the effect of changing climate on species’ distributions should be adequately predicted by climate-only models. Here, we used demographic range models (DRMs) to evaluate the influence of climate and competition on the geographic distribution of Pinus edulis, a desert pine in the southwestern U.S. We parameterized DRMs with data on 23,426 trees in 1,941 forest inventory plots. Vital rate responses were consistent with the predictions of the second hypothesis: negative effects of warm-dry conditions at low-elevation sites and competition at cool-humid, high-elevation sites. Further, including both climate and competition in the DRM yielded a better fit of DRM-predicted population growth rate to the observed distribution than a climate-only DRM. However, at cool-humid sites, negative effects of competition were too weak to offset positive climate effects, resulting in a mismatch between predicted population growth rate and observed distribution. This result leads us to formulate a new hypothesis: climate has complex influences on species’ distributions through its effects on range-limiting processes at a variety of scales, for example, biotic and disturbance feedbacks at community, ecosystem, landscape, and macrosystem scales. The implications of this complex systems hypothesis are that range dynamics may be poorly predictable from static, climate-only models, and may be characterized by sudden changes in abundance, even distribution collapse, with climate change.

Ethylene diamine tetraacetic acid (EDTA) is a chelating agent used worldwide for the phytoextraction of heavy metals as well as household and industrial purposes and persists in the cultivated land for a long time. In this study, the effect of EDTA in the presence and in absence of heavy metal (Chromium) was evaluated on non-hyper accumulating plant rice (Oryza sativa L.) on the hydroponic solution at the cellular and molecular level. EDTA application enhanced phytochelatin (PC) and metallothionein (MT) synthesis, which was assured by up regulation of phytochelatin and metallothionein gene in rice root. However, lower quantity of EDTA (25µM) along with chromium enhanced the chromium (Cr) uptake in root but inhibited its translocation to shoot pointing vacuolar sequestration of excessive chromium in root. One the other hand, in absence of chromium, H2O2 concentration is found to be increased which significantly enhanced electrolyte leakage and lipid peroxidation compared with control plants. The findings of this investigation exhibited that excessive PCs and MTs owing to EDTA enhance reactive oxygen species (ROS) generation in absence of heavy metal (Chromium).

Reaction mechanisms of limonene epoxide isomerization for obtaining dihydrocarvone and carvenone as main products were proposed using three computational methodologies. It was deduced that carvenone can be obtained with a low energetic barrier with respect to dihydrocarvone that is its intermediate; these findings are in accordance with the experimental low selectivity of dihydrocarvone. Apparently, the change in the functional (from B3LYP to PBE, with the same Pople basis set, 6-31++g(d,p)) produces a change in the energetics of the reactions for the synthesis of dihydrocarvone, while in the second part of the reaction mechanism (for obtaining carvenone) did not change after modification of the level of theory (from B3LYP to PBE vs MP2). Based on these results, it is proposed that the reaction mechanism for obtaining both dihydrocarvone and carvenone occurs towards the rearrangement of the carbocation pathway. Reactivity of the carbocations was also analyzed towards the GAPHOMO-LUMO and the charge analysis showed that in some cases, electron withdrawing can be established. The course of the reaction showed in almost all cases that bonds are pure covalent instead of closed-shell interactions. Furthermore, thermodynamic analysis of their stereochemical configuration was also determined; it was concluded that the transformation of cis-limonene epoxide into carvenone is the most spontaneous and exothermic reaction. On the other hand, based on the Gibbs energy it is concluded that cis-limonene epoxide isomerization into trans-dihydrocarvone is the most probable thermodynamic pathway with respect to the other obtained configurations. Finally, kinetic analysis suggests that the determining step corresponds to the elimination of hydrogen to obtain an endo C=C of the carvenone.

Increased animal intensification has led to increased antimicrobial usage (AMU) with consequent antimicrobial resistance (AMR) development. This study assess farmers’ practices regarding AMU in beef cattle farms, explore pathways for AMR dissemination, establish risk status of AMU, and determine residues presence. We hypothesized socio-economic factors not to drive antimicrobial misuse and resistance emergence in beef production systems. Cross-sectional study was conducted on randomly selected beef farms in Northern Nigeria between 2018 and 2019. Traffic Light model was used to assess farms’ AMU risk status. Disc Diffusion Test was performed to detect residues in cattle urine. Descriptive and multivariable logistic regressions analyses were performed at 95% confidence level. Of 660 beef cattle farmers selected, 92.1% (n=608) participated in the study. About 78.9% intensive and 76.6% semi-intensive farmers do not followed instructions on antimicrobial dosage. Also, 72.4% of intensive and 83.9.6% semi-intensive farmers do not observed withdrawal period after AMU on animals. Majorities of intensive (71.5%) and semi-intensive (53.2%) farmers used antimicrobials as growth promoters on beef production. Significantly used antimicrobials on beef cattle were: tetracyclines, sulfonamides, and penicillin. Pathways for AMR spread from beef animals were: consumption of contaminated meat (p=0.007); contacts with contaminated animals and fomites (p<0.001); and contaminated manure and aerosols in environment (p=0.003) Factors that significantly drive antimicrobials misuse and resistance emergence were: inappropriate AMU (OR=2.72; 95% CI:1.93-3.83), non-enforcement of laws (OR=2.98; 95% CI:2.11-4.21), low education and expertise (OR=1.52; 95% CI:1.09-2.12), and management system (OR=10.24; 95% CI:6.75-15.54). Traffic Light model has shown 63.6% intensive and 57.63% semi-intensive farms to be in Class 3 (Red risk) status. Antimicrobial residues were in 48.4% intensively managed and 34.4% semi-intensive farms. The study revealed low practices towards AMU in beef cattle productions. Adequate sanitation and biosecurity, and application of ‘One Health’ will mitigate AMR at animal-human-environment interface.

Background: Most recently, murine kobuvirus (MuKV), a novel recognized member of the family Picornaviridae, has been initially identified from fecal samples of Rattus norvegicus in China. The circulation of MuKV from other murine rodent species is not fully understood, prompted us to investigate the prevalence and genetic characterization of MuKV in Rattus losea, Rattus tanezumi and Rattus norvegicus in Southern China. Results: Between 2015 and 2017, a total of 243 fecal samples from three murine rodent species were screened for the presence of murine kobuvirus (MuKV) from three cities in Southern China, with an overall prevalence of 23.0% (56/243). Phylogenetic analysis based on the complete VP1 gene suggested our sequences were genetically closely related to each other and the Chinese strains. Three complete polyprotein nucleotide sequences of MuKV and the genome organization were acquired in the present study. Phylogenetic analyses also showed our sequences belong to the members of genus Kobuvirus within the genotype of Achivirus A. Conclusion: The present study indicated that MuKV is very common in murine rodent populations.

In this work oplus-e-supplemented modules are defined and some properties of these modules are investigated. It is proved that the finite direct sum of oplus-e-supplemented modules is also oplus-e-supplemented. Let M be a distributive and oplus-e-supplemented R-module. Then every factor module and homomorphic image of M are oplus-e-supplemented. Let M be a oplus-e-supplemented R-module with SSP property. Then every direct summand of M is oplus-e-supplemented.

Background: Bronchopulmonary dysplasia (BPD) is the most common morbidity complicating preterm birth. The soluble receptor for advanced glycosylated end-products (sRAGE) is impilicated in the development of various disease such as pulmonary diseases. The objectives of this study were to evaluate the perinatal factors associated with serum sRAGE levels at birth and to establish whether serum sRAGE levels at birth could be potential biomarkers for BPD. Methods: A total of 124 subjects included 84 preterm and 40 healthy infants were included in this study. Among 84 infants born at less than 32 weeks were categorized into BPD neonates (n=34) and non-BPD infants (n=50). The median serum sRAGE levels in cord blood were measured using an enzyme-linked immunosorbent assay. Results: There were significant positive correlations between gestational age, birth weight, and serum sRAGE levels at birth. Among preterm infants born at less than 32 weeks, serum sRAGE levels at birth were significantly lower in infants with BPD than without. However, serum RAGE levels were not associated with severity of BPD. Conclusions: Serum sRAGE levels at birth were significantly correlated with BW and GA. Furthermore, serum sRAGE levels at birth could serve as a biomarker for predicting BPD, but not its severity.

This paper will introduce the Fourier spectral method combined with the strongly stable exponential time difference method as an attractive and easy-to-implement alternative for the integration of multi-dimensional Allen-Cahn equations with no-flux boundary conditions. The main advantages of the proposed method are that it utilizes the discrete fast Fourier transform which ensures efficiency, allows an extension to two and three spatial dimensions in a similar fashion as one-dimensional problem, and deal with various boundary conditions. Several numerical experiments are carried out on multi-dimensional Allen-Cahn equations to demonstrate the fourth-order temporal accuracy and stability of the method. The numerical results showed that the proposed method is fourth-order accurate in the time direction and is able to satisfy the discrete energy law.

A document by Melissa Fesler. Click on the document to view its contents.

In this case, we report a patient with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis, mainly manifesting as fever, no liver function damage or HLH related gene mutation. After treated with cortisol and intravenous immunoglobulin, the fever got controlled and most aboratory examinations returned to normal. It suggests that we should attach importance to individualized stratified treatment in clinical practice, avoid overtreatment, and reduce the toxic and side effects of drugs.

A whole cell biocatalyst for the production of D-Valine from 5’-isopropyl hydantoin by co-expression of the D-hydantoinase (hyd) gene from Pseudomonas putia YZ-26 and D-N-carbamoylase (cab) gene from Sinorhizobium sp. SS-ori in Escherichia coli BL 21 (DE3) was developed. The expression conditions of D-hydantoinase (HYD) and D-N-carbmoylase (CAB) for recombinant cells were optimized. The cells showed the highest HYD and CAB activities (4.650 and 0.75 U/ml-borth, respectively) after 20-h fermentation. The cells of engineered strain HC01 were immobilized in the form of Ca2+-alginate beads, and the conditions for immobilization were investigated. The optimal gel concentration and cell concentration were found to be 2.5% and 0.029 g/mL in the presence of 3% CaCl2. The thermo-stability of immobilized cells was 5 ℃ higher than that of free cells in the same condition. Divalent metal ions, such as Mn2+, Mg2+, Cu2+, Co2+ and Ni2+ did not affect significantly the enzymatic activity of HYD and CAB in immobilized cells. Conversion of about 91.4% was reached after 42-h reaction when the substrate concentration was 50 mmol/L with the initial pH of 9.0 under the protection of nitrogen. With the optimized amino acid purification process, the overall yield of D-Valine was 72.2% with the optical purity of 96.7%.

Endometritis is among the most common bovine uterine diseases. It may cause infertility and affect the sustenance and progress of the cattle industry. In this study, a novel metabolomics technique based on ultra-performance liquid chromatography/ quadrupole time-of-flight mass spectrometry was used to compare the uterine secretion metabolomics of healthy cows and those with clinical endometritis, classified based on clinical symptoms. Univariate and multivariate statistical analyses identified significant differences between groups. Compared with healthy uterine secretion samples, coumaric acid, benzoic acid, and equol were downregulated in the clinical endometritis samples. However, L-phenylalanine, glutamine, succinic acid, linoleate, arachidonic acid, and other metabolites were significantly upregulated, revealing significant variations between healthy cows and those with endometritis (p < 0.05). This metabolomics approach may provide a more in-depth understanding of the pathobiology of endometritis and a theoretical framework for the diagnosis and treatment of bovine endometritis.

Background: Clinical trajectory and potential predictors for post-acute covid-19 are largely unknown. Methods: One hundred fifty one patients with COVID-19 infection and features suggestive of pneumonia were enrolled in the analysis. Results: Mild lung injury and high platelet mean volume(PMV) were predictors for complete recovery. Low Hb at presentation, length of ICU stay, extensive lung injury, old age and shortness of breath at presentation were predictors for persistent shortness of breath, while high Hb, extensive lung injury, and productive cough at presentation were predictors for persistent fatigue. Conclusion: mild lung injury and high PMV were predictors for complete recovery.

In regard to the global pandemic of COVID-19, it seems that persons with epilepsy (PWE) are not more vulnerable to get infected by SARS-CoV-2, nor are they more susceptible to a critical course of the disease. However, management of acute seizures in patients with COVID-19 as well as management of PWE and COVID-19 needs to consider potential drug-drug interactions between antiseizure drugs and candidate drugs currently assessed as therapeutic options for COVID-19. Repurposing of several licensed and investigational drugs is discussed for therapeutic management of COVID-19. While for none of these approaches, efficacy and tolerability has been confirmed yet in sufficiently powered and controlled clinical studies, testing is ongoing with multiple clinical trials worldwide. Here, we have summarized the possible mechanisms of action of drugs currently considered as potential therapeutic options for COVID-19 management along with possible and confirmed drug-drug interactions that should be considered for a combination of antiseizure drugs and COVID-19 candidate drugs.

Introduction The incidence of new-onset atrial high-rate episode (AHRE) is higher among patients with cardiac implantable electronic devices (CIEDs) than in the general population. We sought to elucidate the clinical factors including P-wave dispersion (PWD) in sinus rhythm associated with AHRE in CIED patients. Methods and results One hundred one patients with newly implanted CIEDs from 2010 to 2014 at our institute were included. PWD was measured at the time of device implantation via a body-surface electrocardiogram. AHRE was defined as any episode of sustained atrial tachyarrhythmia (>170 bpm) recorded in the device’s memory. Patients were divided into an AHRE group (n=34) and non-AHRE group (n=67) in accordance with the presence or absence of AHRE within one year of device implantation and compared. The mean age was 75 ± 11 years old. A greater incidence of sick sinus syndrome (p=0.05) and longer PWD (62.6 ± 13.1 vs. 38.2 ± 13.9 ms; p<0.0001) were apparent in the AHRE group. Multivariate analysis revealed that PWD was an independent predicting factor for new-onset AHRE (odds ratio: 1.11; 95% confidence interval: 1.06–1.17; p<0.0001). In the logistic regression analysis, the receiver-operating characteristic curve (area under the curve: 0.90; p<0.001) suggested the best cutoff value for PWD was 48 mm, achieving a sensitivity of 73.8% and specificity of 77.9%. Conclusion PWD is a simple but feasible predictor for new-onset AHRE in patients with cardiac implantable electronic devices.

Objective To determine whether vaginal progesterone (VP) reduces the rate of preterm birth in pregnant women after abdominal trachelectomy (AT) for early-stage cervical cancer Design Prospective cohort study with a historical cohort Setting University hospital Population Twelve pregnancies in ten women were included in the VP group between October 2016 and September 2020. By contrast, 19 pregnancies in 17 women were included in the historical control group between January 2007 and September 2016. Methods For the interventional study participants, the administration of vaginal progesterone was started between 16+0 and 19+6 weeks of gestation and discontinued at 34 weeks of gestation or at the time of delivery, rupture of membranes, or massive uterine bleeding, whichever occurred first. We investigated obstetric and neonatal outcomes among the study participants and compared them with outcomes of the historical control group participants. Main Outcome Measures The gestational age at delivery and incidence of preterm birth before 37 weeks and 34 weeks of gestation Results The incidence of preterm birth at <37 weeks was 10/12 (83%) in the VP group and 11/19 (58%) in the control group, and the incidence of preterm birth at <34 weeks was 6/12 (50%) in the VP group and 9/19 (47%) in the control group. The incidence of preterm birth in the two groups was similar, and the difference between the two groups was not statistically significant. Conclusions The administration of vaginal progesterone did not reduce the rate of preterm birth among pregnant women after AT.

Jejunal feeding is increasingly utilized in the pediatric population to reduce gastroesophageal reflux or aspiration pneumonia. We describe a pediatric patient who developed persistent neutropenia and anemia secondary to copper deficiency after more than one year of exclusive jejunal feeding. Bone marrow aspiration and trephine biopsy showed vacuolated myeloid and erythroid precursors compatible with copper deficiency. Short term treatment with mineral mixture powder including copper reversed the hematological abnormalities. This report highlights the risk of micronutrient deficiency and the haematological manifestations as a result of acquired copper deficiency in pediatric patients receiving long term jejunal feeding.

We report the case of a 12-year-old girl, who presented with floaters and a white-to-cream peripheral retinal mass in her left eye. No intrinsic calcifications in B-scan ultrasonography and CT scan of the orbits were present and MRI showed a homogenously enhancing peripheral retinal mass with restricted diffusion. Due to close contact with puppies, the patient was initially treated for ocular toxocariasis. However, one month later she developed anterior chamber seeding and anterior chamber tap showed group E retinoblastoma (RB). This case underlines that RB may occur in older ages with atypical manifestations, such as uveitis and absence of calcifications.

Naringin (Nar), a natural flavanone glycoside, has been shown to possess a variety of biological activities, including anti-inflammatory, anti-apoptotic and bone formation, etc. In this study, Nar was oxidized by sodium periodate and the oxidized naringin (ONar) was used as a novel biological crosslinking agent. And ONar-fixed porcine decellularized Achilles tendon (DAT) was developed to substitute anterior cruciate ligament (ACL) for researching a novel ACL replacement materials. The ONar with a 24 h oxidation time had appropriate aldehyde group content, almost no cytotoxicity, and a good crosslinking effect. The critical characteristics and cytocompatibility of ONar-fixed DAT were also investigated. The results demonstrated that 1% ONar-fixed DAT exhibited good resistance to enzymatic degradation and thermal stability as well as suitable mechanical strength. Moreover, 1% ONar-fixed specimens exhibited excellent L929 fibroblasts-cytocompatibility and MC3T3-E1-cytocompatibility. They also promoted the secretion of hepatocyte growth factor (HGF) and basic fibroblast growth factor (bFGF) from fibroblasts and bone morphogenetic protein-2 (BMP-2) from osteoblasts. And they also showed the good anti-inflammatory properties in vivo experiments. Our data provided an experimental basis for ONar as a new cross-linking reagent in chemical modification of DAT and ONar-fixed DAT for ACL repair.

Bile leak after cholecystectomy is associated with significant comorbidity. Biliary duct variant anatomy can complicate identification and management. We report a very rare presentation of recurrent delayed bile leaks years after laparoscopic cholecystectomy secondary to missed right posterior sectoral bile duct injury. Surgical intervention was required after failure of conservative management.Key clinical message: Right posterior sectoral duct injury should be considered in patients presenting with a delayed recurrent bile leak. Deep dissection into liver parenchyma during gallbladder fossa dissection should be avoided to prevent occurrence of such injuries.

The Human Dopamine Transporter (hDAT) plays an essential role in modulating the Influx/Efflux of dopamine, and it is involved in the mechanism of certain neurodegenerative diseases such as Parkinson’s disease. Macromolecules adopt many conformations in solution depending on their structure and shape, which determine their dynamics and function. In this context, several studies have reported important meta-states for Dopamine transport: outward-facing open state (OFo), the outward-facing closed state (OFc), the holo-occluded state closed (holo), and the inward-facing open state (IFo). Furthermore, experimental assays have shown that different phosphorylation conditions can affect the rate of dopamine absorption. This work presents a protocol using hybrid simulation methods to study the conformational dynamics and stability of meta-states of hDAT under different phosphorylation states. With this protocol, we explored the conformational space of hDAT, identified the meta-states, and evaluated the free energy differences and the transition probabilities between them in each of the phosphorylation cases. We also presented the conformational changes and correlated them with those described in the literature. The results suggest that the phosphorylation corresponding to NP-333, where (all sites [Ser/Thr](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380854/) from residue 2 to 62 and residue 254 to 613 are phosphorylated, except residue 333) is the one that would affect dopamine transport the most, corroborating the experimental results. Furthermore, our results showed that just single phosphorylation/dephosphorylation could alter intrinsic protein motions affecting the sampling of one or more meta-states necessary for dopamine transport. In this sense, the modification of phosphorylation influences protein movements and conformational preferences, affecting the stability of meta-states and the transition between them and, therefore, the transport.

The Tanzania-Zambia (TANZAM) Highway traversing Mikumi National Park (MINAPA) has been a concern for wildlife managers since it was first paved in 1973-74. After its upgrade in 1989-90, researchers have documented increasing traffic resulting in considerable animal injuries and mortalities. Yellow baboons in MINAPA are known to use the road as their bridge to and from foraging areas, therefore in addition to the risk of mortality; road use could potentially have significant influence on their feeding behaviour. However, knowledge on the influences of the TANZAM highway in the feeding behaviour of the baboons is sparse. Using focal animal sampling techniques, we collected data on feeding and foraging behaviour of two habituated troops of yellow baboons to examine to what extent the TANZAM highway is important in their feeding and foraging behaviour. Results showed that in relation to habitat availability, visitation to habitat types reflect actual habitat choice of baboons. In general, baboons less frequently visit and spent less time in the highway compared to natural habitats. Whenever they were on the highway, adult females and subadult males engage more into feeding, resting and socializing, while adult males were more vigilant. The major dietary compositions were fruits, seeds, leaves, sap and invertebrates, almost exclusively collected from natural habitats, foods from the highway were opportunistically consumed. This study provides empirical evidence and concludes that yellow baboons do not directly depend on the highway for food, rather they use the TANZAM highway as normal part of their home range. The TANZAM highway is used because it improves visibility and reduces the perceived predation risk compared to natural habitats. However, its location near sleeping sites may have significant impact on baboons’ activity budget. With these findings, we recommend strict implementation of rules against park littering and animal feeding in protected areas traversed by highways.

Following the invasion of Africa by the oriental fruit fly, Bactrocera dorsalis, Classical biological control (CBC) have been exploited as a safer alternative for its suppression by the introduction and release of the koinobiont endoparasitoid, Fopius arisanus. Although, the parasitoids have been released in several African countries, its extent of dispersal resulting in numbers of beneficiaries fruit growers has not yet been elucidated. This paper proposes an innovative multi-level CBC impact analysis combining cellular automata (CA) and ecological niche models to estimate parasitoid dispersal ranges and household beneficiary populations. Firstly, we provide a generic systematic methodological approach using CA rules incorporated into species distribution. Secondly, the model was used to estimate the dispersal range of the parasitoid based on the life history and bioecology of the host insect (fruit fly) and the parasitoid. Finally, the parasitoid dispersal coverage was mapped across fruit crops attacked by the target fruit fly, and the number of households that have benefitted from the parasitoids release programme was extracted from the area of the dispersal (first in Kenya), and the data was projected across all countries where the parasitoid have been released and validated. In Kenya, the model showed that F. arisanus had covered a total area of 50.34 km2 from the initial point of open field release; and at the continental scale, the model predicted that the parasitoid had covered a total area of 229.97 km2. The model estimated that 351,855 and 3,731,330 households have directly benefited from the release of F. arisanus between 2013 to 2018 in Kenya and at the continental level, respectively. The study’s outcome is appropriate for providing feedback information on the impact of CBC to government and development partners to make informed decisions on technological interventions.