We hereby, present the first case of Acute generalized exanthematous pustulosis (AGEP) following treatment with remdesivir in a patient with COVID-19 without hydroxychloroquine use which serves as a reminder for considering remdesivir as a possible causative agent when dealing with AGEP presentation in COVID patients.

We present a rare case of symptomatic giant coronary artery aneurysms due to Kawasaki disease in an elderly patient. Giant coronary aneurysms are uncommon; even more is their association with ischemic symptoms and left coronary system involvement. Treatment can be challenging, and we discuss the management taken in this case.

Atrial fibrillation is an irregular heart rhythm with increased risk of morbidity and mortality. Commonly due to thromboembolism at the left atrial appendage. Guideline therapy for atrial fibrillation is anticoagulation. Alternative treatment includes closure with the Watchman device. We present a case of Watchman device-related thrombus seven months after placement.

Unicuspid aortic valves are rare congenital malformations. Surgical repair is feasible in aortic regurgitation, and in some cases of aortic stenosis. The standard surgical approach is a bicuspidization and symmetrization with pericardial patch augmentation of valve cusps. Herein, we are describing our original technique for bicuspidization of a unicuspid aortic valve without cusp patch augmentation. We also address the surgical management of a commissural diastasis.

Using genus theory, the existence of infinitely many solutions for an anisotropic equation involves subcritical growth is proved. Also by using Krasnoselskii genus and Clark’s theorem, the existence of $k$-pairs of distinct solutions is proved. Finally, the anisotropic equation involves critical growth is considered and the existence of infinitely many solutions is proved.

Objective To investigate the relationship between single nucleotide polymorphisms (SNPs) in human papillomavirus (HPV) receptor gene and HPV susceptibility and the outcomes in Chinese women. Study design A cohort study. Setting Lishui, Zhejiang, China. Population 3066 women were recruited. Methods 29 SNP sites of HPV receptor gene on women with available cytology residual samples were detected. Main outcome measures Develop to cervical intraepithelial neoplasia 2 and worse (CIN2+). Results: 2938 women with sufficient cytology samples performed SNP sites detection. Rs16894821 [GG vs. AA: OR =1.71 (1.08-2.69)] and rs724236 [TT vs. AA: OR=1.73 (1.14-2.62)] in SDC2 increased the HPV susceptibility. TT genotype of rs2575712 in SDC2 was associated with an increased HPV 16/18 susceptibility [OR=2.78 (1.22-6.36)]. Four SNPs (rs1047057 and rs10510097, rs2575735, and rs878949) were significantly associated with HPV persistent infection. In addition, the frequencies of genotype of rs16894821 under recessive model [OR=2.40 (1.12-5.15)] in SDC2, and rs11199993 under dominant model [OR=1.64 (1.01-2.68)] in FGFR2 were significantly associated with the disease progression. Importantly, we found that HPV test in combination with SNPs with sensitivity of 0.51 (0.36-0.66) and specificity of 0.96 (0.96-0.97) in predicting CIN2+ on women with non-HPV16/18+, which had similar performance to HPV test combined with cytology test with sensitivity of 0.44 (0.30-0.60) and specificity of 0.98 (0.97-0.99). Conclusion: Gene variants in HPV receptor related gene may influence the HPV susceptibilities and the outcome of HPV infection. HPV combined with SNPs is a promising alternative to HPV test combined with cytology test in patients with non-HPV16/18 infection.

The optical properties, electronic charge density, electronic structure of the new layered selenides materials, BaGdCuSe3, CsUCuSe3, CsZrCuSe3, and CsGdZnSe3 compounds have been calculated by using the full potential and linear augmented plane wave (FP-LAPW) methods as applied in the WIEN2k package, which is based on the density functional theory. The ALnMSe3 compound’s structure of these was (A= Cs, Ba; Ln = Zr, Gd, U; M= Cu, Zn) is composed of ] (n = 1, 2) layers, which might be separated by A atoms. It is to be observed that there is strong hybridization has been observed between the s, p, and d states of Zr, Gd, and Cu atoms. As the charge density contour, around the gadolinium atom, the charge density contours are completely circular, but the Gadolinium “Gd” atom shows an ionic nature. To calculate the refractive index, we used Kramer’s Kronig correlations with the imaginary part. The decrease in the refractive index is due to the lack of probability for direct excitation of the electrons, resulting in a loss of energy. The value of the static refractive index for all reference compounds is about 1.75 ~ 2.25.

Objectives Long-term survival after coronary artery bypass grafting (CABG) appears superior with bilateral internal thoracic artery (BITA) grafting over grafting a single internal thoracic artery. BITA grafting is recommended in CABG without excessive risk of infection. However, there is concern about an increased risk of sternal wound infection when BITAs are harvested. A recent report demonstrated that sternal closure with rigid plate fixation provided better sternal healing and fewer complications. Thus, a retrospective study was performed to investigate whether BITA grafting can be safely performed in CABG with rigid plate fixation for patients at high risk of sternal wound infection. Methods From June 2017 to December 2018, a total of 31 patients who were deemed preoperatively to be at high risk of sternal wound infection underwent isolated CABG ± pulmonary vein isolation. BITAs were skeletonized, and the chest was closed with rigid plate fixation in all cases. The surgical results were retrospectively reviewed, and the incidence of sternal wound complications was evaluated. Results Each patient had at least 2 risk factors, and the average number of risk factors per patient was 3.1. A total of 14 patients (45%) had obesity, with mean BMI of 31 ± 8.1 kg/m 2, and 27 patients (86%) had diabetes mellitus, with mean HbA1c of 7.6 ± 1.5%. There was one patient with superficial sternal wound infection (3%) and one with wound dehiscence (3%); they were medically treated at the outpatient clinic without readmission. There was no incidence of deep sternal wound infection. Conclusions BITA grafting could be performed in high-risk patients without increasing sternal wound complications. Rigid sternal plating fixation may increase the feasibility of BITA grafting in high-risk patients.

Purposes: Pediatric open cardiac surgical patients usually suffer from acute pain after operation. The aim of this study was to investigate the effect of bilateral PIFB in children undergoing open cardiac surgery. Methods. A group of 110 pediatric patients were randomly allocated to either receive bilateral PIFB (PIF group) or no nerve block (SAL group). The primary endpoint was postoperative pain at rest and exercise. Secondary outcomes included time to drain removal, time to extubation, intraoperative and postoperative fentanyl consumption, time to first feces, length of stay in the ICU and the length of hospital stay. Results. The trends of MOPS were significantly higher at 24 hours after operation both at rest and during coughing in SAL group compared with PIF group. The PIF group reported significantly less intraoperative and postoperative fentanyl consumption. Time to extubation, time to first flatus, length of stay in the ICU and the length of hospital stay were significantly decreased in the PIF group. Conclusion. Bilateral PIFB in pediatric open cardiac surgical patients provide effective analgesia and reduce the length of hospital stay .

A document by Chayma Soltani. Click on the document to view its contents.

Title: Generalized Pustular Psoriasis Triggered by ChAdOx1nCoV-19 Vaccine: a case reportAuthors:Salviano LMOBreda BJRomiti R (MD, PhD)Hirayama ALS (MD)Arnone M (MD)Institution: Department of Dermatology, Hospital das Clínicas, University of São Paulo, São Paulo (SP), BrazilAddress of Institution:Av. Dr Eneas Carvalho de Aguiar, 255, Cerqueira Cesar,São Paulo, SP, Brazil; Post code: 0540300Corresponding author Livia Maria Oliveira Salvianopostal address: Rua Oscar Freire, 1523, apartment 1523, Pinheiros, São Paulo, Brazil; Post code: 05409010E-mail: liviasalviano@gmail.comTelephone number: +55 62 982518945Count: Manuscript: 474 wordsTables: 2Conflict of interestLivia Maria Oliveira Salviano has no conflict of interest.Bruno Jose Breda has no conflict of interest.Ricardo Romiti , MD, PhD, is/has served as a scientific consultant, speaker, or clinical study investigator for AbbVie, Boehringer Ingelheim, Galderma, Janssen-Cilag, Eli-Lilly, Leo-Pharma, Novartis, Pfizer, TEVA, and UCBAndre Hirayama , MD, is/has served as scientific consultant, speaker, or clinical study investigator for Abbvie, Boeheringer-Ingelheim,Janssen, Lilly, Pharma Novartis, Pfizer and RocheMarcelo Arnone , MD, is/has served as scientific consultant, speaker, or clinical study investigator for Abbvie, Boeheringer-Ingelheim, Glenmark, Janssen, Lilly, Leo-Pharma Novartis, Pfizer and UCB BiopharmaShort running title: Pustular Psoriasis after ChAdOx1nCoV-19

This paper documents the bankline dynamics of the Brahmaputra River along the India and Bangladesh region during the period 1976 to 2018. Multiple approaches, including satellite image-based interpretations, fieldwork, and meta-analysis, are performed to explore the factors responsible for the morphological dynamics of the river. Results suggest that the Brahmaputra River has lost ~2686 sq. km of land in the last four decades. Brahmaputra river has also widened ~1.7 km (mean value over the studied reach) during the period. We identified five active erosional sections along the river. The high erosions along these sections are promoted by the past avulsion and the lowlands areas in the floodplain of Brahmaputra. Interestingly, progressive erosions along the active sections of the Brahmaputra River have been sustained for decades to centuries. Sustained and dominant peripheral second order channels (dominant channels) have largely decided such progressive erosions. Interpretation based on historical maps suggests that the observed morphological changes of the Brahmaputra River are the continuation of the river’s recent planform evolution that can be traced back to 2-3 centuries. These rapid morphological changes in Brahmaputra River are conceivably due to high sediment flux, where seismic activities look to be a pragmatic factor.

Abstract : Although COVID-19 is milder in young than adults. However, it can cause pneumonia in children eventually requiring hospitalization. Clinical similarity between COVID-19, other viral, and bacterial pneumonia at initial presentation of the disease caused a great challenge. We aimed to differentiate COVID-19 pneumonia from other viral and bacterial pneumonia in children, and to characterize it . Materials and Methods: This study included 300 children, who were hospitalized with clinically and radiologically confirmed pneumonia during COVID-19 pandemic. Clinical symptoms were collected and analyzed . Cultures , real time polymerase chain transcriptase test for some respiratory viruses and SARS-COV2, C-reactive protein, serum procalcitonin ,serum ferritin , complete blood counts , and ferritin/procalcitonin ratio were done for all patients Results: This study showed that COVID-19 pneumonia was only 15 % of all admitted pneumonia cases. It had low proportion of high fever , mild course, significant lymphopenia , significant thrombocytopenia, low procalcitonin , low C-reactive protein , higher ferritin / procalcitonin ratio , and higher neutrophil/ lymphocyte ratio , significant high percentage of ground glass , and less percentage of consolidation in CT images . Conclusion: During ( COVID-19) outbreak, pneumonia due to COVID-19 was less common , and less severe than that caused by other viruses or bacteria in children. Naso- pharyngeal swabs for multi-respiratory pathogen, including SARS-COV-2, are required to not to attribute most pneumonia cases to be due to COVID-19. However , further large-sample studies are needed to have full blown picture about COVID-19 pneumonia in children.

This case report describes a patient with non-occlusive mesenteric ischemia that developed due to diabetic ketoacidosis. We believe that early diagnosis and intervention may improve the prognosis of non-occlusive mesenteric ischemia that has low vascular risk, with the major risk factor being dehydration due to diabetic ketoacidosis.

In this paper, we study the following eigenvalue problem for Kirchhoff type equation with Hartree nonlinearity: \begin{equation} -M\left(\int_{\mathbb{R}^{N}}|\nabla u|^{2}dx\right)\Delta u+\mu V(x)u=\left( I_{\alpha }\ast Q\left\vert u\right\vert^{p}\right) Q\vert u\vert ^{p-2}u+\lambda f(x)u \quad \text{in}\quad \mathbb{R}^{N}, \end{equation} where $N\geq3, a, \mu>0$ parameters, $M(t)=at+1$, $V\in C(\mathbb{R}^{N},\mathbb{R}% ^{+}) $, $I_{\alpha }$ is the Riesz potential, $Q(x)\in L^{\infty}(\mathbb{R}^{N})$ with changes sign in $\overline{\Omega}:=\left\{V(x)=0\right\}$, and $0

Desert expansions can cause tremendous losses to human well-being. However, the process of shifting from the non-desert state to the desert state, a representation of a system regime shift, remains unclear on the global scale. Clarifying the underpinning pattern, predictors and signals of this process is of great value in advancing understanding of both ecosystem resilience and sustainable developments. Here, we combine the climate classification map and long-term observational land cover data to assess the global desert distribution and its changes from 2000 to 2019. The identified desert areas cover approximately 7.53% of the global land in the past two decades. Only approximately 16.03% of these deserts shows expanding trends, especially in countries such as Tunisia, Tajikistan and Peru. After assessing 26 climatic, ecological and socioeconomic factors that could potentially modify desert expansion rates, vegetation cover diversity was identified as the strongest predictor in both hot and cold deserts, followed by cattle density in hot deserts and desert size in cold deserts. In addition, pronounced high fluctuation in satellite vegetation productivity and flickering between land cover states could serve as two signals for desert conversion and fast expansion, respectively. Our results provide not only a long-term overview of global desert changing patterns but also possible guidance for constraining desert expansion.

In this paper, the ongoing new coronavirus (COVID-19) epidemic is being investigated using a mathematical model. The model depicts the dynamics of infection with several transmission pathways given by general infection functions plus it highlights the significance of the environment as a reservoir for the disease’s propagation and dissemination. We have studied the qualitative behavior of the proposed model representing a system of fractional order differential equations. Under a set of conditions on the general functions and the parameters, we have proven the global asymptotic stability of all equilibria by using the Lyapunov method and LaSalle’s invariance principle. We also carried numerical results using real-world data to confirm the analytical results we obtained.

Implementation of the Natural Forest Protection Project and Grain for Green Programme in China has promoted forest restoration, increased productivity, and enhanced the carbon stocks. However, few studies have characterized temporal and spatial variation in productivity and ecological stability in planted and natural forests and evaluated the factors driving such variation. In this study, we used 1399 permanent forest plots to identify change patters in the productivity and temporal stability of above-ground biomass (AGB) and evaluated the factors driving these changes in planted and natural forests in Sichuan Province, China. The mean temporal stability of AGB was higher for natural forest than for planted forest from 1979 to 2017; While, the productivity of planted forest was higher. The stability decreased at a rate of -0.013 yr-1 in entire natural forest and -0.011 yr-1 in planted forests, and the productivity of natural forest decreased significantly over time, with a slope of -0.0065 Mg ha-1 yr-1 per calendar year. Altitude, latitude, annual precipitation, and stand age dominated variability in the productivity and AGB stability of natural forest. Richness, tree density, and stand age were the determinants of productivity and stability in planted forest. Our results suggest that selective thinning and enriching species richness and forest stand age can effectively balance the productivity and biomass temporal stability of planted forests. Older natural forests still need to be strictly protected under climate change.

Soft tissue malignant tumours of the foot and ankle are rare. Diagnostic imaging and interventional biopsy are vital to establish the nature and grading of a suspicious tumour prior to surgical intervention.

Chikungunya is an arboviral disease caused by a virus with wide geographical distribution in endemic areas. This case report documents a patient with Antisynthetase Syndrome post-chikungunya infection. Autoimmune diseases result from breakdown of immune tolerance. Among all triggers, viruses represent the greatest environmental potential to precipitate inflammatory myopathy.

The artificial planting of grassland serves as the most important means of grassland ecological restoration; however, the impact of artificial planting on soil microbial communities is not well understood. In this study, the evolution of the microbial community structure was studied using 16S and ITS gene sequencing techniques, and the microbial community differences between different forage grasses were analyzed, including different density cropping schemes, multi-year degraded grassland and natural grassland. It was found that the high-density planting scheme of multiple pastures exerts a great impact on soil nutrients as well as on the soil microbial community, effectively increasing the relative abundance of Actinobacteria and Basidiomycota, while the microbial community structure was found to be similar to that of natural grassland. However, in artificial planting treatment, the key node microflora group was noted to be bacteria, which was different from that in natural grassland, in which the key node microflora group was fungi. In comparison, fungi were found to be more sensitive than bacteria to different plantings.The rise in soil fungal diversity did not improve phosphate mineralization.Overall, this study may contribute to understanding the influence of artificial grassland on soil properties as well as the succession of microbial communities, How to accelerate the succession process of grassland ecosystem. which are of great significance in promoting artificial technology to restore the ecological environment.

A 60yr old hypertensive patient presented with inferior wall myocardial infarction. His coronary angiogram showed ectatic coronaries, with a large thrombus in an aneurysmally dilated right coronary artery. Emergency coronary artery bypass grafting was performed, and he was discharged on the seventh post operative day.

The resolution of intelligence tests, in particular numerical sequences, has been of great interest in the evaluation of AI systems. We present a new computational model called KitBit that uses a reduced set of algorithms and their combinations to build a predictive model that finds the underlying pattern in numerical sequences, such as those included in IQ tests and others of much greater complexity. We present the fundamentals of the model and its application in different cases. First, the system is tested on a set of number series used in IQ tests collected from various sources. Next, our model is successfully applied on the sequences used to evaluate the models reported in the literature. In both cases, the system is capable of solving these types of problems in less than a second using standard computing power. Finally, KitBit's algorithms have been applied for the first time to the complete set of entire sequences of the well-known OEIS database. We find a pattern in the form of a list of algorithms and predict the following terms in the largest number of series to date. These results demonstrate the potential of KitBit to solve complex problems that could be represented numerically.

We present a framework for derivation of closed-form continuum equations governing mesoscale dynamics of large particle systems. Balance equations for spatial averages such as density, linear momentum, and energy were previously derived by a number of authors. These equations are exact, but are not in closed form because the stress and the heat flux (e.g. stress in the momentum balance equation) cannot be evaluated without the knowledge of particle positions and velocities. Recently, we proposed a method for approximating exact fluxes by true constitutive equations, that is, using non-local operators acting only on the average density and velocity. In the paper, constitute operators are obtained by using filtered regularization methods from the theory of ill-posed problems. We also formulate conditions on fluctuation statistics which permit approximating these operators by local equations. The performance of the method is tested numerically using Fermi-Pasta-Ulam particle chains with two different potentials: the classical Lennard-Jones, and the purely repulsive potential used in granular materials modeling. The initial conditions incorporate velocity fluctuations on scales that are smaller than the size of the averaging window. Simulation results show good agreement between the exact stress and its closed form approximation.