Hydrogen reduction of tungsten oxide is currently the most widely applied ultrafine tungsten powder production process. The process has the advantage of short, pollution free and simple production equipment. But it is difficult to effectively control the morphology and particle size of the tungsten powder because of lacking in-depth understanding of the dynamic mechanism of the process. The first-principles calculations are carried out to explore the diffusion and internal adsorption of hydrogen on the WO-terminated surface of WO3 based on the density functional theory. The results show that hydrogen can diffuse from the WO terminal surface to the inside of WO3, the activation energy of diffusion is 46.682 Kcal/mol. It’s preferable for hydrogen to diffuse from the surface to the inside than diffuse within the WO3 lattice. The adsorption energy of hydrogen on the WO termination surface of WO3 is 15.093 Kcal/mol, the adsorption energy of hydrogen inside the WO termination surface of WO3 is 14.116 Kcal/mol, which means the hydrogen is easier to adsorb inside the WO3 lattice.

We present a reply to the invited commentary by Jubouri and Abdelhaliem published in response to our original article titled: Prevention vs Cure: is BioGlue priming the optimal strategy against E-Vita Neo graft oozing? The authors highlight key issues associated with the E-Vita Open NEO aortic arch prosthesis, chiefly, the propensity for the prosthesis to exhibit post-anastomotic oozing. We read with great interest their commentary and concur that the issues highlighted therein are significant and warrant discussion.

The empirical linear scaling dependencies between the literature (rHo(Xn,TAB)) and the calculated (rHo((Xn)i,CALC)) values of atomization of 31 reference aromatic and related compounds (T=298.15K), as well as their standard errors ((SE4)i(4)i, Stand.Dev.), are determined for the different quantum mechanical (QMi) approaches. These dependencies are compared and used for the determination of the values of rHo((Xn)i,CORRE)±3(SE4)i of atomization reactions of considered not reference aromatic compounds, as well as for the determination of their values of fHo((Xn)i,CORRE)±3(SE4)i. The values of fHo((Xn)i,CORRE)MEAN±3SEYE (≥99.4% confidence interval), determined using the intersections of the 3(SE4)i intervals, are consistent with all QMi approaches and their literature values. The M06-2X/6-311++G(d,p), M08HX/6-311++G(d,p) and wB97XD/6-311++G(d,p) approaches are recommended for the achievement of accuracy (SEYE)≤3.8 kJ/mol of the calculated values of fHo((Xn)i,CORRE)MEAN. The effects of the number of O-H groups, size and multiplicity of compounds on values of error, also studied in this work, demonstrate the limitations of using of several scaled dependencies.

Case presentation: This case report concerns a 49-year-old woman who developed norethisterone drug -induced cholestasis, a progestin contraceptive, which is quite rare complication generally observed with estrogenic component of combined oral contraceptive pill.

Successful pregnancy is a rare phenomenon in women with Wilson's disease. We report a case of a primigravid 19 -years old woman who presented with hemolytic anemia and was later diagnosed with Wilson's disease for the first time during pregnancy. With prompt treatment, she delivered a healthy albeit pre-term child.

We described the clinical, biochemical, hormonal and developmental status of a patient with 49,XXXXY syndrome with routine Fraccaro syndrome features accompanied with sexual masturbation behavior. This study were compiled and summarized the clinical features and also maternal age at birth time in all yet 49,XXXXY reported in the Iranian population.

A 95-year-old man was diagnosed with left pelvis cancer which presented with rapid tumor growth, multiple metastases, and bilateral tender gynecomastia. Elevated serum human chorionic gonadotropin(hCG), prolactin, estradiol, and progesterone were detected. The patient’s condition rapidly deteriorated and he passed away.

Refractory post-operative chylothorax in congenital heart disease is difficult to treat. We present a case of intractable neonatal chylothorax after cardiac surgery due to central lymphatic flow disorder that was treated by creating a lymphovenous anastomosis of the thoracic duct to the left external jugular vein for definitive treatment

In this paper, we consider the stabilization of the generalized Rao-Nakra beam equation, which consists of four wave equations for the longitudinal displacements and the shear angle of the top and bottom layers and one Euler-Bernoulli beam equation for the transversal displacement. Dissipative mechanism are provided through viscous damping for two displacements. The location of the viscous damping are divided into two groups, characterized by whether both of the top and bottom layers are directly damped or otherwise. Each group consists of three cases. We obtain the necessary and sufficient conditions for the cases in group two to be strongly stable. Furthermore, polynomial stability of certain orders are proved. The cases in group one are left for future study.

Objective: To compare emergency department (ED) presentations and hospital admissions for urgent early pregnancy conditions in Victoria before and after the onset of COVID-19 lockdown on 31 March 2020. Design: Population-based retrospective cohort study Setting: Australian state of Victoria Population: Pregnant women presenting to emergency departments or admitted to hospital Methods: We obtained state-wide hospital separation data from the Victorian Emergency Minimum Dataset and the Victorian Admitted Episodes Dataset from January 1, 2018, to October 31, 2020. A linear prediction model based on the pre-COVID period was used to identify the impact of COVID restrictions. Main outcome measures: Monthly ED presentations for miscarriage and ectopic pregnancy, hospital admissions for termination of pregnancy, with subgroup analysis by region, socioeconomic status, disease acuity, hospital type. Results: There was an overall decline in monthly ED presentations and hospital admissions for early pregnancy conditions in metropolitan areas where lockdown restrictions were most stringent. Monthly ED presentations for miscarriage during the COVID period were consistently below predicted, with the nadir in April 2020 (790 observed vs 985 predicted, 95% CI 835-1135). Monthly admissions for termination of pregnancy were also below predicted throughout lockdown, with the nadir in August 2020 (893 observed vs 1116 predicted, 95% CI 905-1326). There was no increase in ED presentations for complications following abortion, ectopic or molar pregnancy during the COVID period. Conclusions: Fewer women in metropolitan Victoria utilized hospital-based care for early pregnancy conditions during the first seven months of the pandemic, without any observable increase in maternal morbidity.

The aim of this work is to study qualitative dynamical properties of a generalized hepatitis B epidemic model and its dynamically consistent discrete model. Positivity, boundedness, the basic reproduction number and asymptotic stability properties of the model are analyzed rigorously. By the Lyapunov stability theory and the Poincare-Bendixson theorem in combination with the Bendixson-Dulac criterion, we show that a disease-free equilibrium point is globally asymptotically stable if the basic reproduction number $\mathcal{R}_0 \leq 1$ and a disease-endemic equilibrium point is globally asymptotically stable whenever $\mathcal{R}_0 > 1$. Next, we apply the Mickens’ methodology to propose a dynamically consistent nonstandard finite difference (NSFD) scheme for the continuous model. By rigorously mathematical analyses, it is proved that the constructed NSFD scheme preserves essential mathematical features of the continuous model for all finite step sizes. Finally, numerical experiments are conducted to illustrate the theoretical findings and to demonstrate advantages of the NSFD scheme over standard ones. The obtained results in this work not only improve but also generalize some existing recognized works.

Characterizing soil water content (SWC) dynamics is a prerequisite for conducting sustainable vegetation restoration on the Chinese Loess Plateau. However, quantifying the variations of the SWC in the deep soil layers remains a challenge because of the different driving factors and the complexity of surface processes. In this study, SWC in 0–10 m of artificial forestlands (AF), apple orchard (AO), native forestland (NF), farmland (maize; FL), and native grassland (NG) were monitored during 2019–2020. The deficit size (DS) and recovery index (RI) were used to explore the effects of vegetation types on SWC. The results showed that the SWCs of forestlands were significantly lower than the SWC of native grassland (12.32%) and tree species significantly affected the SWC. The monthly DS values in forestlands were negative, while those of FL were positive. The DS value in 0-10 m and predictive values below 10 m were negative of forestlands. Thus, tree planting may have consumed soil water at a depth of > 10 m. During the investigation period, soil water was restored in 0–1 m with the positive RI values. In addition, artificial forestlands showed good performance in deep soil water recovery. Canopy density was the controlling factor for soil water restoration. Our results demonstrated that the current afforestation mode used more soil water but was conducive to deep soil water conservation. Therefore, reasonable adjustments should be made according to the local soil and water resources for future vegetation selection and management.

In this article, we study the global well-posedness and large-time behaviors of solutions to the two-dimensional tropical climate system with zero thermal diffusion for a small initial data in the whole space. The main approaches include high and low frequency decomposition method and exploiting the structure of system (1) to obtain the estimates of thermal dissipation. We utilize the time decay properties of the kernels to a linear differential equation to obtain the decay rates of solutions of the low frequency part and the decay property of exponential operator for the high frequency part. The key ingredient here is the explicit large-time decay rate of solutions.

Outer membrane lipoprotein A (OmlA) is a vaccine antigen against porcine contagious pleuropneumonia (PCP), a disease severely affecting the swine industry. Here, we aimed to systematically potentiate the secretory production of OmlA in Corynebacterium glutamicum (C. glutamicum), a widely used microorganism in the food industry, by establishing a holistic development process based on our high-throughput culture platform. The expression patterns, expression element combinations, medium composition, and induction conditions were comprehensively screened or optimized in microwell plates (MWPs), followed by fermentation parameter optimization in a 4×1 L parallel fermentation system (CUBER4). An unprecedented yield of 1.01 g/L OmlA was ultimately achieved in a 5-L bioreactor following the scaling-up strategy of fixed oxygen mass transfer coefficient (kLa), and the produced OmlA antigen showed well-protective immunity against Actinobacillus pleuropneumoniae challenge. This result provides a rapid and reliable pipeline to achieve the hyper-production of OmlA, and possibly other recombinant vaccines, in C. glutamicum.

A novel fermentation process was developed in which renewable electricity is indirectly used as a fermentation substrate, synergistically decreasing both the consumption of sugar as a first generation carbon source and emission of the greenhouse gas CO2. To achieve this, a glucose-based process is co-fed with formic acid, which can be generated by capturing CO2 from fermentation offgas followed by electrochemical reduction with renewable electricity. This ‘closed carbon loop’ concept is demonstrated by a case study in which co-feeding formic acid is shown to significantly increase the yield of biomass on glucose of the industrially relevant yeast species Yarrowia lipolytica. First, the optimal feed ratio of formic acid to glucose is established using chemostat cultivations. Subsequently, guided by a dynamic fermentation process model, a fed-batch protocol is developed and demonstrated on laboratory scale. Finally, the developed fed-batch process is proven to be scalable to pilot scale. An extension of this proven concept to also recycle the O2 that is co-generated with the formic acid to the fermentation process for intensification purposes, and a potential further application of the concept to anaerobic fermentations are discussed.

 In this paper will be presented the unity formulas that connect the fine-structure constant and the proton to electron mass ratio. The equations are simple,elegant and symmetrical in a great physical meaning. At the beginning we will make a review of the last works. We will suggest the exact formula for fine-structure constant in terms of the golden angle,the relativity factor and the fifth power of the golden mean. Also we propose a simple and absolutely accurate expression for the fine-structure constant in terms of the Archimedes constant. After we propose two exact mathematical expressions for the proton to electron mass ratio. It will be presented  the mathematical formulas that connects the proton to electron mass ratio μ,the fine-structure constant α,the ratio Ν1 of electric force to gravitational force between electron and proton,the Avogadro's number NA,the gravitational coupling constant αG of the electron and the gravitational coupling constant of the proton αG(p). Ιt will be explained that the product of the proton to electron mass ratio with the reciprocal of the fine-structure constant is one of the roots of a trigonometric equation. It will also be shown another way to show this trigonometric equation with the exponential form of the equation. The beautiful formula that connects the fine-structure constant,the proton to electron mass ratio and the fifth power of the golden mean. Also the formula that connects the fine-structure constant,the proton to electron mass ratio and mathematical constants π,φ,e and i. Finally we will show that the speed of light and the maximum speed of sound depends only from the fine-structure constant and not from the proton to electron mass ratio.

Objective: Our hypothesis was that the intervention would decrease (or at least not increase) the number of potentially inappropriate medications (PIMs) and the number of hospital readmissions within 30 days of discharge per hospital stay. Methods: A cohort of hospitalized older adults enrolled in the PAERPA integrated care pathway (the exposed cohort) was matched retrospectively with hospitalized older adults not enrolled in the pathway (unexposed cohort) between January 1st, 2015, and December 31st, 2018. It was an analysis of French health administrative database. The inclusion criteria for exposed patients were admission to an acute care department in general hospital, age 75 or over, at least three comorbidities or the prescription of diuretics or oral anticoagulants, discharge alive, and performance of a medication review. Results: For the study population (n=582), the mean ± standard deviation age was 82.9 ± 4.9, and 190 (65.3%) were women. Depending on the definition used, the overall median number of PIMs ranged from 2 [0;3] upon admission to 3 [0;3] at discharge. The intervention was not associated with a significant difference in the mean number of PIMs. Patients in the exposed cohort were half as likely to be readmitted to hospital within 30 days of discharge, relative to patients in the unexposed cohort. Conclusion: Our results show that a medication review was not associated with a decrease in the mean number of PIMs. However, the integrated care intervention including the medication review was associated with a reduction in the number of hospital readmissions at 30 days.

Objectives To investigate whether the Manchester procedure affects the risk and prognosis of endometrial cancer. Design Nationwide historical cohort. Setting The nationwide Danish registers including all residents with lifelong follow-up. Population All Danish women born 1947–2000, living in Denmark at one point during 1977–2018 undergoing the Manchester procedure (N = 23,935) or anterior colporrhaphy (reference group N = 51,008) during 1977–2018. Methods We conducted a nationwide cohort with full follow-up. Chi-Square test for trend to compare the diagnostic stage for the two groups of women. Cox Regression to analyse the risk of endometrial cancer and mortality. The models were adjusted for age, calendar year, income level, and parity. Main outcome measures Number of women diagnosed with endometrial cancer, the stage of endometrial cancer at the time of diagnosis and the cancer specific and overall mortality. Results During the follow up (median 13 years), 271 (1.13%) women were diagnosed with endometrial cancer after the Manchester procedure and 520 (1.05%) after anterior colporrhaphy. The adjusted hazard ratio (HR) for endometrial cancer was 1.00 (95% confidence interval (CI) 0.86 to 1.16). No difference in stage of cancer was found (p=0.18), nor when stratifying for calendar year. The HR for cancer specific mortality and overall mortality after the Manchester procedure was 0.86 (95% CI 0.65 to 1.15) and 0.93 (95% CI 0.77 to 1.12) respectively. Conclusions The Manchester procedure does not affect the risk or prognosis of endometrial cancer. Keywords Epidemiology, endometrial cancer, Manchester procedure, uterine prolapse, pelvic organ prolapse, vaginal hysterectomy

The Universal Health (UHC) movement in its latest iteration, has adopted key objectives of Primary Health Care (PHC). This is a notable shift in the right direction but achieving what appears to be simple targets is a highly complex endeavour across both wealthy and less wealthy countries and jurisdictions. Improving health for all targets requires political-economic, bureaucratic and alignment with bottom-up grass-roots agencies. Despite present successes, there is a need to adapt to constant challenges including pandemics, adverse climate phenomena and political-economic shifts.

Climate warming is an important stressor in freshwater ecosystems, yet its interactive effects with other environmental changes are poorly understood. We address this challenge by testing the ability of three contrasting null models to predict the joint impacts of warming and a second stressor using a new database of 296 experimental combinations. Despite concerns that stressors will interact to cause synergisms, we found that net impacts were best explained by the effect of the worst stressor (the dominance null model). When this stressor’s impact was at least 50% greater than that of the second, the dominance model was most accurate in 62% of responses. Prediction accuracy depended on the identity of the stressors and declined at higher levels of biological organisation. Together these findings suggest we can often effectively forecast impacts of multiple stressors by focusing on the degree of asymmetry that exists among their independent impacts.

Plateau potentials are a critical feature of neuronal excitability, but their all-or-none behavior is not easily captured in modeling. In this study, we investigated models of plateau potentials in multi-compartment neuron models and found that including glutamate spillover provides robust all-or-none behavior. When glutamate spillover is not included, the all-or-none behavior is very sensitive to the steepness of the Mg2+ block. These results suggest a potentially significant role of glutamate spillover in plateau potential generation, providing a mechanism for robust all-or-none behavior across a wide range of slopes of the Mg2+ block curve. We also illustrate the importance of the all-or-none plateau potential behavior for nonlinear computation with regard to the nonlinear feature binding problem.

Objectives: The three dimensional (3D) endoscope is considered as a new surgical tool which used in different approaches in intranasal and anterior skull base surgical procedures. There are many advantages of the 3D endoscopy over the two dimensional (2D) one that have been demonstrated along clinical applications, surgical training and different experimental studies. Our study aimed to show the difference between using the 3D & 2D endoscopes during endonasal and anterior skull base surgery and its importance specially when used by novice users. Design: Our study is divided into two phases (clinical & cadaveric phases).In the clinical study we have done 52 endonasal & anterior skull base surgical procedures (26 study cases and 26 control cases).We recorded accuracy, duration and intraoperative complication for each case. The cadaveric study was performed on three cadavers, difference in accuracy and dissection time were recorded using 3D & 2D endoscopy for each side chosen by randomization. Results: In the clinical study, the cases done by 3D endoscope were significantly faster and more accurate with less intraoperative complications compared to cases done using 2D endoscope. In cadaveric dissection while using 3D endoscope there was better depth of perception regarding the anatomical landmarks compared to 2D endoscope. Conclusion: 3D endoscopy is an advanced instrument that allows better training for the coming generation of ENT surgeons. Both clinical and cadaveric studies offer a promising outcomes in both endonasal and anterior skull base surgery.

The ATP-binding cassette (ABC) transporter superfamily comprises membrane proteins that efflux various substrates across extra- and intra-cellular membranes. Mutations in ABC genes cause 21 human disorders or phenotypes with Mendelian inheritance, including cystic fibrosis, adrenoleukodystrophy, retinal degeneration, cholesterol, and bile transport defects. Common polymorphisms and rare variants in ABC genes are associated with several complex phenotypes such as gout, gallstones, and cholesterol levels. Overexpression or amplification of specific drug efflux genes contributes to chemotherapy multidrug resistance. Conservation of the ATP-binding domains of ABC transporters defines the superfamily members, and phylogenetic analysis groups the 48 human ABC transporters into seven distinct subfamilies. While the conservation of ABC genes across most vertebrate species is high, there is also considerable gene duplication, deletion, and evolutionary diversification.

Being minimally invasive and highly effective, radiofrequency ablation (RFA) is widely used for small size malignant tumors treatment. However, in clinical practice, a large number of tumors are found in irregular shape, while the current RFA devices are hard to control their morphologic appearance of RFA lesions on demand, which usually ends up excessively ablating the tissues and often brings excessively irreversible damage to the organs’ functions. Here, we introduce active cannulas for each of individually-controlled sub-electrodes to achieve an on-demand shape morphing and thus conformal RFA lesion. The shape as well as the length of inserted sub-electrode can be precisely controlled by tuning the expanded length of the active stylet and relative position of the active cannula. Furthermore, owing to independent movement and energy control of each sub-electrodes, our electrode is shown to be not only efficient enough to accomplish accurate trajectory to target tissue in a single insertion, but also adaptive enough to ablate target tissues with diverse morphologic appearances and locations. Potentially, our RFA electrode is a better choice in the future clinical practice for minimally invasive treatments of malignant tumors of which preferred treatment is conformal ablation. Corresponding author(s) Email:    zgwu@hust.edu.cn