Animals exhibit variation in their space and time use across an urban-rural gradient. As the top-down influences of apex predators wane due to human-driven declines, landscape level anthropogenic pressures are rising. Human impacts can be analogous to apex predators in that humans can drive increased mortality in both prey species and carnivores, and impact communities through indirect fear effects and food subsidies. Here, we evaluate the time use of a common mesocarnivore across an urban rural gradient, and test whether it is influenced by the intensity of use of a larger carnivore. Using multiple camera-trap surveys, we compared the temporal response of a small carnivore, the raccoon (Procyon lotor), to the larger coyote (Canis latrans) at four sites across Michigan that represented a gradient of pressure from humans. We found that raccoon time use varied by site and was most unique at the rural extreme. Raccoons consistently did not shift their activity pattern in response to coyotes at the site with the highest anthropogenic pressures despite considerable interannual variation, and instead showed the stronger responses to coyotes at more rural sites. Temporal shifts were characterized by raccoons being more diurnal in areas of high coyote activity. We conclude that raccoons do partition time to avoid coyotes. Our results highlight that the variation in raccoon time use across the entirety of the urban-rural gradient needed to be considered, as anthropogenic pressures may dominate and obscure the dynamics of this interaction. In an increasingly anthropocentric world, to understand species interactions, it is imperative that we consider the entire spectrum of human pressures that it may occur within.

The Add-my-Pet (AmP) collection of data on energetics and Dynamic Energy Budget (DEB) parameters currently contains 92 species of turtles and 23 species of crocodiles. We discuss patterns of eco-physiological traits of turtles and crocodiles, as functions of parameter values, and compare them with other taxa. Turtles and crocodiles accurately match the general rule that the life-time cumulated neonate mass production equals ultimate weight. The weight at birth for reptiles scales with ultimate weight to the power 0.6. The scaling exponent is between that of amphibians and birds, while that for mammals is close to 1. We explain why this points to limitations imposed by embryonic respiration, the role of water stress and the accumulation of nitrogen waste during the embryo stage. Weight at puberty is proportional to ultimate weight, and is the largest for crocodiles, followed by that of turtles. These facts explain why the precociality coefficient – approximated by the ratio of weight at birth and weight at puberty at abundant food – decreases with ultimate weight. It is the smallest for crocodile,s because of their large size, while that lizards and snakes are much larger than for turtles. The maximum reserve capacity in both turtles and crocodiles clearly decreases with the precociality coefficient. This relationship has not be found that clearly in other taxa, not even in other reptiles. Crocodiles have a relatively large assimilation rate and, as consequence, a large reserve capacity. Sea-turtles have a small weight and age at birth, which we link to reducing risks on the beach.

Here we present two cases in older adult patients with highly destructive changes in ankle joints (Larsen Grade IV) and who underwent retrograde intramedullary nail fixation with fins. In both patients, bony union was achieved, full weight-bearing was attained 3 months after surgery and good functional outcome was acquired.

The ultrarare hepatoblastoma is the most common pediatric liver cancer. HB risk is related to a few rare syndromes, and the molecular bases remain elusive for most cases. We investigated the burden of rare damaging germline variants in 30 Brazilian patients with HB. A high frequency of prematurity (20%) and birth defects (37%), especially craniofacial (17%, including craniosynostosis) and kidney (7%) anomalies, was observed. Pathogenic or likely pathogenic variants mapped to 10 cancer predisposition genes (APC, CHEK2, DROSHA, ERCC5, FAH, MSH2, MUTYH, RPS19, TGFBR2 and VHL,) were detected in 33% of the patients, only 40% of them with a family history of cancer. These findings showed a predominance of CPGs with a known link to gastrointestinal/colorectal and renal cancer risk. A remarkable feature was an enrichment of rare damaging variants affecting different classes of DNA repair genes, particularly those known as Fanconi anemia genes. Moreover, several damaging rare variants mapped to genes impacting liver functions were observed. To our knowledge, this is the first comprehensive assessment of rare germline variants in HB patients, contributing to elucidating the genetic architecture of HB risk.

Background: Children with cancer experience decreased quality of life. The National Institutes of Health has recommended examination of quality of life factors to promote development of clinical interventions to reduce suffering. Measuring quality of life in children based on self-report instruments is limited by subjectivity, age, and developmental stage. Assessment of posture is a pioneering objective physical measure that may augment quality of life preceptions among individuals with cancer. Procedure: This systematic literature review synthesized published evidence regarding the relationship between posture and quality of life. A systematic search using PRISMA guidelines identified articles describing studies of human subjects that included the variables of a) posture measured by the standard thoracic kyphosis angle; and b) quality of life or depression/mood. A total of 14 eligible studies met inclusion criteria (published 2000-2018). Studies were graded for level of evidence and themes were identified. Results: No studies were found in children with cancer. The majority of the studies (8 of 14) were rated at the moderate level. Key review findings include evidence supporting: 1) a consistent bidirectional relationship between posture and quality of life; 2) that when posture improves, quality of life also increases; and when depression decreases, posture improves; and 3) emotion is expressed through posture. Conclusion: If posture is a sensitive and precise measure of quality of life, it could strengthen existing measurements and give a more complete picture to in turn identify children who may benefit from supportive care interventions during cancer treatment.

Objective: To evaluate the relationship between lower respiratory tract infections (LRTI), in the first 2 years of life and lung function at school age in the Piccolipiù birth cohort (Italy). Methods: Data on LRTI (doctor diagnosis of bronchitis, bronchiolitis, pneumonia) and wheezing (≥3 episodes or a diagnosis of asthmatic bronchitis) in the first 2 years of life were obtained from parental questionnaires. Lung function was assessed at 7 years by spirometry and forced volume vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, forced expiratory flow between 25 and 75%, and at 75% of FVC (FEF25-75 and FEF75) were reported as z-scores. The associations between LRTI and spirometric variables were estimated with linear regression models. Results: Among 877 children studied, 22.1% had LRTI only, 5.4% wheezing only, 13.2% had both, and 59.3% had neither LRTI nor wheezing. Children with LRTI had lower FVC and FEV1 than children without (z-score differences: -0.18 (95% Confidence Intervals, -0.31; -0.06) and -0.15 ( 0.27; -0.03)). When children were stratified by history of both LRTI and wheezing, there was no association between LRTI only and spirometric values. Conversely, having had both LRTI and wheezing was inversely associated with all lung function measures: z-score differences of -0.24 ( 0.42; -0.07); -0.42 (-0.59; -0.24); -0.25 (-0.41; -0.08); -0.37 (-0.54; -0.21); -0.30 (-0.46; -0.14) for FVC, FEV1, FEV1/FVC, FEF25-75 and FEF75, respectively. Conclusion: Infants with wheezing and LRTI, but not those with LRTI only, had reduced lung function at school-age.

In 2010, the Iron Disorders Institute published the first seminal article on the underestimated risk of a homozygous HFE gene H63D mutation. This short but important article has lost none of its relevance. Since it is in danger of being forgotten and disappearing from more and more websites, we are publishing a reprint of the still seminal article, expanded with some new findings.

Background: The study objective was to test underlying physical laws behind a proposed novel device for failing Fontan and investigate whether the device could be implemented theoretically to improve hemodynamics in failing Fontan circulation. Methods: A 4-arm setup was designed and fabricated to simulate an actual Fontan circuit in the form of a junction of the superior and inferior vena cavae (SVC, IVC) with the right and left pulmonary arteries (RPA, LPA). A provision for placement of an oscillating ball along the RPA-LPA path to push fluid away from SVC and IVC was created. The rate of ball oscillations and initial pressure of fluid on SVC and IVC limbs were varied. The pressure-drop times in the vena cavae limbs were measured at varying ball oscillations and resistances in the RPA-LPA pathway. The test was considered positive if increasing oscillations of the ball allowed for quicker pressure drop in the SVC and IVC limbs indicating quicker discharge of fluid through the RPA and LPA. 48 different experiments were conducted to simulate different physical conditions and the results were plotted and analyzed to draw a conclusion. Results: The time required for pressure drop in the experiment without ball was the least across all set of readings. This meant that placing an oscillating ball along the RPA -LPA path created obstruction to flow rather than enhance it. Increasing rate of ball oscillations increased degree of obstruction to flow. Conclusion: The proposed interventional method is unsuitable for improving hemodynamics in failing Fontan circulation.

In the COVID-19 pandemic, the overlap of clinical features between the other viral infections, make a reliable diagnosis difficult in the initial stage of illness. We describe the first confirmed case of CCHF in Tehran province during this year, who first misdiagnosed as COVID-19 infection.

Objective: To investigate whether it is better to have surgery before pregnancy for pregnant women with congenital heart disease (CHD). Methods: Patients with CHD in Beijing Anzhen Hospital from 2010 to 2019 were collected and divided into surgical and non-surgical group, and the differences of events between the two groups were compared. Results: A total of 999 patients with CHD (mean age, 28.7±4.3years) were collected, including 403 cases (40.0%) in the surgical group and 596 cases (60.0%) in the non-surgical group. The most common CHD was atrial septal defect(33.1%), followed by ventricular septal defect (26.9 %), patent ductus arteriosus (9.9 %), and Tetralogy of Fallot (6.9 %). There were significant statistical differences in region, education degree and gravidity (P＜0.05), and the percentage of almost all events in the surgical group was higher. Pre-term delivery (17.1 vs. 9.9), low birth weight (11.6 vs. 6.5), heart failure (6.7 vs. 2.7), cesarean section (85.9 vs. 75.7), pulmonary arterial hypertension (36.2 vs. 13.6), Eisenmenger syndrome (9.7 vs. 0.2), and death (2.3 vs. 0.5) had statistically significant (P＜0.05). A total of 16 (1.6%) patients died, 14 (87.5%) in the surgical group, more than 2 (12.5%) in the non-surgical group. Conclusions: The outcome of surgical group was better than that of non-surgical group, surgery before pregnancy can reduce maternal and infant risk.

Background The European CE Mark approval study and the MOMENTUM 3 trial demonstrated safety and a reduction in hemocompatibility-related adverse events with use of HeartMate 3 (HM3) device. This single center study investigated the real-world experience in HM3 patients since FDA approval. Methods This retrospective, observational study included patients implanted with the HM3 LVAD as a primary implant between October 2017-March 2020. Patients were divided into trial group and postapproval group. Primary endpoint was survival at 6 months. Secondary endpoints were adverse events including pump thrombosis (requiring pump exchange), stroke, renal failure, acute limb ischemia, re-exploratory for bleeding, gastrointestinal bleeding, right ventricular failure, and driveline infection. Results A total of 189 patients were implanted with HM3 device during the study period. 174 patients met the inclusion criteria: 82 patients in the trial group and 92 patients in the postapproval group. The postapproval group had younger patients, higher pre-operative mean international normalized ratio, and greater numbers of patients with bridge to transplant (BTT) indications, IINTERMACS profile 1, and use of mechanical assist devices (other than IABP) than the trial group. Other characteristics between the two groups were comparable. Overall survival at 6 months in the postapproval group was 93.3% vs. 93.8% ( p=0.88). The postapproval group demonstrated a statistically significant lower incidence of re-explorative surgery for bleeding (10.9% vs 46.3,  p=0.01) than the trial group. Conclusion In this single-center study, the real-world 6-month survival in the postapproval group was comparable to the trial results. Further studies are needed to monitor long-term outcomes.

A nine-year-old egg allergic child developed anaphylaxis after ingesting the lysozyme-containing over-the-counter-drug Lysopaine®. He complained of a sore throat without fever or cough. His mother administered him one sublingual tablet of the over-the-counter drug Lysopaine®, containing 20 mg lysozyme hydrochloride. A few minutes after intake of the drug, he developed anaphylaxis and received 300 mg intramuscular epinephrine. HE was not exposed to other allergens. The responsibility of lysozyme was confirmed by positive skin prick tests for Lysopaïne® and the presence of specific IgE against lysozyme. When giving this treatment to her son, his mother had no idea that it could contain egg protein and she did not perceive lysozyme as an allergenic protein. However, the box mentioned the presence of lysozyme and also specified “contains lysozyme extracted from egg”. Lysozyme, a minor egg allergen, may induce anaphylaxis in egg-allergic patients. Lysozyme can be found in many commonly consumed industrial food and drug products and its labelling may be misleading. Our observation highlights the importance of properly educating allergic patients to recognize allergens, even minor ones.

As regional heterogeneity on the Qinghai Tibetan Plateau (QTP), the “greening rate” between alpine steppe in the west and alpine meadow ecosystems in the east is difference during the past several decades. To investigate the difference, the net photosynthetic rate (An) and the supply (mesophyll conductance ( g m), stomatal conductance ( g s)) and demand (the maximum rates of Rubisco carboxylase activity ( V cmax) and photosynthetic electron transport ( J max)) for CO 2 of three plants functional types (PFTs) were measured. Other functional traits and influencing factors were compared among ecosystems along the altitudinal gradients of QTP. The An of the PFTs was simulated under potential future conditions. At high altitudes, grass was found to maintain a relatively stable An by decreasing V cmax, J max, and g s, while slightly increasing g m, compared with that at a low altitude. The An of sedge and shrubs increased with rising V cmax, J max and g s and g m values, resulting in a large increment in the An at low altitudes. Grass seemed to be less sensitive to the environment by reducing the supply of and holding onto CO 2, while sedge and shrub increased both. Grass and sedge should be divided into two PFTs rather than remaining as one based on their opposite physiological and morphological functions in response to climate change. The ecosystem at 3600 m was transitional. C a was likely to be a more dominant factor than T a in affecting the An of grass. The order of rising An in PFTs was shrub > sedge > grass and the An of alpine meadow was found to increase more under the two future climate scenarios.

1) The environment experienced during development, and its impact on intrinsic condition, can have lasting outcomes for adult phenotypes and could contribute to the individual variation in senescence trajectories. 2) However, the nature of this relationship in wild populations remains uncertain, owing to the difficulties in summarizing environmental complexity and long-term monitoring of individuals from free-roaming long-lived species. 3) In this study, we determine whether juvenile condition (derived from measures of body mass and size) is associated with senescence-related traits of a closely monitored population of Seychelles warblers (Acrocephalus sechellensis). 4) Juveniles with a higher condition index were more likely to survive to adulthood – suggesting these juveniles experienced better developmental conditions. Furthermore, these juveniles as adults were in better condition and had higher rates of annual survival, independently of age. In contrast, there was no association between juvenile condition and declines in adult telomere length (a measure of somatic stress) nor annual reproduction. 5) These results indicate that juvenile condition, while not associated with senescence trajectories, can influence the likelihood of surviving to old age due to silver-spoon effects. This study shows that measures of intrinsic condition in juveniles can provide important insights into long-term fitness of individuals in wild populations.

Background. Chronic rhinosinusitis with nasal polyps (CRSwNP), characterized by partial (hyposmia) or total (anosmia) loss of smell, is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), worsens disease severity and quality of life. The objective of this study was to determine whether, in real-life conditions, biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare smell improvement in N-ERD and non-N-ERD subgroups. Methods. A multicenter, non-interventional, retrospective, observational study was performed, including 206 patients with severe asthma undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab) with CRSwNP. Results. Improved olfaction was found after treatment with all monoclonal antibodies: omalizumab (35.8%), mepolizumab (35.4%), reslizumab (35.7%), and benralizumab (39.1%), with no differences between groups. Patients with atopy, greater use of short course systemic corticosteroids, and larger polyp size were more likely to experience improvement in smell. The proportion of patients experiencing smell improvement was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. Conclusions. This is the first study to compare real-life improvement in sense of smell among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in sense of smell (with non-significant differences between biologic drugs). No differences were found in smell improvement between the N-ERD and non-N-ERD group.

Varices are a common cause of gastrointestinal bleed, but a small percentage of these bleeds are due to ectopic varices. This case presents bleeding ectopic varices in the third part of the duodenum with portal hypertension secondary to chronic superior mesenteric vein thrombosis that developed after hemorrhagic pancreatitis.

Outcomes may be better when invasive hemodynamic monitoring is used for managing patients with diabetic ketoacidosis associated with septic shock or hypotension. Keywords Diabetic ketoacidosis; Invasive hemodynamic monitoring; Septic shock

Cyclohexyl radicals are crucial primary intermediates in combustion of fossil and alternative fuels. They would present the inherent conformation feature, i.e. diverse conformers retained in inversion-topomerization pathways, jointly controlled by the varying radical site and specific spatial positions of alkyl side chains on “easy-distortion” cyclic ring. These conformers for one radical have different energies and thermodynamics, and are highly expected to influence their subsequent decomposition reactions in terms of energetics and kinetics. To reveal such impact, all conformational structures and their interconversion mechanisms for trans-1,2-dimethylcyclohexyl isomers were explored by employing quantum chemical calculations coupled with transition state theory. Originated from distinct conformers, all accessible transition states were explicitly identified in different reaction paths for each type of intramolecular H-transfer or β-scission, and then were carefully used in computing rate coefficients. The kinetic predictions demonstrate that the fairly speedy equilibrium among conformers would be established for one isomer via conformation before they proceed the initial decomposition over 300-2500 K. This allows thoroughly evaluating the contribution of various conformers to the kinetics for multiple paths in one reaction regarding to their thermodynamic properties. Moreover, conformational analysis elucidates that H-transfers exhibit strong structure dependence. Note that the most favorable 1,5 H-transfer is only feasible for one twist-boat with radical site in axial side chain accompanied by one isoclinal methyl group. The results for β-scissions are affected by steric energies and substituent effects remained in conformational structures. These findings facilitate to finally suggest the proper kinetic parameters for each decomposition reaction with the aim of their potential implication in kinetic modelling.

Energy spectrum as well as various information theoretic measures are considered for Hulthén potential in D dimension. For a given ℓ ≠ 0 state, analytic expressions are derived, following a simple intuitive approximation for accurate representation of centrifugal term, within the conventional Nikiforov-Uvarov method. This is derived from a linear combination of two widely used Greene-Aldrich and Pekeris-type approximations. Energy, wave function, normalization constant, expectation value in r and p space, Heisenberg uncertainty relation, entropic moment of order $$, Shannon entropy, Rényi entropy, disequilibrium, majorization as well as four selected complexity measures like LMC (López-Ruiz, Mancini, Calbert), shape Rényi complexity, Generalized Rényi complexity and Rényi complexity ratio are offered for different screening parameters (δ). The effective potential is described quite satisfactorily throughout the whole domain. Obtained results are compared with theoretical energies available in literature, which shows excellent agreement. Performance of six different approximations to centrifugal term is critically discussed. An approximate analytical expression for _critical screening_ for a specific state in arbitrary dimension is offered. Additionally, some inter-dimensional degeneracy occurring in two states, at different dimension for a particular δ is also uncovered. 02.60.-x, 03.65.Ca, 03.65.Ge, 03.65.-w KEYWORDS: Hulthén potential, Rényi complexity ratio, Statistical complexity, Majorization, Pekeris approximation, Greene-Aldrich approximation.

1. Understanding how differences in intensity and frequency of hydrological disturbances affect the resistance and resilience of aquatic organisms is key to manage aquatic systems in a fast-changing world. Organisms’ responses to environmental changes can be influenced by different life strategies. Some aquatic organisms have strategies that improve the permanence in aquatic systems, while others use strategies that enhance colonization. 2. Therefore, we carried out a manipulative experiment to understand the resistance/resilience of aquatic insects based on their functional characteristics to hydrological disturbances in streams in the Cerrado hotspot. 3. We placed 200 artificial substrates in five streams and submitted them to changing water flow regimes that differed both in frequency and intensity. Then we observed the response of the aquatic community for 39 days. We used a Hierarchical Bayesian strategy approach to estimate the probabilities of permanence and colonization of each life strategy group (nine groups). 4. We observe that the most intense changes in the water flow tend to affect the permanence of almost all groups. However, this effect was reduced in intensity over time. On the other hand, less frequent disturbances, regardless of intensity, tend to reduce the permanence of most groups of aquatic insects over time. The difference in the effect of disturbance regarding intensity (higher or lower) may be related to a greater dispersal capacity of some groups. 5. These results are worrisome in a scenario of reduced riparian vegetation around streams and with the expectation of precipitation to become more concentrated in shorter periods of time due to climate change in the Cerrado hotspot. Together, these anthropogenic changes tend to increase the effect of runoff on the lotic systems and, consequently, reduces the permanence of many groups of aquatic insects in their habitat, particularly those with traits associated with permanence.

In this paper, the advantage of reusing scrap tires in Scrap Rubber Block (SRB) to improve thermal insulation in buildings was examined experimentally. By testing the use of SRB in black and white colours as external wall insulators and comparing their performance with walls without insulation. The results indicated that a wall with scrap tire blocks gave the best thermal insulation results when the outer face was painted white. The decrement factor (f) and the rate of heat loss increase, while the rate of heat gain decreases. This was done through the mechanisms of heat transfer by conduction through the layers of the wall and the effect of adding the rubber block on its thermal properties. The results showed that the use of rubber blocks reduces the temperature of the inner surface of the wall by 3-4oC lower than the traditional wall. The thermal diffusion inside the wall was determined effectively in the case of a wall with the rubber block, where the temperature of the inner surface reaches its maximum value by about 0.5-hour difference from the traditional wall in the case of the wall with the rubber block in black colour, and 9.5-hour in the case with the white block.

The structure of a protein plays a pivotal role in determining its function. Often, the protein surface’s shape and curvature dictate its nature of interaction with other proteins and biomolecules. However, marked by corrugations and roughness, a protein’s surface representation poses significant challenges for its curvature-based characterization. In the present study, we employ unsupervised machine learning to segment the protein surface into patches. To measure the surface curvature of a patch, we present an algebraic sphere fitting method that is fast, accurate, and robust. Moreover, we use local curvatures to show the existence of “shape complementarity” in protein-protein, antigen-antibody, and protein-ligand interfaces. We believe that the current approach could help understand the relationship between protein structure and its biological function and can be used to find binding partners of a given protein.

Antonio Carlos Meinberg1 and Idiberto José Zotarelli Filho2School of Medicine of São José do Rio Preto, Famerp - Discipline of Anesthesiology, São José do Rio Preto, Brazil.Faceres – College of Medicine, São José do Rio Preto, São Paulo, Brazil.

Abstract. I made late breeding season (after 1 July) observations of a central California population of Wilson’s Warbler, Cardellina pusilla, over nine breeding seasons. I sighted males in definitive prebasic molt from 4 July in 2007 through 1 September in 1999. Possibly all territorial males molted on their breeding territories, and molt lasted a maximum of 46 days. Following prebasic molt, territorial males engaged in subdued “post molt singing,” which lasted 14 days in one male, but usually no more than seven days, and was last heard on 6 September in 1999. I sighted no female in definitive prebasic molt, nor in bright basic plumage, during the study. Of 12 color-banded females sighted after 22 July, I confirmed 11 had been in late breeding season uniparental brood care. Possibly all resident females not engaged in late uniparental brood care vacated their breeding territories earlier, and before resident males. They presumably underwent prebasic molt at later times and locations not known. Remaining late nesting females must have molted much later than resident males, and likely later than early departing resident females, and at unknown locations. I last sighted uniparental brood tending females still in dull alternate plumage on 26 and 29 August respectively, whereas some males had completed prebasic molt by 13 August. Three unique study findings are the occurrence of male post molt singing, a male/female difference in location of prebasic molt, and a likely dichotomy of prebasic molt timing between females leaving their breeding grounds early, and those remaining in uniparental brood care.