Litter decomposition is a fundamental nutrient cycling process, and litter diversity decreases induced by biodiversity loss have substantial effects on soil carbon cycling. However, few experimental studies have characterized the effect of litter diversity on and litter chemistry. Here, we used single-species and mixed litters to study the effects of litter chemical properties on the direction, intensity and drivers of non-additive litter-mixing effects. We found that 1) there was no significant effect of litter species richness on soil processes, and the litter chemistry of component species was more robust to soil respiration and non-additive effects. 2) The early-stage mixing effect was negative, ranging from -3.1 to -0.3, and its magnitude was strongest in chemically diverse litter mixtures; the late-stage mixing effect ranged from -2.3 to 1.3, and the non-additive effect of chemically similar species was positive. 3) Litter carbon, lignin, phenols and soluble sugar affected early-stage soil respiration, and litter carbon, nitrogen, phenols, and condensed tannins affected late-stage soil respiration, which accounted for 46% and 56% of the variation in early- and late-stage soil respiration, respectively. 4) Compared with plant species richness, litter chemistry altered the direction and magnitude of litter mixing, and litter chemical composition (including litter chemical traits and their interactions) had a stronger effect on non-additive effects than variation in single chemical compounds according to the R2 value (R2=0.36). 5) Artemisia halodendron, as a key sand-fixing plant species, will accelerate nutrient cycling, but it has negative effects on carbon cycling when mixed with other plant species

Wernicke's encephalopathy should be suspected in hemodialysis patients with appetite loss alone, with careful brain MRI analysis for detecting possible Wernicke's encephalopathy at an early stage.

Background: Pulmonary vein isolation (PVI) with a balloon-based visually guided laser ablation (VGLA) is regarded as a useful therapeutic tool for treating atrial fibrillation (AF). The clinical efficacy of a VGLA has never been fully investigated in patients with a left common pulmonary vein (LCPV). Objective: We investigated the procedural safety as well as clinical usefulness of VGLA in patients with an LCPV. Methods: This study consisted of 130 consecutive patients who underwent VGLA of de novo non-valvular paroxysmal AF. Results: Eleven patients (8.5%) had an LCPV (ostium maximal average diameter: 27.5 ± 4.9 mm, ostium minimal average diameter: 17.7 ± 3.5 mm). Nine out of 11 (81.8%) LCPVs were successfully occluded and isolated at the ostium with a VGLA guided PVI. The ablation procedure time was significantly shorter in the patients with than without an LCPV (61.5 ± 15.4 vs. 86.9 ± 32.9 min, p = 0.01). There was no difference regarding the atrial tachyarrhythmia recurrence between those with and without an LCPV (p = 0.18). A total of fifteen patients underwent a redo procedure, but reconnections were not observed in any of the LCPV patients. Conclusion: The VGLA guided PVI was a useful therapeutic tool even in patients with an LCPV. The presence of an LCPV was not associated with any atrial tachyarrhythmia recurrence.

A document by Rishma Chooniedass. Click on the document to view its contents.

Catecholaminergic Polymorphic Ventricular Tachycardia is a life-threatening disorder. The clinical diagnosis is challenging owing to the absence of electrocardiogram and overt structural heart abnormalities in the majority of patients. Approximately 35% of cases remain without a genetic etiology. Here, we identified two genes as a novel promising candidate for CPVT.

We propose a new scheme to infer the metabolic fluxes of cell cultures in a chemostat. Our approach is based on the Maximum Entropy Principle and exploits the understanding of the chemostat dynamics and its connection with the actual metabolism of cells. We show that, in continuous cultures with limiting nutrients, the inference can be done with _limited information about the culture_: the dilution rate of the chemostat, the concentration in the feed media of the limiting nutrient and the cell concentration at steady state. Also, we remark that our technique provides information, not only about the mean values of the fluxes in the culture, but also its heterogeneity. We first present these results studying a computational model of a chemostat. Having control of this model we can test precisely the quality of the inference, and also unveil the mechanisms behind the success of our approach. Then, we apply our method to E. coli experimental data from the literature and show that it outperforms alternative formulations that rest on a Flux Balance Analysis framework.

Here we present a case report of a chronic lymphoblastic leukemia-related pancytopenia patient where after treatment with Cyclosporin-A, chronic lymphoblastic leukemia has effectively remitted. To further understand the effect of Cyclosporin-A in immune micro-environment reconstruction and its anti-leukemia potential.

Liberal use of oxygen plays a significant role in exacerbating the long-term lung injuries associated in COVID-19. Hypoxemia and hypoxia are two different entities. Correcting hypoxemia without hypoxia tends to have disastrous effect and delays lung healing.

The global pandemic has forced many educators to instruct their students online and use home resources to continue their education. Developing chemistry protocols for students and educators that can be performed at home will further help alleviate the pandemic's pressures on the educational process. This paper explores the process of producing CuSO4 using products and equipment available in stores or online retailers. The protocol developed in this project produced CuSO4 pentahydrate for use in a home laboratory, and the process provides several avenues for lessons and classroom discussion.

Urinary bladder cancer is frequently multifocal and has a high incidence of recurrence. Although the prostatic urethra is a frequent site of tumor relapse in patients with non-muscle-invasive bladder cancer treated with TURBT, such tumors are often underappreciated. Here we present two cases having urethral recurrence after TURBT.

Intramyocardial dissection following cardiac tumor excision is uncommon. The evidence available is limited to few case reports. 1 Herein,we report an infant with large cardiac fibrosarcoma arising from the interventricular septum and underwent surgical excision.One month after surgery echocardiography revealed a cystic dissection located in the interventricular septum with residual shunts within the ventricular chambers. we performed conservative strategy due to the high surgical risk, difficulty of interventional therapy and hemodynamic stability.

Background & Objectives The FlexAbilityTM SE catheter has a laser-cut 8Fr 4-mm flexible tip irrigated through laser-cut kerfs with a thermocouple 0.3mm from the distal end. The TactiCathTM SE catheter has an 8Fr 3.5-mm tip and 6-irrigation port with a thermocouple 2.67mm proximal to the tip. We investigated the impact of these differences on the efficacy and safety of RF-applications. Methods RF applications at a range of powers (20W, 30W, and 40W), contact forces (5g, 15g, and 25g), and durations (10-60s) using perpendicular/parallel catheter orientation, were performed in excised porcine hearts. Lesion characteristics and incidence of steam pops were compared. Results 540 lesions were examined. The FlexAbilityTM SE catheter produced smaller lesion depths (4.0mm vs. 4.4mm, p=0.014 at 20W; 4.6mm vs. 5.6mm, p=0.015 at 30W), surface areas (22.7mm2 vs. 29.2mm2 at 20W, p=0.005; 23.2mm2 vs. 28.7mm2, p=0.009 at 30W) and volumes (126.1mm3 vs. 175.1mm3, p=0.018 at 20W; 183.2mm3 vs. 304.3mm3, p=0.002 at 30W) with perpendicular catheter placement. However, no differences were observed with parallel catheter placement. Steam-pops were significantly less frequently observed with the FlexAbilityTM SE catheter (4% vs. 22%, p<0.001) irrespective of catheter direction to the tissue. Multivariate analysis showed that use of the TactiCathTM SE catheter, power ≥40W, contact force ≥25g, RF duration >30s, parallel angle and impedance drop ≥20Ω were significantly associated with occurrence of steam-pops. Conclusions The FlexAbilityTM SE catheter reduced the risk of steam-pops, but produced smaller lesions with perpendicular catheter placement compared to the TactiCathTM SE catheter.

Two patients with breathlessness were diagnosed as RP, both of them were successfully diagnosed and were controlled well. As a rare autoimmune multisystem disease, RP should be taken into consideration in patients with dyspnea of unknown cause and should be treated timely.

This study aims to develop a high temperature LCF test method using a non-standard miniature thin-plate (MTP) specimen in order to characterize cyclic visco-plasticity behavior of component materials. For demonstration, fully reversed strain-range controlled LCF and creep-fatigue (CF) tests at 600 °C have been performed for a martensitic steel using both standard-sized full-scale (SSFS) and MTP specimens. A scaling factor is determined using cyclic visco-plastic finite element (FE) for geometry constraint evaluation and data conversion based on the reference strain approach. The equivalent energy principal is proposed to assess the geometry constraint effect that non-standard MTP specimen has. The high temperature LCF results from the MTP specimen based on the proposed testing methodology have shown a good agreement with SSFS specimen data under equivalent conditions. The methodology can therefore be used to conduct accurate transferability to achieve equivalent LCF behavior between the conventional standard specimen and the MTP specimen.

In this paper, we study the vanishing viscosity limit for the 3D incompressible micropolar equations in a flat domain with boundary conditions. We prove the existence of the global weak solution of the micropolar equations and obtain the uniform estimate of the strong solution. Furthermore, we establish the convergence rate from the solution of the micropolar equations to that of the ideal micropolar equations as all viscosities tend to zero (i.e., (ε,χ,γ,κ) → 0).

Authors describe a rare case of acute adrenal infarction in pregnancy resulting in hypoadrenalism requiring hydrocortisone replacement therapy and anticoagulation with subsequent resolution of the radiological changes and complete recovery of the glucocorticoid reserve during clinical follow-up.

In this paper, a high-order and fast numerical method is investigated for the time-fractional Black-Scholes equation. In order to deal with the typical weak initial singularities of the solution, we construct a finite difference scheme with variable time steps, where the fractional derivative is approximated by the nonuniform Alikhanov formula and the sum-of-exponentials (SOE) technique. In the spatial direction, an average approximation with fourth-order accuracy is employed. The stability and the convergence with second-order in time and fourth-order in space of the proposed scheme are religiously derived by the energy method. Numerical examples are given to demonstrate the theoretical statement.

Our world is undergoing rapid planetary changes driven by human activities, often mediated by economic incentives and resource management, affecting all life on Earth. Concurrently, many infectious diseases have recently emerged or spread into new populations. Mounting evidence suggests that global change-including climate change, land-use change, urbanization, and global movement of individuals, species, and goods-may be accelerating disease emergence by reshaping ecological systems in concert with socioeconomic factors. Here, we review insights, approaches, and mechanisms by which global change drives disease emergence from a disease ecology perspective. We aim to spur more interdisciplinary collaboration with economists and identification of more effective and sustainable interventions to prevent disease emergence. While almost all infectious diseases change in response to global change, the mechanisms and directions of these effects are system specific, requiring new, integrated approaches to disease control that recognize linkages between environmental and economic sustainability, and human and planetary health.

Objective: To evaluate the immediate and sustained knowledge retention and sense of self-efficacy of homecare nurses following completion of a standardized competency-based tracheostomy education course. Safe discharge of children requiring tracheostomy with or without ventilation relies on the competence of homecare nurses. Study Design: Pragmatic, randomized controlled trial of 44 homecare nurses. Participants were randomized into the intervention group (n=21), which received the tracheostomy course, or the control group (n=23), which received an enterostomy and vascular access course. Multiple-choice question (MCQ) knowledge assessments and self-efficacy questionnaires were administered to both groups pre-course and post-course at 6 week, 3 month, 6 month, and 12 month follow-ups. Results: Twenty participants in the intervention group and 19 in the control group were included. Four withdrew from the study and two crossed over from the control into the intervention arm. The change in mean self-efficacy scores (total score = 100) was significantly higher in the intervention group than in the control group at 6 weeks (intervention (mean ± SD): 18.6±14.5; control: 6.6±20.4; p=0.04) and 3 months (intervention: 19.6±14.2; control: 5.2±17.0; p=0.007), and trended higher at 6 months (intervention: 18.0±14.5; control: 6.9±24.1; p=0.1) and 12 months (intervention: 16.9±15.0; control: 16.8±20.5; p=1.0). The change in mean MCQ assessment scores (total score = 20) trended higher in the intervention group than in the control group at 6 weeks (intervention (mean ± SD): 1.8±2.2; control: 1.6, ±2.9; p=0.8). Conclusions: Homecare nurses who attended the tracheostomy course demonstrated a higher sense of self-efficacy at long-term follow-up.

The Lie group of infinitesimal transformations technique and similarity reduction is performed for obtaining an exact invariant solution to generalized Kadomstev-Petviashvili-Boussinesq (gKPB) equation in (3+1)-dimensions. We obtain generators of infinitesimal transformations, which provide us a set of Lie algebras. In addition, we get geometric vector fields, a commutator table of Lie algebra, and a group of symmetries. It is observed that the analytic solution (closed-form solutions) to the nonlinear gKPB evolution equations can easily be treated employing the Lie symmetry technique. A detailed geometrical framework related to the nature of the solutions possessing traveling wave, bright and dark soliton, standing wave with multiple breathers, and one-dimensional kink, for the appropriate values of the parameters involved.

Background: Contact force (CF) guided catheter ablation (CA) is a novel technology developed to improve efficacy and reduce complications. In a randomised controlled trial (RCT), we previously documented that after three months, rate of persistent conduction block was similar with and without using CF while performing CA for typical atrial flutter (AFL). Clinical effect of CF on recurrent arrhythmia is unknown. Objective: To study recurrent atrial arrhythmia during 12-months follow-up in a RCT investigating whether CF-guided CA for typical AFL is superior to CF-blinded CA. Method: Patients were randomized 1:1 to CA guided by CF (intervention group) or blinded to CF (control group). After 12 months, patients attended clinical check-up preceded by a 5-day ambulatory Holter monitor recording. Primary outcome was any recurrent atrial arrhythmia ≥30 seconds within 12 months, symptomatic or asymptomatic and documented in 12-lead ECG or Holter monitor recording. We did intention-to-treat (ITT) analysis. Results: We included and randomized 156 patients, four patients withdrew consent and two died during follow-up. Thus, 150 patients were included in ITT-analysis, in which recurrent arrhythmia was detected in 47 (31%) patients, 25 in the intervention group and 22 in the control group (p = 0.25). Atrial fibrillation was detected in 38 patients (18 versus 20 patients), and AFL in the remaining 9 patients (7 versus 2 patients). Conclusion: Contact force guided ablation for typical atrial flutter does not reduce recurrent atrial arrhythmia after 12-months follow-up as compared with ablation blinded for contact force.

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To understand antibiotic resistance in pathogenic bacteria, we need to monitor environmental microbes as reservoirs of antimicrobial resistance genes (ARGs). These bacteria are present in the air and can be investigated with the whole metagenome shotgun sequencing approach. This study aimed to investigate the feasibility of a method for metagenomic analysis of microbial composition and ARGs in the outdoor air. Air samples were collected with a Harvard impactor in the PM10 range at 50 m from a hospital in Budapest. From the DNA yielded from samples of PM10 fraction single-end reads were generated with an Ion Torrent sequencer. During the metagenomic analysis, reads were classified taxonomically. The core bacteriome was defined. Reads were assembled to contigs and the ARG content was analyzed. The dominant genera in the core bacteriome were Bacillus, Acinetobacter, Leclercia and Paenibacillus. Among the identified ARGs best hits were vanRA, Bla1, mphL, Escherichia coli EF-Tu mutants conferring resistance to Pulvomycin, BcI, FosB, and mphM. Despite the low DNA content of the samples of PM10 fraction, the number of detected airborne ARGs was surprisingly high.

The poor cold flow property is one of the main obstacle factors in affecting the utilization of high-proportional biodiesel blends in engines. In this study, methcyclohexyl methacrylate-methacrylate copolymers (MCHMA-R1MC, R1 = C12, C14, C16, C18) were synthesized at various molar ratios by radical polymerization and characterized by FTIR, GPC, and 1H NMR. Their structures and properties areanalyzed and characterized by FTIR, GPC, and 1H NMR. The resulting copolymers were tested as the cold flow improver in terms of cold filter plugging point (CFPP) and solid point (SP) measurement for treated and untreated B20 biodiesel blends (20 vol.% biodiesel + 80 vol.% diesel). Results showed that the CFPP and SP of B20 decreased to a varied extent after MCHMA-R1MC treatment. When the monomer ratio of is 1:7, MCHMA-C14MC (1:7) proved the greatest depression in CFPP and SP of B20 by 18 and 25℃ at 2000 ppm dosage. The effects of MCHMA-R1MC copolymers on crystal behavior was studied through polarizing optical microscope(POM), differential scanning calorimetry(DSC) and viscosity-temperature curves. The results indicated that MCHMA-C14MC could effectively delay the aggregation of wax crystals and change their crystalline behavior by changing the shape of the crystals and inhibiting the formation of large wax crystals, and then lower the low-temperature viscosity of biodiesel blends and make it exhibiting better cold flow properties.