We proposed a general and effective approach for accurate calculating method of the electron-electron, nuclear-electron and nuclear-nuclear Coulomb electrostatic interaction energies. It is well known that electron-electron, nuclear-electron and nuclear-nuclear Coulomb electrostatic interaction energies reduced to basic two-center Coulomb integrals. The analytical calculation of electrostatic interaction energies with respect to basic two-center Coulomb integrals over Slater type orbitals (STOs) in molecular coordinate systems allows us the routine evaluation of molecular structures and related properties. In this study we have introduced a new full analytical algorithm for calculation of the basic two-center Coulomb integrals over STOs by using Guseinov’s auxiliary functions especially interactions between electrons. The auxiliary functions has been calculated by using the exact recurrence relations which developed by Guseinov. The new approach is successfully tested on earlier published studies data and can be recommended for evaluation of related problems in atomic and molecular physics.

Knowledge of the sex determination system and sex-associated genes has important implications in physiology, ecology and evolution, but the mechanisms underlying sexual determination systems in turtles has not been fully elucidated, due to their remarkable variability and a lack of reference genomes in some species. In this report, we describe the first genome assembled at the chromosome scale for Mauremys mutica using Illumina and high-throughput chromatin conformation capture (Hi-C) technology. A total of 280.42 Gb of clean data were generated using the Pacific Biosciences platforms, which represented approximately 119× coverage of the Mauremys mutica genome. The assembly comprised 2.23 Gb with a contig N50 of 8.53 Mb and scaffold N50 of 141.98 Mb. Genome Hi-C scaffolding resulted in 26 pseudochromosomes containing 99.98% of the total assembly. Genome annotation predicted 24,751 protein-coding genes, and 97.23% of them were annotated. Comparative genomics analysis indicated that the lizard-snake-tuatara clade diverged from the bird-crocodilian-turtle clade at approximately 283.1-320.5 Mya. Additionally, positive selection of genes and gene families related to calcium signaling, neuroactive ligand-receptor interaction, and expansion of the hormone signaling pathway were identified, implicating their roles of sex regulation inMauremys mutica. High-quality genome assembly may provide a valuable genomic resource for further research investigating gene-environment interactions in Mauremys mutica.

A small molecule probe for simultaneous detection of HSA and SO2 via their distinct fluorescent signals was designed recently. This effective tool provided a significant boost in understand underlying mechanism of synergistic action between SO2 and HSA in disease. The structure and fluorescent character of this probe molecule were studied under density functional theory in this work. The different stable conformations of probe C23 were found through theoretical method which explained the no experimental fluorescent character of the probe itself. The electron excitation analysis indicated the charge transfer process in the restricted C23 (binding to the hydrophobic cavity of HSA) and CS (C23 reaction with SO2) when the molecules were under optical excitation. The theoretical results could be helpful for understanding the electronical properties in the probe and providing the insights for designing new probe molecules.

Background: The optimal treatment of high-risk PE with cardiac arrest is still controversial although various treatment approaches have been developed and improved. Here, we present a serie of patients with high-risk PE showing hemodynamic collapse, who were successfully treated with extracorporeal membrane oxygenation (ECMO) as an adjunct to EKOS™ acoustic pulse thrombolysis. Method: From April 2016 to June 2020, 29 patients with high-risk PE with cardiac arrest were retrospectively included. The mean age was 55.3 ± 9.2 years. Twelve (41.3%) patients were female. All patients had cardiac arrest, either as an initial presentation or in-hospital after the presentation. All patients exhibited acute symptoms, computed tomography (CT) evidence of large thrombus burden, and severe right ventricular dysfunction. Primary outcome was all-cause 30-day mortality. Results: Twenty-two patients survived to hospital discharge, with a mean ICU stay of 9.9 ± 1.6 days (range, 7 to 22 days) and mean length of hospital stay of 23.7 ± 8.5 days (range, 11 to 44 days). Six patients died from refractory shock. Ninety-day mortality was 24.1% (7/29). The Mean ECMO duration was 3.5 ± 1.1 days and the mean RV/LV ratio decreased from 1.31 ± 0.17 to 0.92 ± 0.11 in patients who survived to discharge. The mean tissue plasminogen activator (tPA) dose for survivor patients was 20.5 ± 1.6 mg. Conclusion: Patients with high-risk pulmonary embolism who suffer a cardiac arrest have high morbidity and mortality. APT complemented by ECMO could be a successful treatment option for patients who have high-risk PE with circulatory collapse.

Multisystem Inflammatory Syndrome is a rare and novel clinical presentation described during the evolving Covid- 19 pandemic. The condition is usually presenting as a sepsis-like syndrome leading to secondary multiorgan dysfunction post-COVID-19 infection. Although the syndrome has been mainly described in children, rare adults' form has been similarly described.

Difficulties during surgery are uncommon situations in appendectomy. For granulomatous appendicitis, literature is insufficient about surgical findings. The procedure of a 17-year-old male patient was a struggle due to adhesions. I thought a surgeon could expect granulomatous diseases by evaluating the macroscopic appearance of the appendix during surgical procedure.

Psoriasis is a chronic inflammatory disease with characteristic skin manifestations. Several pathogens can cause flare-ups of psoriasis. The risks of skin infections are increased in patients receiving immunomodulators. A patient with chronic psoriasis presented with human papillomavirus infection and anogenital warts and was treated surgically with acceptable results.

THE NATURE OF EDUCATIONAL PLANNING FOR SUSTAINABLE DEVELOPMENT OF THE SCHOOL SYSTEM IN SOUTH-SOUTH OF NIGERIABYDR. (MRS.) SCHOLASTICA C. O. EKERE

The study investigated teacher's demographic factors to ascertain teaching learning issues in Nigeria. As a descriptive survey, teachers and students in senior secondary schools in Ekiti State constituted the study population. The sample comprised of 288 teachers and 1920 students, randomly selected from 32 schools that were stratified, selected and drawn from 16 local government areas in Ekiti State. Four different measuring instruments were used to collect data. The data collected were subjected to statistical analysis using t-test. Findings from the documentary evidence revealed there is uneven distribution of teachers between sex and location, while statistical calculation results revealed that there is a difference between the effectiveness of male and female teachers as well as teachers from both urban and rural locations in the improvement of teaching and learning. The study recommended that government should do more to monitor implementation stages of its education policy with special regard to gender and locations of teachers. Serious and genuine implementation of policy is as important as its formulation. The inspectorate division of the ministry of education should take seriously the distribution of teachers and monitoring of what goes on in our classrooms, especially schools in rural areas where students expect "miracle" passes.

Fluoroquinolone’s (FQs) pharmacological properties, patient characteristics, and microorganisms responsible for infection play a key role in clinical outcomes. FQs are prescribed in systemic infections due to the adequate disposition properties of the antibiotic at the site of infection. However, variability in important interindividual pharmacokinetic aspects, especially in the elimination process, may contribute to treatment failure. Likewise, today, undesired interregional variability in FQs antimicrobial activity against certain microorganisms exists. The aim of this study was to review the published information about interindividual variability in pharmacological processes for the most used FQs, such as ciprofloxacin, levofloxacin, and moxifloxacin. This review was deemed necessary on the basis of understudied interindividual pharmacokinetic and pharmacodynamic variability of FQs. The understanding of FQs dose-response relationship is critical to optimize the effectiveness of FQs therapy used to treat systemic infections. This may be particularly critical in the case of special populations such as critical ill, elderly, renal, and obese patients. The altered PK in these patients associated with creatinine clearance, together with the variability in pathogen susceptibility, associated with local resistances, may require personalized dosing regimens. Patient-tailored effective FQs dosing is needed to guarantee antimicrobial efficacy while minimizing the risk of adverse events and emergence of resistance.

Background and Purpose: GPR55 is a G protein-coupled receptor that recognizes several lipid molecules. GPR55 expression in human monocytes and its proinflammatory role lead us to investigate the role of GPR55 in monocyte adhesion and atherosclerosis development. Experimental Approach: We investigated monocyte adhesion in human THP-1 monocytes and atherosclerosis development in ApoE-/- mice by using O-1602 (a potent agonist of GPR55), CID16020046 (a specific GPR55 antagonist), and a high-fat diet-induced atherosclerosis model. Key Results: In human THP-1 monocytes, treatment with O-1602 significantly increased monocyte adhesion to human umbilical vein endothelial cells (HUVECs), and the O-1602-induced adhesion was inhibited by treatment with CID16020046. O-1602 induced the expression of Mac-1 adhesion molecules, whereas CID16020046 inhibited this induction. Analysis of the promoter region of Mac-1 elucidated the binding sites of AP-1 and NF-κB between nucleotides -750 and -503 as GPR55 responsive elements. Furthermore, O-1602 induction of Mac-1 through AP-1 and NF-B was found to be dependent on the signaling components of GPR55, that is, Gq protein, Ca2+, CaMKK, and PI3K. In an in vivo study of high-fat diet-induced atherosclerosis in ApoE-/- mice, administration of CID16020046 ameliorated atherosclerosis development. These results suggest that high-fat diet-induced GPR55 activation leads to adhesion of monocytes to endothelial cells via induction of Mac-1, and CID16020046 blockage of GPR55 could suppress monocyte adhesion to vascular endothelial cells through suppression of Mac-1 expression, leading to protection against the development of atherosclerosis. Conclusions: This report suggests that GPR55 may be a therapeutic target for atherosclerosis development.

In this paper, the link between combinatorial structures and alternative algebras is studied, determining which configurations are associated with those algebras. Moreover, the isomorphism classes of each 2-dimensional configuration associated with these algebras is analyzed, providing a new method to classify them. In order to complement the theoretical study, two algorithmic methods are implemented: the first one constructs and draws the (pseudo)digraph associated with a given alternative algebra and the second one tests if a given combinatorial structure is associated with some alternative algebra.

Salivary gland tumors in children are rare, involvement of accessory salivary glands is exceptional. We report a case of pleomorphic adenoma of the palate in a child in order to describe the clinical, radiological features, as well as the management of this rare localization.

This study used a stir casting method to fabricate AA 7075/ (0, 2, 4, and 6 weight percent) TiC/ (0, 1, 5, 3 and 7 weight percent) E-Glass metal matrix composites. A technique known as advanced electron microscope was used to effectively characterise the manufactured composites. The mechanical properties were determined by the tensile strength and hardness results, which have been meticulously investigated. When likened to monolithic AA 7075 alloy, the dispersion of TiC particles with E-Glass fibre and their embedding over the ductile AA 7075 matrix was successfully obtained, resulting in excellent mechanical and surface behaviour with the function of TiC particles with E-Glass fibre. The particulate strengthening of hard TiC particles over the soft ductile phase was responsible for these results. Furthermore, SEM demonstrations that AA 7075-x weight percent TiC-y weight percent E-Glass metal matrix composites were successfully manufactured, with no other intermetallic phases found.

In this paper, we investigate vector Lakshmanan-Porsezian-Daniel (VLPD) model which can be used to describe the ultrashort pulses in the birefringent optical fiber. Based on the unified transformation method, the Riemann-Hilbert problem is introduced and initial-boundary value problems of the VLPD model are studied. By solving the formulated matrix Riemann-Hilbert problem, the potential function solutions of the VLPD model can be reconstructed. Moreover, that the spectral functions are not independent but meet the so-called global relation is shown.

The access of drugs into the central nervous system (CNS) is regulated by the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB). A large body of evidence supports perturbation of these barriers in neurodegenerative diseases, including Alzheimer’s disease and Parkinson’s disease. Modifications to the BBB and BSCB are also reported in amyotrophic lateral sclerosis (ALS), albeit these modifications have received less attention relative to those in other neurodegenerative diseases. Such alterations to the BBB and BSCB have the potential to impact on CNS exposure of drugs in ALS, modulating the effectiveness of drugs intended to reach the brain and the toxicity of drugs that are not intended to reach the brain. Given the clinical importance of these phenomena, this review will summarise reported modifications to the BBB and BSCB in ALS, discuss their impact on CNS drug exposure and suggest further research directions so as to optimise medicine use in people with ALS.

1. Kānuka (Kunzea serotina, Myrtaceae) dryland shrubland communities of the lowland plains of South Island (Te Wai Pounamu) New Zealand (Aoteoroa) contain a ground cover largely consisting of mosses, predominantly Hypnum cupressiforme. There has been no previous study of the role of mosses in this threatened habitat which is currently being restored within a contemporary irrigated and intensively-farmed landscape that may be incompatible with this component of the ecosystem. 2. The aim of the present study was to investigate the influence of moss ground cover on hydrology, nitrogen (N) availability and vascular plant interactions, and in relation to nutrient spillover from adjacent farmland. Experimental work was a combination of glasshouse experiments and field-based studies. 3. Extremes of soil temperature and moisture were found to be mediated by the moss carpet, which also influenced N speciation; available N declined with moss depth. The moss layer decreased the amount of germination and establishment of vascular plants but, in some cases, enhanced their growth. Spillover of mineral nitrogen and phosphate from farmland enhanced invasion of exotic grasses which may have benefited from conditions provided by the moss carpet. 4. Synthesis: We found the moss layer to be crucial to ecosystem functioning in these dry habitats with low nutrient substrate. However, when the moss layer is accompanied by nutrient spillover it has the potential to increase exotic weed encroachment. Our results emphasise the importance of non-vascular plant inclusion in restoration schemes but also highlights the importance of mitigating for nutrient spillover.

The grander challenge of pediatric oncology: disparities in access to careJoseph Lubega, M.D., M.S., C.P.E.Baylor College of Medicine6701 Fannin St., Ste. 1510 Houston, TX 77030lubega@bcm.eduPhone: +1 832 822 4242Fax: +1 832 825 1453Word count: 968Short running title: Disparities in access to pediatric cancer careKeywords: pediatric cancer, disparities, global, minoritiesThe excellent survival of children with cancer in the United States (US) is a grand achievement that has been accomplished mainly through five decades of translating biomedical discoveries to the bedside. However, it obscures the significantly inferior survival of racial-ethnic minorities in the US1, 2, and highlights the unconscionably abysmal survival of children with cancer globally3. Intrinsic differences in epidemiology of prognostically relevant tumor and host biological factors contribute to these survival disparities. However, as demonstrated by the fact that the widest survival disparities occur among children with the most curable cancers and risk-groups2,4, the primary driver of inferior survival among minorities and children globally islack of access to effective pediatric cancer care. Discovery of efficacious therapies was/is the grand challenge to pediatric oncology; ensuring access to effective care for all children in the US and globally is the grander challenge of pediatric oncology.Access to health services is a complex construct that includes5: (1) availability of the services to a specific population, (2) adequate supply of the services to the population, (3) ability to utilize the health services, which includes requisite financial (e.g., medical insurance coverage) and social (e.g., flexibility of work schedule to attend medical appointments) resources, and (4) suitability of the services to the socio-cultural context of all demographic groups in the population. For the majority of the world’s children that develop cancer (~80%) and live in low/middle income countries, infrastructure and expertise for evidence-based pediatric oncology services are simply unavailable or are extremely scanty. On the other hand, racial-ethnic minorities in the US also suffer from lack of access to adequate pediatric oncology care despite the apparent abundance of services – suggesting barriers to utilization and/or suitability of services.In this issue of Pediatric Blood & Cancer , Zheng D.J. et al present an evaluation of access to a psychiatry service that is integrated into a children’s cancer center – the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center (DF/BCH) from 2013 to 2017. The authors examined the relationship between utilization of this psychiatry service and patients’ socio-demographic characteristics. Among a sample of 394 children with cancer that were evaluated, racial/ethnic minorities had 52% lower odds of using the psychiatry service. Household material hardship and household income, two indicators of financial deprivation that may be considered the most obvious determinants of service utilization, did not influence utilization of this psychiatry service. For children who utilized the psychiatry service, 88% were diagnosed with a psychiatric disorder, 76% were given a pharmacological therapy and 62% were given a behavioral intervention for their diagnosis. The high occurrence of a specific diagnosis and therapeutic interventions for the children that used the psychiatry services suggest that this is a highly valuable service for children that are referred.Zheng D.J. et al’s findings demonstrate that availability of services does not equate to access, and that it is often difficult to pin-point the underlying reasons. Although racial-ethnic minorities in the US are associated with financial deprivation, financial indicators did not explain the disparity in utilization of psychiatry services at DF/BCH6. This suggests other utilization or suitability factors were at play. Such factors may include stereotypical beliefs, attitudes, or practices in the interactions between minorities and health providers that negatively influence clinical decision-making and effectiveness7. In this case such stereotypes may influence minority children’s or parents’ rapport with their oncology providers and willingness of parents to report mental or behavior symptoms, and oncologists’ suspicion and threshold to make a psychiatric referral. Other practical social-cultural factors such as language barriers can influence utilization of services even when foreign language translators are used, particularly in the culturally sensitive realm of mental illness and behavioral disorders8.Research to identify and quantify these disparities and their underlying mechanisms is critical to devise effective strategies that will overcome the systemic dynamics that deter minority children from accessing optimal cancer care. In the case of Zheng D.J. et al’s findings, it would be very informative to determine the exact nature of the disparity by evaluating whether, (1) minorities were genuinely less likely to require a psychiatric consultation – a potential difference in disease epidemiology, (2) minorities needed psychiatric services but were not referred – suggesting inferior quality of care, (3) minorities were referred but never followed through on the psychiatric referral – a utilization problem. Mixed methods study designs that complement quantitative data with qualitative insights and involving key players (e.g., providers and minority patients in this case), can unveil critical issues around usability and acceptability that often underly under-utilization of services.Global and US disparities in pediatric cancer care and outcomes epitomize the public health adage that discovery of efficacious biomedical interventions does not automatically translate into improved health services and outcomes for those that need them. Whereas many pediatric oncology researchers are acutely aware of the difficulty to translate research innovations into bedside interventions (aka,“the valley of death”)9, most children/families affected by cancer globally are on the wrong side of a pediatric oncology “death canyon” – a complex milieu of financial, social-cultural, business interests, and health systems barriers that lie between them and the bedside (Figure 1). Enough scientific technologies have made it to the bedside to cure them, but only a few children can make it to the bed.Research that bridges efficacious interventions and their delivery to children with cancer is critically needed. In addition to dedicateddisparities research , hybrid designs that build disparity questions in translational, clinical trials, and epidemiology research are likely to be efficient and even more informative. This requires broadening the scope of research teams and meticulous recruitment of appropriate socio-demographic strata of research participants. For global settings where the landscape of health systems infrastructure and organization and social-cultural norms are very different,implementation research is urgently needed to innovate strategies that will enhance the adoption of pediatric cancer best practices that suit the local context.

A document by Sofie Jepsen. Click on the document to view its contents.

Objectives: We aim to analyze long-term voice outcomes and Quality of Life (QoL) in patients undergoing Open Partial Horizontal Laryngectomy Type II (OPHL Type II) and to compare them to those obtained by patients undergoing Total Laryngectomy (TL) with voice prosthesis (VP). Design: Cross-sectional cohort study Setting: patients undergoing surgery for advanced laryngeal cancer, assessed during the usual follow-up consultations at the Phoniatric Unit (February 2020-December 2020). Participants: Forty-five patients were enrolled and divided into two groups: OPHL Group and TL Group. Main outcomes measures: Maximum phonation time, INFV0 scale, I-SECEL, UWQoL-V4 and MDADI questionnaires were used to assess the long-term outcomes. Results: Voices of patients undergoing OPHL Type II were worse than those of laryngectomized patients with VP. Nevertheless, scores in voice and dysphagia-related QoL were comparable and scores in the Social domain of QoL were better in OPHL group. Conclusions. OPHL Type II allows an acceptable voice recovery and a satisfactory QoL.

OBJECTIVE Little is known about the efficacy of using artificial intelligence to identify laryngeal carcinoma from images of vocal lesions taken in different hospitals with multiple laryngoscope systems. This multicenter study was aimed to establish an artificial intelligence system and provide a reliable auxiliary tool to screen for laryngeal carcinoma. Study Design: Multicentre case-control study Setting: Six tertiary care centers Participants: The laryngoscopy images were collected from 2179 patients with vocal lesions. Outcome Measures: An automatic detection system of laryngeal carcinoma was established based on Faster R-CNN, which was used to distinguish vocal malignant and benign lesions in 2179 laryngoscopy images acquired from 6 hospitals with 5 types of laryngoscopy systems. Pathology was the gold standard to identify malignant and benign vocal lesions. Results: Among 89 cases of the malignant group, the classifier was able to evaluate the laryngeal carcinoma in 66 patients (74.16%, sensitivity), while the classifier was able to assess the benign laryngeal lesion in 503 cases among 640 cases of the benign group (78.59%, specificity). Furthermore, the CNN-based classifier achieved an overall accuracy of 78.05% with a 95.63% negative prediction for the testing dataset. Conclusion: This automatic diagnostic system has the potential to assist clinical laryngeal carcinoma diagnosis, which may improve and standardize the diagnostic capacity of endoscopists using different laryngoscopes.

This case report presents an extremely rare case of left main coronary artery atresia in a 14-week-old female infant presenting with severe symptoms of dilated cardiomyopathy.

ABSTRACTThis document aims to contribute to the discussion about the various aspects of water and sanitation in Uganda's rural regions. It also describes the various steps that were needed to improve the situation in these areas. This report mainly focuses on the qualitative data from house surveys conducted from 2002 to 2013. It is also divided into two sections, one of which includes literature review and the other one focuses on work done. This topic was mainly focused on the various restraints that affect the access to basic hygiene and clean water in rural areas. Next, the MRI methods being used in the study were discussed.

In this paper, we derive and analyze an extended SIRS-model which includes lockdown policies at the early stages of the pandemic. The latter play a salient role for flattening the curve of infectious diseases such as COVID-19, and is introduced as a model compartment. An error function is reported, which serves as a bridge between the outcomes of the model and available databases; we estimate the values of the model parameters by minimizing the error function. The intervention function, obtained from the equivalent system of the proposed model, and effective reproduction function are also derived to understand the underline scenario of the coronavirus outbreak. We then estimate the epidemiological variables such as susceptible, recovered, lockdown etc. for Canada and three of its provinces, Ontario, Qu\’ebec and British Columbia, significantly affected by the coronavirus. Some improvements, such as spatial dependence or “at risk’‘ vs “healthy” population, will finally be proposed in order to increase the accuracy of the modeling.