5 Key Points: Prior studies demonstrated a failure to identify and localize head and neck cancers via near-infrared (NIR) imaging of indocyanine green (ICG) with a robot-integrated platform. However, our group demonstrated success in visualization of neoplasms using a commercially available dedicated NIR camera system and a technique called second window ICG (SWIG), in which ICG is injected 24 hours pre-operatively.We aimed to evaluate the SWIG technique in patients undergoing transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) and compare two NIR camera systems.System 1 showed poor tumor-margin delineation with no fluorescence in 4/6 cases (66.7%) and only minimal fluorescence in the remaining 2 cases (33.3%).System 2 showed marked fluorescence in 5/6 cases (83.3%), with good margin definition in 4 cases (66.7%). In 2 cases (33.3%), System 2 also identified tumor that was not visible under white light.In this preliminary case series, we found that System 2 outperforms System 1 in NIR imaging with SWIG during TORS for oropharyngeal tumor resection.

Snow density is one of the essential properties to describe snowpack characteristics. To obtain the spatial variability of snow density and estimate it accurately in different periods of snow season still remain as challenges, particularly in the mountains. This study analyzed the spatial variability of snow density with in-situ measurements in three different periods (i.e. accumulation, stable, melt period) of snow seasons 2017/2018 and 2018/2019 in the middle Tianshan Mountains, China. The performance of multiple linear regression model (MLR) and three machine learning models (i.e. Random Forest (RF), Extreme Gradient Boosting (XGB) and Light Gradient Boosting Machine (LGBM)) to simulate snow density has been evaluated. It was found that the snow density in melt period (0.27 g cm-3) was generally greater than that in stable (0.20 g cm-3) and accumulation period (0.18 g cm-3), and the spatial variability of snow density in melt period was slightly smaller than that in other two periods. The snow density in mountainous areas was generally higher than that in plain or valley areas, and snow density increased significantly (p < 0.05) with elevation in the accumulation and stable periods. Besides elevation, latitude and ground surface temperature also had critical impacts on the spatial variability of snow density in the middle Tianshan Mountains, China. In this work, the machine learning model, especially RF model, performed better than MLR on snow density simulation in three periods. Compared with MLR, the determination coefficients of RF promoted to 0.61, 0.51 and 0.58 from 0.50, 0.1 and 0.52 in accumulation period, stable period and melt period respectively. This study provide a more accurate snow density simulation method for estimating regional snow mass and snow water equivalent, which allows us to achieve a better understanding of regional snow resources.

Hosts and parasites have often intimate associations. Therefore, the evolution of their interactions is crucial for understanding species-rich host-parasite communities. Yet relatively few studies investigate eco-evolutionary feedbacks in these systems as large datasets remain scarce. Here, we explore African cichlid fishes and their flatworm gill parasites (Cichlidogyrus spp.) including 9901 reported infections and 473 different host-parasite combinations collected through a survey of peer-reviewed literature. We apply network metrics, estimate host repertoires, and use network link prediction (NLP) algorithms to investigate meta-community structures and their predictors including evolutionary, ecological, and morphological parameters. Host repertoire was mostly determined by the hosts’ evolutionary history. Both ecological and evolutionary parameters predicted host parasite associations but many interactions remain undetected according to NLP. We conclude that ecological opportunity paired with ecological fitting has shaped interactions. The cichlid-Cichlidogyrus network is a suitable study system for eco-evolutionary feedbacks but taxonomic research remains key to finding undetected interactions.

The reintroduction of endangered plant species is an essential conservation tool. Reintroductions can fail to create resilient, self-sustaining populations due to a poor understanding of environmental factors that limit or promote plant success. Biotic factors, specifically plant-arthropod interactions, have been shown to affect the establishment of endangered plant populations. Lupinus nipomensis (Nipomo Mesa lupine) is a state of California (California Rare Plant Rank: 1B.1) and federally (65 FR 14888) endangered endemic plant with only one extant population located along the central California coast. How arthropods positively or negatively interact with L. nipomensis is not well known and more information could aid conservation efforts. We conducted arthropod surveys of the entire L. nipomensis extant population in spring 2017. Observed arthropods present on L. nipomensis included 17 families, with a majority of individuals belonging to Thripidae. We did not detect any obvious pollinators of L. nipomensis, providing support for previous studies suggesting this lupine is capable of self-pollinating, and observed several arthropod genera that could potentially impact the reproductive success of L. nipomensis via incidental pollination or plant predation.

Background: Abnormal left ventricular (LV) echocardiographic parameters during non-systolic phase, with or without a diagnosis of heart failure, is a common finding that can be easily diagnosed by intra-operative transesophageal echocardiography (TEE). However, its association with duration of hospital stay after coronary artery bypass (CAB) is unknown. Objective: To determine if Abnormal left ventricular (LV) echocardiographic parameters during non-systolic phase is associated with length of hospital stay after coronary artery bypass surgery (CAB). Method: Prospective observational study at a single tertiary academic medical center Result: Median time to hospital discharge was significantly longer for subjects with abnormal left ventricular (LV) echocardiographic parameters during non-systolic phase (9.1/IQR 6.6-13.5 days) than those with normal LV non-systolic function (6.5/IAR 5.3-9.7days) (P< 0.001). The probability of hospital discharge was 34% lower (HR 0.66/95% CI 0.47-0.93) for subjects with abnormal LV function even during non-systole despite a normal LV systolic function, independent of potential confounders, including a baseline diagnosis of heart failure Conclusions and Relevance: In patients with normal systolic function undergoing CAB, non-systolic LV dysfunction is associated with prolonged duration of postoperative hospital stay. This association cannot be explained by baseline comorbidities or common post-operative complications.

The subphylum Myriapoda included four extant classes (Chilopoda, Symphyla, Diplopoda and Pauropoda), but very little work has been done to explore their phylogenetic relationships. Herein, we determined the complete mitochondrial genome of Polydesmus sp. GZCS-2019 (Myriapoda: Polydesmida) and the mitochondrial genomes are circular molecules of 15,036 bp, with all genes encoded on + strand. The A+T content is 66.1%, making the chain asymmetric, and exhibits negative AT-skew (-0.236). Several genes rearrangements were detected and we propose a new rearrangement model: “TD (N\R) L + C” based on the genome-scale duplication + (non-random/random) loss + recombination. Phylogenetic analyses demonstrated that Chilopoda and Symphyla both were monophyletic group, whereas Pauropoda was embedded in Diplopoda to form the Dignatha. Divergence time showed the first split of Myriapoda occurred between the Chilopoda and other classes (Wenlock period of Silurian). We combine phylogenetic analysis, divergence time, and gene arrangement to yield valuable insights into the evolutionary history and classification relationship of Myriapoda and these results support a monophyletic Progoneata and the relationship (Chilopoda + (Symphyla + (Diplopoda + Pauropoda))) within Myriapod. Our results help to better explain the gene rearrangement events of the invertebrate mitogenome and lay the foundation for further phylogenetic study of Myriapoda.

Large scale manufacturing of viral vectors or vaccines with adherent cells still relies heavily on the inclusion of fetal bovine serum for the growth and production phases. The inclusion of serum presents numerous problems with the undefined chemical makeup, the undesirable safety profile, and the constraints and limitations on the global supply. Despite these challenges, alternatives to serum for adherent cells have been limited; however, advances in large-scale production of recombinant human proteins have enabled the advancement of blood-free media that can support adherent cell growth. In order to circumvent the need for serum in adherent platforms, we developed a serum and blood-free, chemically defined medium specific for adherent human epithelial kidney cells and evaluated growth kinetics as well as viral vector production with associated adenovirus and lentivirus. We observed doubling times equal to or faster than doubling times observed in serum containing medium. We also demonstrate transfection efficiencies and viral titers that are equivalent to or higher than that of serum. Our results demonstrate that fetal bovine serum is not required for culture of adherent HEK cells, and that a serum-free, blood-free, chemically defined approach can be reliably implemented in the production of viral vectors for gene therapy.

Introduction male circumcision is a common procedure, generally performed during the newborn period. Few reports have described circumcision in patients with bleeding disorders. Aim to determine bleeding rate after circumcision in neonatal male subjects who were diagnosed later in life with delta-storage pool disease (SPD). Methods we retrospectively reviewed the medical records of male subjects (<18 years of age) who were diagnosed with SPD later in life and were circumcised at birth without hemostatic prophylaxis due to lack of family history at that time from 2000-2020. Intraoperative/postoperative bleeding and bleeding severity were the main outcomes evaluated. Results 153 male subjects were included. Circumcision was performed at a median age of 2 days (range, 1 day-4 months). The main indication for circumcision was parental request. Median severity of granule deficiency was 2.76 dense granules/platelet (range, 1.12-3.82 DG/Plt). None of the subjects had intraoperative bleeding. Three subjects (2%) had postoperative bleeding and only one (0.65%) required ER intervention to stop bleeding. Conclusion the overall incidence of bleeding in our subjects with SPD who were undiagnosed and untreated at circumcision, is comparable to that reported for patients without a bleeding disorder.

This study compared the microhabitat use, daily activity pattern and diet of Liolaemus etheridgei Laurent 1998 in two Polylepis woodlands: El Simbral (fragmented) and Tuctumpaya (unfragmented), in Arequipa, Southern Peru. In both populations, we did not detect positive selection for any microhabitat; however, the population at El Simbral showed a negative selection for Polylepys trees while the Tuctumpaya population showed negative selection for Polylepis trees and non-thorny bushes. In El Simbral, active individuals were detected between 9:00 and 15:59h, whereas in Tuctumpaya, we detected active individuals from 8:00 to 17:59h. In both populations, observations of active individuals dropped between 11:00 and 11:59h. We recorded 17 and 23 prey categories in the El Simbral and Tuctumpaya populations respectively. The most important animal prey category in each population was found to be Lygaeidae: Hemiptera, and was the only animal prey category that was selected for in El Simbral and Tuctumpaya. In addition, due to the proportions of plant material found, the El Simbral was found to be omnivorous, whereas the Tuctumpaya population was herbivorous. Trophic niche breadth was broader in Tuctumpaya (B_a= 0.202) than the El Simbral (B_a= 0.147) population, despite there being no significant differences in diet (Permanova: F = 1.036, P = 0.409, permutations = 9999), which is coherent with the high value of trophic niche overlap (O_(j,k) = 0.963). Our compiled data reveal that L. etheridgei shows no selection for any of the resources we define in Polylepis woodlands, on the contrary, it selects negatively against Polylepis trees and non-thorny bushes. The daily activity patterns indicate a bimodal pattern with peaks at 9:00-10:59 and 13:00-13:59 h. The diet of L. etheridgei consists mainly of plants (%W: 66.373), and the most important animal prey category is Lygaeidae: Hemiptera (%IRI = 55.3), which is selected positively.

Species traits influence their response to environmental conditions and the match between phenotypes and environment mediates spatial changes in species composition. These trait-environment linkages can be disrupted in human-modified landscapes. Human land-use creates habitat fragments where dispersal limitation or edge effects can exclude species that may otherwise suit a given macro-scale environment. Furthermore, stressful micro-environments in fragments may limit viable trait combinations resulting in stronger trait covariance compared to contiguous forest, especially in harsher macroenvironments. In a wet tropical forest landscape in the Western Ghats Biodiversity Hotspot of peninsular India, I compared fragments with adjacent contiguous forest for signatures of trait-mediated assembly of tree communities along macroenvironmental gradients. Using four key plant traits—seed size, specific leaf area (SLA), wood density, and maximum height—I evaluated changes in trait-mediated abundances and trait covariance across environmental gradients. Trait-mediated abundances primarily changed along the elevation gradient in contiguous forest, smaller-seeded, shorter, thinner-leaved species increased at higher elevations. In fragments, higher SLA species increased in more seasonal climate and decreased with higher precipitation, and larger seeds decreased at warmer sites. However, traits only weakly predicted abundances and only contiguous forests experienced significant compositional change via traits, driven by trait syndromes varying along a composite environmental gradient defined by elevation, water deficit, and soil C:N ratio. Covariance of seed size and maximum height along gradients of precipitation and temperature revealed divergent constraints on viable phenotypes in fragments and contiguous forest. Notably, local biotic conditions (functional diversity) had stronger effects than environment in explaining trait covariance. Overall, the results imply that trait syndromes and trait covariance, rather than single traits, determine the phenotypes best suited to different macroenvironmental conditions and should inform management or restoration goals in fragments.

Objective: Epistaxis is the most common otolaryngological emergency and up to one third of patients in treated on an inpatient basis take oral anticoagulants (OAC). Direct oral anticoagulants (DOAC), an OAC subgroup, have been on the market since 2010 and are being increasingly prescribed due to the cardiologic and hematologic guidelines that favour them over vitamin K antagonists (VKA), the older of the OAC subgroups. The present study aims to investigate which subgroup of epistaxis patients taking OACs has a more favourable outcome. Design/Setting: A systematic review and meta-analysis were performed according to the PRISMA 2020 statement using the PubMed and Cochrane Library databases. Continuous data was analysed and standardized mean difference (SMD) was calculated according to Hedges’ g. Dichotomous data was analysed and the Mantel-Haenszel method was applied to establish the odds ratio (OR). Heterogeneity was assessed according to the I2 statistics. Main Outcome/Results: A total of 8 reports covering 1390 patients were included in the final synthesis. The pooled analysis demonstrated significantly shorter hospital stays in the DOAC group (SMD= -0.22, 95% CI -0.42 to -0.02, P= .03) and a significantly higher rate of posterior bleeding in the VKA group (OR= .39, 95% CI .23 to .68, P= .001). No statistically significant differences with regard to recurrence rates, admission rates, the need for transfusion, or surgical intervention (P= .57, .12, .57 and .38 respectively) were found. Conclusion: According to this meta-analysis, epistaxis patients taking DOACs have a more favourable outcome than patients taking VKAs.

Physical structures of Digital Species are bioelectric, that is, they host electrochemical processes. For instance, the brain has a network of billions of neurons which transmit signals via ions that generate potential at their axions. Thus any brain stores or allows the propagation of electrical energy. This electrobiochemistry is evident throughout the nervous system.Unfortunately, humans are accustomed to reference life as a series of chemical reactions. As a result, biology is disowned of its electricity to the extent that electrobiophysics seems to be categorized as a fundamental branch of science for post-human life enhancement technologies. This work seeks to extinguish such misunderstandings of biological systems and to formulate the principles of electrical biology.ELECTROBRAIN(Here, "brain" implies an organism's center for awareness, computation and coordination.)Famously likened to a natural supercomputer, the human brain is the most complex biological organization in existence. As a principal part of the nervous system it interprets information sets from the reality it is locked away from by the skull. Attempts to advance cognitive capacity, for most researchers begins and ands with artificial intelligence, which is itself a subdiscipline of computer science. But there is an alternative route to enhancing cognitive capacity namely, synthetic biology. This is the road I choose to take here.A synthetic brain - at least in my version(SB) - builds electronic devices onto the components inside the skull. Of course, this is an invasive method that by the first look of it any medical skeptic would shy away from. Nevertheless, it is the most 'natural' of artificially made intelligences.The SB has enhanced neurones and organizational architecture. Conductivity via axions is accelerated by balancing or adding (or reducing) signal transfering ions, thickening (or thinning) the myelin sheath and improving effectiveness of synapses by directed point stimulation. In software, SB places logic filters and uses saved cognitive processes for future application. This is a case that - through increasing cognitive cache - stabilizes fast thinking. Thus making out more accurate, truthful and quickens the slow thinking to at an optimal pace.Electrical components are designed for connectome compatibility and even for applications of the Many-Worlds Interpretation of Cognition (Isai 2020) and Non-Linear Time Chambers (Isai 2021). And, as it turns out, the Synthetic Brain updates to any intelligence enhancement procedure for humans becoming digital species or rather better embodied extants across the tree of life.ELECTROBOWELFor most people, the stomach is a sac for temporal storage of ingested semi-digested food. To digital species it is an interspecies energy link. One's stomach must interact with other stomachs, more broadly via the Cross-Species Gut Network (CSGN).The smart bowel can be externally interfaced such that to check contents composition, quantitatively measure hunger or satisfaction, assess IBD or IBS conditions and activate virtual excretion or deposition of undigested material. Also, It is fit with colorable layerings, anti-ulcers walls and shape to size modulations for malnutrition victims. The electro-bowel contains electrified biochemistry and may be inserted with replaceability and cloud updates that sync with the entire digestive systems and changes in nutrition patterns.ELECTROSTINESHere, the intestines, large and small are enhanced. Ultra absorption capabilities for the colon enable selective hydrobalance. Body water content is matched with requirements, weather and fluids intake data.Cellular walls involve coverings for extra storage and buffering. The illeum and duodenum are redesigned into surface area configurations that improve transport rate and favor gut bacteria among other usefulness.From The Interface, Intestinal gas is combated. So is ulcerative collitis and related conditions. The digital intestines are complemented by nanobots that learn an individual's unique digestion mechanism and solves spontaneous nuisances oftentimes before the effects are experienced by the individual.Enzymatic integration optimizes food processing by using less metabolic currency. Meals count, frequency and quantity are suggested from 'passages' data and performance and effectiveness between ingestions. Selectivity ensures zero waste, that is, no undigested contents, hence presenting a possible end of toiletry and faeces at large across life-forms. Major outputs of the electrostines are for the CGSN. Lastly, the 'stines' can toggle between biofood or digital/electrofood conveniently. This is digestion, solved.***This treatment of bioelectrochemistry has previewed three structures and two systems. Of course, there is room for exploration into more organs and mechanisms. The choice for the digestive and nervous systems is done mainly to suggest the fundamentality of energy - via food - and intelligence - via neural networks. These are two companions without which life does not emerge from the more general status of existence.Biological Digital Electronics shows that it is possible to electrify the human body inwardly, just as exoskeletons, implants and technologies of their like have shown outwardly. We may learn to view chemistry as a mirror of electrostatics and electromagnetism. Life too, can go electric! Welcome to Life Electric.This article was originally titled as "BIOLOGICAL DIGITAL ELECTRONICS" (This version is an unedited adaptation from my handwritten Essays In High School.)

Although insect herbivores are known to evolve resistance to insecticides through multiple genetic mechanisms, resistance in individual species has been assumed to follow the same mechanism. While both mutations in the target site insensitivity and increased amplification are known to contribute to insecticide resistance, little is known about the degree to which geographic populations of the same species differ at the target site in a response to insecticides. We tested structural (e.g. mutation profiles) and regulatory (e.g. the gene expression of Ldace1 and Ldace2, AChE activity) differences between two populations (Vermont, USA and Belchow, Poland) of the Colorado potato beetle, Leptinotarsa decemlineata in their resistance to two commonly used groups of insecticides, organophosphates, and carbamates. We established that Vermont beetles were more resistant to azinphos-methyl and carbaryl insecticides compared to Belchow beetles, despite a similar frequency of resistance-associated alleles (i.e. S291G) in the Ldace2 gene. However, the Vermont population had two additional amino acid replacements (G192S, F402Y) in the Ldace1 gene, which were absent in the Belchow population. Moreover, the Vermont population showed higher expression of Ldace1 and was less sensitive to AChE inhibition by azinphos methyl oxon than the Belchow population. Therefore, the two populations have evolved different genetic mechanisms to adapt to organophosphate and carbamate insecticides.

BJOG Exchange

Three-dimensional (3D) bioprinting is a potential therapeutic method for tissue engineering owing to its ability to prepare cell-laden tissue constructs. The properties of bioink are crucial to accurately control the printing structure. Meanwhile, the effect of process parameters on the precise structure is not nonsignificant. We investigated the correlation between process parameters of 3D bioprinting and the structural response of κ-carrageenan-based hydrogels to explore the controllable structure, printing resolution, and cell survival rate. Small-diameter (<6 mm) gel filaments with different structures were printed by varying the shear stress of the extrusion bioprinter to simulate the natural blood vessel structure. The cell viability of the scaffold was evaluated. The in vitro culture of human umbilical vein endothelium cells (HUVECs) on the κ-carrageenan (kc) and composite gels (carrageenan/carbon nanotube and carrageenan/sodium alginate) demonstrated that the cell attachment and proliferation on composite gels were better than those on pure kc. Our results revealed that the carrageenan-based composite bioinks offer better printability, sufficient mechanical stiffness, interconnectivity, and biocompatibility. This process can facilitate precise adjustment of the pore size, porosity, and pore distribution of the hydrogel structure by optimising the printing parameters as well as realise the precise preparation of the internal structure of the 3D hydrogel-based tissue engineering scaffold. Moreover, we obtained perfused tubular filament by 3D printing at optimal process parameters.

We report a case that the airway can be completely sealed, when the endotracheal tube cuff pressure is 100 cmH2O. The diagnosis was made by the patient’s chest CT（X-ray computed tomography）, This case illustrates that the real cross-sectional area of airway from the case obviously exceeds the normal population.

COVID-19 has been linked to a number of cutaneous symptoms in COVID-19 patients. Although herpes zoster (HZ) was the first sign of COVID-19 infection in several patients, cases of HZ after COVID-19 vaccination are rare. We report case of 51 years old male with Herpes Zoster after Sinopharm (Vero Cell).

Thrombotic complications of SARS-CoV-2 have been increasingly recognized as an important component of COVID-19 in adults; however, they have been less evident in children. We report a case of a teenager with positive SARS‐CoV‐2 RT–PCR and underlying prothrombotic risk factors, including aromatase inhibitor therapy, who developed deep vein thrombosis resulting in pulmonary embolism. Laboratory tests revealed deranged coagulation parameters (high D-dimers and Factor VIII and low antithrombin). The patient required intensive care and was managed with anticoagulants, dexamethasone and antithrombin concentrate. Clinical condition and hemostatic profile gradually improved. A review of the available literature for similar cases is presented.

Patients in respiratory failure on VV ECMO may develop cardiovascular dysfunction necessitating additional hemodynamic support, while patients in cardiovascular failure on VA ECMO may require additional respiratory support for concurrent gas exchange abnormalities. A hybrid venoarterio-venous (VA-V) configuration provides both cardiac support via a traditional arterial reinfusion cannula and respiratory support via an additional venous reinfusion limb. We describe our single center experience using VA-V ECMO for patients (n = 14, median age 54) with combined cardiopulmonary failure or differential hypoxemia. Patients were treated with ECMO support for a median of 148.2 (IQR 122.6 – 174.4) hours, consisting of 0 (IQR 0 – 1.8) hours of VA and 92.4 (IQR 58 – 115) hours of VA-V followed by 46 (IQR 0 – 95.5) hours of VV support. Of these 14 patients, 11 survived to decannulation (79%) and 9 survived to hospital discharge (64%).

In this paper Modified gravity is studied over the weak field linearized metric perturbation in post-Minkowskian theory. This is a different aspect for studying the two body dynamics or binary system. Here despite of usual self force originated from the radiative backscattering of gravitational waves we are considering new paradigm of perturbation that is multiplicative approach. The new perturbed metric is determined over the multiplication of isolated background metric of curved space-time for two different massive sources in post-Newtonian theory. To verify the model and the theoretical result the binary system of Milky Way central super massive black hole to Sun is considered. The computation shows remarkable result without MOND for galactic flat rotation curve and solar rotational speed 249km/sec, obviously very good agreement with recent observed data.

Objective: To evaluate the relation between peripartum infection at first caesarean delivery to uterine dehiscence or rupture at the subsequent delivery. Design: Retrospective case-control study from March 2014 to October 2020. Setting: University-affiliated medical centre. Sample: Women with a prior caesarean delivery and proven dehiscence or uterine rupture diagnosed during their subsequent delivery. The control group included women who had a successful vaginal birth after Cesarean section without evidence of dehiscence or uterine rupture. Methods: We compared the rate of peripartum infection during the first Cesarean delivery and other relevant variables, between the two groups. We also analysed the type of infection correlated with uterine rupture or dehiscence. Main Outcome Measures: Rate of peripartum infection. Results: A total of 168 women were included, 71 with uterine rupture or dehiscence and 97 with successful vaginal birth after Cesarean section as the control group. The rate of peripartum infection at the first caesarean delivery was significantly higher in the study group compared to the control group (22.2% vs. 8.2%, p=0.013). Multivariate logistic regression analysis found that peripartum infection remained an independent risk-factor for uterine rupture at the subsequent trial of labour after Cesarean delivery (95% CI, P=0.018). We also found that endometritis had the highest correlation to uterine rupture (9.8% vs. 0%, p=0.02) Conclusion: Peripartum infection in the first caesarean delivery, may be an independent risk-factor for uterine rupture in a subsequent delivery. Compared to other infections, endometritis may pose the greatest risk for uterine rupture or dehiscence.

Atrial fibrillation (AF) is one of the most common arrhythmia, and radiofrequence catheter ablation has become the most effective treatment method.The inferior vena cava(IVC)is a common approach for radiofrequency ablation of atrial fibrillation. In some cases, this approach cannot be used, such as chronic venous occlusions, surgical ligation of the IVC and heterotaxy syndrome. In patients without femoral vein access, use of the hepatic vein for PVI is a viable alternative for invasive EP procedures.

To determine the mechanisms underlying the response of microbial interactions to vegetation restoration under different climate conditions, we examined the changes occurring at two temperature levels in soil bacterial, fungal, and protist microbiomes under a reference cropland and a plantation forest and a shrubland. Bacterial and protist diversity levels in the high-temperature region of Guangxi (20.9 °C) were higher in cropland than in shrubland or plantation forest. By contrast, fungal richness was lower under cropland than shrubland. The bacterial phyla Cyanobacteria, Gemmatimonadetes, and Nitrospirae, the fungal taxa Ascomycota and Mucoromycota, and the protist groups Ciliophora, Lobosa, and Ochrophyta had lower abundance under vegetation restoration than cropland. There were no significant differences between shrubland and plantation forest in terms of bacterial, fungal, or protist diversity or community composition. A co-occurrence network revealed higher numbers of correlated links among bacterial, fungal, and protist taxa in the low-temperature region of Guizhou (14.6 °C) than Guangxi. Stronger interactions were observed among microbial taxa under cropland than under vegetation restoration. Protist groups Cercozoa and Lobosa showed the highest numbers of links with bacterial phyla Acidobacteria and Proteobacteria and with fungal phylum Ascomycota. Hence, a strong food web existed among these microbiomes. Proteobacteria, Acidobacteria, Ascomycota, and Cercozoa were correlated with soil nutrient levels. Therefore, these dominant taxa determined nutrient availability. The predation of bacteria and fungi by protists was more intense at low temperature than high temperature. Key bacterial, fungal, and protist groups, their co-occurrence networks, and environmental temperature influence soil nutrient accumulation during vegetation restoration.

Levoatrial cardinal vein (LACV) is anomalous connection between the left atrium or pulmonary veins and any systemic vein which is derived from cardinal venous system. Presence of the levoatrial cardinal vein without a cardiac anomaly is a very rare congenital anomaly of the systemic venous return. In the literature, no LACV anomaly was found in two siblings who were asymptomatic and did not have an additional cardiac anomaly. Therefore, we present two cases ( two siblings ) the symptoms, diagnosis (the echocardiographic finding, computed tomography (CT) and aniographic images ) and treatment modalities of isolated levoatrial cardinal vein.