Ecomorphological studies are aimed to find out the relation between the morphology of organisms and their ecology. Many studies on reptile scale microornamentation indicate that it has important functional values. In this study microornamentation and light reflection of scales' surface among six viperid and two colubrid snake species in relation to their habitat were examined. To compare microornamentation and light reflection analyses, skin specimens were prepared and analyzed using scanning electron microscopy and FluoVision Imaging System and spectrometer, respectively. The results showed that snake species inhabiting similar habitats had different microornamentation and vice versa. Likely the scale microstructures are more influenced by phylogenetic relationships than by the environment. In examining the scales' reflection, different species and different body parts reflect various wavelengths of visible light, which relates to ecological condition of them.

Invited Commentary

We describe 68 hematopoietic cell transplantation (HCT) patients who visited our pediatric emergency department during 2014-2015 (188 encounters). Fever was the main complaint in 74 (34.8%) encounters. Diagnostic tests were performed in 147 (78.2%) episodes [100% of patients with unstable Pediatric Assessment Triangle (PAT) and 75.7% with stable PAT (P value 0.02)] and treatment was required in 93 (49.5%) episodes [15 (78.9%) with unstable PAT and 78 (46.2%) with stable PAT (P value <0.001)]. Risk factors for admission were unstable PAT [relative risk (RR) 3.4 (2.6-4.6), P value <0.001] and ≤100 days since HCT [RR 2.1 (1.4-3.1), P value <0.001].

A document by Zachary Enumah. Click on the document to view its contents.

Surgical left ventricle restoration (SVR) was firstly by Cooley in 1958 with the “linear suture technique”, and three decades later, Dor used a circular patch to reconstruct the left ventricle excluding the scarred parts of the septum and ventricular wall. It gained popularity and eventually almost abandoned after the contrasting literature evidences. Hassanabad et al. presented a comprehensive review of current literature on surgical ventricle restoration (SVR) techniques and clinical outcomes, trying to understand if SVR has still a substantial role in the modern medicine.

We report a case of a 32-year-old male patient who sustained an isolated stab injury to the left chest wall. He was initially treated with emergency surgery for right ventricular free wall rupture, with an uneventful postoperative course. During follow-up, the patient complained of exercise intolerance and dyspnea on effort. Transthoracic echocardiography (TTE) demonstrated a previously undiagnosed severe tricuspid regurgitation due to flail of the anterior leaflet and a ruptured chorda. A redo operation was scheduled, and the valve was successfully repaired, with different techniques employed. This case highlights the importance of careful clinical evaluation of victims of chest penetrating trauma and how early diagnosis of hidden valvular lesions might increase the odds of valve repair. It also demonstrates the clover technique as a valuable technique in the correction of traumatic tricuspid regurgitation.

Background. Cor triatriatum is a rare congenital cardiac anomaly, represent 0.1% of all congenital cardiac malformations and may be associated with other cardiac diseases in as many as 50% of cases. The natural history of this defect depends on the size of the communicating orifice between the upper and lower atrial chamber. Case Presentation. We reported case of cor triatriatum in a 12 years old girl with chief complaint of shortness of breath, middle chest discomfort and palpitation since 5 days prior admission. The diagnosis was based on clinical features, chest radiography, electrocardiography and transthoracic echocardiography. Chest radiograph showed rounded cardiac apex and double contour appearance. ECG showed sinus rhythm, 75 beat per minute, RAD, CCWR, RVH, RV strain pattern with ST depression and T-wave inversion in II, III, aVF, V1-V5. TTE revealed 2 chambers of left atrium, with restrictive supramitral membrane, dilated right atrium, right ventricle and left atrium, smallish left ventricle, proximal left atrial thrombus (5.96 x 3.44 cm), relative mitral stenosis, severe mitral regurgitation, mild aortic regurgitation and severe tricuspid regurgitation. A diagnosis of cor triatriatum sinister was made. The only treatment is surgical correction. Medical therapy, with ampicillin and heparin, was administered during admission. Conclusion. Cor triatriatum has been reported in a 12-year-old girl. The diagnosis is confirmed by clinical manifestations, chest radiography and echocardiography. The only therapy is surgical correction. From the field of cardiac surgeon, patients are advised to improve their general conditions before underwent surgical procedures.

In the retina, mineralocorticoid receptor (MR), expressed in vessels, glial and neuronal cells, is mainly activated by glucocorticoids. Under pathological conditions, ocular MR expression and corticoids change, leading in most cases to MR overactivation. Experimental models using MR agonists or antagonists, administered systemically or intraocularly, acutely or chronically and transgenic models, allowed to identify the deleterious consequences of MR pathway overactivation. Among them, oxidative stress, inflammation, deregulation of hydro-ionic channels, alteration of choroidal vasculature, angiogenesis and cell death, are common to major retinal diseases. Specific MR antagonists showed efficacy in models of diabetic retinopathy, ischaemia, retinal and choroidal angiogenesis and in models of glaucoma. It is highly likely that MR antagonists will find a place in the therapeutic arsenal of age-related macular degeneration, diabetic retinopathy, glaucoma and in pachychoroid associated diseases. Their use in humans is still limited by the need of biomarkers of MR activation and specific ocular formulations.

STAT5B protein is an important component of signalling pathway for growth hormone and IL-2 mediated responses. Mutation in STAT5B gene has been reported to be associated with growth hormone insensitivity, immunodeficiency and autoimmunity. Chronic pulmonary involvement is also one component of the disorder. We describe a case an adolescent girl who suffered with poor growth and loose stools since 1 year of age and was subsequently diagnosed with celiac disease and hypothyroidism. She developed features of interstitial lung disease (ILD) which were progressively worsening. Common causes of ILD were ruled out on investigations. She underwent whole exome sequencing and found to be positive for a novel mutation in STAT5B gene on exon 16. On further evaluation, she had growth hormone insensitivity and CD8 cell deficiency. This case highlights that in a child with chronic pulmonary involvement with features suggestive of growth hormone insensitivity, immunodeficiency and autoimmunity, evaluation for STAT5B mutation should be thought of.

In this paper, we pose a new iterative algorithm and show that this newly constructed algorithm converges faster than some existing iterative algorithms. We validate our claim by an illustrative example. Also, we discuss the convergence of our algorithm to approximate the solution of a general variational inclusion problem. Also, we present a numerical example to verify our existence and convergence result. Finally, we apply our proposed iterative algorithm to solve a delay differential equation as an application

A new class of rational parametrization has been developed and it was used to generate a new family of rational k functions B-splines which depends on an index α ∈ ]−∞ , 0[ ∪ ]1 , +∞[. This family of functions verifies, among other things, the properties of positivity, of partition of the unit and, for a given degree k, constitutes a true basis approximation of continuous functions. We loose, however, the regularity classical optimal linked to the multiplicity of nodes, which we recover in the asymptotic case, when α → ∞. The associated B-splines curves verify the traditional properties particularly that of a convex hull and we see a certain “conjugated symmetry” related to α. The case of open knot vectors without an inner node leads to a new family of rational Bezier curves that will be separately, object of in-depth analysis.

The human microbiota, which consists of trillions of microorganisms, impacts the host’s health and treatment of potential diseases. The role of the microbiota in the development and treatment of childhood leukemia is still not clear. This study reviews the current scientific understanding of the changes in gut microbiota composition during chemotherapy in acute lymphoblastic leukemia (ALL) in children and assesses its impact on the treatment process. The findings show alterations in gut microbiota are obvious at the time of diagnosis of ALL. During intensive chemotherapy, dysbiosis persists, and after treatment, the microbiota restores its diversity. However, there are significant gaps in understanding the impact of gut microbiota on the severity of treatment complications and overall survival rate.

We present a case of acute meningitis due to extended-spectrum beta-lactamase-producing E. coli in a patient with immune thrombocytopenic purpura and diabetes mellitus. This challenging entity is uncommon but has a high mortality rate. The exact mechanism for the pathogenesis is not obvious and needs further studies

Objectives: The study sought to examine the prognostic impact of valvular surgery in patients with severe dilated left ventricle(DL) and assess morphological and functional changes of DL in the early period after operation. Methods: From January 2013 to December 2018, at a single center, 126 patients with severe dilated left ventricle (DL group) and 511 patients with 511 patients with normal sized left ventricle (NL group) underwent heart valve surgery. Retrospective review of the procedure and the postoperative clinical course, including echocardiography were analyzed in 6 to 12-month follow up. Results: Compared with NL group, DL group had significantly higher postoperative all-cause mortality (3.2% vs 1.4%) and complication rate, as well as longer duration of mechanical ventilation and vasoactive agents support. In DL group, 4 (3.2%) patients died in the early postoperative stage among which 2 (1.6%) patients died from multiple organ failure (MOF) secondary to severe low-output syndrome, 2 (1.6%) patients died from ventricular fibrillation. The DL group had longer time of mechanical ventilation and vasoactive agents support than NL group postoperatively. In DL group, the progressive regression of end-diastole diameter (LVEDD) was observed during the follow-up; whereas left ventricular ejection function (LVEF) and left ventricular fractional shortening (LVFS) showed a temporary decrease in early postoperative stage and then improved gradually. Conclusion: Heart valve surgery performed in an experienced center, along with sophisticated perioperative management, could bring satisfying early outcomes to patients with severe dilated left ventricle.

Jaguars (Panthera onca) are the largest felids in America, mainly threatened by habitat and prey density loss and hunting. Jaguars are mainly nocturnal predators that need large portions of suitable habitat with abundant prey populations. The aim of this work was to assess both jaguar and prey activity patterns, their relations and to understand if the presence/absence of prey and their activity patterns might determine the movements of jaguars in a spatio-temporal frame. We used data from camera trapping records of 125 jaguar events of presence from 9,360 camera trap days effort and data from five jaguars with GPS collars, to analyze: 1) Activity patterns; 2) Speed movement; 3) Traveled distances and 4) Co-occurrence for jaguars and preys. Differences between sexes and between seasons were also evaluated. A total of 12,566 segments of movement were recorded. Two activity peaks were identified between 07:00-08:00 and 22:00-23:00 hours. Average traveled distance was 265.66 m/h (± 390.98 m/h). The maximum hourly distance was 2,760.25 m/h; with significant differences considering the hour of day (χ2 = 324.51, df 11, p < 0.001), with higher mean values between 00:00 and 08:00 h. The average distance covered by males was higher than females (Z –24.827, p < 0.001): 341.64 ± 440.03 m/h and 146.31 ± 259.04 m/h respectively. Significant differences considering seasons were found (Z = –16.442, p < 0.001): average distance during the dry season was 230.35 ± 365.87 m/h and was higher during the rainy season: 337.082 ± 430.45 m/h. Differences according to season were also consistent considering males and females separately (males: Z = –6.212, p < 0.001; females: Z = –15.801, p < 0.001). Occupation model analysis revealed that two of the five pairs of species (P. onca and P. tajacu and P. onca and C. paca) occur with more frequency than if they were independent, while in terms of co-detection, P. onca and P. tajacu and P. onca and C. paca showed independence

Lesions involving the tongue may present with life threatening complications such as airway compromise and risk of severe hemorrhage. This paper reports the surgical management of a non-involuting massive congenital hemangioma of the tongue in an infant presenting with difficulty breathing, feeding and inability to close the mouth.

Defects in DNA repair genes have been extensively associated to cancer susceptibility. Germline pathogenic variants (GPV) in genes involved in homologous recombination repair pathway predispose to cancers arising mainly in breast and ovary, but also other tissues. The RAD51 paralogs RAD51C and RAD51D were included in this group 10 years ago, when germline variants were associated to non-BRCA1/2 familial ovarian cancer. However, whether GPVs in these genes are associated with other cancers remains unknown. Here, we have reviewed the landscape of RAD51C and RAD51D germline variants in cancer reported in the literature during the last decade, curating a total of 341 variants and the phenotypes found in families with RAD51C/D variant carriers. A comprehensive catalogue has been generated pinpointing to the existence of recurrent variants in both genes. Investigation of pedigrees found fourteen other cancer types reported more than five times in families with carriers of RAD51C/D pathogenic variants. Among those, colorectal (3.72% and 4.43%) (RAD51C/D respectively), pancreatic (1.19% and 0.86%), lung (1.27% and 2.58%), prostate (1.56% and 1.48%), and leukemia (1.56% and 1.11%) cancer were the most prevalent types. This work highlights how both genes might confer susceptibility to a broader spectrum of cancer types than ovary and breast.

Temperature and precipitation regimes are rapidly changing, resulting in forest dieback and local extinction events, particularly in Mediterranean-type climates. Strategic forest management approaches that enhance forests’ resilience to future climates are urgently required, however adaptation to climates in heterogeneous landscapes with multiple selection pressures may be complex. For widespread trees in Mediterranean-type climates we hypothesized that patterns of local adaptation are associated with climate; precipitation is a stronger factor of adaptation than temperature; functionally related genes show similar signatures of adaptation; and adaptive variants are independently sorting across the landscape. To test our hypotheses, we sampled 28 populations across the geographic and climatic distribution of Eucalyptus marginata (jarrah), in south-west Western Australia, and obtained 13,534 independent single nucleotide polymorphic (SNP) markers across the genome. While overall levels of population differentiation were low (FST=0.04), environmental association analyses found a total of 2,336 unique SNPs potentially associated with five climate variables of temperature and precipitation. Allelic turnover was identified for SNPs associated with temperate seasonality and mean precipitation of the warmest quarter (39.2% and 36.9% deviance explained, respectively), suggesting that both temperature and precipitation are important factors in adaptation. SNPs within similarly function genes, according to gene ontology enrichment analysis, had analogous allelic turnover along climate gradients, while SNPs among temperature and precipitation variables had orthogonal patterns of adaptation. These contrasting patterns of adaptation provide evidence that there may be standing genomic variation adapted to changing climates, providing the substrate needed to promote adaptive management strategies to bolster forest resilience in the future.

Background: With the promotion of minimally invasive concepts and advances in total thoracoscopic valve surgery, total thoracoscopic aortic valve surgery has become a new option for patients with aortic valve lesions. However, due to its anatomical characteristics, poor surgical field exposure and limited operating space, only a few centers have performed further studies on this procedure. Methods: We evaluate the safety and advantages of total thoracoscopic aortic valve replacement compared to the upper mini-sternotomy AVR group and the conventional AVR group with important perioperative data as well as early postoperative outcomes. Results: All patients successfully underwent elective surgery, with no intraoperative conversion or death occurring. Patients in the total thoracoscopy group had significantly prolonged CPB and aortic clamping (AC) times compared to the other two groups. The average Postoperative chest drainage in the first 24 h of the total thoracoscopic group was significantly less than the other two groups. The mean VAS pain score in the total thoracoscopic group was significantly less than the other two groups. In addition, the total thoracoscopic group had a significantly decreased ICU stay as well as the total hospital stay. Although the length of mechanical ventilation between groups did not show statistically significant differences, mechanical ventilation in the total thoracoscopy group had a smaller relative number. Conclusions: Despite the need for improvement, total thoracoscopic aortic valve replacement is safe, and may improve clinical outcome

Since the introduction of the saphenous vein graft (SVG) for coronary artery bypass grafting (CABG) in 19621, the SVG has remained the most commonly used conduit to the non-LAD territories for more than half a century. However, several issues surrounding the use of SVGs, including higher graft occlusion rates and wound complications from the harvesting process, have been identified in clinical practice. As such, significant interest has been dedicated towards developing harvesting techniques that minimize the risk of these acute and late complications. In this issue of the Journal of Cardiac Surgery, Yokoyama and colleagues compared the impact of open vein harvesting (OVH), endoscopic vein harvesting (EVH) and no-touch vein harvesting (NT) on all-cause mortality, revascularization and graft failure, using a network meta-analysis based on randomized controlled trials and propensity-score matched studies. The results showed that the risk of graft failure was approximately halved amongst patients receiving NT compared with EVH and OVH; importantly, though, NT was not associated with lower all-cause mortality or revascularization risk. To further examine whether the use of NT grafts endow patients with better long-term clinical outcomes, such as mortality, myocardial infarction, and revascularization rates, a large-scaled randomized controlled trial or a patient-level combined meta-analysis is required.

The mass transfer between a rising bubble and the surrounding liquid is mainly determined by an extremely thin layer of dissolved gas forming at the liquid side of the gas-liquid interface. Resolving this concentration boundary layer in numerical simulations is computationally expensive. Subgrid-scale models mitigate the resolution requirements enormously and allow approximating the mass transfer in industrially relevant flow conditions with high accuracy. However, the development and validation of such models is difficult as only integral mass transfer data for steady-state conditions are available. Therefore, it is difficult to assess the validity of the sub-grid models in transient conditions. In this contribution, we compare the local and global mass transfer of an improved subgrid-scale model for rising bubbles (Re = 72-569 and Sc = 10^2-10^4) to a single-phase simulation approach, which maps the two-phase flow field to a highly-resolved mesh comprising only the liquid phase.

A 62-year-old woman with pulmonary hypertension due to alpha-1 antitrypsin deficiency and known congenital pulmonic valve stenosis presented with palpitations, chest pressure and bradycardia and was found to have a 6 cm pulmonary artery aneurysm on work-up. The patient underwent surgical pulmonary artery aneurysm repair and recovered from operation without complications.

Omega-3 fatty acid consumption is getting more and more common due to their positive impacts on human health. Since consumers cannot get their omega-3 needs from natural sources, omega-3 supplements play an essential part of the diet. Omega-3 fatty acids are highly susceptible to oxidation; thus, storage conditions affect the quality of these fatty acids. Supplement form is also another factor, which is critical for stability. In this project, it is aimed to compare the effects of different forms (capsule, chewable nd syrup) and packaging types of fish oil supplements on fatty acid composition, oxidative stability and sensory properties when stored at room temperature and in dark conditions. Moreover, the effect of consumer behavior regarding the recommended usage after the bottles are opened were assesed during storage study. It was observed that, syrup forms are more susceptible to oxidation than capsule and chewable forms. Moreover, capsule forms complied more with limit values during storage and better protected according to the sensory evaluation scores. Fish oil samples belonging to the same company but provided from different stores showed significant differences in some of the sensory attributes which is an indicator of non-standard raw material, ingredient or processing.

Soil salinity is a big concern and main factor which limit crop productivity. Salt-affected soils can be reclaimed and used for crop production as well as atmospheric carbon sink. In this study, gypsum (G), organic amendments and their combinations were used to remediate marginally salt-affected soils and increasing carbon stocks in three areas (Dijkot, Uchkera and Jhang). Gypsum along with farmyard manure (FYM), poultry manure (PM) and green manure (GM) were used in this study. Except control, treatment 1 received 100% soil gypsum requirement (SGR), all other 3 treatments received 50% SGR and equal amounts of FYM, PM and GM, respectively. A 45 day’s incubation study comprising 0-, 15-, 30- and 45-days intervals resulted that 45 days interval was more effective in remediation than others. All the amendments effectively reclaimed the salt-affected soils and increased soil carbon stocks by increasing carbon sequestration rate through reduction in soil pH (up to 19%), electrical conductivity (EC) (up to 28%) and sodium adsorption ratio (SAR) (up to 71.55%). While cation exchange capacity (CEC) (up to 39%), soil organic matter (SOM) (up to 65%), and total nitrogen (TN) (up to 96%) was increased. SOM increase and carbon sequestration was best seen (62%- or 12.59-tons ha-1) in 50% G and FYM application as compared to control (4.45-ton ha-1) in S-1. Results obtained helps in concluding that G and its combinations with organic amendments can effectively reduce the salt concentration in salt-affected soils and helps in organic matter build-up to support crop production and carbon sequestration.