OBJECTİVE Type D personality is characterized by negative effectiveness (NA) and social inhibition (SI). The aim of study was to investigate the association between Type D personality and premenstruel syndrome (PMS). METHODS: A total of 286 (86 in PMS, 200 in control group) female were recruited for the study. The 14- item Type D Scale) were used. RESULTS: NA (p<0.0001), SI (p=0.03) and Type D personality (p<0.0001) were significantly prevalent in the PMS group. A positive association between Type D personality and PMS (p=0.02, OR[95%CI]=2.05[1.08-3.86]). CONCLUSİON: There is a positive relationship between PMS and Type D personality. KEY WORDS: Premenstrual syndrome, personality type D, depression.

Self-inflicted Multiple organs Injury with Nail Gun

The Antarctic green alga Chlamydomonas sp. UWO241 is an obligate psychrophile that thrives in the cold (4-6°C) but is unable to survive at temperatures ≥18°C. Little is known how exposure to heat affects its physiology or whether it mounts a heat stress response in a manner comparable to mesophiles. Here, we dissect the responses of UWO241 to temperature stress by examining its growth, primary metabolome and transcriptome under steady-state low temperature and heat stress conditions. In comparison with Chlamydomonas reinhardtii, UWO241 constitutively accumulates metabolites and proteins commonly considered as stress markers, including soluble sugars, antioxidants, polyamines, and heat shock proteins to ensure efficient protein folding at low temperatures. We propose that this permanent stress metabolism is an adaptive advantage to life at extreme conditions. A shift from 4°C to a non-permissive temperature of 24°C alters the UWO241 primary metabolome and transcriptome, but growth of UWO241 at higher permissive temperatures (10°C and 15°C) does not provide enhanced heat protection. UWO241 also fails to induce the accumulation of HSPs when exposed to heat, suggesting that it has lost the ability to fine-tune its heat stress response. Our work adds to the growing body of research on temperature stress in psychrophiles, many of which are threatened by climate change.

Background and aim of the study. To report early clinical outcomes of the frozen elephant trunk technique (FET) for the treatment of complex aortic diseases after transition from conventional elephant trunk. Methods. A single-center, retrospective study of patients who underwent hybrid aortic arch and FET repair for aortic arch and/or proximal descending aortic aneurysms, acute and chronic Stanford type A aortic dissection with arch and/or proximal descending involvement, Stanford type B acute and chronic aortic dissections with retrograde aortic arch involvement. Results. Between December 2017 and May 2020, 70 consecutive patients (62.7±10.6 years, 59 male) were treated: 41 (58.6%) for acute conditions and 29 (41.4%) for chronic. Technical success was 100%. In-hospital mortality was 14.2% (n=12, 17.1% emergency vs. 10.3% chronic, P=NS); 2 (2.9%) major strokes; 1 (1.4%) spinal cord injury. Follow-up was 12.5 months (IQR 3.7—22.3. Overall survival at 3, 6, 12 and 24 months was 90% (95% CI, 83.2—97.3), 85.6% (95% CI, 77.7—94.3), 79.1% (95% CI, 69.9—89.5), 75.6% (95% CI, 65.8—86.9) and 73.5 (95% CI, 63.3—85.3). There were no aortic re-interventions and no dSINE; 5 patients with residual type B dissection underwent TEVAR completion. Conclusions. In a real-world setting, FET demonstrated a rapid learning curve and good clinical outcomes, even in acute type A aortic dissections. Techniques to perfect the procedure and to reduce remaining risks, and consensus on considerations such as standardized cerebral protection need to be reported.

Lipofibromatous hamartoma is an uncommon tumor that causes nerve enlargement due to fatty adipose tissue infiltration in peripheral nerves being the median nerve at the carpal tunnel the most commonly affected site, typically associated with macrodactyly. Here we present a case which affected a digital branch of the median nerve

The dynamic of SARS-CoV-2 and other respiratory virus in children and adolescents is relevant in clinical context. There are few studies comparing clinical course in COVID-19 (coronavirus disease) and other respiratory virus in pediatric patients. The aim of this study was to compare demographics and clinical features, exams abnormalities, and outcomes in SARS-CoV-2 and other respiratory virus infections in a pediatric population. This was a single-center prospective study, between April 17 to September 30, 2020. We evaluated 76 pediatric COVID-19 and 157 other respiratory virus infections. Rhinovirus occurred in 132/157(84%). COVID-19 patients were significantly older, had more fever (69% versus 50%; p=0.01), pneumonia (22% versus 5%; p<0.01), myalgia (29% versus 8%; p=0.001), headache (31% versus 14%; p=0.01) and worse outcomes than those with other respiratory virus infections. Our data emphasizes differences in clinical presentation and outcomes between pediatric COVID-19 and rhinovirus infections.

The explosive growth of data and information has motivated technological developments in computing systems that utilize them for efficiently discovering patterns and gaining relevant insights. Inspired by the structure and functions of biological synapses and neurons in the brain, neural network algorithms that can realize highly parallel computations have been implemented on conventional silicon transistor-based hardware. However, synapses composed of multiple transistors allow only binary information to be stored, and processing such digital states through complicated silicon neuron circuits makes low-power and low-latency computing difficult. Therefore, the attractiveness of the emerging memories and switches for synaptic and neuronal elements, respectively, in implementing neuromorphic systems, which are suitable for performing energy-efficient cognitive functions and recognition, is discussed herein. Based on a literature survey, recent progress concerning memories shows that novel strategies related to materials and device engineering to mitigate challenges are presented to primarily achieve nonvolatile analog synaptic characteristics. Attempts to emulate the role of the neuron in various ways using compact switches and volatile memories are also discussed. It is hoped that this review will help direct future interdisciplinary research on device, circuit, and architecture levels of neuromorphic systems. Corresponding author(s) Email:   jiyong.woo@knu.ac.kr  

Commentary to JOCS-2021-OA-0579

Palm-based Tibetan butter equivalent was developed and evaluated from formulation, rheology, texture to microstructure. Firstly, the compatibility of palm stearin and palm olein was ascertained. The formulations of palm-based Tibetan butter equivalent were then optimally developed using a combination of palm stearin (37.5%), palm olein (37.5%) and soybean oil (25%). These were found to contain high unsaturated fatty acids and analogous solid fat content (SFC) at varying temperatures. Moreover, the palm-based Tibetan butter equivalent (TBE) showed a shear-thinning behavior, a gel characteristic, good plasticity and comparable texture characteristics (such as hardness, adhesion, cohesiveness and elasticity) to traditional Tibetan butter (TB). Furthermore, as determined by polarized light microscopy (PLM) and confocal laser scanning microscopy (CLSM), the microstructures also showed a similar structure, thus further indicating that palm oil is a good candidate as a substitute in making Tibetan-style butter. Overall, the palm-based Tibetan butter equivalent was developed by physical technology and could assist in increasing the enjoyable population as well as addressing the challenge of resource shortage, geographical origin and season of production.

Aims In older adults with type 2 diabetes (T2D), overtreatment remains prevalent and undertreatment ignored. The main objective is to estimate the prevalence and examine factors associated with potential overtreatment and undertreatment Method Observational study conducted within an administrative database of older adults with T2D who registered in 2018 at the Portuguese Diabetes Association. Participants were categorized either as potentially overtreated (HbA1c≤7.5%), appropriately on target (HbA1c≥7.5–≤9%), or potentially undertreated (HbA1c>9%). Results of 444 participants, potential overtreatment, and undertreatment were found in 60.5% and 12.6% of the study population. Taking the patients on target as a comparator, the group of potentially overtreated showed to be more males (61.3% vs.52.2%), less-obese (34.1% vs.39.2), higher cardiovascular diseases (13.7% vs.11%), peripheral vascular diseases (16.7% vs.12.8%), diabetic foot (10% vs.4.5%), and severe kidney disease (5.2% vs.4.5%). Conversely, the potentially undertreated participants were more females (64.2% vs.47.7%), obese (49% vs.39.2%), had more dyslipidemia (69% vs.63.1%), peripheral vascular disease (14.2% vs.12.8%), diabetic foot (8.9% vs.4.5%), and infections (14.2% vs.11.9%). The odds of potential overtreatment were mostly decreased by 59% of females, 73.5% in those with retinopathy, and 86.3% in insulin, 65.4% sulfonylureas, and 66.8% in SGLT2 inhibitors users. Contrariwise, an increase in the odds of potential undertreatment was more than 4.8times higher in insulin, and more than 3.1times higher in sulfonylureas users. Conclusion potential overtreatment and undertreatment in older adults with T2D in routine clinical practice should guide the clinicians to balance the use of newer oral antidiabetic agents considering its safety profile regarding hypoglycemia.

Emerging infectious diseases have resulted in severe population declines across diverse taxa. In some instances, despite attributes associated with high extinction risk, disease emergence and host declines are followed by host stabilization for reasons that are frequently unclear. While host, pathogen, and the environment are recognized as important factors that interact to determine host-pathogen coexistence, they are often considered independently. Here, we use a translocation experiment to disentangle the role of host traits and environmental conditions in driving the persistence of remnant populations a decade after they declined 70-99% and subsequently stabilized with disease. While survival was significantly higher than during the initial epidemic within all sites, protection from severe disease only existed within a narrow environmental space, suggesting host traits conducive to surviving disease are highly environmentally dependent. Ultimately, population persistence following pathogen invasion is the product of host-pathogen interactions that vary across a patchwork of environments.

Coronary revascularization is crucial in the treatment of ischemic heart disease (IHD) patients because it relieves symptoms with managing adverse outcomes, including myocardial infarction (MI). To decide on revascularization of the coronary artery, it is necessary to have diagnostic evidence, since only the coronary vessels causing ischemia must be selected for revascularization. Hence, in order not to subject patients to unnecessary revascularization and to treat with medical therapy, accurate measurements of the significance of coronary artery stenosis are necessary. Identifying stenoses that cause ischemia should be achieved in a variety of ways that include invasive and non-invasive tests. Cardiologists use a combination of these investigations together for optimal further treatment. The purpose of this review was to describe publicly available data on recommendations to guide surgical coronary revascularization.

Background: Strokes are a known complication of acute type A aortic dissection (ATAAD) repair. Understanding the neuroanatomy, mechanism, and severity of stroke will facilitate efforts to improve prediction, prevention, and treatment strategies. Methods: Retrospective review of patients who sustained stroke from a consecutive series of patients undergoing ATAAD repair. Neuroimaging was interpreted by two stroke neurologists blinded to clinical results. Severity of stroke was assessed by National Institutes of Health Stroke Scale (NIHSS). Residual disability at thirty days was assessed using the modified Rankin Scale (mRS). Results: Twenty percent (38/189) of patients undergoing repair for ATAAD had stroke [unilateral 58%, bi-hemispheric 42% (p=0.33)]. All strokes were ischemic. No significant lateralization (right vs. left) was noted with unilateral strokes (26% vs 32%, p=0.67). Etiology of stroke was embolic (58%), hypoperfusion (26%), mixed (11%) and unknown (5%). There were no intraoperative variables that correlated with the neuroanatomy or mechanism of stroke. Pre-operative carotid dissection was seen in 40% (n=15), while postoperatively 10% (n=4) sustained intracranial large vessel occlusion (LVO). Strokes were moderate or severe (NIHSS ≥ 9) in 97% of cases, with 66% incidence of moderate residual disability (mRS ≥ 3) at one month postoperatively. Conclusions: Stroke associated with ATAAD is heterogeneous in etiology and location. Most strokes are severe on detection and result in significant residual disability. One in 10 strokes are due to LVO amenable to endovascular treatment. Future trials may evaluate the role for early neuroimaging and treatment of incident stroke given modern advancements in endovascular stroke therapy.

Numerical modeling of braided channels showed no significant differences in the number of cross-sectional branches between different water periods in the middle reaches of the Yarlung Tsangpo River. During most of the year (wet, normal and dry periods), flow velocities in the higher-branching (HB) channels were significantly lower than in the other two branching categories, while the overall distribution of depth in the higher-branching channels maintained a high degree of consistency with the moderate-branching channels (MB), which partly explains why the HB channels are important habitats for fish spawning, nursery and baiting (lower flow velocity distribution with a wider range of depth). Based on the examination of the water surface width, the water surface width may not be a limiting factor for fish habitat within braided rivers. Simulation of the hydrodynamic parameters of the fish-spawning grounds revealed that the average cross-sectional flow velocity and water depth fluctuated the least at different flows during the fish-spawning period for the HB channels. By counting the hydraulic parameters of the spawning grounds during the spawning period, it can be seen that the most preferred flow velocity for fish in the braided river in the study section was 0.1-0.4 m/s, and the water depth was 0-1.2 m. This article analyses the characteristics of the hydraulic parameters of the braided river and provides theoretical support for the restoration of fish habitats in braided rivers.

We describe the case of a 32-year-old-woman, who developed psychomotor agitation and memory disorders.The Clinical, biological and radiological findings initially showed an infectious etiology.The presence of Anti-N-Methyl-D-aspartate receptor (NMDA) antibodies allowed the diagnosis of a dysimmune etiology of the disease

Jejunal diverticulitis is a rare condition and usually occurs in the elderly. Its association with extensive diverticulosis is exceptional and makes the management more challenging. We report a case of a 74-year-old man with perforated jejunal diverticulitis with extensive diverticulosis who underwent a surgical management.

Aims: Laboratory findings in COVID-19 patients vary according to the severity of the disease. This study aimed at defining a system of formulas that may predict the presence of thoracic CT involvement, the extent of such involvement and the need for intensive care stay on the basis of patient laboratory data using the Waikato Environment for Knowledge Analysis (WEKA) software. Methods: This study was conducted with 508 patients whose SARS-CoV-2 RT-PCR test was positive. These patients were divided into 2 groups, with and without thoracic CT involvement typical for COVID-19. Then, those patients who had signs of typical involvement for COVID-19 in their thoracic CT were divided into 3 groups depending on the extent of their lesions. J48 Decision Tree classification and Linear Regression methods were used on the WEKA software. The codes implemented in the Python programming language were used at the estimation, classification and testing stages. Results: Thoracic CT scans showed that lung involvement was absent in 93 of the patients, mild in 114, moderate in 115, and severe in 159. The success rates of WEKA Linear Regression Formulas calculated using laboratory values and demographic data, respectively 78.92%, 71.69% and 91%. The success rate of the J48 Decision Tree formula used to predict the presence of involvement in thoracic CT was found to be 95.95%. The success rate of the J48 Decision Tree, which was used to predict the degree of involvement in thoracic CT, was 84.39%. The success rate of the J48 Decision Tree used to predict the need for intensive care was found to be 93.06%. Conclusion: The results of this study will facilitate revealing the presence of lung involvement and identification of critical patients in the COVID-19 pandemic and particularly under circumstances and can be used effectively to ensure triage.

Investigation on the miniaturized multichannel-based fixed-bed devices to enhance the heat and mass transfer performance is the key focus in the present study. Residence time distribution (RTD) is one of the most critical parameters to characterize the device’s flow distribution. In the current context, the RTDs of a liquid tracer for the air-water two-phase concurrent flows across the multichannel-based miniaturized fixed-bed devices (consist of 11 number of same dimensional parallel channels) with the variable heights were measured by the conductivity measurements and represented by axial dispersion model (ADM). The stream-flow rates of the two phases varied within the range of 8.33 × 10-8 – 3.83 × 10-7 m3 s-1. The axial dispersion coefficients and the specific energy dissipation values were analyzed. The impacts of pressure loss and the geometry on the hydrodynamic characteristics and mixing properties were well expressed. Based on the experimental data, new correlations were proposed.

The droplet generation mechanism in the step T-junction remains unknown, especially for the transition stage from dripping to jetting . In this work, the droplet generation mechanism was systematically investigated in a novel modified step T-junction. We found that under different fluid regimes, different factors take action. In dripping regime, the interfacial tension dominated the formation mechanism when the surfactant concentration was controlled below micelle concentration (CMC). In jetting regime, our experimental results showed that the influence of the surfactant concentration on the size of generated droplets was rather negligible while the phase ratio indeed determined such a parameter. In the dripping-jetting transition stage, an abnormal increase of droplet size was observed despite the increase of continuous phase flow. To the best for our knowledge, it is the first study to report generation mechanism in modified step T-junction from dripping to jetting regimes.

The current pandemic caused by a novel coronavirus named as SARS-CoV2 has underlined the importance of emerging diseases of zoonotic importance. Along with human beings, several species of wild and pet animals have been demonstrated to be infected by SARS-CoV2, both naturally and experimentally. Additionally, with constant emergence of new variants, the species susceptibility might further change, warranting intensification of screening efforts. India is a vast and second most populated country, with a habitat of a very diverse range of animal species. In this study we are reporting infection of SARS-CoV2 in captive Asiatic lions. Detailed characterization revealed involvement of delta mutant (Pango lineage B.1.617.2) of SARS-CoV2 at two different locations. Interestingly, no other feline species enclosed in the zoo/park was found infected. The epidemiological and molecular analysis in this study will contribute to the understanding of SARS-CoV2 emerging mutants in wild and domesticated animals.

Objective: To compare outcomes of hemiarch versus total arch repair during extended ascending aortic replacement. Methods: Between 2004 and 2017, 261 patients underwent hemiarch (n=149, 57%) or total arch repair (aortic debranching or Carrell patch technique, n=112, 43%) in the setting of extended replacement of the ascending aorta. Median follow-up was 17.2 (IQR 4.2–39.1) months. Multivariable models considering preoperative and intraoperative factors associated with mortality and aortic reintervention were constructed. Results: Survival was 89.0, 81.3, and 73.5% vs. 76.4, 69.5, and 61.7% at 1, 3, and 5 years in the hemiarch versus total arch groups, respectively (log-rank p=0.010). After adjustment for preoperative and intraoperative factors, the presence of a total arch repair (adjusted HR 2.53, 95% CI 1.39 – 4.62, p=0.003), and increasing age (adjusted HR per 10 years of age, 1.76, 95% CI 1.37 – 2.28, p<0.001) were associated with increased mortality. The cumulative incidence of aortic reintervention with death as a competing outcome was 2.6, 2.6, and 4.4% and 5.0, 10.3, and 11.9% in the hemiarch and total arch groups, respectively. After adjustment, the presence of a total arch repair was significantly associated with need for aortic reintervention (SHR 3.21, 95% CI 1.01 – 10.2, p=0.047). Conclusions: Overall survival after aortic arch repair in the setting of extended ascending aortic replacement is excellent, however, total arch repair and increasing age are associated with higher mortality and reintervention rates. A conservative approach to aortic arch repair can be prudent, especially in those of advanced age.

As human spaceflight continues with extended mission durations, the demand of effective and safe drugs is going to increase. To date, the medications used during missions (for space motion sickness, sleep disturbances, allergies, pain and sinus congestion) are administered under the assumption that they act similarly as on the Earth. During spaceflights however fluid shifts, muscle and bone loss, immune system dysregulation and changes in the gastrointestinal tract and metabolism are documented. These alterations may change the pharmacokinetics (PK) and pharmacodynamics. The information gained from bed-rest studies and from inflight observations is partial and demonstrates variability in drug PK. The objectives of this review are to report: i) the impact of the space environmental stressors on human physiology in relation to PK; ii) the state-of-the-art on experimental data in space and/or in ground-based models; iii) the validation of ground-based models for PK studies; and iv) the identification of possible research gaps.

Abstract: Background: Pneumocystis pneumonia (PCP) incidence in acute myeloid leukemia (AML) patients have not been well described and some studies have shown the risk of this infection in these groups of patients. In this systematic review, we reviewed the published studies about PCP in AML to evaluate the PCP incidence and outcomes in these patients and then focuses on its immunological mechanism. Method: All articles reviewed in this collection are from recruited sites: PubMed and Embase databases. No time limit was considered for article searching. The following keywords were used: (“Pneumonia, Pneumocystis” OR Pneumocystis Pneumonia” OR “Pneumocystis jirovecii”), AND (“leukemia, myeloid, acute OR acute myeloid leukemia”). Our search strategy yielded 356 articles. After implementing the exclusion and inclusion criteria, the final papers were selected and reviewed. Result: By our search, 356 articles were found (316 in PubMed and 40 in Embase). After the implementation of inclusion and exclusion criteria, seven papers remained. A total of seven articles with a total number of 41 patients were included. Conclusion: Affected patients appear to have a clear resistance to PCP infection despite chemotherapy and bone marrow suppression due to the preservation of a specific immunological milieu in the lung. In fact, may be due to immunological stability of the lungs that remains intact. Further studies are needed.

Introduction: Patients with severe complications of non-malignant haematological disease are considered as candidates for curative treatment with an allogenic bone marrow transplant (ABMT). A non-myeloablative conditioning regimen is used; consisting of an alkylating agent and single fraction total body irradiation (SFTBI) at a dose of 2-4.5 Gy (dose rate 150mu/min). This is distinct from high dose fractionated total body irradiation (TBI) used in a myeloablative conditioning regimen; for which the late effects are well documented. There is however no dedicated study on the late effects associated with low dose SFTBI. Methods: We undertook a single institution study focusing on patient reported outcomes after SFTBI (January 2003 – January 2019) delivered more than 1-year previously, prior to an AMBT in patients aged under 16-years for non-malignant haematological conditions. A 19-point questionnaire was conducted with study subjects over the phone. The primary outcome was late effects as reported by patients. Secondary outcomes were patient demographics. Results: Fifty patients were screened, 31 were invited to take part and 24 consented to participate. Pulmonary toxicity was the most common visceral effect reported (5 patients), followed by kidney (3) and cardiac (2). No patients reported cataracts, diabetes or secondary malignancy. Two patients were on sex hormone replacement although no evidence of female menstrual delay was demonstrated. The majority (21) were enrolled in mainstream schools. Conclusion: Late effects do occur after SFTBI, but are mild and occur less frequently compared to high dose TBI. The consent process with children/parents prior to SFTBI should reflect this.