The capacity of carbon sequestration of limestone soils in karst areas is unclear and needs to be studied, and there are few reports on the effect of calcium ions content on the migration and transformation of soil dissolved organic matter (DOM). In this paper, the leaching process of DOM from four-layered soil samples of two limestone soil profiles was systematically studied by soil column experiment with different Ca2+ concentration runoff. The results show that the elution of DOM can be divided into two stages, a rapid release and dilution stage and a nearly stable DOM release stage. After the elution, the average DOC loss rates are 61.9%, 75.5%, 70.9% and 49.1% for four samples, H1, H2, S1, and S2, respectively. When the Ca2+ concentration of eluent increases, the following phenomena occur: 1) The DOC loss rate decreased, which was reduced by 0.6-7.5% in this study. 2) The elution rate decreased and the desorption activation energy increased. 3) The molecular weight and the aromaticity of effluent DOM increased and decreased respectively. 4) The humic-like components were eluted less. The results demonstrate the higher Ca2+ concentration reduces the elution of soil DOM, improves the aromaticity of retained soil organic matter (SOM), and may inhibit SOM utilization and degradation by microorganisms. This study helps to understand better the transport and fate of SOM in karst regions, and provides theoretical support for soil planning management and carbon sink increase in karst areas.

Objective To determine the prevalence and type of anaemia and its association with pre-eclampsia (PE) in pregnant South Africans of African ancestry. Design Cross-sectional study design Setting A regional hospital in KwaZulu-Natal, South Africa. Sample 671 women seeking antenatal care. Methods Participants had haemoglobin(Hb), anthropometric measurements, HIV status, blood pressure levels(BP) and proteinuria measured to determine PE. Iron studies and transferrin receptor levels were assessed in a subset and chi-square tests of association between normotensive and pre-eclampsia sub-groups and blood parameters were conducted. Results No difference in Hb concentration amongst the 4 groups (F (3,621)=0.981, p< .001, η2=.014) was observed. A chi-square test of association (χ2(3)=6.674, p=.083) showed no associations between study groups and having anaemia. The severity of anaemia did not vary amongst study groups (χ2(12) =10.756, p=.550). Using ferritin, there was an association between the study groups having an iron deficiency, anaemia, both or neither (χ2(3)=12.559, p=.045) with a positive association between normotensive term and iron deficiency (adjusted residual(AR) 2.2) and positive association between early-onset PE(AR 2.4). Similar trends were found for transferrin and soluble transferrin receptor ferritin index. Twenty-two percent of the participants were not iron deficient. Conclusion Early-onset PE is associated with high iron status and not anaemia. Normotensive term pregnancies were associated with iron deficiency anaemia. Broad iron supplementation without adequate determination of iron deficiency in pregnant women needs to be revisited. Funding National Research Foundation (TTK170508230162), University of KwaZulu-Natal UCPD and Medical Research Council of South Africa(SIR Grant UNS14197). Keywords Anaemia, iron deficiency, pre-eclampsia

A document by Eliane Silva. Click on the document to view its contents.

Objective: To evaluate the efficacy of long-term indomethacin therapy (LIT) in prolonging pregnancy and reducing spontaneous preterm birth (PTB) in patients undergoing fetoscopic laser surgery (FLS) for the management of twin-to-twin transfusion syndrome (TTTS). Design: Retrospective cohort study of prospectively collected data. Setting: Collaborative multicenter study Population: 557 consecutive TTTS cases that underwent FLS Methods: LIT was defined as indomethacin use for at least 48 hours. Log-binomial regression was used to estimate the relative risk (RR) of PTB in LIT compared to non-LIT group. Cox regression was used to evaluate the association between LIT use and FLS-to-delivery survival. Main outcome measures: gestational age (GA) at delivery Results: Among the 411 pregnancies included, a total of 180 patients (43.8%) received LIT after FLS and 231 patients (56.2%) did not. Median GA at fetal intervention did not differ between groups (20.4 weeks). Median GA at delivery was significantly higher in the LIT group (33.6 weeks) compared to the non-LIT group (31.1weeks), p<0.001. FLS-to-delivery interval was significantly longer in the LIT group (P<0.001). The risk of PTB prior to 34, 32, 28, and 26 weeks gestation were all significantly lower in the LIT group compared to the non-LIT group (RR=0.69, 0.51, 0.37, and 0.18, respectively). The number needed to treat (NNT) with LIT to prevent one PTB<32 weeks gestation was 4, and to prevent one PTB<34 weeks was 5. Conclusion: Long-term indomethacin after FLS for TTTS was found to be associated with prolongation of pregnancy and reducing the risk for PTB.

This article provides mathematical proof of the existence of stationary solutions for the coagulation equation including source and efflux terms. We demonstrate the convergence of time dependent solutions to these stationary solutions and highlight the exponential rate of convergence. These properties are analyzed for affine linear coagulation kernels, non-negative source terms and positive efflux rates. Numerical examples are included to demonstrate the predicted convergence behaviour.

Waldenström Macroglobulinemia (WM)/lymphoplasmacytic lymphoma (LPL) is often differentiated from myeloma based on the presence of lytic bone lesions (LBL). However, WM/LPL can present with LBL and management is poorly understood. We describe a case of an 81-year-old woman with LPL who presented with LBL and was successfully treated with chemoimmunotherapy.

This paper deals with the following Schr\“odinger-Poisson system \begin{equation}\label{zhaiyaofc}\left\{\begin{aligned} &-\Delta u+u+ \lambda\phi u=f(u)\quad\mbox{in }\mathbb{R}^3,\\ &-\Delta \phi=u^{2}\quad\mbox{in }\mathbb{R}^3, \end{aligned}\right.\end{equation} where $\lambda>0$ and $f(u)$ is a nonlinear term asymptotically cubic at the infinity. Taking advantage of the Miranda theorem and deformation lemma, we combine some new analytic techniques to prove that for each positive integer $k,$ system \eqref{zhaiyaofc} admits a radial nodal solution $U_k^{\lambda}$, which has exactly $k+1$ nodal domains and the corresponding energy is strictly increasing in $k$. Moreover, for any sequence $\{\lambda_n\}\to 0_+$ as $n\to\infty,$ up to a subsequence, $U_k^{\lambda_n}$ converges to some $U_k^0\in H_r^1(\mathbb{R}^3)$, which is a radial nodal solution with exactly $k+1$ nodal domains of \eqref{zhaiyaofc} for $\lambda=0 $. These results give an affirmative answer to the open problem proposed in [Kim S, Seok J. Commun. Contemp. Math., 2012] for the Schr\”odinger-Poisson system with an asymptotically cubic term.

In this paper, we study the asymptotic behavior of the solution to the Lam\’{e} equations with a parameter $\var$. We prove that the solution will converge to the solution of a Maxwell type equations as $\var\rightarrow0$; Meanwhile we will show that the solution converges to the solution of a Stokes type equations as $\var\rightarrow\infty$.

The importance of social and spatial structuring of wildlife populations for disease spread, though widely recognized, is still poorly understood in many host-pathogen systems. In particular, system specific kin relationships among hosts can create contact heterogeneities and differential disease transmission rates. Here, we investigate how distance-dependent infection risk is influenced by genetic relatedness in a novel wild boar ( Sus scrofa) - African swine fever (ASF) system. We hypothesized that the infection risk would correlate positively with proximity and relatedness to ASF-infected individuals but expected those relationships to weaken with distance between individuals due to decay in contact rates and genetic similarity. ASF infection risk was shaped by the number of infected animals throughout the zone of potential contact (0-10 km) but not beyond it. This effect was the strongest at close distances (0-2 km) and weakened further on (2-10 km), consistent with decreasing probability of contact. Overall, there was a positive association between genetic relatedness to infectees and infection risk within the contact zone but this effect varied in space. In the high-contact zone (0-2 km), infection risk was not influenced by relatedness when controlled for the number of ASF-positive animals. However, infections were more frequent among close relatives indicating that familial relationships could have played a role in ASF transmission. In the medium-contact zone (2-5 km), infection risk and frequency of paired infections were associated with relatedness. Relatedness did not predict infection risk in low- and no-contact zones (5-10 and >10 km, respectively). Together, our results indicate that the number of nearby infected individuals overrides the effect of relatedness in shaping ASF transmission rates which nevertheless can be higher among close relatives. Highly localized transmission highlights the possibility to control the disease if containment measures are employed quickly and efficiently.

A document by Mike Kirkby. Click on the document to view its contents.

Fomepizole is a promising new treatment for preventing liver injury following paracetamol (acetaminophen) overdose. However, we need robust clinical trials to be performed to demonstrate its effect on clinical outcomes that are important to our patients and important to healthcare providers. Until such trials are performed, the toxicology community should learn the lessons from the COVID pandemic – potential novel therapeutic options may be theoretically appealing, but their effectiveness needs to be assessed in robust clinical trials before they are used in clinical practice.

Background and Aims: Cholelithiasis is a common upper gastrointestinal tract disorder in the Kingdom of Saudi Arabia. Analyses of risk factors for gallstone formation may explain the need for lifestyle modifications. Therefore, our aim was to identify sex- and age-related differences in the prevalence and risk factors for gallstones among Saudi individuals in the city of Al-Ahsa. Methods: The medical records of patients, ≥1 year of age, with a radiologically confirmed diagnosis of gallstones, between 2014 through 2016, were retrieved and relevant demographic and clinical data extracted. Risk factors for cholelithiasis for all age groups were identified. Results: A total of 618 patients had radiologically confirmed gallstones over the 3-year period of observation. The prevalence was higher among females than males (73% versus 27%, respectively) in all age groups. In the paediatric group, the prevalence of gallstones was higher among girls with obesity and those with sickle cell disorders. Advanced age, a higher body mass index, high low-density lipoproteins, triglycerides, and cholesterol were independently associated with cholelithiasis in both gender of all age groups. Hepatitis B and C were not found to be risk factors for cholelithiasis. Conclusions: Older age, female sex, a high body mass index, and hyperlipidaemia are major risk factors for gall stones formation among all age groups. Haemolytic anaemia, namely sickle cell disease, is a prevalent risk factor in paediatric population.

A document by Cecilia Ugaz. Click on the document to view its contents.

Background and aim of the study: Coronary artery fistula (CAF) is a relatively rare cardiac anomaly. We investigated long-term outcomes following surgical repair of CAF in adults. Methods: We retrospectively investigated 13 consecutive patients undergoing surgical repair of CAF in our institution between 2008 and 2019 (67.3±10.4 years old, 38% male). CAF types were coronary artery-pulmonary artery fistula (77%), coronary artery-coronary sinus fistula (15%), and both (8%). CAFs originated from the left coronary artery (38%), right coronary artery (8%), and bilateral coronary arteries (38%). Pulmonary and systemic flow (Qp/Qs) was measured in seven patients (54%), with a mean value of 1.52. Seven patients underwent surgery for CAFs alone, and others simultaneously underwent surgery for comorbid cardiac diseases. Results: All procedures were conducted under cardiopulmonary bypass. Surgical procedures were direct epicardial ligation of fistula (92%), direct closure of CAF through pulmonary artery incision (38%), direct closure of CAF through coronary sinus incision (8%), or patch closure of CAF through coronary artery incision (8%). Myocardial perfusion scintigraphy showed asymptomatic myocardial ischemia in the right coronary area after surgery in one patient. There were no deaths perioperatively or during follow-up (mean 66.6 months). There were no coronary or other CAF-related events. Conclusions: Several anatomical variations in CAF were observed which coexist with cardiac disease. Long-term outcomes following surgical repair were satisfactory, and the concurrent intervention of CAFs during surgery for comorbid cardiac disease is useful to prevent future complications related CAFs in adults.

Soil erosion is an important problem in the loess landscapes of Europe, resulting in a lowering of soil quality and landscape changes. As a result of soil erosion, SOC is redistributed and stored in SOC pools within the landscape. Understanding the SOC dynamics is important because changes in the SOC stocks may have large impacts on global climate change. Closed depressions (CDs) in loess landscapes collect colluvial sediments resulting from soil erosion and constitute sediment stores enabling the calculation of soil erosion phases and rates. CDs are also SOC pools enabling assessing of SOC erosion and storage in loess landscapes over long periods. Colluvial sediments and fossil soils, infilling five representative CDs in the Polish loess areas used for agriculture during several millennia, were documented. The mean SOC content in CDs were calculated, the area of CDs at the regional scale were mapped. Between 11.66 and 31.78 Mg of SOC are stored in each CD. The SOC within CDs represents a significant SOC storage in the landscape of the studied region and can reach values between 178.96 and 206.73 Mg·ha-1(mean 192.85 Mg·ha-1), the SOC content in the soil cover of the surrounding eroded slopes and plateaus is 102.38 Mg·ha-1. This study indicates that CDs are a key morphological features for a better understanding of the spatial distribution of SOC in agricultural used loess landscapes of eastern Poland. SOC storage in CDs needs to be taken into account when calculating total soil carbon storage at the regional scale.

A document by Javan Carter. Click on the document to view its contents.

1. Neighborhood competition models are powerful tools to measure the effect of interspecific competition. Statistical methods to ease the application of these models are currently lacking. 2. We present the forestecology package providing methods to i) specify neighborhood competition models, ii) evaluate the effect of competitor species identity using permutation tests, and iii) measure model performance using spatial cross-validation. Following Allen (2020), we implement a Bayesian linear regression neighborhood competition model. 3. We demonstrate the package’s functionality using data from the Smithsonian Conservation Biology Institute’s large forest dynamics plot, part of the ForestGEO global network of research sites. Given ForestGEO’s data collection protocols and data formatting standards, the package was designed with cross-site compatibility in mind. We highlight the importance of spatial cross-validation when interpreting model results. 4. The package features i) tidyverse-like structure whereby verb-named functions can be modularly “piped” in sequence, ii) functions with standardized inputs/outputs of simple features ‘sf‘ package class, and iii) an S3 object-oriented implementation of the Bayesian linear regression model. These three facts allow for clear articulation of all the steps in the sequence of analysis and easy wrangling and visualization of the geospatial data. Furthermore, while the package only has Bayesian linear regression implemented, the package was designed with extensibility to other methods in mind.

In this report , we describe the perioperative care of pediatric patient with PSVT undergoing RFCA, in order to improve our understanding of the disease, and provide evidence for its nursing intervention.

This is a case of an elderly female with comorbidities and a history of cardiac transplant 13 years back, presented with diarrhea and diagnosed with COVID-19. She was hospitalized and found to have a cardiac injury and urinary tract infection, treated with antibiotics, antivirals, immunosuppressives, and required non-invasive ventilatory support.

Slow flow and no-reflow phenomenon are taken to sudden loss of coronary artery flow, typically after stenting or angioplasty in primary PCI. Otherwise conventional therapy, we report a technique, which autologous blood into intracoronary to supply oxygen and break process thrombosis results in successfully management no-reflow in primary PCI

Arteria lusoria is a rare vascular malformation. It remains a rare cause of dysphagia which should be considered in the face of any dysphagia unexplained by the usual endoscopic and radiological investigations.

The study object is the Kuibyshev reservoir. The objective is to quantitatively assess reservoir bank landslides and shoreline abrasion in active zones based on the integrated use of modern instrumental methods. Different approaches are used to assess the intensity of landslide and abrasion processes: the specific volume and material loss index, the planar displacement of the bank scarp, and the planar-altitude analysis displacements of soil masses based on the analysis of slope profiles. Shoreline position for the past periods (1958, 1985, and 1987) was obtained from archival aerial photography data; data for 1975, 1993, 2010, 2011, and 2012 were obtained from high-resolution satellite image interpretation. Field surveys of these geomorphic processes at the study areas in 2002, 2003, 2005, 2006, 2014 were carried out using total stations; in 2012-2014 using terrestrial laser scanning and a UAV survey in 2019. The monitoring of landslide processes showed that the rate of volumetric changes at Site 1 remained rather stable during the measurement period with net material losses of 0.03-0.04 m3/m2/year. The most significant contribution to the average annual value of material loss was by snowmelt runoff. The landslide scarp retreat rate at Site 2 showed a steady decreasing trend, due to partial overgrowth of the landslide accumulation zone resulting in its relative stabilization. The average long-term landslide scarp retreat rate is 2.3 m/year. In recent years, landslide control measures realized at this site have reduced the landsliding intensity by more than 2.5 times to 0.84 m/year

Knowledge about the changes in soil organic carbon (SOC) stocks and grain yields under different tillage and straw management is necessary to assess the feasibility and sustainability of conservation agriculture. An 8-year experiment was conducted in an intensive wheat (Triticum aestivum L.)–maize (Zea mays L.) rotation system in the southern Loess Plateau of China. Three tillage methods [control with no-tillage and straw removal (CK), no-tillage with straw stubbles 30–40 cm in height (NT), and rotary tillage with straw incorporation (RT)] were applied before maize planting, and two straw treatments [straw return (SR) and no straw return (SR0)] were applied after maize harvest. Thus, the treatments included CK-SR, CK-SR0, NT-SR, NT-SR0, RT-SR, and RT-SR0. Over 8 years, the SOC stock exhibited similar dynamic trends in all treatments, but was higher in NT, RT, and SR plots than in CK-SR0 plots. Compared with the initial soil, the SOC stock increased largest (34.1%) in NT-SR. Compared with the CK-SR0, the NT-SR, RT-SR, CK-SR, NT-SR0 and RT-SR0 increased the wheat grain yield by 47.2%, 36.8%, 24.9%, 25.1%, and 20.0%, respectively. The NT, RT and SR increased crop yield stability with the highest sustainable yield index in NT-SR for both wheat (0.67) and maize (0.70). This study showed the NT-SR was the best strategy for improving SOC stocks, grain yields and agricultural sustainability for the wheat-maize rotation system in northwestern China and other areas with similar climates and cropping systems.

Serum pregnancy-associated plasma protein A (PAPPA) as a predictor of eosinophilic Type-2 high asthmaTo the Editor,Pregnancy-associated plasma protein A (PAPPA), a metalloproteinase that cleaves insulin-like growth factor (IGF)-binding proteins (IGFBPs) to increase IGF availability, is expressed systemically in pregnant women but also in other tissues (1). Higher serum PAPPA levels are reported in patients with newly-diagnosed asthma (1) and allergic rhinitis compared to healthy controls and are decreased following omalizumab treatment (2). We determined whether PAPPA could represent a novel biomarker for Type-2 (T2) asthma by exploring the relationship between asthma severity and phenotypes of severe asthma and PAPPA gene and protein expression (3).We recruited 288 severe non-smoking asthma (NSA), 102 smokers and ex-smokers with severe asthma (SSA), 86 mild/moderate non-smoking asthmatics (MMA) and 95 healthy non-smoking controls (HC) from the U-BIOPRED cohort (NCT01976767) (4) (Table S1 ). Transcriptomic and proteomic profiling of blood and sputum samples and specific serum periostin ELISA were performed (3). Gene set variation analysis (GSVA) was used to calculate the enrichment score (ES) of 34 genes that were upregulated following in vitro stimulation of primary human bronchial epithelial cells with IL-13 (T2_IL-13_IVS) (3). Eosinophilic inflammation was defined by sputum eosinophilia >1.49% (3). Local Ethics Committees of the recruiting centres approved the study and all participants gave written informed consent.Sputum cell PAPPA mRNA was elevated in NSA compared to SSA, MMA and HC subjects particularly in granulocytic asthmatics and in the transcriptomic-associated cluster (TAC)1; an eosinophilic cluster (5) (Figure 1A-C ). This was more pronounced with sputum PAPPA protein analysis according to asthma severity, in eosinophilic and mixed granulocytic asthmatics and in T2-high asthmatics identified by the T2_IL-13_IVS signature (Figure 1D-F ).PAPPA mRNA expression in blood cells was similar across asthma severities, blood granulocytes and molecular phenotypes (Supplementary Figure 1A-C ). However, serum PAPPA protein levels supported the discrimination seen in sputum with significant elevation seen in SA compared to HC, in eosinophilic and mixed granulocytic asthma and in T2-high asthma (SupplementaryFigure 1D-F ).Sputum eosinophil percentages were significantly correlated with sputum (r=0.88, p=10-6) and serum (r=0.41, p=10-6) PAPPA protein levels. Overall, sputum PAPPA protein gave a greater distinction between asthma severity, granulocyte composition and T2-high asthma than with serum although fewer samples were available.These results were validated in sputum from the Airways Disease Endotyping for Personalized Therapeutics (ADEPT) study (6) (Supplementary Figure S2 ). Elevated PAPPA protein in the serum and sputum of severe asthmatics and in eosinophilic compared to non- eosinophilic subjects was seen (SupplementaryFigure S2A-D ). In addition, sputum PAPPA mRNA levels were also elevated in eosinophilic versus non-eosinophilic asthma in the ADEPT cohort (Supplementary Figure S2E ).The ES score of the T2_IL-13_IVS gene signature in bronchial brushings was significantly, but weakly, correlated with blood eosinophil counts (r=0.329, p=10-6), serum PAPPA (r=0.356, p=10-6), but not with serum periostin levels (r=0.07, p-value=0.48). In contrast, the T2 IL-13 IVS ES score was strongly correlated with sputum PAPPA levels (r=0.72, p=10-3). Sputum PAPPA protein levels also significantly correlated with markers of remodelling such as MMP10 (r=0.646, p<10-6) and MET (r=0.429, p<10-6).Receiver-operating characteristics (ROC) curve analysis was performed for sputum eosinophilia (Supplementary Table S2 ). The area under the ROC curve (AUC) for serum indicated that there was no good predictor although blood eosinophilia was the best (0.79) being marginally better than serum PAPPA and exhaled NO (Figure 2A ). In contrast, sputum PAPPA was an excellent predictor of sputum eosinophilia (0.98), better than blood eosinophilia and exhaled nitric oxide levels (Figure 2B ).Therefore, sputum PAPPA is an excellent biomarker for sputum eosinophilia and for T2-high asthma whilst serum PAPPA is as effective as blood eosinophilia in predicting high sputum eosinophil levels and with T2-high asthma.