We develop a simulation toolset employing density functional theory (DFT) in conjunction with grand canonical Monte Carlo (GCMC) to study coke formation on Fe-based catalysts during propane dehydrogenation (PDH). As expected, pure Fe surfaces develop stable graphitic coke structures and rapidly deactivate. We find that coke formation is markedly less favorable on Fe3C and FeS surfaces. Fe-Al alloys display varying degrees of coke resistance, depending on their composition, suggesting that they can be optimized for coke resistance under PDH conditions. Electronic structure analyses show that both electron-withdrawing effects (on Fe3C and FeS) and electron-donating effects (on Fe-Al alloys) destabilize adsorbed carbon. On the alloy surfaces, a geometric effect also isolates Fe sites and disrupts the formation of graphitic carbon networks. This work demonstrates the utility of GCMC for studying the formation of disordered phases on catalyst surfaces and provides insights for improving the coke resistance of Fe-based PDH catalysts.

There is still no consensus on the reaction pathways and kinetic modeling of magnesiothermic reduction of titanium tetrachloride, and the theoretical innovations are required for further research of titanium metallurgy. We determined efficient reaction pathways via chemical reaction stoichiometry methodology, and proposed an innovative kinetic modeling approach of magnesiothermic reduction of titanium tetrachloride. We explained the reaction pathways by the steps of the phase change near the gas-liquid interfaces, the homogeneous reaction in the gas phase, the heterogeneous reduction near the gas-liquid interfaces, and the like dissolves like in the liquid phase. Net chemical reaction rate of titanium sponge decreased with decreasing of titanium tetrachloride feeding rata and with increasing of gauge pressure. The excellent fitness of the reaction rate constants, f(Δp) and k(Tin), show that the proposed kinetic equation accuately describes the reaction mechanism, and is reasonable and acceptable for magnesiothermic reduction of titanium tetrachloride in titanium metallurgy.

The Bayer process holds an exclusive status for alumina extraction, but a massive amount of caustic “red mud” waste is generated. In this work, three oxalate reagents: potassium hydrogen oxalate (KHC2O4), potassium tetraoxalate (KHC2O4·H2C2O4), and oxalic acid (H2C2O4) were investigated for the Al and Fe extraction process from NIST SRM 600 – Australian Darling range bauxite ore. More than 90% of Al and Fe was extracted into the aqueous phase in less than 2 h with 0.50 M C2O42- for all three reagents. The Fe and Al can be selectively precipitated by hydrolyzing the aqueous phase. By acidifying the Al and Fe free filtrate, 80% of the C2O42- can be precipitated as KHC2O4·H2C2O4. Greater than 90% of the aqueous acid can also be recycled using a cation exchange resin. The proposed closed-loop process is an energy-efficient, cost-effective, environmentally-friendly route for extracting Al and Fe from bauxite ore.

Semi-batch reactor systems can be used at different areas due to its advantages of the feed manipulation. Common practices are temperature control of the exothermic reactions or selectivity adjustment of the production process include serial and parallel reactions. Bisphenol A (BPA) is theoretically synthesized with 2 moles of phenol and 1 mol of acetone. During the reaction, a stoichiometric ratio or high acetone concentration causes the formation of by-products. This situation has been confirmed by density functional theory (DFT) calculations. In these calcula-tions, the B3LYP method and the 6-311++G(d, p) basis set were used. DFT calculations show that by-products can be formed in the synthesis of bisphenol a. The common method used to solve the by-product problem is to work with high molar phenol/acetone ratios. But this brings additional operating and investment costs. In this study, semi-batch reaction experiments were performed which stoichiometric acetone was fed in reactor with various pulsed modes in the presence of homogenous and heterogonous catalysts. Time versus conversion and selectivity data were collected at various catalyst concentrations. All runs were compared with the results of batch and semi-batch runs performed in over molar ratio of phenol/acetone. As a result, it has been shown that high conversion and selectivity can be achieved by providing energy efficiency with pulsed mode semi batch reactor.

Ovarian molar pregnancy, though a very rare entity, behaves like any other molar pregnancy. After surgical management, close follow-up with Beta Human Chorionic Gonadotrophin surveillance is invariable to detect progression to persistent Gestational Trophoblastic Disease, which if develops can be treated successfully with chemotherapy.

The psychological impact of COVID-19 pandemic in patients with genetic diseases such as Tuberous sclerosis complex remains to be misunderstood. We report a case of a patient with Tuberous sclerosis who presented with hallucinations, delusions, and disorganized behavior. He developed psychotic symptoms directly triggered by stress derived from COVID-19 pandemic.

A significant percentage of colorectal cancer patients proceeds to metastatic disease. We hypothesised that mitochondrial DNA (mtDNA) polymorphisms, generated by the high mtDNA mutation rate of energy-demanding clonal immune cell expansions and assessable in peripheral blood, reflect how efficiently systemic immunity impedes metastasis. We studied 44 rectal cancer patients from a population-based prospective biomarker study, given curative-intent neoadjuvant radiation and radical surgery for high-risk tumour stage and followed for metastatic failure. Blood specimens were sampled at the time of diagnosis and analysed for the full-length mtDNA sequence, composition of immune cell subpopulations and damaged serum mtDNA. A high mtDNA variant number, coexisting with an mtDNA non-H haplogroup, was associated with low risk of a metastatic event. Abundant mtDNA variants correlated with proliferating helper T cells and cytotoxic effector T cells in the circulation. Patients without metastatic progression had high relative levels of circulating tumour-targeting effector and natural killer T cells and, of note, the naïve (LAG-3+) helper T cell population, all inversely correlated with cell-free damaged mtDNA in serum known to cause antagonising inflammation. The statistical associations suggested that patient’s constitutional mtDNA manifests the helper T cell capacity to mount immunity that controls metastatic susceptibility.

In this study, we examined the effects of different mass ratios of aged refuse on Tagetes patula and rhizosphere microbes. The results showed that chlorophyll content and activities of superoxide dismutase, catalase, and peroxidase in leaf tissue increased significantly in plants cultivated in soil:aged refuse mixtures compared with ordinary soil, whereas levels of malondialdehyde and protein carbonyl decreased significantly in soil:aged refuse mixtures. Microbial community analysis revealed that aged refuse is rich in a variety of rhizosphere microbes that contribute to pollutant degradation, although microbial diversity was found to be relatively low. Bacterial genera such as Ferruginibacter, Hymenobacter, unclassified_Gemmataceae, Longimicrobium, Tychonema CCAP 1459-11B, Gemmatirosa, and Rubellimicrobium tended to be enriched to a greater extent in ordinary soil compared with soil:aged refuse mixtures. Correspondingly, bacterial genera such as Emticicia, Caedibacter, Anaerosalibacter, Tumebacillus, Patulibacter, Oceanotoga, Dyadobacter, Chloroflexus, and Acidobacteria bacterium SCN 69-37, Polycyclovorans, tended to be enriched in mixtures with a higher proportion of aged refuse. Functional prediction analysis revealed that rhizosphere microbe functions changed markedly following the addition of aged refuse. These findings indicate that aged refuse may represent a source of environmental stress for plants and modifies the dominant bacterial composition of rhizosphere microbes. The combination of organic or inorganic pollutants, plant physiological stress responses, and rhizosphere microbial community composition may have potential cooperative or dynamic equilibrium relationships. With respect to identifying potential approaches to recycling aged refuse, it will be necessary to focus on selecting optimal mass ratios of aged refuse and ordinary soil to control contaminant exposure.

Goblet cell carcinoid is usually diagnosed after simple appendectomy; however, the current case was detected from a metastatic ovarian tumor.

Extrusion-based 3D printing of polymeric biomaterials has emerged as a promising approach for the fabrication of complex tissue engineering constructs. However, the large pore and feature size lead to low cell seeding efficiency and limited control of spatial distribution of cells within the scaffolds. We developed hybrid scaffolds that are composed of 3D printed layers and airbrushed fibrous membranes. Airbrushing time was adjusted to fabricate low (L), medium (M), and high (H) density membranes to effectively control stem cell infiltration. When two distinct populations of stem cells were seeded from top or bottom of the scaffolds, scaffolds composed of LLL membranes showed gradual mixing of the cells with depth whereas LHL membranes led to two distinct regions of cells separated by the H membrane. Our results demonstrate that fibrous membranes incorporated within 3D printed layers enable user-defined and spatially controlled cell compositions within hybrid scaffolds.

Otitis Media (OM) is the most common reason for U.S. children to receive prescribed oral antibiotics, leading to potential to cause antibiotic resistance. To minimize oral antibiotic usage, we developed polyvinylpyrrolidone-coated silver nanoparticles (AgNPs-PVP), which completely eradicated common OM pathogens, i.e., Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) at 1.04µg/mL and 2.13µg/mL. The greater antimicrobial efficacy against S. pneumoniae was a result of the H2O2-producing ability of S. pneumoniae and the known synergistic interactions between H2O2 and AgNPs. To enable the sustained local delivery of AgNPs-PVP (e.g., via injection through perforated tympanic membranes), a hydrogel formulation of 18%(w/v)P407 was developed. Reverse thermal gelation of the AgNPs-PVP-P407 hydrogel could gel rapidly upon entering the warm auditory bullae and thereby sustained release of antimicrobials. This hydrogel-based local delivery system completely eradicated OM pathogens in vitro without cytotoxicity, and thus represents a promising strategy for treating bacterial OM without relying on conventional antibiotics.

AngioVac suction embolectomy is recommended by the manufacturer to be performed with a centrifugal pump due to safety considerations. However, roller head pumps are significantly cheaper to use, and thus may be more readily available during shortages and in resource poor settings. We present the technique of Angiovac suction embolectomy being successfully performed with a roller pump to evacuate a clot-in-transit in the inferior vena cava and right atrium, along with discussion of important safety caveats.

A mechanistic based cavitation model that considers nucleation, early-stage growth and sintering under creep-fatigue interaction is proposed. The number density of cavities ρ and their evolution during multi-cycle creep-fatigue loading are predicted. Both the cavity nucleation and early-stage growth rates, controlled by grain boundary (GB) sliding mechanism during the tension phase, are formulised as a function of local normal stress σ n. The cavity sintering that occurs during the compression phase is described as a function of σ n, but the mechanism switches to the unconstrained GB diffusion. By examining various load waveform parameters, results provide important insights into experimental design of studying the creep-dominated cavitation process under creep-fatigue interaction. First, creep-fatigue test with initial compression will promote higher ρ value compared to that with initial tension, if the unbalanced stress hold time in favour of tension is satisfied. Second, the ρ value does not have a monotonic dependence on either the compressive hold time or stress level, because of their competing effect on nucleation and sintering. Third, the optimum value of stress variation rate exists in terms of obtaining the highest ρ value due to sintering effect.

In this paper, we consider a two-dimensional generalization of the parabolic equation. Using the Fourier method, we study the solvability of the inverse problem with the Dirichlet condition and periodic conditions.

Purpose: To investigate the relationship between lesion size determined using mpMRI and histopathological findings of specimens obtained after mpMRI fusion biopsy and radical prostatectomy. Material and Methods: We retrospectively analyzed 590 patients with PCa who underwent an MRI fusion biopsy between 2017-2019. We measured the diameter of suspicious tumor lesions on diffusion-weighted mpMRI and stratified the cohort into two groups. Group A included patients with a suspicious tumor lesion equal and smaller than 10 mm and Group B included those with a suspicious tumor lesion larger than 10 mm. RP was performed in 53 patients. The patients in Groups A and B were compared according to their pathological findings obtained with fusion biopsy and RP. Results: After applying the inclusion and exclusion criteria, Group A consisted of 144 patients and Group B comprised 146. In Group B, PI-RADS score determined in mpMRI was higher than Group A, and there was a statistically significant difference between the two groups in terms of clinical T-stage. The PCa detection rate and the number of positive cores were statistically significantly higher in Group B than in Group A. In addition, there was a statistically significant difference between the two groups in relation to the biopsy, the ISUP grades and the presence of clinically significant PCa. In Group B, pathological T-stage and extraprostatic extension (EPE) and surgical margin (SM) positivity were found to be higher among the patients who underwent RP. In the multivariate analysis, the mpMRI lesion size being >10 mm was found to be an independent predictive factor for SM and EPE positivity. Conclusion: The radiologists and clinicians should be awared of the possibility of presence of features that may affect local staging, such as EPE positivity, in the presence of lesions larger than 10 mm in which prostate cancer is detected.

Exact nonlinear partial differential equation solutions are critical for describing new complex characteristics in a variety of fields of applied science. The aim of this research is to use the F-expansion method to find the generalized solitary wave solution of the regularized long wave (RLW) equation of fractional order. Fractional partial differential equations can also be transformed into ordinary differential equations using fractional complex transformation and the properties of the modified Riemann–Liouville fractional-order operator. Because of the chain rule and the derivative of composite functions, nonlinear fractional differential equations (NLFDEs) can be converted to ordinary differential equations. We have investigated various set of explicit solutions with some free parameters using this approach. The solitary wave solutions are derived from the moving wave solutions when the parameters are set to special values. Our findings show that this approach is a very active and straightforward way of formulating exact solutions to nonlinear evolution equations that arise in mathematical physics and engineering. It is anticipated that this research will provide insight and knowledge into the implementation of novel methods for solving wave equations.

The actinomycete Lentzea aerocolonigenes produces the antitumor antibiotic rebeccamycin. In previous studies the rebeccamycin production was significantly increased by the addition of glass beads during cultivation in different diameters between 0.5 – 2 mm and the induced mechanical stress by the glass beads was proposed to be responsible for the increased production. Thus, this study was conducted to be a systematic investigation of different parameters for macroparticle addition, such as bead diameter, concentration and density (glass and ceramic) as well as shaking frequency, for a better understanding of the particle induced stress on L. aerocolonigenes. The induced stress for optimal rebeccamycin production can be estimated by a combination of stress energy and stress frequency. In addition, the macroparticle-enhanced cultivation of L. aerocolonigenes was combined with soy lecithin addition to further increase the rebeccamycin concentration. With 100 g L-1 glass beads in a diameter of 969 µm and 5 g L-1 soy lecithin a concentration of 388 mg L 1 rebeccamycin was reached after 10 days of cultivation, which corresponds to the highest rebeccamycin concentrations achieved in shake flask cultivations of L. aerocolonigenes stated in literature so far.

By designing a novel combined event-triggered control technique, this article analytically studies the distributed leader-following consensus problem of nonlinear fractional chaotic multi-agent systems. First, a novel combined event-triggered mechanism which takes into account both the relative error and the absolute error of the samples is proposed, under which each follower agent executes control update independently at its own event times. Next, a fully distributed event-triggered consensus protocol is designed and the sufficient conditions of consensus are attained. Finally, compared with other event-triggered mechanisms, the simulation experiments illustrate that the event-based consensus protocol proposed in this article can effectively reduce the frequency of actuator data update while ensuring desired consensus performance.

Left atrial intramural hematoma is a rare complication of percutaneous coronary intervention. We report a case of left atrial intramural hematoma after percutaneous coronary intervention that was successfully treated by combining surgery with interventional therapy.

Childhood malignancies have a mostly unknown genetic origin. It is critical, therefore, to develop fresh ways for deciphering the range of pediatric cancer genes. Statistical network modeling approaches have emerged as effective methods for inferring gene-disease associations and have been used to adult malignancies but not to pediatric malignancies. We used co-expression network analysis to get a multi-layer knowledge of pan-cancer transcriptome data from the Treehouse Childhood Cancer Initiative. Six modules were shown to be significantly correlated with pediatric tumor histotypes and to be functionally connected to developmental processes. Topological studies revealed that genes associated with childhood cancer propensity and prospective treatment targets were critical regulators of cancer-histotype-specific modules. A module with activities involved in DNA repair and cell cycle control was associated with several pediatric cancers. This canonical oncogenic module encapsulated the majority of the genes associated with pediatric cancer propensity and therapeutically actionable genes. The driver genes were co-expressed in a module associated with epigenetic and post-transcriptional processes in juvenile acute leukemias, indicating a key role for these pathways in the evolution of hematologic malignancies. This integrated pan-cancer analysis characterizes pediatric tumor-associated modules in detail and lays the groundwork for the investigation of new candidate genes implicated in juvenile carcinogenesis.

We describe a case of frozen elephant trunk deployment unintentionally malpositioned into the false lumen. An 83-year-old man underwent total arch repair with a frozen elephant trunk for type A acute aortic dissection complicated by mesenteric malperfusion. However, intraoperative transesophageal echocardiography showed expansion of the false lumen in the descending aorta, suggesting a malpositioned frozen elephant trunk into the false lumen. Endovascular fenestration of the dissecting flap and subsequent endograft deployment from the inside of the malpositioned frozen elephant trunk graft to the true lumen of the descending aorta was successfully performed under intravascular ultrasound guidance.

Impact of COVID-19 on Coronary Artery Surgery: Hard lessons learnedAuthor: Luis Alberto O. Dallan1; Luiz Augusto F. Lisboa1; Luis Roberto P. Dallan1; Fabio B. Jatene1.1 Department of Cardiovascular Surgery, Heart Institute from University of São Paulo Medical School (InCor), São Paulo, São Paulo, Brazil.Corresponding author:  Luis Alberto O. Dallan, Dr. Enéas de Carvalho Aguiar, 44, Postal Code:05403-900. Pinheiros, São Paulo, SP – Brazil. Phone: +55 (11) 2661-5014. E-mail: dcidallan@incor.usp.br.Since March 11th, 2020 when coronavirus disease 2019 (COVID-19) was declared a pandemia, hospitals had to be adapted quickly to increase the assistance capacity for a large part of the population that needed hospitalization for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (1,2). Major disruptions on routine hospital services have occurred, with health professionals needed to assume functions beyond their usual routines and beds were adapted for intensive care due to the increased demand in the treatment of severe acute respiratory failure. Cardiovascular surgery was particularly affected by the coronavirus outbreak, since most of the elective surgeries were canceled and ICU beds, normally dedicated to the postoperative period of cardiac surgery, were transferred to patients with COVID-19 (3-5).In this context, Kalil and Col.(6) examine the impact of the Covid-19 pandemic in the number of procedures and death rate of CABG performed in 2020 in Brazil. They analyzed patients undergoing CABG in the public health system between 2008 and 2020. The data were collected from DATASUS, the data processing system of the Brazilian Ministry of Health, which collects information from every patient who needs in-hospital care and was admitted to a public hospital. Patients operated on the private system were not captured in the database and were excluded from the analysis. The results showed that in 2020, during the pandemic period, there was an average reduction of 25% in the number of CABG performed in Brazil, with the majority of procedures (75%) being performed in the south and southeast regions of the country. Regarding postoperative mortality, they observed an opposite effect with an increase in mortality from 5.6% to 6.3% during this pandemic period (6).This study has some limitations due to results extracted from an administrative database, good for epidemiological analysis such as gender, age, number and type of surgeries performed. Considering the reduction in surgical volume during the pandemic period, surgical status was analyzed altogether (whether elective, or urgent or emergency CABG), expressing a general view of the situation.Brazil was the epicenter of the coronavirus outbreak in Latin America and other publications from Brazil showed different and more detailed results in relation to the pandemic period (7,8). One by Omar et al. (7) who used data from the São Paulo Registry of Cardiovascular Surgery (REPLICCAR), a multicenter registry, showed a 60% reduction in surgical CABG volume during COVID-19 pandemic. Regarding mortality, CABG surgeries had a 2.8-fold increased mortality risk (CI95%,1-7.6, P=0.041), patients who evolved with COVID-19 had a 11-fold increased mortality risk (CI95%, 2.2-54.9, P<0.003), rates of morbidities and readmission to the intensive care unit. (7), compared to 2019.In our own series at the Heart Institute University of Sao Paulo Medical School - Brazil, we observed a 65.8% reduction in cardiac surgery volume in 2020, during the pandemic period, and 2/3 of these were urgent or emergency procedures. Regarding the CABG in-hospital mortality, there was increased from 1.2% (2019) to 3.0% (2020) among elective procedures and from 4.5% (2019) para 18.2% (2020) among urgent or emergency procedures. Patients who had postoperative COVID-19, the in-hospital mortality rate was significantly higher (38.5%).Other publications reported a reduction in surgical volume of more than 70% during the peak disruption due to COVID-19 (9,10). Salenger et al. (11) reported that the volume of cardiac surgery fell to 54% of baseline after the restrictions were implemented and they also estimated a necessity of 2.5 times increase in numbers of procedures in post-COVID-19 era to restore balance to elective surgeries waiting lists. In the COVIDSurg collaborative, in a multi centric cohort of surgeries performed in 24 countries (235 hospitals), found that 75% of the procedures from 1 January and 31 March 2020, were non-elective and the mortality was 24%. Their cohort included 50 patients who underwent cardiac surgery and 30-day mortality was 34%, among the patients who had perioperative SARS-CoV-2 infection (12). Clinical studies have shown that in addition to severe acute respiratory distress syndrome, the coronavirus-2 infection also affects micro-circulation, has prothrombotic state and can cause myocardial injury, even in patients without coronary artery disease (13-14). This may be one of the reasons for the high mortality among patients who undergo surgery and present COVID-19 in the perioperative period, particularly in CABG surgery, where there is also a higher incidence of elderly, hypertensive and diabetic patients.While the COVID-19 pandemic continues to increase globally, measures to control SARS-CoV-2 infection and patient safety need to be established to maintain cardiovascular surgery, even if in small numbers. The consequences of delayed recognition of a patient with COVID-19 are significant. Protocols for triage, early diagnosis, isolation in specific areas and treatment of patients with COVID-19 with cardiovascular complications should be developed to minimize the risk of in-hospital transmission and greater safety for hospitalized patients without COVID-19 and healthcare professionals (15,16).A large number of operations were canceled or postponed due to interruptions caused by COVID-19. Coincidentally, our institution have reported an increased number of mechanical complications, that maybe related to decreased number of patients seeking for medical assistance (17).Studies conducted in the first months of the pandemic showed that if countries increased their normal surgical volume by 20%, it would take an average of 45 weeks to balance the backlog of operations resulting from the interruption of COVID-19 (18). Patients awaiting elective cardiac surgery need to be proactively managed, reprioritizing those with high-risk anatomy or whose clinical status is deteriorating. In this regard, governments must mitigate this heavy burden on patients by developing recovery plans and implementing strategies to safely restore surgical activity as soon as possible.

Stump appendicitis has been reported after either open or laparoscopic appendectomy. Because of the low index of suspicion owing to a previous history of appendectomy, the diagnosis is often delayed and complications can occur. We report a 30-year-old patient with Stump appendicitis, who underwent completion appendectomy laparoscopally.

Revegetation programs aim to avoid land degradation, control soil erosion, reduce floods, and improve ecological conditions. China has planted billions of trees over the past 20 years. However, little is known about the effectiveness of this artificial revegetation, and its consequences on China’s national conservation policies and changes in biophysical factors at the county level. Here we use satellite time series data and develop a new metric, the revegetation index (RVI), that quickly monitors revegetation and its long-term changes. We found that the amount of regions where the Grain to Green Program (GTGP) successfully was implemented only about 55.8% of the areas of GTGP implementation. Surprisingly, we provide observational evidence that the implementation of the GTGP can decrease soil erosion and drought, and increase water availability, but revegetation in the Yangtze River Basin (YRB) in China has a limited impact on soil erosion, water and drought. In particular, for revegetation between 1999 and 2016, indicating that previous an assessment by the government revealed as official statistics may have overestimated the effects of the ecological restoration practices.