Background and aim Papillary fibroelastoma (PFE) represents only 16% of the benign cardiac tumor and approximately 15% of these are located on tricuspid valve. Materials and Methods Over a period of 22 years (1999-2021) we observed 75 pts with cardiac tumors at our Center over 9650 pts operated on. Most of them were mixoma but in 10 cases histology showed a PFE. We describe a rare case (1/75 of cardiac tumors) of a tricuspid valve PFE in a 69-year-old patient. Trans-thoracic echocardiography demonstrated a mobile mass (20 x 10 mm), adhering to the atrial side of the septal leaflet of the tricuspid valve. In consideration of the mobility of the mass and the consequent high embolic risk, surgical removal was made. Patient underwent surgery through a median sternotomy on CPBP. A “gelatinous” mass adhering to the tricuspid leaflet was found and completely removed. The postoperative course was uneventful. The pathological evaluation confirmed the diagnosis of PFE. Conclusions PFE of the tricuspid valve is rare entities being in most cases found incidentally. In our experience the incidence of this tumor in this location is 1/10000 cases of cardiac surgery. Although most patients are asymptomatic, surgical treatment is nevertheless recommended in consideration of the high embolic risk.

We present the chromosome-level genome assembly of Dysdera silvatica Schmidt, 1981, a nocturnal ground-dwelling spider endemic from the Canary Islands. The genus Dysdera has undergone a remarkable diversification in this archipelago mostly associated with shifts in the level of trophic specialization, becoming an excellent model to study the genomic drivers of adaptive radiations. The new assembly (1.37 Gb; and scaffold N50 of 174.2 Mb), was performed using the chromosome conformation capture scaffolding technique, represents a continuity improvement of more than 4,500 times with respect to the previous version. The seven largest scaffolds or pseudochromosomes cover 87% of the total assembly size and match consistently with the seven chromosomes of the karyotype of this species, including the characteristic large X chromosome. To illustrate the value of this new resource we performed a comprehensive analysis of the two major arthropod chemoreceptor gene families (i.e., gustatory and ionotropic receptors). We identified 545 chemoreceptor sequences distributed across all pseudochromosomes, with a notable underrepresentation in the X chromosome. At least 54% of them localize in 83 genomic clusters with a significantly lower evolutionary distances between them than the average of the family, suggesting a recent origin of many of them. This chromosome-level assembly is the first high-quality genome representative of the Synspermiata clade, and just the third among spiders, representing a new valuable resource to gain insights into the structure and organization of chelicerate genomes, including the role that structural variants, repetitive elements and large gene families played in the extraordinary biology of spiders.

Purpose: The prognosis of the relapsed or refractory Wilms tumor (R/R WT) was dismal and new salvage chemotherapy was needed. This study aimed to evaluate the efficacy of the combination of irinotecan and doxorubicin hydrochloride liposome regimen (AI) for R/R WT. Methods: The present study enrolled the R/R WT who were treated with AI regimen at Sun Yat-Sen University Cancer Center from July 2018 to September 2020. The response was defined as the best observed response after the last two cycle and toxicity was evaluated. Result: Total of 16 patients with median age of 4.2 years (0.5 to 11 years) were enrolled, including 14 patients with relapsed disease and 2 patients with refractory disease. These patients received 1 to 8 courses (median 3 courses).14 patients were assessable for response: 2 complete response (CR), 5 partial response (PR), 2 stable disease (SD), 5 progression disease (PD). The objective response rate was 50% (2 CR, 5 PR) and the disease control rate was 64% (2 CR, 5 PR, and 2 SD). The median progression-free survival was 3.5 months (range 0.5-12 months), and the median survival duration was 8 months (range 1-28 months). Sixteen patients were assessable for toxicity, with most common grade 3 or 4 adverse events were alopecia (62%), leucopenia (40%), abdominal pain (38%), etc. No fatal adverse events have been observed. Conclusion: The AI regimen has positive efficacy with tolerated toxicity, it may provide an alternative option for the treatment of R/R WT.

Since the beginning of the COVID-19 pandemic, industry and healthcare providers have investigated methodologies to manage infection of SARS-CoV-2. One treatment breakthrough has been the introduction of monoclonal antibodies to prevent worsening SARS-CoV-2 infection in non-hospitalized patients diagnosed with COVID-19. These monoclonal antibodies, like bamlanivimab, bind to the SARS-CoV-2 spike protein and prevent its ability to binding to human ACE2 receptors. This is a case of a 91 year-old man with no prior seizure history who developed new-onset seizures after bamlanivimab infusion.

In order to analyze promotion and antioxidant effects of tocopherol in Flat-European hybrid hazelnut Oil, different amounts of α and δ-tocopherol were added into the purified Flat-European hybrid hazelnut oil and accelerated at 62 ℃ for 20 days to simulate the storage process of it, and the peroxidation index was measured respectively. Compared with the purified Flat-European hybrid hazelnut oil without tocopherol, the inflection point of tocopherol concentration and the change trend of its oxidation index were observed, and the antioxidant effects of several antioxidants in the hazelnut oil were compared, which provided a theoretical basis for adding antioxidants during storage of Flat-European hybrid hazelnut oil. When the content of α-tocopherol in Flat-European hybrid hazelnut oil filtered from tocopherol or normal one is respectively less than 500mg/kg or 300mg/kg, which plays an anti-oxidation effect. If it exceeds this value, it will act as a pro-oxidant effect, but δ-tocopherol has no such phenomenon. During the storage of oil with two kinds of tocopherol, α-tocopherol has better anti-oxidation ability than δ-tocopherol . The antioxidant effects of various antioxidants in hazelnut oil are: gallic acid> TBHQ> VC> tocopherol. Under the addition conditions specified in the national standard, gallic acid, TBHQ, VC, α-tocopherol and δ-tocopherol can prolong the storage period of Flat-European hybrid hazelnut oil at room temperature by 720.3, 318, 42.3, 19.5, and 9.6 days respectively compared with that without addition.

Background: Pneumococcal infection causes serious illness in children, especially those with underlying conditions. Although pneumococcal vaccination in the pediatric population is recommended, the immune response to pneumococcal vaccines in this group is usually deficient. The aim of this study was to study the response to pneumococcal vaccines in children with underlying conditions. Methods: A one-year retrospective study on children with underlying conditions attended at the Pediatric Immunology Unit of La Fe University Hospital (Valencia, Spain). Patient demographics, immunosuppressive diseases, pneumococcal vaccination coverage, serum levels of C3, C4, IgA, IgM, IgG, IgG1, IgG2, IgG3, IgG4, blood levels of leukocytes, neutrophils and CD4 and CD8 T lymphocyte were analyzed. Results: A total of 85 children were included in the study. Only 29.41% of them had the complete vaccination schedule, most under 5 years of age (76.00%). Protective levels of pneumococcal antibodies were found only in 48% of the correctly vaccinated patients, whose serum levels of IgG4 and CD4/CD8 ratio were higher than in children with deficient response. Low vaccine response was mostly found among leukemic patients, who exhibited the lowest level of CD4 T lymphocyte. Patients’ age, immunosuppressive therapy, and serum levels of C3, C4, IgG3 and lymphocytes were associated with pneumococcal vaccine response. Conclusion: Most of the patients lacked some dose of pneumococcal vaccine and had an inadequate response. Mathematical models can be useful in clinical practice to detect non responders. Emphasis should be placed on completing a vaccination schedule and, if necessary, revaccination with a booster dose of pneumococcal vaccines.

A document by Luke Smart. Click on the document to view its contents.

In the first section of this study, the effects of two different extraction methods on the efficiency and chemical composition and antioxidant activity were compared. Extraction efficiency of supercritical fluid was significantly higher than distillation of water. The results showed that antioxidant activity increased by increasing the concentration of the essential oil. In the second part of the study, to evaluate the impact of various walls, Lepidium sativum (LS) , Lepidium perfoliatum (LP) and a combination of both (LP/LS)were used for nano-encapsulation essential oil of basil by freeze-drying. Nanoencapsulate powder was evaluated regarding efficiency, particle size, PDI, Zeta poteintial,SEM, viscosity, Brix,pH, density.humidity, aw and FTIR. In the third part, essential oil of basil in free mode at Level 1%, 5% and 20% and in encapsulated at the level of 2% and TBHQ at 0.01% added to Kilka oil without antioxidants and then the samples were place in an oven at 60 ° C for 16 days. Storage stability of kilka oil regarding peroxide, thiobarbituric and color were analyzed. The results showed that basil essential oil had antioxidant activity and reduced the oxidation process, and also nanocapsule essential oil (especially with a coating of LP gum) showed better antioxidant activity than free essential oil, so that its antioxidant activity is competitive with TBHQ synthetic antioxidants. Finally, we can conclude that it is possible to substitute synthetic antioxidants by natural ones like olive leaf phenolic compounds but we have to apply some forms of encapsulation techniques in order to protect their properties.

Objective: This study was conducted to evaluate pre- and intraoperative risk factors for 30-day mortality in patients with acute type A aortic dissection (ATAAD). Methods: Three hundred thirteen patients with ATAAD who underwent emergency surgery (264 men and 49 women; mean age, 48±10 years) were enrolled in our study. Preoperative and operative risk factors for death were presented. Multivariable analysis was performed to identify the influence of varying factors on 30-day mortality. Results: Overall, 32 patients (10.2%) died within 30 days. Compared with the surviving group, the deceased patients were more likely to have tachycardia, elevated serum potassium levels, moderate to severe pericardial effusion, suprasternal branch involvement, myocardial ischemia, and lower-extremity ischemia. Regarding factors related to surgery, the duration of surgery and cardiopulmonary bypass and concomitant procedures of coronary artery bypass graft（CABG） were greater in patients who died. In multivariate analysis, independent risk factors were longer duration of surgery (odds ratio [OR]: 4.5, p=0.001) and cardiopulmonary bypass (OR: 5.3, p=0.001), moderate to severe pericardial effusion (OR: 3.3, p=0.017), suprasternal branch involvement (OR: 4.9，p=0.002), and lower-extremity ischemia (OR: 7.6, p＜0.001). Conclusions: Lower-extremity ischemia and suprasternal branch involvement have the poorest outcomes. Moderate to severe pericardial effusion could influence the outcome. Shorter duration of surgery is associated with better outcomes. Key Words: acute type A aortic dissection, surgery, mortality, risk factors

Tailgut cysts are rare diseases but require a particular management. We present two cases report of a tailgut cyst two females. treated with transabdominal surgical approach. We review the relevant information present in the medical literature about the incidence, methods of diagnosis, treatment options and management plans.

Wei River is the largest tributary of the Yellow River, and in recent decades, water resource has changed significantly. Identifying the characteristics and influencing factors of streamflow change in Wei River is needed for development of effective management strategies and economic development for the region and entire Yellow River basin. The analyzations were based on streamflow records from 1957 to 2018 at five hydrological stations as well as precipitation and air temperature data from 22 meteorological stations. Mann-Kendall method and Pettitt test were used to analyze trends and transition years of hydrometeorological variables. Double mass curves (DMC) were used to quantify the impact of climate changes and anthropogenic activities on streamflow change. The results showed that: the annual average streamflow decreased significantly in the upper reaches (URWR), middle reaches (MRWR) of the main Wei River, Jing River Basin (JRB), Beiluo River Basin (BLRB) as well as the whole Wei River Basin (WWRB). There were transition years existed in these reaches and concentrated in 1990s. The annual precipitation showed a significant downward trend in the MRWR, LRWR, BLRB and WWRB (P<0.01). Air temperature in all reaches rise significantly (P<0.01). Analysis of land use from 1980 to 2020 indicated that residential land and grassland increased markedly. The results of DMC showed that anthropogenic activities were the dominant factors for streamflow reduction, accounting for 52.96%-92.2%. For different reaches, the intensity of human activities (domestic water, agricultural irrigation, industrial water, soil and water conservation measures and reservoirs construction, etc.) was different, resulting in the difference of contribution rate. Relevant research results provide basis for scientific regulation of water resources in Wei River Basin.

To systematically generalize the influence of gullies on floods, a distributed model named Improved Grid-Xinanjiang (GXAJ), and a priori parameters estimation scheme based on the Global Digital Soil Mapping System (SoilGrids) are proposed. Within a watershed divided into a series of orthogonal cells, shallow furrows and trenches inside the cells are conceptualized as primary gullies, in which water movement is simulated by kinematic wave equation considering the gullies density, and well-developed grooves between cells are considered as main gullies, where water moves as a kinematic wave and enters the rivers. The simulation of 27 flood events in the Tunxi watershed of Anhui Province from 2008 to 2017 was implemented, and the simulation results were compared with that of Xinanjiang model (XAJ). The relative runoff volume error and flood peak error of the GXAJ model and XAJ model are 8.4% and 10.7%, 8.9% and 12.1%, respectively. The GXAJ model outperforms in the simulation of flood peak, and is capable of producing the dynamics of soil water and gullies flow. The spatial characteristics and the sensitivity of parameters, free storage capacity and gullies density, at various phases, that is, initial, rise, peak, fall and tail, have been analyzed. The value of free storage capacity decreases and then increases with the increase of altitude and distance from the river. The gullies density in the bank and ridge area is greater than that in the middle of the slope segment. Sensitivity analysis shows that gullies density has the noticeable influence on the relative runoff volume error and Nash-Sutcliffe coefficient in the rise phase, while free water storage capacity has a significant effect on the relative runoff volume error during the flood rise phase and Nash-Sutcliffe coefficient in peak phase, respectively.

Introduction: The spatial thermodynamics of very high power-short duration (vHPSD) radiofrequency (RF) application during pulmonary vein isolation (PVI) in in-vivo model has not been well characterized. This study was conducted to investigate the distance-temperature relationship during vHPSD-RF ablation. Methods: PVI was performed using the vHPSD catheter with the settings of 90W, RF time of 4 sec and 15mL/min irrigation in a canine model. Catheter contact force (CF) of 10-20g was defined as ‘normal’ and CF >20g as ‘firm’ CF. Tissue temperature was monitored using thermocouples implanted at the surface of the left atrial-pulmonary vein junction, left phrenic nerve, and the luminal esophagus. PVI using a standard contact-force sensing catheter (SCF) (settings of 35W, 30sec and 30mL/min irrigation) was performed for comparison. Results: A total of 334 TC profiles in 4 animals was investigated. Time to maximum tissue temperature (MTT) (6.0sec [vHPSD/normal CF] vs. 30.5 sec [SCF/normal CF], p<0.001; 8.0sec [vHPSD/firm CF] vs. 24.0sec [SCF/firm CF], p=0.022) was shorter with vHPSD than in SCF groups. MTT within 10mm from catheter-tip was lower in vHPSD ablation with normal CF than using SCF ablation (median 41.9°C [interquartile-range; 40.2-46.1] vs. 49.5°C [45.9-56.2], p=0.013). The distance margin to keep the MTT below 39ºC, 42ºC, and 50ºC were 4.9mm, 4.2mm, and 3.4mm, respectively in the vHPDS group. This margin was larger (8.0mm, 6.6mm, and 4.6mm) in the SCF group. Conclusion: Our study underscores that vHPSD creates greater resistive heating than conventional catheter ablation.

T-cell large granular lymphocytic leukemia (T-LGL) is a chronic malignancy characterized by clonal expansion of cytotoxic T-cells possibly complicated by cytopenias of one or more myeloid lineages. By describing a multiply-refractory T-LGL case, this report highlights the importance of molecular-targeted and non-cytotoxic therapies in the context of frail elderly patients.

PBS provides the hematologic and/or non-hematologic picture of a case.A 40-year-old man with history of alcohol and marijuana abuse presented with extremities and abdominal pain.After extensive investigations, finding basophilic stippling on PBS led to the diagnosis of lead poisoning.PBS is the simplest screening test which provide rich morphological information.

It is an elegant albeit limited study reporting effects of pre op LVEF on long term results in patients with RHD undergoing DVR. Study includes146 pqtients out of 201 who underwent DVR in the study period. Although all had some improvement immediate post op, those with preserved EF and smaller left ventricles regardless of type of prostheses used, surgical techniques ( partial or full Sub-valvular Apparatus Preservation), had more sustained improvement after 3-4 years than those with lower EF and more dilation . It can be partially explained by more prevalence of aortic insufficiency in patients with pre op lower EF <50 and dilation ( average LVESD 49 mm vs 32 mm in EF >50). There are myocardial factors which also play a part , those with abnormal LV function have more extensive loss of myofibrils either due to disproportion of mitochondria-to-myofibril ratio or myofibrillar degeneration exhibiting the extent RHD involves myocardium. Structural adaptation may not all be just a result of hemodynamic abnormalities in these patients (1). The recommendation that surgical intervention should occur before the LV starts to dilate or EF drops is well founded and would be impactful in the developing world, an estimated 250,000 deaths occur annually worldwide and 10.5 million disability adjusted life years due to RHD, mostly in young people.

African swine fever (ASF) is one of the most severe infectious diseases of pigs. In this study, a LAMP assay coupled with the CRISPR Cas12a system was established in one tube for the detection of the ASFV p72 gene. The single-strand DNA-fluorophore-quencher (ssDNA-FQ) reporter and CRISPR-derived RNA (crRNAs) were screened and selected for the CRISPR detection system. In combination with LAMP amplification assay, the detection limit for the LAMP-CRISPR assay can reach 7 copies/μl of p72 gene per reaction. Furthermore, this method displays no cross-reactivity with other porcine DNA or RNA viruses. The performance of the LAMP-CRISPR assay was compared with real-time qPCR tests for clinical samples, a good consistency between the LAMP-CRISPR assay and real-time qPCR was observed. The method shed a light on the convenient, portable, low cost, highly sensitive and specific detection of ASFV, demonstrating a great application potential for monitoring on-site ASFV in the field.

The surgical treatment of pulmonary hypertension (PH), with or without pulmonary artery aneurysm, has evolved during the last 40 years from heart-lung transplants to bilateral lung transplants as the treatment of choice for PH patients with preserved right and left ventricular function and without complex cardiac abnomalies.

Exotic plants can escape from specialist pathogenic microorganisms in their new range, but may simultaneously accumulate generalist pathogens. This creates the potential for pathogen spillover, which could alter plant-competitive hierarchies via apparent competition. To assess the potential for and consequences of pathogen spillover in invaded communities, we conducted a community-level plant-soil feedback experiment in experimental communities that ranged in the extent of exotic dominance, using next-generation sequencing to characterize sharing of putatively-pathogenic, root-associated fungi (hereafter, ‘pathogens’). Exotic plants outperformed natives in communities, despite being subject to stronger negative plant-soil feedbacks in monoculture and harboring higher relative abundance of pathogens. Exotic plants made more general associations with pathogens, making them more prone to sharing pathogens with natives and exerting apparent competition. These data suggest that exotic plants accumulate generalist pathogens that are shared with native plants, conferring an indirect benefit to exotic, over native plants.

1. Quantifying consumption and prey choice for marine predator species is key to understanding their interaction with prey species, fisheries, and the ecosystem as a whole. However, parameterising a functional response for large predators can be challenging because of the difficulty in obtaining the required datasets on predator diet and the availability of multiple prey species. 2. This study modelled a Multi-Species Functional Response (MSFR) to describe the relationship between consumption by harbour porpoises (Phocoena phocoena) and the availability of multiple prey species in the southern North Sea. Bayesian methodology was employed to estimate MSFR parameters and to incorporate uncertainties in diet and prey availability estimates. Prey consumption was estimated from stomach contents data of stranded harbour porpoises. Prey availability to harbour porpoises was estimated based on the spatial overlap between prey distributions, estimated from fish survey data, and porpoise foraging range in the days prior to stranding predicted from telemetry data. 3. Results indicated a strong preference for sandeel in the study area. Prey switching behaviour (change in preference dependent on prey abundance) was confirmed by the favoured Type III functional response model. Variation in the size of the foraging range (estimated area where harbour porpoises could have foraged prior to stranding) did not alter the overall pattern of the results or conclusions. 4. Integrating datasets on prey consumption from strandings, predator foraging distribution using telemetry and prey availability from fish surveys into the modelling approach provides a methodological framework that may be appropriate for fitting MSFRs for other predators.

Pathogens may elicit a high selective pressure on hosts and can alter genetic diversity over short evolutionary timescales. Intraspecific variation in immune response can be observed as variable survivability from specific infections. The great gerbil (Rhombomys opimus) is a rodent plague host with a heterogenic but highly resistant phenotype. Here, we investigate if the most plague-resistant phenotypes are linked to genomic differences between survivors and susceptible individuals by exposure of wild-caught great gerbils from Northwest China to plague (Yersinia pestis). Whole genome sequencing of ten survivors and ten moribund individuals revealed a low genome-wide mean divergence, except for a subset of genomic regions that showed elevated differentiation. Gene ontology (GO) analysis of candidate genes within regions of increased differentiation, demonstrated enrichment of pathways involved in transcription and translation and their regulation), as well as genes directly involved in immune functions, cellular metabolism and the regulation of apoptosis. Differential RNA expression analysis revealed that the early activated great gerbil immune response to plague consisted of classical components of the innate immune system. Our approach combining challenge experiments with transcriptomics and population level sequencing, provides new insight into the genetic background of plague-resistance and confirms its complex nature, most likely involving multiple genes and pathways of both the immune system and regulation of basic cellular functions.

Secondary contact of species that have evolved partial reproductive isolation in allopatry may result in several outcomes, which range from rampant hybridization to barrier reinforcement. Reinforcement arises from reduced hybrid fitness, which promotes assortative mating and hence speciation. In plants, self-fertilization and disjunctions in reproductive-phenology are often invoked as evidence of reinforcement. However, local adaptation and pleiotropic effects during colonization can also lead to reproductive isolation without reinforcement. We explored these possibilities in a fir species complex (Abies flinckii - A. religiosa) distributed in ‘sky-islands’ along the Trans-Mexican Volcanic Belt (TMVB), in central Mexico. Despite co-occurring in two independent sympatric regions (west and center), these two taxa seem to rarely interbreed because of disjunct reproductive phenologies. We genotyped 1,147 SNPs, generated by GBS across 23 populations, and compared multiple demographic scenarios, built based on the geological history of the TMVB. The best-fitting model suggested a recent species split (for a conifer), dating back to ~1.2 Ma, together with early asymmetric gene flow (mostly from A. flinckii into A. religiosa), limited to the central sympatric region. Coupled with the lack of support for colonization models, the summary statistics (f, Hobs, FST, θπ, etc.) and historical demographic inferences made herein point to a rapid speciation with an early development of reinforcement, as a putative mechanism for avoiding hybridization. The role of reinforcement should be thus further explored in the (sub)tropics, as likely explanation for how species diversity is generated and maintained.

A document by Ahmet Tahra. Click on the document to view its contents.

Fishbone perforation, a severe complication causing damage to nearby organs, is difficult to diagnose because the patient and family cannot remember the history of fishbone ingestion exactly. A detailed history of eating, as well as a thorough physical examination and diagnostic imaging, are needed to make an accurate diagnosis.