Aim To evaluate consecutive measurements of the biometric parameters, age, and refraction error in a Turkish population at primary school age. Materials and Methods A total of 197 children aged between 7-12 years were included. The data of three consecutive measurements of children, who were examined at least once a year for three years using both cycloplegic auto-refractometry and optical biometry, were used in this retrospective study. Spherical equivalent <-0.50D was considered to be myopic; >+0.75D was considered to be hypermetropic. Age, gender, body mass index, spherical equivalent, axial length, anterior chamber depth, central corneal thickness, keratometry, and lens thickness were analyzed. The onset data obtained in 2013 whereas, the final data were from 2015. Logistic and Cox regression analyses were performed (p<0.05). Results The mean of the onset and the final spherical equivalents were 0.19D (0.56), and 0.08D (0.80), respectively. The myopia prevalence was increased among refractive errors in observation periods (univariable analysis p=0.029; multivariable analysis p=0.017). The onset axial length (HR:4.55, 95%CI:2.87-7.24, p<0.001), keratometry (HR:2.04, 95%CI:1.55-2.67, p<0.001) and age (HR:0.73, 95%CI: 0.57-0.92, p=0.009) correlated myopia progression. To calculate the estimated spherical equivalent, the onset data were included in the logistic regression model. The onset data of spherical equivalent (β=0.916, p<0.001), axial length (β=-0.451, p<0.001), anterior chamber depth (β=0.430, p=0.005) and keratometry (β=-0.172, p<0.001) were found to be significantly associated with the mean SE at the final data. Conclusions To calculate the estimated spherical equivalent following three years, an equation was proposed. The estimated refractive error of children can be calculated by using the proposed equation with the associated onset optical parameters.

Installation of feral pig (Sus scrofa) exclusion fences to conserve and rehabilitate coastal floodplain habitat for fish production and water quality services remains untested. Twenty-one floodplain and riverine wetlands in the Archer River catchment (north Queensland) were surveyed during post-wet (June-August) and late-dry season (November-December) in 2016, 2017 and 2018, using a fyke net soaked overnight (~14-15hrs) to test: 1) whether the fish assemblage are similar in wetlands with and without fences; and 2) whether specific environmental conditions influence fish composition between fenced and unfenced wetlands. A total of 6,353 fish representing twenty-six species from 15 families were captured. There were no wetland differences in fish assemblages across seasons, years and for fenced and unfenced (PERMANOVA, Pseudo-F <0.589, P<0.84). Interestingly the late-dry season fish were far smaller compared to post-wet season fish: a strategy presumably in place to maximise rapid disposal following rain and floodplain connectivity. In each wetland a calibrated Hydrolab was deployed (between 2-4 days, with 20min logging) in the epilimnion (0.2m) and revealed distinct diel water quality cycling of temperature, dissolved oxygen and pH (conductivity represented freshwater wetlands), which was more obvious in the late-dry season survey because of extreme summer conditions. Water quality varied among wetlands in terms of the daily amplitude and extent of daily photosynthesis recovery, which highlights the need to consider local conditions and that applying general assumptions around water quality conditions for these types of wetlands is problematic for managers. Though many fish access wetlands during wet season connection, the seasonal effect of reduced water level conditions seems more over-improvised when compared to whether fences are installed, as all wetlands supported few, juvenile, or no fish species because they had dried completely regardless of the presence of fences.

Pancreas is an uncommon site for kidney metastasis and this represents a challenge for the different diagnosis of pancreatic masses. Radiological features of secondary pancreatic malignancies from clear cell renal cell carcinoma mimicked a classic neuroendocrine tumor and EUS-guided histology needle is pivotal in providing a correct diagnosis.

Introduction. Atrial Fibrillation and Atrial Flutter (AF/AFL), the most common atrial arrhythmias, have never been examined in combat casualties. In this study, we investigated the impact of traumatic injury on AF/AFL among service members with deployment history. Methods. Sampled from the Department of Defense (DoD) Trauma Registry (n=10,000), each injured patient in this retrospective cohort study was matched with a non-injured service member drawn from the Veterans Affairs/DoD Identity Repository. The primary outcome was AF/AFL diagnosis identified using ICD-9-CM and ICD-10-CM codes. Competing risk regressions based on Fine and Gray subdistribution hazards model with were utilized to assess the association between injury and AF/AFL. Results. There were 130 reported AF/AFL cases, 90 of whom were injured and 40 were non-injured. The estimated cumulative incidence rates of AF/AFL for injured was higher compared to non-injured patients (HR = 2.04; 95% CI = 1.44, 2.87). After adjustment demographics and tobacco use, the association did not appreciably decrease (HR = 1.90; 95% CI = 1.23, 2.93). Additional adjustment for obesity, hypertension, diabetes, and vascular disorders, the association between injury and AF/AFL was no longer statistically significant (HR: 1.51; 95% CI = 0.99, 2.52). Conclusion. Higher AF/AFL incidence rate was observed among deployed service members with combat injury compared to servicemembers without injury. The association did not remain significant after adjustment for cardiovascular-related covariates. These findings highlight the need for combat casualties surveillance to further understand the AF/AFL risk within the military population and to elucidate the potential underlying pathophysiologic mechanisms.

Aim Higher elevation habitats contribute substantially to global biodiversity. Nevertheless, we know comparatively little about how diversity patterns differ among alpine and montane communities across different mountain ranges. Here, we characterized the realized niche space of American seed plants to ask whether or not montane or alpine community compositions define climatically distinct species pools at this regional scale. Location Americas. Time Period Contemporary. Major taxa studied Seed plants. Methods We assembled a niche model dataset of 72,372 American seed plants based on digitized and georeferenced specimen records. We used this dataset to quantify occupied abiotic niche space with regards to temperature, precipitation, and elevation. This approach further permitted differentiation of higher-elevation specialists (i.e., ranges centered at high elevations) from generalists (i.e., ranges centered at lower elevations but extending into mountain areas). Results Montane communities did not differ from the regional species pool in terms of richness patterns, occupied climatic niche space, or niche breadth. In contrast, alpine communities were characterized by a bimodal latitudinal diversity gradient, drastically reduced climatic niche space, and broader temperature but narrower precipitation niche breadth. Alpine generalists further showed statistically significant differences in temperature, but not precipitation, niche breadth from both alpine specialists and lowland taxa. We also highlight non-alpine species whose climatic niche space otherwise overlapped with that of alpine plants. These species were geographically concentrated in the southern US and Mexico, tended to have a greater fraction of their ranges in frost-exposed mountain foothills, and less of their range in lowland, frost-free, areas, compared to other non-alpine species. Main conclusions These results suggest that ecological and physiological barriers, rather than dispersal limitation might better explain alpine community assembly and that alpine, but not montane, communities form a climatically distinct species pool in the Americas.

Purpose: The aim of a color coded protocol for non-elective cesarean-sections is to improve decision-delivery interval by better organization of care in a maternity unit. We set out to assess compliance of a color coded protocol and its impact on maternal and neonatal outcomes since its implementation in our maternity ward. Materials and methods: This was a retrospective study including a sample of 200 patients per year who underwent an non-elective cesarean section delivery in Rennes University Hospital from January 1, 2015 to December 31, 2018. Patients were grouped by year and by color code (red, orange or green). The main outcome was compliance with the protocol (color code in accordance with indication for cesarean section) and compliance with the corresponding decision-delivery interval. Secondary outcomes were maternal and neonatal outcomes. The statistical tests performed were Fisher’s test for qualitative parameters and Kruskal-Wallis test for quantitative parameters. Results: Eight hundred patients were included during the study period. There was no significant difference in patient characteristics over the years. There was a significant improvement in protocol compliance: full compliance increased from 22.4% in 2015 to 76.5% in 2018 (p<0.0001). No difference was observed in the decision-delivery interval overall but compliance with the 15-minute decision-delivery interval imposed by a red coded protocol increased between 2015 and 2018 (p=0.0020). Conclusion: We observed a significant improvement in compliance with the color coded protocol between 2015 and 2018 and in the 15-minute decision-delivery deadline for the red code.

We have studied the long- and short-term periods of seabird influence on coastal vegetation. In the Aleutian Islands during the Holocene, terrestrial predators were virtually absent; as a result, large seabird colonies thrived along the coasts or across entire islands. Bird guano enriches the soil with nitrogen, which can lead to the formation of highly modified ornithogenic (bird-formed) ecosystems. The vegetation of several Aleutian Islands has been reconstructed; however, only the vegetation on Carlisle Island had noticeable impact from the seabird guano. For more detailed investigation of bird influence, we conducted pollen analysis to reconstruct the 9,300-year-old vegetation dynamics of the coast of Shemya Island. From earlier studies of nitrogen isotopes in peat, we discovered that a large seabird colony existed on Shemya from 4600 to 2400 years ago, and birds also influenced coastal ecosystems between 1470–1160 and 810–360 years ago. In these sequences, the tundra dominated by Ericaceae dwarf shrubs initially spread on the coast. During a period of at least 2200-years nitrogen enrichment led to the development of herb meadows with a high presence of Apiaceae. After a noticeable reduction in seabird colonies due to human hunting, grass-meadows spread. During the late Holocene several hundred years of seabird impact led to an increase in abundance of indicator taxa, ferns and umbelliferous species, as well as in total pollen concentration, but this did not result in a radical change of dominants. In recent decades, due to the extinction of the bird colonies, heather communities have begun to spread on the Shemya coast. Also large ash emissions in the Aleutian Islands can lead to a decrease in pollen concentration even in peat located far from an eruption.

Background: There is an increased risk of asthma after viral wheezing episodes in early childhood, but unfortunately, prospective longitudinal data are lacking. The aim of this cohort study was to evaluate the risk of asthma in young adulthood after hospitalization for viral wheezing episodes in early childhood. Methods: The original cohort comprised 100 individuals aged <24 months who were hospitalized for viral wheezing episodes in 1992–1993. After the index episode, data on a diagnosis of asthma 1 year later and at median ages of 4.0, 7.2 and 12.3 years were recorded in follow-up visits. Forty-nine individuals attended the latest follow-up visit at the age of 17-20 years. Current asthma was diagnosed based on symptoms at the time of the last follow-up, use of inhaled corticosteroids and peak expiratory flow (PEF) monitoring. Results: Twenty-six (53%) of the 49 cohort individuals had asthma at a mean age of 18.8 years. In multivariate analyses, a diagnosis of asthma 1 year after index hospitalization and at ages 4.0, 7.2 and 12.3 years were significant risk factors for current asthma (adjusted odds ratios [aORs] of 7.13, 8.86, 8.05 and 21.16, respectively). Atopic dermatitis in infancy (aOR: 4.20) and eosinophilia on admission (5.18) were also significant predictive factors for asthma. Conclusion: Over half (26/49) of the participants who had been hospitalized for viral wheezing episodes in early childhood had asthma in young adulthood. An asthma diagnosis at any age during childhood, as well as eosinophilia in early childhood, were independent significant predictive factors for asthma.

Quantifying species-specific tree transpiration across watershed zones is important for estimating watershed evapotranspiration (ET) and predicting drought effects on vegetation. The objectives of this study are to 1) assess sap flux density (Js) and tree-level transpiration (Ts) across three contrasting zones (riparian buffer, mid-hillslope, and upland-hillslope), 2) determine how species-specific Js responds to vapor pressure deficit (VPD), and 3) compare watershed-level transpiration (Tw) derived from each zone. We measured Js and Ts in eight tree species in the three zones in a 12-ha forested watershed. In the dry year of 2015, loblolly pine (Pinus taeda), Virginia pine (Pinus virginiana), and sweetgum (Liquidambar styraciflua) Js rates were significantly higher in the buffer when compared to the other two zones. In contrast, Js in tulip poplar (Liriodendron tulipifera) and red maple (Acer rubrum) were significantly lower in the buffer than in the mid-hillslope. Daily Ts varied by zone and ranged from 10 to 93 liters in the dry year and 9 to 122 liters in the wet year. Js responded nonlinearly to VPD in all trees and zones. Annual Tw based on scaled-Js data was 447 mm, 377 mm, and 340 mm for the buffer, mid-hillslope, and upland-hillslope, respectively. We conclude that large spatial variability in Js and scaled Tw were driven by differences in soil moisture at each zone and forest composition. Consequently, spatial heterogeneity of vegetation and soil moisture must be considered when accurately quantifying watershed level ET.

Urbanization has a strong signal on the hydrologic cycle, leading to reduced infiltration, and faster and larger runoff. However, less is known in watersheds that have been experiencing such a large and rapid urbanization as those in China. Here we focus on the Wenyu watershed, a fast urbanizing basin located in the Beijing metropolitan area. Using a statistical attribution framework, we examine the hydrological response to the increasing urbanization across a wide range of discharge quantiles, from low to high flows; moreover, we perform analyses at the seasonal scale to capture differences in the physical processes at play during the year. In addition to impervious areas, we also consider precipitation, temperature, antecedent wetness, recycled water amount, and groundwater level as potential predictors. Results indicate that our models can capture well the variability in streamflow in this highly urbanized basin. Overall, urbanization played a different role for the different seasons and discharge quantiles. More specifically, we find its strongest impact to be in winter and spring, and for low and median quantiles. The role of precipitation is the strongest in summer, and it increases as we move towards the upper tail of the discharge distribution. Recycled water, on the other hand, tends to play a more dominant role in winter and spring.

Background: Musculoskeletal pains (MPs) is a widespread public problem that can affect 13.5% to 47% of total population. Dietary changes have strong effects (positive and negative) on a person’s health. Sulfur amino acids (SAAs) as a part of protein structure, can be one of the precursors of neurotransmitters, antioxidative metabolic intermediates such as glutathione, effect on inflammation and finally play a role in severity and frequency of MPs. This article will discuss the relationship between dietary sulfur amino acids intake with severity and frequency of pain in patients with MPs. Methods: This study was a matched case–control study designed. The target population were 175 men and woman. Anthropometric measurements and pain assessment were collected with questionnaires. Dietary data were collected using 7 days 24-hour recall. ANOVA and Spearman correlation was also performed to examine the relationship between independent and outcome variables. For data analysis, P-value <0.05 was considered statistically significant. Results: There was a significant relationship between age, weight, waist circumference (WC), waist circumference to height (WHtR), body mass index (BMI) and severity and frequency of MPs among women. Similarly, in men, there was just a relationship between age and severity of pain. Conclusions: The present study didn’t show a positive and relative association between the dietary sulfur amino acids and severity and frequency of pain. What’s known? Actually we know SAAs can effect on MPs and inflammation via glutathione synthesis, hyperhomocysteinemia or bone and joint structure. What’s new? The relationship between dietary SAAs pattern on inflammation and pain was not statistically significant in this study. More than 98% of participants consume higher amount of RDA of methionine and cysteine.

SARS-CoV2 virus is believed to be originated from a closely related bat Coronavirus RaTG13 lineage after gaining insertions of RBD of spike (S) protein by exchanged recombination with pangolin virus Pan_SL_COV_GD. SARSCoV2 uses its entry-point key residues in S1 protein to attach with human ACE2 receptor. SARS-CoV2 evolution comprises any of these possibilities: it entered human from bat with its poorly developed entry-point residues much before its known appearance with slower mutation rate; or recently with efficiently developed entry-point residues having more infective power with higher mutation rate; or through an intermediate host. RaTG13 has 96.3% identity with SARS-CoV2 genome implying that it substituted ~1106 nucleotides to evolute as present-day virus. Temporal analysis of SARS-CoV2 genome from December 2019 shows that its nucleotide substitution rate is as low as 27nt/year with an evolutionary rate of 9x10-4 /site/year, which is a little less than other retrovirus (10-4 to 10-6 /site/year). Estimation of TMRCA of SARS-CoV2 from bat RaTG13 lineage appears to be in between 9-14 years. Furthermore, evolution of a critical entry-point residue Y493Q needs two substitutions with an intermediate virus carrying Y493H (Y>H>Q), although such an intermediate virus has not been identified in known twenty-nine bat CoV virus. Genetic codon analysis indicates that SARS-CoV2 evolution from RaTG13 lineage strictly follows neutral evolution with strong purifying selection whereas its propagation in human disobeys neutral evolution as nonsynonymous mutations surpasses synonymous mutations with the increase of ω (dn/ds) signifying its proceedings towards divergent selection predictably for its infection power to evade multiple organs.

Mycophenolate mofetil (MMF) as an immunosuppressive agent is widely used in the management of Membranous Glomerulonephropathy (MGN). In this report, we describe a 66-year-old male MGN case treated with MMF and revealed acquired sensory-motor axonal polyneuropathy, which is rare and has not been reported before.

The effects of processing intensity, time and particle surface energy on mixing of binary cohesive blends (size ratio 1:2, fine concentration at 10 %) in high intensity vibration system were investigated via DEM simulations. Results show that both increasing processing intensity from 50 to 100 Gs and reducing surface energy from 50 to 0.5 J/m2 lead to a faster mixing rate. Mixing Bond number (〖Bo〗_m) was introduced to capture the effective mixing rate, Rm; higher 〖Bo〗_m corresponding to lower mixing rate. The coefficient of variation, Cv, formed the basis for the mixing quality and Rm, while the mixing action is quantified by the product of Rm and mixing time (Pr,t). Simulation results show that Cv values drop initially, and then rise with Pr,t. Hence, low Pr,t indicates inadequate mixing intensity, while high Pr,t most likely indicates mixture segregation, and therefore too high or too low Pr,t values should be avoided.

To account for the effect of liquid viscosity, the bubble breakup model considering turbulent eddy collision based on the inertial subrange turbulent spectrum was extended to the entire turbulent spectrum that included the energy-containing, inertial, and energy-dissipation subranges. The computational fluid dynamics-population balance model (CFD-PBM) coupled model was modified to include this extended bubble breakup model for simulations of a bubble column. The effect of turbulent energy spectrum on the bubble breakup and hydrodynamic behaviors was studied in a bubble column under different liquid viscosities. The results showed that when the liquid viscosity was < 80 mPas, the bubble breakup and hydrodynamics were almost independent on the turbulent spectrum. At liquid viscosity > 80 mPas, the bubble breakup rate and gas holdup were significantly under-predicted when the inertial turbulent spectrum was used, and when using the entire turbulent spectrum the predictions were more consistent with experimental data.

The major features of a static batch sublimation process over a hot plate with constant temperature were investigated in an experimental-theoretical study. An experimental apparatus with a real-time display was built to sublimate dry ice blocks of different sizes, in either circular or rectangular geometries. When temperature of the hotplate was changed from -30 to 200 oC, heat transfer coefficient “hsub” decreased from 126 to 70 W/m2K, while thermal flux increased, linearly. Weight and area of the block had a positive/negative effects on heat transfer, respectively. In theoretical part, two “linear- gradient” and “cubic” models were developed by a combined mass-momentum-energy balance. The latter used Von Karman temperature profile, and in cases of circular and rectangular geometries could estimate “hsub” with 17.8 and 13.5 % average error. Linear-gradient was analytic, with similar accuracy in the circular case. The developed model are especially useful for design of sublimation equipment in purificationofthechemicals

In order to investigate characteristics of bubble deformation in immiscible fluids, the bubble shape change during the interface and the relationship between aspect ratio(E) and dimensionless number of forces is obtained. A three-dimensional model is established and the free-floating behavior of a single bubble in immiscible fluids is numerically simulated by phase-field method. The simulation results are in good agreement with experimental results. The research shows that, in the lower liquid, the relationship between E and We, Ta, Re is distributed between two intersecting lines. In the upper liquid, the relationship between E and We, Ta, Re is distributed between two parallel lines. Comparing the bubble deformation and the influence of the forces. Compared with gravity, the inertial force plays a leading role in the bubble shape in the lower liquid and upper liquid. Compared with the viscous force, the surface tension dominates the bubble shape in the lower liquid.

Objectives: To investigate the cardiometabolic risk factors as endocan, dehydroepiandrosterone sulfate (DHEAS), ADAMTS-13, p-selectin as a predictor of atherosclerosis in patients with non-functional adrenocortical adenoma (NFAI). Methods: We included 44 patients with NFAI and 44 healthy individuals as the control group. The demographic, laboratory findings and anthropometric measurements were evaluated. The levels of serum endocan, p-selectin, ADAMTS-13 and carotid intima-media thickness (CIMT) measurement were evaluated. Results: There was no difference between the control group and the patients with NFAI in terms of BMI, WC, systolic and diastolic blood pressure, HDL-C, ACTH, morning cortisol, ADAMTS-13 and p-selectin levels. However, the levels of waist-hip ratio, total cholesterol, insulin, HOMA-IR, LDL-C, CIMT, endocan were significantly higher in the NFAI group in comparison with the control group (p< 0.05). The levels of DHEAS were found significantly lower in the patients with NFAI (p<0.05). There was a positive correlation between ADAMTS-13, and endocan and p-selectin (r=0.436; p=0.003, r=0.414; p=0.005). Conclusions: This is the first study investigating the relationship between endocan, p-selectin, ADAMTS-13 levels and NFAI. Increased endocan levels and decreased DHEAS levels might be used as the indicators of atherosclerosis in patients with NFAI. CIMT was also found as an independent predictor for NFAI. Evaluation of cardiac and metabolic parameters is important in conservative treatment of patients with NFAI. Key Worlds: Adrenal Incidentaloma, Endocan, P-Selectin, ADAMTS-13

We encountered a case in which a recurrent condyloma-like papillary tumor was repeatedly treated as condyloma. Therefore, the patient was re-diagnosed and treated for non-invasive cervical papillary squamous cancer (PSCC) with HPV6 infection. To the best of our knowledge, this is the first report of HPV6 infection in PSCC.

We consider an age-size structured cell population model based on the cell cycle length. The model is described by a first order partial differential equation with initial-boundary conditions. Using the theory of semigroups of positive operators we establish new criteria for an asynchronous exponential growth of solutions to such equations. We discuss the question of exponential size growth of cells. We show how to incorporate into our description models with constant increase of size and with target size division. We also present versions of the model when the population is heterogeneous.

A patient presenting with worsening dyspnea and left-sided chest pain underwent heart catheterization, found to have a rare connection between the right and left coronary arteries draining into the left ventricle, consistent with dual coronary-cameral fistula.

Introduction: The autonomous system plays an important role as a trigger of cardiac arrhythmias. Cardiac sympathetic denervation (CSD) achieved by stellate and proximal thoracic ganglia resection has been reported as an alternative approach for the management of ventricular arrhythmias (VA) in structural heart disease (SHD) patients. Insufficient data regarding Chagas Disease (ChD) is available. Methods: Patients who underwent CSD for better management of ventricular arrhythmias (VA) in SHD, mainly ChD, in a single tertiary center in Brazil were evaluated for safety and efficacy outcomes. Results: Between June 2014 and March 2020, fourteen patients (age 59±7.5, 85% male, mean ejection fraction 30.5±7.9%) were submitted to left or bilateral CSD. In a median follow-up time of 143 (Q1: 30; Q3: 374) days, eight patients (57,2%) presented VT recurrence. A significant reduction in the median burden of ventricular arrhythmias comparing six months before and after procedure (10 to 0; p=0.004). For the nine ChD patients, the median burden of appropriate therapies was also reduced (11 to 0; p=0.008). There were two cases of clinically relevant pneumothorax and three cases of transient hemodynamic instability, but no direct procedure-related deaths occurred. Additionally, there was no long-term adverse events, Conclusion: CSD is safe and seems to be effective in reducing the burden of VT/VT storm in SHD patients, including ChD patients. Randomized trials are needed to clarify its role in the management of these patients.

Underground coal mining causes land subsidence, a large area of cultivated land is destroyed. The Yellow River interlayer filling reclamation technology is the powerful way to restore cultivated land. Understanding the mechanism of action of interlayers in reconstructed soil filled with Yellow River sediments is essential to achieving sustainable land management in the Yellow River regions. Column experiments and Field experiments were conducted to optimum of interlayers in reconstructed soil with Yellow River sediment for restoring subsided coal mined land. Our findings show that the inclusion of interlayers in the sediment reduced water leakage and moisture evaporation, and improved the water-holding capacity of the material in comparison to conventional reconstructed soil profile (Ck2). When the 30 cm thickness of interlayer, putting 2 interlayers in sediment (T6) was the optimal profile with the highest water-holding capacity. In comparison to CK2, the migration rate of wet front decreases by 32.16%, the cumulative evaporation decreases by 16.29%, the volumetric water content of filling layer (θ_fl) increases by 121.56%, and the water-holding coefficient (CWR) increases by 59.47%. It is also proved by field experiments. The wheat and maize yields of T6 improved 51.84% and 54.80%, respectively, as compared with CK2, that closer to undisturbed farmland (CK1). This study provides a valuable framework for subsided land reclamation regarding the method of placing interlayers into Yellow River sediment for enhancing water retention and productivity.

Catheter Ablation of Accessory Pathways: Can We Do Better by Using Dual Chamber Mapping ?