We consider the global well-posedness and asymptotic behavior of compressible viscous, heat-conductive, and non-resistive magnetohydrodynamics (MHD) fluid in a field of external forces over three-dimensional periodic thin domain $\Omega=\mathbb{T}^2\times(0,\delta)$. The unique existence of the stationary solution is shown under the adhesion and the adiabatic boundary conditions. Then, it is shown that a solution to the initial boundary value problem with the same boundary and periodic conditions uniquely exists globally in time and converges to the stationary solution as time tends to infinity. Moreover, if the external forces are small or disappeared in an appropriate Sobolev space, then $\delta$ can be a general constant. Our proof relies on the two-tier energy method for the reformulated system in Lagrangian coordinates and the background magnetic field which is perpendicular to the flat layer. Compared to the work of Tan and Wang (SIAM J. Math. Anal. 50:1432–1470, 2018), we not only overcome the difficulties caused by temperature, but also consider the big external forces.

The purpose of this study is to obtain the solution using the Lie group of symmetry method for the problem of propagating magnetogasdynamic strong cylindrical shock wave in a self-gravitating non-ideal gas with the magnetic field which is taken to be axial. Here, isothermal flow is considered. In the undisturbed medium, varying magnetic field and density are taken. Out of four different cases, only three cases yield the similarity solutions. Numerical computations have been performed for the cases of power-law and exponential law shock paths, to find out the behavior of flow variables in the flow-field immediately behind the shock. Similarity solutions are carried out by taking arbitrary constants in the expressions of infinitesimals of the Lie group of transformations. Also, the study of the present work provides a clear picture of whether and how the variations in the non-ideal parameter of the gas, Alfven-Mach number, adiabatic exponent, ambient magnetic field variation index and gravitational parameter affect the propagation of shock and the flow behind it. Software package “MATLAB” is used for all the computations.

Large cell neuroendocrine carcinoma (LCNEC) was first proposed by Travis et al. in 1991 and subsequently classified as high grade neuroendocrine carcinoma (HGNEC) by the world health organization. It is a rare tumor with unclear clinicopathologic features. Herein, we describe a rare case of LCNEC with a unique Cushing’s presentation.

We are concerned with the inverse problem of recovering the unknown wave speed and also the source in a multidimensional wave equation. We show that the wave speed coefficient can be reconstructed from the observations of the solution taken at a single point. For the source, we may need a sequence of observation points due to the presence of multiple spectrum and nodal lines. This new method, based on spectral estimation techniques, leads to a simple procedure that delivers both uniqueness and reconstruction of the coefficients at the same time.

Objective： Although specific anti-phospholipids antibodies (aPLs) have been used in the diagnosis of the antiphospholipid syndrome (APS) for years, new biomarkers are required to increase its diagnostic as well as risk-predictive power. This study aimed to explore the value of several extra-criteria aPLs in a Chinese cohort. Methods： A total of 312 patients including 100 patients diagnosed with primary APS, 51 with APS secondary to SLE, 71 with SLE, and 90 health controls were recruited. Serum anticardiolipin (aCL) IgG/IgM/IgA, anti-β2-glycoprotein I (aβ2GPI) IgG/IgM/IgA, anti-phosphatidylserine/prothrombin antibodies (aPS/PT) IgG/IgM, anti-annexin A5 antibodies (aAnxV) IgG/IgM were tested using ELISA kits. Results： Totally 30.46% and 6.62% of patients with APS were positive for aCL or aβ2GPI IgA respectively, while 39.07% and 24.50% were positive for aAnxV or aPS/PT for at least one antibodies (IgG or IgM). The addition test of aCL IgA and aAnxV IgM assist in identifying seronegative APS patients, and IgG aANxV was linked with stroke. Conclusion： Detection of aCL IgA, aβ2GPI IgA, aAnxV IgG/M, and aPS/PT IgG/M as biomarker provide additive value in APS diagnosis, and would help in risk prediction for APS patients in medical practice.

Aberrant complement activation can induce “thrombo-inflammation” attacks to host tissue. Beside kidney and blood vessel, the placenta is also susceptible to these attacks. Complement dysregulation is recently classified as one of the new mechanisms leading to pregnancy disorders. Studies have indicated that dampening complement activation can ameliorate pregnancy outcomes. During pregnancy, the mother’s immune system is finely domesticated to accept the semi-allogeneic fetal antigens. As an important part of the innate immune system, some interesting changes have also taken place in complement system during pregnancy. The complement proteins are highly expressed in placenta, and their split products are increased. They are tuned in maintain placental immunity and structural homeostasis. An abundance of evidence shew that complement protein deficiency lead to autoimmunity disease and pathological pregnancy marked by excessive inflammation. Although complement suppressing strategies have been proven effective in treating some pathological pregnancy in individual case studies. we should take the dual role of the complement into consideration that fully and completely inhibit of complement may not be a wise choice.

Aim: Estimation of the prevalence of double diabetes which is the coexistence of metabolic syndrome and Type 1 diabetes in a busy diabetic outpatient clinic. Methods: Thirty patients with type 1 diabetes were assessed to see if they fulfilled the criteria for the metabolic syndrome according to the criteria of the international diabetes federation. A family history of type 2 diabetes was sought as this is considered an important part of double diabetes. The diagnosis of Type 1 diabetes was based on clinical history and presence of anti-Gad antibodies. Results: Thirty patients with Type 1 diabetes were studied (mean age of 41 years, age range 29 to 64 years; 19 males and 11 females). Out of the 30 patients; raised waist circumference was seen in 5, hypertension was present in 9, raised triglycerides was seen in 4 people and low HDL in 5 people. The metabolic syndrome criteria was fulfilled in 4 people (13%). Out of seven patients with a family history of Type 2 diabetes, the metabolic syndrome criteria was fulfilled in 2. Conclusions: Our survey identified 4 people with type 1 diabetes and features of metabolic syndrome suggesting a diagnosis of double diabetes. It would appear from the data presented that the combination of waist circumference and HTN appear to be the most consistent indicators of this condition. These people have a higher risk of both micro and macrovascular complications and need appropriate preventive and broad management strategy for their metabolic syndrome and insulin resistance.

Pediatric chronic myeloid leukemia is a rare entity (2-5% of childhood leukemias) classified as a myeloproliferative neoplasia characterized by the presence of the BCR-ABL fusion gene, the oncogenic translocation product (9; 22) responsible for the disease through its deregulated tyrosine kinase activity.

Background: COVID-19 pandemic has caused fear all around the world. With people avoiding hospitals, there has been a significant decrease in outpatient clinics. In this study, we aimed to compare and explore the first-peak of the pandemic period by studying its effects on patient applications, new diagnoses, and treatment approaches in a non-infected hospital. Methods: We collected data from the first peak of the pandemic period in Turkey, from the pandemic’s declaration (March 11, 2020) to social normalization (June 1, 2020), and compared it with data from a pre-pandemic period with a similar length of time. We analyzed the data of breast cancer patients from application to surgery. Results: The data of 34,577 patients were analyzed for this study. The number of patients who applied to outpatient clinics decreased significantly during the pandemic period. After excluding control patients and benign disorders, a figure was reached for the number of patients who had a new diagnosis of breast cancer (146 vs 250), were referred to neoadjuvant treatment (18 vs 34), and were treated with surgery (121 vs 229). All numbers decreased during the pandemic period, except for surgeries after neoadjuvant treatment (29 vs 27). Surgical treatment approaches also changed. However, the rate of newly diagnosed breast cancer patients treated with surgery was similar in both periods. None of these patients were diagnosed with COVID-19 or died during the pandemic. Conclusion: This study shows that non-infected hospitals can be useful in avoiding delays in the surgical treatment of cancer patients.

Background: SARS-CoV-2 coronavirus disease 19 (COVID-19), which was detected in December 2019, whose first cases were observed in Turkey on 11th March 2020. In the current paper, we present our experience and practices regarding thoracic surgery from the largest pandemic hospital in Europe over the 1-year period of the pandemic. Methods: Patients who were operated by our thoracic surgery clinic in the largest pandemic hospital in Europe between March 2020 and March 20121 in the Covid-19 pandemic in our country and in the world were evaluated retrospectively. Results: 85 patients were operated on during the 1-year pandemic, of which 54 (%63.5) were men and 31 (%36.5) were women. The mean patient age was 47,7. Morbidity rate was 12%. Covid-19 was not seen in any patient in our clinic during the postoperative period. Only one patient died out of those who underwent surgery. Conclusion: Thoracic surgery has one of the highest risks due to direct contact with the lungs, especially in terms of surgery and the postoperative period. We consider that this risk will be minimized by taking measures during all processes. Moreover, we think that surgical treatments should be delayed as little as possible due to the special status of oncology patients. In addition, considering that if all these rules are followed in the COVID-19 pandemic and in other types of pandemics that may occur in the future, there will be no delay or insufficiency in the treatment of patients and healthcare professionals will be able to work safely.

A document by Anand Manickavasagam. Click on the document to view its contents.

Tissue Coverage MattersArvindh Kanagasundram, Travis D Richardson, and William G StevensonFrom the: Division of Cardiovascular Medicine, Arrhythmia Section,Vanderbilt University Medical Center. Nashville, TN

Main Text FileUsefulness of thymus and activation-regulated chemokine (TARC) for FPIES diagnosis

Background: Internationally, the COVID-19 pandemic severely curtailed access to hospital facilities for those awaiting elective/semi elective procedures. For allergic children in Ireland, already waiting up to 4yr for an elective oral food challenge (OFC), the restrictions signified indefinite delay. At the time of the initiative there were approx 900 children on the Chidren’s Health Ireland(CHI) waiting list. In July 2020, a project was facilitated by short term(6wk) access to an empty COVID stepdown facility built, in a hotel conference centre, commandeered by the Health Service Executive Ireland(HSE). The aim was to the achieve rapid rollout of an off-site OFC service, delivering high throughput of long waiting patients, while aligning with hospital existing policies and quality standards, international allergy guidelines and national social distancing standards. Methods: The working group engaged key stakeholders to rapidly develop an offsite OFC facility. Consultant Paediatric Allergists, Consultant Paediatricians, trainees and Allergy Clinical Nurse Specialists were seconded from other duties. The facility was already equipped with hospital beds, bedside monitors(BP, Pulse, Oxygen saturation) bedside oxygen. All medication and supplies had to be brought from the base hospital. Daily onsite consultant anaesthetic cover was resourced and a resuscitation room equipped. Standardised food challenge protocols were created. Access to onsite hotel chef facilitated food preparation. A risk register was established. Results: After 6wks planning, the remote centre became operational on 7/9/20, with the capacity of 27 OFC/day. 474 challenges were commenced, 465 (98%) were completed, 9(2%) were inconclusive. 135(29.03%) OFC were positive, 25(5%) causing anaphylaxis. No child required advanced airway intervention. 8 children were transferred to the base hospital. The CHI allergy waiting list was reduced by almost 60% in only 24 days. Conclusions: OFCs remain a vital tool in the care of allergic children, with their cost saving and quality of life benefits negatively affected by delay in their delivery. This project has shown it is possible to have huge impacts on a waiting list efficiently, effectively and safely with good planning and staff buy in – even in a pandemic. Adoption of new, flexible and efficient models of service delivery will be important for healthcare delivery in the post-COVID-19 era.

Wunderlich syndrome is a rare condition encountered in patients undergoing chronic hemodialysis (HD) usually attributed to acquired cystic kidney disease (ACKD) among other causes. However, presentation of renal hemorrhage after colonoscopy, to the best of our knowledge, has not been previously documented. Nevertheless, only splenic injury was rarely mentioned. Management can range from conservative treatment to angiographic embolization or exploration and nephrectomy. We report an unusual case of a 54-year-old woman HD patient who presented with SRH within a few days of colonoscopy. The reason of spontaneous renal hemorrhage (SRH) was rupture of a cyst of ACKD. We assumed that colonoscopy was a provoking factor and elaborated hypotheses for its etiopathogenesis. The patient underwent left successful nephrectomy. The importance of this case lies in the fact that colonoscopy is not 1 always an innocent procedure in HD patients, and could be complicated by renal cyst hemorrhage.

In this paper, we generalized E.C. Kim’ s estimates by taking in to account the trace of the divergencefree symmetric tensor non−zero. We have also shown that E.C. Kim’s estimates still valid in case of the trace of the divergencefree symmetric tensor vanished identically. In the equality case, we characterized eta−Killing spinor with Killing pair over the Sasakian spin manifolds.

Ferulate-5-hydroxylase (F5H) is a key enzyme involved in the conversion of the guaiacyl monolignol (G-monolignol) to the syringyl monolignol (S-monolignol) in angiosperms. The monolignol ratio has been proposed to affect biomass recalcitrance and the resistance to plant disease. Sclerotinia sclerotiorum (S. sclerotiorum) stem rot of Brassica napus (B. napus) causes heavy damage in oilseed rape production. To date, there is no information about the effect of the lignin monomer ratio on the resistance to S. sclerotiorum in B. napus. Four dominantly expressed BnF5H genes were knocked out by CRISPR/Cas9 simultaneously in B. napus, and the f5h mutant KO-7 was generated. The S/G lignin composition ratio was decreased compared to that of the wild type (WT) based on the results of Mӓule staining and 2D-NMR profiling. The resistance to S. sclerotiorum in stems and leaves increased in KO-7. Furthermore, we found that the stem strength of KO-7 was significantly increased compared to that of the WT. Collectively, for the first time, we demonstrate that knockout of the lignin pathway gene F5H decreases the S/G ratio, improves S. sclerotiorum resistance in B. napus, and increases stem strength.

A 13-year-old healthy girl presented with dizziness and palpitations, found to have a left atrial mass. An 8 cm tumor was removed. Pathology confirmed leiomyosarcoma, Grade 3 with positive margins. She was treated with ifosfamide and doxorubicin prior to radiation with concurrent ifosfamide alone. She was treated to 66 Gy in 33 fractions to the operative bed. Prospectively graded toxicities included Gr 2 esophagitis and Gr 1 anorexia, dermatitis and fatigue. She completed a total of 6 cycles of ifosfamide. One year after treatment she had no evidence of disease with normal ECHO and no cardiac, pulmonary or esophageal symptoms.

Incidental cardiac tumors are rare and mostly detected on autopsy as patients largely remain asymptomatic. However, diagnosis of an incidental cardiac mass on unrelated work up can pose significant ethical and clinical challenge to the care team. Surgical resection has been the most successful intervention for most primary cardiac tumors however, it involves cardiopulmonary bypass assisted major surgery which is not risk free either. Cardiac lipoma is the second most common primary cardiac benign tumor. We report a case of a young otherwise healthy patient who reported have a cardiac lipoma on computerized tomography (CT ) scan that was done to rule out kidney stone.

A kyphotic gentleman with chronic obstructive pulmonary disease and Marfan syndrome whose history was significant for thoracoabdominal aortic replacement secondary contained rupture, presented with chest pain and an acute DeBakey type I aortic dissection. In this anatomically challenging total arch replacement, Cor-Knot fastener was employed without short-term or long-term complications.

In the present work, the standard thermochemical properties of the most thermochemically stable radicals (p-Benzylenephenol and 1-Methyl-2-methylene phthalate), formed by abstraction of the hydrogen atom from the p-Benzylphenol and Dimethyl phthalate are determined using the results of B3LYP/6-311++G(d,p), M06-2X/6-311++G(d,p) and RO/CBS-4M calculations. The consistent values of the standard enthalpies of formation of these structures are determined using the corrected thermochemistry of the homodesmotic and atomization reactions. The values of the standard entropies of these compounds and the temperature dependencies of their thermochemical properties are also calculated in the present work. It is found that the H-transfer reaction of HO2 with p-Benzylenephenol is thermochemically favorable and can lead to the chain oxidation of p-Benzylenephenol at relatively low temperatures.

We investigated the electronic and mechanical properties of single-walled carbon nanotubes (SWCNTs) with different tube diameters using density functional theory (DFT) and molecular dynamics (MD) simulation, respectively. The carbon nanotubes’ electronic properties were derived from the index number ( n 1 , n 2 ), lattice vectors, and the rolled graphene sheet orientation. For (6,1) SWCNT, ( n 1 - n 2 )/3 is a non-integer, so the expected characteristic is semiconducting. We have considered (6,1) Chiral SWCNT with different diameters ‘d’ (4.68 Å, 4.90 Å, 5.14 Å, 5.32 Å, 5.53 Å) corresponds to respective bond-lengths ‘ δ ’(1.32 Å, 1.36 Å, 1.45 Å, 1.50 Å and 1.56 Å) and then analyze the electronic properties from the Linear Combination of Atomic Orbitals (LCAO) based on DFT. We have used both the DFT-1/2 and GGA exchange energy correlation approximations for our calculation and compared the results. In both cases, the energy band gap is decreasing order with the increase in bond lengths. The lowest value of formation energy was obtained at the bond length δ = 1.45 Å ( d = 5.14 Å). For the mechanical properties, we have calculated Young’s Modulus using Molecular Dynamic simulations. From our calculation, we have found that the (6,1) SWCNT with bond length 1.45 Å ( d = 5.14 Å) has Young’s modulus value of 1.553 TPa.

A document by Hartmann Raifer. Click on the document to view its contents.

The three dominant processes contributing to runoff as proposed by the Dunne diagram are Hortonian overland flow (HOF), Dunne overland flow (DOF) and subsurface storm flow (SSF). Using a theoretical perspective, we investigate the impact of climate, soil, topography and vegetation on catchment water balance and the probability distribution of the travel times of each runoff generation component in respect of the connected instantaneous response function (CIRF) including the interaction of a partial contributing area connecting to the outlet. A simple distributed hydrologic model is used to capture the effect of the catchment response and to estimate the CIRFs under different possible integration of combined effect of climate, soil, topography and vegetation. A set of dimensionless similarity parameters represent catchment functions and provide a quantitative explanation of the conceptual Dunne diagram. Behavioral catchments are defined from the empirical range of the Budyko curve and mainly compatible to the physical relationship as illustrated in the Dunne diagram. The results consistent with the Dunne diagram are: (1) DOF and SSF dominates in humid for behavioral sand and silt catchments, (2) HOF dominates in arid for behavioral silt and clay catchments. Inconsistent results are: (1) SSF dominates in arid for behavioral sand, silt and clay catchments, (2) HOF dominates in humid for behavioral clay catchment and (3) no dominant HOF for behavioral sand catchment. For HOF and DOF dominates, the distribution of CIRFs can be grouped into similar shapes, which depend on the relative contribution of hillslope scale and catchment scale. For SSF behavioral catchments, the shape of the CIRFs depends on the dryness index. The combined catchment CIRFs of mean travel time for runoff responses consists with the higher first peak from the HOF and/or DOF and the second peak from the SSF.