Studies reporting S. warneri in infective endocarditis (IE) are rare. We presented a 72-year-old woman with native mitral valve S. warneri IE associated with spondylitis and cerebellar infarction. Physicians should be wary of IE and disseminated lesions when blood cultures reveal S. warneri, especially in elderlies with valvular heart disease.

Lipomatous hypertrophy of the interatrial septum (LHIAS) is a benign cardiac tumor. Differential diagnosis of LHIAS consists of atrial masses such as myxomas or lipomas. Herein, we report a 66-year-old male, admitted as a case of severe COVID-19 and was found to have a LHIAS extending to the crista terminalis.

Bubble breakup plays an important role in gas-liquid flows, but detailed studies are still scarce. In this work, the breakup behavior of a single bubble in a stirred tank was experimentally studied with a high-speed camera, focusing on the effect of gas density, liquid properties, agitation speed and mother bubble size. The bubble breakup time, breakup probability, breakup rate and daughter bubble size distribution were determined. The internal flow phenomenon inside a deformed bubble was studied in detail, which accounted for the effect of gas density or operating pressure. The results showed that with increasing gas density, agitation speed, mother bubble size and decreasing surface tension, the bubble breakup rate and probability of equal-size distribution significantly increased. With increasing liquid viscosity, the bubble breakup rate decreased especially in the high viscosity range. An M-shaped daughter bubble size distribution was observed, which was consistent with our previous bubble breakup model.

Separation of mixed ion, especially Cl- and SO42-, is essential for reduced energy consumption and achievement of the minimal or zero-liquid discharge. Membrane technology has attracted significant attention in this respect owing to its good system coupling and maturity. However, it remains challenging to fabricate highly selective nanofilm with fine-tuning pore and structure that is suitable for the separation of Cl- and SO42-. Herein, we report an asymmetric alicyclic polyamide nanofilm with enhanced interconnectivity pore by manipulating the molecular geometry structure, composed of the porous aromatic polyamide dendrimer layer, and the dense alicyclic polyamide layer with hollow stripes. This resulted membrane shows a 107.14% separation rate of Cl- and SO42-, and a water flux (for Na2SO4) of ~2.2 times that of the pristine polyamide membrane. We estimate this fine-tuning pore approach resulting from alicyclic structure also might be employed in other separation membranes such as gas, solvent or neutral molecules.

Oleosins are mandatory to avoid coalescence of oil bodies (OBs), so commercial proteases are used to efficiently demulsify OBs into food oil. However, the commercial proteases and pH regulators (acid and alkali) greatly restrict this method in industry. In this study, aspartic endopeptidases, subtilisin-like proteases, metalloendopeptidase, and serine carboxypeptidases were identified in isolated sesame OBs by liquid chromatography tandem mass spectrometry (LC–MS/MS). Tricine–sodium dodecyl sulfate–polyacrylamide gel electrophoresis and protease inhibitor assay revealed that aspartic endopeptidases exerted high activity against oleosins in a pH range of 3−6 and a temperature range of 40−70 °C, while subtilisin-like proteases exhibited sharp optimum at pH 5. Metalloendopeptidase contributed to the low activity against oleosins at pH 7−9. Trichloroacetic acid–nitrogen soluble index and free amino acid analyses quantitatively revealed that the activity of serine carboxypeptidases was high at pH 3−5, and optimal at pH 4; the combined activity of aspartic endopeptidases and subtilisin-like proteases was optimal at pH 5. By incubating the isolated sesame OBs at pH 5 and 60 °C for 2 h, approximately 97% of total lipids were recovered as free oil. At last, LC−MS/MS analysis gave deep insight into the intrinsic proteins of sesame OBs: three kinds of oleosins with molecular weights around 17 kDa, and four kinds around 15 kDa; besides 27 kDa caleosin, four kinds of oil body-associated proteins and one kind of peroxygenase-like protein also around 27 kDa; in addition to 39 kDa steroleosin, 11-beta-hydroxysteroid dehydrogenase-like 6 also around 39 kDa.

The aim of this work is to enhance the heat transfer and study the efficiency of stretching/shrinking, radiating and rectangular fins. The effect of the dimensionless parameters, that is, radiation-conduction, convection-conduction stretching, thermo-geometric parameters as well as the Peclet number, and surface temperature are investigated on the efficiency of stretching/shrinking and rectangular fins. The considered model is studied analytically using Differential Transform Method (DTM). The result is analyzed with the numerical solution for the accuracy of the semi-analytical solution, where good agreement is obtained. The impact of the considered parameters is studied numerically on the temperature distribution, fin’s tip temperature, and the efficiency of the fin, where the combined effects of radiation and stretching/ shrinking enhance the system in the heat transfer with better efficiency. The shrinking of the fin with radiation increases the efficiency as compared to stretching with radiation is observed, which plays a significant role in mechanical engineering.

Grade: 5-7Time: roughly 50 minutesGoals: Students will design and build a device that delivers a ping pong ball to a cup. Students are going to be able to explain design considerations based on kinetic energy, and forces   Students will be able to finish the device by the end of class  Vocabulary: Elastic Potential Energy: Potential energy due to tension – either stretch Energy: The ability to do work. Appears in many forms, all of which are either kinetic or potential Force: A push or a pull. An influence on a body or system, causing or tending to cause a change in movement or shape. Friction: Forces resisting motion between one set of molecules and another due to electrical attraction and repulsion, usually between two solid surfaces; static before motion starts and kinetic during motion. Kinetic Energy (KE): Energy of motion. Includes heat, sound, and light (motion of molecules) Mass: The amount of matter that is contained by an object.   Momentum: The quantity of motion of a moving object, equal to the product of its mass and its velocity. Materials per team (2-3) 5 cm of Tape   30 cm of 3-ply string 4 Rubber Bands 1 Dixie Paper Cup 1 Sheet of Copy Paper 2 Paperclips Brown Paper Lunch Bag Lesson Plan:Introduction (3-5 minutes) The United States and its territories encompasses 169 geologically active volcanoes that are monitored by the United States Geological Survey (USGS). In order to prevent loss of life and property, the USGS issues volcano warnings which requires real-time monitoring of volcanoes, their seismology, and gas, thermal, and surface deformation measurements. What challenges do scientists have to overcome in order to monitor volcanoes? What tools do you think scientists use in order to overcome these challenges? (Reference on Volcano Monitoring: http://volcanoes.usgs.gov/about/faq/faqmonitoring.php) Imagine if you had to deposit a small piece of equipment to the center of a lava flow. How would you do it? What science concepts would you use to help you achieve your mission? Starting Challenge (25 minutes) Introduce the Challenge: Devise a way to deposit a ping-pong ball into a paper cup that is located in the middle of a 6-foot diameter circle. Introduce the Constraints:  Every person in the team must be actively involved in the placement of the ball. The ping pong ball must start outside the circle and must come to rest inside the paper cup in the center of the circle. Students may not touch the ping pong ball or reach into the 6-foot circle. No part of anyone’s body may extend into the imaginary cylinder that extends above the circle. Only the provided materials may be used.   Build: Give students about 15 minutes to build and test. The instructor should ask open-ended questions to help guide students through the design process, but should also allow students space to tinker. Testing: During the build time students should be able to test and iterate their designs freely. Students should build their device away from the testing site, and then bring their device over to the testing site in order to test. Teams may not build/iterate in at the test site! The setup for the test site is as follows: Create a 6 foot diameter circle out of tape, string, butcher paper, or a circular table cloth. Securely tape a cup (larger cups for an easier challenge, smaller cups for a more difficult challenge) to the center of the circle. Teams test from along the outer edge of the circle and may not extend any body part into the imaginary cylinder that extends above the circle.Demonstrating and Reflecting (20 minutes) Demonstrating: Have students demonstrate their devices one team at a time. If students have not completed their device, or their device did not function as expected, ask them how the device would have worked.   Reflecting: Have each group of students explain their design strategy and how their device uses energy and force to place the ball in the cup. The instructor should ask leading questions to get at the science behind the designs.  

African Swine Fever (ASF) is one of the most devastating infectious diseases affecting domestic pigs and wild boar. The grave socio-economic impact of African Swine Fever infection at a global level makes large-scale rapid and robust diagnosis a critical step towards effective control. However, the nucleic acid purification required in most molecular detection methods is time- and labor-intensive, prone to nucleic acid loss or contamination, and impractical for massive active screening or for use in resource-limited areas. Here we describe multiple-probe-assisted DNA capture and amplification technology (MADCAT) - a novel sensitive, simple, and reliable method for detecting ASFV directly from whole blood or other complex matrices. Through the unique DNA capture method which specifically capture only the target DNA onto the well for subsequent amplification, MADCAT abandons the complicated extraction protocol and achieves ultrafast and high-throughput detection. The sample-to-result time for 96 samples is about 100 min, as compared with the 3 - 4 h time of the standard real time qPCR method. The limit of detection (LOD) is 0.5 copies/μL and is 10 times more sensitive than an OIE-recommended qPCR assay when testing serially diluted whole blood samples. The assay is 100% specific against other common swine pathogens. In clinical diagnosis of 48 field samples, all 22 positive samples were correctly identified with lower Ct values than OIE-recommended qPCR, confirming its high diagnostic sensitivity (100%). Owing to its high-throughput, specific high-sensitivity, and cost-efficient features, MADCAT shows great potential for future use in clinical ASFV active screening.

Shortness of breath after childbirth is not an uncommon presentation to Emergency Department. Differentials can be divided broadly into cardiac and non-cardiac causes. We encountered a case with postpartum shortness of breath, she was managed as a case of iatrogenic pulmonary edema with diuretics.

Acute aortic dissection with coronary malperfusion is a life-threatening disease, resulting in demanding postoperative management. We report a successful insertion of percutaneous heart pump Impella through the intact true lumen in a patient with residual aortic dissection after the graft replacement and its recovery from the post-cardiotomy cardiogenic shock.

Introduction: Scrub typhus can present with audiological symptoms. Case: A pregnant mother presented with persistent fever, pneumonia and hearing loss. Investigation showed positive serology for scrub typhus. Conclusion: Clinicians must be aware of audiological presentations in scrub typhus. Possibly, permanent hearing loss was due to meningoencephalitis and hormone induced immunomodulation

Spontaneous coronary artery dissection (SCAD) is a rare condition which occurs predominantly in the postpartum period in young women. A SCAD whilst pregnant is very rare and poses significant risk to the mother and unborn child, and with minimal data on SCAD antenatally, this case highlights antepartum clinical considerations.

Papillary fibroelastomes are rare benign neoformations usually originating from the valvular endocardium, presenting with cerebral ischemia and/or myocardial infarction due to embolization from the mass. We report an exceedingly rare case of aortic wall papillary fibroelastoma simulating unstable angina, diagnosed with trans-thoracic/trans-esophageal echocardiography and CT scan and surgically successfully removed

The novel coronavirus disease-2019 (COVID-19) illness and deaths, caused by the severe acute respiratory syndrome coronavirus-2, continue to increase. Multiple reports highlight the thromboembolic complications, such as pulmonary embolism (PE), in COVID-19. Imaging plays an essential role in the diagnosis and management of COVID-19 patients with PE. There continues to be a rapid evolution of knowledge related to COVID-19 associated PE. This review summarizes the current understanding of prevalence, pathophysiology, role of diagnostic imaging modalities, and management, including catheter-directed therapy for COVID-19 associated PE. It also describes infection control considerations for the radiology department while providing care for patients with COVID-19 associated PE.

Background: Cardiac arrests (CA) are a leading global cause of mortality. The American Heart Association (AHA) promotes several important strategies associated with improved cardiac arrest outcomes, including decreasing pulse check time and maintaining a chest compression fraction (CCF) > 0.80. Video review is a potential tool to improve skills and analyze deficiencies in various situations, however its use in improving medical resuscitation remains poorly studied in the emergency department (ED). We implemented a quality improvement initiative, which utilized video review of cardiac arrest resuscitations in an effort to improve compliance with such AHA quality metrics. Methods: A cardiopulmonary resuscitation Video Review Team (CoVeRT) of emergency medicine residents were assembled to analyze CA resuscitations in our urban academic ED. Videos were reviewed by two residents, one of whom was a senior resident (PGY-3 or -4), and analyzed for numerous quality improvement metrics, including pulse check time, CCF, time to intravenous access, and time to patient attached to monitor. Results: We collected data on 94 cardiac arrest resuscitations between July 2017 and June 2020. Average pulse check time was 13.09 (SD ±5.97) seconds, and 38% of pulse checks were less than 10 seconds. After the implementation of the video review process, there was a significant decrease in average pulse check time (p=0.01) and a significant increase in CCF (p=0.01) throughout the study period. Conclusions: Our study suggests that the video review and feedback process was significantly associated with improvements in AHA quality metrics for resuscitation in CA among patients presented to the ED.

Large scale changes in land use pattern such as deforestation and machine-intensive farming process have increased carbon concentrations in atmosphere which negatively affects agricultural sector. Cross-disciplinary approaches were applied to investigate the land use changes and their impacts on the soil properties over Kanshi watershed. The results revealed that vegetation cover has been declined over the Kanshi catchment area during the last two decades. The deforestation and urbanization are the basic reasons for the fall of water tables in the Kanshi catchment area. Furthermore, the decreasing trend of rainfall and increasing trend of temperature was estimated during the last two decades. While the water discharge was decreased by 44.15 % during the last two decades in the Kanshi watershed. This substantial and significant change resultant due to climate change or increased intercession of anthropogenic activities on the earth surface. The highest stream flow was found in 1992 in the Kanshi catchment due to heavy rainfall. But in 2019, flow was on its peak value. Such variations in flow of stream increase due to fluctuations in rainfall pattern and vegetation cover resulted land degradation. 85% of local community is agreed that extensive agricultural practices, population growth, settlement patterns and brick industry have significant negative impact on vegetative cover and water discharge.

Background: Outcome of children with bladder-prostate rhabdomyosarcoma has improved with multimodal therapies, including surgery and/or radiotherapy for local treatment. Our aim was to report the long-term urological complications after a conservative approach combining conservative surgery and brachytherapy. Patients and methods: Eighty-six patients, free of disease, were retrospectively reviewed. Symptoms related to urinary tract obstruction, incontinence, infection and lithiasis were reported and graded according to CTCAE classification. Only symptomatic patients underwent urodynamic studies. Risk factors for complications were analyzed. Results: There were 76 males and 10 females. The median follow-up was 6.3 years (18 months-24 years). Complications occurred after a median follow up 5 years (0-21). Twenty-two patients had long-term urological complications. Urinary tract obstruction was found in 15 patients, urinary incontinence in 14 patients. Recurrent urinary tract infection and urinary lithiasis were found in 5 patients respectively. Beyond symptom, 3 etiologies were identified: bladder dysfunction in 15 patients, urethral stenosis in 6 and uretero-vesical junction stenosis in 5. Posterior bladder wall dissection used in large prostatic tumors, operation at age less than 2 years and partial prostatectomy were identified as risk factors for these complications. Conclusion: The conservative surgical approach combined with brachytherapy for BPRMS leads to long-term urological complications in 22% of patients free of their disease. Optimizing brachytherapy doses for young children and establishing a clear and long term follow-up protocol, could help to reduce these complications.

Large-scale patterns of biodiversity and the underlying mechanisms that regulate these patterns are central topics in biogeography and macroecology. The Qinghai-Tibetan Plateau (QTP) is a natural laboratory for studying these issues. However, most previous studies have focused on the entire QTP, and the independent physical geographical subunits in the region are not well understood. We studied the current plant diversity on the Kunlun Mountains, an independent physical geographical subunit located in northwest China, on the northern edge of the QTP. We integrated measures of species distribution, geological history, and phylogeography, and analyzed the taxonomic richness, origin time, and community phylogenetic structure of the plants present in the area. The distribution patterns of 1,911 seed plants highlighted that species were located mainly in the eastern regions of the Kunlun Mountains. Chinese endemic species of seed plants accounted for 29.8% of the total species on the Kunlun Mountains. The biodiversity patterns and mean divergence times (MDT) indicated that the eastern region of the Kunlun Mountains was the center for biodiversity conservation, particularly in the southeastern region, which has served as a museum for plant diversity on the Kunlun Mountains. According to the MDT, the origin time of the Kunlun Mountains’ flora (KMF) was early Miocene (19.40 Ma), and the KMF is ancient. The biogeographical roles of the Kunlun Mountains were corridor and sink, and the corresponding key processes were species immigration and extinction. The extant biodiversity on the Kunlun Mountains has occurred through species recolonization after climatic fluctuations and glaciations during the Quaternary. The Kunlun Mountains also formed a barrier, representing a boundary among multiple floras, and converted the QTP into a closed physical geographical unit. The nearest taxon index indicated that habitat filtering may have played an important role in biodiversity patterns.

Tropical forest and swidden agriculture are declining, while commercial plantation is continuously expanding. However, little is known about the mechanisms, processes and trends of the tropical forest-swidden-plantation (FSP) nexus. Global ongoing initiatives including the UN-REDD Programme, not only have repeatedly emphasized the significance of conserving forests, reforestation and afforestation, but re-pushed swidden agriculture to the forefront of a long-standing international debate of climate changes and biodiversity. Many facets limit our understanding of swidden agriculture. The lack of geographic and demographic data and their dynamics across the tropics undoubtedly further aggravate this situation since the first appeal of eradication of shifting cultivation by the FAO. Although recent studies have enriched significantly our knowledge of forest loss and plantation expansion, previous research has proceeded separately and has yet to be integrated under the umbrella of sustainable swidden agriculture. Efforts are needed to investigate the dynamics of the FSP nexus for sake of a synergetic goal of climate mitigation and poverty alleviation.

1. Identifying critical uncertainties about ecological systems can help prioritize research efforts intended to inform management decisions. However, exclusively focusing on the ecological system neglects the objectives of natural resource managers and the associated social values tied to risks and rewards of actions. 2. I demonstrate how to prioritize research efforts for a harvested population by applying expected value of perfect information (EVPI) analysis to a matrix projection model of steelhead (Oncorhynchus mykiss) and an explicit utility function that models risk/reward objectives. Research priorities identified by EVPI diverge from priorities identified by matrix elasticity analyses that ignore utility. The degree of divergence depends on uncertainty in population vital rates and the particular form of the utility function used to represent risk/reward of harvest. 3. Synthesis and applications. EVPI analysis that includes perceived utility of different outcomes should be used by managers seeking to optimize monitoring and research spending. Collaboration between applied ecologists and social scientists that quantitatively measure peoples’ values is needed in many structured decision making processes.

National genetic variation registries vastly increase the level of detail for the relevant population, while directly affecting patient management. Herein, we report CanVaS, a Cancer Variation reSource aiming to document the genetic variation of cancer patients in Greece. CanVaS comprises germline genetic data from 7,363 Greek individuals with a personal and/or family history of malignancy. The dataset incorporates ~24,000 functionally annotated rare variants in 97 established or suspected cancer susceptibility genes. For each variant, allele frequency for the Greek population, interpretation for clinical significance, anonymized family and segregation information, as well as phenotypic traits of the carriers, are included. Moreover, information on the geographic distribution of the variants across the country are provided, enabling the study of Greek population isolates. Direct comparisons between Greek (sub)populations with relevant genetic resources is supported, allowing fine-grain localized adjustment of guidelines and clinical decision-making. Most importantly, anonymized data are available for download, while the Leiden Open Variation Database schema is adopted, enabling integration/interconnection with central resources. CanVaS could become a stepping-stone for a countrywide effort to characterize the cancer genetic variation landscape, concurrently supporting national and international cancer research. The database can be accessed at: http://ithaka.rrp.demokritos.gr/CanVaS

Variant interpretation is dependent on transcript annotation and remains time consuming and challenging. There are major obstacles for historical data reuse and for interpretation of new variants. First, both RefSeq and Ensembl/GENCODE produce transcript sets in common use, but there is currently no easy way to translate between the two. Second, the resources often used for variant interpretation (e.g. ClinVar, gnomAD, UniProt) do not use the same transcript set, nor default transcript or protein sequence. Ensembl ran a survey in 2018 to assay attitudes to choosing one default transcript per locus, and to gather data on reference sequences used by the scientific community. This was publicised on the Ensembl and UCSC genome browsers, by email and on social media. We had 788 respondents. Here we report our results and roadmap to create an effective default set of transcripts for resources, and for reporting interpretation of clinical variants.

In order to realize the reproduction and simulation of urban rainstorm and waterlogging scenarios with complex underlying surfaces. Based on the Mike series models, we constructed an urban storm-flood coupling model considering one-dimensional river channels, two-dimensional ground and underground pipe networks. Luoyang City was used as a pilot to realize the construction of a one-dimensional and two-dimensional coupled urban flood model and flood simulation. where is located in the western part of Henan Province, China. The coupled model was calibrated and verified by the submerged water depths of 16 survey points in two historical storms flood events. The average relative error of the calibration simulated water depth was 22.65%, and the average absolute error was 13.93cm; the average relative error of the verified simulated water depth was 15.27%, The average absolute error is 7.54cm, and the simulation result is good. Finally, 28 rains with different return periods and different durations were designed to simulate and analyze the rainstorm inundation in the downtown area of Luoyang. The result shows that the R2 of rainfall and urban rainstorm inundation is 0.8776, and the R2 of rainfall duration and urban rainstorm inundation is 0.8141. Therefore, rainfall is the decisive factor in the formation of urban waterlogging disasters, which is actually the rainfall duration. The study results have important practical significance for urban flood prevention, disaster reduction and traffic emergency management.

BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is a severe and potentially deadly condition associated with extensive inflammation and immune activation. Cytokine adsorption may serve as a supportive treatment that can stabilize organ function in affected patients by reducing their circulating cytokines levels. To date, no descriptions of clinical experiences associated with the use of HA330-II column hemoadsorption for the treatment of HLH children have been published. CASE SUMMARYWe describe a 11-year-old children with Epstein-Barr virus (EBV)-associated HLH combined with liver failure. She underwent HA330-II column hemoadsorption and chemotherapy, and developed a decreased inflammatory cytokines including interleukin (IL)-6, IL-8, IL-10, and interferon (IFN)-γ. The patient’ condition and laboratory parameters gradually improved.CONCLUSIONHemoadsorption may play an important role in eliminating cytokines storm in children with Hemophagocytic lymphohistiocytosis combined with liver failure and consequent multiple organ failure.  Keywords: hemoadsorption; HA330-II column; Hemophagocytic lymphohistiocytosis; Pediatric; Liver failure; Case report