This article describes different results of two methods in treating non-vital human immature mandibular premolar, including the histologic findings of a human immature mandibular premolar with apexification treatment in an 8-year follow-up and the radiographic results of pulp revascularization treatment in a 2-year follow-up.

Zygomatic arch fractures are the most common facial fractures or second in frequency after the nasal fractures. The high incidence of zygomatic fractures probably relates to its prominent position in the facial skeleton hence it is frequently exposed to fractures.

Loss of heterozygosity in HLA-I (HLA-I LOH) may facilitate immune evasion. However, the large population study of HLA-I LOH in Chinese pan-cancer patients remains to be explored. In this study, analysis was performed in 1504 advanced pan-cancer patients and 134 early-stage NSCLC patients using a 1021-gene panel. The consistency between the 1021-gene panel and whole-exome sequencing (WES) was evaluated in 45 samples, where concordant results were obtained in 95.6% (43/45) of the samples. Analytical results revealed that the prevalence of HLA-I LOH presents considerable differences across cancer types. HLA-I LOH was relevant to genomic instability, reflected in higher tumor mutation burden (TMB) level. The incidence of HLA-I LOH in MSS samples was significantly higher than that in MSI-H samples. The alteration frequencies of p53 pathway, RTK/RAS pathway, Notch pathway, Hippo pathway, and Nrf2 pathway in HLA-I LOH group were significantly higher than that in HLA-I stable group (p<0.0001, p<0.0001, p=0.032, p=0.013, p=0.003, respectively). In DNA damage response (DDR) pathways, alterations in CPF pathway and FA pathway are enriched in HLA-I LOH group (p<0.0001, p=0.023, respectively). Besides, HLA-I LOH was accompanied by higher mutation rates of several tumor suppressors, including TP53 and LRP1B. These results may shed light on follow-up research.

In this study, the light version of Hydrologiska Byrans Vattenbalansavdelning hydrological model (HBV), has been used to synthesize river discharge and daily flow series for twelve years in the sub catchments of the Narmada river basin at Hoshangabad. The plain area of Narmada river basin at Hoshangabad is used for this study,with a drainage area of 10594 km2 and co-ordinates lies between 22°46’Nand 77°43’E.The model was run using twelve years data. Parametrization of parameters were obtained after warming, calibration and validating the results. There after the sensitivity analysis was done and acceptable range for each parametrized parameter was obtained. The Coefficient of Determination of observed and simulated discharge at the Hoshangabad was found to be 0.84. In Narmada River Basin at Hoshangabad hydrologicalmodeling using the HBV model, MAXBAS is the most sensitive parameter. The sensitive parameters from high to low along with their slopes values are Maxbas: 0.23, Alpha: 0.018, Fc: 0.012, K1:0.010, Beta: 0.008, K2: 0.005, Perc: 0.001 and Lp 0.001. The study shows that light version of the HBV model can be used to model the runoff of the sub catchment of the Narmada river basin at Hoshangabad.

The colonic involvement in acute pancreatitis is quite rare and most commonly occurs in the adjacent colonic part including transverse and splenic flexure colon. This case showed that extrinsic, secondary acute appendicitis could be as a complication of acute pancreatitis.

Objectives We set out to create Consensus Guidelines, based on current evidence and relative risks of adverse effects and the costs of different treatments, that reflect the views of the British Rhinological Society (BRS) Council on where the use of biologics should be positioned within treatment pathways for CRSwNP, specifically in the setting of the National Health Service (NHS). Methods An expert panel of 16 members was assembled. A review of the literature and evidence synthesis was undertaken and circulated to the panel We used the RAND/UCLA methodology with a multi-step process to make recommendations on the use of biologics. Setting and participants N/A Results Recommendations were made, based on underlying disease severity, prior treatments and co-morbidities. A group of patients for whom biologics were considered an appropriate treatment option for CRSwNP was defined. Conclusions Although biologics are not currently available for the treatment of CRSwNP, the BRS Council have defined a group of patients who have higher rates of ‘failure’ with current treatment pathways, higher resource use and are more likely to suffer with uncontrolled symptoms. We would urge NICE to consider approval of biologics for such indications without applying further restrictions on use.

Objectives: Smell/taste disturbances are a common but underrated, under-researched and under treated sensory loss and an independent risk factor for reduced longevity. This study aimed to characterise the experience of patients these disorders in seeking help. Design: The study was designed by patients together with clinicians through a dedicated workshop and conducted as a cross-sectional survey to capture experiences in public and private healthcare settings internationally. Setting: Primary, secondary and tertiary care. Participants: Any members of the public self-reporting a smell/taste disorder were invited to participate. Main outcome measures: The survey captured information including experience of getting consultations and referrals to medical professionals, treatments offered, costs incurred and related problems with mental health. Results: Of 673 participants; 510 female, 160 male, self-reported aetiology included sinonasal disease (24%), idiopathic (24%) and post-viral olfactory dysfunction (22%); true gustatory disorders were typically rare. Failure of medical professionals to recognise the problem was a key concern - 64%, 76% and 47% of GPs, ENT specialists and Neurologists acknowledged respectively. Other issues included repeated ineffective treatments, difficulties getting referrals to secondary/tertiary care, mental health problems (60%) and a mean personal cost of £421 to seeking advice and treatment. Whilst the participants were self-selecting, however they do represent those who are seeking help and intervention for their disorders. Conclusion: There is an unmet need for these patients in accessing healthcare including a clear need to improve education of and engagement with the medical profession in Otorhinolaryngology, General Practice and other specialties, in order to remove the current barriers they face.

As sea surface temperature increases, many coral species that used to harbor symbionts of the genus Cladocopium have become colonized with the thermally tolerant genus, Durusdinium. Here, we asked how symbionts of one genus react to the presence of another symbiont genus within the same coral host, and what effect this has on the host. We used previously published data from Acropora hyacinthus corals hosting Cladocopium and/or Durusdinium symbionts and looked at gene expression in all three symbiotic partners depending on the relative proportions of symbiont genera within the host. We find that both Cladocopium and Durusdinium change their expression most when their proportions are nearly equal (the state that we call “codominance”): both genera elevate expression of photosynthesis and ribosomal genes, suggesting increase in photosynthesis and growth (i.e. higher productivity). At the same time, the coral host also elevates production of ribosomes suggesting faster cellular growth, and, when heated, shows less pronounced stress response. These results can be explained in two ways. One explanation is that increased competition between symbionts heightens their productivity, which benefits the host, making it more resilient to stress. Alternatively, the symbionts’ elevated productivity might be the consequence of the host being particularly healthy. Under this explanation, rapid growth of the healthy host creates new space, lowering the symbionts’ competition and allowing for codominance. The latter explanation is supported by the fact that codominance is associated with lower symbiont densities. Irrespective of the causation, the presence of mixed symbiont communities could potentially be used as an instant indicator of coral well-being, which would be a useful tool for coral conservation and restoration.

Optimal tip sonication settings, namely tip position, input power, and pulse durations, are necessary to ensure proper mixing and maintain solution temperature below a critical temperature. This is significant for temperature sensitive procedures like preparation of viable cell extract for in vitro protein synthesis. In this paper, the optimum tip immersion depth is estimated which ensures maximum mixing thereby enhancing thermal dissipation of local cavitation hotspots inside the sonication tube; from modeled velocity field streamlines this is found at immersion depths between 20-30% height below the liquid surface. A simplified finite element (FE) heat transfer model is presented and validated experimentally with (R2 > 97%) which can predict the temperature rise over time in a tip-sonicated vessel. This model is used to observe the effect of temperature rise on cell extract performance of E. coli BL21 DE3 star strain and estimate the temperature threshold. From the combined heat map of yield and temperature it is observed that yield is correlated with final steady state temperature. Relative yields in the top 10% are observed for solution temperatures maintained below 32°C; this reduces below 50% relative yield at temperatures above 47°C. To extend utility of these finite element models to other temperature sensitive sonication processes, we also present a generalized workflow for direct simulation using the FE code as well as master plots for estimation of sonication parameters (power input and pulse settings) without need of running the code.

3D printing is revolutionizing many industrial sectors and has the potential to enhance also the biotechnology and bioprocessing fields. Here, we propose a new flexible material formulation to 3D print support matrices with complex, perfectly ordered morphology and with tuneable properties to suit a range of applications in bioprocess engineering. Supports for packed-bed operations were fabricated using functional monomers as the key ingredients, enabling matrices with bespoke chemistry such as charged groups, chemical moieties for further functionalization, and hydrophobic/hydrophilic groups. Other ingredients, e.g. crosslinkers and porogens, provide the opportunity to further tune the mechanical properties of the supports and the morphology of their porous network. Through this approach, we fabricated and demonstrated the operation of Schoen gyroid columns with I) positive and negative charges for ion-exchange chromatography, II) enzyme bioreactors with immobilized trypsin to catalyse hydrolysis, and III) bacterial biofilms bioreactors for fuel desulfurization. We expect this approach will enable simple, cost-effective and flexible fabrication of customized supports in biotechnology and bioengineering.

Rhabdoid tumors (RTs) are a rare and aggressive pediatric cancer that commonly show alterations in the tumor suppressor gene SMARCB1. However, RT prognosis is still poor, with no standard treatment, predictive biomarkers for its aggressiveness, or chemo- and radio-sensitivity. Herein, four cases of extra-cranial RTs are described, two of which were in long-term survivors. These two surviving cases were positive for p16, whereas the other two were p16-negative. These findings suggest that p16 expression may represent a potential positive prognostic biomarker in RTs; nevertheless, further studies are required.

GATA2 deficiency syndrome (G2DS) is a rare autosomal dominant genetic disease predisposing to a range of symptoms of which myeloid malignancy and immunodeficiency including recurrent infections are most common. In the last decade since it was first reported, there have been over 465 individuals identified carrying a pathogenic or likely pathogenic germline GATA2 variant with symptoms of G2DS, with 231 of these confirmed to be familial and 22 de novo. For those that develop myeloid malignancy (75% of all carriers with G2DS disease symptoms), the median age of onset is 17 years (range 0-78 years) and myelodysplastic syndrome (MDS) is the first diagnosis in 75% of these cases with acute myeloid leukemia (AML) in a further 9%. All variant types appear to predispose to myeloid malignancy and immunodeficiency. Apart from lymphedema in which haploinsufficiency seems necessary, the mutational requirements of the other less common G2DS phenotypes is still unclear. These predominantly loss-of-function variants impact GATA2 expression and function in numerous ways including perturbations to DNA binding, protein structure, protein:protein interactions, and gene transcription, splicing and expression. In this review, we provide the first expert curated ACMG/AMP classification with codes of published variants compatible for use in clinical or diagnostic settings.

Lipoblastoma is a rare, benign, fatty tissue tumour that occurs in infancy and early childhood. Intrathoracic and mediastinal involvement of this tumour is rare, and an intracardiac location is even rarer. In this study, we report the case of a 15-month-old girl who presented with a tumour in the pulmonary valve. A complete resection of the tumour was undertaken, with a histopathology report confirming the diagnosis of lipoblastoma.

Mucociliary clearance is a crucial event that supports the elimination of inhaled particles, bacteria, pollution and hazardous agents from the human airways, and it also limits the diffusion of aerosolized drugs into the airway epithelium. In spite of its relevance, few in vitro models sufficiently address the cumulative effect of the steric and interactive barrier function of mucus on the one hand, and the dynamic mucus transport imposed by ciliary mucus propulsion on the other hand. Here, ad hoc mucus models of physiological and pathological mucus are combined with magnetic artificial cilia to model mucociliary transport in both physiological and pathological states. The Lego®-like concept adopted, in this study, enables the development of mucociliary clearance models with high versatility, since these can be easily modified to reproduce phenomena characteristic of healthy and diseased human airways, while allowing to determine the effect of each parameter and/or structure separately on the overall mucociliary transport. These Lego®-like airway models can be available off-the-shelf because they are exclusively made of readily available materials, thus ensuring reproducibility across different laboratories.

Aims: To continually evaluate the role of cardiovascular drugs in COVID-19 clinical outcomes. Methods: Eligible publications were identified from >500 databases on 1-Nov-2020. One reviewer extracted data with 20% of the records independently extracted/evaluated by a second reviewer. Results: Of 52,735 screened records, 429 and 390 studies were included in the qualitative and quantitative syntheses, respectively. The most-reported drugs were angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) with ACEI/ARB exposure having borderline association with positive COVID-19 status (OR 1.14, 95% CI 1.00–1.31). Among COVID-19 patients, unadjusted estimates showed that ACEI/ARB exposure was associated with hospitalization (OR 1.76, 1.34–2.32), disease severity (OR 1.41, 1.27–1.56) and all-cause mortality (OR 1.22, 1.12–1.33) but not hospitalization length (mean difference -0.27, -1.36; 0.82 days). After adjustment, ACEI/ARB exposure was not associated with positive COVID-19 status (OR 0.92, 0.71–1.19), hospitalization (OR 0.93, 0.70–1.24), disease severity (OR 1.05, 0.81–1.38), or all-cause mortality (OR 0.85, 0.71–1.01). Similarly, subgroup analyses involving only hypertensive patients revealed that ACEI/ARB exposure was not associated with positive COVID-19 status (OR 0.93, 0.79–1.09), hospitalization (OR 0.84, 0.58–1.22), hospitalization length (mean difference -0.14, -1.65; 1.36 days), disease severity (OR 0.92, 0.76–1.11) while it decreased the odds of dying (OR 0.76, 0.65–0.88). A similar trend was observed for other cardiovascular drugs. However, the validity of these findings is limited by a high level of heterogeneity and serious risk of bias. Conclusion: Cardiovascular drugs are not associated with poor COVID-19 outcomes in adjusted analyses. Patients should continue taking these drugs as prescribed.

Study of limnology and interrelationship of parameters in two Ecologically Different Beels in Gangetic plain of West Bengal, India

Introduction: Malignant transformation in mature cystic teratoma of ovary is a rare complication. Case report: A 62-year-old woman was diagnosed with squamous cell carcinoma in a mature cystic teratoma of ovary. Conclusion: Malignant transformation should be suspected in elderly woman with large mature cystic teratoma of ovary with thickened wall.

Objective: To determine the incidence of and risk factors for perioperative blood transfusions after urogenital fistula repairs in Uganda. Design: A retrospective cohort study. Setting: A community hospital in Masaka, Uganda. Population: Women who underwent fistula repair at the Kitovu Hospital between 2013 and 2019. Methods: Retrospective review of demographics, and clinical perioperative characteristics of patients surgically treated for urogenital fistula. Patient characteristics were compared between those who did and did not require a blood transfusion. Main Outcome Measures: need for perioperative blood transfusion, risk factors Results: 546 patients treated for urogenital fistulas were included in this study. The median age was 31.1 ± 13.2. A vaginal surgical approach was used in the majority of patients (84.6%). Complications occurred in 3.5% of surgical repairs, and the incidence of blood transfusions was 6.2%. In multivariable analyses, women with fistula repairs approached abdominally were 4.3 (95% CI: 1.85–10.00) times more likely to require transfusions than vaginal operations. A borderline association was observed between timing of repair and perioperative transfusions such that patients who underwent repair after three months from the time of developing the fistula were at lower risk of perioperative transfusions (aOR: 0.48, 95% CI: 0.22–1.04). Conclusions: The incidence of blood transfusions among urogenital fistula repairs in our population is twice that of developed nations. An abdominal surgical approach to urogenital fistula is a significant risk factor for perioperative blood transfusions. Timing of repair may warrant further study.

AIM Using three-dimensional ultrasound speckle tracking echocardiography (3D-STE) to evaluate left ventricular (LV) function in patients with triple vessel coronary artery disease(TVD) without myocardial infarction. METHODS Sixty patients with TVD without myocardial infarction were divided into two groups according to the results of coronary angiography. Group B (n=31)：50%≤the stenosis rate of all triple vessel coronary artery＜75%; Group C (n=29)：the stenosis rate of all triple vessel coronary artery≥75%. Thirty healthy subjects were recruited as the group A. We measured LV end-diastolic and end-systolic volume (LVEDV, LVESV) and LV ejection fraction (LVEF) using real-time dynamic three-dimensional echocardiography. The 3D-STE parameters of LV included global longitudinal strain (GLS), global area strain (GAS), global radial strain (GRS) and global circumferential strain (GCS). The correlation between 3D-STE parameters and NT-proBNP were analyzed by Pearson linear correlation analysis. RESULTS In group C, LVEDV and LVESV were significantly increased (all P＜0.05), while LVEF, GLS, GRS, GCS and GAS were significantly decreased compared with groups A and B (all P＜0.05). In groups A and B, there were no statistical differences in LVEDV, LVESV and LVEF. However, GLS, GCS and GAS were lower in group B than in group A (all P＜0.05). The correlation analysis showed a negative correlation between the absolute values of GLS, GRS, GCS, GAS and NT-proBNP in group C (r=-0.866、-0.587、-0.428、-0.600，P＜0.001、P=0.001、P=0.020、P=0.010). CONCLUSIONS Our study shows that 3D-STE can evaluate the LV function in patients with triple vessel coronary artery disease without myocardial infarction through multiple strain parameters.

This paper presents the development and testing of a low-cost (< $60), portable, electrical impedance based microflow cytometer for single cell analysis under controlled oxygen microenvironment. The system is based on an AD5933 impedance analyzer chip, a microfluidic chip, and an Arduino microcontroller operated by a custom Android application. A representative case study on human red blood cells (RBCs) affected by sickle cell disease is conducted to demonstrate the capability of the cytometry system. An equivalent circuit model of a suspended biological cell is used to interpret the electrical impedance of single flowing RBCs. RBCs exhibit decreased mean membrane capacitance by 24% upon hypoxia treatment while the mean cytoplasmic resistance remains consistent. RBCs affected by sickle cell disease exhibit decreased cytoplasmic resistance and increased membrane capacitance upon hypoxia treatment. Strong correlations are identified between the changes in the cells’ subcellular electrical components and the hypoxia-induced cell sickling process. The results reported in this paper suggest that the developed method of testing demonstrates the potential application for low-cost screening technique for sickle cell disease and other diseases in the field and low-resource settings. The developed system and methodology can be extended to analyze cellular response to hypoxia in other cell types.

Rice (Oryza sativa) is one of the most frequently produced cereals in the world. Rice bran (RB) is obtained as a by-product in the rice milling process. A part of the RB is used for oil extraction, obtaining defatted rice bran (DRB) as a second by-product. The aim of this work was to analyze the emulsifying properties of soluble proteins fraction present in defatted rice bran concentrate (DRBC) in acidic and neutral conditions. Fine emulsions (prepared by high-speed and ultrasound homogenization) stabilized with soluble proteins obtained from DRBC showed a mean particle size lower than coarse emulsions (prepared by only high-speed homogenization) and a significantly lower degree of overall destabilization. Coarse emulsions showed sigmoidal destabilization profiles at pH 4.5 and 7.0, related to the existence of two populations with different particle sizes. In fine emulsions, both pH provided lower particle sizes and greater stability. After 24 h of quiescent storage, the coarse emulsions showed an increase of particle size that was not observed in fine emulsions. Both types of emulsions showed a Newtonian-type behavior. Fine emulsions showed higher viscosity values and higher lightness than coarse emulsions, consistent with the reduction of particle size and increase in the number of particles. The soluble proteins obtained from a waste of the rice industry can be used to obtain stable fine oil-in-water emulsions in acidic and neutral conditions. This result is of interest since it could be used as a food ingredient, increasing the added value of this important by-product.

Background: Patients who survived hospitalization for COVID-19 experienced varying durations of illness but the factors associated with prompt recovery are unknown. This study identifies factors differentiating hospitalized patients who recovered promptly vs. survived a prolonged course of illness due to COVID-19. Methods: This was a retrospective study from March-August 2020 of hospitalized adults with COVID-19 which were grouped based on time to recovery: short (≤ 3 days), intermediate (4-10 days), and prolonged (>10 days). Recovery was defined as resolution of fever, tachypnea, hypotension, extubation and return of mental status at baseline. Multivariate analysis was used to evaluate factors associated with prompt recovery. Results: Among 508 patients hospitalized for COVID-19, 401 (79%) survived. Of those, prompt recovery (within 3 days) was achieved in 43% (174/401) whereas 23% (92/401) recovered after a prolonged period of > 10 days. Overall, median age was 64 y with 73% admitted from home and 25% from a skilled nursing facility. Predictors for prompt recovery upon admission included female sex (OR, 1.8; 95% CI, 1.1-2.7; p = 0.01), no fever (OR, 1.6; 95% CI, 1.1-2.6; p = 0.03), longer time from symptom onset to hospitalization (OR, 1.1; 95% CI, 1.0-1.1; p = 0.001), no supplemental oxygen (OR, 1.9; 95% CI, 1.2-3.0; p = 0.004), no direct ICU admission (OR, 41.7; 95% CI, 2.4-740.4; p = 0.01) and absence of bacterial co-infections (OR, 2.5; 95% CI, 1.5-4.0, p = 0.0003). Conclusions: Our study provides relevant data that could help clinicians triage competing resources in health systems that are challenged by the ebb and flow of COVID-19 cases by identifying clinical features of COVID-19 patients who may require less intensive management including avoidance of unnecessary antibacterial therapy.

Management of patients with acute type A aortic dissection (ATAAD) presenting with cerebral malperfusion due to carotid artery obstruction is still a major challenge and often associated with poor prognosis despite successful surgical aortic repair, due to prolonged cerebral perfusion deficit. Here, we present the first report regarding successful percutaneous recanalization of an internal carotid artery occlusion in the setting of an ATAAD prior to open surgical aortic repair with excellent clinical outcome after three year follow-up, including almost full neurological recovery.

In this article, an approximate analytical solution of an integro-differential system of equations is constructed, which describes the process of intense boiling of a superheated liquid. The kinetic and balance equations for the bubble-size distribution function and liquid temperature are solved analytically using the Laplace transform and saddle-point methods with allowance for an arbitrary dependence of the bubble growth rate on temperature. The rate of bubble appearance therewith is considered in accordance with the Dering-Volmer and Frenkel-Zeldovich-Kagan nucleation theories. It is shown that the initial distribution function decreases with increasing the dimensionless size of bubbles and shifts to their greater values with time.