Knowledge about the genetic adaptations of various organisms to heterogeneous environments in the Northwestern Pacific remains poorly understood. The mechanism by which organisms adapt to temperature in response to climate change must be determined. We sequenced the whole genomes of Sillago japonica individuals collected from different latitudinal locations along the coastal waters of China and Japan to detect the possible thermal adaptations. A total of 5.48 million single nucleotide polymorphisms (SNPs) from five populations revealed a complete genetic break between the China and Japan groups. This genetic structure was partly attributed to geographic distance and local adaptation. Although parallel evolution within species is comparatively rare at the DNA level, the shared natural selection genes between two isolated populations (Zhoushan and Ise Bay/Tokyo Bay) indicated possible parallel evolution at the genetic level induced by temperature. Our result proved that the process of temperature selection on isolated populations is repeatable. Additionally, the candidate genes were functionally related to membrane fluidity in cold environments and the cytoskeleton in high-temperature environments. These results advance our understanding of the genetic mechanisms underlying the rapid adaptations of fish species. Projections of species distribution models suggested that China and Japan groups may have different responses to future climate changes: the former could expand, whereas the latter may contract. The results of the present population genomic work expand our understanding of genetic differentiation and adaptation to changing environments.

We report a patient who presented with paraplegia after ascending aorta and arch replacement using the frozen elephant trunk technique. Immediate postoperatively cerebrospinal fluid drainage allowed successful reversal of spinal chord injury. Early awakening of patients following a frozen elephant technique is mandatory because it allows recognition and treatment of this complication by prompt cerebrospinal liquor drainage.

Risk stratification of HPV positive women in routine cervical screeningHigh risk HPV primary screening is replacing organised cytology-based screening based on increased sensitivity to detect high grade intra-epithelial neoplasia and the very high negative predictive value which will allow extended screening intervals. The benefit of increased CIN detection and cancer prevention needs to balance against the disbenefits to screen positive women in over investigation not east the psychological impact. For colposcopy services, the English cervical screening programme reported a 80% increase in colposcopy referrals in the first round of screening, creating huge pressures on service capacity (Rebolj M et al BMJ 2019;364:l240). The lower positive predictive value also impacts on colposcopy performance with a different referral population wit proportionately less high grade CIN present. In this issue of BJOG, Gori M et al provide observational data from a large longitudinal study of routine primary HPV screening in an organised quality assured cervical screening programme in 3 regions of Italy. Whilst routinely collected data from real-world programmes will have limitations, they do provide an insight into disease detection and importantly impact on colposcopy provision. In a comparison of triage strategies, combined HPV genotyping for HPV16 and high-grade cytology offered an acceptable balance of risk of CIN3+ with number of colposcopies needed to detect one lesion. These results differ from the English pilot (Rebolj M et al 2019 BJC;121(6):455-463) where HPV16/18 genotyping detected only 1.2% more cases of CIN2+ with 5.9% additional colposcopies. Gori M et al did not combine HPV16/18 but they did report that HPV18 on genotyping was not as clinically useful at baseline or 12-month follow-up. Furthermore, 90% of women screened were aged over 35 years when HPV screening is more clinically effective whereas the English pilot started screening at age 25 years when HPV infection is more prevalent and less likely to be clinically significant. Longer follow-up, importantly at the next screening round, is not yet available when the relevance of non-HPV 16 types may be more apparent.The impact of the Covid 19 pandemic on health services and in particular screening, has sharpened the argument of risk stratification following primary screen positive testing both for service providers and those in the target population. Ciavattini A et al (2020 Int J Cancer 30(8):1097-1100) reported on suspension or postponement of cervical screening programmes across Europe relevant to both routine screening and onward referral to colposcopy. As services have needed to adapt to Covid infection rates and health service capacity, the ability to triage effectively and avoid unnecessary hospital visits is critical. Clinicians and women need information on their risk to inform clinical practice and provide reassurance. In the current second wave, the suspension of screening implemented in the first wave is no longer acceptable. Whilst data, such as these from Gori et al, continue to emerge from national and regional screening programmes, Covid has highlighted the need to be responsive and adaptive to allow cancer prevention to continue.

Ophthalmic emergencies may be complicated by occult but clinically significant raised intraocular pressure (IOP). We present a case of hypertensive uveitis accompanied by the finding of retinal arterial pulsation, which when visualised by direct ophthalmoscopy allows the generalist to identify significantly raised IOP requiring urgent specialist evaluation.

Adapting for competitiveness versus climatic stress tolerance constitutes a primary trade-off differentiating tree life-history strategies. This tradeoff likely influences where species’ range-limits occur, but such links are data-demanding to study and key mechanisms lack empirical support. Using an exceptionally rich dendroecological network, we assessed spatial variation in climate and competition effects on Picea abies and Fagus sylvatica throughout the Carpathian Ecoregion. Ring width synchrony aided in diagnosing how the prevalence of resource-limited (competition) and sink-limited (climate) growth changes with altitude and community composition. Contrasting growth patterns towards respective upper and lower range limits of Fagus and Picea reflected tradeoffs between competitive vs. cold-tolerant strategies. Fagus performance declined with altitudinal increases in climate sensitivity, but improved under interspecific competition. Picea growth increased towards the species’ lower range limit, but declined under interspecific competition. Warmer temperatures likely benefit competitively stronger species at mid elevations and thus imply range reductions for alpine conifers.

Photochemical reactions of small molecules occur upon irradiation by ultraviolet or visible light, and they are a very important and controversial chemical process in the Earth’s atmosphere because they impact our quality of life and health. Small-unsaturated carbonyl compounds play an important role in the chemistry of the polluted troposphere. The fluorinated aldehydes are very reactive under the sunlight driving to species that trigger more atmospheric reactions. This paper is focused on a theoretical study of the photochemistry of difluoro-crotonaldehyde using static and dynamic calculations by combination of Global Reaction Route mapping (GRRM) and Trajectory Surface Hopping (TSH) approach. The static analysis of the electronic and geometrical structures at the critical points allowed to rationalize the possible pathways that interconnect the stationary and crossing points in order to get a map of the unimolecular photochemical reactions which take place. The time evolution of the electronic states and the degrees of freedom enabled the identification of the requirements to follow the most probable deactivation pathways. This article reports the unimolecular deactivation pathways after the electronic excitation of the trans and cis isomers. In both cases, the excitation energies were calculated and compared with the analogous in the crotonaldehyde in order to elucidate the effect of fluorine atoms on the electronic structure and stabilities. After the initial excitations to the ππ* excited states, the main deactivation channels follow non-adiabatic pathways via S1/S0 conical intersections. Ultrafast processes leading to the early activation of the S1 govern the decay of the difluoro-crotonaldehyde. Depending on the nature of the S1 state before the crossing with the S0, the system can follow several reaction pathways. The main photochemical processes observed were the cis-trans isomerization, the Norrish type I reaction (α-cleavage), Norrish type II reaction (γ-hydrogen abstraction) and fluorine photodissociation. The time scale, the molecular deformations and the electronic states implied for the different photochemical processes, as well as how these compete with the photophysical deactivation are discussed.

Purpose: To determine if diffusion tensor imaging (DTI) parameters can differentiate metastatic from reactive axillary lymph nodes (ALNs) in patients with breast cancer. Methods: Prospective study was done on 48 patients with breast cancer that were examined by DTI of the breast. The mean diffusivity (MD) and fractional anisotropy (FA) of ALNs were calculated by 2 observers. The final diagnosis was obtained by biopsy. Results: Metastatic nodes (n=50) had significantly lower MD (p = 0.001, 0.001) and higher FA (p = 0.002, 0.01) than reactive (n=20) nodes for both observers respectively. When threshed of MD (0.875, 0.815 X10-3 mm2/s) was used for differentiation of both entities revealed accuracy (80 %, 81.4 %) and had AUC of 0.920 and 0.918 by both observers respectively. When threshold FA (0.565, 0.645) was used for differentiation revealed an accuracy of 87.1%, 81.4% and had AUC of 0.860 and 0.870 by both observers respectively. Combined FA and MD had AUC 0.940, 0.950) with an accuracy of 91.4%, 92.9% for both observers respectively. Conclusion: Combined analysis DTI parameters FA may play a role in differentiation of metastatic from reactive ALNs in patients with breast cancer.

Disturbances often disproportionately impact different vegetation layers in forests and other vertically-stratified ecosystems, shaping community structure and ecosystem function. However, disturbance-driven changes may be mediated by environmental conditions that affect habitat quality and species interactions. In a decade-long field experiment, we tested how kelp forest net primary productivity (NPP) responds to repeated canopy loss along a gradient in grazing and substrate suitability. We discovered that habitat quality can mediate the effects of intensified disturbance on canopy and understory NPP. Experimental pulse and press disturbances suppressed total macroalgal NPP, but effects were strongest in high-quality habitats that supported dense kelp canopies that were removed by disturbance. Understory macroalgae partly compensated for canopy NPP losses and this effect magnified with increasing habitat quality. Disturbance-driven increases in understory NPP were still rising after 7–10 years of disturbance, demonstrating the value of long-term experimentation for understanding ecosystem responses to rapidly changing disturbance regimes.

This Supporting information includes:1. Component Selection and Performance of SFA2. Actuator Manufacturing and Preparation of Conductive Ink 3. Average Thickness of Conductive Coating layer on PU Foam4. Time Response of the Actuator in Different Modes 5. Characterization and Experimental Setup6. Measurement and Data Analysis7. Design Specifications of Soft Robotic Applications8. Supporting Video Corresponding author Email:  saravanaprashanth@outlook.com, barbara.mazzolai@iit.it 

We report a case of spontaneous mechanical papillary muscle rupture (PMR). We believe that the etiology of PMR, in this case, is related to a histological damage of the valve, extreme sudden force to the papillary muscle, and some possible tissue hypo-perfusion of the subvalvular apparatus. We performed a mitral valve replacement and bypass coronary surgery with good results.

We report a case of natural healing of a ruptured unstable coronary plaque using serial OCT examination. Stenting procedure was deferred based on the angiographic and mainly OCT findings. A healing process of ruptured plaque without foreign body was studied using OCT at 3, 14 and 24 months after PCI.

Background: Functional assessment of small airways in young children with bronchiolitis obliterans (BO) is challenging due to their relative inaccessibility and the generally poor lung function test performance of these patients. We analyze the correlation between impulse oscillometry (IOS), spirometry, and plethysmographic parameters in pediatric BO patients. Methods: A total of 89 IOS assessments of pediatric BO patients or children without lung disease were included, and the relationship between pulmonary function tests (PFTs) and diagnostic performance were analyzed. Results: R5, R5-20, X5, and AX were statistically significantly worse in the BO group. In Spearman’s correlation analysis, AX and R5 showed the strongest correlation with conventional PFT parameters, and AX was the variable with the highest relative correlation with FEV1, FEF25-75%, and both measures of plethysmographic resistance. Receiver operating curve analysis highlighted AX and Raw% pred as the most optimal parameters for BO diagnostic performance with areas under curve of 0.811 and 0.827, respectively. Conclusion: The AX and R5 parameters can be useful in identifying the severity of airway obstruction in children with BO, and IOS more generally can accurately detect pathological obliteration of small airways in pediatric BO patients.

Atrial tachycardia (AT) in the right atrium often occurs following open-heart surgery. Catheter ablation for these AT is challenging and can lead to unintended conduction block. We performed late-gadolinium enhancement magnetic resonance imaging prior to catheter ablation and predicted wavefront propagation during SR as well as the slow conduction zone

Grassland systems constitute a significant portion of the land area in the U.S., and as a result, harbor a significant amount of arthropod diversity. During this time of biodiversity loss around the world, bioinventories of ecologically important habitats serve as important indicators for the effectiveness of conservation efforts. We conducted a bioinventory of the foliar, soil, and dung arthropod communities in 10 cattle pastures located in the southeastern U.S. during the 2018 grazing season. In sum, 126,251 specimens were collected. From the foliar community, 13 arthropod orders were observed, with the greatest species richness found in Hymenoptera, Diptera, and Hemiptera. The soil-dwelling arthropod community contained 18 orders. The three orders comprising the highest species richness were Coleoptera, Diptera, and Hymenoptera. Lastly, 12 arthropod orders were collected from cattle dung, with the greatest species richness found in Coleoptera, Diptera, and Hymenoptera. Herbivores were the most abundant functional guild found in the foliar community, and predators were most abundant in the soil and dung communities. While bioinventories demand considerable time, energy, and resources to accomplish, the information from these inventories has many uses for conservation efforts, land management recommendations, and the direction of climate change science.

Vaccines are essential public health tools with a favorable safety profile and prophylactic effectiveness that have historically played significant roles in reducing infectious disease burden in populations, when the majority of individuals are vaccinated. The COVID-19 vaccines are expected to have similar positive impacts on health across the globe. While serious allergic reactions to vaccines are rare, their underlying mechanisms and implications for clinical management should be considered to provide individuals with the safest care possible. In this review, we provide an overview of different types of allergic adverse reactions that can potentially occur after vaccination and individual vaccine components capable of causing the allergic adverse reactions. We present the incidence of allergic adverse reactions during clinical studies and through post-authorization and post-marketing surveillance and provide plausible causes of these reactions based on potential allergenic components present in several common vaccines. Additionally, we review implications for individual diagnosis and management and vaccine manufacturing overall. Finally, we suggest areas for future research.

Thrombotic microangiopathy (TMA) is a rare but serious complication of hematopoietic stem cell transplantation (HSCT). The purpose of our study is to estimate the incidence and risk factors of TMA in 93 out of a total of 12369 children (0.8%) receiving HSCT. HHV6 infection was an independent risk factor associated with increased mortality in patients with TMA (Hazard Ratio: 2.86 [1.01, 8.39], p=0.05), and our study conducts a review of the literature with the association of HHV-6 and complement activation. Studies exploring the pathophysiology of TMA and its relationship to HSCT are needed to optimize the outcome of pediatric patients.

Project Jupyter is an open-source project for interactive computing widely used in data science, machine learning, and scientific computing. We argue that even though Jupyter helps users perform complex, technical work, Jupyter itself solves problems that are fundamentally human in nature. Namely, Jupyter helps humans to think and tell stories with code and data. We illustrate this by describing three dimensions of Jupyter: interactive computing, computational narratives, and  the idea that Jupyter is more than software. We illustrate the impact of these dimensions on a community of practice in Earth and climate science.

Drought limits the growth and productivity of plants. Reproductive development is sensitive to drought but the underlying physiological and molecular mechanisms remain unclear in tomato. Here, we investigated drought effect on tomato floral development using morpho-physiological and transcriptome analyses. Drought induced bud and flower abortions, and reduced fruit set/yield, triggered by male sterility due to abnormal anther and pollen development. Under drought stress (DS), anthers at pollen mother cell to meiotic (PMC-MEI) stage survived while anthers at tetrad to uninucleate microspore (TED-VUM) stage aborted. PMC-MEI stage had lower ABA increase, reduced IAA and higher sugar contents under DS relative to well-watered. However, TED-VUM stage had higher ABA increase, higher IAA level and no accumulation of soluble sugars, indicating abnormal carbohydrate and hormone metabolisms. Moreover, RNA-Seq analysis identified altogether ˃15,000 differentially expressed genes that were assigned to multiple pathways, suggesting tomato anthers utilize complicated mechanisms to cope with drought. Major genes involved in tapetum/microspore development and ABA homeostasis were drought-induced while those involved in sugar utilization and IAA metabolism were repressed at PMC-MEI stage. Our results suggest crosstalks between phytohormones and carbohydrate metabolism at different anther stages under DS and provide novel insight into molecular mechanisms of drought tolerance in tomato.

Background: Modern therapeutic advances in high-risk neuroblastoma have improved overall survival (OS), but it is unclear whether these survival gains have been equitable. This study sought to examine the relationship between socioeconomic status (SES) and OS in children with high-risk neuroblastoma, and to investigate whether SES-associated disparities have changed over time. Procedure: In this population-based cohort study, children <18 years diagnosed with high-risk neuroblastoma (diagnosis at age ≥12 months with metastatic disease) from 1991-2015 were identified through the National Cancer Institute’s Surveillance, Epidemiology, and End Results database. Associations of county-level SES variables and OS were tested with univariate Cox proportional hazards regression. For a sub-cohort diagnosed after 2007, insurance status was examined as an individual-level SES variable. Multivariable regression analyses with treatment era and interaction terms were performed when SES variables reached near-significance (p≤0.1) in univariate and bivariate modeling with treatment era. Results: Among 1,217 children, 2-year OS improved from 53.0±3.4% in 1991-1998 to 76.9±2.9% in 2011-2015 (p<0.001). In univariate analyses, children with Medicaid (hazard ratio [HR]=1.40, 95% confidence interval [CI]=1.05-1.86, p=0.02) and those in high-poverty counties (HR=1.74, CI=1.17-2.60, p=0.007) experienced an increased hazard of death. No interactions between treatment era and SES variables were statistically significant in multivariable analyses, indicating that changes in OS over time did not differ between groups. Conclusions: Low SES is associated with inferior survival in children with high-risk neuroblastoma. Survival disparities have not widened over time, suggesting equitable access to and benefit from therapeutic advances. Interventions to narrow existing disparities are paramount.

BACKGROUND AND PURPOSE The cysteine674 (C674) thiol of Sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2 (SERCA2) is easily and irreversibly oxidized under atherosclerotic conditions. However, contribution of the C674 thiol redox status in the development of atherosclerosis remains unclear. Our goal was to elucidate the possible mechanism involved. EXPERIMENTAL APPROACH Heterozygous SERCA2 C674S knock-in (SKI) mice in which half of the C674 was substituted by serine674 were used to mimic removal of the reactive C674 thiol which occurs under patholog-ical conditions. The whole aorta and aortic root were isolated for histological analysis. Bone marrow derived macrophages (BMDMs) and a cardiac endothelial cell line were used for intra-cellular Ca2+, macrophage adhesion and protein expression analysis. KEY RESULTS SKI mice developed more severe atherosclerotic plaque and macrophage accumulation. Cell cul-ture studies suggest the partial substitution of SERCA2 C674 increased intracellular calcium lev-els and ER stress in both BMDMs and ECs. The release of pro-inflammatory factors and macro-phage adhesion increased in SKI BMDMs. In normal ECs, the overexpression of C674S mutant induced endothelial inflammation and promoted macrophage recruitment. Additionally, 4-phenyl butyric acid (4-PBA), an ER stress inhibitor, prevented the increased atherosclerosis observed in SKI mice, and alleviated ER stress and inflammatory responses in BMDMs and ECs exposed to 4-PBA. CONCLUSIONS AND IMPLICATIONS The substitution of SERCA2 C674 thiol accelerates the development of atherosclerosis by in-ducing ER stress and inflammation. Our findings highlight the importance of SERCA2 C674 redox status in the context of atherosclerosis, and open up a novel therapeutic strategy to combat atherosclerosis.

Objective: In this study, we aimed to establish a frequency-specific ABR (fs-ABR) system via loudspeakers to assess the hearing improvement in ossiculoplasty intra-operatively and observe its efficiency and accuracy in predicting the long-term outcome. Setting Blackman-gated 1kHz tone-pips with 1ms, 2ms and 3ms duration were used in normal hearing (NH) subjects to calibrate the system and the standard ABR threshold and wave V latency for this system were established. All subjects would take four hearing tests: Pure tone audiometry (PTA) before and six-month after the surgery, fs-ABR under anesthesia before surgery and right after the ossicular chain reconstruction intra-operatively. PTA was used as the standard test to measure hearing. Bland-Altman analysis and linear correlation analysis were used to compare the agreement between PTA and fs-ABR results. Participants Forty-two conductive hearing loss (CHL) subjects. Results: For NH and CHL subjects in operating room before surgery, the fs-ABR threshold showed a high linear relation with the PTA results (r=0.88, P<.0001). For CHL follow up results: for 1ms group, PTAI showed a better correlation with fs-ABRI (r=0.67, P<.01) with the equation: PTAI=2.15*fs-ABRI-3.49; for 3ms group, PTA showed a better correlation with fs-ABR (r=0.76, P<.01) with the equation PTA=0.93*fs-ABR+3.48. Bland-Altman analysis showed no difference between PTA and fs-ABR in all above analysis. Eustachian tube malfunction would negatively affect the prediction efficacy, for subjects with normal ETF, the correlation between fs-ABRI and PTAI was even higher: PTAI=1.6*fs-ABRI+12.48 with r=0.77 (P=.0407<0.05). Conclusions This system could monitor the function of the reconstructed ossicular chain intra-operatively and predict the post-surgical 6-month hearing improvement efficiently and accurately. The average testing time for the fs-ABR was short, about 10 to 15 minutes. This system would serve as a promising tool clinically to help surgeons optimize the efficacy of ossiculoplasty. Besides, ETF should be taken into consideration as a risk factor that would negatively influence the hearing impairment.

Purpose: The aim of this study is to analyze the preoperative and intraoperative factors that might induce systemic inflammatory response syndrome after semirigid ureteroscopic lithotripsy (SULL) , and to evaluate the impact of duration between preoperative bladder urine culture (PBUC) and surgery on postoperative systemic inflammatory response syndrome (SIRS). Methods: A retrospective review was conducted including patients who underwent SULL in our center between January 2011 and June 2020. Prior to surgery, PBUC were obtained from all patients and postoperatively patients were observed for signs of SIRS. Univariable and multivariable binary logistic regression analysis were implemented to demonstrate the factors that predict SIRS postoperatively. Results: The entire study included a cohort of 572 patients. The rate of SIRS following SULL was 1.7%. Predictive factors for SIRS were listed as stone volume, surgical time, and history of recurrent urinary tract infection. No significant difference was detected in terms of the duration between PBUC and SULL when comparing the SIRS group with the other group. Conclusion: The duration between PBUC and SULL is not an efficacious factor for SIRS. It may be useful to conduct prospective studies to enlighten this issues as endourologists deal with this duration dilemma often in daily practice. Keywords: Semirigid ureteroscopic lithotripsy, Systemic inflammatory response syndrome, Preoperative bladder urine culture

Background: Acute asthma exacerbations are a common cause for emergency department (ED) visits and hospitalizations in children. Since the outbreak of COVID-19 and the education system closure/ total lockdown in Israel on March 2020, we have noticed a decrease in pediatric ED visits and an increase in hospitalizations of asthma exacerbations. Objective: to examine the patterns of ED visits for asthma exacerbations during COVID-19 outbreak, in comparison to the previous year. Methods: a retrospective study comparing asthma related ED visits and hospitalizations among children aged 2-18 years at a tertiary center in southern Israel. Three time periods were selected: 2020A (pre- lockdown, 1/2/20-14/3/20), 2020B (lockdown, 15/3/20-15/5/20) and 2020 C (post- lockdown, 16/5/20-30/6/20) and compared to the three parallel time periods in 2019. Data regarding demographics, number of ED visits and clinical severity parameters were collected and analyzed. Results: 512 children visited the ED for asthma exacerbation: 273 children during 2019 and 239 children during 2020, with significantly fewer ED visits per day during the lockdown period (1.8 vs 1.43, p<0.001), compared to the parallel period in 2019. Significantly higher hospitalization rate (47.1% vs 33.7%, p=0.05) and longer length of stay (LOS) (3.15 vs 1.9 days, p= 0.03) were observed during the lockdown. Conclusion: lockdown is associated with fewer ED visits for asthma exacerbation, probably due to; reduced exposure to viral infections and environmental allergens, decreased availability of primary physicians and families’ reluctance to arrive to the ED. ED visits during lockdown were characterized by higher hospitalization rate and longer LOS.

Drought stress is a major limiting factor for crop growth and yield. Water availability in the field can cyclically change between drought and rewatering conditions, depending on precipitation patterns. Concurrently, light intensity under field conditions can fluctuate, inducing dynamic photosynthesis and transpiration during crop growth period. The present study aimed to characterize carbon gain and water use in fluctuating light under drought and rewatering conditions by conducting gas exchange measurements in two major crops, namely rice and soybean. In both crops, drought stress reduced steady-state photosynthesis and/or photosynthetic capacity, and delayed photosynthetic induction even when it had relatively small impact on photosynthetic capacity, suggesting that the drought effects on photosynthesis should be evaluated based on induction, maximum, and steady states. This delayed photosynthetic induction resulted in a substantial loss of carbon gain under fluctuating light conditions, which can be a limiting factor for crop growth and yield in the field. Meanwhile, rewatering after drought conditions completely recovered photosynthetic capacity and induction in both crops, whereas drought experience would be memorized to slow down the stomatal opening. Therefore, the stability of photosynthetic induction can be a promising target to improve drought tolerance during crop breeding in the future.