Aims of the study: To investigate the effect of clinical predictors on admission and the set of therapeutic interventions on length of stay, ICU admission, need for MV and mortality. Methods used to conduct the study: Retrospective cohort of inpatients with RT-PCR positive for COVID-19 from March to July 2020. Multivariate models were used to assess risk for ICU admission, need for MV and hospital mortality. Logistic regression analysis was conducted to examine factors associated with the results. Results of the study: 459 patients were enrolled (median age 60.0 years old). For patients treated with AZM-Corticosteroid (46.8%) the risk for ICU admission was 0.17 (OR; 95%CI 0.05-0.57), for MV 0.16 (OR; 95%CI 0.04-0.74) and for mortality 0.16 (OR; 95%CI 0.03-0.91). AZM-Corticosteroid also decreased the length of stay in 1.5 day. AZM-Corticosteroid and anticoagulation when indicated (17.2%), also reduced the ICU stay in 1.5 and MV in 4 days. When included HCQ, the benefits were lost and the times increased. Age >65 years, presence of up one comorbidity, pulmonary involvement more than or equal to 50%, saturation <93%, lymphocytes <900 mm3, D-dimers >1,250 ng/mL and CRP >8.0 mg/dL at admission were clinical predictors for death. HFNC was able to prevent intubation by 38.1%. Conclusion drawn from the study and clinical implications: AZM-Corticosteroids and anticoagulation represented a favorable combination for inpatients with COVID-19, reducing length of hospitalization, risk of MV and mortality. HCQ did not yield benefits to combination therapy and we do not support its use for inpatients. HFNC was able to prevent intubation in one third of patients. Already on admission some clinical predictors may help to estimate a higher risk of poor evolution.

Aims: We aimed to investigate fertilization rates, quality of embryo, pregnancy and live birth rates, endocrine, sexual function, psychological status and quality of life of cases diagnosed with Klinefelter syndrome (KS). Methods: Clinical findings, hormone values and semen analyses in patients with nonmosaic KS (Group 1, n=121) and those with non-genetic nonobstructive azoospermia (NOA) (Group 2, n=178) were retrospectively analyzed. Sperm retrieval outcomes with microdissection testicular sperm extraction (micro-TESE), fertilization rates and embryo quality, pregnancy, abortion, and live birth rates were compared. Sexual functions were assessed using IIEF-15, quality of life was evaluated, and psychological status was assessed. Results: There was no difference in terms of age between groups. Sperm retrieval rates was 38% and 55.6% in Group 1 and 2, respectively (p=0.012). Sperm retrieval rates were higher in Group 1 before 31.5 years than in Group 2 (AUC=0.620, 0.578). Compared to Group 2, the fertilization rate was low in Group 1, whereas embryo quality was similar. Live birth rates were 12.5% and 23% in Group 1 and 2, respectively (p=0.392). The education level, libido, erectile functions, and general health satisfaction were lower in Group 1 than in Group 2 (buraya p değeri yaz). Depression and anxiety levels were higher in Group 2 than Group 1 (p değeri yaz). Conclusion: Higher sperm retrieval rate has been achieved in group 1 younger than 31.5 years. Similar embryo quality is provided between groups. Sexual dysfunction and psychiatric problems were higher in Group 1, with lower satisfaction and general health than Group 2. Patients with KS should be monitored not only with their reproductive functions but also with their general health status.

Fully coupled atmospheric-hydrological models allow a more realistic representation of the land surface–boundary layer continuum, representing both high-resolution land-surface/subsurface water lateral redistribution and the related feedback towards the atmosphere. This study evaluates the potential contribution of the fully coupled approach in extended-range mesoscale hydrometeorological ensemble forecasts. Previous studies have shown, for deterministic simulations, that the effect of fully coupling for short-range forecasts is minor compared to other sources of uncertainty, however, it becomes not negligible when increasing the forecast period. Through a proof-of-concept consisting of an ensemble (50 members from the ECMWF Ensemble Prediction System) seven-days-in-advance forecast of a high impact event affecting the Calabrian peninsula (southern Italy, Mediterranean basin) on November 2019, the paper elucidates the extent to which the improved representation of the terrestrial water lateral transport in the Weather Research and Forecasting (WRF) – Hydro modeling system affects the ensemble water balance, focusing on the precipitation and the hydrological response, in terms of both soil moisture dynamics and streamflow in 14 catchments spanning over 42% of the region. The fully coupled approach caused an increase of surface soil moisture and latent heat flux from land in the days preceding the event, partially affecting the lower Planetary Boundary Layer. However, when shoreward moisture transport from surrounding sea rapidly increased becoming the dominant process, only a weak signature of soil moisture contribution could be detected, resulting in only slightly higher precipitation forecast and not clear variation trend of peak flow, even though the latter variable increased up to 10% in some catchments. Overall, this study highlighted a remarkable performance of the medium-range ensemble forecasts, suggesting a profitable use of the fully coupled approach for forecasting purposes in circumstances in which soil moisture dynamics is more relevant and needs to be better addressed.

Masting, the synchronous highly variable flowering across years by a population of perennial plants, has been shown to be precipitated by many factors including nitrogen levels, drought conditions, spring and summer temperatures. However, the molecular mechanism leading to the initiation of flowering in masting plants in particular years remains largely unknown, despite the potential impact of climate change on masting phenology. We studied genes controlling flowering in Chionochloa pallens, a strongly masting perennial grass. We used a range of in situ and manipulated plants to obtain leaf samples from tillers (shoots) which subsequently remained vegetative or flowered. Here, we show that a novel orthologue of TERMINAL FLOWER 1 (TFL1; normally a repressor of flowering in other species) promotes the induction of flowering in C. pallens (hence Anti-TFL1), a conclusion supported by structural, functional and expression analyses. Global transcriptomic analysis indicated differential expression of CpTPS1, CpGA20ox1, CpREF6 and CpHDA6, emphasising the role of endogenous cues and epigenetic regulation in terms of responsiveness of plants to initiate flowering. Our molecular-based study has provided insights into the cellular mechanism of flowering in masting plants and will supplement ecological and statistical models to predict how masting will respond to global climate change.

Widespread tree species span large climatic gradients that often lead to high levels of local adaptation and phenotypic divergence across their range. To evaluate the relative roles of selection and drift in driving divergence in phenotypic traits, we compared molecular and quantitative genetic variation in Populus fremontii (Fremont cottonwood), using data from > 9000 SNPs and genotypes from 16 populations reciprocally planted in three common gardens that span the species’ climatic range. We present three major findings: 1) There is significant within- and among-population variation in functional traits expressed in each of the common gardens. 2) There is evidence from all three gardens that population divergence in leaf phenology and specific leaf area has been driven by divergent selection (QST > FST). In contrast, QST-FST comparisons for performance traits like height and basal diameter were highly dependent on growing environment, indicating divergent, stabilizing, or no selection across the three gardens. We show this is likely due to local adaptation of source populations to contrasting growing environments. 3) Climate is a primary selective force driving trait divergence, where the traits showing the strongest correlations with a genotype’s provenance climate also had the highest QST values. We conclude that climatic gradients have contributed to significant phenotypic differences and local adaptation in Fremont cottonwood. These results are important because as climate is changing much more rapidly, traits such as phenology that are finely tuned to local conditions may now be subject to intense selection or quickly become maladaptive.

Primary distal renal tubular acidosis (dRTA) is a rare tubular disease associated with variants in SLC4A1, ATP6V0A4, ATP6V1B1, FOXⅠ1 or WDR72 genes. Currently, there is growing evidence that all types of exonic variants can alter splicing regulatory elements, affecting the pre-mRNA splicing process. This study was to determine the consequences of variants associated with dRTA on pre-mRNA splicing combined with predictive bioinformatics tools and minigene assay. As a result, among the 15 candidate variants, 8 variants distributed in SLC4A1 (c.1765C>T, p.Arg589Cys), ATP6V1B1( c.368G>T, p.Gly123Val; c.370C>T, p.Arg124Trp; c.484G>T, p.Glu162* and c.1102G>A, p.Glu368Lys) and ATP6V0A4 genes (c.322C>T, p.Gln108*; c.1571C>T, p.Pro524Leu and c.1572G>A, p.Pro524Pro) were identified to result in whole or part of exon skipping by either disruption of ESEs and generation of ESSs, or interference with the recognition of the classic splicing site, or both. To our knowledge, this is the first study on pre-mRNA splicing of exonic variants in the dRTA-related genes. These results highlight the importance of assessing the effects of exonic variants at the mRNA level and suggest that minigene analysis is an effective tool for evaluating the effects of splicing on variants in vitro

Abstract Increasing pressures on aquatic ecosystems due to pollutants, nutrient enrichment and global warming have severely depleted oxygen concentrations. This sudden and significant lack of oxygen has resulted in persistent increases fish mortality rates. Revealing the molecular mechanism of fish hypoxia adaptation will help researchers to find hypoxic markers for hypoxia induced by environmental stress. Here, we used a multi-omics approach to identify several hypoxia-associated miRNAs, mRNAs, proteins, and metabolites involved in diverse biological pathways in the muscles of Pelteobagrus vachelli. Our findings revealed significant hypoxia-associated changes in muscles over 4 h of hypoxia exposure and discrete tissue-specific patterns. We have previously reported that P. vachelli livers exhibit increased anaerobic glycolysis, heme synthesis, erythropoiesis, and inhibit apoptosis when exposed to hypoxia 4 h. However, the opposite was observed in muscles. According to our comprehensive analysis, fishes show an acute response to hypoxia, including activation of catabolic pathways to generate more energy, reduction of biosynthesis to decrease energy consumption, and shifting from aerobic to anaerobic metabolic contributions. Also we found that hypoxia induced muscle dysfunction by impairing mitochondrial function, activating inflammasomes, and apoptosis. The hypoxia-induced mitochondrial dysfunction enhanced oxidative stress, apoptosis, and further triggered IL-1β production via inflammasome activation. In turn, IL-1β further impaired mitochondrial function or apoptosis by suppressing downstream mitochondrial biosynthesis-related proteins, thus resulting in a vicious cycle of inflammasome activation and mitochondrial dysfunction. Our findings contribute meaningful insights into the molecular mechanisms of hypoxia, and the methods and study design can be utilized across different fish species.

Porcine astroviruses (PoAstVs) have been reported globally and are divided into at least five distinct lineages (PoAstV1-PoAsV5). The primary objective of this study was to summarize the scientific literature about the frequency of detection, associated clinical presentations, and type of samples and diagnostic tools used for the detection of porcine astroviruses. The secondary objective was to summarize the body of knowledge about the causal role in disease of PoAstVs using the Bradford Hill framework. A search was conducted using Centre for Biosciences and Agriculture International (CABI), MEDLINE, American Association of Swine Veterinarians (AASV) Swine Information Library (SIL) abstracts, swine conferences including American College of Veterinary Pathologists (ACVP), and American Association of Veterinary Laboratory Diagnosticians (AAVLD). From 168 studies identified by the search, 29 studies were eligible. Results indicated that 69% (20/29) of the literature on PoAstVs has been published between 2011 and 2018. Of 29 papers, 52% were detection studies (15 of 29) and 48% (14 of 29) were case-control studies. Seventy-two percent (21 of 29) reported differential diagnosis and 10% (3 of 29) reported histologic lesions, out of which 67% (2 of 3) associated the detection of PoAstV3 with development of polioencephalomyelitis. PCR-based assays were the most common diagnostic tools. Keywords: Swine, Astrovirus, Scoping review, Bradford Hill, PoAstV detection

Device insertion is a common cardiovascular procedure. Devices are implanted into the right heart; which is a safeguard against systemic thromboembolism. Lead insertion into the left ventricle is rare. This is a case of a defibrillator lead inadvertently inserted into the left cavity. This was discovered 6 years later.

Introduction: Disordered coagulation, clot formation and distal limb ischemia are complications of extracorporeal membrane oxygenation (ECMO) with significant morbidity and mortality. Medicinal leech therapy (hirudotherapy) has been attempted in plastic and orthopedic surgeries to improve venous congestion and salvage ischemic flaps. To our knowledge this has not been reported in pediatric cardiac surgery or during ECMO support. We present a complex neonate whose ECMO course was complicated by distal limb ischemia for whom leech therapy was attempted. Patient and Intervention: A 2 week-old 2.7 kg infant required ECMO support secondary to perioperative multiorgan system dysfunction following repair of critical coarctation and ventricular septal defect. Despite systemic anticoagulation, his clinical course was complicated by arterial thrombus, vasopressor-induced vascular spasm and bilateral distal limb ischemia. Medicinal leech therapy was tried after initially failing conventional measures. Result: Following the third leech application, this patient developed significant hemorrhage from the web space adjacent to the left great toe. An estimated 450 mL of blood loss occurred and more than 300 mL of blood product transfusions were required. He ultimately progressed to irreversible systemic end organ dysfunction and comfort care was provided. Conclusion: The use of medicinal leech therapy in pediatric cardiac surgery may be considered to minimize the consequences of advanced limb ischemia and venous congestion. However, this should be used with caution while patients are systemically anticoagulated during ECMO support. A directed review is presented here to assist in determining optimal application and potential course of therapy.

ABSTRACT Introduction Radioactive iodine (RAI) is widely used as a treatment for differentiated thyroid cancer following total thyroidectomy. There is a risk of second primary malignancy (SPM) in these patients which is estimated between 0-5% although research to support this is limited. The primary aim of this study was to ascertain the rate of SPM in patients who have undergone RAIT for thyroid cancer. The secondary objectives were to assess whether the risk is dose dependant and examine the overall survival and recurrence rates. Methods A retrospective review of all patients treated with radioactive iodine for thyroid cancer between 2002 and 2014. Patient information was collected from a structured database. Data regarding second cancers and recurrence rates was obtained from an online clinical portal. Follow up was 5 years minimum. Results 199 patients underwent RAI treatment. Median age was 53. 71.4% patients were female and 28.6% were male. All patients underwent total thyroidectomy. 13.6% underwent total thyroid and central neck dissection. 11% underwent total thyroidectomy and lateral neck dissection. 5.5% required post-operative radiotherapy. 12% patients developed recurrent thyroid cancer. 8% developed a SPM of which prostate, skin, head and neck SCC were the most common. A dose ≥3.7 (Gigabecquerel) GBq was statistically significantly more likely to lead to a SPM with a P value of 0.041 (95% CI -0.52 – 0.01318). Conclusions Increased risk of developing a second primary malignancy should be taken into account, especially in younger patients with low risk disease, when deciding on RAIT. Key words Radioactive iodine, Differentiated thyroid cancer, Second primary malignancy, Radioiodine, Thyroid cancer

Objective To assess the efficacy and outcome of a pilot model in triaging urgent suspected head and neck cancer referrals during the Covid-19 pandemic. Design Prospective observational cohort study Setting Regional Head and Neck Cancer hub, United Kingdom. Participants 84 patients who were referred via the 2 week wait pathway and streamed directly for imaging investigations after initial telephone consultation. Main outcome measures The malignancy detection rate using the telephone-and-test model Results 495 2-week wait referrals were received during the study period. 104 patients were discharged following their initial telephone consultation. 84 (17%) patients were streamed directly for imaging investigations following their telephone consultation. Malignancy was identified in 11.9% of patients which included squamous cell carcinoma, differentiated thyroid carcinoma and lymphoproliferative disease. 51% of patients had other benign pathologies such as benign salivary gland tumour, benign thyroid disease and physiological lymphadenopathy. Following their radiological investigation, 48.8% of patients were discharged without any need for further consultations. Conclusions The telephone-and-test approach is an effective and efficient model for triaging head and neck two-week wait referrals, which could be applicable outside the pandemic times.

Objectives: To determine the immediate post-operative course and outcome of pediatric patients with complicated acute mastoiditis (CAM) undergoing simple mastoidectomy. Study Design: A retrospective chart review of children diagnosed with CAM who underwent a mastoidectomy during 2012-2019. Setting: Tertiary care university hospital. Participants: 33 patients were divided into two groups: 17 patients with subperiosteal abscess (SPA) alone- single complication group (SCG) and 16 patients with SPA and additional complications (sigmoid sinus vein thrombosis, perisinus fluid/abscess, epidural abscess)-multiple complications group (MCG). Main Outcome Measures: post-operative data were collected. Demographics, microbiology data, inflammatory parameters, hospitalization length, and POF pattern were recorded, compared, and analyzed. Results: Of 162 acute mastoiditis patients, 33(20.4%) underwent surgery due to CAM; 17(51%) and 16(49%) belonged to the SCG and MCG, respectively. 6/17(35.3%) SCG patients experienced POF vs. 12/16(75%) in the MCG (P=0.012). At post-operative day 2 (POD2), 10/13(77%) febrile patients belonged to MCG and 3/13(23%) to SCG (P=0.013). POF was recorded until POD6 in both groups. Seven patients, all from MCG with POF, underwent second imaging with no new findings; A total of 18 positive cultures were reported. Fusobacterium necrophorum counted for 8/18(44.5%) of all positive cultures, 7/9(77.8%) in the MCG vs. 1/9(11.1 %) in the SCG, P=0.004. Streptococcus pneumoniae was reported only in SCG (5/9, 55.5%, vs. 0/9, P=0.008). Conclusion: Post-mastoidectomy fever due to CAM is not unusual and seems to be a benign condition for the first 5-6 days following surgery. MCG patients are more prone to develop POF. F. necrophorum is more likely to be associated with MCG, and S. pneumoniae is common in SCG patients. Keywords: Mastoiditis, post-operative fever, complications, microbiology

Patent foramen ovale (PFO) is a common congenital defect in adults; its closure with an occluder device is usually a safe procedure. However, a rare and potentially fatal complication is the device embolization. We report a case of a 52-year-old man with bicuspid aortic valve and surgically corrected aortic coarctation in which a PFO occluder device migrated to the abdominal aorta. We recommend paying attention to the risk factors before the intervention (PFO characteristics and multiple congenital defects) and to the clinical-echocardiographic follow-up, to prevent, recognize and treat this severe complication as soon as possible.

Deoxymiroestrol is the most potent phytoestrogen in chromenes group that has been found in Pueraria candollei, Thai name known as Kwao Krua Khao. Several studies reported estrogenic activity of P. candollei in order to using as hormone replacement therapy for postmenopausal women. Previously, specific determination of deoxymiroestrol content by enzyme-linked immunosorbent assay (ELISA) using polyclonal antibody (pAb) have been reported. However, production of pAb has limitation and variability from different batches. Therefore, in this study, we established quantitative method for determination of deoxymiroestrol using fragment antigen-binding (Fab) antibody-based immunoassay. The developed immunoassay has specificity to deoxymiroestrol with a calibration range of 15.6-1000 ng mL-1. Precision including intra-assay and inter-assay are 1.48-7.11 and 0.58-9.31%, respectively. Accuracy of the assay showed in recovery between 99.77-101.61% when spike deoxymiroestrol standard into the samples. The limit of detection (LOD) is 30.80 ng mL-1. Comparation antibody-based immunoassay for determination of deoxymiroestrol using Fab with pAb was represented consistency (R2 = 0.9807) when analysis roots bark of Pueraria candollei from difference areas. Therefore, this development assay can apply to determine deoxymiroestrol content in the plant samples.

Given the potential applications of gas vesicles (GVs) in multiple fields including antigen-displaying and imaging, heterologous reconstitution of synthetic GVs is an attractive and interesting study that has translational potential. Here, we attempted to express and assemble GV proteins (GVPs) into GVs using the model eukaryotic organism Saccharomyces cerevisiae. We first selected and expressed two core structural proteins, GvpA and GvpC from cyanobacteria Anabaena flos-aquae and Planktothrix rubescens, respectively. We then optimized the protein expression conditions and validated GV assembly in the context of cell flotation and GV shapes. We found that when two copies of AnaA were integrated into the genome, it resulted in cell floatation and GV production regardless of GvpC expression. Next, we co-expressed chaperone-RFP with the GFP-AnaA to aid the AnaA aggregation. The co-expression of individual chaperones (Hsp42, Sis1, Hsp104, and GvpN) with AnaA led to the formation of larger inclusions and enhanced the sequestration of AnaA into the perivacuolar site. To our knowledge, this represents the first study on reconstitution of GVs in S. cerevisiae. Our results could provide insights into optimizing conditions for heterologous protein expressions as well as the reconstitution of other synthetic microcompartments in yeast.

Understanding the interactions among soil microbial species and how they respond to land reclamation is essential to evaluate the success of ecological restoration actions in disturbed mining soil. In this study, we strived to reveal the interactions among soil bacterial communities along the reclamation timeline of a coal mine in Zoucheng, China. To do so, we investigated changes in the composition of soil bacterial over time and constructed molecular ecological networks (i.e. microbial network) following mining soil reclamation into agricultural land. The relationships between microbial networks and selected soil attributes (i.e. soil pH, electric conductivity, organic matter, soil nutrients and enzymatic activities) were also analyzed. The results showed that the composition of soil bacteria changed significantly along the reclamation timeline. The microbial network profile revealed that Acidobacteria, Planctomycetes and Proteobacteria were the key microbial populations. Soil pH, soil organic matter content, soil dehydrogenase and urease activities were significantly correlated (0.001 ≤ P < 0.05) with the microbial network structure, suggesting that the microbial networks found influenced the provision of relevant soil ecological functions after reclamation. The variation in complexity of the microbial networks along the reclamation timeline revealed that microbial development was promoted by the shift in land use from mining into agriculture. Overall, our findings shed light on how soil microbial communities and networks change following mine reclamation into agricultural land. The results presented herein will undoubtedly aid in the establishment of success indicators of ecological restoration activities in disturbed mining soil.

ABSTRACT Background: Neural mechanisms may play an important role in non-eosinophilic asthma. This study compared airway sensory nerve reactivity, using capsaicin challenge, in eosinophilic and non-eosinophilic asthma and non-asthmatics. Methods: Thirty-eight asthmatics and nineteen non-asthmatics (aged 14-21 years) underwent combined hypertonic saline challenge/sputum induction, exhaled nitric oxide (FeNO), atopy, and spirometry tests, followed by capsaicin challenge. Eosinophilic (EA) and non-eosinophilic asthma (NEA) were defined using a sputum eosinophil cut-point of 2.5%. Airway hyperreactivity (AHR) was defined as a ≥15% drop in FEV1 during saline challenge. Sensory nerve reactivity was defined as the lowest capsaicin concentration that evoked 5 (C5) coughs. Results: Non-eosinophilic asthmatics (n=20) had heightened capsaicin sensitivity (lower C5) compared to non-asthmatics (n=19) (geometric mean C5: 58.3μM, 95% confidence interval 24.1-141.5 vs 193.6μM, 82.2-456.0; p<0.05). There was a similar (but non-significant) difference in capsaicin sensitivity in NEA compared with EA (n=18), (58.3μM, 24.1-141.5 vs 191.0μM, 70.9-514.0; p=0.07). FEV1 was significantly reduced from baseline following capsaicin inhalation in both asthmatics and non-asthmatics but no differences were found between subgroups. No associations with capsaicin sensitivity and atopy, sputum eosinophils, blood eosinophils, asthma control, or treatment were observed. Conclusion: Non-eosinophilic asthma, but not eosinophilic asthma, showed enhanced capsaicin sensitivity compared with non-asthmatics. Sensory nerve reactivity may therefore play an important role in the pathophysiology of non-eosinophilic asthma.

Although both esophageal and gastric cancers are highly prevalent, the prevalence of both esophageal and gastric cancers simultaneously is very rare overall. Herein, we present a case of simultaneous occurrence of two cancers including esophageal squamous cell carcinoma and gastric adenocarcinoma.

This care report presents a 51-year-old woman patient with a cyst-like mass in the liver. The proliferated histiocytes, with the eosinophilic nucleolus, occasionally showing lymphophagocytosis (emperipolesis) positively for CD68 protein S-100 were reported in the pathological study, and the plasma cells were positive for CD138, consistent with Rosai-Dorfman disease.

Pathologic amyloid β and tau protein accumulation in the cerebral cortex does not necessarily lead to a diagnosis of Alzheimer’s disease. Our current report presents a patient with Alzheimer’s disease pathology who presented general cognitive impairment we considered derived from the lung cancer itself, without metastasis.

First principles studies combined with the microkinetic analysis were performed to study the reliability and reaction mechanisms of single-atom doped graphene (SADGr) materials in catalyzing NOx reduction with CO. By screening the 3d transition metals (Sc-Zn) and group-IV elements (Si and Ge), it was found that the Ti and Co doped graphene sheets (TiGr and CoGr) respectively own excellent catalytic activities in the NO/NO2-to-N2O and the N2O-to-N2 processes at low temperatures. Therefore, the TiGr/CoGr composite can be a promising catalyst in NOx reduction with CO. It was further revealed the combination of adsorption energy and electronegativity was a good descriptor to predict the activation energies. The obtained results can provide useful information for rational design of carbon-based single-atom catalysts for NOx reduction by CO at low temperatures.

In this paper, we investigate the models of the impulsive cellular neural network with piecewise alternately advanced and retarded argument of generalized argument (in short IDEPCAG). To ensure the existence, uniqueness and global exponential stability of the equilibrium state, several new sufficient conditions are obtained, which extend the results of the previous literature. The method is based on utilizing Banach’s fixed point theorem and a new IDEPCAG’s Gronwall inequality. The criteria given are easy to check and when the impulsive effects do not affect, the results can be extracted from those of the non-impulsive systems. Typical numerical simulation examples are used to show the validity and effectiveness of proposed results. We end the article with a brief conclusion.

An 80 year old man with metastatic castrate-resistant prostate cancer was treated with multiple systemic agents but after carboplatin/paclitaxel, developed a morbilliform rash conforming precisely to a skin site of previous palliative radiotherapy, a so-called radiation recall reaction.