Research has conclusively demonstrated the potential for dispersal evolution in range expansions and shifts through a process termed spatial sorting. However, the degree of dispersal evolution observed has varied substantially among organisms. Further, it is unknown how the factors influencing dispersal evolution might impact other ecological processes at play. We use an individual-based model to investigate the effects of the underlying genetics of dispersal and mode of reproduction in range expansions and shifts. Spatial sorting behaves similarly to natural selection in that dispersal evolution increases with sexual selection and loci number. Contrary to our predictions, however, increased dispersal does not always improve a population's ability to track changing conditions. The mate finding Allee effect inherent to sexual reproduction increases extinction risk during range shifts, counteracting the beneficial effect of increased dispersal evolution. Our results demonstrate the importance of considering both ecological and evolutionary processes for understanding range expansions and shifts.

Ecologists are still puzzled by the diverse population dynamics of herbivorous small mammals that range from high-amplitude, multi-annual cycles to stable dynamics. Theory predicts that this diversity results from combinations of climatic seasonality, weather stochasticity and density-dependent food web interactions. The almost ubiquitous 3-5-yr cycles in boreal and arctic climates may theoretically result from bottom-up (plant-herbivore) and top-down (predator-prey) interactions. Assessing empirically the roles of such interactions, and how they are influenced by environmental stochasticity, has been hampered by food web complexity. Here, we take advantage of a uniquely simple High-Arctic food web, which allowed us to analyze dynamics of a graminivorous vole population not subjected to top-down regulation. This population exhibited high-amplitude, non-cyclic fluctuations - partly driven by weather stochasticity. However, the predominant driver of the dynamics was direct density dependence, which alternated between being weak in summer and strong (overcompensatory) in winter that the population frequently crashed. Model simulations showed that this season-specific density dependence would yield regular 2-year cycles in absence of stochasticity. While such short cycles have not yet been observed in mammals, they are theoretically plausible if graminivorous vole populations are deterministically bottom-up regulated. When incorporating weather stochasticity in the model simulations, cyclicity became disrupted and the amplitude was increased - akin to the observed dynamics. Our findings contrast with the 3-5-yr population cycles involving delayed density dependence that are typical of graminivorous small mammals in more complex food webs, suggesting that top-down regulation is an important component of such dynamics.

While a large body of research has focused on the physiological effects of multiple environmental stressors, behavioral effects remain far less studied. However, behavioural plasticity can not only directly drive responses to stressors but can also mediate physiological responses. Here, we provide a conceptual framework incorporating four fundamental tradeoffs explicitly linking animal behaviour to life history-based pathways for energy allocation, shaping the impact of multiple stressors on fitness. We first address how small-scale behavioural changes can drive conflicts between the effects of multiple stressors and alternative physiological responses. We then discuss how animal behaviour gives rise to three additional understudied and interrelated trade-offs: balancing the benefits and risks of obtaining the energy needed to cope with stressors, allocation of energy between life-history traits and stressor responses, and larger-scale escape from stressors in space or time via dispersal or dormancy. Finally, we outline how these trade-offs interactively affect fitness and qualitative ecological outcomes resulting from multiple stressors. Our framework suggests that animal behavior could underlie the extensive context dependence in results from stressor research, highlighting promising avenues for future empirical and theoretical research.

Aim: The present study compares the effectiveness of four different remineralization agents on the demineralized enamel of permanent human incisors. The purpose of this study is to evaluate the effectiveness of remineralization agents on the initial enamel lesion. Material- Methods: Crowns affected by demineralization were divided into two equal parts. The right halves of the teeth were subjected to no other processes after demineralization for control purposes and were kept in artificial saliva for the duration of the experiment. The left halves of the crowns were remineralized using a 5% NaF-containing fluoride varnish (GC MI Varnish GC Corp, Tokyo, Japan), a casein phosphopeptide and amorphous calcium toothpaste (GC Tooth Mousse, GC Corp, Tokyo, Japan), fluoride, hydroxyapatite, and xylitol, containing a water-soluble remineralization paste (Remin Pro™, Voco, Germany) and calcium, magnesium and phosphate-containing gel (Medical Remineralizing gel (R.O.C.S. Trading GmbH, Munich, Germany). After a 21-day remineralization process, and SEM/EDX analysis was performed, and a One Way Anova was used for statistical analysis. Results: According to EDX analysis, the R.O.C.S. medical remineralizing gel was found to have a lower Ca/P ratio than the other material groups (p =0.04). Remin Pro™, Voco, and the R.O.C.S. were higher than the control group in evaluating the Ca / P ratio (p=0.014), (p=0.025). Conclusions: The R.O.C.S group, treated with fluoride-free xylitol-containing, a remineralization agent, showed the lowest Ca/P ratio. Compared to demineralized halves of the teeth (control groups), Remin Pro™, Voco, and R.O.C.S. medical remineralizing gel may be considered as affecting on initial enamel lesions. Key Words: Remineralizing Agents, EDX, SEM, Enamel,

Background: Evidence shows that simplified SOFA scoring system has better clinical practice. Objective: This study aimed to compare the scores acquired with the simplified sequential organ failure assessment (sSOFA), simplified organ dysfunction criteria optimized for electronic health records (eSOFA), and simplified and accurate sequential organ failure assessment (sa-SOFA) for their accuracies in predicting the prognosis of septic patients. Methods: This retrospective observational study was conducted at three major academic hospitals. Clinical data from 574 patients diagnosed with sepsis following the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)were retrospectively retrieved and analyzed. Scores from the quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA) were used as reference scores. The area under the receiver operating characteristic curve (AUROC) was used to compare the accuracies of eSOFA, sSOFA, and sa-SOFA scores in predicting in-hospital mortality. Results: AUROC analysis demonstrated the predictability of the five scoring systems for sepsis surveillance, listed in descending order as: sa-SOFA,0.790 (95% confidence interval [CI]: 0.754-0.822); SOFA, 0.774 (95% CI: 0.738-0.808); eSOFA,0.729 (95% CI: 0.691-0.765); sSOFA,0.681 (95% CI: 0.641- 0.719); and qSOFA,0.618(95% CI: 0.577-0.658). Moreover, sa-SOFA and SOFA scores (Z= 1.950, p = 0.051) did not significantly differ from each other in discriminatory power, but the sa-SOFA score had a higher power than either the sSOFA or eSOFA scores (p values <0.001). Conclusion: sa-SOFA showed the highest accuracy in predicting in-hospital fatality of septic patients when compared with sSOFA and eSOFA.

Mini-commentary on BJOG-20-1156.R2: Post-mortem confirmation of fetal brain abnormalities: challenges highlighted by the MERIDIAN cohort study

A document by Nathan Gold. Click on the document to view its contents.

In this paper, it is shown that discrete equations with Hilb ert matrix operator, circulant matrix operator, conference matrix operator, banded matrix operator, and sparse matrix operator are ill-posed in the sense of Hadamard. These ill-posed problems cannot be regularized by Gauss Least Square Method (GLSM), QR Factorization Method (QRFM), Cholesky Decomposition Method (CDM) and Singular Value Decomposition (SVDM). To overcome the limitations of these methods of regularization, an Eigenspace Spectral Regularization Method (ESRM) is introduced which solves ill-p os ed discrete equations with Hilb ert matrix operator, circulant matrix operator, conference matrix operator, banded matrix operator, and sparse matrix operator. Unlike GLSM, QRFM, CDM, and SVDM, the ESRM regularize such a system. In addition, the ESRM has a unique property, the norm of the eigenspace spectral matrix operator κ (K) = ||K − 1K|| = 1. Thus, the condition number of ESRM is bounded by unity unlike the other regularization methods such as SVDM, GLSM, CDM, and QRFM.

Background: The nutritional status of the patient is an important parameter in patients undergoing surgery. This study aims to determine of prognostic nutritional index value that predicts hospital mortality and morbidity in on-pump cardiac surgery. Methods: In this study, we scanned the medical data of 1003 patients who underwent on-pump cardiac surgery. Patients’ divided into two groups according to in-hospital mortality. 934 patients without in-hospital mortality were defined as Group I, and 69 patients who died in the hospital were defined as Group II. Their preoperative nutritional status was determined using the prognostic nutritional index classification. Results: In our series, age is statistically higher in Group II rather than Group I (62.5 ± 0.3 vs. 67.4 ± 1.2; p=0.001). There was a significantly different a higher tendency of hospital-acquired infection in Group II (151; 16.2% vs. 44; 63.8%; p=0.001). Postoperative stroke significantly higher in Group II (35; 3.7% vs. 62; 89.9%; p=0.001). Multivariate analysis revealed that cross clamp time, cardiopulmonary bypass time, intraaortic balloon pump usage and intensive care unit stay significantly higher in Group II (p<0.05, respectively). The prognostic nutritional index value was found statistically low in Group II (48.34 ± 6.71 vs. 44.76 ± 7.63; p=0.001). Multivariate analysis revealed that male gender, age, and the prognostic nutritional index were independently associated with postoperative survival. Conclusion: In on-pump cardiac surgery, postoperative mortality and morbidity are significantly associated with preoperative low prognostic nutritional index, and the prognostic nutritional index can be a useful and suitable parameter for preoperative risk evaluation.

Abstract Objectives: There is no study in the literature that patients with clinically-proven PET were evaluated by Valsalva CT. We aimed to evaluate the merit of Valsalva computed tomography (CT) in patients who had clinically-proven patulous Eustachian tube (PET). Design: Case-series Setting and participants: We recruited patients with clinically-proven PET. Participants: Main outcome measures: All participants underwent temporal bone CTs while they were performing the Valsalva maneuver in the supine position. Standard axial plane CT images, along with multiplanar reconstruction and 3D Air volume rendering, were used to visualize the ET in its entirety. Results: Three patients (2 females, one male) with a total of 6 ears were included in the study. All patients had suggestive symptoms of PET, including aural fullness, aerophony, and autophony and underwent clinical examination and audiologic tests. In all ears, the whole Eustachian tube could be visualized with Valsalva CT. Conclusion: For the first time, we demonstrated the merit of Valsalva CT in visualization of the Eustachian tube in its entirety in patients with clinically diagnosed PET.

The exact solutions of the Riemann problems for the two different perturbed macroscopic production models are considered and constructed respectively for all the possible cases. It is found that the asymptotic limits of solutions to the Riemann problem for the first kind of perturbed macroscopic production model do not coverage to those of the pressureless gas dynamics model, because the delta shock wave in the limiting situation has different propagation speed and strength from those for the pressureless gas dynamics model. In order to remedy it, the second kind of perturbed macroscopic production model is proposed, whose asymptotic limits of Riemann solutions are identical with those of the pressureless gas dynamics model.

In case of decompensated heart failure related to chemotherapy-induced cardiomyopathy, ivabradine administration could lead to favorable hemodynamics via the increase of stroke volume with reducing sinus heart rate. Assessment of the overlap between the E- and A-waves facilitates understanding the effects of ivabradine in such cases.

Sinus of Valsalva aneurysm is a rare disease characterized by the partial elevation of the aortic root. Few reports are available on the surgical treatment for infants. We report the repair of an extremely rare case of a sinus of Valsalva defect with a ventricular septal defect and right ventricular outflow tract stenosis in an infant. It was not a sinus of Valsalva aneurysm, but it exhibited abnormal partial bulging of the aortic root and forming an aneurysm-like cavity within the right ventricular myocardium. We performed direct closure of the sinus of Valsalva aneurysm-like cavities and intracardiac repair in two stages. Three years after total repair, the patient remained healthy and asymptomatic.

Structure-based computational protein design (CPD) refers to the problem of finding a sequence of amino acids which folds into a specific desired protein structure, and possibly fulfills some targeted biochemical properties. Recent studies point out the particularly rugged CPD energy landscape, suggesting that local search optimization methods should be designed and tuned to easily escape local minima attraction basins. In this paper, we analyze the performance and search dynamics of an iterated local search (ILS) algorithm enhanced with partition crossover. Our algorithm, PILS, quickly finds local minima and escapes their basins of attraction by solution perturbation. Additionally, the partition crossover operator exploits the structure of the residue interaction graph in order to efficiently mix solutions and find new unexplored basins. Our results on a benchmark of 30 proteins of various topology and size show that PILS consistently finds lower energy solutions compared to Rosetta fixbb and a classic ILS, and that the corresponding sequences are mostly closer to the native.

1. Almost all organisms grow in size during their lifetime and switch diets, trophic positions, and interacting partners as they grow. Such ontogenetic development introduces life-history stages and flows of biomass between the stages through growth and reproduction. However, current research on complex food webs rarely considers life-history stages. The few previously proposed methods do not take full advantage of the existing food web structural models that can produce realistic food web topologies. 2. We extended the niche model by Williams & Martinez (2000) to generate food webs that included trophic species with a life-history stage structure. Our method aggregated trophic species based on niche overlap to form a life-history structured population; therefore, it largely preserved the topological structure of food webs generated by the niche model. We applied the theory of allometric predator-prey body mass ratio and parameterized an allometric bioenergetic model augmented with biomass flow between stages via growth and reproduction to study the effects of a stage structure on the stability of food webs. 3. When life-history stages were linked via growth and reproduction, fewer food webs persisted while persisting food webs tended to retain more trophic species. Topological differences between persisting linked and unlinked food webs were small to modest. Temporal variability of biomass dynamics and slopes of biomass spectra were lower in the linked food webs than the unlinked ones, suggesting that a life-history stage structure enhanced stability of complex food webs. 4. Our results suggest a positive relationship between the complexity and stability of complex food webs. A life-history stage structure in food webs may play important roles in dynamics of and diversity in food webs.

We report mild COVID-19 manifestation in high-risk patient with sufficient plasma 25-OH-Vitamin D3 level. Given the global pandemic of vitamin D deficiency, as well as its likely beneficial effects during SARS-CoV-2 infection, report highlights importance of routine 25-OH-Vitamin D3 measurement, either for clinical course prediction or deciding on supplementation.

Cyclohexanone monooxygenase (CHMO), a member of the Baeyer-Villiger monooxygenase family, is a versatile biocatalyst that efficiently catalyzes the conversion of cyclic ketones to lactones. In this study, an Acidovorax-derived CHMO gene was expressed in Pseudomonas taiwanensis VLB120. Upon purification, the enzyme was characterized in vitro and shown to feature a broad substrate spectrum and up to 100% conversion in 6 h. Further, we determined and compared the cyclohexanone conversion kinetics for different CHMO-biocatalyst formats, i.e., isolated enzyme, suspended whole cells, and biofilms, the latter two based on recombinant CHMO-containing P. taiwanensis VLB120. Biofilms showed less favorable values for KS (9.3-fold higher) and kcat (4.8-fold lower) compared to corresponding KM and kcat values of isolated CHMO, but a favorable KI for cyclohexanone (5.3-fold higher). The unfavorable KS and kcat values are related to mass transfer- and possibly heterogeneity issues and deserve further investigation and engineering, in order to exploit the high potential of biofilms regarding process stability. Suspended cells showed an only 1.8-fold higher KS, but 1.3- and 4.2-fold higher kcat and KI values than isolated CHMO. This together with the efficient NADPH regeneration via glucose metabolism makes this format highly promising from a kinetics perspective.

We developed process-based tree phenology models for four subtropical tree species, and for the first time for these trees, we based the model development on explicit experimental work particularly designed to address the processes being modelled. For all the four species, a model of seedling leafout was developed, and for Torreya grandis, a model for female flowering in adult trees was additionally developed. The models generally showed reasonable accuracy when tested against two sources of independent data. In scenario simulations, the models projected an advanced spring phenology under climatic warming for 2020 – 2100. For the leafout of seedlings, the advancing rates varied between 4.7 and 5.9 days per one oC warming, with no major differences found between the climatic scenarios RCP4.5 and RCP8.5. For Torreya flowering, less advancing was projected, and the projected advancing per one oC warming was less for RCP8.5 (0.9 days / oC) than for RCP4.5 (2.3 days / oC). The low advancing rates of Torreya flowering were caused by reduced chilling under the warming climate and by the particular temperature responses found for Torreya flowering. These findings highlight the need to base the model development on explicit experiments particularly designed to address the process modelled.

A nationwide lockdown was initiated to prevent the worsening of the COVID-19 pandemic in India. This study aims to understand the impact of the lockdown on the well-being of Indians, mainly focusing on their life satisfaction and job satisfaction. Though, before the lockdown, family income was not related to life satisfaction, during the lockdown, it was found that higher income families experienced higher levels of life satisfaction. One's opinion on the beneficiality of the lockdown too was related to their level of income. Decline in both, job satisfaction and life satisfaction was seen. Gender, marital status and companions during the lockdown were significantly related to life satisfaction. Those who were married were more satisfied during the lockdown. Job satisfaction was irrespective of one’s gender, marital status and educational qualification. An attempt has been made to understand the embracement of work from home culture by Indians. The study also tries to answer if the time one spends on oneself and on social media impact their well-being. A lot of changes were seen in the lifestyle and state of mind of people. With change in working conditions and income for a majority of people, there was uncertainty as to when things would normalize. The importance of companionship during these hard times was also revealed. Like every coin has two sides, this too has its positive side. People have inculcated habits that have improved their lifestyle. A lot of people have also found this as an opportunity to work on their relationships. 

Basilar artery occlusion (BAO) represents 1–4% of ischemic strokes and includes variable symptoms, resulting in delayed diagnosis. Treatment is not codified and outcome depends on the severity of clinical presentation and extent of the occlusion. We present a case of two patients with BAO and we discuss treatment protocols.

Background: Echocardiographic transaortic jet velocity (Vmax), mean pressure gradient (mPG), and aortic valve area (AVA) are routinely measured for severity of aortic stenosis (AS). Additionally, prolonged ejection time (ET), acceleration time (AT), and its ratio AT/ET are also known as indexes of AS severity. However, acoustic window dependency of AT/ET is not well studied. Methods: Eighty-one patients with AS assessed by transaortic jet tracing of all of three approaches (apical 3-chamber (3C), apical 5-chamber (5C), and right parasternal (R)) were included in this study. ET, AT, and AT/ET were measured on continuous Doppler recordings obtained by 3C, 5C, and R approaches. Also, ET and AT were corrected by dividing by (R-R interval)1/2, and they were named as cET and cAT. Results: No differences were observed in cET among 3 approaches. However, cAT was significantly longer in R (115+23 msec: p<0.05) compared to that of 3C (105+21 msec) or 5C (105+20 msec). AT/ET was significantly greater in R (0.340+0.058, p<0.05) compared to that of 3C (0.317+0.053) or 5C (0.316+0.055). AT/ET-peak V relation of R approach positioned significantly upward (ANCOVA, p<0.05) comparing to that of 3C or 5C. Also, AT/ET-AVAi relation of R approach positioned upward (ANCOVA, p<0.05) comparing to that of 3C or 5C. Conclusions: AT/ET by R approach was greater than that by 3C or 5C approach. Although multiple acoustic window’s approaches including R is recommended to obtain the maximal Vmax or mPG, AT/ET is better in 3C or 5C approach than R when AT/ET is used for AS severity.

Background In order to address the COVID-19 pandemic, health systems have used all their resources, including health care workers in training. Knowing the insights of these workers is of the utmost importance to generate adequate educative/political /administrative strategies. Methods An anonymous cross-sectional online survey was made by the General Directorate of Quality and Health Education in Mexico, in a convenience sample of 6,020 participants who belong to personnel in training for the health area, which included practitioners and professional technologists, undergraduate doctors, nursing, and residents in several specialties. Results Different positive and negative feelings were identified by the health workers who participated in facing this health emergency; emphasizing elements such as the need for Personal Protection Equipment (PPE) that, when deficient or lacking, generate concerns that raise questions about the medical/epidemiological attention to the pandemic. Based on an analysis of feelings, 8 main feelings were identified, which by frequency of appearing were: distrust(24.83%), fear(21.97%), sadness(12.45%), anticipation(11.65%), anger(10.71%), disgust(9.69%), joy(4.97%) and surprise(3.72%) which influence health workers in training and their wrok performance day to day. Concerning their positive and negative evaluation of their experience facing this health emergency, 13.83% of participants had a positive perception about participating in this kind of health emergency to support the country, 49.94% showed a negative evaluation, and 36.23% kept a neutral evaluation about their participation. Conclusions The health workers in training in Mexico gave a negative evaluation of the management of the health emergency. Distrust as a response to the absence of timely information from the education/health institutions, as well as concern about lack of personal protection equipment/inputs, are the main conflicts reported. We must establish a credible globally relevant continuity plan for the education of health care personnel in training, facing emergencies and disasters, so that next time we are properly prepared.

Purpose To evaluate the effect of risk factors and selected surgical methods on operative and oncological results of patients undergoing radical prostatectomy (RP) with high-risk prostate cancer (HRPC). Methods Retrospective analysis of patients, who underwent RP for HRPC from 13 urology centers between 1990 to 2019, was performed. Groups were created according to the risk factors of D’Amico classification. Patients with one risk factor were included in group 1 where group 2 consisted of patients with two or three risk factors. Results A total of 1519 patients were included in this study and 1073 (70.6%) patients assigned to group 1 and 446 (29.4%) patients to group 2. Overall (biochemical and/or clinical and/or radiological) progression rate was 12.4% in group 1 and 26.5% in group 2 (p =0.001). Surgical procedure was open RP in 844 (55.6%) patients and minimally invasive RP in 675 (44.4%) patients (laparoscopic and robot-assisted RP in 230 (15.1%) and 445 (29.3%) patients, respectively). Progression rates were similar in different types of operations (p=0.22). Progression rate was not significantly different in patients who either underwent pelvic lymph node dissection (PLND) or not in each respective group. Conclusion RP alone is an effective treatment in the majority of patients with HRPC and PLND did not affect the progression rates after RP. According to the number of preoperative high-risk features, as the number of risk factors increases, there is a need for additional treatment.

Introduction. Unstable reentrant atrial tachycardias (ATs) (i.e. those with frequent circuit modification or conversion to atrial fibrillation) are challenging to ablate. We have tested a strategy to achieve arrhythmia stabilization into mappable stable ATs based on the detection and ablation of rotors. Methods and Results. From May 2017 to December 2019, 97 consecutive patients with reentrant ATs were ablated. Of these, 18 (18.6%) presented unstable circuits and were included. Mapping was performed using conventional high-density mapping catheters (IntellaMap ORION, PentaRay NAV or Advisor HD Grid). Rotors were subjectively identified as fractionated continuous (or quasi-continuous) electrograms on 1-2 adjacent bipoles of the mapping catheter, without dedicated software. 13 patients (72%) had detectable rotors (median 2 [1–3] rotors per patient); focal ablation achieved conversion into stable AT or sinus rhythm in 12 (92%). In the other 6 patients, sites with spatiotemporal dispersion (i.e. all the cycle length comprised within the mapping catheter) plus non-continuous fractionation on single bipoles were targeted. 17 sites with spatiotemporal dispersion were detected and focally ablated. Globally, and excluding 1 patient with spontaneous AT stabilization, ablation success to stabilize the AT was achieved in 16/17 patients (94.1%). One-year freedom from atrial arrhythmias was similar between patients with unstable and stable ATs (66.7% Vs 65.8%, p=0.946). Conclusion. Most unstable reentrant ATs show detectable rotors, identified as sites with single-bipole fractionated quasi-continuous signals, or spatiotemporal dispersion plus non-continuous fractionation. Ablation of these sites is highly effective to stabilize the AT or convert it into sinus rhythm.