This paper deals with the study of photothermoelastic interactions in an isotropic homogeneous semiconductor solid, using a new model of generalized thermoelectricity with a memory-dependent derivative of heat conduction. The plasma and thermal effects study of semiconductor structures include the simulation of a complex system using simultaneous analysis of carrier density, thermal waves, and elastic wave equations. On this topic, there are few research works that have been achieved. To investigate the problem, Tzou’s generalized theory is employed. The governing equations of the system are derived based on the dual-phase lag model (DPL) and the wave equation of coupled plasma. We examined the transient response of a rotating solid cylinder subjected to the applied magnetic field and a time-dependent heat flow under the new proposed model. The analytical expressions for the investigated fields are derived by using the Laplace transform process and the numerical results are graphically previewed. A comparison of the numerical results is provided for various models of thermoelasticity as well as the impact of memory- dependent derivatives. The effects of rotation, time-delay and the kernel function are also investigated

The management of Post-Dural Puncture Headache; a prospect from a low and middle-income country: A viewpoint.

BACKGROUND: COVID-19 has significantly impacted the healthcare landscape in the United States in a variety of ways including a nation-wide reduction in operative volume. The impact of COVID-19 on the availability of donor organs and the impact on solid organ transplant remains unclear. We examine the impact of COVID-19 on a single, large-volume heart transplant program. METHODS: A retrospective chart review was performed examining all adult heart transplants performed at a single institution between March 2020 and June 2020. This was compared to the same time frame in 2019. We examined incidence of primary graft dysfunction (PGD), continuous renal replacement therapy (CRRT) and 30-day survival. RESULTS: From March-June 2020, 43 orthotopic heart transplants were performed compared to 31 performed during 2019. Donor and recipient demographics demonstrated no differences. There was no difference in 30-day survival. There was a statistically significant difference in incidence of post-operative CRRT (9/31 v. 3/43; p = .01). There was a statistically significant difference in race (23W/8B/1AA v. 30W/13B; P=.029). CONCLUSION: We demonstrate that a single, large-volume transplant program was able to grow volume with little difference in donor variables and clinical outcomes following transplant. While multiple reasons are possible, most likely the reduction of volume at other programs allowed us to utilize organs to which we would not have previously had access. More significantly, our growth in volume was coupled with no instances of COVID-19 infection or transmission amongst patients or staff due to an aggressive testing and surveillance program.

A 14-year-old boy presented to our Emergency Department complaining of fever, and abdominal pain. An abdominal computed tomography showed a large abscess of the spleen. Percutaneous aspiration of the lesion was performed. Splenectomy was performed 38 days after percutaneous aspiration because of the abscess's considerable size.

Introduction: Left and right atrial volume indices (LAVI and RAVI) are markers of cardiac remodeling. LAVI and RAVI are associated with worse outcomes in other cardiac conditions. This study aimed to determine the association of LAVI and RAVI with survival time post-cardiac arrest. Hypothesis: Atrial volumes will be associated with survival time post cardiac arrest. Methods: This was a single academic center, retrospective study of patients with a cardiac arrest event during index hospitalization from 2014-2018. LAVI was calculated using a biplane Simpson’s method, while RAVI was calculated using a single plane summation in the 4-chamber view. Patients were further stratified into either having a Vfib/pulseless VT (pVT) event or a PEA arrest/asystole event. Survival time was measured in days from event to death date. Kaplan-Meier plots were used to evaluate differences in survival time for patients based on mean LAVI and RAVI. Results: Of 305 patients studied (64 +/- 14 years, 37% female (112 out of 305)), 162 had reliable LAVI measurements with a mean of 34.1 mL/m2 (SD=15.8) and163 had reliable RAVI measurements with a mean of 25.1 mL/m2 (SD=15.5). In patients who had sustained VFib/pVT, those with reduced LAVI (p=0.045) and RAVI (p=0.041) values below the mean had significantly improved survival time. No association was found in PEA/asystole. KM plots of patient survival for both LAVI and RAVI compared to mean are presented in figures 1a and 1b. Conclusion: Among patients presenting with a Vifb/pVT arrest, increased LAVI and RAVI were associated with decreased survival time.

Respiratory syncytial virus (RSV) infection is the leading cause of bronchiolitis among infants <12 months old. It is widely known that coinfections between RSV and other viruses can worsen the clinical picture of affected patients. To evaluate the severity of clinical pictures of bronchiolitis in the 2019-2020 winter season, we performed a retrospective study of our third-level Pediatric Emergency Department (ED) admission charts. From February 2 to March 9, 2020 (start date of the Italian lockdown), we observed a peak of patients with a clinical picture of bronchiolitis requiring oxygen therapy of 55.1%, compared with 18% and 14.5% during the same period in 2017-2018 and 2018-2019, respectively (p<0.0001), without other clinically significant differences between the groups. Several authors hypothesized that SARS-CoV2 was present in northern Italy some weeks be-fore the first confirmed case. We suggest that one of the causes of this unexpected severe bronchiolitis peak may be a SARS-CoV2 - RSV coinfection in a period when SARS-CoV2 was already circulating in north-ern Italy. Given the lack of real-time polymerase chain reaction (RT-PCR) tests for SARS-CoV2 at that time, our suggestion remains a hypothesis.

This is the first case of adefovir dipivoxil (ADV)-induced hypophosphatemic osteomalacia (HO) and Fanconi’s syndrome in which bone mineral density (BMD) is continuously reduced after drug discontinuation. Sustained elevation of urine β2-MG also supports the recent view that ADV-induced renal injury is not completely reversible.

Objective: To study the profile of patients with obstructive sleep apnea syndrome (OSAS) and laryngopharyngeal reflux (LPR) at the hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH) and to compare their reflux findings with LPR patients without OSAS. Design: Prospective controlled study. Methods: Patients with LPR and OSAS were prospectively recruited from Augustus 2019 to June 2020. The profile of hypopharyngeal reflux events (HRE) of patients was studied through a breakdown of the HEMII-pH findings over the 24-hour of testing. Reflux symptom score (RSS), gastrointestinal and HEMII-pH outcomes were compared between LPR patients and patients with LPR and OSAS. Multivariate analysis was used to study the relationship between reflux data and the following sleep outcomes: Apnea-Hypopnea Index, Epworth Slippiness Scale (ESS) and paradoxical sleep data. Results: A total of 89 patients completed the study. There were 45 patients with LPR and 44 subjects with both OSAS and LPR. The numbers of upright and daytime HREs and the otolaryngological RSS were significantly higher in patients with LPR compared with those with OSAS and LPR. There was a significant positive association between RSS quality of life score and ESS (p=0.001). The occurrence of HREs in the evening was associated with higher ESS (p=0.015). Patients with OSAS, LPR and GERD had higher number of nocturnal HREs compared with those without GERD (p=0.001). Conclusion: The presence of OSAS in LPR patients is associated with less severe HEMII-pH and ear, nose and throat symptoms. There may have different OSAS patient profiles according to the occurrence of GERD.

Cutaneous Larva MigransTakahiro Matsuo M.D.1, Toshiaki Nakano M.D.2, Nobuyoshi Mori M.D.11 Department of Infectious Diseases, St. Luke’s International Hospital, Tokyo, Japan2 Department of Dermatology, St. Luke’s International Hospital, Tokyo, JapanKeywords: cutaneous larva migrans, bilateral, hookwormTotal word count: 99 words

In spring of 2012, we studied the feeding habits of snow leopard using a comprehensive approach that combines fecal genetic sampling, macro and microscopic analysis of snow leopard diets and direct observation of Naur and livestock in Kangchenjunga Conservation Area of east Nepal. Out of collected 88 putative snow leopard scat samples from 140 transects (290 km) in 27 (4*4 km2) sampling grid cells, 83% were confirmed to be from snow leopard. The genetic analysis accounted for 19 individual snow leopards (10 male and 9 female) with a mean population size estimate of 24 (95% CI: 19- 29), and an average density of 3.9 snow leopards/100 km2 within 609 km2. Total available prey biomass of Naur and Yak was estimated at 355,236 kg (505 kg yak/km2 and 78 kg Naur/km2). From the available prey biomass, we estimated snow leopards consumed 7% annually which was comprised of wild prey (49%), domestic livestock (45%), and 6% unidentified items. The estimated 47,736 kg Naur biomass gives a snow leopard-Naur ratio of 1: 59 on a weight basis. The proportion of young Naur was estimated at 17%, with an almost double predation rate at 28%. Predators such as common leopard and wolf share the same habitat and might compete with snow leopard for prey which will likely influence future predator-prey associations in KCA. Along with livestock insurance scheme improvement, there needs to be a focus on improved livestock guarding as well as engaging and educating local people to be citizen scientists on the importance of snow leopard conservation, involving them in long-term monitoring programs and promotion of ecotourism.

The mycorrhizal symbiosis is ubiquitous in boreal forests. Trees and plants provide their fungal partners with photosynthetic carbon in exchange for soil nutrients like nitrogen, which is critical to the growth and survival of the plants. But plant carbon allocation to mycorrhizal symbionts can also fuel nitrogen immobilization, hampering tree growth. Here we present results from field and greenhouse experiments combined with mathematical modelling, showing that mycorrhizal fungi can be simultaneously mutualistic to an individual tree and parasitic to the networked community of trees. Mycorrhizal networks connect multiple plants and fungi, and we show that each tree gains additional nitrogen at the expense of its neighbors by supplying more carbon to the fungi. But this additional carbon supply eventually aggravates nitrogen immobilization in the shared fungal biomass. Individual trees may thus independently benefit from increasing their carbon investment to mycorrhiza, while causing a decline in nitrogen availability for the whole plant community. We illustrate the evolutionary underpinnings of this situation by drawing on the analogous the tragedy of the commons, and explain how rising atmospheric CO2 may lead to greater nitrogen immobilization in the future.

It's easy to miss diagnosis of insidious onset uterine rupture in a pregnant woman without obvious risk factors. This can impair timely management with increased fetal and maternal mortality. We present such an unusual encounter which otherwise in the absence of suspicious hand could have easily resulted in maternal demise.

While 1992 marked the first major dam – Manwan – on the main stem of the Mekong River, the post-2010 era has seen the construction and operationalisation of mega dams such as Xiaowan (started operations in 2010) and Nuozhadu (started operations in 2014) that were much larger than any dams built before. The scale of these projects implies that their operations will likely have significant ecological and hydrological impacts from the Upper Mekong Basin to the Vietnamese Delta and beyond. Historical water level and water discharge data from 1960 to 2020 were analysed to examine the changes to streamflow conditions across three time periods: 1960-1991 (pre-dam), 1992-2009 (growth) and 2010-2020 (mega-dam). At Chiang Saen, the nearest station to the China border, monthly water discharge in the mega-dam period has increased by up to 98% during the dry season and decreased up as much as -35% during the wet season when compared to pre-dam records. Similarly, monthly water levels also rose by up to +1.16m during the dry season and dropped by up to -1.55m during the wet season. This pattern of hydrological alterations is observed further downstream to at least Stung Treng (Cambodia) in our study, showing that Mekong streamflow characteristics have shifted substantially in the post-2010 era. In light of such changes, the 2019-2020 drought – the most severe one in the recent history in the Lower Mekong Basin – was a consequent of constructed dams reducing the amount of water during the wet season. This reduction of water was exacerbated by the decreased monsoon precipitation in 2019. Concurrently, the untimely operationalisation of the newly opened Xayaburi dam in Laos coincided with the peak of the 2019-2020 drought and could have aggravated the dry conditions downstream. Thus, the mega-dam era (post-2010) may signal the start of a new normal of wet-season droughts.

Introduction Little is known on the effect of catheter contact angle on lesion formation and durability of pulmonary vein isolation (PVI). Methods Both in vitro experiment and retrospective observational study were conducted. For in vitro experiment, radiofrequency lesions were created on explanted swine hearts in three different catheter contact angles (0°, 45°, and 90°). In the retrospective observational study, we assessed patients who had undergone repeat catheter ablation due to atrial fibrillation recurrence after initial PVI. When pulmonary vein (PV) reconnection was observed, we analyzed the previous ablation points within and without the gap area. The gap areas were defined where ablation had changed the PV activation sequence or eliminated the PV potential in the repeat session. Results In the in vitro experiment, lesion width was the smallest (5.3 ± 0.4 mm) in perpendicular contact compared to 0° (vs 5.8 ± 0.5 mm, p=0.040) and 45° (vs 6.4 ± 0.4 mm, p<0.001). In the retrospective observational study, we assessed 666 tags of 16 patients with PV reconnections, and 60 tags were in the gap area. Tags in the gap area had longer interlesion distance (odds ratio [OR] 1.49, p < 0.001), greater contact force variability (OR 1.03, p = 0.008), and higher rate of perpendicular contact (OR 3.26, p < 0.001) on multivariate analysis. Conclusion Perpendicular contact was associated with a smaller lesion and higher rate of PV reconnection.

Background: An oral food challenge (OFC) is required for diagnosing food allergies; however, uncertain reactions can impair the determination of when to stop the test. We aimed to determine the associations between immediately occurring mild allergic skin signs/laryngeal symptoms and positive OFC results. Methods: We retrospectively included children (aged 6 months to 15 years) who underwent open OFC for hen’s egg (HE), cow’s milk (CM), or wheat at a single centre between May 2012 and March 2020. Participants with mild skin signs or laryngeal symptoms at OFC initiation were classified as “skin” or “laryngeal” cases, respectively. Using logistic regression, the risk of positive OFC results, in a skin or laryngeal case, was assessed using univariate and multivariate analyses. Age, sex, total target dose, and serum levels of total and food-specific immunoglobulin E were used as covariates in prediction models. Results: In total, 2954, 1126, and 850 tests for HE, CM, and wheat, respectively, were included and comprised 115 (4%) and 25 (0.9%), 92 (9%) and 24 (2%), and 7 (1.3%) and 0 (0%) skin and laryngeal cases, respectively. Children with reactions to both HE and CM had a higher risk of a positive OFC than controls (odds ratio [95% confidence interval]: 4.6 [3.3–6.4], 2.9 [2.0–4.1] and 6.5 [3.0–10.9], 4.9 [2.2–10.9], respectively). Areas under the curves of prediction models ranged from 0.61 to 0.71. Conclusions: Uncertain reactions immediately after test initiation could not robustly predict OFC results, indicating the OFC could be continued under careful observation.

1. Phyllostomid bats exhibit great diversity in skull size and morphology that reflects the degree of resource division and ecological overlap in the group. In particular, Stenodermatinae has high morphological diversification associated with cranial and mandibular traits that is associated with the ability to consume the full range of available fruits (soft and hard). In terms of morphology, performance (bite force) appears to play an important role in niche partitioning among bat species, however, very few studies have confirmed these relationships using functional cranial traits. 2. Here, we analyzed craniodental traits and their relationship to the bite force in 308 specimens distributed in seven species of stenodermatine bats with two foraging types: nomadic and sedentary frugivorous bats. We evaluated 19 functional traits of the skull and jaw related to feeding and bite force in live animals by correcting bite force with body size. We used a GLM model and post hoc tests to determine possible relationships and differences between cranial traits, species, and sex. 3. The results showed that there is significant interspecific variation between stenodermatines that are nomadic and sedentary. The greatest variation in bite force within species was explained by the mandibular toothrow length (MANDL) between sexes, which was greater in females. The larger species of Artibeus, together with Platyrrhinus helleri, Uroderma convexum and Sturnira giannae, which have a greater length of the skull, condylo-incisor, condylo-canine, mandibular toothrow and height of the coronoid, exhibit greater bite force. By contrast, the smaller species A. anderseni and A. phaeotis have short skulls and the lowest values of bite force, which suggests that the size of the skull confers a biomechanical advantage. 4. Our results highlight the usefulness of analyzing functional traits related to feeding to establish the performance of bats in terms of the bite force.

Stretchable gas barrier films achieved by hydrogen-bond self-assembly of nano-brick multilayers

Product formulations for industrial processes are typically developed at lab-scale. However, the mixing conditions are not easily mimicked in the lab. A rotational device is proposed in this work as a fast lab-scale formulation development, which enables mimicking the mixing conditions in the industrial process. The geometrical configurations of the rotational device are from rheometry devices (plate-plate and cone-plate). The main advantages of this method are the small amounts of raw materials, and shorter testing times. This methodology is applied to an industrial case study, the Reaction Injection Moulding (RIM) process. The mixing length scales evolution in the rotational rheometer were matched to those in RIM machines. The main novelty of this work is the introduction of a protocol that bridges the processing conditions at lab using small amounts of raw materials to high throughput continuous flow reactors.

A rare case of mixed total anomalous pulmonary venous connection (TAPVC) associated to right extra-lobar bronchopulmonary sequestration (BPS) was diagnosed at birth in a full-term newborn. At one month of age, the patient underwent embolization of the BPS, complicated by coil entrapment in the right common iliac artery requiring urgent laparotomy. Few days later, the congenital cardiac repair was accomplished uneventfully. At 12-months follow-up, the patient did not have pulmonary hypertension, but presented a moderate stenosis of the right femoral artery, which was effectively treated with anticoagulation therapy.

Patients with bicuspid aortic valve (BAV) represent a significant proportion of adults with severe aortic stenosis (AS) requiring aortic valve intervention (AVI). Evidence is discordant concerning progression of AS in BAV. The aim of this study was to compare baseline characteristics and the impact of the aortic valve phenotype on major cardiovascular outcomes. Methods: Retrospective observational study (consecutive AS in database, 2014-2016, third-level institution). Baseline characteristics were compared between BAV (n = 43) and tricuspid (TAV) (n = 159) patients. Primary end point was a composite of mortality and AVI. Survival analysis and logistic regression analysis was used to identify predictors of primary end-point. Results: 202 patients (72.2 ± 13.4 years, 63% men) were included. Patients with TAV were older, had more comorbidities and less aorta dilation. No significant differences were observed in the primary end point between the two valve phenotypes (34.8 vs. 40.8%; p=0.47, follow-up of 3.2 ± 1.6 years). In BAV group most of the events were at the expense of AVI (32.5 vs. 13.8%; p=0.001). The incidence of CV death was similar between both groups (4.8% vs. 12%, p=0.25). Non-CV mortality was higher in TAV group (16.8% vs 0%, p=0.001). Vmax and dimensionless index were independently associated with primary end point (p<0.001). Conclusions: Patients with AS have a high incidence of all-cause mortality and aortic valve intervention, regardless of valve phenotype. In particular, patients with BAV present different clinical characteristics with lower overall mortality and a more advanced AS when requiring aortic valve intervention.

Odd chain fatty acids (C15:0 and C17:0) from dairy fat as well as odd chain phenolic lipids (alkylresorcinols) from whole grain are commonly reviewed as candidate biomarkers for dietary analysis and their ingestion are inversely related to chronic disease risks. Therefore, low levels of dietary intake of these odd chain molecules may be related to higher risk of physiological states that cause chronic diseases or mortality. It is a prerequisite to examine and understand their main role in beneficial health effects in disease prevention. We propose odd chain fatty acids (OC-FA) and most importantly odd chain phenolic lipids (OC-PL) as potential essential dietary compounds since they play key roles in physiological mechanisms. This review evaluates potential roles of OC-FA and OC-PL in mitigating chronic diseases in vitro and in vivo studies to support our hypothesis for odd chain molecules as essential dietary lipids. Further studies are needed to investigate the relationship between reduced intake of OC-FA and OC-PL containing foods and susceptibilities to chronic diseases.

White-nose syndrome (WNS) has decimated hibernating bat populations across eastern and central North America for over a decade. Disease severity is driven by the interaction between bat characteristics, the cold-loving fungal agent, and the hibernation environment. While we further improve hibernation energetics models, we have yet to examine how spatial heterogeneity in host traits is linked to survival in this disease system. Here we develop predictive spatial models of body mass for the little brown myotis (Myotis lucifugus) and reassess previous definitions of the duration of hibernation of this species. Using data from published literature, public databases, local experts, and our own fieldwork, we fit a series of generalized linear models with hypothesized abiotic drivers to create distribution-wide predictions of pre-hibernation body fat and hibernation duration. Our results provide improved estimations of hibernation duration and identify a scaling relationship between body mass and body fat; this relationship allows for the first continuous estimates of pre-hibernation body mass and fat across the species’ distribution. We used these results to inform a hibernation energetic model to create spatially-varying fat use estimates for M. lucifugus. These results predict that WNS mortality of newly and soon-to-be infected M. lucifugus populations in western North America may be comparable to the substantial die-off observed in eastern and central populations.

An 11-year-old boy affected by pulmonary atresia with intact ventricular septum (AP-IVS) was listed for percutaneous pulmonary valvuloplasty and closure of multi-fenestrated atrial septal defect (ASD). Intraprocedural transesophageal echocardiography arose the suspect of abnormal coronary artery pattern while selective angiography documented a single sinoatrial node artery (SANa) with an unusual retro-aortic course. As consequence, we proceeded to effectively close the defects with a not self-centering device placed in the most central side hole. This case supports the hypothesis that sometimes arrhythmic complication during ASD closure procedures might be due to unrecognized injury of the SANa.

Introduction: Children treated for cancer with a central venous catheter are often bothered by scarring. We studied whether glucocorticosteroid during patch occlusion has a beneficial effect on scar outcome in children and adolescents treated for neoplastic disease. Methods: A double-blinded placebo-controlled randomized clinical trial was performed. The main outcome was the Vancouver Scar Scale (VSS). Secondary outcomes were scar width and scar quality measured using the Patient and observer scar assessment (POSAS). The patients were divided into an intervention groups and a control group. The intervention group was randomized into two groups; Active and placebo group. The active treatment consisted of cream with glucocorticosteroid and fusidic acid. The placebo treatment consisted of cream with fusidic acid. Both groups were also treated with a silicone gel patch for three months after central venous catheter removal. The control group did not receive any specific skin care. Results: Assessment at 6 months were completed for 44 in the intervention group (21 in the active and 23 in the placebo group) and 47 in the comtrol group. The intervention group had a significantly lower VSS and a smaller scar compared to the control group (p = 0.00, p = 0.02). The POSAS by the patients and the study nurse showed no significant difference between the intervention and control groups (p = 0.84, p= 0.36). Conclusions: Silicone gel sheet alone or in combination with application of glucocorticosteroid during sheet occlusion improved scar outcome after removal of central venous catheter in children treated for neoplastic diseases.