A man with chronic kidney disease (CKD) under hemodialysis was diagnosed with acute promyelocytic leukemia (APL). He received arsenic trioxide as a single agent and achieved complete molecular remission without severe adverse events. Arsenic trioxide (ATO) can be used safely and effectively for APL with CKD

The dynamic adsorption isotherms of CO2-EGR were measured by using a Intelligent Gravimetric Analysis system.In the beginning stage of CO2 injection, all the injected CO2 enters into the adsorbent and the mole fraction of CH4 (yCH4) keeps 1.0. The CH4 recovery factor (RCH4) increases. The during of this stage (tcd) depends on the selectivity of CO2 over CH4 ( SCO2/CH4). A adsorbent with large SCO2/CH4 has long tCD. When SCO2/CH4 is greater than 1.0, CO2 reduces the fraction of CH4 in the adsorbed phase (xCH4) and more CH4 is driven out. In the second stage,the injected CO2 competes with CH4 for adsorption. The cumulative RCH4 of this stage is much larger than that of the initial stage. However, yCH4 decrease sharply. pCH4 in the whole CO2 injection is always larger than that before CO2 injection, suggesting CH4 desorption results from the displacement by CO2 rather than from pressure depletion.

Atrial fibrillation (AF) is the most common atrial arrhythmia but it is not a benign disease. AF is an important risk factor for thromboembolic events, causing significant morbidity and mortality. The left atrial appendage (LAA) plays an important role in thrombus formation but the ideal way to manage the LAA is still debated. The increasing popularity of surgical epicardial ablation and hybrid endo-epicardial ablation approaches, especially in patients with a more advanced diseased substrate, has raised the interest in epicardial LAA management. Minimally invasive treatment options for the LAA offer a unique opportunity to close the LAA with a clip device. This review highlights morphologic, electrophysiologic and surgical aspects of the left atrial appendage with regard to atrial fibrillation surgery, and aims to illustrate the different surgical management strategies.

This is an article that share clinical manifestation and diagnosis of patient with THR mutation, who found to have very rare mutation in THR-beta.

In considerazione della sempre minore disponibilità di acque di buona qualità, un tema, oggetto di attenzione sia scientifica che legislativa, è la possibilità di riutilizzo delle acque reflue. Obiettivo del riutilizzo è la limitazione del prelievo delle acque superficiali e sotterranee, e la riduzione degli scarichi sui corpi idrici recettori. Il trattamento biologico rappresenta la fase più importante del ciclo depurativo delle acque reflue. I naturali processi biologici sono sfruttati all’interno degli impianti a fanghi attivi (CAS). Gli impianti di depurazione MBR si sono affermati nel panorama nazionale e internazionale come una consolidata alternativa ai convenzionali impianti a fanghi attivi, in particolare laddove sia necessario contenere l’ingombro planimetrico e/o garantire un effluente di qualità elevata. L’attività di tirocinio, svolta presso il Laboratorio di Ingegneria Sanitaria Ambientale (SEED) dell’Università degli Studi di Salerno, è stata finalizzata in una prima fase allo studio approfondito e al confronto tra le tipologie di trattamento convenzionali e innovative e, nella seconda fase, alla progettazione di modelli virtuali tridimensionali che rappresentano impianti innovativi, basati sull’utilizzo della tecnologia MBR.

Abstract An 80-year-old male patient developed exertional dyspnea and bilateral peripheral oedema. Investigations including an echocardiogram, cardiac computed tomography and cardiac magnetic resonance suggested calcific pericardial thickening encapsulating the heart with associated constriction. This is an interesting case as constriction was associated with a large chylopericardium of unknown cause

In this study our aim was to assess the diversity and distribution of cavity-nesting solitary bees, wasps and the spider-hunting wasps' prey with regards to the influence of landscape context in a study area with relatively low human disturbance. The study took place between May and August 2018 at eight study sites in the hilly-mountainous central part of Romania, where the majority of the landscape is used for extensive farming or forestry. During the processing of the trap nest material, we recorded several parameters regarding the nests of different hymenopteran groups, the spider prey found inside these nests, and also tested the influence of the landscape structure surrounding the sites on both hymenopteran groups and spider prey. The majority of nests was built by the solitary wasp group of Trypoxylon, followed by Dipogon and Eumeninae. Solitary bees were much rarer, with Hylaeus being most common group. The groups showed partially differing size preferences concerning the diameter of the occupied reed stalks. In the nests of Trypoxylon we predominantly found spider prey from the family of Araneidae, followed by representatives from the families of Linyphiidae and Theridiidae. In contrast to Trypoxylon, the wasp group Dipogon preferred spider prey from the family of Thomisidae. Concerning the hymenopteran groups, significant effects of landscape structure were found on the number of both nests and brood cells of Eumeninae and on the number of brood cells of Hylaeus, Osmia and Trypoxylon. We also found that the diversity of Trypoxylon spider prey was significantly positively affected by an increasing proportion of grassland and negatively by an increasing proportion of woodland. Altogether, our study presents several new aspects concerning the diversity and distribution of solitary bees, wasps and the spider-hunting wasps' prey and also the effects of landscape context on these groups.

Species invasion represents one of the major drivers of biodiversity change globally, yet there is widespread scientific and popular confusion and controversy about the nature of non-indigenous species (NIS) impact. This confusion stems from differing notions and understanding of what constitutes invasive species ‘impact’ and the scales at which it should be assessed. I argue that the proximate mechanisms determining invasive species impact happen at smaller scales where species interact, and by understanding these mechanisms, we can scale up to a broader understanding of how invasive species impact biodiversity. The mechanisms of NIS impact on potential competitors can be classified into four scenarios: 1) minimal impact from NIS inhabiting unique niche space; 2) neutral impact spread across the community and proportional to NIS abundance; 3) targeted impact on a small number of competitors with overlapping niches; and 4) pervasive impact that is disproportionate to NIS abundance and ostensibly caused by ecosystem modification that filters out other species. I develop a statistical test to distinguish these four mechanisms based on community rank-abundance curves. Using an example dataset from plant communities invaded by the dominant invasive vine, Vincetoxicum rossicum, I show that in long-term plots that had high native plant diversity and where V. rossicum increased, impact resulted in either targeted extirpations (scenario 3) or widespread biodiversity loss (scenario 4). Regardless of whether NIS impact is neutral, targeted or pervasive, the net outcome will be the homogenization of ecosystems and reduced biodiversity at larger scales, perhaps reducing ecosystem resilience.

Prediction scores and metrics are being increasingly utilized throughout the fields of cardiothoracic and congenital cardiac surgery to identify areas for perioperative optimization or guide therapeutic intent. Here, we review a novel submission by Yang and colleagues to the Journal of Cardiac Surgery identifying preoperative factors which predict adverse postoperative outcomes from cone reconstruction for Ebstein's anomaly.

The use of radial artery (RA) grafts for coronary bypass surgery has recently gained newer attention since it has been associated with significant reduction in the risk of midterm cardiac events. Surprisingly the use on the RA graft as second ‘best’ conduit has been limited among the surgical community. There may be several explanations for the little popularity of the RA graft; one of the reasons that could prevent surgeons to include the RA in the daily surgical armamentarium it is that patients with RA grafts may require postoperative calcium-channel blocker (CB) therapy. Due to the thick muscular wall, it seems possible that the RA would needs CB in order to prevent spasm and ameliorate patency. CBs are, however, associated with important side effects; also they have hypotensive effect that can hamper the use of other therapy such as beta-blocker or angiotensin-converting enzyme inhibitors. The evidence supporting the use of CB after RA graft (either in the early phase or as chronic calcium-blocker (CCB)) is weak. A the post-hoc analysis from the ‘RADIAL’ (Radial Artery Database International ALliance), showed that in patients with RA, the use of CB for at least 12 months was associated with better clinical and angiographic outcomes at mid-term follow-up, but confounders and bias may be responsible for the reported findings (as healthier patients are more likely to tolerate CB) . This review aims to summarize current evidences available on the topic and to serve as benchmark for evidence-based decision-making for CB prescription after RA grafting.

Habitat fragmentation and infectious disease threaten amphibians globally, but little is known about how these two threats interact. In this study, we examined the effects of Brazilian Atlantic Forest habitat fragmentation on frog genetic diversity at an immune locus known to affect disease susceptibility in amphibians, the MHC IIB locus. We used a custom high-throughput assay to sequence the MHC IIB locus across six focal frog species in two regions of the Atlantic Forest. We also used a molecular assay to quantify infections by the fungal pathogen Batrachochytrium dendrobatidis (Bd). We found that habitat fragmentation is associated with genetic erosion at the MHC IIB locus, and that this erosion is most severe in frog species restricted to intact forests. Significant Bd infections were recovered only in one Atlantic Forest region, potentially due to the relatively higher elevation. In this region, forest specialists showed an increase in both Bd prevalence and loads in fragmented habitats. We also found that reduced population-level MHC IIB diversity was associated with increased Bd infection risk. On the individual-level, MHC IIB heterozygotes (by allelic genotype as well as supertype) exhibited a reduced risk of Bd infection. Our results suggest that habitat fragmentation increases infection susceptibility in amphibians, mediated at least in part through loss of immunogenetic diversity. Our findings have implications for the conservation of fragmented populations in the face of emerging infectious diseases.

1. The description and analysis of animal behaviour over long periods of time is one of the most important challenges in ecology. However, most of these studies are limited due to the time and cost required by human observers. The collection of data via video recordings allows observation periods to be extended. However, their evaluation by human observers is very time-consuming. Progress in automated evaluation, using suitable deep learning methods, seems to be a forwardlooking approach to analyse even large amounts of video data in an adequate time frame. 2. In this study we present amulti-step convolutional neural network system for detecting animal behaviour states, which works with high accuracy. An important aspect of our approach is the introduction of model averaging and post-processing rules to make the system robust to outliers. 3. Our trained system achieves an in-domain classification accuracy of >0.92, which is improved to >0.96 by a postprocessing step. In addition, the whole system performs even well in an out-of-domain classification task with two unknown types, achieving an average accuracy of 0.93. We provide our system at https://github.com/Klimroth/Video-Action-Classifier-for-African-Ungulates-in-Zoos/tree/main/mrcnn_based so that interested users can train their own models to classify images and conduct behavioural studies of wildlife. 4. The use of a multi-step convolutional neural network for fast and accurate classification of wildlife behaviour facilitates the evaluation of large amounts of image data in ecological studies and reduces the effort of manual analysis of images to a high degree. Our system also shows that post-processing rules are a suitable way to make species-specific adjustments and substantially increase the accuracy of the description of single behavioural phases (number, duration). The results in the out-of-domain classification strongly suggest that our system is robust and achieves a high degree of accuracy even for new species, so that other settings (e.g. field studies) can be considered.

I rifiuti e le problematiche derivanti dalla mancanza di un loro corretto smaltimento rappresentano un serio pericolo per la sopravvivenza del genere umano e per la conservazione dell’ecosistema. Il seguente articolo focalizza l’attenzione sull’ isola ecologica o centro di raccolta, che negli ultimi anni è tra le principali soluzioni per il miglioramento della raccolta differenziata a livello locale. Si partirà dalla progettazione di un centro di raccolta, analizzando le unità che lo caratterizzano, dopodiché si procederà con la sua descrizione attraverso un modello realizzato mediante l’utilizzo di un software e di un plastico in scala. Il lavoro svolto ha lo scopo di individuare i benefici del corretto smaltimento dei rifiuti, ma anche quello di riscontrare le problematiche che la raccolta di ciascun rifiuto crea e di individuare le possibili soluzioni.             L’ attento studio delle dinamiche di funzionamento di un’isola ecologica consente di indicare ai cittadini produttori le modalità corrette di conferimento di ogni categoria di rifiuto.

Background The purpose of this study was to determine the alterations of a specific set of miRNA levels in gastric adenocarcinoma tissues in order to identify gastric cancer specific miRNAs. Identification of the relationship between alteration of miRNA expressions and clinical features of these gastric cancer patients was set as a secondary outcome. Material and Methods Gastric adenocarcinoma and normal stomach tissue samples of 20 patients who underwent surgery for gastric cancer were studied. miRNA expression profiling was performed for 8 miRNAs (2 of which has not been studied in detail for gastric cancer) in a total of 40 tissue samples using Quantitative Reverse Transcription Polymerase Chain Reaction. Alterations in expressions were compared with the clinicopathological characteristics of the patients. Results Five out of eight miRNAs were underexpressed in malignant tissues. A decrease in the expression levels of miR-375-3p, miR-196a-5p, miR-376c-3p, miR-34c-5p, and miR-767-5p were observed. Furthermore, the expression of miR-662 was reversely related with age (r: -0,44, p: 0.04933); miR-129-3p and miR34c-5p levels were correlated with an increase in the number of metastatic lymph nodes (r: 0,47, p: 0.036495; r: 0,51, p: 0.020289); and miR-376c-3p levels were negatively associated with smoking (p: 0.04321). In addition, the variability of miRNA expression in cancerous tissues was lower than that in normal tissues. Conclusion Alterations in miRNA expressions in gastric adenocarcinoma tissues compared to healthy tissues of each individual may serve as a starting point for research and development of a diagnostic tool for gastric cancer.

Floodplains provide valuable social and ecological environment functions, and understanding the rates and patterns of floodplain sedimentation/erosion is critical for floodplain management and rehabilitation. The sediment entering the lower Yellow River has been dramatically reduced, and the geomorphology has changed greatly during the operation of the Xiaolangdi (XLD) reservoir since 2000. Utilizing sediment resources is the key to managing the downstream river, and the floodplains not only play the roles of flood mitigation, detention and de-sanding but also provide land to support local residents and economic development; however, the floodplain currently faces competition between land development and protection. This research presents a detailed investigation of changes in the sediment budget and morphology of the braided reach between Huayuankou (HYK) and Gaocun (GC) during 2000-2017 using digital elevation models (DEMs) and the historical bathymetry of the braided reach. During the implementation of the water-sediment regulation scheme (WSRS), the long-term low-concentration flow released from the XLD reservoir leads to a fully scoured long channel, further improving the bank-full discharge and reducing the risk of floods on floodplains. However, the floodplains have gradually changed from sedimentation to erosion due to the continual construction of farm dykes and control works, land use changes and other forms of land disturbance, including water and soil conservation measures and climate change. The cumulative eroded volume was approximately 11.47×108 m3 along the HYK - GC reach between 2000 and 2017, of which 3.08×108 m3 originated from the floodplains, with an average annual erosion rate of 1.3 cm/yr. To develop the economy and guide floodplain construction, we propose a new method of environmental management to reconstruct the floodplain domain into different zones for immigration resettlement areas, agricultural areas and resource development and utilization areas, with the methods of river dredging and floodplain filling.

A microcontroller based pulse width modulation implementation for multilevel quasi Z source inverter is proposed in this paper. The component design of quasi z source inverter (qZSI) is first considered with continuous and discontinuous mode of operations. The low switching frequency operation of multilevel quasi Z source inverter is proposed in this paper. The detailed modelling for qZSI is then established for effective implementation of PIC microcontroller (PIC 16F877A) for generating the switching signals. A prototype of five level quasi z-source inverter have been developed and the control signal to the gate drivers have been applied by properly adjusting the shoot through and non shoot through switching states. The hardware result shows the effective implementation of the proposed scheme.

Objectives: To evaluate the efficacy of tamsulosin, silodosin, and tadalafil as medical expulsive therapy for distal ureteral stones in men. Methods: Adult males meeting the inclusion criteria were randomized into one of four treatment arms - dexketoprofen (control group), tamsulosin (Group 1), silodosin (Group 2), and tadalafil (Group 3). The stone expulsion rate after four weeks represented the primary endpoint, while the stone expulsion rate at the end of the study and the incidence of adverse events constituted secondary endpoints. Clinical findings were compared between all four drug groups. Results: No statistically significant difference was observed among the groups in terms of age, body mass index, stone futures, expulsion time, pain episodes, or total analgesic use. Expulsion rates in the fourth week were 42.5%, 80%, 82.5%, and 75%, respectively. The stone expulsion rates in groups 1, 2, and 3 were significantly higher than in the control group (p < 0.001). However, the differences between groups 1, 2, and 3 were not statistically significant. No serious adverse effects were observed during the study period. Conclusion: The study results showed a higher expulsion rate in male patients using tamsulosin, silodosin and tadalafil for distal ureteral stones, but no significant superiority between these. All three are safe, effective, and well-tolerated, causing minimal side-effects.

Purpose: Recent studies have shown a relationship between cancer and inflammatory response. The aim of this study is to compare NLR and PLR values, which are inflammatory parameters, in precancerous and cancerous lesions and to determine whether there is a parameter that can be used in the early diagnosis of laryngeal squamous cell carcinoma. Methods:174 patients who were benign as a result of pathology, 122 patients who were malignant, 39 patients who were premalignant (335 patients in total) and 117 normal individuals were included in the study. Data groups were divided into 4 groups as Benign Laryngeal Lesion(BLL), Precancerous Laryngeal Lesion(PLL), Malignant Laryngeal Lesion(MLL) and Control Group(CG). In addition, the PLL group was subdivided into Mild Dysplasia(MiD), Moderate Dysplasia(MoD) and Severe dysplasia-carcinoma in situ (SeD/CIS). NLR, PLR and other parameters were calculated. Results: NLR and PLR values were significantly different between the groups. (p = 0.000, p = 0.002) The mean NLR was higher in the MLL and PLL groups, and was lower in the BLL and control groups. The mean PLR was also higher in the MLL and PLL groups. When the groups were compared in pairs, there was a significant difference between BLL and MLL (p = 0.001) and MLL and CG.(p = 0.006) The PLL group was subdivided into MiD, MoD and SeD / CIS. There was a significant difference in NLR when CG and other subgroups were compared.(p = 0.027) Significant differences were found between CG and SeD when the groups were compared in pairs.(p = 0.007) There was no significant difference between the groups in terms of PLR and dysplasia.(P = 0.516) Conclusion: As revealed in this study, these rates were low in the CG and BLL groups and high in the MLL group, so they could be used as markers to differentiate malignant lesions.

Most terrestrial nutrient sources are hypothesized to shift in dominance from mineral- to organic matter (OM)-derived over millennia. We investigated how overlaying this hypothesis with plant rooting dynamics that can feedback to soil development offers insight into ecosystem functioning. To test the hypothesis that the nutritional importance of OM as mineral weathering proceeds is mediated by rooting system nutrient economies that vary with vegetation development, we paired litterfall decay experiments with soil mineralogical data from diverse forests across the Critical Zone (CZ) Observatory Network. We demonstrate that sources of phosphorus shift from OM-bound stocks to minerals as the rooting zone expands during the transition from mid to late stages of forest growth. Root-driven, plant-soil feedbacks thus can prompt inconsistencies with soil development models that posit a unidirectional transition from mineral to organic nutrient dominance, and illuminate how forest growth and land use influence nutrient bioavailability in Earth’s CZ.

This paper presents the roles that religious heritage among the Yorùbá plays in sustaining their peacefulness. The Yorùbá use both formal and informal interactions to engage one another in discourses that enhance their togetherness but often faced with outside influences that can truncate their desired goals. This paper, therefore, places the Yorùbá by the established peaceful societies (PS) to see how they compare in their attitude to peacefulness and providing explanation to the Yorùbá’s effort to keep the peace despite the outside influences on their society. Please note: The bulk of this article is taken from chapter 8 of the author's doctoral dissertation with a few amendments to suit this journal. Keywords: Christian-Muslim relations, peace studies, Africa - Yorùbá, religious – ethics, culture – values, Covid-19.

Herbivore disturbance can affect the grassland ecosystem services though creating extensive disturbances vegetation and soil. This study focused on plateau pika (Ochotona curzoniae) disturbance to investigate the effect of disturbance by small burrowing herbivores on ecosystem services of alpine grasslands though five sites. In this study, the palatable plant biomass, plant species richness, soil water storage, soil organic carbon, total nitrogen, phosphorus and potassium stocks were used to estimate the forage availability, biodiversity conservation, water conservation, carbon sequestration and soil nutrient maintenance. This study showed that plateau pika disturbance was related to higher plant species richness and soil organic carbon stock, associated with lower palatable plant biomass and soil water storage, and had no effect on total potassium stock, whereas the responses of soil total nitrogen and phosphorus stocks to plateau pika disturbance were different among sites. The palatable plant biomass, plant species richness, soil organic carbon, total nitrogen and phosphorus stocks showed downward parabolas, whereas the soil water storage showed a decreasing trend with increasing plateau pika disturbance intensity. These results indicated that the role of plateau pikas is dependent not only on the management target of alpine grasslands but also on the plateau pika disturbance intensity.

Recently non-statutory allergy management guidance for schools has been produced in the United Kingdom however there has been limited progress in implementing this. The aim of this study was to evaluate the effect of face-to-face training on self-reported school staff preparedness in managing the severely allergic child and whether it would stimulate schools’ allergy policy review. A preparedness survey was conducted prior and 2 months post-intervention to assess the effect of training on self-reported preparedness and perceived confidence to manage children with food allergies. A sample of 18 (10%) primary schools that consented to participate were selected. Of the trained schools, 89% felt confident in dealing with an allergy emergency compared to 39% prior training (p=0.016). Post intervention all but one had arranged/were considering introducing allergy awareness sessions to help pupils manage their allergies (45% pre-training vs post-training 93%, p=003). Preventative measures for accidental exposure to food allergens (i.e. no food sharing policy) were adopted by all (pre-training 61% vs post- training 100%, p=0.03). A face-to-face school allergy training programme enhances self-reported staff preparedness and promotes internal allergy policy review in managing the needs of these children, hence addressing the current gap between recommendations and practice in schools.

Ursolic acid (UA) is a ursane-type pentacyclic triterpenoid compound, naturally produced in plants via specialized metabolism and exhibits vast range of remarkable physiological activities and pharmacological manifestations. Owing to significant safety and efficacy in different medical conditions, UA may serve as a backbone to produce its derivatives with novel therapeutic functions. This review systematically provides an overview of the pharmacological activities, acquisition methods and structural modification methods of UA. In addition, we focused on the synthetic modifications of UA to yield its valuable derivatives with enhanced therapeutic potential. Furthermore, harnessing the essential advances for green synthesis of UA and its derivatives by advent of metabolic engineering and synthetic biology are highlighted. In combination with the advantages of UA biosynthesis and transformation strategy, large-scale production and applications of UA is a promising platform for further exploration.

Objective: We hypothesized that omega-3 fatty acids would be an appropriate adjunct therapy for alleviating the inflammatory response and clinical manifestation in hospitalized patients with covid-19 disease. Methods: This was a single-blind randomized controlled trial in Amir-Alam hospital in Tehran. Thirty adult men and women diagnosed with covid-19 were allocated to either control group (receiving Hydroxychloroquine) or intervention group (receiving Hydroxychloroquine plus 2 grams of DHA+EPA) for 2 weeks. Primary outcome of the intervention including CRP, ESR as well as clinical symptoms including body pain, fatigue, appetite and olfactory and secondary outcomes including liver enzymes were determined at the baseline and after omega-3 supplementation. Clinical signs were measured using self-reported questionnaires. There were commercial kits for determination of CRP and liver enzymes concentrations in the serum of patients. For determination of ESR automated hematology analyzer was applied. Results: In comparison to control group, patients receiving omega-3 indicated favorable changes in all clinical symptoms except for olfactory ((p<0.001 for body pain and fatigue, p= 0.03 for appetite and p=0.21 for olfactory). Reducing effects of omega-3 supplementation compared to control group were also observed in the levels of ESR and CRP after treatment (p<0.001 for CRP and p=0.02 for ESR). However, no between group differences in the liver enzymes serum concentrations were observed after supplementation (p>0.05). Conclusion: Current observations are very promising and indicate that supplementation with moderate dosages of omega-3 fatty acids may be beneficial in the management of inflammation-mediated clinical symptoms in covid-19 patients. Key words: Covid-19, omega-3, inflammation, clinical symptoms