Aiming at improving the visible-light photocatalytic activities of TiO2(101) surface (TiOS) we make an in-dept study on the TiOS doped with 4d transition metal (TM) atoms. It is shown that the 4d TM dopings can not only produce new impurity energy bands in the bandgap but also result in the semiconductor-metal phase transition. Consequently, the visible-light absorption is strongly strengthened due to the dopings of Y, Zr, Nb, Mo, and Ag, while it is only weakly improved for Tc, Ru, Rh, Pd, and Cd dopings. The improvement in visible-light absorption can be attributed to the intraband or interband transition of electrons. Moreover, the photocatalytic activities are explored, and we find Y and Ag dopings can effectively enhance the photocatalytic activity of TiOS. Thus the mechanism of improving photocatalytic activity of TiOS has been clearly addressed, which is beneficial to further experimental and theoretical researches on TiO2 photocatalysts.

Nell’ottica di una progettazione in cui si fa sempre più attenzione ad uno sviluppo sostenibile, assume particolare importanza la valutazione di impatto ambientale, attraverso la quale si valuta l’impatto positivo e negativo che l’opera ha sui diversi fattori ambientali. In questo articolo verrà trattato, nello specifico, il comparto vegetazione, flora e fauna per il quale si dispone di un vasto quadro normativo che nel corso del tempo ha subito una forte evoluzione.Allo scopo di una più profonda comprensione della materia, si esporrà un caso studio relativo alla realizzazione di un impianto eolico e si valuteranno gli effetti che questo ha sulle componenti ambientali vegetazione, flora e fauna.

Rationale, Aims and Objectives: One of the sectors challenged by the COVID-19 pandemic is medical research. COVID-19 originates from a novel coronavirus (SARS-CoV-2) and the scientific community is faced with the daunting task of creating a novel model for this pandemic or, in other words, creating novel science. This paper aims to explore the intricate relationship between the different challenges that have hindered biomedical research and the generation of scientific knowledge during the COVID-19 pandemic. Methods: During the early stages of the pandemic, research conducted on hydroxychloroquine (HCQ) was chaotic and sparked several heated debates with respect to the scientific methods used and the quality of knowledge generated. Research on HCQ is used as a case study in this paper. The authors explored biomedical databases, peer-reviewed journals, pre-print servers and media articles to identify relevant literature on HCQ and COVID-19, and examined philosophical perspectives on medical research in the context of this pandemic and previous global health challenges. Results: This paper demonstrates that a lack of prioritization among research questions and therapeutics was responsible for the duplication of clinical trials and the dispersion of precious resources. Study designs, aimed at minimizing biases and increasing objectivity, were, instead, the subject of fruitless oppositions. These two issues combined resulted in the generation of fleeting and inconsistent evidence that complicated the development of public health guidelines. The reporting of scientific findings highlighted the difficulty of finding a balance between accuracy and speed. Conclusions: The COVID-19 pandemic presented challenges in terms of (1) finding and prioritizing relevant research questions, (2) choosing study designs that are appropriate for a time of emergency, (3) evaluating evidence for the purpose of making evidence-based decisions and (4) sharing scientific findings with the rest of the scientific community. This paper demonstrates that these challenges have often compounded each other.

May-Thurner syndrome (MTS), also known as iliac vein compression syndrome which results in luminal narrowing and intimal hyperplasia, which predispose to venous stasis and recurrent deep vein thromboembolism (DVT) We present a 32-year-old woman with MTS who developed recurrent deep venous thromboses despite undergoing thrombectomy and being on recommended anticoagulation.

The active rock glacier “Innere Ölgrube”, and its catchment area (Ötztal Alps, Austria) are assessed using various hydro(geo)logical tools to provide a thorough catchment characterization and to quantify temporal variations in recharge and discharge components. During the period from June 2014 to July 2018, an average contribution derived from snowmelt, ice melt and rainfall of 35,8 %, 27,6 % and 36,6 %, respectively, is modelled for the catchment using a rainfall-runoff model. Discharge components of the rock glacier springs are distinguished using isotopic data as well as other natural and artificial tracer data, when considering the potential sources rainfall, snowmelt, ice melt and groundwater. Seasonal as well as diurnal variations in runoff are quantified and the importance of shallow groundwater within this rock glacier-influenced catchment is emphasized. Water derived from ice melt is suggested to be provided mainly by melting of two small cirque glaciers within the catchment and subordinately by melting of permafrost ice of the rock glacier. The active rock glacier is characterized by a layered internal structure with an unfrozen base layer responsible for groundwater storage and retarded runoff, a main permafrost body contributing little to the discharge (at the moment) by permafrost thaw and an active layer responsible for fast lateral flow on top of the permafrost body. Snowmelt contributes at least 1/3rd of the annual recharge. During droughts, meltwater derived from two cirque glaciers provides runoff with diurnal runoff variations; however, this discharge pattern will change as these cirque glaciers will ultimately disappear in the future. The storage-discharge characteristics of the investigated active rock glacier catchment are an example of a shallow groundwater aquifer in alpine catchments that ought to be considered when analysing (future) river runoff characteristics in alpine catchments as these provide retarded runoff during periods with little or no recharge.

Rock glaciers are increasingly influencing the hydrology and water chemistry of Alpine catchments, with important implications for drinking water quality and ecosystem health under a changing climate. During summers of 2017 - 2019, we monitored the physical and chemical conditions of springs emerging from two active rock glaciers (ZRG and SRG) with distinct geomorphological settings in the Eastern Italian Alps (Solda/Sulden catchment). Both springs had constantly cold waters (1.4 ± 0.1 °C), and their ionic composition was dominated by SO42-, HCO3-, Ca2+ and Mg2+. Concentrations of major ions and trace elements, and values of water isotopes (δ18O, δ2H), increased towards autumn with an asymptotic trend at SRG, and a positive unimodal pattern at ZRG, where concentrations peaked 60 - 80 days after the end of the snowmelt. Wavelet analysis on electrical conductivity (EC) and water temperature records revealed daily cycles only at SRG, and significant weekly/biweekly fluctuations at both springs attributable to oscillations of meteorological conditions. Several rainfall events triggered a transient (0.5 - 2 hrs) EC drop and water temperature rise (dilution and warming) at SRG, whereas only intense rainfall events occasionally increased EC at ZRG (solute enrichment and thermal buffering), with a long-lasting effect (6 - 48 hrs). Our results, supported by a limited but emerging literature, suggest that: i) the distinctive composition of the bedrock drives different concentrations of major ions and trace elements in rock glacier springs; ii) pond-like and stream-like springs have distinct fluctuations of water parameters at different timescales; iii) peaks of EC/solute concentrations indicate a seasonal window of major permafrost thaw for rock glaciers feeding pond-like springs. These results provide a first quantitative description of the hydrological seasonality in rock glacier outflows, and their hydrochemical response to precipitation events, bringing relevant information for water management in the European Alps under climate change.

Species interact both within and across communities, forming complex networks of biotic interactions and spatial links that underpin ecosystem functioning. However, while recent technological advances permit the analysis of increasingly complex and realistic ecological networks, data availability remains a major challenge. Here, we present a novel approach that uses readily available ecological data to build spatially-structured species interaction networks and predict metacommunity responses to environmental change. Predictive Multilayer Networks (PMNs) model the distributions, interspecific interactions, and spatial connectivity of multiple species across a landscape and quantify network structure and stability. We provide a proof-of-concept using a simulated plant-pollinator community, measure network centrality to identify areas of high functional connectivity, and compare land cover scenarios to predict effects of forest loss and restoration on PMN connectance and robustness. PMNs synthesize network approaches from community and landscape ecology and offer a flexible, predictive approach for examining the spatial dynamics of species interactions.

Background:In this study, we investigated predictors of favourable responses to CRT using electrocardiography parameters in heart failure patients. Methods : Seventy-two patients with heart failure, sinus rhythm, left bundle branch block and receiving CRT were included in the study. Patients were classified as “responders” with an improvement in ejection fraction of 10% and “non-responders” as any patient not meeting this definition. Electrocardiograms were evaluated before and after 6 months CRT implantation. Results: There was no difference between responder and non-responder groups in terms of age, co-morbidities, medications, pre-implantation ECG parameters (p>0.05). A number of women CRT-responders higher than non-responder (25.4 % vs 6 %, p=0.026), and NYHA Class III patients dominantly in CRT-responder groups (36.9 % vs 29.2 %, p=0.014, respectively).Post–implantation QRS duration (143.3± 18.6 vs 160.1 ± 29.2 ms), cQT interval (474.8 ± 43.4 vs 502.7 ± 49.6 ms), T-wave (165.6 ± 25.7 vs 192.1 ± 25.0 ms) and T peak-end (82.9 ± 13.2 vs 98.1 ± 13.3 ms) values were very shorter in CRT responders group (p<0.05). In univariate regression analyses showed shortening of QRS, QT interval, T-wave, Tpeak-end interval associated with favourable response to CRT (p<0.05). The receiver operating characteristics curve analyses were showed the optimal cut-off T-wave <182 ms, with 76 % sensitivity, 75 % specificity, and Tpeak-end interval < 92 ms with 80 % sensitivity, for the favourable response CRT (p<0.05). Conclusion: QRS duration and QT interval narrowing are known to be associated with favourable outcomes, although the T-wave duration and T peak-to-end interval may also be considered in heart failure patients to predict a favourable CRT response.

Involvement of small airways, those of less than 2 mm in internal diameter, is present in all stages of asthma and contributes substantially to the pathophysiologic expression of asthma. Therefore, small airways are increasingly viewed as a potential target in optimal asthma control. Airway tone, which is increased in asthma, is mainly controlled by the vagus nerve that releases acetylcholine (ACh) and activates muscarinic ACh receptors (mAChRs) post-synaptically on airway smooth muscle (ASM). In small airways, M3 mAChRs are expressed, but there is no vagal innervation. Non-neuronal ACh released from the epithelial cells that may express choline acetyltransferase (ChAT) in response to inflammatory stimuli, as well as from other structural cells in the airways, including fibroblasts and mast cells, can activate these receptors. By antagonizing M3 mAChR, the contraction of the ASM is prevented and, potentially, local inflammation can be reduced and the progression of remodeling may be affected. In fact, ACh also contributes to inflammation and remodeling of the airways and regulates the growth of ASM. Several experimental studies have demonstrated the potential benefit derived from the use of mAChR antagonists, mainly long-acting mAChR antagonists (LAMAs), on small airways in asthma. However, there are several confounding factors that may cause a wrong estimation of the relationship between LAMAs and small airways in asthma.

Aim: Bibliometrics has been used for assessing and predicting trends in macro-health science and medical systems, especially in the field of cancer. Bibliometric and scientometric studies in the field of cytokines may guide further research in this field. Cytokines in particular cytokine storm has recently started to be highly discussed and studied in global viral infections. In the SARS-CoV-2 pandemic, cytokine storm was seen in many patients. In this study we want to present to perform bibliometric analysis of articles on cytokine and cytokine storm published in the academic literature during 1980 to 2018. Methods: The bibliometric analysis was performed using the Thomson Reuters Web of Science database. Results: A total of 232,606 articles were retrieved, 82.52% of which were original articles. The United States was the leading country by total publication number (n=84,426, 36.29%), followed by Japan (n= 21,983, 9.45%) produced the most literature on cytokine. Among the institutions identified, Harvard University (USA) contributed the most articles on cytokine. All authors and institutions in the top 10 contributor’s lists were from the developed countries. Conclusions: Researchers from the developing and least-developed countries should be encouraged to perform novel studies on cytokine. Cytokine studies are associated with the pathology and physiological variability of many diseases and may have beneficial results in the medical field. Cytokine and cytokine storm studies may be particularly useful in identifying the pathogenesis of global viral infections such as SARS-CoV-2, evaluating and developing new treatment strategies.

Background: Pediatric cancer patients and survivors have historically struggled to receive adequate educational supports. In the Spring of 2020, the COVID19 pandemic forced an emergency switch from traditional in-person education models to distance education. Methods: The current study presents initial data from a quality improvement project which included a round of qualitative interviews conducted with parents of pediatric oncology patients at risk for educationally-relevant neurocognitive impacts of disease or treatment. The focus of the interviews was patient experiences of education and instructional delivery during the COVID19 school closures in Spring of 2020 and the beginning of the 2020-2021 school year; interviews were conducted via videoconference and transcripts were analyzed using a phenomenological approach. Results: Three emergent themes were found regarding the shared experiences of distance schooling for children with cancer during the COVID19 school closures: 1) attention, 2) mental health, and 3) access to instruction. This study describes and explores each theme and offers suggestions for changes to provider service delivery as a result of new pandemic-related schooling needs.

The aim of this work is to prove analytically the existence of symmetric periodic solutions of the family of Hamiltonian systems with Hamiltonian function H(q_1,q_2,p_1,p_2)= 1/2(q_1^2+p_1^2)+1/2(q_2^2+p_2^2)+ a q_1^4+b q_1^2q_2^2+c \q_2^4 with three real parameters a, b and c. Moreover, we characterize the stability of these periodic solutions as function of the parameters. Also, we find a first-order analytical approach of these symmetric periodic solutions. We emphasize that these families of periodic solutions are different from those that exist in the literature.

Objectives: To estimate the cost-effectiveness of alternative risk-dictated strategies utilizing prophylactic tranexamic acid (TXA) for the prevention of postpartum hemorrhage (PPH).Study Design: We constructed a microsimulation-based Markov decision-analytic model estimating the cost-effectiveness of three alternative risk-dictated strategies for TXA prophylaxis versus the status quo (no TXA) in a cohort of 3.8 million pregnant women delivering in the United States. Each strategy differentially modified risk-specific hemorrhage probabilities by preliminary estimates of TXA’s prophylactic efficacy. Outcome measures included incremental costs, quality-adjusted life-years (QALYs), and adverse maternal outcomes averted. Costs and benefits were considered from the healthcare system and societal perspectives over a lifetime time horizon.   Results: All TXA strategies were dominant versus the status quo, implying that they were more effective while also being cost-saving. Providing TXA to all delivering women irrespective of hemorrhage risk produced the most favorable results overall, with estimated cost savings greater than $670 million and up to 149,505 PPH cases, 2,933 hysterectomies, and 70 maternal deaths averted, per annual cohort. Threshold analysis suggested that TXA is likely to be cost-saving for health systems at costs below $184 per gram.   Conclusions: Our findings suggest that routine prophylaxis with TXA would likely result in substantial cost-savings and reductions in adverse maternal outcomes in this context. The integrity of this conclusion is maintained across all risk-dictated strategies, even when the cost of TXA is significantly higher than what is supported in the literature.  

Background: Data related to electrophysiologic characteristics of atypical atrial flutter (AFL) following atrial fibrillation (AF) ablation and its prognostic value on repeat ablation success are limited. Methods: We studied consecutive patients undergoing a repeat LA ablation for either recurrent AF or atypical AFL, following 3 months after index AF ablation, between January 2012 and July 2019. The demographics, procedural data, complications, and 1-year arrhythmia-free survival rates were recorded for each subject after the first repeat ablation. Results: Of the total 336 included patients, 102 underwent a repeat ablation for atypical AFL and 234 for recurrent AF. The mean age was 63.7  10.7 years, and 72.6 % of patients were male. The atypical AFL cohort had significantly higher LA diameters (4.6 vs. 4.4 cm, p=0.04) and LA volume indices (LAVi; 85.1 vs. 75.4 ml/m2, p=0.03) compared to AF patients at repeat ablation. Atypical AFLs were roof-dependent in 35.6% and peri-mitral in 23.8% of cases. Major complications at repeat ablation occurred in 0.9 % of the total cohort. Arrhythmia-free survival at one year was significantly higher in the recurrent atypical AFL than the recurrent AF cohort (75.5 vs. 65.0 %, p=0.04). Conclusion: In our series, roof-dependent flutter is the most common form of atypical atrial flutter post AF ablation. Patients developing atypical AFL after index AF ablation have greater LA dimensions than patients with recurrent AF. The success rate of first repeat ablation is significantly higher among patients with recurrent atypical AFL compared to recurrent AF after index AF ablation.

Liu et al. reviewed case reports of type A acute aortic dissection occurring in the last trimester of pregnancy and described the fetal and maternal outcomes after cesarean section and aortic intervention.

Objective: Given growing interest in alternatives to hospital birth, particularly given the COVID-19 pandemic, we developed a peripartum intervention risk calculator (PIRC) to estimate maternal and neonatal risk of requiring hospital-based peripartum intervention. Design: National cohort study. Setting: United States. Sample: Hospital births captured by the Pregnancy Risk Assessment Monitoring System from 2009-2018. Methods: The cohort was stratified by receipt of hospital-based interventions, defined as: 1) operative vaginal delivery (forceps or vacuum), 2) cesarean delivery, or 3) requiring neonatal intensive care unit admission. Gravidas with prior cesarean delivery or fetal malformation were excluded. Main Outcome Measures: Risk of requiring hospital-based intervention. Results: A total of 63,234 births were evaluated (72.6% full-term, 48.5% nulliparous) including 37.9% who received one or more hospital–based interventions. Gestational age was the most predictive factor of requiring hospital-based intervention, with lowest odds at 400/7-406/7 weeks. Previous live births (Ref: none; 1, OR 0.41; 2, OR 0.35; ≥3, OR 0.29; p<0.05 for all) were protective. Other predictors included advanced maternal age, high pre-pregnancy body mass index, maternal diabetes, maternal hypertension, and not exercising during pregnancy. The resulting seven-factor model demonstrated strong discrimination (optimism corrected C-statistic=0.776) and calibration (mean absolute error=0.009). Conclusions: We developed and validated the PIRC for predicting individualized risk for hospital-based intervention among gravidas based on seven readily accessible prenatal factors. This calculator can support personalized counseling regarding planned birth setting, helping to close a critical gap in current clinical guidance and providing an evidence-based risk assessment for those contemplating alternatives to hospital birth.

Cardiac resynchronization therapy (CRT) is an effective treatment for a subgroup of heart failure patients, but more than 30 % of those selected do not respond. Inadequate criteria for patient selection and optimization are the main causes of the high non-response rate. Mechanical parameters, such as work done during the isovolumetric phase, are promising, but are complicated and require invasive measurements. In this study, we use a computational modeling framework to calculate the regional stress of the left ventricular wall of seven CRT patients and seven healthy controls. The standard deviation of the regional wall stress at the time of mitral valve closure (SD_MVC) was used to quantify dyssynchrony and was compared between patients and controls and among the patients. The results show that SD_MVC is significantly lower in controls compared to patients and correlated with the degree of long-term response among the patients based on end-diastolic volume reduction. The patients with lower SD_MVC responded best to therapy. The patient with the highest SD_MVC was the only non-responder in the cohort. The distribution of fiber stress at the beginning of the isovolumetric phase seems to correlate with the degree of response and this parameter could potentially improve patient selection and optimization of CRT. Further studies with a larger cohort are needed to validate these results.

37-year-old man presented to the emergency department with a three-hour history of severe, generalized abdominal pain. Computed tomography of abdomen revealed two distal ileoileal intussusceptions with high suspicion of 3 cm mass within the intussusception around the ileocecal region. Laparoscopic right hemicolectomy with extracorporeal ileocolic anastomosis which showed Meckel

$i\dot{U} = HU$ (or $\dot{U} = -iHU$) is the equation that is  said to govern the evolution of a unitary matrix $U$ given the Hamiltonian $H$ of the system. This equation is said to hold true even if the Hamiltonian is time dependent. We show iU = HU (or $\dot{U} = -iHU$) is the equation that is  said to govern the evolution of a unitary matrix $U$ given the Hamiltonian $H$ of the system. This equation is said to hold true even if the Hamiltonian is time dependent. We show in this paper that $i\dot{U} = HU$ may not  always hold for time dependent Hamiltonians.this paper that $i\dot{U} = HU$ may not  always hold for time dependent Hamiltonians.

A patient with hypothyroidism, Addison’s disease, and celiac disease had persistent hypothyroid symptoms, and frequent fluctuations in TSH, prompting transition to L-T4 sodium oral solution (Tirosint®-SOL). Implementing a gluten-free diet and switching to the oral solution significantly improved malabsorptive and subsequent hypothyroid symptoms without the need to increase L-T4 dosage.

Medullary and papillary thyroid carcinoma are two distinct neoplasms. Its simultaneous is uncommon and its occurrence as a mixed follicular medullary carcinomas is extremely rare. We present a 60-year-old man with the mixed medullary-papillary carcinoma of the thyroid and papillary and medullary component metastases on lymph nodes.

The search for life-supporting molecules in outer space is an ever growing endeavour. Towards this, the quantum-mechanical computations supporting the astronomical spectroscopic observations are becoming valuable tools to unravel the complex chemical network in the interstellar medium (ISM). In the present work, quantum-mechanical computations are performed to obtain the rotational and vibrational line-data of gas-phase conformers of amino acid Leucine and its isomeric species predicted to be involved in its stereoinversion under the conditions of ISM. These species exhibit diverse chemistry including branched skeleton and zwitterionic ammonium ylides. Notably, the present work employs vibrational second order perturbation theory to account for anharmonic effects in rotational and vibrational transitions. The spectroscopic data computed in this work can assist in the detection of Leucine and its isomeric species in different regions of ISM.

A document by Mohd Riyaz Beg. Click on the document to view its contents.

Mini-commentary on BJOG-20-1239.R3: Intramuscular oxytocin versus Syntometrine versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: a randomised double blinded clinical trial of effectiveness, side effects and quality of life