Runoff coefficient (C) values are tabulated and enshrined in hydrological engineering. Its values are considered to be constant although it may not correspond to reality. In the same catchment, they can vary according to the intensity, temporal and spatial distribution of precipitation events, humidity conditions, soils and land uses. This study had the objective of analyzing extreme events of precipitation and their corresponding flows to obtain experimental runoff coefficients (C) and compare them with the tabulated values. The study was conducted in five experimental catchments in the state of São Paulo, Brazil, with different land uses. The runoff coefficients (C) were obtained from the analysis of hydrograms and using a digital filter, which allowed the separation of the direct runoff, of the total flow. We observed a variation of the flow coefficient values between catchments different from those obtained from the tables. The runoff coefficients had a high correlation with land use. In the catchments with original vegetation cover, such as cerrado and forest, it varied little among the events analyzed, differently from the catchments where land use is diversified, with predominantly agricultural and urban occupation.

On magnetic resonance imaging (MRI), a butterfly lesion is most commonly described in Glioblastoma Multiforme (GBM), however we report an unusual case of Cryptococcus Meningoencephalitis with the butterfly lesion on MRI. This infection is generally diagnosed via lumbar puncture, however MRI may reveal perivascular space involvement, dilation and leptomeningeal enhancement.

Acute post-infarction posterior ventricular septal defect (VSD) is associated with high mortality. Furthermore, patients with cardiogenic shock have been reported to have worse outcomes (1). There are conflicting reports about the optimum timing and method of surgical repair (2). Early surgical intervention has been reported to have high mortality, whereas the risk of dying in the waiting period with the medical management is also exponentially high (1). We present a case of post-infarction posterior VSD complicated by cardiogenic shock. The patient was successfully supported with peripheral veno-arterial extracorporeal membrane oxygenator as a bridge to a trans-right atrial repair.

Direct coronary embolism in the setting of oral contraceptive pills (OCP) use is a rare adverse effect. It is known for OCP to increase the risk of thrombosis, however leading to an inferior ST elevated myocardial infarction (STEMI) due to an acute occlusive embolism is a rare entity.

All people including those with Haemoglobinopathies are at risk of COVID-19 infection. Though those patients were considered vulnerable, a clear prognosis, as well as the possibility of reinfection, was not mentioned before. We report here the first case of Thalassemia beta major who had COVID-19 reinfection detected by screening.

We experienced a successful case of cardiopulmonary arrest due to left ventricular free wall rupture treated with venoarterial extracorporeal membrane oxygenation and immediate induction of targeted temperature management.

An 18-year-old female presented with hypopigmentation, ulcerative skin changes and masses of both breasts for over a year. She was referred to the Uganda Cancer Institute (UCI) with suspected inflammatory breast cancer. Radiological findings and trucut biopsy were consistent with secondary CD3+ CD20- T-cell NHL of both breasts.

The purpose of this study is to investigate the outcomes of an alternative method for large defects reconstruction after mastectomy by applying negative pressure wound therapy onto the grafts.

Nodular pulmonary amyloidosis is a rare and localized manifestation of amyloid deposition in the lungs. This rare entity, though asymptomatic, is often misdiagnosed on imaging alone, due to its resemblance to metastatic pulmonary nodules. This report highlights the significance of histologic confirmation before treatment, as a preventive measure against overtreatment.

Minimally Invasive Aortic Valve Replacement is not just a matter of the incision, but it should be rather considered as a holistic approach to minimize surgical trauma: our technique aims to reproduce the gold-standard conventional procedure in terms of safety, effectiveness and operative time through a small and different incision; furthermore with a thorough optimization of the procedure, the surgical time can be at least equal to the classic approach. We introduced our approach about 10 years ago; after more than 1000 aortic valve replacement via right anterior mini-thoracotomy, we developed with some tips and tricks in the attempt of turning this technique into our choice approach. Indeed, it is our belief that a highly standardized technique is pivotal to perform a safe and valuable procedure.

There are no specific serological markers or imaging techniques for Adult-onset Still’s disease (AOSD) diagnosis. It is essential to rule out other diseases, especially malignant lymphoma, because both diseases sometimes show similar clinical presentations. However, unfortunately, this case showed PET-CT findings in AOSD patients could mimic those in malignant lymphoma.

Elevation of alkaline phosphatase (ALP) is reported to be an abnormal feature in TAFRO syndrome. However, the cause is unknown. Herein, we report a case of TAFRO syndrome showing intrahepatic cholangitis on autopsy, which may be the cause of ALP elevation in TAFRO syndrome.

Predator and prey α-diversity are often positively associated; yet, underlying mechanisms remain unclear. We attempt to address this issue by deciphering how α-diversity of predator and prey influences each other’s community assembly processes and subsequently determines α-diversity. The occurrence of assembly processes were indicated by the mean pairwise taxonomic index within a community (αMPTI), assuming assembly processes left traceable imprints on species’ phylogeny. Specifically, αMPTI quantifies deviations of observed phylogenetic distances from that of random, thus indicating that non-random/deterministic assembly processes are in action. Less negative αMPTI, which hints at the occurrence of weaker homogeneous deterministic assembly processes, is expected to increase α-diversity of the community. We hypothesize that higher predator and prey α-diversity make each other’s αMPTI less negative, which then increases their α-diversity. To test the hypothesis, we calculated Shannon diversity and αMPTI for heterotrophic nanoflagellates (HNF; predator) and bacteria (prey) communities in the East China Sea. The HNF Shannon diversity was found to make the αMPTI of bacteria less negative, which then increased bacterial Shannon diversity. In contrast, bacterial Shannon diversity did not affect HNF’s αMPTI. We provide evidence that top-down control underpins the positive α-diversity association among trophic levels in microbes of the East China Sea.

This study focuses on a 10-m2 plot within a granitic hillslope in Cevennes mountainous area in France, in order to study infiltration and subsurface hydrological processes during heavy rainfalls and flash floods. The monitoring device included water content at several depths (0-70cm for the shallow soil water; 0-10m for the deep water) during both intense artificial and natural rainfall events, chemical and physical tracers, time-lapse electrical resistivity tomography. During the most intense events, the infiltrated water was estimated to be some hundreds of millimeters, which largely exceeds the topsoil capacity (≤40 cm deep in most of the cases). The weathered/fractured rock area below the soil clearly has an active role in the water storage and sub-surface flow dynamics. Vertical flow was dominant in the first 0-10m, and lateral flow was effective at 8-10 m depth, at the top of the saturated area. The speed of the vertical flow was estimated between 1 and 10 m/h, whereas it was estimated between 0.1 and 1 m/h for the lateral flow. The interpretation of the experiments led to a local pattern of the 2D-hydrological processes and profile properties. It suggests that fast triggering of floods at the catchment scale cannot be explained by a mass transfer within the hillslope, but should be due to a pressure wave propagation through the bedrock fractures, which allows exfiltration of the water downstream the hillslope.

Tree functional traits together with processes such as forest regeneration, growth, and mortality affect forest and tree structure. Forest management inherently impacts these processes. Moreover, forest structure, biodiversity, resilience, and carbon uptake can be sustained and enhanced with forest management activities. To assess structural complexity of individual trees, comprehensive and quantitative measures are needed, and they are often lacking for current forest management practices. Here, we utilized 3D information from individual Scots pine (Pinus sylvestris L.) trees obtained with terrestrial laser scanning (TLS) to first, assess effects of forest management on structural complexity of individual trees, and second, understand relationship between several tree attributes and structural complexity. We studied structural complexity of individual trees represented by a single scale independent metric called “box dimension”. This study aimed at identifying drivers affecting structural complexity of individual Scots pine trees in boreal forest conditions. The results showed that thinning increased structural complexity of individual Scots pine trees. Furthermore, we found a relationship between structural complexity and stem and crown size and shape as well as tree growth. Thus, it can be concluded that forest management affected structural complexity of individual Scots pine trees in managed boreal forests, and stem, crown, and growth attributes were identified as drivers of it.

Injury to epicardial coronary arteries following mitral valve replacement surgery, albeit rare, could have fatal complications. In this case, we suggest conservative medical treatment as a safe approach in patients who are not suitable to undergo revascularization.

This study presents a rare case of postoperative amyloidosis of the tongue base and provides a summary of the known literature of tongue amyloidosis. The diagnosis was by physical examination, radiological findings, and histopathological Congo red stain. Bone marrow biopsy the revealed “Plasma cell myeloma” as a cause.

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is one of the most destructive diseases of wheat in China. Due to the pandemic in 2017~2018, a total of 709 single-lesion samples, including 285 collected in 7 provinces in 2017 and 424 collected in 4 provinces in 2018, were isolated to explore the underlying causes. The population structure was analyzed by using 13 simple sequence repeat (SSR) makers. 306 multi-locus genotypes (MLGs) were detected and the genetic diversity was different among populations. Regardless of the year difference, 11 populations were clustered into two group: Gansu, Sichuan and Shaanxi belong to one group, while Yunnan, Guizhou, Hubei, and Anhui belong to another group. Genetic identity and shared genotypes along with the minimum spanning network (MSN) showed the Pst population from Sichuan play an intermediate role of genetic communication between Yunnan-Guizhou and Gansu. Since Berberis spp. has been identified as the alternate host of Pst, our results also provided a molecular evidence of potential sexual reproduction in Gansu population. In addition, the closer relationship between Yunnan-Guizhou and Hubei-Anhui was demonstrated. It was showed the role of Pst population in Yunnan-Guizhou might was underestimated in epidemiology. Previously, it was believed that the inoculum was limited locally. Our study provided strong evidence that the Pst inoculum source of Yunnan-Guizhou dispersed to Hubei areas by the upper airflow, and migrated to Anhui finally detriment Huang-huai regions.

Background: COVID-19 causes a variety of signs and symptoms. Case presentation: A boy with COVID-19 presented with acute abdomen. Then he showed features of Kawasaki-like syndrome, a multiorgan inflammatory syndrome in children, and finally systemic juvenile idiopathic arthritis. Conclusion: We reported the first case presenting systemic JIA triggered by COVID-19.

We report a successful case of ruptured abdominal aortic aneurysm (rAAA) treated with endovascular aortic repair (EVAR) following resuscitative endovascular balloon occlusion of the aorta (REBOA) and treated with devised open abdominal management (OAM) for abdominal compartment syndrome (ACS). We used an applied shoelace technique with vacuum pack closure.

Introduction: The Sudden Cardiac Death-Screening of Risk FactOrS survey included a 12-lead ECG plus a digital-based questionnaire and aimed to screen for warning signs of diseases that may course with sudden cardiac death in children and young-adults. We aimed to estimate the prevalence of unexplained syncope (US) and characterize its high-risk features and predictors in this cohort. Methods and results: We determined the most probable etiology of the transient loss of consciousness (TLOC) episodes based on clinical criteria. US was an exclusion diagnosis and we analyzed its potential clinical and ECG predictors. Among 11,878 individuals, with a mean age of 21±6 (range 6-40) years-old, the cumulative incidence of TLOC was 26.5%, 76.2% corresponding to females. Reflex syncope was present in 61.0%, orthostatic hypotension in 7.9% and 12.6% of the individuals had US. Unexplained syncope was independently associated with age < 18 years-old (OR1.72; 95%CI 1.27-2.32,p<0.001), male gender (OR1.650; 95%CI 1.22-2.23,p=0.001), participation in competitive sports (OR1.64;95%CI 1.01-2.66,p=0.044), major syncope high-risk features (OR 2.61;95%CI 1.96-3.47,p<0.001), syncope after exertion (OR2.77;95%CI 1.80-4.27,p<0.001), fever context (OR9.58;95%CI 4.12-22.30,p<0.001), lower number of previous syncopal episodes (OR0.36;95%CI 0.37-0.48,p<0.001) and history of palpitations requiring medical care (OR1.98;95%CI 1.16-3.38,p=0.012). We found no ECG predictors of US in this population. Conclusions: The cumulative incidence of TLOC in children and young-adults is high and remains unexplained in an important proportion of individuals. We identified eight clinical characteristics that may be useful for the risk stratification of individuals evaluated in a non-acute setting.

Key points: -Patients with severe coronavirus disease 2019 may have neck endothelial inflammation, pseudo-aneurysm and an increased risk of bleeding, especially during neck surgical procedures.-The management of vascular lesions may be performed through interventional radiological procedures that may be useful to reduce the risk of virus aerosolization and healthcare provider contamination.-Neck pseudo-aneurysm may be managed through percutaneous glue injection under ultrasonography guidance while active hemorrhage may be managed by endovascular embolization with coil.

Panicle traits exhibit quantitative variation controlled by genes, the environment, and their interaction. In switchgrass, a perennial biofuel crop, identification of quantitative trait loci (QTL) and QTL x E interactions controlling panicle architecture could aid breeding efforts and cultivar development by impacting seed productivity. In this study, we evaluate the genetic architecture of panicle traits including panicle length, primary branching number, and secondary branching number in an outcrossing switchgrass population grown across ten field sites in the central United States. We evaluated pleiotropic relationships between panicle traits and flowering time, tiller production and biomass. We also identified environmental factors correlated with QTL x E interactions and potential candidate genes underlying panicle trait QTL in switchgrass. Overall, our multi-environment mixed QTL model detected 18 QTL for panicle traits. Twelve of the QTL exhibited consistent effects (i.e., no QTL x E), and most (4 of 6) of the effects with QTL x E exhibited condition-specific effects. Many of the QTL x E effects were associated with yearly mean temperature and photoperiod. Panicle QTL co-localized with previously identified flowering time QTL and candidate genes associated with flowering, supporting a pleiotropic model of panicle development based on shared developmental genetics and responses to environmental signals.

Background: Pregnancy significantly increases the need for iron. The prevalence of anemia in pregnant women is high, affecting 41.8% of all pregnant women worldwide. In patients with low tolerance to oral iron, it is recommended to start them on parenteral iron therapy but with variable degree of efficacy. Hence this meta-analysis was done with the following aim. Aim: This study aims to assess the efficacy of various iron preparations in pregnant women with Iron deficiency anemia (IDA). Methods: Randomised controlled trials (RCTs) (available as full free text) which included iron therapy in pregnant women with iron deficiency anemia were retrieved from electronic databases viz. PubMed, Google scholar and IndMed, with specific search terms. Qualities of RCTs were assessed using JADAD score and four RCTs with high score were included for analysis using RevMan 5.3 software. Outcome measures were change in hemoglobin levels and serum ferritin concentration after one month of therapy. Results: In the four RCTs included, a total of 267 patients were treated with oral iron and 267 patients were treated with parenteral iron therapy. Change in the hemoglobin levels between the 2 groups had a standard mean difference of 0.73, 95% CI (-0.05-1.52), with the p-value of 0.07. To assess the change in the serum ferritin concentration a total of 188 patients in oral iron and 197 patients in parenteral iron therapy were included. There was a standard mean difference of 0.88, 95% CI (0.60-1.66), with a p-value of <0.00001.