In this paper, we deal with a new approximation of a diffusive predator--prey model with Leslie--Gower term and social behavior for the prey subject to Neumann boundary conditions. A new approach for a predator-prey interaction in the presence of prey social behavior has been considered. Our main topic in this work is to study the influence of the prey's herd shape on the predator-prey interaction in the presence of Leslie--Gower term. First of all, we examine briefly the system without spatial diffusion. By analyzing the distribution of the eigenvalues associated with the constant equilibria, the local stability of the equilibrium points and the existence of Hopf bifurcation have been investigated. Then, the spatiotemporal dynamics introduced by self diffusion was determined, where the existence of the positive solution, Hopf bifurcation, Turing driven instability, Turing-Hopf bifurcation point have been derived. Further, the effect of the prey's herd shape rate on the prey and predator equilibrium densities as well as on the Hopf bifurcating points has been discussed. Finally, by using the normal form theory on the center manifold, the direction and stability of the bifurcating periodic solutions have also been obtained. To illustrate the theoretical results, some graphical representations are given.

In this paper, we investigate the existence of global attractors, extreme stability, periodicity and asymptotically periodicity of solutions of the delayed population model with survival rate on isolated time scales given by \[ x^{\Delta} (t) = \gamma(t) x(t) + \dfrac{x(d(t))}{\mu(t)}e^{r(t)\mu(t)\left(1 - \frac{x(d(t))}{\mu(t)}\right)}, \ \ t \in \mathbb T. \] We present many examples to illustrate our results, considering different time scales

Background The onset of the Corona Virus Diseases of 2019 (Covid19) pandemic has led to debates on the relevance of country-wide lockdowns as tools for responding to this pandemic. This commentary contributes to this debate by focusing on Sub-Saharan Africa (SSA). Thus the aim here is to interrogate the relevance of total country lockdowns in responding to the Covid19 pandemic in SSA. A search of existing literature in academic journals was done in order to build the premise of the commentary. The search included capturing publications that focused on Covid19 with relevance to SSA; through this process, 8 publications were identified and included in the study.

Introduction: Without universal access to point-of-care SARS-CoV-2 testing, many hospitals rely on clinical judgement alone for identifying cases of COVID-19 early.Methods: Cambridge University Hospitals NHS Foundation Trust introduced a traffic lights clinical judgement aid to the COVID-19 admissions unit in mid-March 2020. Ability to accurately predict COVID-19 was audited retrospectively across different stages of the epidemic. Results:  One SARS-CoV-2 PCR positive patient (1/41, 2%) was misallocated to a ‘green’ (non-COVID-19) area during the first period of observation, and no patients (0/32, 0%) were mislabelled ‘green’ during the second period. 33 of 62 (53%) labelled ‘red’ (high risk) tested SARS-CoV-2 PCR positive during the first period, while 5 of 22 (23%) ‘red’ patients were PCR positive in the second. Conclusion: COVID-19 clinical risk stratification on initial assessment effectively identifies non-COVID-19 patients. However, diagnosing COVID-19 is challenging and risk of overcalling COVID-19 should be recognised, especially when background incidence is low. Key words: SARS-CoV-2, COVID-19, Coronavirus, Triage, Diagnostics, Infection Control

Maize shading affects the growth and development of soybean in maize soybean intercropping systems. Two different soybean varieties were (ND12, high shade-tolerant, and GX3, low shade-tolerant) relay intercrop with maize in different (T1, double row, and T2, single row) relay strip intercropping systems, and the results of the both planting arrangements of strip intercropping system were compared with the sole planting system of soybean. The results showed that shading reduced the content of photosynthetic pigment per unit area of soybean leaf, Fv/Fm, ΦPSⅡ, and Fv/Fo of ND12 and GX3 under T1 and T2. Moreover, T1 and T2 also decreased the density and size of stomata, leaf thickness, palisade tissue thickness of the tissue, and the size of the chloroplast and starch grains, while increased the thickness of the granum lamellae in both varieties of soybean. Nevertheless, the leaf area, aboveground biomass, photosynthetic capacity, photosynthetic organs measured morphological and architectural indices were found maximum in ND12 compared to GX3 in all planting patterns.

Özet:     1791 yılında Sanayi Devrimi’nin etkisini yoğun bir şekilde gösterdiği dönemde İngiltere’de zengin bir ailenin çocuğu olarak dünyaya gelen Babbage üniversite zamanlarında matematiğe aşık olmuştur ve insanların yaptığı işlem hatalarını ortadan kaldırmak için sırasıyla Fark Makinesi No.1, Analitik Makine ve Fark Makinesi No.2 hakkında çalışmıştır. Analitik Makine bugünkü dijital bilgisayarların temelini oluşturan çalışma olmuştur. 1871 yılında yine İngiltere’de hayatını kaybetmiştir. İlk dijital bilgisayarın 1946 yılında kullanılmaya başlandığını düşünürsek çağının çok ötesinde olan Babbage eğer tasarımlarını tamamlayabilseydi şu anda bilgisayarlar nasıl olurdu sorusu her zaman akıllarda bir soru işareti olarak kalacak.

This article comments on: ‘Short- and long-term effects of fire on stem hydraulics in Pinus ponderosa saplings’ by Partelli-Feltrin et al. (2020), https://doi.org/10.1111/pce.13881.

Radiologic evidence of aortic disease is not always consistent with the diagnosis. With lack of accompanying symptoms or with an atypical presentation, diagnosis of aortic pathology relies greatly on imaging techniques. We report the case of a 58 year-old female who presented with incidental radiographic findings consistent with a type A aortic intramural hematoma and a vague left-sided chest discomfort. After follow-up imaging was consistent with disease progression and hematoma expansion, the affected segment was resected and pathology reported lymphoplasmacytic aortitis as the underlying etiology of the imaging findings rather than an intramural hematoma. The patient lacked symptoms or serology consistent with rheumatologic disease and the postoperative course was uneventful. The management of a suspected ascending intramural hematoma is controversial, especially when the patient presents with atypical signs and symptoms. Features of disease progression may warrant urgent surgical intervention.

Dual-chamber pacemaker is a fully automatic pacemaker with the function of simulating human physiological pacing. It regulates pacing by programming different refractory periods and various special functions, which are closely related to arrhythmia. After in-depth understanding of these special functions, regular ECG follow-up analysis is required to provide individualized optimal program control and so is appropriate administrations of special functions of pacemaker so as to better provide optimal clinical guidance for patients with arrhythmia.

Understanding range edges is key to addressing fundamental biogeographic questions about abiotic and biotic drivers of species distributions. Range edges are where colonization and extirpation happen, so their dynamics are also important for natural resource management and conservation. We quantified positions for 153 range edges of marine fishes and invertebrates from three US continental shelf regions using decades of survey data and a spatiotemporal model to account for changes in survey design. We analyzed whether range edges maintained their edge thermal niches—temperature extremes at the range edge—over time. Most range edges (86%) maintained either cold or warm temperature extremes; 73% maintained both. However, the substantial fraction of range edges that altered their thermal niche underscore the multiplicity of relevant drivers. This study suggests that temperate marine species largely maintained their edge thermal niches during rapid change and provides a blueprint for testing temperature tracking of species range edges.

Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) is an immune checkpoint, which downregulates T cell activation and T regulatory cell function. CTLA-4 haploinsufficiency (CTLA4 HI) leads to T cell hyperactivation, immune dysregulation, lymphoproliferation and cancer predisposition. Less well understood is the penetrance and expressivity of CTLA-4 mutations. We describe five members of a single family with heterozygous CTLA-4 splice site mutation c.458-1G>C, previously shown to result in CTLA-4 HI, who presented with variable degree of immune dysfunction, lymphocytic infiltration and autoimmunity. The host, environmental and the epigenetic factors affecting the penetrance and expressivity of CTLA-4 mutations merits further investigation.

Introduction: Partial hepatectomy in children with primary hepatic malignancies has a complication rate as high as 30%. This has a negative effect on outcomes. We organized a multidisciplinary team (MDT) dedicated to the care of these patients to lower complication rates and improve outcomes. Methods: A retrospective chart review was completed for all patients < 18 years of age who underwent liver resection at our institution between 2002 and 2019 for primary hepatic cancer. Demographic, intraoperative, postoperative, pathologic, and outcome data were analyzed for perioperative complications using the CLASSIC and Clavien-Dindo (CD) scales, event-free survival (EFS) and overall survival (OS). Results: Ten (13%) of 73 patients experienced a major perioperative complication (CLASSIC or CD > 3); two (3%) died within 30 days of surgery. After the implementation of a dedicated MDT in 2014, the major perioperative complication rate decreased from 18% to 10%, and rates for all complications dropped from 52% to 20% (p=0.005). Older patient age (median 62 months vs. 50 months, p=0.05) and the presence of pulmonary metastases at diagnosis (p=0.01) were associated with increased rates of major perioperative complications. Among patients with a hepatoblastoma (n=62), the presence of a major perioperative complication was associated with a worse EFS (HR=5.45, p=0.03) on multivariate analysis. Patients treated following MDT implementation had improved EFS (HR=0.18, p=0.04). Conclusions: Our results demonstrate that, for children with primary liver malignancies, a MDT can decrease the rate of complications of liver resection and improve the oncological outcome of hepatoblastoma.

Rationale Prescribed opioids are major contributors to the current international public health opioid crisis. Such iatrogenic calamities usually result from collective decision failures of healthcare organizations rather than solely of individual organizations or professionals. Findings from a system-wide safety analysis of the iatrogenic opioid crisis that includes roles of pertinent healthcare organizations may help avoid or mitigate similar future tragedies. In this exploratory study, we report on such an analysis. Methods Root cause analysis, incorporating recent suggestions for improvement, was used to retrospectively identify possible causal factors from the literature. Based on their mandated roles and potential influences to prevent or mitigate the iatrogenic crisis, relevant organizations were grouped and stratified from most to least influential. Results The analysis identified a chain of multiple interrelated causal factors within and between organizations. The most influential organizations were: pharmaceutical, political and drug regulatory; next: experts and their related societies, and publications. Less influential: accreditation, professional licensing and regulatory, academic and healthcare funding bodies. Collectively, their views and decisions influenced prescribing practices of frontline healthcare professionals and advocacy groups. Financial associations between pharmaceutical and all other organizations/groups were common. Ultimately, patients were adversely affected. There was a complex association with psychosocial variables. Limitations Our analysis suggests associations not causality. Conclusions The iatrogenic crisis has multiple intricately linked interacting roots. The major catalyst: pervasive pharma-linked financial conflicts of interest (CoIs) involving most of the other healthcare organizations. These extensive financial CoIs were likely triggers for a cascade of erroneous decisions and actions that adversely affected patients. The actions and decisions of pharma ranged from unethical to illegal. The iatrogenic opioid crisis exemplifies widespread “institutional corruption of pharmaceuticals.”

Rationale,aims and objectives:The aim of this in vivo study was to evaluate the clinical 1 year follow-up of silica and flouroapatite reinforced glass carbomer filling material.Materials and Methods:In this study, total of 100 restorations were performed.All cavities were prepared conventionally.Half of the restorations were restored with nano composite resin (TEP) (Tokuyama Estelite, Tokuyama Dental, Japan) and the other half were restored with glass carbomer material (GC) (GCP Dental, The Netherlands). Each restorative material was applied according to the manufacturer’s instructions. Restorations were evaluated with modified USPHS criteria at the end of the first week, 6 months and 12 months.Data were analyzed using Fisher’s Exact Chi-Square test, Fisher Freeman Halton Test and Continuity (Yates) Correction.Wilcoxon sign test was used for intra-group comparisons of the parameters.Statistically significance was evaluated at p <0.05.Results:When the filling materials were compared with each other, statistically significant difference was observed at the 12th month on the marginal discoloration. Statistically significant difference was observed between the two materials in the 6th month on the marginal adaptation (p<0.05).Conclusions:In view of this results, there is a need to improve the physical properties of the GC filling material and further in vivo study. Clinical Relevance:Due to not provide good marginal sealing for Class II cavities, it is suggested that GC systems are applied to Class I cavities for now. Key Words; Glass-carbomer; Glass-ionomer cement; Resin composite; Clinical trial ClinicalTrials.gov Identifier: NCT04127929 (16.10.2019)

Bronchoalveolar Lavage in Children: Still the Gold StandardShivanthan Shanthikumar1,2,3 and Sarath C Ranganathan1,2,3Respiratory and Sleep Medicine, Royal Children’s Hospital, Melbourne, AustraliaRespiratory Diseases, Murdoch Children’s Research Institute, Melbourne, AustraliaDepartment of Paediatrics, University of Melbourne, Melbourne, AustraliaCorresponding Author; Dr Shivanthan Shanthikumar; Respiratory Medicine, Royal Children’s Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia; shivanthan.shanthikumar@rch.org.auAcknowledgements; The authors have no conflicts of interest to declareDear Editor,We read with great interest the recent article by Craven et al , entitled “High levels of inherent variability in microbiological assessment of bronchoalveolar lavage samples from children with persistent bacterial bronchitis and healthy controls .”1 In a small study of 18 children, funded by GlaxoSmithKline, the authors demonstrate variability in the results of bronchoalveolar lavage (BAL) collected from controls and children with protracted bacterial bronchitis (PBB). Specifically, they show that when the BAL was divided and sent to two laboratories the results were discordant in terms of both the organisms isolated and their relative abundance. From these data the authors draw conclusions which include questioning “assumptions about this procedure being the gold standard .” Whilst these data are of interest, there are significant limitations to their value especially when considering existing literature.One of the key findings of the study is the discordant results between laboratories. A lack of detail regarding the methods used at each site is a major limitation. It is recognised that laboratory processes can affect the yield of samples collected from patients with chronic airway infection, and the need for a consistent approach has led to disease specific consensus guidelines on this topic.2 The discordant results seen in the study could result from different laboratory handling of specimens, and hence the findings of this study could purely be explained by a difference in practice between two centres, not least of which was the transport of samples to the second laboratory in STGG. Molecular studies have identified that even media considered sterile can contain numerous organisms albeit in low densities.3 We note that it was laboratory 2 where additional bacteria were cultured from the BAL.Hare et al analysed BAL samples from 655 children collected and analysed at two different sites compared with 18 samples in the study of Craven et al .4 They compared bacterial pathogen load (control, negative, 102 colony forming units per ml (CFU/ml), 103 CFU/ml, 104 CFU/ml, 105 CFU/ml) and inflammatory markers to determine an appropriate definition for infection. They found that a bacterial pathogen load of ≥104 CFU/ml was associated with increased markers of inflammation and hence an appropriate threshold for defining infection. This was in keeping with previous studies.4 Whilst the authors contend the current paper does not support the use of ≥104 CFU/ml, given it only includes 13 children with PBB an explanation of the findings of Hareet al in their considerably larger study and other studies needs explanation.Another key finding of the study was the limited correlation between semiquantitative and quantitative methods of measuring bacterial pathogen load. Whilst there has not been direct comparison of different methods of determining bacterial pathogen load in PBB and other paediatric suppurative disorders, a large amount of data speaks to the validity of using a semiquantitative or qualitative approach. For instance, the previously discussed Hare et al study utilised a semiquantitative approach, and was able to clearly identify a threshold for lower airway infection that was associated with inflammation. In addition, the qualitative approach used by AREST CF (the long running study of CF patients cited in the article) to define infection is supported by the fact that this definition is associated with important clinical outcomes. For example, in a recent AREST-CF study analysing 1161 BAL from 265 children with CF, the presence of early life infection using the AREST-CF definition, was associated with future risk of structural lung disease severity.5Further, we have used molecular studies to assess the microbiome in CF and shown considerable agreement between pathogen-dominated microbiota and routine laboratory bacterial culture even though these samples were assessed by two different techniques, in two laboratories in different continents and analysed two decades apart in time.6Despite the data that contradicts the findings of their study, and while not discussed by the authors themselves, we do contend that use of both quantitative and semi-quantitative microbiologic cultures are likely problematic given that bacterial density is influenced by the dilution from the 0.9% saline used to lavage the target lobe. Dilution further depends on the volume of return retrieved on suctioning. The consensus has been that standardising for this dilution is not required but data supporting this are few.In summary, there are significant issues that limit the value of the key findings of the study by Craven et al . A large amount of published data in PBB and cystic fibrosis support the use of BAL as a biological specimen associated with important clinical outcomes. These studies have been conducted in multiple centres, over many years, and included many children. While the findings of Craven et alhighlight there can be inconsistencies in results, this potentially speaks to the methods used by the laboratories involved in handing the small number of samples. When these findings are compared to the large amount of evidence already generated, they should prompt evaluation of local practices and not just a reconsideration of whether BAL is the gold standard method of sampling the lower airway of children with suppurative lung disease. While we believe that BAL remains the gold standard for the detection of lower respiratory infection we do not believe it is a perfect test and its use and many limitations need to be considered and minimised.Therefore, we agree with the authors that interpretation of microbial culture results utilizing BAL samples can be challenging. However, we disagree that assumptions about this procedure being the “gold standard” fail to take into account its many limitations as despite these BAL remains the best test to detect endobronchial infection that is associated with lower respiratory inflammation especially in CF.

A twenty-five days old girl, admitted to pediatric pulmonology clinic, with collapse on the anterior chest wall while breathing. Physical examination revealed total retraction of the chest wall especially on the upper part, paradoxical chest wall movements with respiration, and a raphe extending from the umbilicus to the lower end of the sternum. Hypoplasia of the inferior and non-development of the superior segment of the sternum was shown on 3-dimensional(3D) thorax CT. At the age of fifty-six days, she had been operated. Due to the large defect, primary closure couldn’t be performed and the sternum was reconstructed with the cartilage obtained from the tissue around the ribs. The sternal cleft is a rare malformation; complete assessment, based primarily on thoracic imaging is required for diagnosis. Also cardiac, abdominal and cranial imaging for concominant malformations should be performed; our patient had none. Immediate surgical management is essential to avoid possible complications.

Transverse crack often occurs in the trailing edge region of the blade when it is subjected to excessive fatigue load in edgewise. In this paper a refined model was established through local mesh refinement methods in order to investigate the initiation mechanism of crack and its extension in blade trailing edge. The material stress around the crack in trailing edge region under different thicknesses is calculated based on the fracture mechanics theory. Then the coupons test is conducted to verify the simulation results. The factors affecting the fatigue robustness of blade trailing edge are concluded by investigating the results of finite element analysis and coupons test. In final, a practical design scheme to prevent crack initiation is given for the manufacture of wind turbine blade.

Domino effects of COVID-19 in pregnancy：it’s time for action Rui-Hong Xue1, He-Feng Huang2,3,4,5

A blockchain is, in the easiest of terms, a period stepped arrangement of unchanging records of information that is overseen by ia igroup iof iPCs inot ipossessed iby iany isingle ielement. iEvery ione iof ithese isquares iof iinformation iis imade isure iabout iand ibound ito ione ianother iutilizing icryptographic istandards. Ethereum iis ia iworldwide, idecentralized istage ifor icash iand inew isorts iof iutilizations. iOn iEthereum, iyou ican icompose icode ithat icontrols ithe icash, iand imanufacture iapplications iavailable ianyplace ion ithe iplanet.IA Smart iContract iis ia iPC iprogram ithat ilegitimately iand iconsequently icontrols ithe iexchange iof icomputerized iresources ibetween ithe igatherings iunder ispecific iconditions. iA ikeen iagreement iworks isimilarly ias ia iconventional iagreement iwhile ilikewise iconsequently iimplementing ithe iagreement. iSavvy icontracts iare iprograms ithat iexecute iprecisely ias ithey iare iset iup (coded, imodified) iby itheir imakers. iMuch ithe isame ias ia icustomary iagreement iis ienforceable iby ilaw, ishrewd iagreements iare ienforceable iby icode. iA ibrilliant iagreement iis ionly ian iadvanced iagreement iwith ithe isecurity icoding iof ithe iblockchain. iA isavvy icontract ihas isubtleties iand iconsents iwritten iin icode ithat irequire ia iprecise igrouping iof ioccasions ito ihappen ito itrigger ithe iunderstanding iof ithe iterms ireferenced iin ithe ibrilliant iagreement.  

Overexpression of c-MYC protein without genomic amplification occurs in multiple cancers, including neuroblastoma and small cell lung cancer. In searching for the mechanisms of c-MYC protein overexpression, we demonstrated that the transcription factor, OCT4 mediates c-MYC transcriptional activation in progressive disease neuroblastoma. Subsequently, we identified two kinases, MAPKAPK2 (MK2) and DNA-PK, which are predicted to bind and phosphorylate OCT4 at S111 and S93 residues, respectively. Based on these novel observations, we developed a cell-based luminescence assay to screen and identify compounds that inhibit the interactions between MK2 and OCT4. By screening 79,671 compounds, we identified 65 compounds we designated as “hits”. Using a two-step validation of co-immunoprecipitation and pOCT4S111 detection, the compounds were further narrowed down to three for further studies. The three compounds were tested for their ability to inhibit kinase activity, in vitro cytotoxic activity, and anti-inflammatory activity. In conclusion, we developed a cell-based luminescence assay for the discovery of new agents targeting the c-MYC transcriptional activation pathway. Screening and subsequent validation identified a small number of compounds for further development.

COVID-19 disease, caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), first appeared in Wuhan, China, and spread throughout the world in a short period of time (1). On 30 January 2020, WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC) and than on 11 March 2020, WHO declared the Coronavirus as a pandemic. The pandemic was called as COVID-19.

Objectives: To explore Knowledge and perceptions about COVID-19, among Syrian refugee mothers in Irbid governorate, the first outbreak of coronavirus in Jordan. Methods: This is an exploratory cross-section study was conducted among Syrian refugee mothers, who were currently pregnant or have a newborn child. The data collected through an online survey in April 2020 in North Jordan. Results: A total of 389 Syrian refugee mothers have participated in the study. The study showed that 66% of mothers often access information regarding COVID-19. The main used resources for information, were Facebook pages’ posters (87%), WhatsApp groups’ messages (69%), Television News (53%). While 21% indicated that they access a professional database or governmental websites. In general, Syrian refugee mothers appear well knowledgeable about COVID-19 the transition ways and prevention measures, and aspects that should be considered when diagnosing Coronavirus cases. However, they appeared to have a lack of knowledge about the aspects that should be considered for the transition of COVID-19 between the mother and the child and the concepts about the smoking risks associated with COVID-19. Conclusions: There is less focusing on media on aspects or still understudying of concepts about the smoking risks associated with COVID-19 and concepts around the transition of COVID-19 between the mother and the child. Providing health education regarding COVID-19 to mothers in Irbid would be helpful.

We present an 11-year-old female with persistent hypoglycemia in the setting of new-onset type I diabetes mellitus, with further diagnosis of both Hashimoto's thyroiditis and Addison's disease for a diagnosis of autoimmune polyglandular syndrome type II, an autosomal dominant syndrome. Three years later, the child's mother was subsequently diagnosed.

Keratosis lichenoides chronica (KLC) is a rare dermatosis which represents different clinical characteristics between adult- and pediatric-onset cases. We described a childhood case of KLC with features typical for adult onset disease. Acitretin led to partial improvement of her skin (but not mucosal) lesions.