We evaluated the peptide-specific immunoglobulin G (IgG) response and the safety of the personalized peptide vaccine in four children with refractory solid cancer. Although the pre-vaccination IgG responses were suppressed compared to those observed in children with upper respiratory tract infection, IgG levels against the vaccinated peptides after 12 times vaccination increased in all the three cases tested. Vaccination-related adverse effects were grade 1 injection-site local skin lesions. One patient had maintained remission for 37 months. The remaining three patients exhibited progressive disease. These results indicate the next steps in phase II studies considering their immune boosting effect and safety.

1.Large carnivore conservation is complex and remains a massive challenge across the world. Owing to their wide-ranging habits, large carnivores encounter various anthropogenic pressures which may potentially lead to conflict. Animal movement is linked with individual fitness as it is important for various biological processes. Therefore, studying how large carnivores adapt their movement to dynamic landscape conditions is vital for management and conservation policy. 2.We first quantified the movement parameters of four large carnivores in and outside protected-areas in India (tiger, leopard, dhole and wolf). We then tested the effects of human pressures like human density, road density and land use types on the movement of the species. Finally, we examined the configuration of core areas as a strategy to exploit human-dominated landscape. 3.Our findings suggest that the mean hourly displacement of 4 large carnivores differed across habitats. Mean displacement of large carnivores varied from 77.58m/h for leopards to 665.3m/h for wolves. Tigers outside PAs exhibited higher displacement as compared to tigers inside PAs. Displacement during day and night were significantly different for tigers inside and outside PAs (P=0.03), and wolf whereas no difference was found for leopard and dholes. The movement and ranging patterns of species outside PAs were influenced by anthropogenic factors such as human population, road network density, and landuse. All carnivores showed multiple areas of intensive use or cores in their home ranges. The range of the core area sizes was greater for species outside PAs (tiger and wolf) in human-altered landscapes. 4.Movement ecology of large carnivores has not been explored using such an exhaustive dataset in India. Our study attempts to extend theoretical concepts to applied management problems. This study can be a starting point for rigorous studies on interlinking animal movement and landscape management for large carnivore conservation and policy-making in the Anthropocene.

The reliability of evolutionary reconstructions based on the fossil record critically depends on our knowledge of the factors affecting the fossilization of soft-bodied organisms. Despite considerable research effort, these factors are still poorly understood. The extreme rarity of unicellular non-skeletal eukaryotic fossils compared to multicellular ones is an example of a pattern that apparently requires taphonomic explanation. In order to elucidate the main prerequisites for the preservation of soft-bodied organisms, we conducted long-term (1-5 years) taphonomic experiments with the model crustacean Artemia salina buried in five different sediments. The subsequent analysis of the carcasses and sediments revealed that, in our experimental settings, better preservation was associated with the fast deposition of aluminium and silicon on organic tissues. Other elements such as calcium, magnesium and iron, which can also accumulate quickly on the carcasses, appear to be much less efficient in preventing decay. Next, we asked if the carcasses of uni- and multicellular organisms differ in their ability to accumulate aluminium ions on their surface. The experiments with the flagellate Euglena gracilis and the sponge Spongilla lacustris showed that aluminium ions are more readily deposited onto a multicellular body. This was further confirmed by the experiments with uni- and multicellular stages of the social amoeba Dictyostelium discoideum. The results lead us to speculate that the evolution of cell adhesion molecules, which provide efficient cell-cell and cell-substrate binding, probably can explain the rich fossil record of multicellular soft-bodied organisms, the poor fossil record of non-skeletal unicellular eukaryotes, and the explosive emergence of the Cambrian diversity of soft bodied fossils.

We firstly discuss the unchanged quasi direction motion (UDQM) with biharmonicity condition in the Heisenberg space. We define the energy of velocity magnetic particles and some Lorentz fields. Also, we construct the new relationship between the Fermi-Walker parallel transportation and the unchanged quasi direction motion in the Heisenberg space. In other words, we obtain the applied geometric characterization for the unchanged quasi direction motion of biharmonic velocity magnetic particles in the Heisenberg space. This concept also boosts to discover some physical and geometrical characterizations belonging to the particle such as the magnetic motion, the electrical energy functional, the torque, and the Poynting vector. Finally, we obtain electrical energy with respect to its electric field and energy flux density in the radial direction.

We derive relationships between the shape deformation of an impenetrable obstacle and boundary measurements of scattering fields on the perturbed shape itself. Our derivation is rigourous by using systematic way, based on layer potential techniques and the field expansion (FE) method (formal derivation). We extend these techniques to derive asymptotic expansions of the Dirichlet-to-Neumann (DNO) and Neumann-to-Dirichlet (NDO) operators in terms of the small perturbations of the obstacle as well as relationships between the shape deformation of an obstacle and boundary measurements of DNO or NDO on the perturbed shape itself. All relationships lead us to very effective algorithms for determining lower-order Fourier coefficients of the shape perturbation of the obstacle.

A nonlinear oscillator arising in a micro-electro-mechanical system (MEMS) is difficult to be solved analytically due to the zero conditions. so the main objective of this work is to analyze the mathematical model of this system, and its approximate analytical solution is solved via the coupling Variational Iteration method and Laplace transform(LVIM). This method provides an efficient way to obtain the approximate nonlinear frequency and approximate solutions of MEMS. Moreover, LVIM also approximates the pull-in threshold in terms of model parameters. Finally, the results are compared with the exact one and a good result is obtained.

In this work we consider the three-dimensional solvable Lie group denoted by $Sol_{3}$, equipped with any left-invariant metric, either Lorentzian or Riemannian. The existence of non-trivial (i.e., not Einstein) Ricci solitons on both Lorentzian and Riemannian three-dimensional solvable Lie group $Sol_{3}$ is proved. Moreover, we show that they are not gradient Ricci solitons.

In many mathematical types of research, in order to solve the fuzzy fractional differential equations, we should transform these problems into crisp corresponding problems and by solving them the approximate solution can be obtained. The aim of this paper is to present a new direct method to solve the fuzzy fractional differential equations without this transformation. In this work, the fuzzy generalized Taylor expansion by using the sense of fuzzy Caputo fractional derivative for fuzzy-valued functions is presented. For solving fuzzy fractional differential equations, the fuzzy generalized Euler's method is applied. In order to show the accuracy and efficiency of the presented method, the local and global truncation errors are determined. Moreover, the consistency, the convergence and the stability of the generalized Euler's method are proved in detail. Eventually, the numerical examples, especially in the switching point case, show the flexibility and the capability of the presented method.

In this work, we study a nonlinear coupled system of fractional q-difference equations with nonlocal boundary conditions involving the fractional q-derivatives of the Caputo type. Uniqueness result for solution of the underlying problem is presented with the aid of Banach’s contraction principle, while the existence result is derived from Leray-Schauder’s alternative. Finally, we introduce some examples to support our main results.

The power method with the extrapolation process based on trace (PET) method was proposed by Tan (2017). It is an extrapolation strategy derived from the Google matrix. Considering the weighted inner product, a generalized Arnoldi (GArnoldi) method was constructed by Yin et al. (2012) for computing PageRank. In this paper, we present a new algorithm by employing the extrapolation strategy and the GArnoldi method together. In order to accelerate the convergence speed of PageRank computations, the weights are changed adaptively with the current residual corresponding to the approximate vector in each cycle. The new method is called as GArnoldi-PET algorithm, whose implementation and convergence are analyzed in detail. Numerical experiments on several examples are used to illustrate the effectiveness of our proposed algorithm.

The aim of this paper is to present analytical solutions of fractional delay differential equations (FDDEs) of an incompressible generalized Oldroyd-B fluid with fractional derivatives of Caputo type. Using a modification of the method of separation of variables the main equation with non-homogeneous boundary conditions is transformed into an equation with homogeneous boundary conditions, and the resulting solutions are then expressed in terms of Green functions via Laplace transforms.This results presented in two condition , in first step when $0\le \alpha ,\beta \le {2}$ and in the second step we considered ${2}\le \alpha ,\beta \le 1$,for each step 1,2 for the unsteady flows of a generalized Oldroyd-B fluid, including a flow with a moving plate, are considered via examples.

Aims: Chronic Kidney Disease (CKD) is a worldwide problem with increasing prevalence. End-stage renal disease accounts for 8% of all medical admissions and 42% of renal admissions in Nigeria. We review the literature on risk factors that might have impacted the prevalence and how awareness level of risk factors screening contributes to CKD. Design: Systematic literature review. Methods: A search was carried out on databases, PubMed, Medline and Google by means of (MeSH) terms, prevalence, demographics, risk factors, history of previous medical screening, age groups, income and education were indicators. Multivariate analyses were used to identify correlates. Reviewers screened 84 articles and 40 full texts were checked following inclusion criteria (1) publication between January 1985 and December 2018, (2) availability as full text in English (3) categorization as original research, review and meta-analysis. Results: A total of 7 articles were included. The hospital study with a total of 1574 patients were reviewed. A total of 908 with a mean age of 42.55±15.42 years were analyzed, prevalence (12.0%). One epidemiological study screened 2186 respondents, 1941 with a mean age of 43.7±13.2 were analyzed. Overall prevalence of 11.4% (semi-urban 11.7% and rural 11.1%) was observed. The glomerular filtration rate (GFR) was estimated using CKD-EPI equation. Another study screened 400 respondents, 328 with a mean of 54.8±13.2 were analyzed. The GFR used was MDRA equation with prevalence (7.8%). The observed risk factors; older age (P<0.001), hypertension (P<0.001), use of nephrotoxins (P<0.001), obesity (P<0.001), history of renal disease (P<0.001) were independent risk factors that influence the prevalence, diabetes mellitus (P<0.005), use soaps containing mercury (P<0.056) and use of bleaching cream (P=0.138) were not significant, low income and education were significantly prevalent among the population. Conclusion: The early onset of the risk factors among younger adults clearly underlines the need for early screening and intervention.

A document by Krishna Kumar Mohanan Nair. Click on the document to view its contents.

Surgical treatment of Popliteal Artery Aneurysm (PAA), either medial or posterior approach, remains controversial. Debate continues regarding which approach has the less morbidity and the better long patency. A single center retrospective study in our department was done comparing the primary patency between the two different approaches. Both approaches have relatively the same primary patency. Concerning the bypass material, vein bypass stays patent for a longer period of time. By adding the preoperative run-off situations as a variable to compare the two approaches, the posterior approach using the vein as a bypass material has more competitive results. With a poor run-off situation, the prognosis is not promising. 

Currently, the COVID‐19 has directly affected the millions of humans lives. The symptoms of the disease involving fever, malaise, chest infection, and breathing difficulties, were identified, and its existence is continuously becoming restructured. The World Health Organization (WHO) had mentioned the wide diagnostics test besides COVID-19 that would also assist medical facilities to recognize infectious diseases as well as currently focusing efficiently on preventing and afterward defeating this viral disease. The infection is usually transmitted among human beings in direct contact, greatest through the liquid bubbles generated through cough, sneeze, or speaking. This paper reviews the COVID 19 pandemic, its history, current updates, contact tracing applications, and use of emerging technologies like the Internet of Things (IoT) and Blockchain for stopping the spreading and provide service online to the patient from a distance.

The COVID-19 is an exponentially growing disease that has intentioned nations to use technologies to detect the coronavirus infection. Several nations are working greatly to fight against COVID-19. Many nations have been using a range of devices to combat the pandemic, seeking information about growth, monitoring as well as the leaking the confidential information of the residents. This research aims to assist infected people online using the Internet of Things (IoT) and Blockchain technologies through smart devices. IoT-based healthcare devices gather useful information, provide additional insight through symptoms and behaviors, allow remote monitoring, and simply give people better self - determination and healthcare. Blockchain allows the secure transfer of patient health information, regulates the medical distribution network. A four-layer architecture is proposed using IoT and Blockchain to detect and prevent individuals to be COVID 19. This research provides a framework for patients with COVID-19 infectious disease and recognizes health issues and diagnoses online. Smart devices such as smartphones can install any mobile apps such as Aarogya Setu, Tawakkalna, and so on. These applications can track COVID-19 patients properly. The installation of mobile apps on smart devices focuses to reduce the time and cost and increase the performance of the infectious patient's condition. A four-layer architecture is proposed using IoT and Blockchain technologies. Many research works focus on investigating, analyzing, and highlighting the affected individuals through guiding the COVID-19 infection. Eventually, various mobile apps are recognized and addressed in this paper.

To the Editor, Immediate hypersensitivity reactions are related to mast cell and/or basophil activation. The mediators released such as tryptase and histamine are involved in clinical symptoms and are key parameters that contribute to diagnosis. Serum tryptase concentrations peak between 30 minutes and 4 hours following the reaction. Tryptase release is considered a robust marker of mast cell degranulation but is not informative in mild reactions.1 Histamine is released at the early beginning of the reaction but has a short half-life. The concentration value can be altered by pre-analytic conditions.2 Anaphylactic reactions can occur during night and week-end when laboratories can’t take charge of samples. To our knowledge, no thorough study of the stability in whole blood of these markers in anaphylaxis has been published. The aim of our study was to evaluate the impact of whole blood sample storage conditions (temperature and delay before centrifugation and plasma collection) on the reliability of tryptase and histamine measurements.Blood samples from 14 patients suspected of anaphylactic reactions (grade 2 to 4 of the Ring and Messmer scale)3 and from 10 volunteers were collected on EDTA after signed informed consent (CCPPRB Caen Basse-Normandie protocol 2004-32). The description of the patient anaphylactic episodes appears in Table 1.When received in the lab, an aliquot of whole blood was processed for diagnostic (reference measurement) and the remaining was divided in aliquots stored at room temperature (RT) or at +4°C for 24, 72 hours or 7 days (patients) or 2, 6, 24 or 72 hours for controls before centrifugation and plasma collection.Total tryptase concentrations were measured by an automated fluoroimmunoassay (ThermoFisher, Phadia SAS, ). Increased tryptase is defined as ≥ 1.2 x basal value + 2 µg.L-1.4 In our hands, tryptase uncertainties of measurement for low and high concentrations (9 µg.L-1 and 38.2 µg.L-1) are 17% and 16% respectively, in accordance with published results.5 Plasma histamine concentrations were measured by a radioimmunoassay (Beckman Coulter, Immunotech, France). Increased values defined by the manufacturer are >10 nmol.L-1, in accordance with published data.6 In our hands, histamine uncertainties of measurement for low and moderate concentrations (4.7 nmol.L-1 and 12.9 nmol.L-1) were 22% and 25%, respectively.The differences between the concentrations measured before and after storage were compared by paired two-tailed t-tests using SAS software. Results were considered significant for p < 0.05.As shown in Figure 1A, storage conditions did not modify tryptase concentrations (linear regression: slope=1.079, R²=0.9675). Tryptase concentrations appeared stable in whole blood left at +4°C for 7 days or 72 hours at RT.Histamine concentrations in patient samples were not modified during 72h at +4°C (Figure 1B) or at RT (Figure 1C). In the control group at RT, histamine concentrations were significantly increased at 6 hours (p=0.005) although moderately increased and staying within the limits of uncertainty measurement and never reaching the positivity threshold (Figure 1E). After 24 hours at RT a false positivity was observed for 8 of 10 samples (p<0.0001) (Figure 1E). At +4°C, histamine concentrations were significantly increased after 24 hours (p<0.0001) but remained in the limits of uncertainty measurement and under the threshold of positivity (Figure 1D). After 72h at +4°C, histamine concentrations exceeded the limits of uncertainty measurement and the positivity threshold for 4 samples of 10 (Figure 1D).Tryptase and histamine measurements are recommended to prove degranulation in anaphylaxis.7 Anaphylactic reactions occur unexpectedly. It is thus important to master sample shipment and processing before mediator measurement.The knowledge of possible artifacts modifying the measured values is necessary for the biochemist to address accreditation criteria of pre-analytic requirements (ISO 15189 standard) and for the physician to rely on trustable diagnostic data.Tryptase stability in whole blood had not been described. Our data has shown no impact on results after 72h at RT or 7 days at +4°C. Tryptase stability in plasma or serum has been evaluated by the manufacturer who ensured stability for 48h at RT or 5 days at +2°C to +8°C (Thermofisher).8 Thus, measured values of tryptase appear highly reliable.Histamine stability in whole blood had only been evaluated in controls and false positive results may be attributed to passive release from basophil during prolonged storage.2 We observed no impact for patient blood samples after 72h at +4°C or at RT. In contrast, false positive results were observed in controls after storage at RT during 24h or at +4°C during 72h. Histamine is known to be stable in the plasma obtained after centrifugation up to 4 days at RT for patients and controls.9According to these results, we suggest that whole blood samples can be stored at +4°C up to 72h for histamine and 7 days for tryptase when the laboratory is not available immediately. In any case, the biochemist must accept all these unrenewable samples. It is his role to take into account the pre-analytical conditions to interpret the results and provide helpful information to the physician.Keywords : pre-analytic; tryptase; histamine; whole blood.

• SARS and COVID-19; the two deadly pandemics to humans emerged from animal markets • A modern design for animal markets for preventing possible future pandemic diseases coming from animals is a top priority for the current time. • Animal market can be divided into high-risk and low-risk areas. • Visitor policy at the entrance of the market for the safety of animal market visitors.

Few studies have reported re-sternotomy after an omental flap procedure. We describe the case of a 78-year-old man who received re-sternotomy after omental flap procedure for deep sternal wound infection and successfully underwent coronary artery bypass grafting. Although preoperative computed tomography showed funnel chest and limited space between the sternum and omentum, re-sternotomy was performed safely using circular electric sternum saw under partial cardiopulmonary bypass. Because the omentum functioned as cushioning material between the sternum and mediastinal organs, no injuries of the mediastinal organs occurred. An ultrasonic scalpel effectively dissected between the omentum and mediastinal organs, especially above the ascending aorta. The targeted coronary arteries were easily detected. The patient experienced no major cardiac or infectious events for three months. An ultrasonic scalpel is recommended for dissecting between the omentum and mediastinal organs.

RLF-100 (aviptadil) is a synthetic form of Vasoactive Intestinal Polypeptide (VIP), a ubiquitous, naturally synthesized human peptide with extensively documented antiinflammatory, anti-cytokine cascade properties. It has been granted FDA Fast Track Designation for treatment of Critical COVID-19 with Respiratory Failure. A phase 2/3 trial is underway that has passed its first evaluation at 30 patients for safety and futility. This expanded access protocol is designed to offer access to investigational use of RLF-100 to patients who do not qualify for inclusion in Protocol RLF-100-001 (NCT04311697) either on the basis of specific medical exclusions or because there is no accessible study site available to the prospective participant.

The association of right heart thrombus (RiHT) and massive pulmonary embolism (PE) has an incidence of 4-18%. It is a life-threatening condition that requires emergent diagnosis and treatment with reported fatal outcomes up to 21% in 14 days. Endovascular mechanical thrombectomy of right heart clot has been described focused on the use of AngioVac (AngioDynamics, Latham, NY, USA), however, a recent report supported the safety of image guided FlowTriever(Inari Medical Inc., Irvine, CA, USA). Our case report describes the use of FlowTriever device as a unique modality to treat clot in transit and massive PE when thrombolysis is contraindicated.

This paper introduces a new direct scheme based on Dickson polynomials and collocation points to solve a class of optimal control problems (OCPs) ruled by Volterra integro-differential equations namely Volterra integro-OCPs (VI-OCPs). Studies in this regard require to calculate the corresponding operational matrices for expanding the solution of this problem in terms of Dickson polynomials. This recommended method allows us to transform the VI-OCP to a system of algebraic equations for choosing the coefficients and control parameters optimally. The error estimation of this technique is also investigated. Finally, some example are given to bring about the validity and applicability of this approach in comparison with those obtained from other methods.

We consider a PDE/ODE system for two pairs of competing species and study the spatial segregation limit as the interspecific competition rate tends to infinity. We show that the limiting problem is a one-phase Stefan problem for nonlinear diffusion equations.

Objective: There is wide variations in practice about the exact timing of coronary artery bypass grafting (CABG) post-acute myocardial infarction (AMI) and admission to hospital. This study aims to review current literature evidence to provide an up-to-date evaluation of the optimal CABG timing and parameters indicative of patient outcomes. Method: Electronic literature search was done to look into articles that discussed acute myocardial presentation and their referral for CABG either as urgent in-patient or as elective cases. The evidence was synthesised based on each reported article and their outcomes. Results: The timing of CABG following AMI have been explored in multiple studies, however there is no clear consensus on when to proceed with CABG following AMI and this remains controversial. The mortality rates vary with timing of CABG, but confounding factors such as age, poor pulmonary functions, renal insufficiency, poor left ventricular function and many others can all contribute to the variable reported outcomes. Conclusion: There is need for large, multi-centre study to identify optimal timings for CABG in cases of complex coronary artery diseases or failed PCI in patients with acute MI. Upcoming guidelines should emphasize patient cohorts by taking their risk factors into consideration.