Aims Capmatinib, an orally bioavailable, highly potent and selective MET inhibitor, was recently approved to treat adult patients with metastatic non-small cell lung cancer with METex14 skipping mutations. The study investigated the effect of capmatinib on the pharmacokinetics of a single oral dose of digoxin and rosuvastatin, administered orally as a two-drug cocktail in patients with MET-dysregulated advanced solid tumors. Methods This was a multicenter, open-label, single-sequence study. An oral drug cocktail containing 0.25 mg digoxin and 10 mg rosuvastatin was administered to adult patients with MET-dysregulated advanced solid tumors on Day 1, and then on Day 22 with capmatinib. Between Days 11 and 32, capmatinib 400 mg was administered twice daily to ensure the attainment of steady state for drug-drug interaction (DDI) assessment. Pharmacokinetics of cocktail drugs and safety of capmatinib were evaluated. Results Thirty-two patients (median age: 61.5 years) were enrolled. Co-administration of capmatinib increased digoxin Cmax, and AUCinf by 74%, and 47%, respectively. Co-administration of capmatinib increased rosuvastatin Cmax, and AUCinf by 204%, and 108%, respectively. Most frequent adverse events (AEs; ≥25% for all grades) were nausea (56.3%), asthenia (43.8%), constipation and vomiting (40.6%, each), peripheral edema (28.1%) and pyrexia (25%). Most frequent Grade 3/4 AEs (≥5%) were anemia and pulmonary embolism (9.4%, each), asthenia, dyspnea, nausea and vomiting (6.3%, each). Conclusion This study demonstrated that capmatinib is an inhibitor of P-gp as well as BCRP transporters, with clinically relevant DDI potential. Capmatinib was well-tolerated and no unexpected safety concerns were observed.

Abstract Background: Current literature on COVID-19 pandemic has identified diabetes as a common comorbidity in patients affected. However, the evidence that diabetes increases the risk of infection, effect of diabetes on outcomes and characteristics of patients at risk is not clear. Objectives: To explore the prevalence of diabetes in COVID-19 pandemic, effect of diabetes on clinical outcomes and to characterise the patients with diabetes affected by COVID-19. Methods: A literature review of articles published in English language and reported outcomes on prevalence and effect of diabetes on outcomes and patients characteristics. Results: The prevalence of diabetes in COVID-19 patients appears similar to that in the general population. The evidence of diabetes increasing the risk of severe infection and adverse outcomes is substantial. The progression of the disease into acute respiratory distress syndrome, the requirement for intensive care admission or mechanical ventilation and mortality all have been increased by the presence of diabetes. Patients with diabetes at risk of COVID-19 appear to be obese, of older age, have uncontrolled glycaemia and have coexisting comorbidities especially cardiovascular disease and hypertension. Tight glycaemic control on admission to hospital using insulin infusion has shown some beneficial effects however, the role of hypoglycaemic medications in the management of these patients is not yet clear. Conclusion: High risk group should be identified and prioritised in future vaccination programmes. Future research is required to optimise management of patients with diabetes and develop new ways to manage them via technological developments such as telecare.

Rationale, aims and objectives: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an important uncommon complication. Due to its complexity, its prevention requires a multidisciplinary approach, involving physicians and dental clinicians. This study aimed to assess the knowledge level of physicians prescribing bisphosphonates in Tehran about dental considerations in such patients and prevention and treatment of BRONJ in 2019. Methods: This descriptive, cross-sectional study evaluated 100 physicians (rheumatologists, endocrinologists, oncologists, and orthopedists) practicing in Tehran. A questionnaire comprising of a demographic section, and knowledge questions regarding dental considerations in patients taking bisphosphonates was administered among the physicians. The frequency of qualitative variables such as gender, type of specialty, and physicians’ responses to each question was calculated, and the knowledge scores were analyzed separately based on the type of specialty of physicians using one-way ANOVA followed by the Tukey’s test for pairwise comparisons. The effect of different variables on knowledge score was analyzed by simple regression. Results: The mean knowledge score of physicians was 5.19±1.78 (range 2-8). The mean knowledge score of oncologists was significantly higher than that of endocrinologists (5.88 versus 4.52, P=0.03). No other significant differences were noted. Work experience (P=0.04), age (P=0.02), orthopedics specialty (P=0.05) and oncology specialty (P=0.006) had significant effects on the knowledge score. Type of practice (P=0.75), gender (P=0.32), and rheumatology specialty (P=0.07) had no significant effect on the knowledge score. Conclusion: Considering acquiring about 50% of the total score, physicians seem to have limited knowledge about dental considerations in patients taking bisphosphonates. Attempts must be made to enhance their knowledge by the continuing education programs or revising the curricula.

Wildfires are a cause of soil water repellency (hydrophobicity), which reduces infiltration while increasing erosion and flooding from post-fire rainfall. Post-fire soil water repellency degrades over time, often in response to repeated wetting and drying of the soil. However, in mountainous fire-prone forests such as those in the Western USA, the fire season often terminates in a cold and wet winter, during which soils not only wet and dry, but also freeze and thaw. Little is know about the effect of repeated freezing and thawing of soil on the breakdown of post-fire hydrophobicity. This study characterized the changes in hydrophobicity of Sierra Nevada mountain soils exposed to different combinations of wet-dry and freeze-thaw cycling. Following each cycle, hydrophobicity was measured using the Molarity of Ethanol test. Hydrophobicity declined similarly across all experiments that included a wetting cycle. Repeated freezing and thawing of dry soil did not degrade soil water repellency. Total soil organic matter content was not different between soils of contrasting hydrophobicity. Macroscopic changes such as fissures and cracks were observed to form as soil hydrophobicity decayed. Microscopic changes revealed by scanning electron microscope imagery suggest different levels of soil aggregation occurred in samples with distinct hydrophobicities, although the size of aggregates was not clearly correlated to the change in water repellency due to wet-dry and freeze-thaw cycling. A nine year climate and soil moisture record from Providence Critical Zone Observatory was combined with the laboratory results to estimate that hydrophobicity would persist an average of 144 days post-fire at this well-characterized, typical mid-elevation Sierra Nevada site. Most of the breakdown in soil water repellency (79%) under these climate conditions would be attributable to freeze-thaw cycling, underscoring the importance of this process in soil recovery from fire in the Sierra Nevada.

Background: recent epidemiological studies state that a high dose of folic acid status during pregnancy increases the risk of asthma, wheezing, and respiratory disease in childhood. As potential biological mechanism, folate acid can modify inflammation and immune susceptibility of offspring with some epigenetic differentiation, including DNA methylation. This study evaluated the association between maternal folate levels during pregnancy with childhood wheeze, and whether DNA methylation differentiation of children in genes is related to wheezing or not. Methods: the cohort comprised 6651 mother–child pairs who were evaluated for an association between maternal folate level during pregnancy and childhood wheeze at 1, 2, 4, and 7 years age, which were assessed by the International Study of Asthma and Allergies in Childhood questionnaire. Results: the median of maternal serum was 16.76 nmol/l, assayed by chemiluminescent immunoassay. We found significantly increased adjusted odds ratios of childhood wheeze at 2 years age according to maternal folate levels, compared with lowest folate quartile (odds ratio [95% confidence interval] = highest; 1.27 [1.03, 1.56], and second; 1.27 [1.05, 1.55]), however, no changes were observed at 1, 4, and 7 years age. In a case-control study of childhood wheeze due to DNA methylation at 7 years age, no association of maternal folate levels with DNA methylation was observed. Conclusion: our result proposes that the negative effect of maternal folate on an infant’s wheeze did not remain until 7 years of age and no association with maternal folate levels and DNA methylation (at the same age) was observed.

Objectives: The Mucous membrane of the maxillary sinus is sensitivis susceptible to infection or inflammation adjacent to it, which may contribute to mucous membrane thickening (MMT). Residual alveolar bone quality (RABQ) is the nature of the remaining bone apical to periodontal defect adjoining to the floor of the maxillary sinus. The current study aimed to analyze the minimum RABQ to prevent the extension of periodontal pathology from reaching maxillary sinus using Cone-beam computed tomography (CBCT). Methods: In this retrospective observational study, 240 sinus exposure CBCT records of 134 patients were evaluated. Patients with at least one sinus exposure were included. RABQ and MMT were calculated using CBCT inbuilt tools. RABQ was divided into four groups based on Gray scale values (GSV). Statistical analysis was performed using One way ANOVA and independent sample t-tests. Correlation was completed applying Pearson’s correlation coefficient. Results: Significant difference (p<0.05) was observed between the MMT values of the four RABQ groups. Inverse correlation was observed between mean MMT and GSV values. Mean MMT is higher than pathological MMT range (>2mm), with significant differences in groups A and B, where mean GSV values are less than 500. Mean GSV greater than 500 in groups C and D show non-pathological MMT. Prevalence of MMT is 91.4% if GSV is <500 and 7.5% if GSV is >500. Conclusions: Our study suggests that MMT is present if RABQ has GSV values < 500. Maxillary sinusitis and its etiology from periodontal pathology can be excluded based on RABQ adjoining periodontal lesion. Early detection and prompt treatment, along with appropriate regenerative protocols can be performed to increase the RABQ. Further microbiological investigation is required to support the present results.

The COVID-19 pandemic has modified many aspects of clinical practice. Although the COVID-19 crisis is, primarily, a physical health crisis, in many cases physicians understood the urgency of the mental aspects as well and tried to find new ways to humanize the patients’ hospitalization. Policies designed to keep patients and medical staff safe required extreme but necessary measures, including social distancing. That meant that patients were isolated from their families until discharge, remaining in a sort of undefined mental space.That meant that patients were isolated from their families until discharge, remaining in a sort of undefined mental space. The common question that brought the patients’ relatives together was: is this really a temporary separation or a start towards a final departure? The paper shows strategies to humanize and manage the ICU treatments and mourning during the COVID-19 pandemic.

Juvenile myelomonocytic leukemia (JMML) is an aggressive clonal hematopoietic disorder of infancy and early childhood. About 15% of these patients have CBL mutation, which is usually a germline mutation with a high incidence of CBL syndrome. Conventional chemotherapy would be little benefit to these children, but epigenetic therapy with the DNA-hypomethylating agents can make a great difference in disease control. Here we report two infants diagnosed as JMML with CBL mutation. One case was treated with 6-mercaptopurine intermittently, but she was often hospitalized for pneumonia since the disease was not well controlled. The other one was treated with decitabine. He achieved clinical complete remission (CR) after three cycles of decitabine (20mg/m2/d×5 days, repeated every 4 weeks). Unfortunately, the patient’s symptoms were recurrent two months later. Thus, JMML patient with CBL mutation has a good clinical response to decitabine, while how and how long it could be used remain to be further explored.

Objectives Frequently used rapid rifampicin drug susceptibility tests (RMP-DST) miss certain rifampicin resistance (RR)-conferring mutations, leaving RR-tuberculosis undetected. Unknown for RR-TB is the therapeutic threshold, the probability of disease at which there is equipoise between treating and not treating. In Mozambique, in a patient not responding to first-line treatment, clinicians decided to start RR-TB treatment without bacteriological proof of RR-TB. We determined the probability of RR-TB in this patient. Methods We converted probabilities and odds ratios of clinical arguments for RR-TB from literature to likelihood ratios. We then combined the associated confirming and excluding power of those arguments to estimate the probability of RR-TB when the patient was started on RR-TB treatment, and simulated its variation. We used a log-odds scale to illustrate the effect of confirming and excluding arguments. Results The starting point was the prevalence of RR-TB in Mozambique. Positive HIV-status, treatment failure after a first treatment and after retreatment were included as confirming arguments, and RMP-DST showing rifampicin susceptibility as excluding argument for RR-TB. In this patient, the probability of RR-TB was 46.6% (95% uncertainty interval: 25.0%-72.0%) when RR-TB treatment was started. Treatment failure and retreatment failure provided strong confirming arguments, and the RMP-DST result a strong excluding argument for RR-TB. Conclusions The therapeutic threshold to start RR-TB-treatment is unknown but probably lower than 47%. The uncertainty in our estimation reflects the clinical uncertainty in low-resource settings. Determining the RR-TB therapeutic threshold is needed to guide clinical decisions.

Telangiectatic osteosarcoma(TOS) is one of the rare subtypes of osteosarcoma(OS) and mainly affects the male of adolescents and young adults in the appendicular skeleton. We report a case of a 3-year-old girl who was diagnosed with TOS arising from the upper and proximal of the left humerus.

The authors present a case report about elective replacement of a mechanical bental with a bioprosthetic valve. The authors describe a technique whereby the mechanical valve is ‘broken’ off it’s mechanism and the new valve is sutured in the old cuff.

Ecosystems wherein social and solitary predators share space, complex asymmetric intraguild interactions actively shape the group size of social carnivores. Intense intraguild predation has been known to result in reduced group size and low recruitment rates in subordinate social carnivores. In South and South-east Asia, Dhole, tiger and leopard form a widely distributed sympatric guild of large carnivores. In this paper we attempted to understand the pack size dynamics of a subordinate social predator, the dhole, by investigating factors underlying pack size variation at two neighbouring sites. We further evaluated our local-scale patterns of pack size variation at a larger scale by doing a distribution-wide assessment of pack size across dhole ranging countries. Across study sites, we found an inverse relationship between the local abundance of a top predator and group size of a subordinate predator while accounting for variability in resources and habitat heterogeneity. Tiger density was low (0.71/100 Km2) at the site having large dhole packs (16.8 ± 3.1) whereas, a relatively smaller average dhole pack size (6.4 ± 1.3) was observed in a higher tiger density (5.67/100 Km2) area. Our results on distribution-wide assessment are concurrent with local-scale results, showing a positive association between prey abundance and pack size and a negative association between tiger densities and dhole pack size. Our study takes us one step closer to trying to answer the age-old question of what drives the pack size of social predators in a multi-predator system. Linking behaviour to population dynamics and carnivore interactions is another highlight of the study. Often helpful while optimizing conservation triage and formulation of management implications like recovery and translocations.

Objective: Sentinel lymph node biopsy (SLNB) seems as efficient as selective neck dissection (SND) for the treatment of occult metastases in T1-T2cN0 oral squamous cell carcinoma (SCC). The aim of our study was to assess and compare the cost of these two surgical procedures. Patients and methods: This retrospective cost analysis includes consecutive patients treated between 2012 and 2017 in two French hospitals either by SLNB or SND. Hospital cost (hospital stay for initial surgery and re-hospitalizations over a period of 60 days after the initial surgery), the length of hospital stay for the initial surgery and the perioperative management were described and compared between the two techniques. The propensity score regression adjustment method was used to address selection bias. Results: Ninety-four patients underwent SLNB procedure and seventy-seven patients underwent SND. The length of hospital stay for initial surgery was lower in SLNB group: 5.8 days (SD: 3.8) versus 9.2 days (SD: 5) in the SND group. Hospital costs were lower in SLNB group: \euro7 489 (standard deviation: \euro3 691) versus \euro8 886 (standard deviation: \euro4 381) but this difference was not significant after propensity score regression adjustment. The rate of complication, the delay of full oral feeding and postoperative drainage were lower in SLNB group. Conclusion: SLNB in T1-T2cN0 oral SCC is less invasive than SND with fewer complications, a shorter length of hospital stay and favorable perioperative management. This study shows that this technique could be also less expensive than SND.

Introduction Exit block, which is difficult to strictly confirm and cannot be adopted for adenosine triphosphate (ATP) injections to provoke dormancy, is an essential concept of atrial fibrillation (AF) ablation. We investigated exit conduction using high frequency stimulation (HFS) and evaluated whether dormant “exit” conduction of the pulmonary veins (PVs) and left atrial posterior wall (LAPW) would remain in patients in which an encircling isolation of all PVs and LAPW isolation (Box PVI) were performed. Methods We enrolled 345 consecutive patients with various severities of AF undergoing a Box PVI and defined the procedure endpoint as complete bidirectional block with no dormant “entrance and exit” conduction of all PVs and the LAPW using HFS and ATP. Results Dormant “exit” conduction of the PVs with HFS delivered at the PV carina following an ATP injection remained in 0.9% after additional applications, and that for the LAPW was provoked in 5.5%, which remained in 1.4%. Our definition of a complete bidirectional Box PVI was satisfied in 79.7% and showed the best clinical outcome. In the non-paroxysmal AF group, there were significant differences in the recurrence rates between the groups with and without a complete LAPW isolation, however, the clinical outcome was independent of a complete LAPW isolation in the paroxysmal AF group. Conclusion HFS delivered at the PV carina and LAPW following a Box PVI could clearly elucidate true exit block, and a concomitant ATP injection could define dormant “exit” conduction, suggesting incomplete lesions that had been missed.

Introduction: Achievement of a favorable pacing threshold with a Micra transcatheter pacing system (Micra-TPS) is important for reducing battery depletion; in some cases, the threshold increases shortly after the device is implanted, and a higher pacing threshold may be required. This study aimed to define the causes and predictors of the increase in pacing threshold observed shortly after Micra-TPS implantation. Methods and Results: The study included 64 consecutive patients who underwent Micra-TPS implantation between 2017 and 2020. Patients were divided into two groups depending on their pacing threshold, namely, the increased pacing threshold (IPT) group (threshold increased by ≥0.5 V/0.24 msec within 1 month of implantation) and the stable pacing threshold (SPT) group. Excluding 4 patients we were unable to conduct follow-up on, 9 of the 60 remaining patients (15%) were in the IPT group and 51 (85%) were in the SPT group. The IPT group had significantly lower implant impedance values and higher implant thresholds than the SPT group: 582 ± 59 vs 755 ± 167 Ω (P <0.001) and 1.29 ± 0.87 vs 0.71 ± 0.40 V/0.24 msec (P =0.014), respectively. Implant impedance and threshold may serve as predictors of a threshold increase after implantation (area under the curve: 0.737–0.943 and 0.586–0.926, respectively). Conclusion: An increased pacing threshold was noted shortly after Micra-TPS implantation owing to micro-dislodgement because of insufficient anchoring of the device on the myocardium. Impedance >660 Ω and threshold <1.0 V/0.24 msec may be predictive factors for an increased pacing threshold.

Background Marijuana usage is increasing world over for both medicinal and recreational purposes. Several states are legalizing cannabis and physicians can expect to encounter more patients who use or abuse marijuana. Adverse cardiovascular effects of marijuana like myocardial infarction, cardiomyopathy and arrhythmias have been well described but bradyarrythmia are rare and mechanisms are not well pronounced. Case summary A 26 years old young medical intern with history of chronic marijuana usage presented with complains of dizziness and recurrent syncope. Heart rate at presentation was 42 beats per minute and rest of the physical examination was unremarkable. There was high grade atrioventricular block in the Electrocardiogram (ECG) and subsequent electrophysiological (EP) study showed high grade supra-hisian (nodal)atrioventricular block with mildly prolonged his-ventricular (HV) interval. Urinary screen was positive for Δ9-tetrahydrocannabinol (THC). After ruling out other possible causes, diagnosis of high-grade AV block due chronic marijuana use was made. Dual chamber pacemaker was implanted, and patient was discharged in stable condition. The heart rhythm completely improved at three-month follow-up. Discussion We report a novel finding in marijuana induced bradyarrythmia. Reversible high grade atrioventricular (AV) block with electrophysiologic determination of site of conduction blockade is not reported previously. The mechanism of bradyarrythmia is thought to be mediated by increased vagal tone. However direct toxic effects of Δ9-tetrahydrocannabinol (THC), through cannabinoid receptors 1(CB1R ) on the cardiac conduction system cannot be ruled out.

Background: Literature reports 5% of recurrence/ failure in pediatric accessory pathway ablations. Our aim was to investigate the reasons underlying this finding and share techniques to obtain long term success. Methods: Thirty-nine pediatric patients referred for a repeat procedure were analyzed: characteristics of the pathways and the initial and redo procedures were identified. Results: Mean age was 11.9 ± 3.3 years (59% males). Three patients (8%) had multiple accessory pathways. The most frequent location was left lateral (26%). Left sided pathway recurrence was caused mainly by poor contact (60%) and inadequate mapping (40%). For right lateral accessory pathways, poor contact accounted for 70% of failures. For antero-septal and para-hisian locations, the use of cryoablation and choice of low radiofrequency energy delivery accounted for > 75% of failures. Long-term success strategies included choice of contact force catheters and radiofrequency applications at the ventricular insertion of the pathway and in the aortic coronary cusps. In postero-septal substrates, the main reason accounting for failure was deep or epicardial location of the pathway (37%), solved by using an irrigated tip catheter or applying lesions within the coronary sinus, or applications from both right and left postero-septal areas. Conclusion: Acute failure and post-procedure recurrence in pediatric accessory pathway ablations have multiple reasons related to the characteristics of the pathway and the technology available. Accurate understanding of the anatomy, careful mapping and pacing maneuvers, and incorporation of new technologies contribute to achieve a definitive success in > 98% of procedures.

Case report A 74-year-old man presented with frequent palpitations, described as “the heart beating on the neck.” He also had a history of two syncope episodes; the most recent was more than six months before his admission. By careful history taking, we found that the syncope episodes did not seem to occur as a result of vasovagal reflex. The patient’s resting electrocardiogram (ECG) showed a right bundle branch block (RBBB) pattern (Figure 1 ). Holter monitoring and exercise tests revealed a bundle branch block alternating between the right and left bundles. His echocardiogram was normal with preserved ejection fraction (EF) (66%).After this initial evaluation, he was subjected to an electrophysiological study (EPS) and the basic intervals measured were as follows: PR, 186 ms; QRS, 153 ms (RBBB); AH, 86 ms (basal); and HV, 60 ms. Atrial electrical stimulation (AES) induced a wide QRS complex tachycardia (Figure 2A ), with predominantly RBBB morphology, some of the QRS having a left bundle branch block (LBBB) pattern, and some atrial beats being blocked to the ventricles below the bundle of His (Figure 2B ).

Authors’ reply re: ’Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis (Response to BJOG-20-1416)Kate F Walker1, Keelin O’Donoghue2, Nicky Grace3, Jon Dorling4, Jeannette L Comeau4, Wentao Li5 Jim G Thornton11Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham2The Irish Centre for Maternal and Child Health, University College Cork, Cork University Maternity Hospital, Cork, Ireland3 School of English, University of Nottingham4Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada5Department of Obstetrics and Gynaecology, Monash University, Clayton, AustraliaThank you for the opportunity to comment on the letter by Dr Xue from Shanghai Jiao Tong University. We agree there are many weaknesses in the data we reviewed. Dr Xue has identified one. Others are the incomplete reporting of infant feeding and mother-child interactions, and the frequent lack of infant testing to confirm or refute the possibility of vertical transmission of COVID-19. Finally, although we simply provided summary totals, it would be statistically preferable to combine series using the Mantel-Haenszel method and calculate a relative risk. We judged that doing this in light of the uncertainties around the data which Dr Xue has identified, might give a spurious precision to our results. As he says, more work is needed. For now we think it remains reasonable to not regard COVID-19 in itself, as an indication for Caesarean, artificial feeding or separation, in the mother and baby’s interest.

Uniaxial static and cyclic creep tests are carried out on a bainite 2.25Cr-1Mo steel at 455°C. The dependence of cyclic response on varied unloading conditions is investigated, with unloading rates from 0.6 MPa/s to 39 MPa/s and the valley stress duration from 0 to 30 min. A systematic classification of strain components under cyclic creep is proposed to determine the actual damage. The results indicate that, the fracture modes under static and cyclic creep conditions both have ductile features. Due to the effect of anelastic strain recovery, the strain accumulation rate under cyclic creep is significantly retarded as compared with static creep, and the unloading conditions apparently influence the behaviour of anelastic strain recovery. Moreover, a life prediction method for cyclic creep tests based on mean actual strain deducted recovery strain is proposed.

Optical cables are enormous transmission media which carries high-speed data across transatlantic, intercontinental, international boundaries and cities. The optical cable is essential in data communication. The cable has become an indispensable component in optical communications infrastructure; hence, conscious efforts are always adopted to prevent or minimize faults in the optical network infrastructure. Typically, tracing fault in the underground optical network has been difficult even though optical time-domain reflectometer (OTDR) has been used to measure the distance of faults in the underground fiber cable. The methodologies deployed in the reviewed literature indicate a vast gap between the fault distance measured by the OTDR and the actual distance of fault. This paper observed the difficulties involved in tracing the actual spot of fault in the underground optical networks. The difficulty of tracing these underground faults mostly result in an undue delay and loss of revenue. This research presents a machine learning (ML) approach to predict the actual location of a fiber cable fault in an underground optical transmission link. Linear regression in the python sci-kit learn library was used to predict the actual location of a fault in an underground optical network. The MSE and MAE evaluation matrix used provided good accuracy results of 0.061291 and 0.080143, respectively. The result obtained in this paper indicates that faults in underground optical networks can be found quickly to avoid the delays in the fault tracing process, which leads to an excessive revenue loss.

In plants Heat Shock Factors (HSFs) are encoded by large gene families and are primary regulators of responses not only to high temperatures but also to a number of other abiotic stresses and pathogen threats. Here we provide an overview of the diverse world of the plant HSFs through analysis of their functional versatility, regulation and interactions. HSFs can regulate tolerance to a number of extreme conditions including high or low temperatures, drought, hypoxic conditions, soil salinity, toxic minerals, strong irradiation or pathogen defenses. Variability is reflected in expression control with considerable differences in transcript profiles of individual HSF genes. Moreover, alternative splicing and posttranslational modifications provides further variability. HSFs are involved in complex web of protein-protein interactions which include formation of homomeric and heteromeric HSF trimers, and complexes with a number of other regulatory proteins including transcription regulators, chromatin-associated proteins or heat shock proteins (HSPs). Interactions of the Arabidopsis HSFA4A with proteins which control transcription, cellular homeostasis, responses to different stresses and programmed cell death, illustrate the complexity of the regulatory networks related to a plant HSF. Diversity in plant HSFs facilitates the adaptation to multiple adverse environmental conditions, an important feature in response to climate change.

How to get the discharge information of the river becomes a hot topic in global research. However, most river discharge measurement methods involve long cycles, low efficiency, and transdisciplinary expertise. This makes it impossible to assess river flows in ungauged basin rapidly. With the improvement of accuracy of hydrological parameters and variables, the data obtained by remote sensing method can not satisfy the hydrological calculation. This study presents a new method to rapidly assessing river discharge coupling remote sensing images and UAVs. We selected eight typical river-course cross-sections in Bortala river and Jing river to calculate river discharge. Construction of river cross-section shape by UAV data combined with groundwater level monitoring. Dividing the reach and generalizing the relationship of hydraulic geometry of the reach. By extracting the river width, the river discharge of river cross-section was estimated. The results showed that the calculated results were consistent with the measured data and the accuracy was above 90%. This paper discusses the application of this method in satellite remote sensing. The results compared with the measured daily data of hydrological station, and the accuracy of the calculated results can reach above 85%. The method used in this study for calculating river discharge based on a combination of UAV and satellite remote sensing can effectively promote research progress into basin river discharge, and provide an important reference for river discharge monitoring in ungauged basins.

Thyroglossal duct on the dorsum of the tongue in the pediatric patient can cause a difficult airway due to the large mass and risk of airway obstruction associated with a swollen tongue after surgery.