Background. 2018 Guideline from the College of American Pathologists(CAP), the International Association for the Study of Lung Cancer (IASLC) , and the Association for Molecular Pathology(AMP) established a benchmark turnaround time (TAT), according to which the results were supposed to be available to the treating oncologist within 10 working days. Methods. In this study, we established and validated a new protocol for pathological diagnosis and treatment pathway that was tested in the Henan Cancer Hospital, China. Results. Compared with the routine pathway, the new path adopts a parallel approach to conventional pathology and molecular pathology, which significantly shortens the TAT to 4-6 days. Self-designed DNA biology collector “BIOCO” tool, designed by our team to collect specimens that are discarded when the wax block is trimmed, can effectively save pathological samples, avoid cross-contamination and reduce the period extension caused by re-sampling. Most importantly, its accuracy and effectiveness are consistent with conventional collection methods. Conclusions. Therefore, the new diagnosis and treatment pathway based on the BIOCO collector can be used as a practical approach to the molecular diagnostic platform of the hospital pathology department.

In this paper, authors introduce the generalized Bessel-Maitland transform whose kernel is the generalized Bessel-Maitland function. New identities are obtained for special cases of the generalized Bessel-Maitland function. Using these relations, several identities are obtained for generalized Bessel-Maitland integral transform. It is shown that some special cases of them are related with the Laplace transform and the Hankel transform. Also, some examples are given as representations of the outcomes presented here.

In this paper, we give a new method to show a monotonicity result for a function $f$ satisfying $(_{a}\nabla_{h}^{\nu}f)(t)\leq0$ ($(_{a}\nabla_{h,\ast}^{\nu}f)(t)\leq0$) with $\nu\in(0,1]$, which has never been solved in other papers. In addition, we give an example to illustrate one of our main results.

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\begin{abstract} In this work, we discuss the existence of positive periodic solutions of a class of second order nonlinear neutral delay differential equations of the form \\ \begin{align*} & [u(t)-p(t)f(u(t-\alpha))-q(t)g(u(t-\beta))]’‘= -\sigma(t) u(t)+ h(t, u(t-\alpha), u(t-\beta))\\ & [u(t)-p(t)f(u(t-\alpha))-q(t)g(u(t-\beta))]”= \sigma(t) u(t)- h(t, u(t-\alpha), u(t-\beta)) \end{align*} by using Krasnoselskii’s fixed point theorem. \\ {\bf{Mathematics subject classification (2010)}}: 34K13, 34A34\\ {\bf{Keywords}:} Periodic solution, neutral differential equation, delay, nonlinear.\\ \\ \end{abstract}

This article presents to evaluating the sway of thermal radiation and chemical reaction on MHD flow of Ag/SWCNT – Water based Maxwell hybrid nanoliquid over a vertical cone by considering Cattaneo - Christov heat flux, convective boundary condition and suction parameter. By using appropriate transformations the nonlinear partial differential equations are converted into ordinary differential equations. The governing dimensionless equations are solved by using an optimized and extensively validated Finite element method. The sway of dissimilar parameter on hydrodynamic, thermal and solutal boundary layer is perceived and the results are laid out graphically. Additionally, the values of skin – friction coefficient, Nusselt number and Sherwood numbers are authorized for different values of pertinent parameters and results are demonstrated in tabular form. Comparison of the present problem results with existing results shows good agreement. The key observations are summarized as the velocity grows with (ϕ1), Temperature increases for Biot number (Bi) and Skin – friction coefficient, Sherwood number declines, nevertheless Nusselt number escalates as values of Deborah number (α) improves.

Erdheim–Chester disease (ECD) is a rare non-Langerhans disease. This report describes a 51-year-old woman with a history of weakness, bone pain, xanthelasma palpebrarum, diabetes insipidus, and hypothyroidism. ECD is a multisystemic condition with a poor prognosis. This disease should be considered in patients with diabetes insipidus and multiorgan involvements.

Secondo uno studio della FAO entro il 2050 ci sarà un forte aumento della popolazione mondiale, il che porterà a conseguenze gravi quali un aumento sostanziale della domanda di cibo, la riduzione della risorsa idrica e un eccessivo consumo del suolo.  In questi quadro ricopre un ruolo di interesse l'agricoltura urbana, essa consiste nel coltivare cibo all'interno di contesti urbani. Si ricercherà sempre più spesso un legame tra agricoltura ed economia circolare, essa consiste in un'economia pensata per potersi rigenerare da sola. L'unione tra economia circolare e agricoltura urbana porta i BIA che consistono in edifici che ospitano al proprio interno delle serre. Si pone quindi come necessaria la transizione dal modello lineare ad un modello circolare, che a considerazione di tutte le fasi sappia limitare l'apporto di materia ed energia in ingresso e di minimizzare scarti e perdite.

Objective: Examine the trajectory of left ventricular ejection fraction (EF) among patients eligible for implantable cardioverter-defibrillator (ICD) therapy Background: Ejection fraction is the cornerstone criterion for ICD therapy, but the risk of sudden cardiac death (SCD) remains after an improvement in EF. Methods: We examined the trajectory of EF among 1178 participants of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) who had 3 or more assessments of EF, at least 90 days apart. A follow-up EF >35% or >10% absolute increase in EF from baseline were examined as the criteria for EF improvement. Results: At first follow-up, 381 (32%) patients had an improvement of EF to >35%. However, EF had returned back to 35% in 109 (27%) of these patients at second follow-up. Similarly, 446 (38%) patients experienced a >10% improvement in EF at first follow-up, but 109 (24%) of these had a subsequent >10% decrease in EF at the second follow-up. Of the 32 patients with normalized EF (≥55%) at first follow-up, 18 (56%) had a subsequent >10% decrease in EF. The fluctuation in EF was present in both ischemic and non-ischemic cardiomyopathy but a higher proportion of patients with non-ischemic cardiomyopathy had an improvement in EF to >35% at first follow-up compared to those with ischemic cardiomyopathy (38% vs. 27%, p=<0.0001). Conclusion: There is substantial fluctuation of EF among patients who are eligible for ICD therapy. These data may help explain the continued risk of SCD after improvement in EF.

A 54-year-old man with paroxysmal atrial fibrillation underwent pulmonary vein (PV) isolation using a 28 mm second-generation cryoballoon catheter. Unexpected electrical superior vena cava (SVC) isolation during cryoballoon application to the right superior PV was observed in the first procedure. Thirteen-months after cryoballoon-based PV isolation, sustained SVC fibrillation was confirmed irrespective of sinus rhythm. Voltage mapping visualized a low voltage area around the SVC was consistent with that around the right superior PV. SVC isolation was obtained by cryoballoon application to the right superior PV and persisted for over a year.

Pulmonary artery sling (PAS) and tracheal agenesis (TA) are both very rare diseases. Most of PAS are associated with tracheal bronchial malformations. However, PAS associated with TA have not yet been reported so far. Here, we report one case of PSA associated with TA diagnosed prenatally in our hospital. Due to the extremely low incidence of two diseases, physicians do not have sufficient understanding of these disease, prenatal ultrasound examination found that these kinds of diseases are very challenging and confusable. Prenatal ultrasound and MRI examination of pulmonary artery branches, trachea and esophagus will provide useful information. Improving the accuracy of prenatal fetal diagnosis is helpful for perinatal management and counseling.

Estimating snow water equivalent (SWE) and snowmelt in semi-arid mountain ranges is an important but challenging task, due to the large spatial variability of the seasonal snow cover and scarcity of field observations. Adding solar radiation as snowmelt predictor within empirical snow models is often done to account for topographically induced variations in melt rates, at the cost of increasing model complexity. This study examines the added value of including different treatments of solar radiation within empirical snowmelt equations. Three spatially-distributed, enhanced temperature index models that respectively include the potential clear-sky direct radiation (HTI), the incoming solar radiation (ETIA) and net solar radiation (ETIB) were compared with a classical temperature-index model (TI) to simulate SWE within the Rheraya basin in the Moroccan High Atlas Range. Extensive model validation of simulated snow cover area (SCA) was carried out using blended MODIS snow cover products over the 2003-2016 period. We found that models enhanced with a radiation term, particularly ETIB which includes net solar radiation, better explain the observed SCA variability compared to the TI model. However, differences in model performance were overall small, as were the differences in basin averaged simulated SWE and melt rates. SCA variability was found to be dominated by elevation, which is well captured by the TI model, while the ETIB model was found to best explain additional SCA variability. The small differences in model performance for predicting spatiotemporal SCA variations is interpreted to results from the averaging out of topographically-induced variations in melt rates simulated by the enhanced models, a situation favored by the rather uniform distribution of slope aspects in the basin. Moreover, the aggregation of simulated SCA from the 100 m model resolution towards the MODIS resolution (500 m) suppresses key spatial variability related to solar radiation, which attenuates the differences between the TI and the radiative models.

Being able to link clinical outcomes to SARS-CoV-2 virus strains is a critical component of understanding COVID-19. Here we discuss how current processes hamper sustainable data collection to enable meaningful analysis and insights. Following ‘Fast Healthcare Interoperable Resource’ implementation guide, we introduce an ontology-based standard questionnaire to overcome these shortcomings and describe patient “journeys” in coordination with the World Health Organization. We identify steps in the clinical health data acquisition cycle and workflows that likely have the biggest impact in the data-driven understanding of this virus.

Main aim of the present paper is explore certain physical phenomena by means of $p$-adic probability theory. To overcome this study, we deal with a more general setting to define $p$-adic Gibbs measures. For the sake of simplicity of explanations, we restrict ourselves to the Ising model on the Cayley tree, since such a model has broad theoretical and practical applications. To study $p$-adic quasi Gibbs measures, we reduce the problem to the description of the fixed points of the Ising-Potts mapping. Finding fixed points is not an easy job as in the real setting. Furthermore, the phase transition for the model is established. In the real case, the phase transition yields the the singularity of the limiting Gibbs measures. However, we show that the $p$-adic quasi Gibbs measures do not exhibit the mentioned type of singularity, such kind of phenomena is called strong phase transition. Finally, we deal with the solvability and the number of solutions of ceratin $p$-adic equation depending on several parameters. Such a description allows us to find all possible translation-invariant $p$a-adic quasi Gibbs measures.

Objective: To evaluate the oxygen uptake at peak exercise (VO2 peak) and to correlate with lung volume and capacity and body composition of children and adolescents with cystic fibrosis (CF). Methodology: Cross-sectional study with CF patients treated at the pediatric pulmonology outpatient clinic of a public hospital in Porto Alegre, aged ≥ 7 years up to 18 years. Study assessments included: cardiopulmonary stress testing, plethysmography, and body composition assessment using body bioimpedance. Results: Thirty patients were studied, with a mean peak VO2 of 1.511 ± 0.539 liters in the population studied. Correlation analysis showed a strong correlation between peak VO2 in liters and lean mass (r = 0.77 and p <0.001), and strong and inverse correlation with fat percentage (r = - 0.77 and p <0.001). ), a strong correlation with forced vital capacity (FVC) in liters (r = 0.72 and p <0.001) and forced expiratory volume in the first second (FEV1) also in liters (r = 0.69 and p <0.001). We observed a strong correlation between load (W) and lean mass and during CPET (r = 0.64 and p <0.001), and inversely with fat percentage (r = -0.64 and p <0.001). This study showed that patients with higher lean body composition have a better performance on cardiopulmonary testing, contributing to greater exercise tolerance.

Background: High frequency (HF) oscillatory ventilation has been shown to improve CO2 clearance in premature infants. In a previous in vitro lung model with normal lung mechanics we demonstrated significantly improved CO2 washout by HF oscillation of bubble CPAP (BCPAP). Objective: To examine CO2 clearance in a premature infant lung model with abnormal lung mechanics via measurement of end-tidal CO2 levels (EtCO2) while connected to HF oscillated BCPAP. Design/Methods: A 40mL premature infant lung model with either: normal lung mechanics (NLM): compliance 1.0 mL/cmH2O, airway resistance 56 cmH2O/(L/s); or abnormal lung mechanics (ALM): compliance 0.5 mL/cmH2O, airway resistance 136 cmH2O/(L/s), was connected to BCPAP with HF oscillation at either 4,6,8,10 or 12 Hz. EtCO2 was measured at BCPAPs of 4,6 and 8 cmH2O and respiratory rates (RR) of 40,60 and 80 breaths/min and 6mL tidal volume. Results: HF oscillation decreased EtCO2 levels at all BCPAPs, RRs, and oscillation frequencies for both lung models. Overall mean±SD EtCO2 levels decreased (p<0.001) from non-oscillated baseline by 19.3±10.2% for NLM vs. 14.1±8.8% for ALM. CO2 clearance improved for both lung models (p<0.001) as a function of oscillation frequency and RR with greatest effectiveness at 40-60 breaths/min and HF at 8-12 Hz. Conclusions: In this in-vitro premature infant lung model, HF oscillation of BCPAP was associated with improved CO2 clearance as compared to non-oscillated BCPAP for both NLM and ALM. The significant improvement in CO2 clearance in an abnormal lung environment is an important step towards clinical testing of this novel respiratory support modality.

A two-dimensional tumor-immune model with the time delay of the adaptive immune response is considered in this paper. The model accounts for the interaction between cytotoxic T lymphocytes (CTLs) and cancer cells on the surface of a solid tumor with a necrotic kernel. The system has three equilibria. Both zero and maximum tumor volume equilibria are unstable, while the behavior of the positive equilibriums is closely related to the ratio of the immune killing rate to tumor volume growth rate. The positive equilibrium is more likely to be locally asymptotically stable when the ratio is smaller than a critical value, and unstable otherwise. We also derive conditions to guarantee the existence of Hopf bifurcation at the positive equilibrium. Applying the center manifold reduction and normal form method, we obtain explicit formulas to determine the properties of Hopf bifurcations. The global continuation of local Hopf bifurcation is studied based on the coincidence degree theory. The results reveal that long immune delay can lead to oscillation dynamics. We also carry out detailed numerical analysis for parameters to illustrate our qualitative analysis. Numerically, we find that a shorter immune response time leads to a longer patient survival time and the period and amplitude of a stable periodic solution increase with the immune response time. When CTLs recruitment rate and death rate vary, we observe how the ratio metioned above and the first bifurcation value change numerically, which yields further insights to the tumor-immune dynamics.

Finding the nth term of a sequence is one of the most common questions in Algebra. This article introduces an original and alternative formula to calculate any term of any degree sequence. The examples are solved by using this formula first, then the answers are confirmed by using either Newton's Formula or Lagrange Interpolation Formula. Both the formula and its proof take advantage of Pascal's triangle.

In the current research work, we are going to discuss the Modified Bergman's Minimal blood glucose-insulin model.We are restructuring the old model by including one more component known as diet, which is also very essential for blood glucose model. Many years ago the minimal model was define which explain the relation between blood glucose and insulin level, and after that a lots of work and research has been done on it. We define the fractional model to show the strength of Caputo-Fabrizio fractional derivative and also examined the existence and uniqueness of the result along with its numerical and graphical representation.

In this work, a new discrete formulation for a tracer aggregation population balance equation is developed based on an assumption that the particles properties are concentrated on the representative of the cell. The new formulation is simpler, easy to code and can be easily adaptable to any kind of grid. The proposed method is extended to solve a mixed-suspension mixed-product removal (MSMPR) system in which aggregation and nucleation are main mechanisms that effect the particles properties. The performance of the new formulation is tested against the cell average technique (Giri and Nagar, ESAIM-Math. Model. Num., 49(2), 349-372 (doi.org/10.1051/m2an/2014035)) for different analytically tractable problems. The testing is conducted by taking into consideration two bench marking cases, namely, batch and MSMPR systems using both gelling and non gelling kernels. It is demonstrated that the new scheme is computationally less expensive and predicts the numerical results with high precision even on a coarser grid. For even a refined grid, the new scheme tends to produce better results than the cell average technique at a lesser computational time.

Monitoring of the fluctuations of groundwater storage is particularly important in arid and semi-arid regions where water scarcity brings about various challenges. Remote sensing data and techniques play a preponderant role in developing solutions to environmental problems. Emergence of GRACE satellites have eased the remote monitoring and evaluation of groundwater resources with an unprecedented precision over large scales. Within the scope of the current study, the latest release of GRACE Mascon’s dataset as well as GLDAS models of Noah and CLSM were integrated to extract groundwater storage anomalies (GWSA) over Turkey. The temporal interactions of the estimated GWSA with the climatic variables of precipitation and temperature (derived from the reanalysis datasets of CHELSA and FLDAS, respectively) were investigated statistically. The results suggest the there is a descending trend for TWSA and GWSA over Turkey with a total loss of 11 and 6 cm respectively. The statistical analysis results also indicate that the monthly variations of GWS over Turkey are highly correlated with precipitation and temperature at 2-month lag. The analysis of the climatology (long-term) values of monthly GWSA, precipitation and temperature also revealed high agreement between the variables.

Letter to editor It has been demonstrated that the latest outbreak-causing novel coronavirus pneumonia (COVID-19) virus (2019-nCoV, SARS-CoV-2) invades human alveolar epithelial cells primarily by angiotensin-converting enzyme 2 ACE2 (Zhou et al., 2020). The SARS-CoV engages ACE2 for cellular entry to produce final infection (Hoffmann et al., 2020). Furthermore, Zhao et al documented that in human lungs, ACE2 is found primarily in alveolar epithelial cells of type II (AT2), indicating that this virus activates ACE2-positive AT2 cells to cause pneumonia (Zhao et al., 2020). Recently an epidemiological research indicated that certain patients with SARS-CoV-2 exhibit symptoms of severe liver injury (Chen et al., 2020). The investigators also established that ACE2 is significantly enriched in cholangiocytes by studying stable liver cells at single-cell resolution (Chai et al., 2020), depicting that the virus may bind ACE2-positive cholangiocytes directly causes dis-regulation result in liver function. Now the main question arises that why ACE2 is crucial for COVID-19 control and treatment strategies? Normally, ACE2 catalyzing the transformation of angiotensin-II into angiotensin-1–7. Angiotensin-II acts on angiotensin receptor-1(AT1) and controls the processes of vasoconstriction, apoptosis, proinflammatory changes, and fibrosis cycle, while angiotensin 1–7 acts on Mas receptors induces contrary symptoms (Paz Ocaranza et al., 2020 ). Thus any loss in the activity of ACE2 in the alveolar cells may increase the level of angiotensin II and result in acute respiratory distress. The expression of ACE2 is comparatively higher in lung and a study documented the protective role of ACE2 in lung injury (Imai et al., 2005). It was proved in a mice model that acidic gas inhaled by mice downregulated ACE2 and increased the level of Ang II in the lung and plasma of wild-type mice, and the levels of Ang II in the lung. Further, the research team found that recombinant human ACE2 (rhACE2) protein action may reduce the plasma Ang II levels and reduce the risk of acute lung injury in ACE2 Knockout mice. The binding mode of COVID-19 virus with ACE2 and the clinical importance of renin-angiotensin System, revealed that this system is extensively involved in the pathology of COVID-19 (Gurwitz, 2020; Vaduganathan et al., 2020). Mostly the COVID-19 patients develop fever, inflammatory changes, and respiratory distress. It can be hypothesized that these changes might be due to lack of ACE2 and imbalance in renin-angiotensin system in the pulmonary interstitium. Furthermore, Gurwitz suggested that telmisartan as an alternative choice for treating COVID19 before the respiratory distress develops. Interestingly, Zhang et al. noticed a low fatality rate in COVID-19 hypertensive patients that were exposed to Angiotensin converting enzyme inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) than control ones (Zhang et al., 2020). Hoffmann and his co-workers proved that protease inhibitor-mediated blocking of Ace2 and Tmprss2 might be a target in the prevention and treatment of COVID-19 (Hoffmann et al., 2020).Based on the above findings, we can speculate that the treatment strategies for COVID-19 may include recombinant ACE2 therapy, hormones such as estradiol, which increases the level of ACE2, and drugs that decrease the level of angiotensin II.Keywords: ACE2, Angiotensin II, Zoonosis, COVID19, therapeutic purpose

BACKGROUND Prior studies have suggested that LVAD implantation technique and positioning may be associated with subsequent thromboembolic complications. This study evaluated the impact of inflow cannula positioning of the HeartWare LVAD (HVAD) on clinical outcomes. METHODS Adults undergoing primary HVAD implantation between 2009-2018 at a single center were reviewed. HVAD position parameters were calculated from plain chest radiographs and included cannula angle, pump depth, and pump area. These were measured at the day of HVAD implant, at 1 month post-HVAD, and at 6 months post-HVAD. Changes in these parameters over time were measured. Multivariable analysis was also conducted to evaluate associations between pump position parameters on the day of implant and one-year composite outcome of thromboembolic complication (embolic stroke or pump thrombosis) and death. RESULTS 159 HVAD recipients were included with a median follow up of 2.6 years (IQR 1.3 - 4.8 years). Pump area decreased from immediate post-HVAD implantation to one-month follow up (-0.7 cm2; p=0.002), but no significant changes were noted with other position parameters. Increasing preoperative serum creatinine level (HR 1.46, 95% CI 1.03 - 2.08, p=0.034) was associated with increased hazards for the composite outcome in multivariable analysis. Cannula angle, pump depth, nor pump area were associated with the one-year composite outcome, readmission, or other one-year complications including thromboembolic events or mortality when separately modeled. CONCLUSION This review of HVAD recipients demonstrates device position as assessed by chest X-ray does not have significant predictive associations with one-year outcomes.

Background: Influenza remains a clinically heavy burden worldwide. However, evidence about clinical manifestation has been lacking among severely ill patients infected with influenza. Methods: The clinical data for patients who were severely ill with influenza, and required hospitalization were gathered and analyzed between November 2014 and August 2019 (5 influenza seasons) using an internet-surveillance system. Results: A total of 924 patients were enrolled and analyzed. The median age was 78 years (IQR, 67-84), and the patients in the 2015-2016 season were significantly younger than those in other seasons. Pneumonia was the most common disease indicated as a cause for hospitalization, followed by a poor general condition and exacerbation of underlying respiratory diseases. Antiviral drugs were administered in 97.0% of the patients with peramivir being the most-frequently use antiviral. In-hospital death was recorded for 44 patients (4.8%). Multivariate analysis indicated that nursing home resident (OR: 6.554) and obesity (OR: 24.343) were independent predictors of in-hospital mortality. Conclusion: Complications of influenza infection remain a heavy burden especially among the elderly. Continuous nationwide surveillance will be required to grasp the actual situation of influenza epidemics.