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Title PageArticle Type: Letter to the Editor

Foreign body ingestion(FBI) is a common clinical occurrence worldwide, with high morbidity in the pediatric population and in adult patients.Clinical manifestation varies depending on the impaction sites, the types and sizes of the ingested foreign bodies, the time elapsed following ingestion, and complications.In adults, a metal foreign body in the esophagus

AN INFANT WITH POLAND SYNDROME AND COEXISTING BETA THALASSEMIA TRAIT: A CASE REPORTAtta Owusu JuniorUniversity Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.outcyda@gmail.comCharles K. HammondUniversity Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana.kumihammond@yahoo.comPriscilla Abrafi Opare-AddoKomfo Anokye Teaching Hospital, Kumasi, Ghana.priscillaadjei23@gmail.comSandra Konadu BonnahUniversity Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghanabonnahsandra95@gmail.comVivian PainstilDepartment of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana.vivpee@yahoo.comObed Kojo OtooUniversity Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Department of Radiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.bonesabade@gmail.comSeth Kyei-FramKomfo Anokye Teaching Hospital, Kumasi, Ghana.kyeiframseth@gmail.comKeywords : Poland syndrome, chest wall deformity, limb anomalies, infant thalassemia, case report

Successful replantation of the amputated nose in a childLongfei Ma, Chaofeng Xing, Zhenfeng Li

Women with 21-hydroxylase deficiency produce excessive adrenal progesterone, which inhibits the development of endometrial receptivity, resulting in decreased fertility. A 40-year-old woman with 21-hydroxylase deficiency had persistently high adrenal progesterone levels despite increased corticosteroid therapy. With high dose of estradiol and progesterone, she could conceive after frozen thawed embryo transfer in

There is growing interest in how the climate would change under net zero carbon dioxide emissions pathways as many nations aim to reach net zero in coming decades. In today's rapidly warming world, many changes in the climate are detectable, even in the presence of internal variability, but whether climate changes under net zero would be detectable is less well understood. Here, we use a bespoke set of 1000-year-long net zero carbon dioxide emissions simulations branching from different points in the 21st century to examine the detectability of large-scale and local climate changes as time passes under net zero emissions. We find that many changes under net zero become detectable within centuries. While local changes and changes in extremes are more challenging to detect, warming in the Southern Hemisphere and cooling in the Northern Hemisphere becomes detectable at many locations within a few centuries under net zero emissions. We also study detectability of differences in climate indices due to delays in achieving emissions cessation. We find that for global mean surface temperature and other large-scale indices, such as Antarctic and Arctic sea ice extent, the effects of even a five-year delay in emissions cessation are detectable. Short delays in emissions cessation result in significantly different local temperatures for most of the planet, and most of the global population. The long simulations used here help with identifying local climate change signals. Multi-model frameworks will be useful to examine confidence in these changes and ultimately improve understanding of post-net zero climate changes.

As physics-based global magnetosphere-ionosphere-thermosphere models enter operations for space weather forecasting, it is imperative that the sources of uncertainty in model outputs are thoroughly investigated. Global magnetosphere models rely on a set of input solar wind conditions to drive the model; such inputs are often propagated from upstream in the solar wind where the IMF and plasma parameters can be constantly monitored. Generally, this data is provided by the OMNI dataset, a set of observations of the solar wind typically collected near the L1 Lagrange point and propagated to Earth’s bow shock nose. The actual solar wind conditions outside the bow shock may differ from the OMNI data, leading to erroneous model inputs. Erroneous model inputs will lead to erroneous model outputs, and contribute to poor predictions of space weather phenomena. We present a study on the effects of variability in OMNI solar wind propagation accuracy on ionosphere-thermosphere model outputs at the individual grid cell level. Models are driven with OMNI and ARTEMIS solar wind time series for three events at varying levels of correlation between both inputs (Pearson Correlation Coefficient = 0.95, 0.82, 0.58). Thermospheric neutral densities at three heights (200 km, 400 km, 600 km) are compared for each simulation at grid cells over Kennedy Space Center, Florida, USA and College Magnetometer Station, Alaska, USA.

Bufalin is one main component of the dried venom from Bufo gargarizans Cantor. Bufalin has anti-tumor, cardiotonic, anti-inflammatory and other physiological activities. However, in recent years, researchers have mainly paid attention to its anti-tumor effect and neglected its anti-inflammatory effect. We used lipopolysaccharide (TLR4 ligand) and poly inosinic acid (TLR3 ligand) to stimulate cultured macrophages to induce inflammatory condition, and found that bufalin could significantly reduce the production of pro-inflammatory factors (IL-6, TNF-α, IL-1β, IL-8, CXCL10, etc.). Transcriptome sequencing and molecular experiments showed that bufalin inhibited phosphorylation of IKBα and IRF3, and thus down-regulated Toll-like receptor pathway. Molecular docking predicted that one of the molecular targets of bufalin is MD2 coupled with lipopolysaccharide-activated TLR4. These findings not only support the pharmacological basis of using toad to treat inflammatory diseases in the Chinese medical history, but also provide a promising anti-inflammatory drug candidate for future clinical application.

This research delves into the thermal performance characteristics of basalt fiber-reinforced polyester composites, emphasizing their potential for advanced engineering applications. The study systematically varies the fiber volume fraction across a range from 6.667% to 33.35% to assess its impact on thermal conductivity. Experimental evaluations were performed to measure the thermal properties, which were subsequently validated through simulation analyses using Digi-mat software, ensuring the reliability and accuracy of the findings. Results demonstrate a consistent positive correlation between the fiber content and the thermal conductivity of the composites, attributed to the intrinsic thermal properties of basalt fibers and their effective distribution within the polyester matrix. The enhanced thermal performance, coupled with the material’s inherent mechanical strength and environmental benefits, positions these composites as promising candidates for sustainable solutions in sectors such as construction, automotive, and aerospace. The study not only highlights the advantages of utilizing basalt fibers for reinforcing polyester matrices but also provides a comprehensive understanding of their behaviour under thermal loads. This contributes significantly to the development of high-performance and eco-friendly composite materials, addressing industry demands for innovation and sustainability.

NO abstract as per the author guidlines for clinical experience articles

Gravel augmentation has become a viable restoration technique below dams to replace degraded salmonid spawning habitats with high quality habitat. The technique can reduce the reliance on hatchery and trap and haul projects which have associated costs to native fish productivity. However, gravel augmentation can be cost-prohibitive while it is often unknown what stream segments have the highest potential to benefit spawning salmonids. We created Intrinsic Potential (IP) habitat models using stream attributes related to salmonid spawning habitat: elevation, width, and gradient, from the publicly available synthetic stream channel dataset NetMap. We then used the IP models to develop an easy to use, inexpensive, and flexible prioritization tool to identify high spring-run Chinook Salmon ( Oncorhynchus tshawytscha) IP ~100 m reaches. The tool has the capacity to select reaches that are also high winter Steelhead Trout ( O. mykiss) IP spawning habitats and incorporates constraints on mean August current stream temperature maxima, temperature maxima with expected future climate change, land ownership, reach access, distance to and type of gravel sources, and gravel transport potential. We explore the prioritization tool and demonstrate its use with three potential strategies for the Upper Rogue River basin: 1) Spring Chinook Salmon Strategy, 2) Winter Steelhead Trout Strategy, and 3) Climate Change Strategy. The results of the tool suggest that management priorities dictate priority stream reaches for gravel augmentation. In the three strategies we compared, a small number of reaches located downstream of current spring Chinook Salmon spawning in Shady Cove were high priority, an area already designated in the Rogue spring Chinook Salmon Conservation Plan. In strategy 2, gravel augmentation would benefit winter Steelhead Trout spawning in a small number of reaches in Evans Creek area. Under the Climate Change strategy, many reaches were identified with new permitting of other potential gravel sources. The tool is publicly available on GitHub.

RATIONALE In the manufacturing process of Trimetazidine hydrochloride (TMZ), N Nitroso trimetazidine (NTMZ) generate, final purification of active pharmaceutical ingredient (API) done in the presence of the charcoal, which has been identified as a possible source of nitrite. Secondary amine is present in TMZ, due to the favorable condition for nitrosamine & NDSRIs, NTMZ is generated in TMZ. Significant genotoxic and mutagenic effects of NDSRIs effect on human and regulatory requirement to control. METHODS This study is held for the trace level identification and quantification of NTMZ in TMZ drug substance and in drug product by using ultra-fast liquid chromatography-mass spectrometry/mass spectrometry (UFLC-ESI-MS/MS). The method was developed and validated for the NTMZ content in gradient mode using inert Sustain PFP (4.6 mm x 150 mm x 5 µ) column, a buffer containing 0.63 g/L ammonium formate in water and 1 mL formic acid as solution A and while solution B a mixture of methanol and acetonitrile in the ratio of 50:50 (v/v). Positive ionization in electrospray ionization (ESI) with MRM ( m/z 296.15 > 181.15, 296.15 > 166.05, 296.15 > 136.15) used for NTMZ quantification and identification. RESULTS The limit of detection and Quantification 0.16 ppm and 0.50 ppm respectively. The method is linear in the range of 0.5 ppm to 7.5 ppm (0.00025 ppm to 0.00375 ppm). System precision (% RSD= 4.47), Method precision (% RSD = 1.92), Intermediate precision (% RSD = 2.47), Accuracy (77.7 – 126.85 %). CONCLUSIONS To identify and quantify the trace level NTMZ in commercial drug substances and drug products, this validated analytical method was effectively applied. As the knowledge this is the first method to identify and quantify NTMZ with UPLC-ESI-MS/MS and no comparable techniques.

We present new approach and new model with new equation for diatomic homonuclear molecules contains new molecular constant connecting the number of sharing electrons and their circumference to determine their covalent radii. All diatomic homonuclear molecules are consists of two atoms of the same element held together by covalent bond, so the main equation of this type of molecules with its constant is controlled by these two main physical parameters and consequently the covalent radii can be calculated by using the main physical factors (number of sharing electrons & constant of molecules). The calculations and results of covalent radii is in good agreement with known experimental determined values. It is found that this homogenous distribution of electrons in the diatomic homonuclear molecules for their number and radius give a molecular constant value to be ( m -1).

Purpose: Exercise-induced pulmonary hypertension (EIPH), assessed using exercise stress echocardiography (ESE), is important in diagnosing early stage of heart failure (HF) with preserved ejection fraction (EF) and affects exercise tolerance and prognosis. Left atrial (LA) reservoir strain, which reflects the left ventricular filling pressure, is an important factor in the diagnosis of HF. This study aimed to investigate the association between the LA reservoir strain at rest and EIPH. Methods: This retrospective analysis included 188 participants with a left ventricular EF ≥ 50% who underwent ESE. EIPH was defined as a peak tricuspid regurgitation (TR) pressure gradient > 50 mmHg. HF events (HF hospitalization or diuretic use with brain natriuretic peptide ≥ 100 pg/mL) were evaluated in patients with ≥ 3 months follow-up. Results: Thirty-four (18.1%) patients were diagnosed with EIPH. LA reservoir strain at rest with an optimal cutoff value of 21% identified patients, with 73% sensitivity and 59% specificity. Among the resting echocardiographic parameters, LA reservoir strain was independently associated with EIPH (odds ratio; 0.93, P = 0.018). Furthermore, adding LA reservoir strain to the TR-velocity significantly improved EIPH discrimination. During a median follow-up period of 336 days, 29 patients (21.6 %) experienced HF events. Patients with LA reservoir strain ≤ 21% had a fourfold increased risk of HF events after adjusting for age and HFA-PEFF score. Conclusion: LA reservoir strain at rest was associated with EIPH and HF events in patients with preserved EF, suggesting that impaired LA reservoir strain could increase the risk of HF.

Atrial fibrillation (AF) is the common heart rhythm abnormality, with about 12.1 million US cases and 1.2 million new cases predicted by 2030[1](#ref-0001). AF doubles mortality and raises stroke risk by 2.4 time[2](#ref-0002). Guidelines recommend oral anticoagulation for non-valvular AF with intermediate or higher thromboembolic risk. If OAC is contraindicated, percutaneous left atrial appendage closure (LAAC) is considered. Surgical occlusion is done if patients are already undergoing cardiac surgery, though outcomes vary.[3](#ref-0003) . We present two high-stroke-risk AF patients who underwent surgical LAAC but had incomplete closure, resulting in cerebral ischemic events. Subsequently, they underwent successful percutaneous LAAC device closure with complete occlusion.

Black soldier fly larvae (BSFL) decompose various organic wastes into valuable oil and protein for promising biofuel, cosmetic, food and feed applications. In this paper, temperature-controlled mechanical pressing (70, 90, 110, 130 °C) was employed to fractionate BSFL oil and defatted protein meal simultaneously. Higher temperature obtained higher oil yield without significant impact on the protein yield and material losses. BSFL oil extracted at 110 °C showed a good yield (18.83%), fatty acid profile and saturation level (53.48 g I 2/100 g iodine value and 219.10 mg KOH/g saponification value) similar to palm oil. It exhibited the lowest peroxide value (12.90 mEq/kg) and free fatty acid content (1.14%), with a high carotenoids content (192.60 ppm). Due to the potent antioxidant capacity, the accumulation of carotenoids would help to maintain the quality and protect the oil against oxidative attack. As a result, lower degree of oxidation ultimately improved the oxidative stability and reduced the peroxide value of oil. Moreover, the high protein dispersibility index (71.25%) of BSFL meal defatted at 110 °C also indicated superior quality and bioavailability. Hence, the optimum fractionation temperature was found at 110 °C which produced lower oil rancidity, higher stability and quality of both oil and protein meal for diverse food and non-food applications.

As wolves recolonise their historical range across Europe, ungulates face predation once more – but in landscapes profoundly altered by human activity. This shift raises crucial questions about their capacity to express adaptive antipredator behaviors. Using a quasi-experimental camera-trap design, we examined diel activity responses in ungulates along the ongoing wolf recolonisation in the south-eastern Alps. In summer, red deer gradually increased diurnal activity by 17.6% within a decade of wolf establishment, also heightening activity overlap with humans. This ‘diel shield effect’ disappeared when human hunting occurred. Roe deer adjusted diel activity only to hunting, while Alpine chamois only responded to spatial distribution of outdoor activity. Our findings show that wolf recovery can induce immediate and lasting diel activity shifts in large herbivores, yet responses may strongly depend on species biology and plasticity. Human risk can offset or override these behavioural responses, potentially altering the ecosystemic effects of returning large carnivores.

Biodiversity promotes ecosystem productivity and stability, a positive impact that often strengthens over time. But ongoing global changes such as rising atmospheric carbon dioxide (CO2) levels and anthropogenic nitrogen (N) deposition may modulate the impact of biodiversity on ecosystem productivity and stability over multiple decades. Using a multidecadal grassland biodiversity-global change experiment we show that diversity increasingly enhanced productivity over time irrespective of global change treatments. In contrast, the positive influence of diversity on ecosystem stability strengthened over time under ambient conditions but weakened to varying degrees under global change treatments, largely driven by a greater reduction in species asynchrony under global changes. Thus, over multiple decades, CO2 and nitrogen enrichment can gradually erode the positive effects of biodiversity on ecosystem stability. As elevated CO2, N eutrophication, and biodiversity loss increasingly co-occur in grasslands globally, our results raise concerns about their potential joint detrimental effects on long-term grassland stability.

Tropical forests can vary enormously in their 3D structure and dynamics even within the same landscape. However, the drivers that underpin this local-scale variation in forest dynamics remain poorly understood. Here we used repeat airborne laser scanning data acquired across >1500 ha of old-growth tropical forest in Malaysian Borneo to explore how soils and topography influence rates of gap formation, closure and canopy growth across the landscape. We found that both canopy gains and losses were 2.5–4.7 times greater in low-lying alluvial forests on fertile soils compared to nearby nutrient-depleted heath forests on hilltops. Moreover, we found that variation in canopy 3D structure and dynamics were tightly coupled across the landscape, with taller and more structurally heterogeneous canopies also experiencing faster rates of gap dynamics. Our study highlights the key role that soils and topography play in shaping the structural complexity and dynamics of tropical forest landscapes.

Introduction: Numerous algorithms have been published to estimate the origin of Premature Ventricular Complexes PVCs from the outflow tract, and many studies have compared them. However, a clear consensus on the best algorithm has not yet been established. We aim to assess and compare algorithms for locating the origin of Premature Ventricular Complexes (PVCs) in ECG recordings from patients undergoing outflow tract PVC ablation. Methods and Results: We analyzed ECG records from 116 patients who underwent successful PVC ablation from the outflow tract between June 1st, 2015, and June 30th, 2020. Of these patients, 53 had PVCs originating from the right ventricular outflow tract (RVOT), and 63 had PVCs originating from the left ventricular outflow tract (LVOT). R wave amplitude index in V1 combined with R wave deflection interval in V3, V2 transition ratio, V2S/V3R index, Transition Zone (TZ) İndex, Combined TZ and V2S/V3R index, S and R wave difference in V1 and V2 and R wave duration index and R/S wave amplitude index algorithms and their components were analyzed. The Combined TZ Index algorithm had the maximum sensitivity and negative predictive value, which were 90.48% and 85.37%, respectively. The R Wave Duration Index and R/S Amplitude Index algorithms had the highest specificity and positive predictive value, which were assessed at 98.11% and 94.74%, respectively. With the logistic regression analysis method, the “Y=8.436 – 2.036 x PVC TZ score- 0.06 x PVC V2 R wave duration + 4.661 x PVC V3 R wave amplitude - 1.958 x PVC V2 S wave amplitude” algorithm was created. In this algorithm, the value of the “Y” variable was accepted as >0.5 for LVOT. Conclusion: The Combined TZ Index algorithm had the maximum sensitivity and negative predictive value and the R Wave Duration Index and R/S Amplitude Index algorithms had the highest specificity and positive predictive value in our population (85.71%, 85.37%, 92.45%, 89.47% respectively). “Y=8.436 – 2.036 x PVC TZ score- 0.06 x PVC V2 R wave duration + 4.661 x PVC V3 R wave amplitude - 1.958 x PVC V2 S wave amplitude” algorithm predicts LVOT if Y>0.5.

Diabetes mellitus (DM) is a metabolic disease influenced by both genetic and environmental factors. The global incidence of DM is rising, and its multiple complications seriously affect patients’ quality of life and create a huge economic burden. At present, the prevention and treatment of DM mainly rely on oral or subcutaneous drugs, although oral drugs are more acceptable, they may produce more side effects and have limited effect on the treatment of diabetic complications. Artesunate (ART) is a first-line antimalarial drug widely used worldwide. Whether orally or intravenously, ART has high bioavailability and excellent pharmacokinetic properties in humans, and has shown good tolerance and safety in patients of multiple ages. Recent pharmacological studies have shown that, except for its antimalarial properties, ART also has a wide range of therapeutic potential for DM and its complications. This review aims to synthesize the latest research results, summarize and discuss the current role and mechanism of ART in improving diabetes and its complications, and provide a theoretical basis for the subsequent exploration of the anti-diabetes mechanism and the development of new antidiabetic agents based on ART, which has great clinical significance for strengthening the prevention and treatment effects of DM and its complications.

Grado: III Basico Tiempo: 50 minutosDescripción: Los estudiantes aprenderán sobre las energías renovables, investigarán sobre los recursos energéticos renovables y cómo la naturaleza nos puede proveer estas energías sin perjudicar nuestro medio ambienteObjetivos: Identificar la energía eólica y demostrar como transformarla a energía lumínica Comprender los principios científicos detrás de la conversión de energía renovable en electricidad u otras formas de energía Diseñar y construir prototipos de dispositivos que utilicen energías renovables en este caso especifico un generador eólico Materiales:-Motor de 12v 4400 rpm-Cartón -Led -Cables -Tapa de botella  -Palitos de helado -Silicon caliente -Cuter -tijera -Estaño Recursos Multimedia:https://www.youtube.com/watch?v=rFUkeqLT9xcLa lección Parte 1: (Introducción 5 minutos)pregunte a los estudiantes que saben sobre la energía eolicacómo creen que el viento se convierte en electricidadMuestra una foto de un parque eólico impresionanteParte 2:¿Cómo funciona la energía eólica? (10 minutos)

Background: Youngstock are susceptible to parasitic disease; the development of anthelmintic resistance is increasing. Objectives: Investigate stud owners’/managers’ perceptions of prevalence of parasite-associated diseases and current management approaches to control parasites on UK studs. Study Design: Cross-sectional study; on-line survey. Methods: SurveyMonkey questionnaires (multiple choice, Likert scale and free text questions) distributed via practices, press, social media and snowball sampling. Descriptive and inferential statistics performed in Microsoft Excel and STATA. Statistical differences assessed with Fisher’s exact test or Mann Whitney U test. Results: 56 usable responses. The median number of foals born per farm per year was 9, and the median number of resident mares/permanent boarders was 14. Predominant breeds were Thoroughbreds and Warmbloods. Perceived parasite-associated illness in the past year was reported by 35.7% respondents (weight loss (65.0%), diarrhoea (40.0%) and colic (15.0%)) with young adults (1-3 years) most affected (47.7%), followed by adults (31.8%), weanlings (27.3%) and foals (20.5%). New mares weren’t turned out until they were administered an anthelmintic in 53.6%, whilst 41.1% performed faecal egg counts and treated if necessary, and 16.1% turned mares out without treating or testing. The median stocking density was 0.3 mares / acre (significantly lower for Thoroughbreds than Warmbloods / “others” (p<0.01)). 32.1% of farms never “poo picked” pastures; 89.3% harrowed paddocks; and 57.1% co-grazed horses with ruminants. Main Limitations: Small sample size. Potential selection bias and response bias. Conclusions: Parasite-associated diseases on stud farms are common. Many farms fail to implement management practices (eg poo-picking, co-grazing with ruminants) that could reduce the risk of parasite transmission on the premises. Harrowing paddocks could increase the risks of parasite transmission. Results identify areas where management practices should be improved.