Title: Colo-Cholecystic Fistula Secondary to Diverticular Disease: A Case ReportAuthors:Fatima Bhojani1Wasim Ahmed Memon1Mallick Muhammad Zohaib Uddin1Muhammad Nadeem Ahmad1Sibgha Khan1Naila Nadeem1Faheemullah Khan2Uffan Zafar11Aga Khan University Hospital, Karachi2Cleveland Clinic, Main CampusCorresponding author:Faheemullah KhanEmail: khanf7@ccf.orgKeywords: Diverticulum; Diverticular diseases; Biliary Fistula; Radiology; ImagingIntroduction:Fistulous communication between the colon and the biliary tree, or cholecysto-colic fistula (CCF), is a rare clinical entity that poses diagnostic and therapeutic challenges for clinicians. It accounts for 8-26.5% of all cholecystoenteric fistulas (CEF) (1-3), making it the second most common type of CEFs after cholecystoduodenal fistulas. The incidence of CCF in patients undergoing cholecystectomy is reported to be 0.06-0.14% (2-4). CCF usually occurs in the background of a gallbladder pathology, most commonly gallstones (4,5). Other etiologies include surgery (6,7), cholecystostomy (8) and abdominal wounds (9, 10). Diverticular disease, a common gastrointestinal disorder predominantly affecting the elderly, is characterized by the presence of diverticulae, small pouch-like protrusions, in the colonic wall. Despite its prevalence, the development of a colo-cholecystic fistula in the setting of diverticular disease remains a seldom-reported occurrence in medical literature. To the best of our knowledge, two cases of CCF developing as sequelae of colonic pathologies have been reported (11, 12). One of these reported colonic diverticulosis as the etiological factor of CCF (12).In this report, we present a rare case of colo-cholecystic fistula secondary to diverticular disease of the ascending colon, emphasizing the clinical, radiological, and therapeutic aspects of this unique presentation. Through a comprehensive review of the literature, we aim to enhance understanding of this rare condition, its pathogenesis, diagnostic approach, and optimal management strategies.Case History:A 74 year old male with diabetes mellitus, hypertension and ischemic heart disease, presented as an outpatient to the ultrasound clinic of Aga Khan University Hospital, Karachi with the complaint of lower urinary tract symptoms.Methods:Ultrasound kidneys and bladder was performed which showed a soft tissue density polypoidal mass along the right lateral wall of the urinary bladder.As part of the primary team’s management plan, CT abdomen and pelvis with contrast was performed which showed a large polypoidal lesion arising from the base of urinary bladder, indenting and possibly infiltrating the prostate.However, an additional finding of an abnormal linear air-containing tract was identified arising from the ascending colon, extending up to the gallbladder. Another abnormal communication was noted in the region of fundus of the gallbladder with the adjacent hepatic flexure. Air was also seen in the normally distended gallbladder (Figures 1-3). Multiple tiny diverticulae were also seen arising from the ascending colon (Figure 4). These findings were concluded to be resulting from a colo-cholecystic fistula involving the ascending colon secondary to diverticulitis.Two small fluid collections were also identified adjacent to the gallbladder fossa (Figure 4-5). Patient was then electively admitted to the hospital for cystoscopy and transurethral resection of bladder tumor was planned.Patient was started on chemoradiotherapy for bladder carcinoma. However, since the patient did not complain of any related symptoms, no intervention was done for the colo-cholecystic fistula.Conclusion and result:Follow-up CT a year later showed that the fistulous tract between the ascending colon and the biliary tree had healed, and air in the gallbladder lumen had resolved (Figures 6-7).Discussion:Colo-cholecystic fistula is a complex pathological entity often presenting with nonspecific symptoms, making its diagnosis challenging. While the majority of cases are attributed to gallstone disease or inflammatory bowel conditions, the association with diverticular disease is infrequently encountered. To the best of our knowledge, only a single such case has been documented in medical literature where the patient experienced fever and raised white cell counts, and subsequently had to undergo open cholecystectomy (12). On the other hand, in our case, the fistulous communication was symptomless and discovered as an incidental finding. Furthermore, follow-up imaging showed that the fistula had healed in interval.Since CCFs have no specific symptoms or signs, they are often overlooked unless complications occur. These complications include gallstone ileus, ascending cholangitis, or hemorrhage.Common symptoms of CCFs include pain in the right upper quadrant, nausea, vomiting, and intolerance to fatty meals. These symptoms are characteristic of cholecystitis and are of no help in diagnosing CCF.Diagnostic evaluation of colo-cholecystic fistula often necessitates preoperative and intraoperative evaluation. Preoperative diagnosis of CCF is made in only 7.9% of the cases (3). Radiological investigations including x-ray (13), ultrasound (1), barium enema (14), CT (15) and scintigraphy (16) have been useful in identifying CCF. Ibrahim et al. demonstrated intraoperative diagnosis of CCF by intraoperative cholecystography (17).Therapeutic management of colo-cholecystic fistula primarily entails surgical intervention, aimed at cholecystectomy and colonic resection (18). Laparoscopic techniques have gained prominence in recent years, offering advantages of minimally invasive surgery, reduced postoperative pain, and shorter hospital stays (19). Nevertheless, the choice of surgical approach should be tailored to individual patient factors, including the extent of disease involvement, presence of complications, and surgical expertise.Our report underscores the significance of recognizing colo-cholecystic fistula as a potential sequelae of diverticular disease, despite its rarity. Through a comprehensive understanding of its pathogenesis, clinical presentation, and diagnostic approach, clinicians can facilitate prompt recognition and appropriate management, thereby optimizing patient outcomes. Further research endeavors are warranted to elucidate the underlying mechanisms and refine therapeutic strategies for this intriguing clinical entity.References:Costi R, Randone B, Violi V, Scatton O, Sarli L, Soubrane O, Dousset B, Montariol T. Cholecystocolonic fistula: facts and myths. A review of the 231 published cases. J Hepatobiliary Pancreat Surg. 2009;16(1):8-18. doi: 10.1007/s00534-008-0014-1. Epub 2008 Dec 17. PMID: 19089311.Angrisani L, Corcione F, Tartaglia A, Tricarico A, Rendano F, Vincenti R, et al. Cholecystoenteric fistula (CF) is not a contraindication for laparoscopic surgery. Surg Endosc. 2001;15:1038–41.Chowbey PK, Bandyopadhyay SK, Sharma A, Khullar R, Soni V, Baijal M. Laparoscopic management of cholecystoenteric fistulas. J Laparoendosc Adv Surg Tech A. 2006;16:467–72.Glenn F, Reed C, Grafe WR. Biliary enteric fistula. Surg Gynecol Obstet. 1981;153:527–31.Paolucci V, Schaeff B, Schneider M, Gutt C. Tumor seeding following laparoscopy: international survey. World J Surg. 1999;23:989–97.Sing RF, Garberman SF, Frankel AM, Chatzinoff M. Cholecystocolic fistula: an unusual presentation and diagnosis by endoscopic retrograde cholangiopancreatography. Surg Endosc. 1990;4:39–40.Wagtmans M, Kooy M, Snel P. Persistent diarrhoea in cholecystocolic and gastrocolic fistula after gastric surgery. Neth J Med. 1993;43:218–21.Hutchin P, Harrison TS, Halasz NA. Cholecystocolic fistula: a complication of cholecystostomy; with special reference to the management of cholecystostomy. Ann Surg. 1963;157:587–90Griffith CD, Saunders JH. Cholecystoduodenocolic fistula following abdominal trauma. Br J Surg. 1982;69:99–100Ahn SI, Hong KC, Hur YS, Lee KY, Kim SJ, Seo JM, et al. Cholecystocolic fistula caused by blunt trauma. Injury. 2001;32:341–2Menda RK, Chulani HL. Cholecystocolonic fistula following ameboma of the ascending colon: report of a case. Dis Colon Rectum. 1971;14:386–8Goenka P, Iqbal M, Manalo G, Youngberg GA, Thomas E. Colo-cholecystic fistula: an unusual complication of colonic diverticular disease. Am J Gastroenterol. 1999 Sep;94(9):2558-60. doi: 10.1111/j.1572-0241.1999.01396.x. PMID: 10484027.Dutta U, Nagi B, Kumar A, Vaiphei K, Wig JD, Singh K. Pneumobilia—clue to an unusual cause of diarrhea. Trop Gastroenterol. 2002;23:138–40.Hession PR, Rawlinson J, Hall JR, Keating JP, Guyer PB. The clinical and radiological features of cholecystocolic fistulae. Br J Radiol. 1996;69:804–9.Singh AK, Gervais D, Mueller P. Cholecystocolonic fistula: serial CT imaging features. Emerg Radiol. 2004;10:301–2.I131–rose bengal scanning in the detection of cholecystocolic fistula. New use of an established procedure. Am J Gastroenterol. 1977;68:396–8.Ibrahim IM, Wolodiger F, Saber AA, Dennery B. Treatment of cholecystocolonic fistula by laparoscopy. Surg Endosc. 1995;9:728–9Chaffee JS. Cholecystocolic fistula with large bowel hemorrhage. Case report. Ann Surg. 1960;152:901–4.Reddy KM, Fiennes AG. Cholecystocolic fistula at laparoscopic cholecystectomy: primary closure and laparoscopic caecostomy. Surg Laparosc Endosc. 1998;8:400–1.Images/Figures:

During the development of gas reservoirs with water, water invades the reservoir along preferential pathways, trapping a large amount of residual gas in the reservoir. Research on the distribution of residual gas after water invasion is crucial for further exploitation of the gas reservoir. Based on 50 core samples from the loose sandstone reservoir of the Se-Bei gas field, single-core water flooding gas experiments (20 samples) and parallel-core water flooding gas experiments (15 groups) were conducted under reservoir conditions (15MPa, 40°C) to study the effect of permeability difference on the distribution of residual gas. The results showed that: (1) The higher the permeability, the lower the residual gas saturation, exhibiting an exponential decrease. When the permeability is less than 4mD, the residual gas saturation is greater than 40%, indicating a focus area of water trapping gas. When the permeability is greater than 15mD, the change in permeability has a minor effect on the residual gas saturation, which is less than 30%. (2) The greater the permeability ratio, the greater the difference in residual gas saturation between high and low permeability cores, with the low permeability core having a higher residual gas saturation. The influence of the permeability ratio on the distribution of residual gas can be categorized into water trapping zone (permeability ratio > 15), water trapping zone (6 < permeability ratio < 23) and no influence zone (permeability ratio < 6). (3) After water invasion, the residual gas mainly distributes in the region with permeability less than 4mD and permeability ratio greater than 15. The experimental results can provide technical support for the study of the distribution of residual gas in similar reservoirs and the optimal selection of potential gas reservoir areas.

Targeted for characteristics such as their colourful appearance, intelligence, and ability to recognize the human voice, parrots (order Psittaciformes) have become a coveted commodity. They are therefore common victims of the illegal wildlife trade, which in turn has contributed to their overall decline. Many of the world’s most traded and threatened parrot species originate from Indonesia. Yet Indonesia is also a renowned transit and market country for (illegal) parrot trade. Our study is the first of its kind to document in detail the online trade of all parrot species on one of Indonesia’s most popular social media platforms, Facebook, as pertaining to the trade within Indonesia. Over the period of 1 January 2020 until 31 August 2021, we analysed 283 posts, containing 861 identifiable parrots of 22 species across 38 Facebook user groups. Employing visual and textual analysis, we find clear trends for certain species that we highlight as a potential indicator for targeting. Overt indicators of illegality were common in visual references, despite textual references being coded to avoid detection. Finally, we find the online illegal trade of parrots increased during the global pandemic, despite the stricter approach taken by Facebook regarding trade in live animals on their platform. Overall, our analysis confirms the importance of Facebook as a virtual marketplace for parrots, and it is clear more rigorous monitoring of social media is needed to counter the harmful consequences of the illegal wildlife trade.

Vision is ones’ window to the world, enabling individuals to fully engage in and enjoy various aspects of daily life. Diseases can result in loss of vision. Developing an automated diagnostic system is crucial to support the limited number of ophthalmologists in managing the growing number of patients with severe ocular diseases. This research proposes a multiclass diagnostic system for identifying three ocular diseases: Diabetic Retinopathy (DR), Glaucoma (G), and Cataract (C). The study begins by identifying Contrast-Limited Adaptive Histogram Equalization (CLAHE) in LAB color space as an effective image enhancement technique for fundus photographs (FP). By leveraging the unique architectures of various pre-trained models, different features of an image are identified. We evaluate combinations of seven pre-trained models and find that the combination of DenseNet121 and EfficientNetB5 (DeB5-XNet) achieves the highest test accuracy of 95%, with a significant reduction in false negatives compared to individual models. Grad-CAM is then employed to provide a visual explanation of our ensemble model’s predictions, demonstrating that the features captured by the model are aligned closely with those utilized by ophthalmologists for diagnosis.

Long-term changes in health-related quality of life (HrQoL) after SARS-CoV-2 infection are common, but the causes and consequences of these changes are not well understood. HrQoL was assessed using the European Quality-of-Life-5-Dimensions-5-Level-Version (EQ-5D-5L) in 2,618 participants (56% female; aged 18–88 years) approximately 9 months (baseline) and 26 months (follow-up) after their first infection. The results were compared to 40 different demographic and clinical variables. A clinically important improvement in HrQoL was noted during the observation period. At baseline, the number of remaining symptoms from the infection (RS), fatigue (FACIT-Fatigue Scale), depressive symptoms (PHQ-8), muscle pain, age, and anxiety (GAD-7) explained 43% of the variance in HrQoL. At follow-up, fatigue, RS, depressive symptoms, anxiety, and muscle pain explained 50% of the variance. Although changes in fatigue, depressive symptoms, anxiety, and RS were associated with a change in HrQoL, the predictive value of the variables was virtually zero. The study suggests that HrQoL improves statistically significantly during the observation period. However, the extent of recovery is difficult to predict from concurrent changes in demographic and clinical variables. Besides a high RS number, fatigue is the main predictor of poor HrQoL after infection, followed by the presence of depressive and anxiety symptoms.

The article proposes a novel solution to the control problem of centrifugal gas compressors which are driven by three-phase induction motors (IMs) and three-phase permanent magnet synchronous motors (PMSMs), through a novel flatness-based control scheme which is implemented in successive loops. By re-arranging state variables and by splitting suitably the state vector of the IM-driven gas-compressor and of the PMSM-driven gas compressor into subsystems one arrives at writing the associated state-space models in the triangular (strict feedback) form. For the latter state-space description it is possible to solve the control and stabilization problem using chained control loops. The state-space model of the IM-driven gas-compressor and of the PMSM-driven gas-compressor is decomposed into cascading subsystems which satisfy differential flatness properties. For these subsystems virtual control inputs are computed, capable of inverting their dynamics and of eliminating the associated tracking error. The control inputs which are actually applied to the complete nonlinear form of the IM-actuated gas-compressor and of the PMSM-actuated gas compressor are computed from the last subsystem of the chained state-space description. These control inputs incorporate in a recursive manner all virtual control inputs which were computed from the individual subsystems included in the initial state-space equation. The control inputs that should be applied to the nonlinear system so as to assure that all state vector elements will converge to the desirable setpoints are obtained at each iteration of the control algorithm by tracing backwards the subsystems of the chained state-space model. The method is of proven global stability and ensures fast and accurate tracking of the reference setpoints by the state variables of the IM-driven gas compressor and of the PMSM-driven gas compressor.

Here we have conducted a comprehensive experimental and theoretical investigation into the impact of the phosphorus diffusion gettering (PDG) process on n-type industrial silicon heterojunction (SHJ) solar cells. Our findings indicate that phosphorus penetrates deeply into the silicon substrate as circular channels. While PDG effectively eliminates Fe from silicon wafers, it also introduces impurities like O, P, and Cu, which are not entirely eradicated during subsequent cleaning and texturing processes. Optimizing the gas flow to 1000 sccm achieved a balance between carrier lifetime and saturated dark current density in SHJ solar cells, resulting in a 0.21% increase in average efficiency to 25.14%. Simulated analyses revealed that variations in energy loss due to different gas flows were primarily attributed to bulk recombination and series resistance. Our work provides valuable insights for the application and improvement of the PDG process in industrial SHJ solar cells.

Purpose: Pulmonary hypertension (PH) is a chronic complications of sickle cell disease (SCD) with limited known biomarkers, beyond increases in plasma brain natriuretic peptide levels. Experimental Design: We conducted a proof-of-concept study to identify serum protein biomarkers that were differentially expressed in SCD patients with elevated tricuspid regurgitation velocity (TRV – a noninvasive marker of PH). Results: We found 41 out of 92 target proteins that were significantly different between the non-elevated (TRV≤2.6 m/sec; N = 35) and highly elevated TRV group (TRV≥2.9 m/sec; N = 35, p<0.05). Six of them passed a Bonferroni correction (p value < 0.0005) including T-cell surface glycoprotein, lymphotactin, SLAM family member 7, galectin-9, TNF-related apoptosis-inducing ligand receptor 2, and tumor necrosis factor receptor superfamily member 11A . We observed up to a 1.2-fold increase in the high TRV group for these six proteins. These six proteins had strong positive correlation with serum NT-proBNP levels (a positive control marker elevated in PH (r >= 0.44). Additionally, these markers correlated with other clinical parameters of PH in SCD. Conclusion: Circulatory protein markers of the immune response are increased in SCD patients with elevated TRV as compared to those without elevated TRV.

Objectives: The purpose of this study was to look into the efficacy of caffeic acid phenethyl ester (CAPE), which we believe may be therapeutically useful in facial nerve restoration due to its neuroprotective and antioxidant properties. Materials and Methods: 20 Sprague Dawley rats were divided randomly into 4 primary and 2 secondary groups and assigned as control, methylprednisolone, CAPE, CAPE+methylprednisolone groups and the sham and the trauma groups. Except for the sham group, all groups had the left facial nerve crushed. Three weeks after surgery, prospective functional, electrophysiologic, and histologic recovery was assessed. Results: The CAPE and CAPE+ methylprednisolone group had similar and more significant recovery at Nerve Excitability Thresholds at the end of three weeks. In histopathological evaluation, when the groups were compared in terms of myelin sheath thickness, vascular congestion and axonal degeneration, it was observed that only the CAPE+ methylprednisolone group achieved a significantly faster improvement compared to the control group. Although there was an earlier improvement in the blink tests in the CAPE and CAPE+steroid group compared to the methylprednisolone and control groups, complete recovery was observed in all groups on the 21st day. Conclusion: The combination of caffeic acid phenethyl ester and methylprednisolone was found to be efficient in nerve regeneration and may be a good alternative for lowering the dose of methylprednisolone to minimize adverse effects. Key Words: Caffeic acid phenetyl ester, facial nerve, neuroprotective agents, experimental rat model.

This study introduces an innovative method to regulate the target price of a new automotive product by amalgamating deep learning, game theory, and control theory. Through this interdisciplinary approach, we aim to enhance pricing strategies to align with market demands and optimize profitability. Specifically, we leverage Artificial Intelligence, employing Convolutional Neural Networks (CNNs) to extract and analyze cost features from design data, such as Product Lifecycle Management Software. Subsequently, a Generative Adversarial Network (GAN) facilitates effective management of design choices. By integrating Learning-based control, utilizing a reinforcement learning model, the game dynamics converge to the Nash equilibrium, thereby achieving optimal cost values aligned with the target cost.

A document by Ashish Tamang. Click on the document to view its contents.

Pulmonary fibrosis represents the end-stage pathological change of various interstitial lung diseases, often resulting from alveolar injury and dysregulated repair process. Our previous study found that human embryonic stem cells-derived immunity-and-matrix-regulatory cells (IMRCs), expressing high level of leukemia inhibitory factor (LIF), effectively mitigated bleomycin-induced pulmonary fibrosis in a mouse model. To elucidated the regulatory role of LIF in pulmonary fibrosis, we applied recombinant LIF in vitro and in vivo models. Our data demonstrated that recombinant LIF can inhibit MRC-5 fibroblast activation and α-SMA expression during epithelial-mesenchymal transition in A549 cells. Administration of LIF in a bleomycin-induced pulmonary fibrosis mouse model, either during the alveolar injury phase (days 0-2) or the fibrosis phase (days 9-11) post-bleomycin administration alleviated pulmonary fibrosis by day 21. Moreover, our study observed a modulation of inflammatory factors with a concurrent downregulation of Tnf, Cxcl10, and Ccl22.

Background Nirsevimab, a novel monoclonal antibody, provides passive immunity against RSV-infections in infants. In October/2023, Spain adopted immunization for children <6 months and those born during the epidemic season. Our main goal was to compare clinical, epidemiological and virological characteristics of respiratory infections in hospitalized infants before and after nirsevimab introduction. Methods. A prospective study was conducted in two Madrid hospitals during the 2022-23 and 2023-24 epidemic seasons. Infants <12 months admitted with lower respiratory tract infections were included. Clinical, epidemiological, and virological characteristics were compared based on admission before or after nirsevimab introduction and whether they received it. Results A total of 717 infants were included: 526 before October/2023 and 191 thereafter. Admissions from October-March 2023/24 decreased by 59% (95%CI:58.7-62.3%) compared to October-March 2022/23. ICU admissions dropped by 74% (95%CI:70.7-77.3%). Of those hospitalized after October/2023, 55(28.8%) received nirsevimab, with 11(20%) contracting RSV. The RSV-detection rate was lower after October/2023 (39% vs. 65%, P<0.001), as was the detection of other respiratory viruses, except rhinovirus and human bocavirus. Patients admitted after October/2023 were older (P=0.002), included fewer infants under 1 month (P=0.005), and had shorter hospital stays (P=0.001). For infants under 3 months, the likelihood of needing a stay > 5 days was 70% lower compared to those admitted before October/2023 (P<0.001;OR:0.39, 95%CI:0.22-0.66). Conclusions Nirsevimab has shown considerable effectiveness in shielding young infants from severe outcomes linked to RSV-infection. Furthermore, our study observed a notable decrease in hospitalizations for infections caused by other respiratory viruses after the introduction of nirsevimab.

Abstract was not required for this Letter to the Editor.

A document by Riccardo Pieraccini. Click on the document to view its contents.

Organic materials, with low environmental impact and adaptable structures, are attractive for Hybrid capacitive deionization (HCDI). However, the scarcity of active sites and tendency to dissolve in water-based solutions remain significant challenges. Herein, we synthesized a polynaphthalenequinoneimine (PCON) polymer with stable long-range ordered framework and rough three-dimensional floral surface morphology, along with high-density active sites provided by C=O and C=N functional groups, enabling efficient redox reactions and achieving a high Na+ capture capability. The synthesized PCON polymer showcases outstanding electroadsorption characteristics and notable structural robustness, attaining an impressive specific capacitance of 500.45 F g-1 at 1 A g-1 and maintaining 86.1% of its original capacitance following 5000 charge-discharge cycles. Benefiting from the superior pseudocapacitive properties of the PCON polymer, we developed an HCDI system that not only exhibits exceptional salt removal capacity of 100.8 mg g-1 and a remarkable rapid average removal rate of 3.36 mg g-1 min−1, but also maintains 97% of its initial desalination capacity after 50 cycles, thereby distinguishing itself with the comprehensive performance that significantly surpasses reported organic deionization materials. Prospectively, the synthesis paradigm of the double active-sites polymer may be extrapolated to other organic electrodes, heralding new avenues for the design of high-performance desalination systems.

Hydrogen sulfide (H 2S) impacts biological systems in multiple ways, including the arrest of aerobic respiration rendering it a highly toxic substance. However, H 2S can paradoxically drive plant germination rates when administered in micromolar concentrations. We investigated changes in δ 34S, δ 13C, δ 15N, and masses of sulfur, carbon, and nitrogen in Zea mays L. (corn) seedling stems grown at these low concentrations of H 2S associated with growth. The δ 34S and sulfur composition in seedlings increased with concentration, but only when grown in light-exposed conditions. Light-exposed seedlings also scored lower in both compared to their dark-grown counterparts. Additionally, δ 34S signatures in seedlings with the longest stems matched values of S 0 products of the H 2S oxidation process within anoxygenic photosynthesis in Chlorobium tepidum. It appears from these findings that 34S fractionation patterns in H 2S-induced plant germination is a result of the light-dependent reactions of photosynthesis. Furthermore, this δ 34S signature could suggest the presence of anoxygenic photosynthesis via sulfur oxidation in vascular plants, challenging the current understanding of plant evolution.

Entropy production is scrutinized within a 2-D rectangular cavity housing a cylindrical heat exchanger featuring rectangular fins with sharp and smoothed edges. This study examines the influence of fin geometry on entropy production in pursuit of a strategic design for minimizing irreversibility and enhancing system efficiency. Numerical simulations are implemented to examine fluid dynamics and thermal exchange within the enclosure considering fins with both sharp and rounded edges. The results indicate that while both fin types yield minimal disparity in total entropy production at lower heat fluxes, significant differences emerge as heat generation escalates, stabilizing at around 5 percent beyond 60 kW. These findings offer valuable insights into optimal system design strategies aimed at minimizing irreversibility and enhancing overall efficiency.

Leishmaniasis is a neglected disease caused by protozoa belonging to the Leishmania genus. The search for effective anti-Leishmanial compounds is challenging due to high costs, time requirements, and long-term treatment. However, today, with the help of computational approaches, we can undertake projects with lower costs and shorter timelines. The objective of this study was to discover novel and potent anti-Leishmanial compounds and establish the real relationship between the structure of these compounds and their biological activity. To achieve this goal, a total of 26 chemical compounds underwent QSAR analysis. After data preprocessing, a suitable set of molecular descriptors was calculated, and significant descriptors were selected. The Stepwise-MLR model identified nine important descriptors that influenced the activity of the chemical compounds: ” EEig01x,” ” IVDE,” ” G2m,” ” Mor16m,” ” JGI5,” ” E2e,” ” H0e,” ” G1p,” and ” RDF030m.” The developed model was evaluated based on the correlation between observed and predicted values (R=0.97), the correlation coefficient (R 2=0.94), and the root mean square error (RMSE=0.211). Additionally, molecular docking using AutoDock Vina was employed to explore the binding modes of 26 compounds with Leishmania major N-myristoyltransferase. The binding energy fit score of the best inhibitor, inhibitor 8, was –9.6 kcal/mol. For further investigation, the docked structure obtained from the AutoDock results underwent a molecular dynamics (MD) simulation for 100 ns. Analysis of the trajectory file confirmed the efficacy of the final compound against Leishmania. This study marks a significant step in the development of drug candidates against Leishmaniasis.

This article develops a variational formulation for a chemical reaction corresponding to a hydrogen nuclear fusion. The results are obtained through standard tools of calculus of variations and optimization theory in function spaces. In such a chemical reaction, at an appropriate high temperature, a Deuterium ion reacts with a Tritium one resulting a Helium ion and an energetic neutron. We highlight such a reaction result of an energetic neutron field has a great variety of practical applications, including the possibility of clean electric energy production.

With protoescigenin as starting material and through orchestrated application of Yu and Schmidt glyco-sylation protocols, the synthesis of acyl group-free escin derivatives were achieved for the first time. As the undesired non-specific toxicity, originated from the existence of acyl groups on aglycone, prohibits the wide application of escins, the established strategies toward non-acylated protoescigenin-type sap-onins would dramatically ease the access to escin derivatives dispense of acyl groups, thereby speeding up the pace of pharmaceutical use of these valuable compounds.

Generalized phase retrieval aims at recovering an unknown signal x ∈ C n from quadratic measurements of the form x ∗ A j x , j=1 ,…,m, where measurement matrices A j are given. For real signal x ∈ R n , we show that when A j ∈ R n × n are independently drawn from standard Gaussian matrix distribution, the least squares loss function of generalized phase retrieval has a negative directional curvature around its saddle points and all its local minimizers are global minimizers with high probability under O( n) measurements. This benign geometric structure guarantees good performance of any algorithm that can escape saddle points. Especially, we present that the Gauss-Newton method is efficient in terms of convergence rate and empirical success rate, either in the case of spectral or random initialization.

Models of infectious disease dynamics suggest that treatment, vaccination, and isolation are required for the control of infectious diseases. Considering that vaccination is one of the most effective methods to control infectious diseases, it is often not possible to rapidly vaccinate all susceptible populations in the early stages of the spread of infectious diseases due to the limitation of the number of vaccines, insufficient medical personnel, or the slow progress of vaccination efforts. Our simulation analysis by building an SVIWRD model found that the degree of negative impact of infectious diseases shown when young and old people were divided into two populations and vaccinated at different rates was different.Therefore, for the current problem of continued spread of COVID-19, we consider the infectious disease dynamics model to achieve the goal of making the risk of infection of COVID-19 lower by controlling the proportion of vaccination of elderly and young people. In this paper, we divided young and old people into two groups, established an SVIWRD model, performed single-objective optimization using Pontryagin's maximum principle, and used the Runge-Kutta method for numerical calculation and simulation, so as to arrive at a certain vaccination ratio that plays the effect of reduced negative impact of COVID-19.

Pollen, a pivotal stage in the plant reproductive cycle, is highly sensitive to temperature fluctuations, impacting seed quality and quantity. While the importance of understanding pollen temperature limtits (Tmin, Topt, Tmax – collectively PTLs) is recognized, a comprehensive synthesis of underlying drivers is lacking. Here, we examined PTLs, correlating them with vegetative tissue thermotolerance and assessing variability at the intra- and interspecific levels across 198 species with contrasting phylogeny, cultivation history, biology and ecology. At the species level, the PTLs range from 6.1 to 39.5 0C, with considerable differences among growth forms and cultivation histories. Positive correlations were found between PTLs and leaf/stem temperature tolerances. Notably, pollen cold tolerances varied significantly across species populations, while Topt and Tmax values remained stable. Phylogenetic analysis revealed family-level conservation in pollen cold tolerance, contrasting with heat tolerance’s independence from evolutionary history. Climate emerged as a significant PTL driver, with species at higher elevations and latitudes exhibiting enhanced cold and heat tolerance. Cultivated species displayed narrower temperature tolerances (10.3-39.9 °C) than their wild counterparts (5.2-42.3 °C), highlighting potential crop vulnerabilities to global warming. Herbaceous plants exhibited superior tolerance to both low and high temperatures compared to shrubs and trees, reflecting divergent thermal conditions during anthesis. This study illuminates complex relationships between pollen temperature limits, plant characteristics, and environmental factors, providing crucial insights into climate change impacts on plant reproduction.