Background: Since the COVID-19 pandemic started in 2019, has resulted in various health conditions, including adverse effects on different systems. The female reproductive system (FRS) is known to be one of the organs affected by the virus or the vaccination due to its high expression of the ACE 2 receptor, which is one of the primary receptors of COVID-19 that facilitates its entry into the cells. This review assessed the impact of COVID-19 infection and vaccination on the female reproductive system and their relationship with endometrial, ovarian, cervical, and vulvar cancers. Recent findings: COVID-19 virus may elevate pro-inflammatory factors, such as TNF-α, IL-6, interleukin-1β (IL-1β), and interferon-gamma (IFN-γ), during both the acute and recovery phases of infection. COVID-19 infection can heighten the inflammatory response and cell susceptibility by downregulating the ACE-2 receptor. Additionally, COVID-19 influences the female reproductive system by altering the epithelial-mesenchymal tissue microenvironment and disrupting blood vessels and endothelial cells. However, studies fail to acknowledge the potential impact of vaccination on FRS. Conclusion: Given the pivotal roles of the TMPRSS2 enzyme and ACE2 receptor in the pathogenic mechanism of the coronavirus, it is suggested that cells expressing higher levels of these enzymes and receptors may be more prone to endometrial cancer development. Notably, the cytokine storm and ACE/ACE2 pathway imbalance increase the risk of ovarian cancer. Cervical cells have a low expression of the ACE2 receptor, reducing the likelihood of infection in intraepithelial cervical cells and cervical cancer. Although coronavirus infection and its immunization can lead to vulvar aphthous ulcers, limited research investigates the link between COVID-19 infection, immunization, and vulvar cancer.

1. Rivers are crucial ecosystems supporting biodiversity and human well-being, yet they face increasing degradation globally. Traditional river biomonitoring methods based on morphological identification of macroinvertebrates present challenges in terms of taxonomic resolution and scalability. 2. This study explores the application of DNA metabarcoding analysis in both bulk and environmental DNA (eDNA) samples for comprehensive assessment of macrozoobenthic biodiversity, detection of invasive and endangered species, and evaluation of river ecological status in northwestern Spain. 3. DNA metabarcoding of homogenised bulk samples and water eDNA revealed a mean of 100 and 87 macrozoobenthos species per sample respectively. However, it was a significantly different specific composition with only 27.3% of the total species shared. It was not possible to identify all the OTUs to species level, only 17.43% and 49.4% of the OTUs generated could be identified to species level In the Bulk and eDNA samples respectively. However, a total of 11 exotic species (2 first records for the Iberian Peninsula and another 3 first records for Asturias region) and 1 endangered species were detected by molecular tools. Molecular methods showed significant correlations with morphological identification for EQR values (Ecological quality ratio) of IBMWP index, yet differences in inferred river ecological status were noted, with bulk samples tending to indicate higher status. 4. Overall, DNA metabarcoding offers a promising approach for river biomonitoring, providing insights into biodiversity, invasive species, and ecological status within a single analysis. Further optimization and intercalibration are needed for its implementation in routine biomonitoring programs, but its scalability and multi-tasking capabilities position it as a valuable tool for integrated monitoring of river ecosystems.

A Rare Occurrence of Isolated Superior Mesenteric Artery Dissection, A Case Image ReportNida Ansari, D.O.1, Sacide S. Ozgur, M.D.1, Alan Alcantara, M.D.1, Patrick Michael, M.D.1Disclosure of Interest: The authors report no conflict of interest. An ethical review is not necessary because this is a case report. This research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Consent: As this is a case report, consent was obtained for the purpose of this paper.Acknowledgments: We would like to acknowledge the patient and his family for allowing us to share this case with our colleagues.Author affiliation: Ansari, N., Ozgur, S., Alcantara, A. performed the literature review and wrote the manuscript, and all authors contributed to the writing, the final editing, and the collection of the patient’s clinical data. All work was performed at St. Joseph’s University Medical Center at the following address:St. Joseph’s University Medical CenterDepartment of Internal Medicine703 Main StreetPaterson, NJ USA 07503973-754-2000All authors, including the corresponding author, may be reached using the aforementioned contact information.

Abstract: A Foliar anatomical study of five Kalanchoe species in Nigeria was carried out for taxonomic purposes. The study tends to provide anatomical information on Nigerian Kalanchoe species, for the purpose of documentation and delimiting the taxa studied. Matured fresh samples of the leaves of Kalanchoe crenata (Andr.) Haw, Kalanchoe gastonis-boonieri Raym.-Hamet & H.Perrier , Bryophyllum pinnatum (Lam.) Oken, Bryophyllum delagoense (Eckl. and Zeyh.) Schinz, Bryophyllum houghtonii (D.B Ward) P.I.Forst were used. Epidermal peels and transverse sections were carried out according to standard procedures. Unifying and diagnostic characters important for the taxonomy of the selected five species of the genus Kalanchoe were identified. Unifying characters include amphistomatic leaves, a non-pitted anticlinal wall, mesophyll not differentiated into palisades and a spongy layer. Diagnostic characters such as uniseriate to multiseriate epidermis in Bryophyllum houghtonii. The study provides concise information on the anatomical attributes of the epidermis and transverse section of the leaf of the Kalanchoe species studied

Comprehending the genetic background of pediatric Acute Myeloid Leukemia (AML) is the key to risk stratification. Next Generation Sequencing (NGS) technology uses target panels that may detect additional genetic subsets. The study describes the experience of using NGS at an institution. Patients who showed poor outcome aberration were referred to hematopoietic stem cell transplant (HSCT). 11 patients were tested. Aberrations were found in all subjects, indicating referral to HSCT in first remission in 2 cases and helping to outline the genetic features in all cases. NGS is a valuable tool in the precision medicine era and should be widely accessible.

1 Background Parameningeal Rhabdomyosarcomas (PM-RMS) in children are challenging to treat. While ten-year Event Free Survival (EFS) of 62% have been reported from High-Middle Income Countries (HMICs) for localized disease, data is limited from Low-Middle Income Countries (LMICs). We studied the clinical profile, outcomes, and prognostic factors in PM-RMS. 2 Materials and Methods Children≤15 years with PM-RMS treated on a uniform chemotherapy protocol from January 2013-December 2021 were retrospectively analysed. Local therapy at 10-12weeks of induction was radiotherapy (RT)+/-surgery where possible with early RT for intracranial extension (ICE). 3 Results Seventy-six patients with a median age of 6.7years (range,3.2-15years), male to female ratio of 1.8:1 formed the study cohort. Eleven patients (14.5%) had metastasis (lungs-8, bone-2, bone marrow-1) and ICE seen in 46.1%(n=35). Twenty-five patients (49.0%) had alveolar histology with PAX3/7 positive in 17/59 (28.8%). Median tumor size(t size) at baseline was 5.2cm(range,1.2-12.8cm). Seventy-one patients received RT, 5 also underwent surgery. At a median follow-up of 65months (range,53-76months) 4year EFS, OS of the whole cohort were 47.3%(95%CI:34.8%-58.8%), 51.7%(95%CI:38.0%-64.0%) respectively. Four-year EFS, OS of localized and metastatic cohort were 54.7%(95%CI:41.3%-68.1%), 56.0%(95%CI:42.0%-70.0%) and 9.1%(95%CI:0%-26.5%), 18.2%(95%CI:0%-47.8%) respectively. Metastases (HR-3.38,95%CI:1.57-7.26,p=0.002), t size (HR-1.17,95%CI:1.02-1.34,p=0.026) were prognostic for survival on multivariate analysis. 4 Conclusions Survival of children with localized PM-RMS in our study is relatively fair compared to the reported literature probably due to application of RT in all despite higher proportion of larger tumors, unfavorable sites of primary and intracranial extension. Identification of high-risk subsets and optimizing current treatment strategies, both systemic and local therapy may partly improve outcomes.

Plants share their habitats with a multitude of different microbes. This close vicinity promoted the evolution of inter-organismic interactions between plants and many different microorganisms that provide mutual growth benefits both to the plant and the microbial partner. The symbiosis of Arabidopsis thaliana with the beneficial root colonizing endophyte Serendipita indica represents a well-studied system. Co-colonization of Arabidopsis roots with S. indica significantly promotes plant growth. Due to the notable phenotypic alterations of fungus-infected root systems, the involvement of a reprogramming of plant hormone levels, especially that of indole-3-acetic acid, has been suggested earlier. However, until now, the molecular mechanism by which S. indica promotes plant growth remains largely unknown. This study used comprehensive transcriptomics, metabolomics, reverse genetics, and life cell imaging to reveal the intricacies of auxin-related processes that affect root growth in the symbiosis between A. thaliana and S. indica. Our experiments revealed the essential role of tightly controlled auxin conjugation in the plant–fungus interaction. It particularly highlighted the importance of two GRETCHEN HAGEN 3 ( GH3) genes, GH3.5 and GH3.17, for the fungus infection-triggered stimulation of biomass production, thus broadening our knowledge about the function of GH3s in plants. Furthermore, we provide evidence for the transcriptional alteration of the PIN2 auxin transporter gene in roots of Arabidopsis seedlings infected with S. indica and demonstrate that this transcriptional adjustment affects auxin signaling in roots, which results in increased plant growth.

A case report of an oral hemangioma with unusual features

A document by Carlos Olaya. Click on the document to view its contents.

This paper studies consensus of linear multi-agent systems with binary-valued measurements and switching topologies. Unlike the existing consensus of multi-agent systems with binary-valued measurements, Markovian switching topology is introduced in this paper. A new algorithm is proposed to improve the consensus speed of multi-agent systems, with constant gains in both estimation and control, instead of time-varying gains. By analyzing the estimation error and the consensus error simultaneously, we prove that the proposed algorithm can make agents achieve consensus in a bouned range, and the consensus speed is negative exponential under certain conditions, which is faster than that in existing literature. Finally, simulation results are given to demonstrate the theoretical results.

Background: The study examines critical role of school teachers in executing National Deworming Day (NDD) and their awareness of adverse drug reaction (ADR) reporting. The study aims to evaluate teachers’ knowledge and attitudes on ADR reporting to improve pharmacovigilance during NDD, ensuring children’s safety during preventative chemotherapy with Albendazole. Method: After prior approval from Institutional Ethics Committee, a total of 164 participants were selected from 20 cluster heads overseeing 94 schools. The study utilized a validated questionnaire, scored on a binary system (0-10). Employing a prospective quasi-experimental one group pre-test and post- test research design, the primary aim was to evaluate the impact of the awareness program, with secondary objectives focused on demographic correlations with program effectiveness. Results: The study shows a significant improvement in participants’ scores from the pre-test (mean score of 5.60) to the post-test (mean score of 8.28), resulting in a mean deviation of -2.681 (t = -19.7, p < .001), suggesting that the intervention significantly enhanced outcomes. Additionally, the results indicate that the mean post-test score was slightly higher among urban participants compared to rural participants, with mean scores of 8.45 and 8.10, respectively. Conclusion: The sensitisation programme significantly improved awareness among school teachers engaged in NDD regarding ADR reporting, as evidenced by the substantial increase in post-test scores compared to pre-test scores. However, further studies with larger sample size are needed to corroborate these findings.

The performance of industrial strains has gradually improved with the rapid development of synthetic biotechnology. The production efficiency of traditional batch and fed-batch culture is limited and product quality varies since both are dynamic processes, whereas multi-stage continuous culture can maximise the production efficiency of specific fermentation processes and achieve consistent product quality. However, each single-stage fermentation under multi-stage continuous fermentation requires accurate steady-state control, and a model with adequate accuracy is required for designing and controlling a multi-stage continuous fermentation process. At present, there are few reports on kinetic models for the control of multi-stage continuous fermentation. In this work, we constructed a hybrid model for Saccharomyces cerevisiae multi-stage continuous culture, taking both oxygen limitation and Crabtree effect. The accuracy of the model was ~ 80%, advantages and limitations of the model are discussed and potential improvement strategy is proposed.

Here, we assessed resting respiratory sinus arrythmia (rRSA) and RSA reactivity (ΔRSA) as common and distinct emotion-adjustment mechanisms for affective and anxiety disorders and their treatments. We recruited samples of healthy controls and patients with anxiety and affective disorders, assessed rRSA during baseline and ΔRSA as RSA-change from baseline to viewing emotional films. Patients then underwent disorder-specific Cognitive Behavior Therapy. Although both patient groups exhibited lower rRSA than controls, depression-, but not anxiety-symptomatology was transdiagnostically associated with less rRSA and ΔRSA. Complementing these depression-specific results, better ΔRSA predicted better treatment-outcome in depression, but not anxiety. Our data confirm RSA as a transdiagnostic marker for mood and anxiety, support recent attempts towards transdiagnostic, dimensional classification systems (HiToP, RDoC) and provide evidence for a more robust association of RSA with depression-symptomatology and -treatment. They thus suggest rRSA and ΔRSA as potential markers to assess common and distinct mechanisms associated with depression and anxiety.

A document by Mohammad Yassin Zamanian. Click on the document to view its contents.

This study sought to analyze the impact of Metabolic Syndrome (MeS) and Type 2 Diabetes (T2DM) on metabolism and their relationship of Body Mass Index (BMI) and to identify potential predictive protein biomarkers for MeS and T2DM. The proteomes of saliva and blood, clinical parameters were analyzed in 103 adult individuals from the State of Rio de Janeiro, Brazil, a mixed-race population. Healthy individuals were sorted by their Body Mass Index (BMI) in normal (n=29), overweight (n=25) and obese (n=15) and were compared with individuals with MeS (n=23) and T2DM (n=11). Random forest predictive model revealed that 3 clinical variables, BMI, HOMA-IR, and fasting blood glucose, are most important for predicting MeS and T2DM. A total of 6 plasmatic proteins (ABCD4, LDB1, PDZ, Podoplanin, Lipirin-alpha-3 and WRS) and 6 salivary proteins (Hemoglobin subunit beta, POTE ankyrin domain family member E, T cell receptor alpha variable 9-2, Lactotransferrin, Cystatin-S, Carbonic anhydrase 6), are enhanced in T2DM and in MeS. Salivary and plasmatic proteomes, in a population of brazil, demonstrates that the physiopathological conditions associated with abnormal weight gain, T2DM, and MeS share similar modifications in protein composition, offering potential predictive biomarkers, potentially mitigating the adverse health consequences of these metabolic disorders.

In modern power systems, the randomness and uncertainty of the generation and loads greatly increase the balance discrepancy between the power supply and demand, which introduces major potential security hazards to the stable operation of power systems. In particular, out-of-bounds frequencies emerge. To control the system frequencies, a frequency control method based on the state space model for power systems under small, uncertain disturbances is proposed in this paper. Considering the general model of the power system frequency response with the aim of improving the input‒output finite-time stability of the system, the frequency deviation of the power system is controlled in a closed loop. The Monte Carlo simulation of different systems shows that the proposed method can effectively control the frequency deviation of the power system. When the closed-loop system is disturbed by uncertain power fluctuations, its frequency will always remain within the allowable range to ensure the secure and stable operation of the power system.

The geographical distribution and diversity of viruses can differ between cultivated areas and adjacent natural environments, raising questions about the interplay between plant diversity and the species richness and prevalence of the phytoviruses. As both the amplification and the dilution of viral species richness due to increasing host diversity have been theorized and observed, a deeper understanding of how plant-viruses interact in natural environments is needed to explore how host availability conditions viral diversity and distributions. This study explores interactions of viruses from the Mastrevirus genus (family Geminiviridae) with hosts from the Poaceae family across ten sites from three contrasting ecosystems on La Réunion. Among 273 plant pools, representing 61 Poales species, 15 Mastrevirus species were characterized from 22 hosts. We find a strong association of mastreviruses with hosts from agro-ecosystems and the absence of mastreviruses in subalpine areas, dominated by native plants. This suggests that all detected mastreviruses likely originated from viruses introduced through agricultural activities rather than being native to La Réunion. Analyses of the structure of the host plant-mastrevirus interaction network revealed a pattern of increasing viral richness with increasing host richness. Accounting for variations in the diversity of hosts across sites, we observed increasing viral niche occupancies with increasing host species richness. Virus realized richness at any given site is conditioned on the global capacity of the plant populations to host diverse mastreviruses. Whether this tendency is driven by synergy between viruses, or by an interplay between vector population and plant richness, remains to be established.

Background For over 70 years the addition of fluoride to public water with intent to prevent dental caries continues to be controversial and risks are seldom included in monetary evaluations. Objectives To estimate an economic cost-benefit-risk of Community Water Fluoridation (CWF) using 2021 USA dollars Per Person Per Year (PPPY), with the inclusion of two risks: dental fluorosis and lower income resulting from developmental neurotoxicity as measured with lower IQ. Methods Published operational costs and benefits of CWF are used. Published and clinical experience treating dental fluorosis are utilized to estimate treatment costs of patient perceived dental fluorosis, and lost wages from lower IQ. Patients of record provided consent for photographs. Results: Published estimated caries averted, less operational costs, were calculated at $8 PPPY and estimates of compensation for functional and cosmetic dental fluorosis were $126 PPPY. Lower earnings from presumed harm of developmental neurotoxicity $438 PPPY. Net loss from CWF is estimated at $556 PPPY. Conclusions Previous economic evaluations of CWF have estimated caries averted and costs of operations. Few evaluations include the costs of treating harm. CWF is not cost effective if the cost of harm is included. Policy Implications Alternatives for the prevention of dental caries should be promoted and the cessation of CWF is indicated.

Introduction:About 0.3% to 0.5% of gastrointestinal malignancies are duodenal adenocarcinomas, an uncommon gastrointestinal malignancy that was first described by Hamburger in 1746. Due to the vague nature of duodenal adenocarcinoma symptoms, most patients arrive with advanced disease and a poor prognosis with high morbidity and death rates. Although it can originate anywhere in the duodenum, including the duodenal bulb, duodenal adenocarcinoma most frequently affects the descending duodenum (D2) [1, 2]. Here, we present a case report of an extremely rare location of duodenal adenocarcinoma in a patient with complex medical comorbidities. We also provide a comprehensive literature review on duodenal adenocarcinoma, focusing on their occurrence in the duodenal bulb.

Objective: Vocal fold immobility (VFI) is a cause of significant morbidity and mortality in the paediatric population. Laryngoscopy is the current first-line investigation for patients with suspected VFI. Laryngeal ultrasound (LUS) has recently emerged as an alternative method of identifying VFI. Compared to laryngoscopy, LUS is less invasive, does not require anaesthesia, and can be performed by non-otolaryngologists. The primary objective of this study is to evaluate LUS as a diagnostic method for the identification of unilateral VFI in a cohort of paediatric patients in Aotearoa New Zealand (NZ). The secondary objective is to estimate the frequency of use of LUS in the paediatric population around the world. Methods: A retrospective, single-centre cohort study was performed on all paediatric patients who had undergone laryngoscopy and LUS at Starship Children’s Health between 2020 to 2023 in Auckland, NZ. An eight-question survey was also developed and distributed to better understand clinicians’ use of LUS to diagnose paediatric VFI globally. Results: Twenty-three paediatric patients met the inclusion criteria. LUS demonstrated high sensitivity (100%), specificity (63%), positive predictive value (83%), and negative predictive value (100%) for detecting unilateral VFI within our patient population. Out of the eighty-seven respondents to the survey, nearly half utilise LUS in their clinical practice in the paediatric population. The main barrier for those who do not is lack of expertise, equipment, and training. Conclusions: These findings support the use of LUS as a safe and accurate diagnostic tool for the detection of unilateral VFI. Further studies in non-surgical populations and standardised guidelines for LUS technique and reporting are required.

A document by Md. Rezaul Islam. Click on the document to view its contents.

Objectives: To compare outcomes of patients with benign neoplasms undergoing superficial parotidectomy, with or without facial nerve dissection, the latter a surrogate for extracapsular dissection technique. Methods: Retrospective review of the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database providing 30-day postoperative outcome data from 676 sites nationwide. Inclusion criteria were primary diagnosis of benign salivary neoplasm, age 18-89 years, primary procedure superficial parotidectomy either with (CPT 42415 (SPwFND)) or without (CPT 42410 (SPwoFND)) facial nerve dissection between 2012-2019. We analyzed demographics, operative time, length of stay, perioperative complications, readmission, and reoperation rates between the two procedure groups. NSQIP contained no information on postoperative facial paralysis or estimated blood loss. Results: In total, 2651 patients underwent SPwFND while 764 underwent SPwoFND. Operative time was shorter (111.59 +/- 63.417) for SPwoFND than for SPwFND (135.05 +/- 64.313, p<;0.0001). Fewer patients undergoing SPwoFND required overnight stay than those undergoing SPwFND (41.5% vs 59.4%, p<0.001). There were no significant differences between rates of reoperation, unplanned readmission, or perioperative complications between the groups. Conclusion: SPwoFND nerve dissection had a shorter operative time and led to fewer postoperative overnight stays than SPwFND, with no significant differences in rates of reoperation, unplanned readmission, or perioperative complications. This suggests that for appropriately selected patients, SPwoFND may be a comparable treatment option with the benefit of lower resource utilization than SPwFND.

USE OF 3D EXOSCOPE FOR FREE FLAPS MICROANASTOMOSIS

In the North-west of Sierra Leone, customary land access hinges on “Bora” – a system tied to respect and social obligations, not formal ownership. While “Bora” plays a crucial role in rural women’s livelihoods, their land rights remain precarious. This study examines how the emergence of “Respect Money” – a cash payment replacing traditional obligations – challenges and reinforces gendered inequalities in land access. Drawing on qualitative and quantitative methods, the research investigates the shifting dynamics, how “Respect Money” alters traditional power structures and customary gender roles related to land. Livelihood impacts on the consequences of commodified land access for women’s agricultural practices, income, and food security. Social implications on the potential erosion of communal values and increased risk of land dispossession for women under the “Respect Money” system. Empowerment or exploitation? whether “Respect Money” presents an opportunity for women’s agency or contributes to their further marginalization within land governance. The case study design employ both qualitative and quantitative data analysis that reveals how the monetization of customary land access, while offering some flexibility, can exacerbate existing gender inequalities. Key informant interviews from women’s group, civil society organizations, land advocates, traditional leaders couple with Focus group discussion with communities and Biographic survey of various women to understand lived experiences from those that are constraint to land access due to ‘’Bora” compare to those from landowning families that benefit more from land access. The result of the study sheds light on the complex interplay between cash, tradition, and gender in shaping land rights.The need for inclusive land governance frameworks that recognize and protect women’s customary rights alongside formal structures. The study highlight the need for alternative strategies for securing women’s livelihoods and ensuring equitable access to land in resource-constrained settings. This study contributes to ongoing debates about gender, land rights, and the evolving nature of customary practices in the face of economic and social transformations. It recommends that policymakers and development practitioners to consider the nuances of “Bora” beyond the lens of mere monetization and advocate for solutions that truly empower rural women in land ownership and management.