bluuebunny/crossref_metadata_2025 huggingface dataset:
Seven-year follow-up of Perceval sutureless bioprosthesis for aortic valve endocarditis.
Authors: Piperata Antonio , d'Ostrevy Nicolas , Busuttil Olivier , Avesani Martina , Labrousse Louis , Pernot Mathieu
Published: September 2021

Although some anecdotal experience concerning the use of modern
sutureless aortic valve bioprosthesis for the treatment of endocarditis
has been reported, no data is available on the mid-and long-term
results. We describe a case of a patient successfully treated with
Perceval sutureless bioprosthesis for aortic valve endocarditis and his
seven years follow-up.
Precipitation's complicated role in driving the abundance of an emerging disease vector in an urban, arid landscape
Authors: Newman Erica , Feng Xiao , Walker Kathleen , Young Steven , Smith Kirk , Townsend John , Damian Dan , Soto José , Ernst Kacey
Published: September 2021

Understanding population dynamics of disease vectors is a pressing
challenge for human health. A major challenge is that landscape-level
models for organisms like mosquitoes must also account for the highly
local scale of their reproductive biology. Aedes aegypti, a
vector of multiple emerging diseases, has been increasing in abundance
and range in desert population centers, where water availability may be
limiting. We examined daily precipitation and Ae. aegypti
abundance in the urbanized Maricopa County (metropolitan Phoenix),
Arizona, USA for >660 trapping locations over 3 years. By
connecting daily precipitation to subsequent trapped abundances of
mosquitoes through kriging, we determined the timing and amount of
precipitation that lead to large outbreaks, and thresholds of
interference with mosquito development. In this context, anthropogenic
sources of water likely supersede the limiting effect of precipitation
by providing constantly available oviposition sites, and could therefore
be targeted for disease management.
Stable isotope modeling of the groundwater discharge in complex watersheds of the State of São Paulo, Brazil
Authors: Santarosa Lucas , Gastmans Didier , Quaggio Carolina
Published: September 2021

The increasing pressure on water resources demands integrated
multidisciplinary approaches to deal with environmental, scientific, and
social issues related to water availability in watersheds. In large
watersheds, many factors control hydrological processes, requiring the
application of a methodology capable of describing water dynamics in
complex situations. This study uses stable isotope (2H and 18O) modeling
to characterize groundwater contribution in an area of heterogeneous
hydrogeological framework and advanced anthropization, located in the
Piracicaba-Capivari-Jundiaí (PCJ) and Tietê-Jacaré (TJ) water management
units – central-eastern portion of the State of São Paulo, Brazil.
Groundwater dynamics is controlled by the direct interaction of the
rainfall regime with hydrogeological domains. The modeling performed in
this study indicates that a portion ranging from 60 to 80% of the total
volume of streamflow comes from groundwater discharge (for studied
year). However, in the crystalline domain, the aquifer capacity of
storing surplus water is smaller, increasing the importance of rainfall
for the generation of direct runoff and maintenance of the streamflow.
In most of the PCJ unit, there is a greater dependence on surface water
and vulnerability to prolonged droughts. On the other hand, in the
sedimentary areas, the contribution of groundwater discharge is around
80%, showing that the aquifer storage capacity guarantees
homogenization of the discharge throughout the year, and ensures water
security in drought periods. This study attests to the successful
application of stable isotope modeling to large basins, as the method is
able to describe natural hydrological processes occurring in watersheds
with a heterogeneous hydrogeological framework and the effects of the
anthropogenic action. It is concluded that the use of stable isotopes
can aid water resources management in expanding the capacity of
monitoring surface and groundwater resources to identify negative
effects on water availability.
Haemoglobin I -Toulouse: A rare haemoglobinopathy presenting with low oxygen saturations
Authors: Xu Ziheng , Masters Ian , Kapur Nitin , Barbaro Pasquale , Miller Stephen
Published: September 2021

We report a child with persistently low SpO2 with delayed diagnosis due
to the co-existing CPAM with possible AVM. The diagnosis was only
achieved after low SpO2 incidentally discovered from the child’s father.
The eventual cause was Haemoglobin I-Toulouse, making both patients the
first reported cases with low SpO2.
International Union of Basic and Clinical Pharmacology. Guidelines for GPCR ligand bias
Authors: Kolb Peter , Kenakin Terry , Alexander Stephen , Bermudez Marcel , Bohn Laura , Breinholt Christian , Bouvier Michel , Ehlert Frederick , Hill Stephen , Martemyanov Kirill A. , Neubig Richard D , Onaran Ongun , Rajagopal Sudar , Roth Bryan , Selent Jana , Shukla Arun , Sommer Martha , Gloriam David
Published: September 2021

G protein-coupled receptors modulate a plethora of physiological
processes and mediate the effects of one-third of FDA-approved drugs.
Notably, depending on which ligand has activated a particular receptor,
it can engage different intracellular transducers. This paradigm of
ligand-dependent ‘biased signaling’ dictates a need to advance beyond
the level of receptors to consider the combined ligand-receptor pair in
order to understand physiological signaling. Bias signaling also has the
potential to improve medicines by reducing adverse effects. However,
this is challenged by inconsistent interpretation of results and lack of
commonly agreed guidelines. Here, we present recommended terminology and
guidelines to conduct, report and quantify bias in a comparable and
reproducible fashion. We expect these recommendations will facilitate a
common understanding of experiments and findings across basic receptor
research and drug discovery, while the area and the analytical methods
to measure bias are still evolving, especially in complex cellular,
tissue and organismal systems.
Delta Opioid Receptor Agonist KNT-127 Facilitates Neuroexcitability in the Mouse Infralimbic Cortex via mTOR Pathway to Exert an Antidepressant Effect
Authors: Yoshioka Toshinori , Yamada Daisuke , Iio Keita , Nagase Hiroshi , Saitoh Akiyoshi
Published: September 2021

Background and Purpose Growing evidence demonstrates that the
delta opioid receptor (DOP) is an attractive candidate for novel
antidepressants with the potential to exhibit rapid action with few
adverse effects. However, the underlying detailed functional mechanism
remains elusive. Previously, we reported that the selective DOP agonist,
KNT-127, produced robust antidepressant-like effects in the mice forced
swimming test (FST). Thus, we attempted to identify the cellular
mechanism underlying this effect. Experimental Approach Male
ICR mice (4–6 weeks) were used in all experiments. The FST was
conducted as a screening model for antidepressants. The phosphorylation
level of proteins in specific brain regions was quantified using Western
blotting. Glutamate/gamma-aminobutyric acid-dependent postsynaptic
currents were detected using whole-cell voltage-clamp recordings.
Key Results The selective mTOR inhibitor, rapamycin, and the
PI3K inhibitor, LY294002, blocked the antidepressant-like effects of
KNT-127 in the FST. KNT-127 increased the phosphorylation level of mTOR
signal-related proteins, Akt and p70S6K, in the medial prefrontal
cortex. The bilateral microinfusion of KNT-127 in the infralimbic cortex
decreased immobility in the FST. The frequency of miniature excitatory
postsynaptic currents in the infralimbic cortex increased and that of
miniature inhibitory postsynaptic currents decreased with the perfusion
of KNT-127, which was blocked by pretreatment with rapamycin.
Conclusions and Implications KNT-127 displays
antidepressant-like actions through the direct facilitation of neuronal
excitability in the mice infralimbic cortex, which is implicated in the
PI3K-Akt-mTOR-p70S6K signaling pathway. These results could indicate the
first steps in elucidating the complete mechanical functions of DOPs as
a potential candidate for novel antidepressants.
PROGNOSTIC VALUE OF DIASTOLIC FUNCTION PARAMETERS IN SIGNIFICANT AORTIC REGURGITATION. THE ROLE OF THE LEFT ATRIAL STRAIN.
Authors: Garcia-Martin Ana , Abellás María , Gómez Ariana González , Diaz Luis Rincon , Monteagudo-Ruiz Juan Manuel , Hinojar-Baydes Rocio , Mur Jose Luis Moya , Zamorano Jose , Fernandez-Golfin Covadonga
Published: September 2021

Aims. The management of patients with asymptomatic significant aortic
regurgitation (sAR) is often challenging and appropriate timing of
aortic valve surgery remains controversial. Prognostic value of
diastolic parameters has been demonstrated in several cardiac diseases.
In particular, left atrial (LA) function has been shown to be an
important determinant of morbimortality. The purpose of this study was
to analyze the prognostic significance of diastolic function in
asymptomatic patients with sAR. Methods and results. A total of 126
patients with asymptomatic sAR were included. Conventional
echocardiographic systolic and diastolic function parameters were
assessed. LA auto-strain analysis was performed in a subgroup of 57
patients. During a mean follow up of 33±19 months, 25 (19,8%) patients
reached the combined end-point. Univariate analysis showed that LV
volumes, LVEF, E wave, E/e’ ratio, LA volume and LA reservoir strain
(LASr) were significant predictors of events. Multivariate model 1 that
tested all echocardiographic variables statistically significant in the
univariate model showed that LVEDV [HR=1,02;95% CI:1,01-1,03
(p<0,001)] and E/e’ ratio [HR=1,12;95% CI:1,03-1,23
(p=0,01)] were significant predictors of events. In the subgroup of
patients with LA auto-strain analyzed, a second multivariate model
including the previous significant variables for the first model as well
as LASr, showed that LVEDV [HR=1,05;95% CI:1,01-1,08 (p=0,016)] and
LASr [HR=0,8;95% CI:0,65-0,98 (p<0,035)] were the most
significant predictors of cardiovascular events. Conclusions. In this
population of asymptomatic patients with sAR and normal LV systolic
function, baseline diastolic parameters were prognostic markers of
cardiovascular events; among them, LASr played a strong independent
predictor role.
Pseudo micro-reentrant activation pattern created by coherent mapping of the right atrial free wall: A case report
Authors: Takahashi Masao , Hojo Rintaro , Arai Tomoyuki , Kimura Takashi , Fukamizu Seiji
Published: September 2021

Coherent mapping with CARTO3 is useful to identify the critical isthmus
of scar-related AT. However, it has also a pitfall. We present atrial
tachycardia (AT) with pseudo micro-reentrant activation pattern created
by coherent mapping on the right atrial free wall. It is possible that a
pseudo tachycardia circuit was created due to the algorithm for the
reconstruction of coherent mapping. Finally, entrainment mapping led to
the identification of correct tachycardia circuit and termination of
tachycardia by catheter ablation. When using coherent mapping with
CARTO3, it is necessary to understand the pitfall well.
All roads lead to Rome, but someone are safer
Authors: Mauro Michele Di , Calafiore Antonio , Lorusso Roberto
Published: September 2021

Since the first in-human implantation, trans-catheter aortic valve
replacement (TAVR) has shown an exciting development in both technical
and technological terms, becoming the standard of care for many
patients, even not only inoperable ones. Although trans-femoral (TF)
access has the scepter of first-line route for TAVR, in some cases, this
access is not feasible, so several alternative routes were introduces
over time. The network meta-analysis by Hameed et al has the great merit
to provide a comprehensive picture. Hence, through either direct and
indirect comparison, the authors confirmed as TF is the gold standard as
access, followed by trans-carotid and trans-subclavian. Conversely,
trans-thoracic (trans apical and trans-aortic) routes are the least safe
and should be reserved only to sporadic cases.
Organogels as nutraceutical carriers: Effect of addition of lecithin, tocopherols, and EPA/DHA on properties of candelilla wax-soybean oil organogels
Authors: Buitimea-Cantúa Nydia E. , Arellano Daniel , Serna-Saldívar Sergio O. , Buitimea-Cantúa Génesis V.
Published: September 2021

Organogels are semisolid and 3D systems in which both an organic liquid
solvent and other dispersed particles are entrapped. Today there is not
much information about the potential of organogels as carriers of
lipophilic nutraceuticals. Therefore, in this work, the preparation and
characterization of soybean oil-based organogels with candelilla wax
(CW) and lecithin, tocopherol, or EPA/DHA were studied. Soybean oil was
structured with 0.5, 1.0, 2.0, and 4.0% w/w of CW. In the organogels,
the visual appearance, thermal stability, color parameters,
microstructure, hardness, and rheological properties were analyzed.
Results showed that soybean oil was successfully structured into an
array of solid-like organogels varying in concentrations of CW and added
nutraceutical compounds. Increasing CW concentration yielded stronger
3D-network gel formation (type 5 or solid organogel). All organogels
were stable at 5, 25, and 35°C during the cyclization process. The
nutraceuticals affected the color parameters and 3D network structure.
Larger crystalline spherulites and a uniform microstructure were
observed, especially in organogels formulated with 4.0% w/w of CW and
lecithin. In comparison with the control, organogels (4.0% w/w) with
tocopherol or EPA/DHA required lower shear stress to flow whereas
lecithin required higher shear stress to flow. Texture analysis showed
that organogels with nutraceuticals presented higher hardness, this
behavior was attributed to the formation of a larger and softer crystal
networks. In conclusion, soybean oil-based organogels formulated with
lecithin, tocopherol, or EPA/DHA yielded stable organogels with
promising properties as nutraceutical carriers.
Acute Paediatric Mastoiditis in the UK Before and During the COVID-19 Pandemic: A National Observational Study
Authors: Smith Matthew , Jones G. Huw , Hardman John , Nichani Jaya , khwaja sadie , HERE . INSERT COLLABORATOR LIST , Bruce Iain , Rea Peter
Published: September 2021

Objectives To explore the impact of COVID-19 on the management and
outcomes of acute paediatric mastoiditis across the UK. Design National
retrospective and prospective audit Setting 48 UK secondary care ENT
departments Participants Consecutive children aged 18 years or under,
referred to ENT with a clinical diagnosis of mastoiditis. Main outcome
measures Cases were divided into: Period 1 (01/11/19-15/03/20) before
the UK population were instructed to reduce social contact, and Period 2
(16/03/20-30/04/21), following this. Periods 1&2 were compared for
population variables, management and outcomes. Secondary analyses
compared outcomes by primary treatment (medical/needle
aspiration/surgical). Results 286 cases met criteria (median 4 per site,
range 0-24). 9.4 cases were recorded per week in period 1 versus 2.0 in
period 2, with no winter increase in cases in Dec 2020-Feb 2021. Patient
age differed between period 1&2 (3.2 Vs 4.7 years respectively,
p<0.001). 85% of children in period 2 were tested for
COVID-19 with a single positive test. In period 2 cases associated with
P. aeruginosa significantly increased. 48.6% of children were scanned
in period 1 vs 41.1% in period 2. Surgical management was used more
frequently in period 1 (43.0% Vs 24.3%, p=0.001). Treatment success
was high, with failure of initial management in 6.3%, and 30-day
re-admission for recurrence in 2.1%. The adverse event rate (15.7%
overall) did not vary by treatment modality or between periods 1& 2.
Conclusion The COVID-19 pandemic led to a significant change in the
presentation and case-mix of acute paediatric mastoiditis in the UK.
Effects of climate change on the distribution of wild Akebia trifoliata
Authors: Zhang Jun-Ming , Peng Xiang-Yong , Song Min-Li , Li Zhen-Jian , Xu Xin-Qiao , Wang Wei
Published: September 2021

Understanding the impacts and constraints of climate change on the
potential geographic distribution of wild Akebia trifoliata is crucial
for its sustainable management and economic development as a medicinal
material or fruit. In this study, according to the first-hand
information obtained on-the-spot investigation, the geographic
distribution and response to climate factors of Akebia trifoliata were
studied by the MaxEnt model and ArcGIS. The genetic diversity and
population structure of 21 natural populations of Akebia trifoliata were
studied by SSR markers. The results showed that precipitation and
temperature were the two most important climatic factors that restrict
the geographic distribution of Akebia trifoliata. Under the current
climate scenario, the suitable growth regions of Akebia trifoliata in
China were 91.7-121.9 °E and 21.6-37.5 °N. Combined with the
evolutionary relationship and prediction results, 21 populations of
Akebia trifoliata tended to migrate to the north. In the scenarios
(SSP2-4.5, SSP3-7.0, and SSP5-8.5) of higher greenhouse gas emission
concentration, the distribution area of Akebia trifoliata continued to
expand, while in the low concentration greenhouse gas emission scenario
(SSP1-2.6), the distribution area of Akebia trifoliata remained stable.
The distribution center of Akebia trifoliata in China will shift to high
latitude regions with the increase of temperature in the future. The
results evaluated the impact of climate factors on the spatial
distribution of wild Akebia trifoliata, displayed the possible changes
of geographical distribution of Akebia trifoliata under different
climate scenarios, and provided scientific evidence for durative
protection and supervise of Akebia trifoliata.
Prevalence, main serovars, and antimicrobial resistance profiles of Non-typhoidal Salmonella in poultry samples from the Americas: A systematic review and meta-analysis
Authors: Diaz Daniel , Hernandez-Carreño Pavel Eduardo , Velazquez Diana Zuleika , Chaidez-Ibarra Miguel Angel , Montero-Pardo Arnulfo , Martinez-Villa Francisco Antonio , Canizalez-Roman Adrian , Ortiz-Navarrete Vianney Francisco , Rosiles Rene , Gaxiola Soila Maribel , Jimenez-Trejo Francisco
Published: September 2021

Poultry and poultry-derived products such as meat and eggs are among the
main sources of non-typhoidal Salmonella (NTS) transmission to
the human. Therefore, we performed a systematic review and used
random-effects meta-analyses to 1) estimate the prevalence of NTS in
poultry samples from birds, products and subproducts, and environmental
samples, 2) examine the diversity and frequency of their serovars, and
3) estimate the prevalence and profiles of antimicrobial resistance
(AMR) in NTS isolates reported in studies from the Americas. We included
157 studies from 15 countries comprising 261,408 poultry samples and
estimated an overall pooled prevalence of 17.9% (95% CI: 10.8–26.3)
in birds, 21.8% (17.7–26.1) in products and subproducts, and 29.5%
(24.2–35.1) in environmental samples. At the national level, the
prevalence of NTS was heterogenous across countries with the highest
values in Mexico, the USA, and Canada. In total, 131 serovars were
identified from 13,388 isolates, Heidelberg, Kentucky, Enteritidis, and
Typhimurium were the most prevalent in the overall top 10 ranking (range
6.5–20.8%). At the national level, Enteritidis and Typhimurium were
identified in most of the countries, though with national differences in
their ranks. The prevalence of AMR increased from 24.1% for 1
antibiotic, to 36.2% for 2-3 antibiotics, and 49.6% for ≥ 4
antibiotics. Kentucky, Heidelberg, Typhimurium, and Enteritidis were the
serovars with the highest prevalence of AMR and tetracycline,
ampicillin, streptomycin, ceftiofur, and amoxicillin-clavulanic acid
were the top five antibiotics to which NTS isolates were resistant. In
conclusion, NTS was distributed through the avian production chain with
high and heterogenous values of prevalence in poultry samples. Besides,
there were distinctive patterns of serovars distribution across
countries and an alarming prevalence of AMR among zoonotic serovars.
A Single Center Experience with Early Adoption of Physiologic Pacing Approaches
Authors: Oates Connor , Kawamura Iwanari , turagam Mohit , Langan Marie-Noelle , McDonaugh Mary , Whang William , Miller Marc , Musikantow Daniel , Dukkipati Srinivas , Reddy Vivek , Koruth Jacob
Published: September 2021

Background: Increasing interest in physiological pacing has been
countered with challenges such as accurate lead deployment and
increasing pacing thresholds with His-bundle pacing (HBP). More
recently, left bundle branch area pacing (LBBAP) has emerged as an
alternative approach to physiologic pacing. Objective: To compare
procedural outcomes and pacing parameters at follow-up during initial
adoption of HBP and LBBAP at a single center. Methods: Retrospective
review, from September 2016 to January 2020, identified the first 50
patients each who underwent successful HBP or LBBAP. Pacing parameters
were then assessed at first follow-up after implantation and after
approximately one year, evaluating for acceptable pacing parameters
defined as sensing R-wave amplitude >5 mV, threshold
<2.5 V @ 0.5 ms and impedance between 400 and 1200 Ohms.
Results: The HBP group was younger with lower ejection fraction compared
to LBBP (73.2±15.3 vs 78.2±9.2 years, p=0.047; 51.0±15.9% vs
57.0±13.1%, p = 0.044). Post-procedural QRS widths were similarly
narrow (119.8±21.2 vs. 116.7±15.2ms; p = 0.443) in both groups.
Significantly fewer patients with HBP met the outcome for acceptable
pacing parameters at initial follow-up (56.0% vs 96.4%, p = 0.001) and
most recent follow-up (60.7% vs 94.9%, p = <0.001; at
399±259 vs. 228±124 days, p = <0.001). More HBP patients
required lead revision due to early battery depletion (0 vs 13.3%, at
an average of 664 days). Conclusion: During initial adoption, as
compared with LBBAP, HBP is associated with a significantly higher
frequency of unacceptable pacing parameters, energy consumption, and
lead revisions.
CRISPR/Cas9 inhibits rather than induces non-targeted DNA cleavage more likely to cause off-target single-nucleotide variants
Authors: Zhang Ze , Guo Yuanyuan , Zhang Rongjia , Yang Wuchen , Xie Zhengqing , Chen Weiwei , Ling Hua , Cao Gangqiang , Tian Baoming , Wei Fang , gongyao shi
Published: September 2021

CRISPR/Cas9 gene targeting technology has become the most widely used
gene editing technology in both plants and animals. However, substantial
off-target effect remains as a major imperfection hindering its further
application. Here, Nicotiana benthamiana leaf cell-free system was used
to simulate in vivo environment. And the effects of different
CRISPR/Cas9 components on DNA stability in cell-free system were studied
to explore possible mechanisms causing CRISPR off-target. The results
showed that overexpressing Cas9, nCas9 and dCas9 significantly inhibited
DNA cleavage in the cell extracts. While overexpressing RNPs accelerated
the target DNA cleavage but inhibited non-target DNA digestion in cell
extracts, overexpressing nRNP and dRNP blocked the cleavage of either
target or non-target sequences. Meanwhile, analysis of whole-genome
sequencing data from mice and rice edited by different CRISPR tools
revealed that the main off-target mutations were SNVs (single nucleotide
variants), rather than Indels (insertions and deletions) that were
readily induced by DNA double-strand breaks. The off-target sites did
not match the conventionally predicted places but were PAM-rich sites
preferred. Our study suggests that PAM-dependent binding without
cleavage of CRISPR/Cas9 to non-target sequences may increase off-target
mutation risks through impeding the necessary cleavage process for
repairing spontaneous or environmentally induced non-targeted DNA
mutations.
Different root exudates C/N ratios accelerate CO2 emission from paddy soil
Authors: Cai Guan , Shahbaz Muhammad , Ge Tida , Hu yajun , Li Baozhen , Liu Yuhuai , Liu Qiong , Shibistova Olga , Sauheitl Leopold , Wu Jinshui , Guggenberger Georg , Zhu Zhenke
Published: September 2021

Root exudates can greatly modify microbial activity and soil organic
matter (SOM) mineralization. However, the mechanism of root exudation
and its stoichiometric ratio of C/N controlling upon paddy soil C
mineralization are poorly understand. In this study, we used a mixture
of glucose, oxalic acid, and alanine as root exudate mimics, employing
three C/N stoichiometric ratios (CN6, CN10, and CN80) to explore the
underlying mechanisms involved in C mineralization. The input of root
exudates enhanced CO2 emission by 1.8–2.3-fold than that of the
control. Artificial root exudates with low C/N ratios (CN6 and CN10)
increased the metabolic quotient (qCO2) by 12% over those obtained at
higher stoichiometric ratios (CN80 and C-only), suggesting a relatively
high energy demand for microorganisms to acquire organic N from SOM by
increasing N-hydrolase production. The stoichiometric ratios of enzymes
(β-1,4-glucosidase to β-1,4-N-acetyl glucosaminidase) promoting organic
C degradation compared to those involved in organic N degradation showed
a significant positive correlation with qCO2; the stoichiometric ratios
of microbial biomass (MBC/MBN) were positively correlated with carbon
use efficiency. This suggests that root exudates with higher C/N ratios
entail an undersupply of N for microorganisms, triggering the release of
N-degrading extracellular enzymes. This in turn decreases SOM
mineralization, implying the C/N ratio of root exudates to be a
controlling factor. Our findings show that the C/N stoichiometry of root
exudates controls C mineralization by the specific response of the
microbial biomass through the release of C- and N-releasing
extracellular enzymes to adjust for the microbial C/N ratio.
Trends in adult otitis media incidence - a 20-year national observational study
Authors: Gisselsson-Solen Marie
Published: September 2021

Objective: Otitis media (OM) is a common disease in childhood, but much
less prevalent in adults, where it, however, tends to have a less benign
course. The incidence of OM in children has decreased in recent years,
which might be partly explained by the introduction of watchful waiting
strategies, and by the introduction of conjugate pneumococcal
vaccination (PCV) in children. Adult OM has been sparsely studied, and
it is not known whether a herd immunity effect has been achieved after
the introduction of PCV. Watchful waiting is usually not considered in
adult OM patients. The purpose of this study was to use a national
database to investigate the incidence of adult OM in Sweden during the
last 20 years. Design: The yearly number of patients aged 20 and over,
admitted to hospital with OM was obtained through a national database
from 2000 to 2019. The corresponding numbers for outpatients were
obtained between 2005 and 2019. Main outcome measures: incidence of
acute otitis media in adults in in- and outpatient care. Results:
Incidence rates decreased steadily during the study period. Comparing
data on hospitalised patients from 2016-2019 to 2005-2008 (PCV was
introduced in 2009), the incidence rate ratio was 0.49 (95% CI
0.45-0.53); p<0.0001. The corresponding figures for
outpatients were 0.62 (95% CI 0.61-0.63); p<0.0001. The
decrease in hospital admissions was most pronounced among younger
patients, whereas the opposite was true for outpatient visits.
Conclusions: There has been a continuous decrease in incidence of adult
patients admitted to hospital with OM in Sweden during the last twenty
years. Outpatient visits for OM have declined since 2009.
Kinetic Modeling and Algorithm of Three-Component Reaction Network
Authors: Zhang Yanping , Xing Li , Liu Huan , Huang Pingping , Wei Chunjin , Fang Weiping , Lai Weikun , Yi Xiaodong
Published: September 2021

The definite solutions of the differential equations from a
three-component triangle reaction network have been obtained by
utilizing the concept of virtual component concentration and some
mathematical techniques. The kinetic model forming from the above
definite solutions reveals that the overall reaction rate will be
affected by the distribution entropy of the rate coefficients. The
improved eigenvector method including a basic equation, algorithm, and
criterion has been proposed for calculating the rate coefficients from
experimental concentration curves.
Bed structure and its impact on liquid distribution in a trickle bed reactor
Authors: Srivastava Akarsha , Nigam Krishna , Roy Shantanu
Published: September 2021

The work reported in this investigation involves the determination of
the hydrodynamic properties of the Trickle Bed Reactor which has been
loaded in various ways to mark the effect of the loading methodologies
employed to pack the catalyst pellets. The bed structure of a packed
three-phase reactor is critical to study as it provides the essential
contact between the phases and provides the catalytic sites where the
reaction takes place. Depending on the structural properties of the bed
such as local void structure, liquid distribution, two-phase pressure
drop, and holdup of fluids gets affected. The study aims to envelop the
catalyst bed characteristics such as the local void structure, the
length of the catalyst bed, flow characteristics such as liquid and gas
flow rate, and liquid distributor at the top of the catalyst bed to
gauge and quantify their effect on the hydrodynamics of a trickle bed
reactor.
Upwelling-level acidification and pH variability moderate effects of ocean acidification on brain gene expression in black surfperch (Embiotoca jacksoni), a temperate fish with no pelagic larval stage
Authors: Toy Jason , Kroeker Kristy , Logan Cheryl , Takeshita Yuichiro , Bernardi Giacomo
Published: September 2021

Acidification-induced changes in cognitive function and behavior have
recently been documented in tropical marine fishes, raising concerns
about related shifts in species interactions. Here, we investigate
whether similar patterns of broad neurological impacts are observed in a
temperate Pacific fish that experiences regular and often large shifts
in environmental pH due to upwelling events and other natural phenomena.
In two manipulative laboratory experiments, we tested the effect of
acidification, as well as pH variability, on gene expression in the
brain tissue of a common temperate kelp forest/estuarine fish, Embiotoca
jacksoni. We found that patterns of global gene expression in brain
tissue differed significantly across pH level treatments. Additionally,
differential gene expression analysis and gene set enrichment analysis
identified significant differential expression of specific genes and
gene sets both in comparisons of static pH level treatments as well as
in static vs. variable pH treatment comparisons where mean pH was
consistent. Enriched gene sets included those related to ion transport,
signaling pathways, mRNA processing and splicing, and epigenetic
regulation of gene expression, among others. Importantly, we found that
pH variability decreased the number of differentially expressed genes
detected between high and low pH treatments, and that the
inter-individual variability in gene expression was significantly
greater in variable pH treatments than static treatments of the same
mean pH. By demonstrating a broad shift in brain gene expression, these
results provide important confirmation of neurological impacts of
acidification in a temperate fish species, which are likely to translate
to shifts in behavior. This study also provides critical insight into
the potential of natural environmental variability to mediate the
impacts of ocean acidification.
Floral traits and environmental factors regulate insects visits to flowering plants at night
Authors: Feng Lichao , Du Zhiqi , Kulhavy David , Adl Sina , Meng Qingfan
Published: September 2021

Flower-visiting insects have co-evolved with flowering-plants. While it
has been shown that floral traits and environmental factors influence
insects visitations during the day, it is yet unclear how these factors
influence insects visitations at night. We sampled a montane meadow
located near Jilin in northeastern China in July and August in 2019, 4
nights each month, and two time periods each night. We sampled 94
flower-visiting insect species in total and documented the floral traits
and ambient factors. First, focusing on the insects functions, we
allocated all insects into three functional groups (pollination,
predation, and feeding). We found that most nocturnal insects exhibited
predation behavior, and they had the highest species turnover rate.
Second, focusing on the environmental factors, we found that ambient
temperature and relative humidity strongly influence the diversity of
flower-visiting insects. Variation partitioning analysis further
suggested that ambient temperature has a stronger effect on the
flowering-visiting insects at early night, while the relative humidity
has a stronger effect on the flowering-visiting insects at late night.
Third, focusing on floral traits, we found that most insects have a
preference for flowers with moderately-sized corolla diameters (20 to 30
mm). Furthermore, display size had a strong linear correlation with
flowering-visiting insect species richness and frequency of presence. In
sum, our findings suggest that ambient temperature, relative humidity,
and floral display size strongly regulate nocturnal flower-visiting
insects.
Consistency of demographic trade-offs across tropical forests
Authors: Kambach Stephan , Condit Richard , Aguilar Salomón , Bruelheide Helge , Bunyavejchewin Sarayudh , Chang-Yang Chia-Hao , Chen Yu-Yun , Chuyong George , Davies Stuart , Ediriweera Sisira , Ewango Corneille , Fernando Edwino , Gunatilleke Savitri , Gunatilleke Nimal , Hubbell Stephen , Itoh Akira , Kenfack David , Kiratiprayoon Somboon , Lin Yiching , Makana Jean-Remy , Mohamad Mohizah , Pongpattananurak Nantachai , Perez Rolando , Rodriguez Lilian , Sun Ifang , Tan Sylvester , Thomas Duncan , Thompson Jill , Uriarte Maria , Valencia Renato , Wirth Christian , Wright S. Joseph , Wu Shu-Hui , Yamakura Takuo , Yao Tzeleong , Zimmerman Jess , Rüger Nadja
Published: September 2021

All species must balance their allocation to growth, survival and
recruitment. Among trees, evolution has resulted in different strategies
of partitioning resources to these key demographic processes, i.e.
demographic trade-offs. It is unclear whether the same demographic
trade-offs structure tropical forests worldwide. Here, we used data from
13 large-scale and long-term tropical forest plots to estimate the
principal trade-offs in growth, survival, recruitment, and tree stature
at each site. For ten sites, two trade-offs appeared repeatedly. One
trade-off showed a negative relationship between growth and survival,
i.e. the well-known fast−slow continuum. The second trade-off
distinguished between tall-statured species and species with high
recruitment rates, i.e. a stature−recruitment trade-off. Thus, the
fast-slow continuum and tree stature are two independent dimensions
structuring most tropical tree communities. Our discovery of the
consistency of demographic trade-offs and strategies across forest types
in three continents substantially improves our ability to predict
tropical forest dynamics worldwide.
A Nepalese Bipolar case amidst risk and protective factors during COVID-19 pandemic: A Case Report
Authors: Shakya Dhana , Upadhaya Sandesh
Published: September 2021

Bipolar disorder is a chronic and recurring psychiatric illness.
Emphasis on enhancing key protective factors like social support systems
and promoting this to minimize risk factors like non-compliance is one
of the key strategies tied to enhance overall health for symptoms
remission and relapse prevention even during the COVID-19 Pandemic.
Deciphering complex groundwater age distributions and recharge processes in a tropical and fractured volcanic aquifer system
Authors: Sanchez-Murillo Ricardo , Montero-Rodríguez Irene , Corrales-Salazar José , Esquivel-Hernández Germain , Castro-Chacón Laura , Rojas-Jiménez Luis , Vargas-Víquez José , Quezadas Juan Perez , Gazel Esteban , Boll Jan
Published: September 2021

Groundwater recharge in highly-fractured volcanic aquifers remains
poorly understood in the humid tropics, whereby rapid demographic growth
and unregulated land use change are resulting in extensive surface water
pollution and a large dependency on groundwater extraction. Here we
present a multi-tracer approach including
δO-δH,
H/He, and noble gases within the
most prominent multi-aquifer system of central Costa Rica, with the
objective to assess dominant groundwater recharge characteristics and
age distributions. We sampled wells and large springs across an
elevation gradient from 868 to 2,421 m asl. Our results suggest
relatively young apparent ages ranging from 0.0±3.2 up to 76.6±9.9
years. Helium isotopes R/RA (0.99 to 5.4) indicate a dominant signal
from the upper mantle across the aquifer. Potential recharge elevations
ranged from ~1,400 to 2,650 m asl, with recharge
temperatures varying from ~11°C to 19°C with a mean
value of 14.5±1.9°C. Recharge estimates ranged from 129±78 to 1,605±196
mm/yr with a mean value of 642±117 mm/yr, representing 20.1±4.0% of the
total mean annual rainfall as effective recharge. The shallow unconfined
aquifer is characterised by young and rapidly infiltrating waters,
whereas the deeper aquifer units have relatively older waters. These
results are intended to guide the delineation and mapping of critical
recharge areas in mountain headwaters to enhance water security and
sustainability in the most important headwater dependent systems of
Costa Rica.
LYMPHADENITIS BY PARACOCCIDIOIDOMYCOSIS MIMETIZING PANCREATIC HEAD CANCER
Authors: Puls Matheus , Barbieri Flávio , Carrascossi Henrique , Duch Cibele , Lopes Daniel , Moura Lídia , Duarte Giulia , Montoro Mariane , Perugini Matheus
Published: September 2021

Chronic paracoccidioidomycosis is an endemic fungal infection in Latin
America and, although uncommon, the opening of the clinical condition
can be an obstructive abdominal syndrome that can simulate a pancreatic
head neoplasm. There are few cases like this reported in the literature.
Sparse Representations of Random Signals
Authors: Qian Tao
Published: September 2021

Sparse (fast) representations of deterministic signals have been well
studied. Among other types there exists one called adaptive Fourier
decomposition (AFD) for functions in analytic Hardy spaces. Through the
Hardy space decomposition of the $L^2$ space the AFD algorithm also
gives rise to sparse representations of signals of finite energy. To
deal with multivariate signals the general Hilbert space context comes
into play. The multivariate counterpart of AFD in general Hilbert spaces
with a dictionary has been named pre-orthogonal AFD (POAFD). In the
present study we generalize AFD and POAFD to random analytic signals
through formulating stochastic analytic Hardy spaces and stochastic
Hilbert spaces. To analyze random analytic signals we work on two
models, both being called stochastic AFD, or SAFD in brief. The two
models are respectively made for (i) those expressible as the sum of a
deterministic signal and an error term (SAFDI); and for (ii) those from
different sources obeying certain distributive law (SAFDII). In the
later part of the paper we drop off the analyticity assumption and
generalize the SAFDI and SAFDII to what we call stochastic Hilbert
spaces with a dictionary. The generalized methods are named as
stochastic pre-orthogonal adaptive Fourier decompositions, SPOAFDI and
SPOAFDII. Like AFDs and POAFDs for deterministic signals, the developed
stochastic POAFD algorithms offer powerful tools to approximate and thus
to analyze random signals.
Pulmonary Artery Aneurysm Repair with Alpha-1 Anti-trypsin Deficiency
Authors: Starr Brett , Takahashi-Pipkin Caitlin , Bates Michael , Akhter Shahab
Published: September 2021

A 62-year-old woman with pulmonary hypertension due to alpha-1
antitrypsin deficiency and known congenital pulmonic valve stenosis
presented with palpitations, chest pressure and bradycardia and was
found to have a 6 cm pulmonary artery aneurysm on work-up. The patient
underwent surgical pulmonary artery aneurysm repair and recovered from
operation without complications.
Increased patency with comparable mortality and revascularization risk: Is the case for no-touch vein harvesting open and shut?
Authors: Hibino Makoto , Dhingra Nitish , Verma Subodh
Published: September 2021

Since the introduction of the saphenous vein graft (SVG) for coronary
artery bypass grafting (CABG) in 19621, the SVG has remained the most
commonly used conduit to the non-LAD territories for more than half a
century. However, several issues surrounding the use of SVGs, including
higher graft occlusion rates and wound complications from the harvesting
process, have been identified in clinical practice. As such, significant
interest has been dedicated towards developing harvesting techniques
that minimize the risk of these acute and late complications. In this
issue of the Journal of Cardiac Surgery, Yokoyama and colleagues
compared the impact of open vein harvesting (OVH), endoscopic vein
harvesting (EVH) and no-touch vein harvesting (NT) on all-cause
mortality, revascularization and graft failure, using a network
meta-analysis based on randomized controlled trials and propensity-score
matched studies. The results showed that the risk of graft failure was
approximately halved amongst patients receiving NT compared with EVH and
OVH; importantly, though, NT was not associated with lower all-cause
mortality or revascularization risk. To further examine whether the use
of NT grafts endow patients with better long-term clinical outcomes,
such as mortality, myocardial infarction, and revascularization rates, a
large-scaled randomized controlled trial or a patient-level combined
meta-analysis is required.
Early clinical outcomes of total thoracoscopic aortic valve replacement
Authors: Song Chao , Jiang Shengli , Zhu Siming , Fan YunLong
Published: September 2021

Background: With the promotion of minimally invasive concepts and
advances in total thoracoscopic valve surgery, total thoracoscopic
aortic valve surgery has become a new option for patients with aortic
valve lesions. However, due to its anatomical characteristics, poor
surgical field exposure and limited operating space, only a few centers
have performed further studies on this procedure. Methods: We evaluate
the safety and advantages of total thoracoscopic aortic valve
replacement compared to the upper mini-sternotomy AVR group and the
conventional AVR group with important perioperative data as well as
early postoperative outcomes. Results: All patients successfully
underwent elective surgery, with no intraoperative conversion or death
occurring. Patients in the total thoracoscopy group had significantly
prolonged CPB and aortic clamping (AC) times compared to the other two
groups. The average Postoperative chest drainage in the first 24 h of
the total thoracoscopic group was significantly less than the other two
groups. The mean VAS pain score in the total thoracoscopic group was
significantly less than the other two groups. In addition, the total
thoracoscopic group had a significantly decreased ICU stay as well as
the total hospital stay. Although the length of mechanical ventilation
between groups did not show statistically significant differences,
mechanical ventilation in the total thoracoscopy group had a smaller
relative number. Conclusions: Despite the need for improvement, total
thoracoscopic aortic valve replacement is safe, and may improve clinical
outcome
Signatures of natural selection in a foundation tree along Mediterranean climatic gradients
Authors: Filipe João , Rymer Paul , Byrne Margaret , Hardy Giles , Mazanec Richard , Ahrens Collin
Published: September 2021

Temperature and precipitation regimes are rapidly changing, resulting in
forest dieback and local extinction events, particularly in
Mediterranean-type climates. Strategic forest management approaches that
enhance forests’ resilience to future climates are urgently required,
however adaptation to climates in heterogeneous landscapes with multiple
selection pressures may be complex. For widespread trees in
Mediterranean-type climates we hypothesized that patterns of local
adaptation are associated with climate; precipitation is a stronger
factor of adaptation than temperature; functionally related genes show
similar signatures of adaptation; and adaptive variants are
independently sorting across the landscape. To test our hypotheses, we
sampled 28 populations across the geographic and climatic distribution
of Eucalyptus marginata (jarrah), in south-west Western Australia, and
obtained 13,534 independent single nucleotide polymorphic (SNP) markers
across the genome. While overall levels of population differentiation
were low (FST=0.04), environmental association analyses found a total of
2,336 unique SNPs potentially associated with five climate variables of
temperature and precipitation. Allelic turnover was identified for SNPs
associated with temperate seasonality and mean precipitation of the
warmest quarter (39.2% and 36.9% deviance explained, respectively),
suggesting that both temperature and precipitation are important factors
in adaptation. SNPs within similarly function genes, according to gene
ontology enrichment analysis, had analogous allelic turnover along
climate gradients, while SNPs among temperature and precipitation
variables had orthogonal patterns of adaptation. These contrasting
patterns of adaptation provide evidence that there may be standing
genomic variation adapted to changing climates, providing the substrate
needed to promote adaptive management strategies to bolster forest
resilience in the future.
SURGICAL MANAGEMENT OF A MASSIVE CONGENITAL HEMANGIOMA OF THE TONGUE IN AN INFANT: A RARE CASE REPORT
Authors: Sarna Krishan , Kamau Martin , Guthua Symon
Published: September 2021

Lesions involving the tongue may present with life threatening
complications such as airway compromise and risk of severe hemorrhage.
This paper reports the surgical management of a non-involuting massive
congenital hemangioma of the tongue in an infant presenting with
difficulty breathing, feeding and inability to close the mouth.
A New Class of Curves of Rational B-Spline Type
Authors: ALLAOUI Mohamed , ADETOLA Jamal , HOUEDANOU Wilfrid , GOUDJO Aurélien
Published: September 2021

A new class of rational parametrization has been developed and it was
used to generate a new family of rational k functions B-splines which
depends on an index α ∈ ]−∞ , 0[ ∪ ]1 , +∞[. This family of
functions verifies, among other things, the properties of positivity, of
partition of the unit and, for a given degree k, constitutes a true
basis approximation of continuous functions. We loose, however, the
regularity classical optimal linked to the multiplicity of nodes, which
we recover in the asymptotic case, when α → ∞. The associated B-splines
curves verify the traditional properties particularly that of a convex
hull and we see a certain “conjugated symmetry” related to α. The case
of open knot vectors without an inner node leads to a new family of
rational Bezier curves that will be separately, object of in-depth
analysis.
Commentary Left ventricle restoration. Keep the door open.
Authors: Moscarelli Marco , Olevano Carlo
Published: September 2021

Surgical left ventricle restoration (SVR) was firstly by Cooley in 1958
with the “linear suture technique”, and three decades later, Dor used
a circular patch to reconstruct the left ventricle excluding the scarred
parts of the septum and ventricular wall. It gained popularity and
eventually almost abandoned after the contrasting literature evidences.
Hassanabad et al. presented a comprehensive review of current literature
on surgical ventricle restoration (SVR) techniques and clinical
outcomes, trying to understand if SVR has still a substantial role in
the modern medicine.