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Practice variations in managing infantile hemangiomas
Thomas McLean
Alexandra Borst

Thomas McLean

and 8 more

June 09, 2023
Background Infantile hemangioma (IH) is the most common benign tumor of infancy. For children with IH who require treatment, propranolol and other beta blockers have been shown to be safe and effective. Although consensus guidelines for propranolol have been published, anecdotal experience suggests that there remain variations in management. This study was performed to document these variations amongst providers and to identify areas for future research. Methods We conducted an internet-based survey of clinicians who treat patients with IH. Characteristics of respondents were collected. Hypothetical cases and management scenarios were presented and respondents were ask to comment on dosing, monitoring, frequency of follow-up, duration of therapy, whether to taper or abruptly discontinue mediation, and which patients should get additional evaluation. Results Twenty-nine respondents participated in the survey: pediatric hematologists/oncologists (n= 15), pediatric cardiologists (n= 10), dermatologists (n = 2), an ophthalmologist (n = 1), and a neonatologist (n = 1). Most respondents use generic propranolol in infants with growing IH of the head and neck, with a goal dose of 2 mg/kg/day, until approximately one year of age. A variety of management strategies were documented including which patients should be treated, optimal dose and duration of therapy, how patients should be monitored, which patients should get additional work up, how propranolol should best be discontinued, and how often to see patients in follow-up. Conclusions This study demonstrates wide practice variations in managing patients with infantile hemangioma. Further research is indicated to address these variations and develop additional/updated evidence-based guidelines.
Adjuvant immune checkpoint inhibitor therapy may benefit pediatric patients with stag...
Acacia Bowden
Jeanette Zambito

Acacia Bowden

and 3 more

June 09, 2023
Background: Melanoma is the most common skin cancer in children. While the current literature establishes treatment protocols for adult-type melanoma, very few pediatric-specific studies exist, and children are often excluded from melanoma clinical trials 2. Case Report: We report a case series of 23 consecutive pediatric patients diagnosed with melanoma at the University of Rochester Medical Center between 1/1/2011 and 1/1/2022. 2/23 (8.7%) patients had recurrence of their malignancy after therapy while 21/23 (91.3%) remained without disease progression; 1 patient died from unknown cause, but the rest are alive and currently without disease. All patients whose initial therapy included nivolumab in addition to wide local excision did not have recurrence or progression of their disease. Conclusions: This case series highlights trends in the presentation, treatment, and outcomes of pediatric melanoma; however, additional multi-center studies are needed to establish the clinical utility of such features in pediatric melanoma.
Predictors of Control of Chemotherapy-Induced Nausea and Vomiting; experience from a...
Sheri Pariha
Nadia Ayoub

Sheri Pariha

and 2 more

June 09, 2023
Background: CINV is a known distressful symptom in pediatric cancer patients. In a resource-limited setting, insight regarding CINV frequency and current practice can help optimize symptom control. Methods: Prospective study in the pediatric oncology daycare and inpatient services within a tertiary care hospital over 6 months. Patient demographics, chemotherapy and antiemetic regimen details were recorded. Frequency of acute nausea, vomiting and nausea severity for each session was recorded using a self-report questionnaire. Primary outcome was complete control (CC) (defined as no acute nausea or vomiting). Secondary outcomes included nausea severity and antiemetic prescription patterns. Results: A total of 61 (median age 7 years, 45.9% girls) patients received chemotherapy over 265 visits (85 single-day, 56 blocks). Inpatient sessions were more frequently of high emetogenicity (47.8% of 138 sessions) and most daycare sessions moderately emetogenic (79.5% of 127). Overall CC was 65.7%, significantly better for inpatients (73.2%, P<.009) and for sessions with weight-appropriate ondansetron dosing (p = 0.033). Odds of experiencing nausea (median severity 4) were higher in day care (OR 2.11, 95% CI 1.13-3.92) and lower (OR 0.25, 95% CI 0.09-0.72) when ondansetron dosing was weight-appropriate. CC did not vary significantly with age or gender. Conclusion: The overall CC rate was 65%, and was significantly higher for inpatients, highly emetogenic regimens, and when appropriate ondansetron dosing was used. This study identified gaps in our antiemetic practice, with moderately emetogenic sessions failing to receive guideline-recommended antiemetics, correlating with significantly lower complete control for daycare sessions.
Comment on: Neurocognitive and Emotional Factors Predict Pain Related Health care Uti...
Heeta Kumari
Mohadisa Asif Rawalia

Heeta Kumari

and 2 more

June 09, 2023
A document by Heeta Kumari. Click on the document to view its contents.
Primary Central Nervous System Anaplastic Large Cells Lymphoma in children: case pres...
Raffaella Messina
Teresa Perillo

Raffaella Messina

and 12 more

June 09, 2023
Primary Central Nervous System Lymphoma is a rare extranodal non-Hodgkin lymphoma, primarily arising in brain and spinal cord tissue, leptomeninges and vitreoretinal eye. Pediatric PCNSLs are even rarer. We describe the case of a boy presenting with seizures and a suspected brain meningioma, but a final diagnosis of ALK+ Anaplastic Large Cell Lymphoma. We conducted a qualitative systematic review following the ENTREQ framework on pediatric cases of PCNSL, identifying only nine cases of brain ALCL. Our work describes the high frequency of misdiagnosis correlating with poor prognosis, and highlights the importance of a multidisciplinary approach considering ALCL among differential diagnosis.
Effect of Integrated Soil and Water Conservation on Selected Soil Physicochemical Pro...
Solomon Umer
Degineh Lagiso

Solomon Umer

and 1 more

June 09, 2023
To overcome the problem of land degradation expanding the elephant grass to the degraded land for soil and water conservation in sustainable land management practice were better option for farmer. Objectives are assesses the effect of integrated soil and water conservation on selected soil physicochemical property and factors determining its adoption in, Ethiopia. Materials and Methods of data were collected through soil sampling, field observation and household interviews. SPSS software version 21, the data were analyzed using descriptive statistical. Survey data was analysis for continuous variables by using independent sample t-test and for dummy variable chi-square and logistic regression to determine the predictive variable. Results, Based on the finding sand, silt and clay contents were varied significantly (P < 0.05) between the land management practices. There was significantly higher mean bulk density value for the soil bund compared to the values for the rest of the land management practices. When comparing the soil bund with elephant grass to the soil bund without elephant grass, the mean value of hydrogen power was much higher. The trend was similar for total nitrogen, available phosphorus. Furthermore, sex, total tropical livestock unit, and information about agriculture were significantly influenced adoption of soil and water conservation technology (elephant grass). Main finding the soils under the bund with elephant grass revealed that overall change towards the direction of increasing their fertility status compared to soil bund alone. Thus, stabilization of bunds with elephant grass significantly benefit to the soil for its fertility improvement.
Increased Ammonium/Nitrate (NH 4 + /NO 3 - ) ratios along Faidherbia albia Stand age...
Solomon Amare
Mitiku Hailu

Solomon Amare

and 3 more

June 09, 2023
Increased in soil total nitrogen (TN) as influenced by Faidherbia albida here after F. albida have been explored for decades. However, changes in ammonium (NH 4 +) to nitrate (NO 3 -) ratios as influenced by the tree and the relationships with other soil physicochemical and biological properties were not explored. Thus, the present study was carried out in 2023 to investigate changes in soil NH 4 +/ NO 3 - ratios and the relationships with biotic and abiotic factors across different stand age of F. albida in a semi-arid Arenosols at Abraha we Atsbeha, northern Ethiopia. Soil NH 4 + and NO 3 - were extracted using analytical grade potassium chloride solution and their concentrations were determined by colorimetric method using UV-VIS spectrophotometer (Model: UV-VIS Spectrophotometer, Series No.: AE1605020). One-way analysis of variance (ANOVA) was done to compare means and Pearson correlations using IBM SPSS Statistics Version 20, and redundancy analysis (RDA) using CANOCO software to understand the relationships among soil physicochemical and biological variables. Our results indicated that TN, NH 4 +, NO 3 - and NH 4 +/ NO 3 - ratios significantly (P < 0.05) increased with F. albida stand age. The most important thing here was that the proportion of NH 4 + has been succeeding over NO 3 - and this could have profound effect on both below and above ground features of the Arenosol agro-ecosystem. Moreover, redundancy analysis (RDA) showed that NH 4 + concentration strongly associated with soil moisture content (MC), cation exchange capacity (CEC), TN, extractable base cations (K, Ca, Mg), extractable phosphorus (EP), soil organic Carbon (SOC), organic matter (OM) microbial biomass carbon (MBC), clay texture, abundance of nematodes, density of fibrous rooted weeds while it was found to have negative relationships with soil bulk density, sandy texture and pH. Our findings enabled us to accept the hypothesis that NH 4 +/ NO 3 - ratios would increase with increasing F. albida stand age. In conclusion, increased F. albida stand age in agro ecosystems would increase NH 4 +/ NO 3 - ratios. Consequently, this triggered below and above ground communities successions and ultimately surpasses production and productivity of arid and semi-arid Arenosols.
A Confusing case, leptospirosis during COVID-19 pandemic: A case report
sara mohammadnia
Arefeh Babazadeh

sara mohammadnia

and 3 more

June 09, 2023
Introductionsince march 11, 2020 world health organization (WHO) reported a worldwide pandemic occurring by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) (1, 2). COVID-19 infections symptoms includes a variation of fever, cough, dyspnea, headache, myalgia and abdominal pain (3).Since then, there were reports of coinfections or misdiagnoses of covid-19 with other infections which have the same clinical or paraclinical symptoms (4, 5). Leptospirosis is a common infection in Southeast Asia and is one of those infections which can have the same symptoms as COVID-19 including cough and myalgia (6). In this study we are reporting a case that was not surely a severe pulmonary leptospirosis or covid-19.
The effect of LLLT at 5 mW on corneal alkali burn rat model
Kyong-Jin Cho
Hoon Kim

Kyong-Jin Cho

and 1 more

June 09, 2023
Purpose: This study aimed to investigate the effect of 5mW low-level light therapy (LLLT) on corneal alkali burn rat model, as no prior research has examined this specific treatment parameter. Method: Eighteen male SD rats were randomly assigned to three groups: control, 5-minute LLLT, and 10-minute LLLT. Corneal alkali burns were induced using 1N NaOH, and LLLT was performed daily with an 830-nm LED device. Ocular signs and immunohistochemistry analysis were conducted. Result: LLLT-treated groups exhibited faster wound healing at 12 hours but had higher cataract incidence. Neovascularization and corneal opacity scores were significantly higher in LLLT-treated groups. Immunohistochemical analysis showed increased IL-1β and IL-6 levels in cornea and retina. Discussion: LLLT accelerated wound healing but increased cataract formation, corneal opacity, neovascularization, and inflammatory response in ocular tissues. LLLT may have therapeutic potential for corneal alkali burns, but further studies are necessary to optimize treatment parameters and mitigate adverse effects.
Proteomic profiling of ovarian clear cell carcinomas identifies prognostic biomarkers...
Liang Yue
Ting-Ting Gong

Liang Yue

and 14 more

June 09, 2023
CCOC s a relatively rare subtype of ovarian cancer with high degree of resistance to standard chemotherapy. Little is known about the underlying molecular mechanisms, and it remains a challenge to predict its prognosis after chemotherapy. We analyzed the proteome of CCOC tissue samples from two independent cohorts using DIA-MS. A total of 8697 proteins were characterized in the first cohort (H1 cohort, 32 patients, 35 FFPE samples) and 9409 proteins in the second cohort (H2 cohort, 24 patients, 28 FF samples). After bioinformatics analysis, we narrowed our focus to 15 proteins significantly correlated with RFS in both cohorts. These proteins are mainly involved in DNA damage response, extracellular matrix, and mitochondrial metabolism. We further developed a 13-protein model to predict the prognosis of patients with CCOC in H2 cohort, and validated the model in the H1 cohort in both DIA and PRM data. Finally, we verified the modulated pathways from our CCOC proteomic dataset in several published CCOC transcriptome and proteome datasets. Taken together, this study presents a CCOC proteomic data resource and a promising 13-protein panel which could potentially predict the recurrence and survival of CCOC.
Local adaptation of a native herbivore to a lethal invasive plant.
Nitin Ravikanthachari
Rachel Steward

Nitin Ravikanthachari

and 2 more

June 09, 2023
Understanding the evolutionary processes that influence fitness is critical to predicting species' responses to selection. Interactions among evolutionary processes including gene flow, drift and the strength of selection can lead to either local adaptation or maladaptation especially in heterogeneous landscapes. Populations experiencing novel environments or resources are ideal for understanding the mechanisms underlying adaptation or maladaptation, specifically in locally co-evolved interactions. We used the interaction between a native herbivore that oviposits on a patchily distributed introduced plant that in turn causes significant mortality to the larvae to test for signatures of local adaptation in areas where the two co-occurred. We used whole genome sequencing to explore population structure, patterns of gene flow and signatures of local adaptation. We found signatures of local adaptation in response to the introduced plant in the absence of strong population structure with no genetic differentiation and low genetic variation. Additionally, we found localized allele frequency differences within a single population between habitats with and without the lethal plant, highlighting the effects of strong selection. Our work highlights the potential for adaptation to occur in a fine-grained landscape in the presence of gene flow and low genetic variation.
The Order of Finite Generation of SO(3) and Optimization of Rotation Sequences
Danail Brezov

Danail Brezov

June 09, 2023
We generalize an old result due to Lowenthal [1] and a more recent one due to Hamada [2] on the order of finite generation of the rotation group SO ( 3 ) both for fixed and arbitrary compound transformations. Unlike the above cited authors, we consider decompositions into factors with more than two invariant axes and provide rather intuitive geometric proofs. Thus, we derive a simple estimate for the number of factors in a decomposition and discuss possible means of optimization as well as particular examples of potential interest for the applications.
A maize enzyme from the 2-oxoglutarate-dependent oxygenase family with unique kinetic...
Paula Casati
Paloma Serra

Paula Casati

and 5 more

June 09, 2023
In plants, salicylic acid (SA) hydroxylation regulates SA homoeostasis, playing an essential role during plant development and response to pathogens. This reaction is catalyzed by SA hydroxylase enzymes, which hydroxylate SA producing 2,3- dihydroxybenzoic acid (2,3-DHBA) and/or 2,5-dihydroxybenzoic acid (2,5-DHBA). Several SA hydroxylases have been recently identified and characterized from different plant species; however, no such activity has been previously reported in maize. In this work, we describe the identification and characterization of a new SA hydroxylase in maize plants. This enzyme, with high sequence similarity to previously described SA hydroxylases from Arabidopsis and rice, converts SA into 2,5-DHBA; however, it shows different kinetics properties to those from previously characterized enzymes, and it also catalyzes the conversion of the flavonoid dihydroquercetin into quercetin in in vitro activity assays, suggesting that the maize enzyme may have different roles in vivo as those previously reported from other species. Despite this, ZmS5H-1 can complement the resistance to pathogen and early senescence phenotypes of Arabidopsis s3h mutant plants. Finally, we characterized a maize mutant in the S5H-1 gene ( s5h-1Mu) that has altered growth, senescence and increased resistance against Colletotrichum graminicola infection, showing not only changes in SA and 2,5-DHBA but also variations in flavonol levels. Together, the results presented here provide evidence that SA hydroxylases in different plant species have evolved to show differences in catalytic properties that may be important to fine tune SA levels and other phenolic compounds such as flavonols to regulate different aspects of plant development and defense against pathogens.
Basic Clinical Management of Preschool Wheeze
Andrew Bush

Andrew Bush

June 09, 2023
Pre-school wheeze is very common and often difficult to treat. Most children do not require any investigations, only a detailed history and physical examination to ensure an alternative diagnosis is not being missed; the differential diagnosis, and hence investigation protocols for the child in whom a major illness is suspected, shows geographical variation. The pattern of symptoms may be divided into episodic viral and multiple trigger to guide treatment, but the pattern of symptoms must be re-assessed regularly. However, symptom patterns are a poor guide to underlying pathology. Attention to the proper use of spacers, and adverse environmental exposures such as tobacco smoke exposure, is essential. There are no disease-modifying therapies, so therapy is symptomatic. This paper reviews recent advances in treatment, including new data on the place of leukotriene receptor antagonists, prednisolone for acute attacks of wheeze and antibiotics, based on new attempts to understand the underlying pathology in a way that is clinically practical.
Melatonin biosynthesis gene MdASMT9 confers tolerance to nitrogen deficiency in an Md...
赵 里
Tengteng Gao

赵 里

and 8 more

June 09, 2023
Nitrogen (N) is a vital nutrient for crop growth and development which influences both yield and quality. Melatonin (MT), a known enhancer of abiotic stress tolerance, has been extensively studies; however, its relationship with nutrient stress, particularly N, and the underlying regulatory mechanisms of MT on N uptake remain unclear. In this study, exogenous MT treatment was found to improve the tolerance of apple plants to N deficiency. Apple plants overexpressing the MT biosynthetic gene N-acetylserotonin methyltransferase 9 ( MdASMT9) was used to further investigated the effects of endogenous MT on low-N stress. The overexpression of MdASMT9 improved the light harvesting and heat transfer capability of apple plants, thereby mitigating the detrimental effects of N deficiency on the photosynthetic system. Proteomic and physiological data analyses indicated that MdASMT9 overexpression enhanced the trichloroacetic acid (TCA) cycle and positively modulated amino acid metabolism to counteract N-deficiency stress. Additionally, both exogenous and endogenous MT promoted the transcription of MdHY5, which in turn bound to the MdNRT2.1 and MdNRT2.4 promoters and activated their expression. Notably, MT-mediated promotion of MdNRT2.1 and MdNRT2.4 expression in an MdHY5-dependent manner, ultimately enhancing N absorption. Taken together, these results may provide useful insights into the relationship between MdASMT9-mediated MT biosynthesis and N uptake under N-deficiency conditions in apple plants.
Revisiting an ecophysiological oddity: hydathode-mediated foliar water uptake in Cras...
Marc Fradera-Soler
Jozef Mravec

Marc Fradera-Soler

and 5 more

June 09, 2023
Hydathodes are usually associated with water exudation in plants. However, foliar water uptake (FWU) through the hydathodes has long been suspected in the leaf-succulent genus Crassula (Crassulaceae), a highly diverse group in southern Africa, and, to our knowledge, no empirical observations exist in the literature that unequivocally link FWU to hydathodes in this genus. FWU is expected to be particularly beneficial on the arid western side of southern Africa, where up to 50% of Crassula species occur and where periodically high air humidity leads to fog and/or dew formation. To investigate if FWU is operational in different Crassula species we used the apoplastic fluorescent tracer Lucifer Yellow in combination with different imaging techniques. Our images of dye-treated leaves confirm that hydathode-mediated FWU does indeed occur in Crassula and that it is probably widespread across the genus. Hydathodes in Crassula have been repurposed as moisture-harvesting structures, besides their more common purpose of guttation, an adaptation that has likely played an important role in the evolutionary history of the genus. Our observations suggest that FWU ability is independent of geographical distribution and its associated environmental conditions, as FWU is possible in species occurring within the fog belt of western southern Africa but also in those from the rather humid eastern side. We did not find a strong apparent link between FWU ability and leaf surface wettability. Instead, the hierarchically sculptured leaf surfaces of several Crassula species may facilitate FWU due to hydrophilic leaf surface microdomains, even in seemingly hydrophobic species. Overall, these results confirm the ecophysiological relevance of FWU in Crassula and reassert the importance of atmospheric humidity for some arid-adapted plant groups.
Foray into the topology of poly-bi-[8]-annulenylene
Varadharajan Muruganandam
Manas Sajjan

Varadharajan Muruganandam

and 2 more

June 09, 2023
Analyzing phase transitions using the inherent geometrical attributes of a system has garnered enormous interest over the past few decades. The usual candidate often used for investigation is graphene- the most celebrated material among the family of tri co-ordinated graphed lattices. We show in this report that other inhabitants of the family demonstrate equally admirable structural and functional properties that at its core are controlled by their topology. Two interesting members of the family are Cylooctatrene(COT) and COT-based polymer: poly-bi-[8]-annulenylene both in one and two dimensions that have been investigated by polymer chemists over a period of 50 years for its possible application in batteries exploiting its conducting properties. A single COT unit is demonstrated herein to exhibit topological solitons at sites of a broken bond similar to an open one-dimensional Su-Schrieffer-Heeger (SSH) chain. We observe that Poly-bi-[8]-annulenylene in 1D mimics two coupled SSH chains in the weak coupling limit thereby showing the presence of topological edge modes. In the strong coupling limit, we investigate the different parameter values of our system for which we observe zero energy modes. Further, the application of an external magnetic field and its effects on the band-flattening of the energy bands has also been studied. In 2D, poly-bi-[8]-annulenylene forms a square-octagon lattice which upon breaking time-reversal symmetry goes into a topological phase forming noise-resilient edge modes. We hope our analysis would pave the way for synthesizing such topological materials and exploiting their properties for promising applications in optoelectronics, photovoltaics, and renewable energy sources.
The Insertion Sequence Excision Enhancer (IEE): a PrimPol-based system for Immobilizi...
Michael Chandler
Karen Ross

Michael Chandler

and 2 more

June 09, 2023
Evolutionary studies often identify genes that are shared between different organisms and the phrase Lateral or Horizontal Gene Transfer is often used in this context. However, they rarely provide any mechanistic information concerning how these gene transfers might have occurred. With the astonishing increase in the number of sequences in the public databases over the past two or three decades, identical antibiotic resistance genes have been identified in many different sequence contexts. One explanation for this would be that genes are initially transmitted by transposons which have subsequently decayed and can no longer be detected. Here, we provide an overview of a protein, IEE (Insertion Sequence Excision Enhancer) observed to facilitate high frequency excision of IS 629 from clinically important Escherichia coli O157:H7 and subsequently shown to affect a large class of bacterial insertion sequences which all transpose by using the copy-out-paste-in transposition mechanism. Excision depends on both IEE and transposase indicating association with the transposition process itself. We review genetic and biochemical data and propose that IEE immobilizes genes carried by compound transposons by removing the flanking IS copies. The biochemical activities of IEE as a primase with the capacity to recognize DNA microhomologies and the observation that its effect appears restricted to IS families which use copy-out-paste-in transposition, suggests IS deletion occurs by abortive transposition involving strand switching during the copy-out step. This reinforces the proposal made for understanding loss of IS Apl1 flanking mcr-1 in the compound transposon Tn 6330 which we illustrate with a detailed model.
Treatment strategy in chronic lymphocytic leukemia with symptomatic central nervous s...
Rosina Dewaide
Kirsten Saevels

Rosina Dewaide

and 1 more

June 09, 2023
Treatment strategy in chronic lymphocytic leukemia with symptomatic central nervous system involvement : a case reportAuthor: Rosina Dewaide, M.D. University Hospital Antwerp: Universitair Ziekenhuis Antwerpen Antwerpen, BELGIUMCo-author: Kirsten Saevels, , M.D. University Hospital Antwerp: Universitair Ziekenhuis Antwerpen Antwerpen, BELGIUMCorresponding author: Rosina.Dewaide@uza.beThe author and co-author state that they have no conflict of interest.Written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy.
Weight Loss Associated with Semaglutide Treatment Among People with HIV
Sherif Eltonsy
Lara Haidar

Sherif Eltonsy

and 23 more

June 09, 2023
Purpose There is limited real-world evidence about the effectiveness of semaglutide for weight loss among people with HIV (PWH). We aimed to investigate weight change in a US cohort of PWH who initiated semaglutide treatment. Methods We conducted an observational study using data from the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. We identified adult PWH who initiated semaglutide between 2018 and 2022 and with ≥2 weight measurements. The primary outcome was within-person bodyweight change (kg/year). The secondary outcome was within-person Hemoglobin A1c percent (HbA1c) change per year. Both outcomes were estimated using multivariable linear mixed model. Results In total, 222 new users of semaglutide met inclusion criteria. Mean follow up was 1.1 years. Approximately 75% of new semaglutide users were male, and at baseline, mean age was 53 years (standard deviation [SD]: 10), average weight was 108 kg (SD: 23), mean body mass index was 35.5 kg/m 2, mean HbA1c was 7.7% and 77% had clinically recognized diabetes. At baseline, 97% were on ART and 89% were virally suppressed (VL < 50 copies/mL). In the adjusted mixed model analysis, treatment with semaglutide was associated with significant weight loss of 6.47 kg per 1 year (95% CI: -7.67 to -5.18) and with a reduction in HbA1c of 1.07% per 1 year (95% CI -1.64 to -0.50) among the 157 PWH with a post-index HbA1c value. Conclusions Semaglutide was associated with significant weight loss and HbA1c reduction among PWH, comparable to results of previous studies from the general population.
Simplified environmental flow metrics and environmental water requirements for Medite...
Douglas Green
Kumar Savadamuthu

Douglas Green

and 1 more

June 09, 2023
1. The flow regime of a river is well established as being one of the key drivers of riverine ecosystem type, diversity and condition. This is especially true of seasonal rivers that experience a cease to flow period over the dry months of the year. 2. In order to effectively assess changes to the flow regime, it is required that flow data be quantified into metrics for ease of assessment and to effectively relate changes to environmental outcomes. 3. Previous methods have used large numbers of, often complex, flow metrics to assess the flow regime. These metrics are often highly internally correlated with each other which may pose problems when considering how these metrics are assessed. The metrics are also often complicated which introduces issues for communication of results. We suggest that due to high internal correlation between metrics, significantly fewer metrics are required to describe the flow regime, and owing to the high correlation within same season flow metrics, simple metrics can be selected. 4. We report on a series of six flow metrics that cover the whole of the flow regime, that are reported annually and that are simple to assess and interpret. We then apply those six metrics to establish environmental water requirements for the North Para River in the Barossa Valley of South Australia. 5. Environmental water requirements are defined using upper and lower bounds of a moving average for each metric, rather than a defined threshold. We suggest this better reflects the highly variable nature of seasonal rivers, and the subsequent tolerances of the flora and fauna that inhabit them.
Geometric Active Disturbance Rejection Control of Rotorcraft on SE(3) with Fast Finit...
Ningshan Wang
Reza Hamrah

Ningshan Wang

and 3 more

June 09, 2023
This article presents a tracking control framework enhanced by an extended state observer for a rotorcraft aerial vehicle modeled as a rigid body in three-dimensional translational and rotational motions. The system is considered as an underactuated system on the tangent bundle of the six-dimensional Lie group of rigid body motions, S E ( 3 ) . The extended state observer is designed to estimate the resultant external disturbance force and disturbance torque acting on the vehicle. It guarantees stable convergence of disturbance estimation errors in finite time when the disturbances are constant and finite time convergence to a bounded neighborhood of zero errors for time-varying disturbances. This extended state observer design is based on a Hölder-continuous fast finite time stable differentiator that is similar to the super-twisting algorithm, to obtain fast convergence. A tracking control scheme that uses the estimated disturbances from extended state observer for disturbance rejection, is designed to achieve fast finite-time stable tracking control. Numerical simulations are conducted to validate the proposed extended state observer and tracking control scheme with disturbance rejection. The proposed extended state observer is compared with other existing research to show its supremacy.
Mortality and morbidity of Human Metapneumovirus infection in the pre COVID19 Era, th...
Merita Shehu
Piotr Kapinos

Merita Shehu

and 3 more

June 09, 2023
Abstract Introduction: Human metapneumovirus (HMPV) was recently recognized as an important cause of seasonal respiratory tract infections mainly in children and immunocompromised adults. The use of Charlson Comorbity index (CCI) to predict outcome in hospitalized patients has been validated in several settings. Objective: Describe the clinical characteristics of adult patients with HMPV infection, evaluate the value to the CCI in predicting outcome. Methods: Single center retrospective chart review study of hospitalized patients with HMPV infection in 2017. Results: 22 adult patients with a mean age of 65 years were reviewed. The mean CCI was 4.6±2.6. The overall mortality was 22%. Abnormal chest radiograph (CXR) was reported in 15 patients. CCI was not different between survivors and non survivors. Non survivors were more likely to have abnormal CXR and higher fever at the time of diagnosis, required mechanical ventilation or were treated for other concomitant infections. Conclusion: The average of CCI was 4.5 which was not significantly different between survivors and non survivors. Mortality rate was elevated at 22% and is likely associated with admission to the ICU and presence of another concomitant infection.
Intraspinal metastasis of choroid plexus papillary carcinoma: a case report and liter...
Ye  Yuan
Jin Geng

Ye Yuan

and 1 more

June 09, 2023
Choroid plexus papillary carcinoma (CPC) is a rare intracranial malignant tumor that originates from choroid plexus epithelium and is categorized as a malignant type of choroid plexus papillary tumor. It accounts for only about 0.05%-0.1% of all intracranial tumors [1]. CPC predominantly affects children, and a few cases are detected before or shortly after birth. The lateral ventricle and the third ventricle are the most common sites of choroid plexus tumors in children. CPC has a higher propensity to occur in the fourth ventricle in adults. Tumors are a rare occurrence in the cerebellopontine angle. Choroid plexus papillary tumors have the potential to disseminate via the cerebrospinal fluid. Currently, there is no literature reporting intraspinal choroid plexus papillary carcinoma. We present a case of a 6-year-old male who presented with headaches and was admitted to the Department of Neurosurgery in our hospital. The MRI of the head revealed a cerebellar mass, which was later confirmed as choroid plexus papillary carcinoma through postoperative pathology. Six months after discharge, the patient was admitted to the hospital again due to low back pain. MRI examination showed an intraspinal mass, which was confirmed as choroid plexus papillary carcinoma by postoperative pathology.
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