Background – Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease. Cardiac involvement is important due to its impact on survival. Transthoracic echocardiography (TTE) is a sensitive technique to assess cardiac structure and function. The degree of cardiac involvement according to SLE subsets defined by non-echocardiographical manifestations remains unknown. The objective of this study was to identify differences in TTE parameters associated with different SLE clinical subgroups. Methods and Results – One hundred and eighty-one patients fulfilling the ACR/EULAR 2019 classification criteria for SLE and who had undergone systematic TTE at least once were included in this cross-sectional study. The earliest available TTE from the date of diagnosis was considered the baseline TTE. We defined four subsets of SLE which was based on the predominant clinical manifestations. A multivariate multinomial regression analysis was performed to determine whether TTE parameters differ between the phenotypical subsets. The first subset (n = 37) of patients showed clinical features of mixed connective tissue disease (MCTD); the second subset (n = 76) had primarily cutaneous involvement; the third subset (n = 18) exhibited serositis; the last subset (n = 50) had severe disease with significant organ involvement, including renal involvement. Forty TTE parameters were assessed in all patients. Using a multivariate multinomial regression analysis, 3 parameters differed according to groups: RV-E’(early diastolic tricuspid annular velocity, p<0.0001), RV-S’ (RV-pulse DTI systolic peak wave, p = 0.0031), and RV end-diastole diameter (p = 0.0419). Conclusion – SLE is an heterogeneous disease. Four distinct clinical subsets based on clinical manifestations differed in terms of TTE derived parameters of right heart dysfunction and diastolic dysfunction. This SLE heterogeneity in cardiac involvement could help to tailor the follow-up required for these patients.

Background: In some breast cancers, decreased estrogen-sulfotransferase (SULT1E1) and its inactivation caused by oxidative-stress lead to elevated E2 levels as well as hypoxia-inducible tissue-damaging factors. Methods: Here, matrix-metalloproteases (MMP2/9) activity and SULT1E1-HIF1α protein/gene expression (Western-blot/RTPCR) were assessed in human breast-cancers versus their adjacent-tissues. Oxidant-stress neutralizer, chalcone (α,β unsaturated ketone) and SULT1E1-inducer dialyl-sulfide (source garlic; Allium sativum) were tested to prevent cancer causing factors in rat, in-vitro and in-vivo model. The antioxidant-enzymres SOD1, catalase, GPx and LDH, and matrix-degenerating MMP2/9 activities were assessed (gel-zymogram). Histoarchitecture (HE-staining) and tissue SULT1E1-localization (immuno-histochemistry) were screened. Extensive statistical-analysis were performed. Results: Human cancer-tissue expresses higher SULT1E1, paralleling HIF1α protein/mRNA owing to lower LDH activity. In addition, increase of MMP2/9 activities commenced tissue damage. However, chalcone and DAS significantly induced SULT1E1 gene/protein, and suppressed HIF1α expression, and MMP2/9 activities in rat tissues. Correlation of individual parameter statistics and group statistics of t-test suggest significant correlation of oxidative-stress (MDA) with SULT1E1 (p=0.006), HIF1α (p=0.006) protein-expression. The NPSH showed a negative correlation (p=0.001) with HIF1α, These two proteins and SULT1E1 mRNA expressions in human breast tumor were significantly higher (p<0.05) compared to the adjacent tissues. Pearson correlation data suggest, SULT1E1 is correlated with NPSH in different exposure groups. Conclusions: Breast cancers associate with SULT1E1, HIF1α and MMPs deregulations. Higher SULT1E1-protein in advanced cancer, remain inactive in oxidant oxidative environment and may be re-activated in chalcone induced reducing-state. Moreover, DAS induced SULT1E1 mRNA expression augments its protein increment. Synergistic drug-effects commenced HIF1α and MMPs suppression. Further studies are necessary.

Solar steam generation is a promising water purification technology due to its low-cost and environmentally friendly applications in water purification and desalination. However, hydrophilic or hydrophobic materials alone are insufficient in achieving necessary characteristics for constructing high-quality solar steam generators with good comprehensive properties. Herein, novel hydrophile/hydrophobe amphipathic Janus nanofibers aerogel is designed and used as a host material for preparing solar steam generators. The product consists of an internal cubic aerogel and an external layer of photothermal materials. The internal aerogel is composed of electrospun amphipathic Janus nanofibers. Owing to the unique composition and structure, the prepared solar steam generator integrates the features of high water evaporation rate (2.944 kg·m-2·h-1 under 1 kW m-2 irradiation), self-floating, salt-resisting, and fast performance recovery after flipping. Moreover, the product also exhibits excellent properties on desalination and removal of organic pollutants. Compared with traditional hydrophilic aerogel host material, the amphipathic Janus nanofibers aerogel brings much higher water evaporation rate and salt resistance.

Comparisons of plant traits between native and invasive congeners are useful approaches for identifying characteristics that promote invasiveness. We compared germination patterns and seedling growth of locally sympatric populations of native Mimosa himalayana and two varieties of invasive M. diplotricha (var. diplotricha and var. inermis) growing in south-eastern Nepal. Seeds were germinated under 12h photoperiod or complete dark, low (25/15°C day/night) and (30/20°C) high temperatures, different water stress levels, and soil depths. Plant height, biomass allocations, and relative growth rate (RGR) of seedlings were measured. Invasive M. diplotricha had higher germination percentage, rate, and shorter germination time than native species. Germination of both congeners declined as water stress increased, but the decline was more pronounced in native species. Seedling emergence declined with increasing depth in all taxa. The seedlings of invasive species were taller with higher leaf number and allocated greater proportion of biomass to shoot, while the native congener allocated greater biomass to root. The RGR was nearly twice as high in invasive species as it was in native congener. Seedling height and number of leaves were always higher in invasive than in native and the native-invasive differences increased over time. Better germination and higher growth performance of invasive species than congeneric native one suggests that seed germination and seedling growth can be useful traits for the prediction of species’ invasiveness in their introduced range during risk assessment process.

There are many natural resources generated in cities that are not being used. Inflorescences litter produced by trees in cities can have great potential for use and little is known about the nutritional contributions and chemical composition they could have as soil improvers. The objective of this study was to evaluate the nutritional properties and chemical composition of inflorescence litter of two tree species commonly used in urban landscaping, Jacaranda (Jacaranda mimosifolia) and Jabin (Piscidia piscipula), and mixtures of inflorescence litter material with Andosol type soil. Soil was mixed with inflorescence litter material in different proportions and after an incubation period of 69 days. Changes in nutrient concentrations and chemical composition of substrates were recorded using infrared spectroscopy. It was found that the physical state of the matter and its transformation dynamics differ according to the litter material of the inflorescence and the proportion of mixtures; each species reacts differently to the availability, immobilization or sequestration of elements such as C, N, P, K, Na, Ca, Mn, Mg, Zn and Cu. Microbial capacity intrinsically contained in substrates could partly explain these results, changing the structural and chemical composition, and the physical state of the matter in substrates. The use of inflorescence litter to fertilize or improve soil can be an innovative but still unexplored technique, and a viable line of research to take advantage of a sustainable natural resource that is generally wasted in urban areas.

Seed germination in Melocactus and other cactus species is hampered by the occurrence of dormancy. However, most studies failed to achieve high seed germination rates, suggesting a complex mechanism of dormancy in Cactaceae. Thus, the objective of this study was to demonstrate that dormancy in Melocactus seeds may be associated with factors such as light and phytoregulators. Two consecutive experimental sets were designed: one with seed germination paper under different wavelengths and Photosynthetically Photon Flux Densities (PPFDs); and one in vitro experiment using a culture medium to evaluate the influence of different plant growth regulators, both in the germination of seeds of Melocactus zehntneri. The results obtained showed that seeds of M. zehntneri are positive photoblastic. Red light and gradual increases in PPFD resulted in the highest germination rates and speed germination index. The experiment with phytoregulators showed a major effect of Ethephon to release the germination of dormant seeds of M. zenhtneri, totalizing 98% of seeds germinated under in vitro conditions, compared to 76% in control. The present study develops an efficient technique to break seed dormancy and the results can be useful to better understand cacti seed dormancy.

Long chain α-olefin is a high value intermediate of organic synthesis. The separation of α-olefin/paraffin with low energy consumption is a challenging problem in the process of efficient utilization of Fischer-Tropsch synthesis products. Adsorption separation is a promising alternative to the traditional energy-intensive distillation. Herein, a simulated moving bed unit was built and applied for the separation of C8 α-olefin/paraffin using NaX zeolite as adsorbent and cyclohexane as desorption reagent. Initial SMB parameters were determined reasonably by fixed bed chromatography pulse experiment and safety factor method. The parameters, including switching time, flow rates, and configuration, were further optimized by SMB experiments. The separation with low cost and energy consumption was developed with a 2-3-2-1 SMB configuration. The obtained purity of C8 α-olefin was 96.3% and the yield was 90.4%. The parameter design and optimization lay an important foundation for the industrial implementation of α-olefin/paraffin adsorption separation in the future.

Properties of the vapor-liquid interface of 16 binary mixtures were studied using molecular dynamics simulations and density gradient theory in combination with the PCP-SAFT equation of state. All binary combinations of the heavy-boiling components (cyclohexane, toluene, acetone, and carbon tetrachloride) with the light-boiling components (methane, carbon dioxide, hydrogen chloride, and nitrogen) were investigated at 0.7 times the critical temperature of the heavy-boiling component in the whole composition range. Data on the surface tension, the enrichment, the relative adsorption, and the interfacial thickness, as well as for the vapor-liquid equilibrium and Henry’s law constant are reported. The binary interaction parameters were fitted to experimental data in a consistent way for all systems and both methods. Overall, the results from both methods agree well for all investigated properties. The interfacial properties of the different studied systems differ strongly. We show that these differences are directly related to the underlying phase equilibrium behavior.

This paper presents an in-pixel histogramming time-to-digital converter (hTDC) based on octonary search and 4-tap phase detection, aiming to improve frame rate and reduce distance error. The proposed hTDC is a 12-bit two-step converter consisting of a 6-bit coarse quantization and a 6-bit fine quantization, which achieves a time resolution of 120 ps without a GHz reference frequency and supports multiphoton counting up to 2 GHz. The proposed hTDC is designed in 0.11 μm CMOS process with an area consumption of 6900 μm 2. Timestamp sequences from a behavioral-level model are imported to the hTDC circuit for simulation verification. The post-simulation results show that the proposed hTDC achieves about 0.8% depth precision in 9-m range for short-range system design specifications and about 0.2% depth precision in 48-m range for long-range system design specifications. Under 30 klux background light conditions, the proposed hTDC can be used for SPAD-based flash LiDAR sensor to achieve a frame rate to 40 fps with 200-ps resolution in 9-m range.

The present study is devoted to articulating a modified Folded-Cascode circuit, to make Folded-Cascode structures an attractive configuration as a Transimpedance Amplifier (TIA) for being employed in Giga-bit per second optical communication receiver systems. Giga-bps communication receivers are highly necessitating circuits to isolate the input parasitic capacitance of the photodiode. The present modification makes Folded Cascodes comparable to the famous Regulated Cascode (RGC) structures by isolating this parasitic capacitor almost by the same quantity. The system is shown to be capable of operating at 2.5Gbps up to 8Gbps data rate with a fixed bandwidth. The paper analyzes and evaluates the designed circuit mathematically, and the obtained simulated results from Cadence using TSMC 65nm CMOS validate the suitability of the modified circuit as a transimpedance amplifier.

IntroductionThe risk of thromboembolism is increased in cancer patients and its incidence varies in different tumor types (1). Thromboembolic events are common in lung cancer and are relatively higher in adenocarcinoma than in other subtypes (2). Driver mutations in lung adenocarcinoma affect the behavior of cancer and the prognosis of the disease. In addition, these different genomic mutations have been found to be associated with thromboembolic events at varying rates. Anaplastic lymphoma kinase (ALK) rearrangement is detected in approximately 5% of patients with non-small cell lung cancers (NSCLC), and targeted tyrosine kinase therapies can be used in these patients (3). Patients with ALK rearrangement have an increased risk of both venous and arterial thrombosis (4). The risk of venous thromboembolism was found to be 3 to 5 times higher in patients with ALK rearrangement (5). However, there is limited information about arterial thromboembolism risk and mechanism in this patient group with driver mutation. The mechanism of thromboembolism in patients with ALK rearrangement is still unclear. Here, we present a case of diffuse brain infarction due to massive thromboembolism in a young male patient with ALK-positive non-small cell lung cancer.

Compensatory gait mechanics in person with multiple toe amputation:

Topical Betadine Exposure Precipitating Sterile Cerebritis and Systemic Iodine Toxicity

Two cases of severe mitral regurgitation and pulmonary hypertension immediately after birth are presented. Initial echocardiographic findings showed a thick atrial septum rather than a normal flap septum. The patients were tentatively diagnosed with premature restriction of the foramen ovale and congenital mitral regurgitation. Subsequently, the mitral regurgitation resolved over time with improvement of pulmonary hypertension. The postnatal ductus arteriosus closure process was considered to be the cause of the mitral regurgitation and pulmonary hypertension.

As one of the primary medicinal species of Glycyrrhiza under state key protection, Glycyrrhiza iflata has the characteristics of light-loving, drought-tolerant, heat-resistant, and salt-tolerant, and belongs to the dominant species in Xinjiang extreme desert ecosystem. Based on 130 effective distribution records and 8 environmental factors in China, the Maxent model was used to construct the potential geographical distribution pattern of Glycyrrhiza iflata in the last glacial maximum, middle Holocene, modern and future (2050). Essence Results show that: (1) The key climate restrictions that affect the geographical distribution of Glycyrrhiza iflata is the average annual precipitation. (2) The modern area of Glycyrrhiza iflata is 18.3 × 105km2. (3) Under the low emission scenario from the last interglacial maximum to 2050, the potential habitable area is 18.1×105km2, and the reduced area is 4.2×105km2, with a reduction rate of 19.0%. The highly suitable area was 2.5×105km2, and the reduced area was 2.8×105km2, with a reduction rate of 52.6%. (4) From the last glaciation maximum to the middle Holocene, the geographical distribution center shifted to the southwest margin of the Kumtag Desert, Xinjiang. Since then, the geographical distribution center of Glycyrrhiza iflata will continue to migrate to the southwest, but it’s going to stabilize in the future (2050). These results provided theoretical basis for the protection, utilization, origin, and evolution of Glycyrrhiza iflata.

OBJECTIVES: There is a need for early identification and intervention of Adverse Drug Reaction (ADR) to alleviate unacceptably growing burden, morbidity and mortality associated in People With Epilepsy (PWE). This study is aimed at identifying factors associated with ADR and medication adherence among patients in PWE. METHODS: It is a cross-sectional questionnaire-based study consisting of 940 consenting participants aged 16 years and above attending epilepsy clinics for period of 5years with diagnosis confirmed by International League against Epilepsy (ILAE) criteria and supported by Electroencephalography (EEG). 21-item Liverpool Adverse Effect Profile (LEAP) and 8-item. Morinsky Medication Adherence Scale (MMAS) were used to assess ADR and adherence respectively. RESULTS: The highest reported ADR in PWE were nervousness (34.3%), aggression (33.6%) and weight gain (32.3%). Specifically, (20.1%) of the participant complained of memory problem, while the lowest were hair loss (7.2%), trouble with mouth (8.9%) and problem with skin (9.3%). Using the MMAS, 545(90.2%), 28(4.6%) and 31(5.1%) of PWE in this study were classified as having high, medium, and low adherence, respectively. Duration of AEDs use and duration of epilepsy were the major determinant of ADR in PWE on regression model. CONCLUSION: Duration of AEDs use and duration of epilepsy are the major determinant of ADR in PWE. Effective strategies to identify and reduce ADR should be incorporated to management of PWE by Health Care Providers to improve their quality of life. Furthermore, physician should aim towards reducing the duration of AED use and the epilepsy.

A document by Nagaveni Somayaji. Click on the document to view its contents.

Root exudates serve as crucial mediators for the information exchange between plants and soil, which is an important evolutionary mechanism for plants to adapt to environmental changes. In this study, 15 different abiotic stress models were established using various stress factors, including drought (D), high temperature (T), nitrogen deficiency (N), and phosphorus deficiency (P) and their combinations. We investigated their effects on the seedling growth of Salvia miltiorrhiza Bunge and the activities of

1. After the Fukushima Daiichi Nuclear Power Plant accident in 2011, radionuclides have been detected in the tissues of wild animals. It was found that some individuals had higher radiocesium activity concentrations than others, despite being captured in the same area. One of the reasons for this disparity was attributed to migration from areas where radiocesium contamination level was different. 2. We identified the genetic population of Asian black bears using two genetic markers, such as mtDNA D-loop haplotype and SNPs by MIG-seq analysis. Then, we assessed migration between populations and variation in the radiocesium activity concentrations in the muscle tissue of distinct populations. 3. The SNPs analysis identified clearer two populations (SP1 and SP2) than the mtDNA analysis. Population distribution inferred based on SNPs was affected by geographic features and land use. 4. The radiocesium activity concentrations in muscle tissues in SP2 were higher than those in SP1. The radiocesium activity concentrations in muscle tissue were positively correlated with radiocesium contamination levels at the capture site. Since the radiocesium contamination levels at the capture sites of SP2 were higher than those of SP1, it was inferred that the levels of radiocesium contamination in each population would show a similar pattern. 5. Migration occurred between the genetic populations and migration rate differed between the genetic populations, with the rate of individuals migrating from SP2 to SP1 being smaller than that from SP1 to SP2. Therefore, it was suggested migration was responsible for some individuals having relatively higher radiocesium activity concentrations in muscle tissue, despite being captured in the same area. 6. This study is the first report that showed the genetic structure of Asian black bear in Fukushima Prefecture in fine scale, the migration rate between the populations, and the effect of migration on the variation of radiocesium activity concentration.

Introduction:Snapping at the lateral knee can be caused by a variety of pathologies involving surrounding soft tissue structures such as the popliteus, semitendinosus and/or gracilis tendons, IT Band syndrome, lateral meniscus tears, or rheumatoid nodules.1-4snapping In rare instances, lateral knee pain may also be caused by the distal tendon of the biceps femoris long head shifting over the fibular head.5-6 Regardless, the various differential diagnoses should be properly ruled out by a careful history, a detailed physical exam, and advanced imaging.Few cases of snapping biceps femoris tendons have been recorded in the literature across various case reports. Causes of the snapping biceps femoris tendon have been attributed to anomalous insertions (most prevalent), 7-16 tendon subluxation,17-18 abnormalities of the fibular head,19-23 or secondary to trauma. 6, 24 Conservative treatment is usually attempted first and consists of physical therapy and anti-inflammatory medications as needed. Surgery, which is usually the last resort and the most effective, consists of resecting the anomalous tendon insertion or correcting any fibular deformities.In this report, we present a patient with lateral knee pain from an accessory insertion of the snapping biceps femoris tendon and discuss surgical exploration and repair. The patient was informed that his case would be submitted for publication and he provided consent.

Halophilic microorganisms play a crucial role in plant health and growth in salinity affected lands. The objective of this study was to evaluate the haloarchaeal diversity from the rhizosphere of halophytes and plant growth promoting abilities of these strains. The whole genome sequences of two haloarchaeal strains, Halorubrum lacusprofundi HL1RP11 and Halobacterium noricense NRS2HaP9, were analyzed, and genes related to plant growth promoting traits were identified. Phylogenetic analysis showed that archaeal strains of Halococcus, Halorubrum, Halobacterium and Natrinema were dominant in the rhizosphere of halophytes. More than 60% of the strains were positive for phosphate solubilization and IAA production. About 50% of strains were positive for nitrogen fixation, while 33% were siderophore producers. More than 40% of haloarchaeal strains showed the heavy metal resistance for Nickel, Cadmium, Chromium and Zinc at a concentration of 5 mM. Genes involved in plant growth promotion were identified through annotation. Gene clusters related to secondary metabolites including phenazine, siderophore production and terpene were also identified in this study. Our results suggested that these haloarchaeal strains can be used as an eco-friendly biofertilizer to improve growth and productivity in hypersaline environment.

A 46-year-old woman underwent pericardiocentesis and pericardial window for recurrent pericardial effusion. She presented 17 months later with signs and symptoms consistent with constrictive pericarditis. Cardiac magnetic resonance imaging revealed an infiltrative mass surrounding the pericardium. A transcutaneous core needle biopsy of the pericardium confirmed the diagnosis of pericardial mesothelioma.

To improve the detection rate of pulmonary nodules in early lung cancer screening, a low-dose CT pulmonary nodule detection algorithm based on 3D CNN-CapsNet (3D convolution neural network and capsule network) was presented. However, the convolution kernel size of the traditional CNN is relatively simple at each layer, and it is difficult to obtain more abundant features, which is not effective for medical images with a hierarchical structure and does not fully consider the spatial information of medical sequence data. CapsNet is a new network architecture that can be used to classify, using a group of neurons as a capsule to replace the traditional neural networks, it may be made to the attribute information and spatial feature extraction. The network structure we designed includes FCN and CapsNet. First, the convolution kernels of different sizes are used to extract features at different scales. Then enter the initial feature map to obtain the first part into the designed CapsNet to get the final classification result. Through the experimental verification of the ELCAP database, the nodule detection rate is 95.19%, the sensitivity is 92.31%, the specificity is 98.08% and the F1-score is 0.95 which are much better than other baseline methods.

Rationale: The United States has one of the highest healthcare expenditures among developed nations despite performing poorly on health metrics and access to care. Wasteful healthcare expenditures in the US not only affect patients but also have broader implications for public health. Aims and objectives: To identify major sources that contribute to wasteful spending in the US healthcare system. Method: A comprehensive literature search was conducted to identify relevant studies on wasteful expenditures burdening the US healthcare system. Search terms such as “wasteful expenditures,” “healthcare costs,” and “inefficiencies in US healthcare” were used in PubMed and Google Scholar databases. Full-text peer-reviewed articles, reports, internet articles, and policy documents were included in the study. Studies published in languages other than English were excluded. No ethical approval was required for this review as the analysis was conducted on previously published literature. Results: Approximately a third of US healthcare spending is considered wasteful. According to the Institute of Medicine, excess costs have been associated with unnecessary services, inefficient delivery of services, high service prices, excessive administrative costs, low emphasis on prevention, and fraud. Other factors that were identified to affect the healthcare experience for patients included insurance payment denials, high out-of-pocket expenses, and administrative complexities. Overcoming these aspects might result in annual savings that can range up to $282 billion. Additionally, the US has greater preventable and treatable mortality rates than other nations due to increasing chronic diseases, emphasizing the need for greater utility of preventive and primary care services. Despite the ACA’s intention to include preventive services in health plans, obstacles persist in their consistent integration across states. Conclusion: In summary, improving access to care by increasing affordability and prioritizing preventive care services can substantially reduce unnecessary costs to the US healthcare system.