Abstract The posterior rupture of the left ventricle has been a complication recognized since the beginning of mitral valve surgery and, despite advances in cardiac surgery, the outcome of the rupture of the left ventricle has remained tragic. During mitral valve surgery, care must be taken not to traumatize the free wall of the left ventricle. On the other side, septal Myectomy is performed on hypertrophied septums to address the left ventricular outflow tract obstruction. In this article I have presented a theory that could give a part of the explanation of the resistance of the interventricular septum of surgical trauma unlike the ventricular wall.

Bronchial artery aneurysms are a rare vascular entity. They can have various presentations ranging from an incidental finding on radiological examination to life-threatening hemoptysis. We report the case of a 60-year old woman with three posterior mediastinal bronchial artery aneurysms who presented with unilateral periscapular pain, shortness of breath, hoarseness, and dysphagia. The bronchial artery aneurysms were removed successfully via thoracotomy, with excellent recovery and relief of the periscapular pain. We use this case as a platform to discuss unilateral periscapular pain as an atypical referral pattern for a bronchial artery aneurysm, as well as implications for treatment.

A quarter of coronary arteriovenous fistulas may present aneurysmal dilatation; however, spontaneous rupture of the aneurysm is rare. We present a rare case of ruptured coronary artery aneurysm (CAA) associated with coronary fistulas that presented cardiac tamponade. Subsequent to pericardial drainage, surgical repair of the CAA associated with coronary fistulas was performed electively. The aneurysm was located on the left anterior aspect of the pulmonary artery trunk. It communicated with both the left and right coronary arteries by anomalous fistulous vessels that drained into the pulmonary artery trunk. The feeding arteries and fistulous opening were ligated and closed, respectively, from within the aneurysm. Intraoperative fluorescence imaging was performed pre- and postoperatively to ensure no residual coronary fistulas were present. Although the rupture of CAA associated with coronary fistulas is rare, it should be considered as one of the potential causes of acute cardiac tamponade.

Knowing how switchgrass (Panicum virgatum L.) responds and adapts to phosphorus (P)-limitation will aid efforts to optimize P-efficiency in this species for sustainable biomass production. This integrative study investigated the impacts of mild, moderate, and severe P-stress on genome transcription and whole-plant metabolism, physiology and development in an unprecedented way for this species. P-limitation reduced overall plant growth, increased root/shoot ratio, increased root branching at moderate P-stress, and decreased root diameter with increased density and length of root hairs at severe P-stress. RNA-seq analysis revealed thousands of genes that were differentially expressed under moderate and severe P-stress in roots and/or shoots compared to P-replete plants, with many stress-induced genes involved in transcriptional and other forms of regulation, primary and secondary metabolism, transport, and other processes involved in P-acquisition and homeostasis. Amongst the latter were multiple miRNA399 genes and putative targets of these. Metabolite profiling showed that levels of most sugars and sugar alcohols decreased with increasing P stress, while organic and amino acids increased under mild and moderate P-stress in shoots and roots, although this trend reversed under severe P-stress, especially in shoots.

Aim: The COVID pandemic is caused by infection with the SARS-CoV-2 virus. The major mutation detected to date in the SARS-CoV-2 viral envelope spike protein, which is responsible for virus attachment to the host and is also the main target for host antibodies, is a mutation of an aspartate (D) at position 614 found frequently in Chinese strains to a glycine (G). We sought to infer health impact of this mutation. Result: Increased case fatality rate correlated strongly with the proportion of viruses bearing G614 on a country by country basis. The amino acid at position 614 occurs at an internal protein interface of the viral spike, and the presence of G at this position was calculated to destabilize a specific conformation of the viral spike, within which the key host receptor binding site is more accessible. Conclusion: These results imply that G614 is a more pathogenic strain of SARS-CoV-2, which may influence vaccine design. The prevalence of this form of the virus should also be included in epidemiologic models predicting the COVID-19 health burden and fatality over time in specific regions. Physicians should be aware of this characteristic of the virus to anticipate the clinical course of infection. What is known about this topic? Nothing is known about the health significance of the D614G SARS-CoV-2 variant. What does this article add? A molecular clue to viral molecular pathogenesis of COVID-19 disease.

Understanding the scaling between leaf size and leafing intensity is crucial for comprehending theories about light interception and leaf carbon uptake and adjustments in life history strategies. To test whether have the broad scope predictions between leaf size variation and leafing intensity on first year stem in evergreens and deciduous. A comprehensive data set of minimum (Mmin) and maximum (Mmax) leaf mass and total leaf number in twig was compiled, as well as data for the stem volume and mass. The datasets provide measurements of 123 woody species in subtropical mountain forests. Standardized major axis (SMA) analysis was used to determine the effects of the variation in leaf size (i.e., Mmin to Mmax) and the effects of different functional groups on the trade-off between leaf size and leafing intensity, i.e., the leafing intensity based on stem volume (LIV) and stem mass (LIM). Leaf size plasticity variation did not differ between evergreen and deciduous functional groups, but Mmin scaled as the 1.19 power of Mmax. Across the 123 species, the scaling exponents of the pooled data ranged between -1.14 to -0.96 for Mmin and Mmax vs. the leafing intensity based on stem volume (LIV) and from -1.24 to -1.04 for Mmin and Mmax vs. the leafing intensity based on stem mass (LIM). Across the subtropical woody species examined in this study, the results show the scaling relationship between leaf mass and leafing intensity is constrained to be ≤ -1.0. More importantly, the scopes in twig leaf size and the leafing intensity correlate with the biomass allocation to minimum and maximum leaf mass, and not sensitive to plant functional groups in subtropical mountain forests.

Personalization of oral small molecule anticancer drug doses based on individual patient blood drug levels, also known as therapeutic drug monitoring or TDM, has the potential to significantly improve the effectiveness of treatment by maximizing drug efficacy and minimize toxicity. However, this option has not yet been widely embraced by the oncology community. Some reasons for this include increased logistical complexity of dose individualization, the lack of clinical laboratories that measure small molecule drug concentrations in support of patient care, and the lack of reimbursement of costs. However, the main obstacle may be the lack of studies clearly demonstrating that monitoring of oral small molecule anticancer drug levels actually improves clinical outcomes. Without unequivocal evidence in support of TDM-guided dose individualization, especially demonstration of improved survival with TDM in randomized controlled trials, wide acceptance of this approach by oncologists and reimbursement by insurance companies is unlikely, and patients may continue to suffer as a result of receiving incorrect drug doses. This article reviews the current status of therapeutic drug monitoring of oral small molecule drugs in oncology and intends to provide strategic insights into the design of studies for evaluating the utility of TDM in this clinical context.

The deployment of artesunate for severe malaria and the artemisinin combination therapies (ACTs) for uncomplicated malaria has been a major advance in antimalarial therapeutics. These drugs have reduced treated mortality, accelerated recovery, and reduced treatment failure rates and transmission from the treated infection. These drugs remain highly effective against falciparum malaria in most malaria endemic areas but significant resistance has emerged in the Greater Mekong subregion of Southeast Asia. Resistance to artemisinin was followed by resistance in the ACT partner drugs, and fit multidrug resistant parasite lineages have now spread widely across the region. ACTs are highly effective against P. vivax and the other malaria species. Recent studies show that radical curative regimens of primaquine (to prevent relapse) can be shortened to seven days, and that the newly introduced single dose tafenoquine is an alternative, although the currently recommended dose is insufficient in Southeast Asia and Oceania. Targeted malaria elimination using focal mass treatments with dihydroartemisinin-piperaquine have proved safe and effective malaria elimination accelerators, but progress overall towards malaria elimination is very slow. Indeed since 2015 overall malaria case numbers globally have risen.

The present paper is devoted to study the space identification problem for the elliptic-telegraph differential equation in Hilbert spaces with the self-adjoint positive definite operator. The main theorem on the stability of the space identification problem for the elliptictelegraph differential equation is proved. In applications, theorems on the stability of three source identification problems for one dimensional with nonlocal conditions and multidimensional elliptic-telegraph differential equations are established.

In that paper, firstly we get two additional different non-null space curve evolutions in Minkowski 3-space by considering Landau-Lifshitz (LL-) equation where we identify the spin vector with the binormal vector and the normal vector of these curves, respectively. Then, we obtain some links for constructing the moving non-null space curves by using the integrable LL- equation. Finally, we give as an application, the exact solution of the moving non-null curve evolutions obtained by taking the spin vector the normal vector of the curve and we showed graphically that these solutions are wave solutions.

The native and invasive species in the Yellow River Delta were examined for their spatiotemporal characteristics and succession pattern. First, the appropriate Sentinel-2 and Landsat-8 images from 2018 were selected according to phenological characteristics. A random forest algorithm was used to verify the image spectral band significance and separability using selected images to determine the native and invasive species. Then, the spatiotemporal variation of habitat structure of native and invasive species is discussed in depth from the perspective of landscape ecology. Finally, the expansion direction and expansion mode of S. alterniflora were further analyzed, and main results were obtained as follows. (1) At the medium-high resolution multi-spectral image level, the accuracy of different vegetation community extractions can be improved by taking into consideration both the vegetation phenology and the spectral features of remote sensing images. (2) Sentinel-2 images with red edge bands have obvious advantages in vegetation community extraction as compared to Landsat-8 images (Sentinel-2, OA=82.86%, Kappa coefficient=0.79; Landsat-8, OA=78.77%, Kappa coefficient=0.74). (3) The expansion pattern of the S. alterniflora community became spatially continuous, more regularized and aggregated overtime. (4) The expansion in the north shore mainly faces to the sea, and the south bank mainly faces to the land, and this phenomena is closely related to the sedimentation of the Yellow River Delta. Marginal and external expansion both occurred, but marginal expansion predominated. The results from this study have important theoretical and scientific value for the environmental protection and sustainable development of the entire Yellow River Delta.

Letter to the Editor, BJOG Exchange

This article seeks to analyze relevant federal public policies in Brazil related to soil and water conservation in order to extract the key lessons learned upon its implementation to support the participatory formulation of the National Plan for Soil and Water Sustainable Management. The policy analysis was made based on six strategic axis: Legislation, Prevention, Conservation, Recovery, Monitoring and Integration. These analyzes results aim to contribute to subsidize the Plan construction and identify instruments to increase the use of soil and water resources efficiency in agricultural production according to the different environmental, social and economic conditions of the country’s regions. Seven public policies were selected, characterized and analyzed. The results showed that none of the analyzed public policies are taking enough actions to accomplish with the six strategic axis for soil and water sustainability. These gaps were detected and described as opportunities to be considered under the new national policy framework. The needs for greater involvement of civil society and other relevant stakeholders on policy design and decision making as well as integration among federal ministries were also identified. In conclusion, it is suggested that the new Plan should be designed under a decentralized and participatory process to effectively gather engagement and stronger commitment from governments and other strategic stakeholders in public decisions towards soil and water sustainable management in the agriculture, thus contributing to sustainable rural development.

Acidithiobacillus ferrooxidans cells can oxidize iron and sulfur and are key members of the microbial biomining communities that are exploited in the large-scale bioleaching of metal sulfide ores. Some minerals are recalcitrant to bioleaching due to presence of other inhibitory materials in the ore bodies. Additives are intentionally included in processed metals to reduce environmental and microbially influenced corrosion. We have previously reported a new aerobic corrosion mechanism where A. ferrooxidans cells combined with pyrite and chloride can oxidize low grade stainless steel (SS304) with a thiosulfate-mediated mechanism. Here we explore process conditions and genetic engineering of the cells to enable corrosion of a higher grade steel (SS316). The addition of elemental sulfur and an increase in the cell loading resulted in a 74% increase in the corrosion of SS316 as compared to sulfur- and cell-free control experiments. The overexpression of the endogenous rus gene, which is involved in the cellular iron oxidation pathway, led to further 85% increase in the corrosion of the steel. Thus, the modification of the culturing conditions and cell line, led to a more than 3-fold increase in the corrosion of SS316 stainless steel, such that 15% of the metal coupons was dissolved in just 2 weeks. This work demonstrates how the engineering of cells and the optimization of their cultivation conditions can be used to discover conditions that lead to the corrosion of a complex metal target.

Ancient DNA research has developed rapidly over the past few decades due to the improvement in PCR and next-generation sequencing (NGS) technologies, but challenges still exist. One major challenge in relation to ancient DNA research is to recover genuine endogenous ancient DNA sequences from the raw sequencing data. This is often difficult due to the degradation of ancient DNA and high levels of contamination, especially homologous contamination. In this study, we collected whole genome sequencing (WGS) data from 6 ancient samples to compare different mapping algorithms. To further explore more effective methods to separate endogenous DNA from the homologous contaminations, we attempted to recover reads based on the ancient DNA specific characteristics of deamination, depurination, and DNA fragmentation with different parameters. We propose a quick and improved pipeline for separating endogenous ancient DNA while simultaneously decreasing the homologous contaminations to a very low proportion. Overall, these recommendations for ancient DNA mapping and separation of endogenous DNA in this study could facilitate future studies of ancient DNA.

A 59-year-old male with a history of unstable angina was diagnosed with a myocardial bridge of the left anterior descending artery (LAD) and apical variant hypertrophic cardiomyopathy (AHCM). He underwent unroofing of the myocardial bridge and a left ventricular apical myectomy. Intraoperatively, epicardial ultrasound was used to identify the myocardial bridge with systolic compression of the LAD and confirm resolution of this compression postoperatively. Furthermore, epicardial ultrasound was used for guiding the degree of apical resection of the decompressed heart. This novel use of intraoperative epicardial ultrasound can help guide surgeons preoperatively and confirm results immediately after an operation.

Pyoderma Gangrenosum could mimic early postoperative sternal wound infection. Steroids therapy is the only method of treatment recognizing the fact that steroids can lead to immunosuppression and inhibits healing after major surgery.

The brain is the most cholesterol rich organ in the body containing about 25% of the body’s free cholesterol. Cholesterol cannot pass the blood brain barrier and be imported or exported directly, instead it is synthesised in situ and metabolised to oxysterols, oxidised forms of cholesterol, which can pass the blood brain barrier. 24S-Hydroxycholesterol is the dominant oxysterol in brain after parturition but during development a myriad of other oxysterols are produced which persist as minor oxysterols after birth. During both development and in later life, oxysterols and other sterols interact with a variety of different receptors, including nuclear receptors e.g. liver X receptors; membrane bound G protein-coupled receptors e.g. smoothened; the endoplasmic reticulum resident proteins e.g. INSIG (insulin induced gene), or the cholesterol sensing protein SCAP (SREBP cleavage activating protein); and the ligand-gated ion channel N-methyl-D-aspartate receptors found in nerve cells. In this review we summaries the different oxysterols (neuro-oxysterol) and sterols (neuro-sterols) found in the central nervous system whose biological activity is transmitted via these different classes of protein receptors.