The low effectiveness factor of catalyst pellet caused by high internal diffusion limitation is a common issue in fixed-bed reactor. Nevertheless, hierarchical structured catalyst provides a promising solution for the contradiction between reaction activity and diffusion efficiency in large catalyst pellets. Herein, we studied the effect of pore structure parameters of the meso-macroporous catalyst on Fischer-Tropsch synthesis performances through experiment and pellet scale reaction-diffusion simulation. The pellet simulation firstly elucidated the reason for the significant improvement on activity and product selectivity for the meso-macroporous catalyst observed in our experiment. Further optimization via pellet simulation indicated the critical influences of wax filling degree and that the perfect matching between reaction and mass transfer rates by increasing macropore size and adjusting porosity within pellet enables the C5+ space-time yield to the maximum. This work could provide a theoretical guideline for the engineering design of the hierarchical structured catalyst pellet.

Although children are less affected by Novel coronavirus disease 2019 than adults, it should not be missed, especially in those with underlying diseases. Herein, we report a patient with primary antibody deficiency, who was affected with COVID-19. This infection could be presented mildly in patients with immunodeficiency.

We report a case of Takotsubo cardiomyopathy (TTC) induced by diffuse fear of the COVID-19 pandemia and aggravated to ventricular fibrillation. After succesfull resuscitation the patient developed temporarily a J-wave after event. Though potentially live threatening in the acute phase both J-wave and TTC are reversible with receding of edema.

We are very thankful to Dr. Vendramin et al. (1) for their interest in our article about the “off label” use of new cardiac prosthetic valves in different clinical scenarios, and for their thoughtful comments.

The complexity of lipid feedstocks and the lack of data on physical properties hinder the simulation of oleochemical processing units. In this work, an iterative lumping approach is proposed to define an adequate number of key components such that diversification between lipid feedstocks becomes possible, while keeping the determination of physical properties as required for process modelling manageable. As a case study, the iterative lumping approach is used for simulation and optimization of a fatty acid distillation plant. For predicting vapour-liquid equilibria of fatty acids, the best results were acquired using the property method UNIQ-HOC. Using the iterative lumping approach, 11 key components were selected to represent the feedstock. The process model properly predicts the product composition, yield, purity and heat duty. The most important process parameters are found to be side-reflux-ratio, reboiler-outlet-temperature and heat-duty of the pitch-distiller. For optimization, an increase of the side-reflux-ratio and reboiler-outlet-temperature, is recommended.

In this paper, we consider switched coupled system of nonlinear implicit impulsive Langevin equations with mixed derivatives. Some sufficient conditions are constructed to observe the existence, uniqueness and generalized Ulam--Hyers--Rassias stability of our proposed model, with the help of Generalized Diaz--Margolis's fixed point approach, over generalized complete metric space. We give an example which supports our main result.

Background: Although minimally invasive mitral valve surgery (MIMVS) has become the first choice for primary mitral regurgitation (MR) in recent years, clinical evidence in this field is yet limited. The main focus of this study was the analysis of preoperative (Pre), postoperative (Post) and 1-year follow-up (Fu) data in our series of MIMVS in order to identify factors that have an impact on the left ventricular ejection fraction (LVEF) evolution after MIMVS. Methods: We reviewed the perioperative and 1-year follow-up data from 436 patients with primary MR (338 isolated MIMVS und 98 MIMVS combined with tricuspid valve repair) to analyzed patients baseline characteristics, the change of LV size, the postoperative evolution of LVEF and its factors, and the clinical outcomes. Results: The overall mean value of EF slightly decreased at 1-year follow-up (mean change of LVEF: -2.63±9.00%). A significant correlation was observed for PreEF und EF evolution, the higher PreEF the more pronounced decreased EF evolution (in all 436 patients; r= -0.54, p<0.001, in isolated MIMVS; r= -0.54, p<0.001, in combined MIMVS; r= -0.53, p<0.001). Statistically significant differences for negative EF evolution were evident in patients with mild or greater tricuspid valve regurgitation (TR) (in all patients; p<0.05, OR=1.64, in isolated MIMVS; p<0.01, OR=1.93, respectively). Overall clinical outcome in NYHA classification at 1 year was remarkably improved. Conclusions: Our results suggest an excellent clinical outcome at 1 year, although mean LVEF slightly declined over time. TR could be a predictor of worsened FuEF in patients undergoing MIMVS.

To assess the techno-economic screening of HTL oil for various feedstock, it is crucial to have information on molecular composition of the feed and products. There are limitations of existing analytical methods to identify and quantify all the molecules present in the bio-fuel. Therefore, there is a need to find alternate ways to quantify the molecular composition of feed and expected products. The modelling work on bio-oil is developed based on a mathematical approach using simple analytical results like CHNO along with structural analysis of oil like FTIR, NMR analysis for HTL derived oil from microalgae. This mathematical framework is further extended to predict the molecular composition of HTL-oil obtained from feedstocks like mixed plastic waste, sludge etc. A multi-dimensional molecular matrix is developed based on the distributions of side chains, aromatic rings, and olefinic carbon on top of core molecules. Optimum parameters are found using appropriate optimization algorithms.

Introduction Irrational medicine use is proportionately higher in low and middle-income countries like Sierra Leone. This study aims at exploring the structure, functions, and challenges of Drug, and Therapeutics Committees (DTC) recently piloted in Sierra Leone. Method A two-phase mixed-method study design was used in this study. Firstly, a cross-sectional survey using an online questionnaire to assess the structure, indicators, and challenges of DTC . In phase two, a semi-structured interview was used to get deeper insights into the key issues that emerged from the survey. Participants were mainly pharmacists in-charge at the hospitals where the DTC program hasbeen established. MS Excel 2019 and NVivo version 12 were respectively used for data management and analysis. Results DTCs mostly had a minimum of ten members consisting of a mix of both medical and hospital administrative staff. The main functions of DTC are ensuring rational medicines use, monitoring, and reporting adverse drug reactions. All but one hospital had subcommittees that are either effective or nonfunctional. The main challenges in DTC functions and maintenance were funding (n=6), DTC decision implementation (n=4), and unmotivated members (n=4). Strategies suggested to improve DTC at public hospitals and nationwide include; resource allocation, monitoring, and evaluating DTC functions and capacity building of its members. Conclusion DTC present a compelling opportunity towards achieving rational medicines use at the hospital level in Sierra Leone. Nonetheless, lack of funding, operational resources, are significant limitations. Policymakers must note these drawbacks whilst expanding DTC programs to other hospitals in Sierra Leone.

Drought-related tree mortality is increasing globally, but the sequence of events leading to it remains poorly understood. To identify such sequence, we used a 2016 tree mortality event in the semi-arid pine forest of Yatir were dendrometry and sap flow measurements were carried out in 31 trees, of which seven died. A comparative analysis revealed three stages leading to mortality. First, a decrease in tree diameter in all dying trees, but not in the living ones, eight months ‘prior to the visual signs of mortality’ (PVSM; e.g., brown needles). Second, a decay to near zero in the diurnal stem swelling/shrinkage dynamics, reflecting the loss of stem radial water flow in the dying trees, six months PVSM. Third, cessation of stem sap flow three months PVSM. Eventual mortality could therefore be detected long before visual signs are observed, and the three stages identified here demonstrated the differential effects of drought on stem growth, water storage capabilities, and soil water uptake. The results indicated that breakdown of radial stem water flow and phloem functionality is a critical element in defining the ‘point of no return’ in the sequence of events leading to mortality of mature trees.

Technological advances in DNA sequencing over the last decade now permit the production and curation of large genomic datasets in an increasing number of non-model species. Additionally, this new data provides the opportunity for combining datasets, resulting in larger studies with a broader taxonomic range. Whilst the benefits of new sequencing platforms are obvious, shifts in sequencing technology can also pose challenges for those wishing to combine new sequencing data with data sequenced on older platforms. Here, we outline the types of studies where the use of curated data might be beneficial, and highlight potential biases that might be introduced by combining data from different sequencing platforms. As an example of the challenges associated with combining data across sequencing platforms, we focus on the impact of the shift in Illumina's base calling technology from a four-channel to a two-channel system. We caution that when data is combined from these two systems, erroneous guanine base calls that result from the two-channel chemistry can make their way through a bioinformatic pipeline, eventually leading to inaccurate and potentially misleading conclusions. We also suggest solutions for dealing with such potential artifacts, which make samples sequenced on different sequencing platforms appear more differentiated from one another than they really are. Finally, we stress the importance of archiving tissue samples and the associated sequences for the continued reproducibility and reusability of sequencing data in the face of ever-changing sequencing platform technology.

The literature describes multiple approaches for the repair of stenosed branch pulmonary arteries. Regardless of the technique, restenosis is undesirably and notoriously common. We describe a case of severe left pulmonary artery stenosis repaired with a novel technique in consideration of factors leading to restenosis. The native main pulmonary artery was transected and turned down to create a direct anastomosis with the left pulmonary artery. The child had a normal sized main pulmonary artery with tricuspid atresia and pulmonary atresia with ductus arteriosus feeding the severely stenosed left pulmonary artery. Our novel technique resulted in hemodynamically gratifying results with a tension free tissue-tissue anastomosis with potential for growth.

Background: Vernal keratoconjunctivitis (VKC) is a rare chronic conjunctivitis characterized by a predominantly eosinophil-mediated inflammatory disorder that could develop critical complications such as blindness. Oxidative stress plays a pivotal role in the pathogenesis of several allergic diseases. The role of oxidative stress has been hypothesized in VKC, but no study explored this issue.Furthermore, cyclosporine A (CsA) exerts an anti-inflammatory and antioxidant action on the conjunctiva. This study aims to assess oxidative stress in VKC patients and controls and to study the effect ofCsA on oxidative stress in these subjects. Methods:Thirty-six consecutive children, including 12 VKC(9 males, 75%; mean age 10,17; SD ± 2.48) patients without treatment,12 VKC treated with CsA(9 males, 75%; mean age 9,08; SD± 2.75) and 12 controls (CT) (7males,58%; mean age8,58; SD ±1,78) were recruited. A cross-sectional study was performed to compare H2O2 in the serum and the tears ofthese children. Results: Compared with CT and VKC children treated with CsA, VKCuntreated children had significantly higher values ofHydrogen peroxide (H2O2) in theserum and the tears.No significant differences were observed between CT and VKC treated with CsA. A significant correlation was found at the linear regression analysis between serum and tear H2O2 levels. Conclusion: This study provides the first report attesting that patients with VKC have high oxidative stress; furthermore, it suggests that CsA could have an anti-inflammatory and antioxidant action that could be useful to prevent the poor VKC outcome.

Congenital left atrial appendage aneurysm is an extremely rare anomaly. It is seen at any time ranging from fetal to ninth decade of life. Patients with left atrial appendage aneurysm may be asymptomatic, or present with dyspnea, arrhythmias, thromboembolic phenomenon. We report a case of prenatal diagnosis at 26 weeks of gestation , postnatal management and outcome of left atrial appendage aneurysm.

A Kalman reduced form is obtained for linear systems over Hermite rings. This reduced form gives information of the set of assignable polynomials to a given linear system.

Aortic atresia is uncommonly associated with atrioventricular and ventriculoarterial discordance.(1) Presence of severe regurgitation of Ebsteinoid malformation of the tricuspid valve in this subset results in reduced aortic blood flow in-utero. The hemodynamic explanation of this anomaly was reported by Celermajer and colleagues.(2) We report here a term neonate with this anomaly detect antenatally.

Long-term application of high nitrogen and phosphorus fertilizer and mono-tillage practices can adversely affect soil health, carbon sequestration and crop growth. A 10-year field experiment was conducted in a wheat-maize cropping system on the Loess Plateau in China to explore fertilization and tillage methods that improve SOC sequestration and crop yields. We evaluated the effects of (1) fertilization (balanced fertilization (BF), low fertilization (LF), and conventional fertilization (CF)) and (2) alternating years of different tillage (no-tillage and subsoiling (NS), subsoiling and ploughing (SP), ploughing and no-tillage (PN)) or continuous ploughing tillage (PP) on input-C, SOC pool, and crop yields. BF and rotational tillage (NS, SP, and PN) increased the amount and stabilization rate of input-C, thereby increased SOC storage, and the highest effect was found in BF+NS treatment. Simultaneously, BF produced higher contents of SOC, readily oxidizable carbon (ROC), particulate organic carbon (POC) and dissolved organic carbon (DOC) and C pool management index (CMI) at 0-10 cm depth. For tillage, rotational tillage increased labile C contents and CMI at 0-10 cm, 20-35 cm and 35-50 cm depths, which improved soil quality. Crop yields showed an increase tendency with the increases of SOC content, labile C fraction contents, and CMI. Therefore, the higher yields of wheat and maize were found in BF and rotational tillage; the highest were in BF+NS treatment. Our finding suggested that NS combined with BF may be the best management to increase SOC storage, improve soil quality and productivity on China’s Loess Plateau.

We describe a novel surgical technique of 31 patients with histopathologically–confirmed placenta accreta spectrum (PAS) disorders managed by a multidisciplinary team using prophylactic infrarenal abdominal aortic cross-clamping technique during cesarean hysterectomy. We conclude that this new surgical procedure is a safe and effective technique to reduce operative blood loss. Hopefully, our pioneer work will stimulate others to develop protocols assessing this innovative technique to improve surgical outcome of PAS disorders.