Ski tourism’s popularity is driving a rise in the number of ski resorts. This study aims to present the impact of ski infrastructure on soil erosion processes on the example from a small catchment in the Gubałowskie Foothills in southern Poland, where landscape changes before (since 1879) and after the construction of the ski station (2007) were presented. The analyses of changes in flow accumulation, slope morphometry, and drainage ditches were conducted in the test area. Quantitative analyses were performed using repeated DEMs derived from LiDAR survey and detailed geodetic measurements, complemented by geomorphological mapping done in the field. The study has revealed that the ski infrastructure has not only directly transformed the hillslope by flattening and constructing escarpments (up to 3 m high) but has also created alternating patterns of erosion and accumulation. In the test area, the drainage ditch was poorly designed. It was filled by materials (0.1–0.5 m), and two new outlets formed. The escarpment of the analyzed ski run has been diminished by 0.5 m. An alluvial fan (0.1 to 0.22 m thick) has developed on the flattened surface below the escarpment with drainage ditch outlets. This fan is eroded by subsurface flow that creates a piping system. The gully below the alluvial fan has retreated upslope, accelerated by subsurface erosion. This study enables the presentation of hillslope adjustments and processes in response to the new conditions caused by ski infrastructure. Such results may support more effective land management in regions changed by ski infrastructure.

INTRODUCTIONAs a subtype of biliary tumors, gallbladder cancer is rare yet highly malignant1. Characterized by its ease of metastasis and poor prognosis, its common sites of metastasis include lymph nodes and the liver. However, it can also spread to other organs and tissues such as the lungs, bones, and peritoneum2. It’s critical to note that the incidence of lung metastasis in gallbladder carcinoma hovers around 10-30%, with a dismal 5-year survival rate of around 5-10%3-4. Unusually, when gallbladder carcinoma metastasizes to the lungs, it can sometimes present as pulmonary cavitary lesions, although this manifestation is not commonly observed. In this light, we present a case of gallbladder carcinoma with pulmonary manifestations of cavitary lesions.

Anophthalmia AO and microphthalmia MO have both heritable and environmental causes. The proband described in this study was a 32-year-old symptomatic The detected homozygous canonical splice site variant in the TENM3 gene has not been reported up to now for its pathogenicity and can be considered as a novel mutation.

Early sowing can help summer crops escape drought and can mitigate the impacts of climate change on them, but it exposes them to cold stress during initial developmental stages, which has both immediate and long-term effects on development and physiology. To understand how early night-chilling stress impacts plant development and the yield, we studied the reference sunflower line XRQ under controlled, semi-controlled and field conditions. We performed high-throughput imaging of the whole plant parts and obtained physiological and transcriptomic data from leaves, hypocotyls and roots. We observed morphological reductions in early stages under field and controlled conditions, with a decrease in root development, an increase in reactive oxygen species content in leaves and changes in lipid composition in hypocotyls. A long-term increase in leaf chlorophyll suggests a stress memory mechanism that was supported by transcriptomic induction of histone coding genes. We highlighted leaf transcriptomes in cold-acclimation genes such as chaperone, heat shock and late embryogenesis abundant proteins. We identified genes in hypocotyls involved in lipid, cutin, suberin and phenylalanine ammonia lyase biosynthesis and ROS scavenging. This comprehensive study describes new phenotyping methods and candidate genes to understand phenotypic plasticity better in response to chilling and study stress memory in sunflower.

A document by Tatsuya Horibe. Click on the document to view its contents.

In recent works, well-known three-dimensional localization methods studied in the aerospace field have been revisited for applications on multirotor aerial vehicles (MAVs). However, most of these classic methods employ stochastic estimators that are asymptotically stable, in a stochastic sense, and exhibit high sensitivity to disturbances and model uncertainties. The goal of this paper is to propose and evaluate a novel solution to the localization problem of MAVs, employing multivariable robust observers based on sliding-mode techniques. Aiming to improve on the existing methods usually based on the extended Kalman filter, this paper investigates sliding-mode techniques to reach finite-time stabilization of the estimation error and provide robustness to disturbances and uncertainties. The super-twisting algorithm (STA) is considered as a starting point for its recognized performance when used to design differentiators. In particular, a modification of the STA is proposed, replacing one of its terms with a certain time-varying function that allows the upper bound of the settling time of the resulting algorithm to be a direct adjustable parameter. The proposed algorithm’s behavior is numerically evaluated and is shown to yield the predicted properties even in the presence of bounded disturbances and uncertainties. Additionally, an attitude determination problem employing the proposed algorithm is presented as an application. The three-dimensional attitude and angular velocity of an MAV are accurately estimated under strict settling-time restrictions, using only the vector measurements provided by an accelerometer and a magnetometer.

A document by Paula Perlea. Click on the document to view its contents.

Katsurao Village, one of the affected municipalities after the Fukushima nuclear accident, faced problems associated with care for older people, necessitating the need to examine the measures to deal with these issues in the affected areas.

The effectiveness of patent foramen ovale closure for migraine has been previously discussed. By contrast, very few studies have reported the association between migraine and atrial septal defect closure. Here we report a case in which atrial septal defect closure effectively relieved migraine headaches.

The performance of industrial strains has gradually improved with the rapid development of synthetic biotechnology. The production efficiency of traditional batch and fed-batch culture is limited and product quality varies since both are dynamic processes, whereas multi-stage continuous culture can maximise the production efficiency of specific fermentation processes and achieve consistent product quality. However, each single-stage fermentation under multi-stage continuous fermentation requires accurate steady-state control, and a model with adequate accuracy is required for designing and controlling a multi-stage continuous fermentation process. At present, there are few reports on kinetic models for the control of multi-stage continuous fermentation. In this work, we constructed a hybrid model for Saccharomyces cerevisiae multi-stage continuous culture, taking both oxygen limitation and Crabtree effect. The accuracy of the model was ~ 80%, advantages and limitations of the model are discussed and potential improvement strategy is proposed.

In this paper, we study the symmetry on a class of multiparameter Markov Processes in Khoshnevisan (2002), and obtain some important and interesting results.

Background: Systemic Sclerosis (SSc), an intricate autoimmune disease causing tissue fibrosis, introduces cardiovascular complexities, notably pulmonary hypertension (PH), affecting both survival and quality of life. This study centers on evaluating echocardiographic parameters and endothelial function using Flow Mediated Dilatation (FMD) in SSc patients, aiming to differentiate those with and without pulmonary arterial hypertension (PAH). The emphasis lies in early detection, given the heightened vulnerability of the right ventricle in the presence of PH. Methods: 59 SSc patients and 48 healthy subjects participated, undergoing clinical examinations, echocardiography, FMD assessments, blood analyses, and, when necessary, right heart catheterization (RHC). Results: SSc-PAH patients displayed lower FMD, increased TAPSE <18 mm, RA area >18 cm2, and TRV >280 cm/sec compared to those without PAH and healthy controls. Resting Resistivity Index (RI) was higher in SSc patients, with no significant difference between those with and without PAH. Lower FMD% serves as a predictive marker for adverse cardiovascular outcomes in both SSc and SSc-PAH patients. Stratification by TRV levels and PAH presence reveals notable FMD% variations, emphasizing its potential utility. Conclusions: Early identification of endothelial dysfunction and echocardiographic parameters, such as TAPSE and TRV, could aid in predicting right ventricular dysfunction and PAH in SSc patients.

Nodular pulmonary amyloidosis is a rare and localized manifestation of amyloid deposition in the lungs. This rare entity, though asymptomatic, is often misdiagnosed on imaging alone, due to its resemblance to metastatic pulmonary nodules. This report highlights the significance of histologic confirmation before treatment, as a preventive measure against overtreatment.

Cardiac Transplantation as Surgical Treatment for Cardiac Sarcoidosis Ali Ghodsizad MD, PhD, FACC, FETCS, FACSSarcoidosis is a complex disease with different clinical presentations that can involve multiple organs (1). The lung is typically the most common organ involved, multiple organ involvements with pulmonary and cardiac sarcoidosis account for most of the morbidity and mortality observed with this disease (1). Cardiac sarcoidosis presents as a progressive infiltrative cardiomyopathy that can lead to heart failure, arrhythmia and death (1).Here McGoldrick and colleagues report on their database study with data from Organ Procurement and Transplantation Network (OPTN) involving 289 cardiac sarcoidosis patients with end stage restrictive cardiomyopathy, who needed cardiac transplantation and compared them with all non-sarcoid patients undergoing cardiac transplantation for restrictive cardiomyopathy and end stage heart failure of other causes between Jan 1999 to March 2020 (n=41447).Patients with cardiac sarcoidosis had a comparable survival to non-sarcoid patients at 1 and 5 years and a significantly longer survival at up to 10 years.Patients with cardiac sarcoidosis had an increased chance to die from aspergillus infections at 1 year. Jackson et al showed in their multicenter trial comparable survival, rate of graft failure, and incidence of treated rejection at 1 year when compared to matched non-sarcoid patients. Sarcoid patients after heart transplantation were less likely to be hospitalized for infection in their study at 1 year (2). Liu et al performed a similar UNOS data base study showing that cardiac sarcoidosis heart transplant recipients were an older population with less underlying co-morbidities with a lower overall mortality (3).The diagnosis of cardiac sarcoidosis in patients who undergo left ventricular assist device implantation can be confirmed by histological examination of myocardium at the time of ventricular assist device insertion, but unclear is the predictive value (4,5).McGoldrick and colleagues excluded patients who required multiorgan transplantation in all 3 groups and we have to consider that multiorgan recipients belong to the sickest subpopulation.McGoldrick et al and other groups confirm the role of cardiac transplantation as a viable option for patients with cardiac sarcoidosis. Considering the increasing number of the cardiac transplantation for sarcoidosis in recent years, the 10 years survival data may have to be reevaluated with more follow up time in future.

George and colleagues report their experience with a non-transplant left ventricular assist device program (1). This manuscript spans a decade’s experience with LVADs and clearly demonstrates that LVAD therapy is possible in centers without a heart transplant program. 100 LVADs were placed during this period. The positive findings from this report include that as volume increased, the complications of right heart dysfunction and bleeding decreased. Noteworthy is that 85 of the 100 patients were implanted with a fully magnetically levitated ventricular assist device. Given the superior performance of a fully magnetically levitated device to a rotary pump (2) these findings are relevant for all contemporary centers with LVAD programs.The authors importantly sought the resources of a transplant center to ensure that patients who were offered LVAD in their non-transplant center were indeed not candidates for cardiac transplantation. In addition to this fundamental necessity, three features are necessary for a successful non-transplant LVAD program. Firstly, the institution must offer robust infrastructure and support. Secondly there must be a strong surgeon-leader dedicated to overseeing the program. Lastly, cardiologists who are dedicated to heart failure are essential to guide patients to this therapy.The extension of LVAD therapy to patients in non-transplant centers is essential for durable mechanical circulatory support to remain as a vital part of advanced therapies for heart failure. VADs will continue to play an important role in the management of end-stage heart failure for patients who are not eligible for cardiac transplantation. The 2020 Society of Thoracic Surgeons INTERMACs report now offers patients a 5-year survival of 45%(3). The survival of patients with LVADs continues to increase. The data in this current report offer a new perspective and increased access to LVAD therapy for patients with end stage heart failure.ReferencesGeorge TJ, Aldrich A, Smith III RL, et al. Development of a Non-Transplant Left Ventricular Assist Device Program. J Card SurgMehra MR, Uriel Y, Naka Y, et al. A Fully Magnetically Levitated Left Ventricular Assist Device – Final report. N Engl J Med 2019:380:1618-27.Molina EJ, Shah P, Kierman MS, et al. The Society of Thoracic Surgeons Intermacs 202 Annual Report. Ann Thorac Surg 2021;111:778-92.

Many subcomponents of human language can be found within the vocal communication systems of other species, most notably songbirds. One of the most prominent of these subcomponents is syntax. While studies of syntax are abundant, a lack of consensus on the definition of syntax has led to much debate. The goal of this review paper is to solidify the definitions of syntax and to explore the mechanisms that shape syntax formation in songbirds and other species, with a specific focus on neurobiology, genetics, dopamine, and chunking organization.

Chronic limb-threatening ischemia (CLTI) with severe below-the-ankle (BTA) lesions is often difficult to revascularize with endovascular treatment (EVT) and surgical treatment. We present a case of successful limb salvage using percutaneous deep venous arterialization (pDVA) in a patient with CLTI whose BTA lesion reconstruction failed. A 57-year-old man with diabetes mellitus

Efficacy and safety of a 7-week immunotherapy protocol with aluminium hydroxide absorbed hymenoptera venomTo the Editor,Hymenoptera venom allergy can cause life threatening anaphylaxis in patients sensitised to wasp and bee venom. Venom immunotherapy is effective in 77%‐84% of patients treated with honeybee venom and in 91%‐96% of patients receiving vespid venom1. Adverse events are usually rare and mild, and symptoms occur in only 4.3%‐11.4% of patients during the updosing1.A variety of therapy regimes exist for the updosing phase, from conventional, rush, ultrarush or clustered modalities1,2. Current conventional protocols are time‐consuming for patients, and some patients decline the potentially life-saving treatment due to the time commitment required for immunotherapy. Adverse events appear to be less frequent in conventional protocols during the updosing phase compared to rush and ultrarush protocols1,2; however, patients may remain unprotected for weeks as it takes considerable time to reach the maintenance dose.The only licensed venom immunotherapy product in the UK is Alutard SQ® (ALK Abelló) for Vespula and Apidae venom. The SPC recommends updosing with a 7-week clustered protocol or 15- or 25-week conventional protocol.To enhance the acceptance of treatment and increase compliance, we reduced the length of the SPC protocol. Another significant factor was the COVID-19 pandemic, which significantly reduced outpatient capacity to comply with social distancing.Based on previous data using the same product3, we introduced a shorter updosing protocol with 8 injections in 7 weeks and monitored its efficacy and safety. We used this in a wider age range of patients, including one patient with indolent mastocytosis and more patients with severe sting reactions.Seventy‐four patients aged 17 to 85 years with a history of a systemic sting reaction to vespid and apidae stings grade 2-4 were included (Table 1). Further information about patient selection and the updosing protocol is in supplementary file S1.We managed to retain all the patients during updosing and maintenance, and no dose reduction was needed.During updosing, there were no objective systemic adverse reactions recorded. Only one objective systemic adverse reaction was documented during maintenance, which was mild and limited to the skin. There were 6 incidences of mild and subjective systemic reactions during updosing and maintenance, which included symptoms of feeling hot, dizzy and itchy. The symptoms were treated with additional antihistamines with no change in regime required. We had a lower incidence of systemic reactions at 1.4% compared to Schrautzer et al3, who reported objective systemic reactions in 3.9% of patients during just the updosing phase.9.5% of our patient cohort reported large localised reactions throughout both the updosing and maintenance phase, which generally only occurred once or twice during the full treatment course.The prevalence of cardiovascular disease and treatment with beta-blockers were not related to the occurrence of side effects.Reactions to field stings were monitored to assess efficacy as sting challenges are not performed in the UK. 20 patients had field stings and all reported localised reactions. Some patients were stung by multiple insects (such as one patient who was stung by 19 insects at one time) and this was more common in beekeepers.We have extended the work of Schrautzer et al3 and demonstrated the efficacy and safety of their 7-week protocol in a large group of patients in a real-world setting. We have also demonstrated safety and efficacy of the 7-week protocol for Alutard SQ® apidae immunotherapy. Our data includes a larger group of patients with more severe reactions. Interestingly, our data also shows a lower number of reactions to immunotherapy treatment.The quicker updosing protocol improved patients’ acceptance of treatment and increased the efficiency of our immunotherapy clinic in terms of time and cost for patients, and medical staff.