Dentigerous cysts are the second most common type of odontogenic cysts. We performed a combination of conservative treatment and enucleation to prevent fracture and preserve vital structures in a two-staged approach

Although it was first described over 100 years ago,lumbar puncture is still an important diagnostic tool for a variety of infectious and noninfectious neurologic conditions.With the widespread use of this common and relatively safe performed medical procedure, minor and major complications can occur even when standard infection control measure

Patterns of intra- and interspecific variation based on environmental conditions in which populations live may reflect adaptive responses to their habitat. This is particularly relevant in a lake habitat where closely related species occur sympatrically. This study was aimed at determining consistency in morphological traits in head and body shapes in two haplochromine species (Haplochromis insidiae and Haplochromis kamiranzovu) in littoral and/ pelagic zones and to estimate the extent to which the habitats affect variations between the species. Specimens of both species were taken from littoral and pelagic zones, in the northern and southern parts of Lake Kivu. Morphometrics and landmark-characteristics were recorded and compared within and between habitats. The results showed that differences were found among the two species, among the two zones and for both. The most prominent difference was in the head; including the relative size of the jaws, head length and position of the pectoral fin insertion. Variation in head morphology is normally related to feeding. Changes in body shape can be linked to differences in environment and food availability between the two habitats which could have enabled the species to co-exist. This capacity is important in lakes like Kivu which have low habitat diversity compared to other African Great lakes like Malawi, Tanganyika and Victoria and provide some explanation in the differences in the number of haplochromine species in these lakes. The genetic basis of these phenotypic changes should be examined in future research.

Background Premature ventricular contraction (PVC) is a frequent kind of arrhythmia that affects around %1 of the general population. While PVC most frequently impairs ventricular function in structurally normal heart, retrograde ventriculo-atrial conduction can occur in people with PVC. These retrograde atrial activations may mimic pulmonary vein-derived atrial ectopies. As a result, PVC may raise the risk of AF by retrograde ventriculo-atrial conduction. The Four-Dimensional Automated Left Atrial Quantification (4D Auto LAQ) tool is a left atrial analytical approach that utilizes three-dimensional volume data to quantify the volume, as well as LA longitudinal and circumferential strains. The purpose of this study was to determine if clinical diagnosis of PVC is connected with abnormal LA function as determined by LA strain evaluation utilizing a 4D Auto LAQ compared to the healthy population. Methods The 58 patients with frequent PVCs and 53 healthy volunteers as a control group were enrolled in the study. Imaging was performed using the GE Vivid E95 echocardiography equipment (GE Healthcare; Vingmed Ultrasound, Horten, Norway) equipped with an M5S probe (frequency range: 1.5–4.6 MHz) and a 4V probe (frequency range: 1.5–4.0 MHz). Images were imported into and were selected for analysis using the EchoPAC203 software (GE Healthcare). The analysis mode was selected, followed by the volume and 4D Auto LAQ submodes. Following that, the sample point was positioned in the center of the mitral orifice in each of the three planes. The review function was used to acquire the LA parameters measured by 4D Auto LAQ, including volume and strain parameters. Results The maximum left atrial volume (LAVmax) and minimal left atrial volume (LAVmin) were signifcantly higher in the patient group (38.91 ± 9.72 vs. 46.31 ± 10.22, 17.75 ± 4.52 vs. 23.10 ± 7.13 respectively, all p values <0,001). On the other hand left atrial reservoir longitudinal strain (LASr), conduit longitudinal strain (LAScd), contraction longitudinal strain (LASct), reservoir circumferential strain (LASr-c), conduit circumferential strain (LAScd-c), and contraction circumferential strain (LASct-c) were signifcantly lower in patient group (26.64 ± 5.64 vs.19.16 ± 4.58, -19.53 ± 3.72vs.-11.28 ± 3.47, -10.34 ± 1.56 vs.-4.59 ± 1.49, 30.72 ± 4.04 vs.19.31 ± 2.60, -19.91 ± 1.78 vs. -13.38 ± 2.85,-15.89 ± 6.37vs.-9.24 ± 1.63 , respectively, all p values <0,001). Conclusions The present study found that premature ventricular complexes can lead to atrial remodeling as well as ventricular remodeling in patients with PVC and 4D LAQ technology can quantitatively examine left atrial function and determine these alterations early.

A 40-year-old patient with a known case of uncontrolled hyperthyroidism was admitted secondary to acute ST-segment elevation myocardial infarction and thyroid storm. Acute medical therapy was started followed by a coronary angiogram because he developed signs of heart failure. There were no complications, and he was discharged in stable condition.

Ventricular septal defects are the most common congenital heart defects. They account for approximately 20% of all forms of congenital heart disease as an isolated lesion. Perimembranous Ventricular septal defects are the most common form (70%), followed by muscular (15–20%).Muscular VSDs are a challenging problem in neonates and infants when they present with significant congestive heart failure from interventricular shunting. However, with careful adjustments to technique, most of these can be closed.

Minimally invasive mitral valve surgery can be performed with or without robotic assistance. In this issue of the journal Zheng et al compare between these two approaches in a propensity matched study over a 5 year period and show that the two techniques have similar successful short and mid term outcomes. Although we are proponents of the robotic approach, we agree with their conclusions and discuss in this commentary some of the previously published studies that have shown similar findings.

1. Stable nucleic acid storage and preservation in resource limited settings is often a barrier to widespread pathogen surveillance. 2. Dried Blood Spot (DBS) filter paper has a long history of preserving nucleic acid in whole blood, we tested extending this technology to the room temperature storage of DNA extract. 3. We found that DNA extracted from whole mammalian blood can be stored at room temperature on DBS filter paper, then washed with the buffer solution Tris-HCL, and used in downstream PCR analysis with results comparable to PCR performed on DNA extracted from whole blood dried on DBS filter paper which is the gold standard. 4. The success of this method means DNA can be stored at room temperature making sharing genomic samples easier by eliminating the need for cold chain.

Primary cardiac tumors are exceedingly rare. Among them, papillary fibroelastomas (PFEs) are the third most common. These tumors are often incidental findings but can also precipitate a myriad of clinical presentations, mainly embolic events. Most common in the left-sided valves, PFEs rarely occur in the right side of the heart. They are usually resected surgically following diagnosis, thwarting assessment of their natural history. We present the case of a woman diagnosed with pulmonary valve PFE following recurrent pulmonary embolism who did not undergo surgery, allowing for an extended follow-up of the condition.

Methadone is a long-acting opioid medication used for maintenance therapy in heroin addiction. Presenting a case of a patient on methadone therapy who developed neurological complications as mental status changes and choreiform movements. Workup revealed lesions involving the subcortical white matter and basal ganglia. and movements improved with treatment.

In this paper, the effect of light size and intensity on photoconductive effect-based optically-induced dielectrophoresis (ODEP) for three-dimensional manipulation of cells is studied. The photoconductive effect-based ODEP enabled the three-dimensional manipulation of multiple cells, whether normal cells or cancer cells. When the light spot size is similar to the cell and the photoconductive layer resistance is about 150 MΩ, the spot repels other cells after manipulating a single cell. When the light spot size is much larger than the cell and the photoconductive layer resistance is about 120 MΩ, multiple cells are controlled inside the spot and distributes in the same plane. When the light intensity is increased and the photoconductive layer resistance is about 40 MΩ, the cells are manipulated in three-dimensions. Using a light spot similar in size to the cells to gather specific cells at different locations into a specific area, and then increasing the light intensity enabled three-dimensional manipulation. We find that the cells three-dimensional manipulation by ODEP is achieved only when the photoconductive effect induced by the light pattern reaches a higher intensity. The realization of ODEP-based three-dimensional manipulation is related to the spot size and the photoconductive layer resistance determined by light intensity.

We present a low-power area-efficient subarray beamforming receiver (RX) structure for a miniaturized 3-D ultrasound imaging system. Given that the delay-and-sum (DAS) and digitization functions consume most of the area and power in the receiver, the beamforming successive approximation register (SAR) analog-to-digital converter (ADC) shares its capacitive digital-to-analog converter (CDAC) with the delay cells. As a result, the delay cells implemented with capacitors are embedded in the CDAC with significant area reduction, further eliminating the need for power-hungry ADC buffers. Furthermore, the dual reference 10-bit SAR ADC reduces the area of CDAC by 32 times, achieving a switching energy reduction of 98.3%, compared to the conventional SAR ADC. As a result, the proposed beamforming SAR ADC, simulated using a 0.18 μm CMOS process, consumes 230 μW per channel, significantly reducing the per channel capacitance.

Application of deep learning (DL) for automatic condition assessment of bridge infrastructure has been on the rise in the last few years. From the published literature, it is evident that lot of research efforts has been put in identifying the surface defects such as cracks, potholes, spalling etc. using deep learning. However, a concrete bridge deck health is jeopardized by the presence of subsurface defects substantially, however, the task of defect detection using deep learning has not received the proper attention. The goal of this survey paper is to provide a critical review of existing technical knowledge for DL application on NDE data for bridge deck evaluation. The authors reviewed prominent NDE techniques for subsurface defect detection of bridge decks and explored the various DL models proposed to identify these defects. First a brief overview of the working principle of NDE techniques and DL architectures is provided, and then the information about proposed DL models and their efficacy is highlighted. Based on the existing knowledge gaps, various challenges and future prospects associated with application of DL in bridge subsurface inspection are discussed.

Erdheim-Chester disease is a rare multisystemic disease. A 50-year-old woman, presented with a recurrent pain and swelling of the left knee. Bone scintigraphy showed increased tracer uptake of peripheral skeleton. The computed tomography showed tissular infiltration in the retroperitoneum, around the vessels. Immunohistochemistry showed CD68 (+) and CD1a (-).

The recognition of Cannabis as a source of new compounds suitable for medical use has attracted strong interest from the scientific community in its research, and substantial progress has accumulated regarding cannabinoids’ activity; however, a thorough description of their molecular mechanisms of action remains a task to complete. Highlighting their complex pharmacology, the list of cannabinoids’ interactors has vastly expanded beyond the canonical cannabinoid receptors. Among those, we have focused our study on the glycine receptor (GlyR), an ion channel involved in the modulation of nervous system responses, including, to our interest, sensitivity to peripheral pain. Here, we report the use of computational methods to investigate possible binding modes between the GlyR and Δ 9-tetrahydrocannabinol (THC). After obtaining a first pose for the THC binding from a biased molecular docking simulation and subsequently evaluating it by molecular dynamic simulations, we found a dynamic system with an identifiable representative binding mode characterized by the specific interaction with two transmembrane residues (Phe293 and Ser296). Complementarily, we assessed the role of membrane cholesterol in this interaction and positively established its relevance for THC binding to GlyR. Lastly, the use of restrained molecular dynamics simulations allowed us to refine the description of the binding mode and of the cholesterol effect. Altogether, our findings contribute to the current knowledge about the GlyR-THC mode of binding and propose a new starting point for future research on how cannabinoids in general, and THC in particular, modulate pain perception in view of its possible clinical applications.

Background: From early life, respiratory viruses are implicated in the development, exacerbation and persistence of respiratory conditions such as asthma. Complex dynamics between microbial communities and host immune responses, shape immune maturation and homeostasis, influencing health outcomes. We evaluated the hypothesis that the respiratory virome is linked to systemic immune responses, using peripheral blood and nasopharyngeal swab samples from preschool-age children in the PreDicta cohort. Methods: Peripheral blood mononuclear cells from 51 children (32 asthmatics, 19 healthy controls), participating in the 2-year multinational PreDicta cohort were cultured with bacterial (Bacterial-DNA, LPS) or viral (R848, Poly:IC, RV) stimuli. Supernatants were analyzed by Luminex for the presence of 22 relevant cytokines. Virome composition was obtained using untargeted high troughput sequencing of nasopharyngeal samples. The metagenomic data were used for the characterization of virome profiles and the presence of key viral families (Picornaviridae, Anelloviridae, Siphoviridae). These were correlated to cytokine secretion patterns, identified through hierarchical clustering and principal component analysis. Results: High spontaneous cytokine release was associated with increased presence of Prokaryotic virome profiles and reduced presence of Eukaryotic and Anellovirus profiles. Antibacterial responses did not correlate with specific viral families or virome profile, however, low antiviral responders had more Prokaryotic and less Eukaryotic virome profiles. Anelloviruses and Anellovirus-dominated profiles were equally distributed amongst immune response clusters. The presence of Picornaviridae and Siphoviridae was associated with low interferon-λ responses. Asthma or allergy did not modify these correlations. Conclusions: Antiviral cytokines responses at a systemic level reflect the upper airway virome composition. Individuals with low innate interferon responses have higher abundance of Picornaviruses (mostly Rhinoviruses) and bacteriophages. Bacteriophages, particularly Siphoviridae appear to be sensitive sensors of host antimicrobial capacity, while Anelloviruses are not affected by TLR-induced immune responses.

Owing to the complicated environments, the service life of bag-filter or electrostatic-bag composite precipitators with polyphenylene sulfide (PPS)-based bag-filter materials is greatly deviated from the ideal time. In this paper, the structural transformation of PPS-based bag filter materials collected from the coal-fired power plants with different loading units were investigated systematically. As the SO2 content increases, the surface evolution of PPS fibers from smoothness to crack occurs.The major reason for the failure of PPS-based bag filters is that working temperature (T) often passes through acid dew gas point (Ta), and the SO3 would be produced during the condensing of H2SO4 when T is lower than Ta. This work discloses the actual structural evolution of PPS and some corresponding rules under the complicated corrosive gases with high temperatures, which provides a guidance for prolonging the service life of PPS-based bag filters during the usage of coal-fired power plant

In an attempt to obviate the costly and protracted separation of final products from powdered catalyst particles in stirred slurry catalytic reactors, the electrochemical technique was used in the present study to determine mass transfer in a stirred vessel equipped with different baffle configurations placed at the tank bottom. Additionally, the effect of baffle tube diameters, as well as the impeller speed and geometry were examined. Mass transfer data obtained were correlated using the governing dimensionless groups from which heat transfer rates can be deduced by analogy. Results revealed the merits of using tubular baffles in terms of mass transfer and consequently heat transfer enhancement. Besides acting as a catalyst support where liquid-solid diffusion-controlled catalytic reactions, electrochemical reactions, photochemical reactions, and immobilized enzyme-catalyzed biochemical reactions take place, a tubular baffle can act also as a built-in cooler, in case of highly exothermic reactions to avoid hot spots and catalyst deactivation.

The effect of two-step aging treatment on the fatigue behavior of welded AA 7020 Al. alloy was investigated. For fatigue tests to be carried out in atmospheric and seawater environments, a plane bending tester at a stress ratio of R=0 was used. Experiments in the control group were carried out with non-welded specimens at a strain rate of R= -1 in air. The gradual heat treatment (two step aging, TSA) significantly improved the fatigue and corrosion fatigue behavior of welded AA 7020 alloys. Unwelded specimens showed better fatigue properties than welded ones. In experiments in a seawater environment, pitting and exfoliation corrosion occurred on the surface. It was determined that the corrosion pits reduce the fatigue life of welded and unwelded samples. It was also observed that the corrosion sensitivity of the welded specimens increased in the heat affected zone (HAZ) and corrosion fatigue cracking occurred in these zones.

Background/objectives: Ataxia Telangiectasia (A-T) is a complex inherited disease that is associated with an increased risk of malignancy. Surveillance guidelines have demonstrated significant health benefits in other cancer predisposition syndromes (CPS). Evidence-based guidelines for cancer screening are not currently used in the UK for people affected by A-T. This study aims to understand how people with A-T and their parents feel about cancer surveillance using whole-body MRI to inform the future development of cancer surveillance guidelines. Design/Methods: We conducted semi-structured interviews of people affected by A-T. Data were analysed inductively using thematic analysis. Results: Nine parents of children with A-T and four adults with A-T were interviewed. Five main themes emerged from the data. All participants viewed cancer screening for children with A-T as invaluable and emphasised the perceived value of early detection. The second theme acknowledged the anxiety associated with cancer and cancer surveillance and the third theme highlighted the perceived limitations around current practice, with the responsibility for monitoring falling too strongly on parents and patients. The fourth theme identified the need for effective preparation for cancer screening, including clear communication, and the challenges of MRI screening were recognised in the fifth theme with specific recommendations made for improving the child’s experience. Conclusion: This study suggests that stakeholders are positive about the perceived advantages of a cancer screening programme. Ongoing support and preparation techniques should be adopted to maximise adherence and minimise adverse psychosocial outcomes.

Background. Studies on the long-term treatment outcomes of childhood acute lymphoblastic leukemia (ALL) in resource-limited countries are scarce. The purpose of this study was to assess the evolution of survival outcomes of pediatric ALL in a tertiary care center in Thailand over a 40-year period. Patients and methods. We retrospectively reviewed the medical records of pediatric patients who were diagnosed with ALL and treated at our center between June 1979 and December 2019. We classified the patients into 4 study periods depending on the therapy protocol used to treat the patients (period 1: 1979-1986, period 2: 1987-2005, period 3: 2006-2013, and period 4: 2014-2019). The Kaplan Meier method was used to determine overall and event-free survival for each group. The log-rank test was used to identify statistical differences. Results. Over the study period, 726 patients with ALL were identified, 428 boys (59%) and 298 girls (41%), with a median age at diagnosis of 4.7 years (range: 0.2–15 years). The study periods 1, 2, 3, and 4 had 5-year event-free survival (EFS) rates of 27.6%, 41.6%, 55.9% and 66.4%, and 5-year overall survival (OS) rates of 32.8%, 47.8%, 61.5%, and 69.3%, respectively. From period 1 to period 4, both the EFS and OS rates increased significantly (p<0.0001). Age, study period, and white blood cell (WBC) count were all significant prognostic indicators for survival outcomes. Conclusions. The overall survival of patients with ALL treated in our center improved significantly over time from 32.8% in period 1 to 69.3% in period 4.

Symbiosis often occurs between partners with distinct life history characteristics and dispersal mechanisms. Many bacterial symbionts have genomes comprised of multiple replicons with distinct rates of evolution and horizontal transmission. Such differences might drive differences in population structure between hosts and symbionts and among the elements of the divided genomes of bacterial symbionts. These differences might, in turn, shape the evolution of symbiotic interactions and bacterial evolution. Here we use whole genome resequencing of a hierarchically-structured sample of 191 strains of Sinorhizobium meliloti collected from 21 locations in southern Europe to characterize population structures of this bacterial symbiont and its host plant Medicago truncatula. Sinorhizobium meliloti genomes showed high local (within-site) variation and little isolation by distance. This was particularly true for the two symbiosis elements pSymA and pSymB, which have population structures that are similar to each other, but distinct from both the bacterial chromosome and the host plant. The differences in population structure may result from among-replicon differences in the extent of horizontal gene transfer, although given limited recombination of the chromosome, different levels of purifying or positive selection may also contribute to among-replicon differences. Discordant population structure between hosts and symbionts indicates that geographically and genetically distinct host populations in different parts of the range might interact with genetically similar symbionts, potentially minimizing local specialization.

Introduction Pharmaceutical treatment in the neonatal intensive care unit (NICU) is challenging, and newborns are often exposed to numerous different medicines during their hospitalization There is currently insufficient knowledge of gestational age dependent medicine disposition, and accordingly the use of off-label medicines, i.e., use of medicines outside its approved marketing authorization, is high. This study aims to estimate the off-label medicine use in Danish neonatal departments. Methods By using data from the Danish National Pharmaceutical Hospital Purchase Database, we identified the most commonly occurring medicines and calculated the on/off-label ratios for premature and term neonates. Data was extracted on ATC level 5 and based on defined daily doses as per WHO. Results Data included was covering the 4 high-level NICUs and 10 of 13 of the intermediate/standard level neonatal departments in Denmark. Of the identified medicines, 87% and 70% did not have approved marketing authorization for use in premature and full-term neonates, respectively. Furthermore one-fifth of the top 100 medicines did not have a (Danish) marketing license. Overall, the presence of off-label medicines was widespread covering virtually all ATC groups and no ATC group had an off-label level lower than 50%. Finally, in 21% of the identified medicines, additives from 8 different chemical groups with potential deleterious effects for neonates were identified. Conclusion Off-label medication in the Danish neonatal departments is widespread, and the current state of neonatal official regulatory drug approval leaves both patients and neonatologists in a limbo between legal pharmaco-regulation and clinical need for pharmacotherapy in neonatology.

In this article, we have use Fuzzy Laplace-Adomian Decomposition method to evaluate the approximate solution of non linear and linear Time Fractional Klein-Gordan equations with suitable initial conditions in Fuzzy environment. We apply Fuzzy Laplace Transform and iterative method under caputo fractional derivative