Whilst climate change is recognised as a major future threat to biodiversity, most species are currently threatened by extensive human-induced habitat loss, fragmentation and degradation. Tropical high altitude alpine and montane forest ecosystems and their biodiversity are particularly sensitive to temperature increases under climate change, but they are also subject to accelerated pressures from land conversion and degradation due to a growing human population. We studied the combined effects of anthropogenic land-use change, past and future climate changes and mountain range isolation on the endemic Ethiopian Highlands long-eared bat, Plecotus balensis, an understudied bat that is restricted to the remnant natural high altitude Afroalpine and Afromontane habitats. We integrated ecological niche modelling, landscape genetics and model-based inference to assess the genetic, geographic and demographic impacts of past and recent environmental changes. We show that mountain range isolation and historic climates shaped population structure and patterns of genetic variation, but recent anthropogenic land-use change and habitat degradation are associated with a severe population decline and loss of genetic diversity. Models predict that the suitable niche of this bat has been progressively shrinking since the last glaciation period. This study highlights threats to Afroalpine and Afromontane biodiversity, squeezed to higher altitudes under climate change while losing genetic diversity and suffering population declines due to anthropogenic land-use change. We conclude that the conservation of tropical montane biodiversity requires a holistic approach, using genetic, ecological and geographic information to understand the effects of environmental changes across temporal scales and simultaneously addressing the impacts of multiple threats.
Hydatid cyst is an endemic disease especially in underdeveloped and developing countries affecting mostly the liver and lungs. However, a wide range of unusual anatomical sites in the abdomen has been reported, including the spleen, pancreas, kidney, and ovaries as well as dissemination within the abdominal and pelvic cavities. The location of hydatid disease in the colon is very infrequent, and very few cases have been presented. The hydatid cysts located in other sites are mostly due to rupture or extrusion of primary liver or splenic cysts. In this article, we present a case of primary left-sided colon hydatid cyst, resected laparoscopically with the affected intestinal segment. The diagnosis of hydatid cyst was made by macroscopic and microscopic examination.
In the present work, novel core-shell polymer magnetic colloids are prepared and employed as a potential candidate in ultrasensitive molecular imaging. The synthesized colloids possess high colloidal stability, magnetization (43.85 emu g-1) and uniformity of particle size with an average diameter of 527 nm. FTIR spectrum of magnetic emulsion shows two characteristic peaks at 570 and 630 cm-1 which related to Fe-O vibration bands. Both T1 and T2 relaxation times were successfully measured. Based on signal intensities, the prepared colloids observed to perform as better T2 weighted contrast agents. The T2-weighted MR images showed significant signal intensity reduction and contrast darkening. Moreover, the prepared colloids were also employed to fabricate thin films via a facile method of layer by layer self-assembled multilayers (LBL-SAMU) to explore their potential application in imaging. Uniform particle size distribution with spherical morphologies was obtained for the fabricated bilayers. In addition, a 20% increment in iron contents was observed for 5-15 bilayer thin films decorated with film colloidal particles. The reported work opens new avenues for designing powerful T2 contrast agents in various biomedical applications such as analysis of biomacromolecules, diagnostics, and therapy.
Plants host diverse microbial communities, but there is little consensus on how we sample and characterize these communities, and this has unknown consequences. Using root and leaf tissue from 20 showy milkweed (Asclepias speciosa) plants in the field, we compared two common sampling strategies by: 1) homogenizing after subsampling a small proportion of tissue (30 mg), and 2) homogenizing bulk tissue before subsampling 30 mg. Due to potential differences in richness and spatial distributions among microorganisms, we targeted bacteria, arbuscular mycorrhizal (AM) fungi and non-AM fungi in roots, as well as foliar fungal endophytes (FFE) in leaves. We also sampled FFE twice across the season using sampling strategy 1 to assess temporal dynamics, and we extracted DNA from all remaining homogenized bulk leaf tissues to determine the extent of potential undersampling. Bacterial richness was higher under sampling strategy 2, and all microbial groups except AM fungi differed in composition. Community overlap between the two sampling strategies increased when rare taxa were removed, but FFE and bacterial communities remained more different than alike and showed largely non-overlapping communities within individual plants. Increasing the extraction mass 10x also increased FFE richness ~10x, confirming the severe undersampling indicated in the sampling strategy comparisons. Even so, seasonal patterns in FFE communities were apparent, suggesting that strong drivers may be identified despite severe undersampling. Our findings highlight that current sampling practices poorly characterize many microbial groups and that increased sampling intensity is necessary to identify subtler patterns and to increase the reproducibility of studies.
A 33-year-old male admitted with sudden and spontaneous painless left infraorbital swellings after forceful nose-blowing. He was diagnosed orbital emphysema with orbital floor blow-out fracture. This case shows that forceful nose-blowing can cause orbital floor fracture and subcutaneous orbital emphysema by rapid increase in pressure in the upper airways.
In this study, we performed density functional theory calculations using the B3LYP, M052X, M062X, and APFD functionals to investigate substituent effects on the mechanism of 1,3-dipolar cycloaddition, a classical and effective method for the synthesis of heterocyclic compounds. The results showed that changing the substituents on the chloroxime compounds affects the energy level of the highest occupied molecular orbital and consequently, the progress of the reaction. Finally, it provided an effective idea for this kind of reaction in the design of organic synthesis and the necessary theoretical basis for revealing the course of this reaction.
Population and conservation genetics seek to understand how adaptive diversity is shaped by the interweaving forces of molecular evolution in small and endangered populations. On the one hand, selection shapes variation, on the other hand, genetic drift impedes the selection by stochastic changes of allele frequencies. Drift is hypothesised to prevail if the population size is small. However, in practice empirical estimates of the population size are often challenging. Here we used island size as a proxy to population size to reveal the evolutionary constraints of molecular diversity in Toll-like receptors (TLRs) of mockingbirds (genus Mimus) inhabiting Galápagos islands. TLRs are crucial for pathogen recognition by host immunity and thus under various selection constraints. We focused on the interaction of drift and selection in TLR1B, TLR4, and TLR15 across 12 size-variable insular populations and compared them with the mainland population of the northern mockingbird (Mimus polyglottos), aiming to test if population size impacts selection efficiency. Nucleotide diversity positively correlated with the island size indicating an increasing effect of genetic drift in small populations. Despite this pattern, functional TLR properties were largely conserved, presumably due to purifying selection opposing drift independently on the island size. The degree of protein conservatism differed between the loci with TLR15 being the least conserved. Island colonisation did not lead to relaxed selection or to local adaptations. Together with the invariable physicochemical properties of the TLR variants, these observations imply that drift did not outweigh purifying selection despite restricted population size.
Objectives This study aimed to measure the prevalence of potentially inappropriate medications (PIMs) in Chinese elderly population according to the 2019 Beers Criteria and to evaluate the associative factors of PIMs. Methods Prescriptions of patients aged over 65 years who were hospitalized during January 2017 to December 2017 were retrieved from Hospital Prescription Analysis Cooperation Project, covering seventy-six facilities in six cities in China. PIMs were identified by 2019 Beers Criteria. Results In total, 40.1% elderly patients were treated with at least one PIM independent of their diagnoses or conditions according to the 2019 Beers Criteria. The most frequently prescribed inappropriate medications independent of diagnoses or conditions were proton-pump inhibitors (12.9%). Diuretics (8.2%) and central nervous system medications (6.9%) also showed a relatively high prevalence among the investigated patients. Based on the Beers Criteria’s lists of drug-disease interactions, elderly patients with central nervous system conditions (including delirium, dementia or cognitive impairment) or with a history of falls or fractures were most commonly exposed to PIMs. Logistic regression revealed that inappropriate medication use was associated with age (≥80 years old), number of conditions (≥5), number of medications prescribed (≥10) and class of healthcare facilities. Conclusion This study was able to confirm that the phenomenon of prescribing potentially inappropriate medications was common in China. Our findings support the importance of developing explicit criteria to detect PIMs in China and implementing effective interventions to promote better quality of prescribing for elderly patients.
Differential diagnoses of patients with multiple bony lesions that are confined to one side of the body should include polyostotic fibrous dysplasia with and without McCune-Albright Syndrome, particularly if there is no history of malignancy. Lesion biopsy ultimately provides the definitive diagnosis.
Objectives To investigate the ability of a physical barrier to reduce aerosol particle spread during a simulated aerosol generating procedure. Design A simulated aerosol generating procedure. Setting Standard hospital ward, St George’s Hospital, London. Participant One volunteer participant - they were healthy, asymptomatic, and a non-smoker. Main Outcome Measures 1. To compare the effect of the shield on particle frequency (according to particle size) at different locations. 2. To evaluate the length of time that particles remained within the shield, both with and without an aspiration unit. Results Clinical investigations using the shield demonstrated a twelve-fold decrease in the number of particles detected at the position of the operating surgeon when the shield was used (particle size 0.3μm; with shield 8662 versus 103800 without shield). Over a 7-minute period, there was a reduction in the number of particles. At 7 minutes, the total number of particles (size 0.3μm) measured within the shield was comparable to the particle frequency at ambient levels (8752 within the shield compared with 8592 within the ambient environment). The aspiration unit reduced the number of particles detected within the shield over time. An average of 9649 particles (similar to ambient level) sized 0.3μm were measured under the shield after 2 minutes when the aspiration unit was used. Conclusion The clinical simulation illustrates a significant decrease in the number of particles detected at varying locations when the shield is used. The shield, used with appropriate PPE, could help to minimise exposure to aerosol-generated particles such as during tracheostomies on patients with COVID-19.
Current technological developments in the field of wireless communications has enabled the use of ultra-low power, lightweight, miniature types of smart health monitoring devices which are integrated into a Wireless Body Sensor Network (WBSN). Vital signs in humans such as temperature, heartbeat, and pulse can be tracked and detected from a remote location with help of biomedical wireless sensors. This article proposes a method to securely encrypt the patient’s data and transmit it to the authorized doctor using wireless devices with in the hospital premises. This article is aimed at generating electrocardiogram (ECG) based key agreement scheme for the sake of generating a common key in a body area network. This kind of smart health information communication method by means of sensors and internet connection to servers is more confidential and encrypted to protect the patient’s health data. Security and Privacy mechanisms use a significant part of the available energy and should therefore be energy efficient and light weight. The Proposed work in this article is implemented in Telosb running ContikiOS. The TelosB mote is designed for experimentation with low-power personal wireless area network (LoWPAN) with IEEE 802.15.4/ZigBee/Telosb compliant RF transceiver. By using iris or fingerprints, the security of this technique can be further improved.
An adolescent female with ventilator-dependent spinal muscular atrophy type 1 (SMA-1) and megalencephaly-capillary malformation-polymicrogyria (MCAP) syndrome had been struggling with recurrent small to large volume hemoptysis for years secondary to complex arteriovenous malformations (AVMs) in her lungs. Despite numerous embolizations, she continued to experience hemoptysis from new AVMs. She was then started on sirolimus (rapamycin) and remains hemoptysis-free for over 12 months. To our knowledge, there are no known cases of SMA-1 with MCAP syndrome and related complex vascular malformations successfully treated with sirolimus.
Human overexploitation of natural resources has placed conservation and management as one of the most pressing challenges in modern societies, particularly regarding highly vulnerable marine ecosystems. Although a large effort has been made to design Marine Protected Areas (MPAs) worldwide, it is still unclear how many species actually exist in these MPAs, what is the genetic connectivity between areas with different protective regimes, and what is their relative genetic diversity. We answer these questions using morphologically cryptic species of the genus Mugil that are sympatric in the largest MPA in the Tropical Southwestern marine province. Population structure analyses show the existence of five highly divergent species (FST > 0.855) and no genetic divergence between two estuaries with different protection status (FST = 0.005). Sympatric individuals are assigned to single clusters and show strong concordance among hundreds of independent gene trees, consistent with full reproductive isolation and no ancestral nor ongoing hybridization. Differences of genetic diversity within species suggest that effective population sizes differ up to two-fold, probably reflecting differences in the magnitude of population expansions during the evolutionary history of these species, rather than recent impact of fisheries. Together, our results suggest that designing MPAs with areas of integral protection in between areas where fisheries are permitted could be an effective way to manage cryptic species that cannot have species-specific quotas. More generally, this work shows a cost-efficient approach that is transferable to other marine or terrestrial organisms of special concern, helping to implement science-based regulations for management and conservation.
Lactobacillus (L.) plantarum is widely distributed in the natural environments and previous studies failed to identify habitat-specific genomic signatures. Thus, comparative genomic analysis together with genome-wide association study of 551 L. plantarum genomes were performed to investigate how natural habitats shaped the bacterial genomes. Firstly, the study constructed a phylogenic tree using a strict core-genome of L. plantarum, followed by refining the clades with genome-wide single nucleotide polymorphisms (SNPs). Our data showed that plant-originated isolates dispersed evenly across the phylogenetic tree, supporting a previously reported model of nomadic lifestyle. Isolates from animal and dairy sources showed significant biases in clade distribution, suggesting close association between bacterial genomes and habitats. The animal-originated isolates distributed mainly to clade A and were characterized with more carbon utilization-associated genes. The dairy isolates distributed mainly to subclades B2 and B3, which harbor more nitrogen utilization-associated genes. Both animal and dairy isolation sources were directly linked with the development of human civilization in the aspects of food culture and food industry. Furthermore, based on five population genetic signals, subclade B2 had the highest genetic diversity and SNP distance. Subclade B1 had the highest mutation rate, possibly resulted from recombination events. The animal-originated isolates had lower nucleotide diversity and higher recombination/mutation ratio, which might be the genetic trail remained from the adaptation process. Our data have provided an explanation for the high versatility of L. platnarum on the genomic level and showed that the L. plantarum species is more genetically diverse than previously expected.
Objective: Drug-related problems (DRPs) can lead to consequences such as morbidity, mortality and increased costs. An electronic expert support system (EES) has been developed by the Swedish eHealth Agency to help pharmacists in community pharmacies identify potential DRPs, and to resolve actual DRPs. The objective of this study was to examine whether the use of the EES in a Swedish community pharmacy will result in more identified and resolved DRPs. Methods: In an open, prospective and controlled study, prescriptions were dispensed by three pharmacists with the use of EES during two weeks and without EES during two weeks in the spring of 2019. A DRP documentation template was developed and used. Identified DRPs, suggested actions and actions presented to patients and prescribers, and resolved DRPs, were documented and compared using Chi2-tests. Key findings: 100 patients were included in both the EES intervention group and in the control group. At least one actual DRP was identified in 26 intervention patients and 28 control patients. The number of patients with at least 1, 2 or 3–5 DRPs did not differ, but including the total number of DRPs reached statistical significance, favouring the EES-support group. EES-support helped pharmacists to present suggestions to physicians and consequently to resolve DRPs, primarily drug-drug interactions. Conclusion: Our study indicates that the EES dispensing support system contributes to the identification and resolution of DRPs, mainly DRPs related to drug-drug interactions and suggestions to the prescriber.
Background: Although diastolic dysfunction is common among patients treated with cancer therapy, no clear evidence has been shown that it predicts systolic dysfunction. This study evaluated the correlation of longitudinal diastolic strain (Ds) with echocardiography diastolic parameters and to estimate its role in the early detection of cardiotoxicity among patients with active breast cancer. Methods: Data were collected as part of the Israel Cardio-Oncology Registry (ICOR), a prospective registry enrolling all adult patients referred to the cardio-oncology clinic. All patients with breast cancer, planned for Doxorubicin therapy were included. Echocardiography, including Global longitudinal systolic strain (GLS) and Ds, was assessed at baseline before chemotherapy (T1), during Doxorubicin therapy (T2) and after the completion of Doxorubicin therapy (T3). Cardiotoxicity were determined by GLS relative reduction of ≥15%. Ds was assessed as the time of lengthening =diastolic time (ms) measured. Results: Among 69 patients, 67 (97.1%) were females with a mean age 52±13years. Diastolic strain time measurement was significantly associated with the standard diastolic parameters. Significant GLS reduction was observed in 10 (20%) patients at T3 . Both in a univariate and a multivariate analyses the change in Ds basal time from T1 to T2 emerged to be significantly associated with GLS reduction at T3 (p<0.04). Conclusions: Among breast cancer patients, Ds time showed high correlation to standard diastolic echocardiography parameters. Relative reduction in Ds basal time emerged associated with clinically significant systolic dysfunction as measured by GLS reduction.
Unilateral pulmonary artery discontinuity (UPAD) is a rare malformation which is associated with other intracardiac abnormalities. Cases accompanied by other cardiac abnormalities are often missed on prenatal echocardiography. We reported our case which was prenatally diagnosed as pulmonary atresia with ventricular septal defect (PAVSD) and left pulmonary artery (LPA) discontinuity.