In this paper, we deal with the numerical approximation of the coupled wave equation of Kirchhoff type with nonlinear boundary damping and memory term. Since the equation is a nonlinear equation, the Raviart-Thomas mixed finite element method is one of the most suitable techniques to obtain the approximated solution. In this paper, we will show that using the Raviart-Thomas method the optimal convergence order of the scheme can be achieved. To that end, we prove the necessary lemmas and the main theorem. Finally, the efficiency of the method is certified by numerical examples.
Assuming non-Fourier thermal effects, Tzou's dual-phase-lag model has been applied to introduce the governing heat conduction equation in the presented mathematical model. Moreover, in order to design a well-posed stable dual-phase-lag model, the governing time fractional dual-phase-lag heat equation has been established by introducing conductive temperature and thermodynamical temperature, satisfying the two-temperature theory. Due to the application of phase-lags the heat conduction equation became hyperbolic. The corresponding governing equations of motion and stresses have been considered in two-dimensional bounded spherical domain. The spherical boundaries are assumed to be traction free. The Laplace and the Legendre integral transforms have been applied to obtain the analytical solutions of conductive and thermodynamical temperatures, displacement components and thermal stresses. The Gaver-Stehfest algorithm has been employed to achieve the time domain inversions of Laplace transforms numerically, satisfying the Kuznetsov convergence criteria. Classical, fractional and generalized thermoelasticity theories has been recovered theoretically and numerically as well for various fractional orders and phase-lags values.
How to understand the dynamical collective performances is of particular significance in both theories and applications. In this paper, we are interested in investigating the combined influences of local interaction and processing delay on the asymptotic behaviour in a particle model with local communication weights. As new observations, we show that the desired particle system undergoes both periodic flocking and periodic clustering behaviors when the processing delay crosses a threshold value and the eigenvalue $1$ of average matrix is semi-simple. In this case, the connectedness of the particle system may be absent. Also, the number of clusters is discussed by using the subspace analysis. In results, some criterion of flocking and clustering emergence with exponential convergent rate are established by the standard functional differential equations analysis when the processing delay is small. When the processing delay reaches the threshold value, the system undergoes periodic flocking and periodic clustering emergence. It also shows that the processing time lags qualitatively change the emergent performances in a nonlinear way. Finally, we conclude this study with several numerical simulations that intuitively illustrate the validity of the theoretical results and address some discussions for both variable communication weight and distributed processing delay.
Background: Alterations of the circadian rhythm negatively impact several aspects of the health, including the lung function. Chronic shiftwork scale classically induces alterations in the circadian rhythm. However, its effects on pulmonary immune response are unknown. Aims: To evaluate the impact of chronic alteration of circadian rhythm on pulmonary function and immune response. Methods: In this context, a 12h x 24h and 12h x 48h work scale in shiftwork scale policemen (n = 25; 38,73±6,92 years old) were compared with fixed work scale (8h/day) civil men (n = 25; 34,00±9,60 years old) who were evaluated for perceived stress, sleepiness, physical activity levels, anthropometric characteristics, sleepiness levels, lung function, pulmonary and systemic cellular and humoral immune response. Results: Policemen presented increased levels of perceived stress (p<0.0008), impaired sleepiness (p<0.04) and lung function as demonstrated by reduced FVC (p<0.053) and FEV1 (p<0.043) when compared to civil men. In addition, increased levels of exhaled nitric oxide (p<0.037) and of IL-2 (p<0.0046) in the breath condensate revealed that policemen presented chronic lung inflammation compared to civil men. Although the whole blood analysis did not showed any differences between the two groups concerning the number of leukocytes, the humoral response revealed that policemen presented increased levels of IL-2 (p<0.002) and lower levels of IL-10 (p<0.001), clearly displaying a clinical status of low grade inflammation. Conclusions: Chronic alteration of circadian rhythm in shiftwork scale policemen results in impaired lung function, beyond to impair pulmonary and systemic immune function.
Tyrosine kinase inhibitors (TKIs) have revolutionized the management of chronic myeloid leukemia (CML), and currently in patients with CML in chronic phase (CML-CP) the first-line treatment is based on BCR-ABL targeted therapy with TKIs . Although generally well tolerated, all BCR-ABL TKIs can be associated with hematologic and non-hematologic toxicities . Most of the patients with CML-CP continue receiving TKIs, unless there is lack of optimal response and/or serious toxicities.
This case series study was performed on 19 patients with facial papule The patients were treated with oral isotretinoin 20 mg for 6 months. Oral isotertinoin was an effective and safe treatment in patients with facial LPP. There were some patients with only facial involvement without FFA or scalp LPP
We present a case of non-leukemic (lymphomatous) variant of HTLV-1 associated adult T-cell leukemia/lymphoma in a young woman. Tumor demonstrated strong and diffuse CD30 and PD-1 expression which is very unusual finding in this entity. Very good clinical response was obtained with brentuximab-containing treatment regimen.
Current study investigates thermal-hydraulic performances of turbulent forced hybrid nanofluid flow and heat transfer inside a parabolic through solar collector equipped with turbulators. The main aim of present work is to simulate and investigate the effects of different Reynolds numbers and geometrical parameters on thermal and hydraulic characteristics of the system to achieve the maximum PEC value. The heat transfer fluid is water-based MWCNT-Al2O3 (80%:20%) hybrid nanofluid which makes a Newtonian nanofluid. The RANS equations with the shear-stress (SST) k–ω turbulence model have been employed for modeling the turbulence regime. Based on obtained results, usage of turbulators leads to higher thermal diffusion because of destroying the laminar sub layer, increasing heat transfer surface and convection heat transfer. For θ=180°, the maximum values of average Nusselt number (Nuave) are achieved during all studied range of Reynolds numbers followed by θ=90° and θ=0°, respectively. For HO=15mm, the maximum values of Nuave are achieved followed by HO=10mm and HO=5mm, respectively. The model with HO=5mm has not the maximum Nuave; but, it has lower pressure drop than HO=15mm. For BO=1000mm, the maximum values of Nuave are achieved followed by BO=800mm and smooth channel, respectively. Furthermore, for δ=60°, the maximum Nuave are achieved followed by δ=40° and δ=20°, respectively. For model δ=40° the maximum values of PEC are achieved followed by smooth channel, δ=20° and δ=60°, respectively. The parabolic through solar collector model with θ=180°, HO=15, BO=1000mm, δ=40° and bO=20mm filled with hybrid nanofluid suggested as the optimum model in the present investigation.
Granulocyte-colony stimulating factor (G-CSF)-producing uterine cervical cancer (UCC) is a rare aggressive disease. We report a case of G-CSF-producing UCC treated with chemoradiotherapy. Target-capture sequencing results indicate that G-CSF-producing UCC is genetically distinct from other UCCs, warranting further research to establish specific treatment strategies.
Background and Purpose: Resurgence in the use of chloroquine as a putative treatment for COVID-19 has seen recent cases of fatal toxicity due to unintentional overdoses. Protocols for the management of poisoning recommend diazepam, although there are uncertainties in its pharmacology and efficacy in this context. The aim was to assess the effects of diazepam in experimental models of chloroquine cardiotoxicity. Experimental Approach: In vitro experiments involved cardiac tissues isolated from rats and incubated with chloroquine, alone, or in combination with diazepam. In vivo models of toxicity involved chloroquine administered intravenously to pentobarbitone-anaesthetised rats and rabbits. Randomised, controlled interventional studies in rats assessed diazepam, clonazepam and Ro5-4864 administered: (i) prior, (ii) during, and (iii) after chloroquine; and the effects of diazepam: (iv) at high dose, (v) in urethane-anaesthetised rats, and (vi) co-administered with adrenaline. Key Results: Chloroquine decreased the developed tension of left atria, prolonged the effective refractory period of atria, ventricular tissue and right papillary muscles, and caused dose-dependent impairment of haemodynamic and electrocardiographic parameters. Cardiac arrhythmias indicated impairment of atrioventricular conduction. Studies (i), (ii) and (v) showed no differences between interventions and control. Diazepam increased heart rate in study (iv) and, as with clonazepam, also prolonged the QTc interval in study (iii). Combined administration of diazepam and adrenaline in study (vi) improved cardiac contractility but caused hypokalaemia. Conclusion and Implications: Neither diazepam, nor other ligands for benzodiazepine binding sites, protect against or attenuate chloroquine cardiotoxicity. However, diazepam may augment the effects of positive inotropes in reducing chloroquine cardiotoxicity.
Bosutinib is a tyrosine kinase inhibitor (TKI) approved for the management of chronic myeloid leukemia (CML). TKIs are associated with pulmonary complications but are rarely described with bosutinib. Here, we report the first description of bosutinib-induced interstitial lung disease and pleural effusion, which resolved after the discontinuation of bosutinib.
Objective: Atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a factor that causes an increase in mortality and morbidity. Therefore, predicting post-CABG AF development is important for treatment management. In this study, we investigated the value of the ratio E/(Ea × Sa) as a combined systolic-diastolic index in predicting post-CABG AF development. Methods: This prospective study included 102 patients who underwent only isolated coronary bypass. Preoperative demographic features, biochemical and hematological parameters, and the electrocardiographic data of all patients were recorded. The E/(Ea × Sa) indices were calculated from the echocardiographic measurements. Those who retained their postoperative sinus rhythm were defined as group 1, and those who developed AF were defined as group 2. Results: Group 2 had significantly higher lateral (group 1: 1.14 ± 0.61 vs. group 2: 1.47 ± 0.87; p = 0.02), medial (group 1: 1.61 ± 0.70 vs. group 2: 1.99 ± 0.91; p = 0.02), and mean (group 1: 1.30 ± 0.58 vs. group 2: 1.62 ± 0.74; p = 0.001) E/(Ea×Sa) indices than group 1. In the univariate analysis, age, CHA2DS2-VASc score, sPAP, and mean E/(EaxSa) index were found to be significant predictors of post-CABG AF development. However, only the mean E/(EaxSa) index was found to be a significant predictor of post-CABG AF development in the multivariate analysis (OR: 2.31 95% CI 1.02–5.24; p = 0.04). Conclusions: The combined systolic-diastolic index predicted the development of post-CABG AF.
Migration of sternal wires into vital structures is a rare but potentially life-threatening complication. While a few cases have been reported, the sternal wires were broken in those cases. To our knowledge, this is the first report of multiple, non-broken migrated sternal wires stabbing vascular grafts. A 65-year-old woman with a long history of treatment for extended aortic pathology, which included replacement of the aortic root (Bentall procedure, coronary artery reconstruction with Piehler technique), aortic arch and thoracoabdominal aorta, as well as thoracic endovascular repair (TEVAR), underwent mitral valve replacement due to severe mitral regurgitation under third median sternotomy. The postoperative course was uneventful, and she was followed as an outpatient. Two years after the surgery, she complained of anterior chest discomfort. Computed tomography (CT) revealed hemorrhaging around the vascular grafts in the mediastinum and migration of several non-broken sternal wires into the vascular grafts. We suspected graft injury due to the sternal wires, and open repair by reopening the sternotomy incision was performed. During redo sternotomy, massive bleeding occurred, so cardiopulmonary bypass was urgently established via femoral cannulation, and her body temperature was brought down. After careful dissection, tearing of the grafts at both the ascending aorta and left coronary artery was found under circulatory arrest with moderate hypothermia. Polypropylene sutures were placed to control bleeding.
Increasing evidence indicates that hypertension and hypertensive end organ damage are not only mediated by hemodynamic injury but that inflammation plays an important role in the pathophysiology and contributes to the deleterious consequences of this disease. The complement system is an ancient part of innate immunity comprising multiple serum proteins and cellular receptors that protect the host from a hostile microbial environment and maintain tissue and cell integrity through the elimination of altered or dead cells. As an important effector arm of innate immunity, it plays also central roles in the regulation of adaptive immunity. Innate and adaptive immune responses have been identified as crucial players in the pathogenesis of arterial hypertension and hypertensive end organ damage. Thus, complement activation may drive the pathology of hypertension and hypertensive injury through its impact on innate and adaptive immune responses aside from direct effects on the vasculature. Indeed, recent experimental data strongly support a role for complement in all stages of arterial hypertension and hypertensive end organ damage. The remarkably similar clinical and histopathological features of malignant nephrosclerosis and atypical hemolytic uremic syndrome, which is driven by complement activation, suggest also a role for complement also in the development of malignant nephrosclerosis. We herein review the role of complement proteins in hypertension and hypertensive end organ damage.
We use recent plot-level panel data from Tanzanian smallholder farmers to investigate maize yield responses to inorganic fertilizer under variable soil carbon conditions. Unlike many prior studies which consider total carbon measurements, we focus on active soil carbon, which is the component that most influences key soil functions, such as nutrient cycling and availability. Active soil organic carbon is found to strongly influence maize yield response to nitrogen fertilizer. These results highlight important sources of variation in the returns to fertilizer investments across plots and smallholder farmers in the region. When farmgate prices for maize and fertilizer are incorporated into calculations of economic returns, we find that the profitability of fertilizer use is strongly dependent upon farmgate price ratio assumptions: under our most optimistic agronomic response estimates, 71% of farmer plots have an average value-cost ratio (AVCR) greater than 1.5 at a maize-nitrogen price ratio of 0.15. That share drops to 30% at a price ratio of 0.12 and 2% at a price ratio of 0.09. Our findings provide insights into the intertwined biophysical and economic underpinnings of low levels of fertilizer use in Tanzania and elsewhere in the region. Raising active carbon stocks in smallholder systems may be a strategic priority in many areas for incentivizing greater use of inorganic fertilizer, reversing land degradation, and achieving sustainable agricultural intensification.
As the global population continues to shift into cities, urban hydrologic systems are becoming increasingly important drivers of overall water quality. Engineered waterways and impervious surfaces strongly influence baseline flow, peak flow, and the transport of pollutants in the urban environment. Between May 2016 -- May 2019, we systematically measured water temperature, pH, dissolved oxygen, biochemical oxygen demand, and the concentrations of nitrate-N, ammonia-N, and orthophosphate in the South Platte River in the Denver metropolitan area, Colorado, USA. We found that the overall water quality of the river decreased through the study area. In addition, there appear to be several hotspots with consistently poor water quality. While it is beyond the scope of this paper to determine the specific sources of the hotspots, it seems likely that wastewater treatment facilities contribute to elevated pollution levels. We also found that water quality was strongly influenced by season. Decreased natural flows during the late fall and winter lead to higher concentrations of nutrients and lower dissolved oxygen levels. Most of the samples collected in this study had nutrient levels that were out of compliance with state regulations for nitrogen and phosphorus concentrations while dissolved oxygen and temperature levels were better than threshold values. Urban hydrologic systems are complex and improving water-quality may be difficult. However, tightening of water-quality standards could result in positive changes to this system.
Various causes of Recurrent Acute pancreatitis have been identified in the past. This report presents a novel case of “recurrent” acute pancreatitis in the setting of superior mesenteric artery syndrome (SMAS). Thus, highlighting SMAS as a rare yet possible cause of recurrent pancreatitis facilitating early diagnosis and prompt treatment.