Two-dimensional (2D) nanosheets with thickness of one to several atoms serve as ideal building units for separation membranes. Herein, we report the construction of ultrathin membranes with layered double hydroxides (LDHs) nanosheets, polyacrylic acid (PAA) and polyethyleneimine (PEI) alternately deposited on porous substrates. The chemical tuning of PEI leads to an accurate regulation of interlayer spacing in angstrom scale, resulting in selective nanochannels for CO2 permeation. The laminar membranes with CO2 transport-facilitated channels exhibit excellent gas separation performance and exceed the limit of the state-of-the-art membranes with CO2 permeance of 1068 GPU, CO2/N2 and CO2/CH4 selectivity of 126 and 330 respectively. A synergistic effect of solution-diffusion and molecular sieving was proposed for this prominent CO2 separation performance. The strategy demonstrated in this work would open up new avenues for effective CO2 separation and capture in recycling of carbon resources.

：In order to explore the impact of ecological planting pattern on runoff sediment transport rate(T 2), this study in two planting modes with a single planting of Prunella vulgaris (A) and P. vulgaris and earthworms (B) were investigated through simulated rainfall experiments in the field. The results showed that: 1) T 2 decreased first and then stabilized with the rainfall duration,which is dominated by the composition of soil particle size and runoff depth;2) T 2 under gentle slope and steep slope conditions is greatly affected by rainfall intensity and slope, respectively; 3) T 2 ,which has a good correlation with runoff separation rate (D 2), needs to be explained in conjunction with soil properties or raindrop kinetic energy. The main controlling factors of T 2 in bare slope, B, A are raindrop kinetic energy, D 2, and organic matter, which explain 93.10%, 95.76%, and 98.65%.Compared with B, A has obvious economic and ecological value.

A document by Krzysztof Sadko. Click on the document to view its contents.

An atrial septal aneurysm (ASA) is saccular defect of the atrial septum, and it may be associated with congenital heart disease. Cryptogenic strokes are strokes of unknown origins, and ASA may be one of these causes. In this case report, we described a cryptogenic stroke in an adult Sudanese female with interatrial septal aneurysm.

Background: In atrial fibrillation patients undergoing left atrial appendage occlusion with a Watchman device, surveillance imaging with a transesophageal echocardiogram (TEE) is typically performed at 45 days and 1 year to evaluate for device-related thrombus (DRT) and peri-device leak (PDL) before cessation of oral anticoagulation. The incidence of these complications is relatively low, and the ideal timing and duration of surveillance is unknown. We sought to evaluate the incidence of DRT and PDL after Watchman placement at 45 days and 1 year to determine the necessity of surveillance TEEs. Methods: We retrospectively analyzed 361 patients who received a Watchman device between January 2016 and January 2020. Baseline clinical and echocardiographic data, post-procedure antithrombotic therapy and surveillance echocardiographic data were collected from the NCDR LAAO Registry. Nested backward variable elimination regression was performed to derive independent predictors of the composite outcome of DRT and PDL. Results: A total of 286 patients who had post-procedure TEEs were included in the analysis. At 45 days, 9 patients had DRT (3.2%) and 44 patients had PDL (15.0%). At 1 year, 5 patients had DRT (5.6%) and 8 patients had PDL (8.9%). All DRT at 45 days was treated with continued anticoagulation while no change in protocol occurred with PDL. All DRT at 1 year occurred in new patients without prior thrombus. A history of prior transient ischemic attack (TIA) and thromboembolism were significantly associated with DRT or PDL at 1 year. Conclusions: We identified several patients with device-related complications at 45 days and 1 year despite appropriate device sizing and adequate use of antithrombotic therapy. The incidence of DRT increased from 45 days to 1 year and occurred in patients without prior thrombus. These findings highlight the importance of surveillance imaging and suggest the potential need for extended surveillance in select patients.

Aircraft cabins have high-performance ventilation systems, yet typically hold large numbers of people in close proximity for long periods. The current study estimated airborne virus exposure and infection reductions for vacant middle seats and masking in aircraft. Tracer particle data reported by U.S. Transportation Command (TRANSCOM) and CFD simulations reported by Boeing were used, along with NIOSH data, to build nonlinear regression models with particle exposure and distance from particle source as variables. These models that estimate exposure at given distances from the viral source were applied to evaluate exposure reductions when middle seats are vacant compared to full occupancy. Reductions averaged 54% for the seat row where an infectious passenger is located and 36% for a 24-row cabin containing one infectious passenger, with middle seats vacant. Analysis of the TRANSCOM data showed that universal masking (surgical masks) reduced exposures by 62% and showed masking and physical distancing provide further reductions when practiced together. For a notional scenario involving 10 infectious passengers, compared with no intervention, masking, distancing, and both would prevent 6.2, 3.8 and 7.6 secondary infections, respectively, using the Wells-Riley equation. These results suggest distancing and masking reduce SARS CoV-2 exposure risk when an infectious passenger is present.

Abstract: Multirooted supernumerary tooth is a rare finding, which predisposes to various malocclusion. The present case report depicts the presence of a multirooted supernumerary tooth in the anterior maxilla just adjacent to the midline in a 24-year-old patient. Keywords: anterior, maxilla, multirooted, supernumerary.

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The glucocorticoid receptor (GR) is a nuclear receptor that controls critical biological processes by regulating the transcription of specific genes. GR transcriptional activity is modulated by a series of ligands and coenzymes, where a ligand can act as an agonist or antagonist. GR agonists, such as the glucocorticoids dexamethasone (DEX) and prednisolone, are widely prescribed to patients with inflammatory and autoimmune diseases. DEX is also used to induce osteogenic differentiation in vitro. Recently, it has been highlighted that DEX induces changes in osteogenic differentiation of human mesenchymal stromal cells by downregulating the transcription factor SRY-box transcription factor 9 (SOX9) and upregulating the peroxisome proliferator-activated receptor γ (PPARG). SOX9 is fundamental in the control of chondrogenesis, but also in osteogenesis by acting as a dominant-negative of RUNX2. There are still many processes to be clarified during cell fate determination, such as the interplay between the key transcription factors. The outcome of this research could help the understanding of possible molecular interactions between GR and SOX9 and their role in the determination of cell fate. The main objective pursued by this work is to shed light on the interaction between GR and SOX9 in the presence and absence of DEX at an atomic level of resolution using molecular dynamics simulations. The results highlight the key residues at the interface between GR and SOX9 involved in the complexation process, as well as, shed light on the mechanism through which DEX modulates GR-SOX9 binding and exerts its biological activity.

Background and Aim: We assessed the anatomical variations in coronary arterial patterns relative to the techniques of reimplantation in the setting of the arterial switch operation, relating the variations to influences on outcomes. Methods: We reviewed pertinent published investigations, assessing events reported following varied surgical techniques for reimplantation of the coronary arteries in the setting of the arterial switch procedure. Results: The prevalence of reported adverse events, subsequent to reimplantation, varied from 2% to 11%, with a bimodal presentation of high early and low late incidence. The intramural pattern continues to contribute to mortality, with some reports of 28% fatality. The presence of abnormal course relative to the arterial pedicles in the setting of single sinus origin was associated with a three-fold increase in mortality. Abnormal looping with bisinusal origin of arteries was not associated with increased risk. Conclusion: The techniques of transfer of the coronary arteries can be individually adapted to cater for the anatomical variations. Cardiac surgeons, therefore, need to be familiar with the myriad creative options available to achieve successful repair when there is challenging anatomy. Long-term follow-up will be required to affirm the superiority of any specific individual technique. Detailed multiplanar computed-tomographic scanning can now reveal all the variants, and elucidate the mechanisms of late complications. Coronary angioplasty or surgical revascularization may be considered in selected cases subsequent to the switch procedure.

Background We evaluated short- and mid-term outcomes with use of aortic valve-sparing root replacement to treat bicuspid aortic valves. Methods From December 2007 to January 2022, all patients with bicuspid aortic valves who underwent aortic root replacement using Tirone’s procedure were included. This study based on department database information for retrospective and follow-up data. Results Among 51 adults undergoing aortic root replacement using Tirone’s procedure, the mean age was 47.4±12.5 years, and most were men (92.2%). Three presented with a dysmorphic syndrome and one had Marfan’s syndrome. All patients were alive at 30 days, and as of January 2022, 45 were alive, two were lost to follow-up, and there were four noncardiac deaths. Two patients had infectious endocarditis and needed a Bentall’s procedure. One patient had a double biologic valve replacement in the context of severe mitral insufficiency with moderate aortic stenosis at 4.5 years post-procedure. Echocardiographic follow-up showed a left ventricular ejection fraction of 63±7% (n=36), V max 2±0.6 m/s (n=17), and a mean gradient of 9.4±5.4 mmHg (n=27). No patients had grade 3 or 4 aortic regurgitation, one patient had grade 2, and four had grade 1. Conclusion Tirone’s procedure is an option for bicuspid aortic valve surgery, with good safety and outcomes, especially in younger patients.

Tetralogy of Fallot (TOF) is rarely associated with partial anomalous pulmonary venous return (PAPVR). Unidentified PAPVR, however, might increase the risk of pulmonary valve replacement in repaired TOF patients by right ventricular (RV) dilatation and RV dysfunction. Here, we present a case of a 19-year-old male who received a correction of TOF 18 years ago and a rare type of PAPVR was identified during the follow up period. The anomalous pulmonary veins were connected to the left hepatic vein, left superior vena cava, and the right superior vena cava. Performing a pulmonary valve replacement, PAPVR was also corrected by an intra-atrial baffle with a new approach using the venous plexus between the left hepatic vein and the right hepatic vein.

Deep sternal wound infection (DSWI) with prosthetic graft infection is a rare, though lethal, complication after cardiovascular surgery via median sternotomy. This commentary is a review of a report by Takagi et al. published in the Journal of Cardiac Surgery that reported favorable outcomes in patients with DWSI with prosthetic graft infection treated with an enhanced strategy consisting of hydro-debridement with pulsed lavage and negative pressure wound therapies.

A systematized description of the morphology of congenitally malformed hearts is recognized as essential for the understanding of the important features that will determine the appropriate clinical and surgical approaches.

Cervantes-Salazar and colleagues report the long-term surgical outcomes of 414 patients with total anomalous pulmonary venous connection (TAPVC) from January 2003 to June 2019. With an overall survival rate of 87.2% from 2003 to 2019, the authors found that an increased mortality risk was associated with infra-cardiac TAPVC, pulmonary venous obstruction (PVO), and postoperative mechanical ventilation. Their comprehensive study with a large sample size of varying age groups, and patients with late referrals for surgery, provide valuable insight into TAPVC surgical outcomes. Improved survival for these patients continues to be a major goal of clinical teams striving to transform treatment paradigms. The comprehensive and promising results of the study reported by Cervantes-Salazar and colleagues gives our field hope for a better future for these patients.

There is no definitive animal HBV reservoir for transmission to humans. We reported a case of 48-year-old male with acute liver failure due to acute hepatitis B infection and considered the possibility of concomitant zoonotic hepatitis E (HEV) infection to explain the severity of his presentation.

Abstract BACKGROUND: Meniere’s disease (MD) involves cochlear and vestibular symptoms, but the underlying cause remains unclear. Findings predominantly show a low-to-mid-tone hearing impairment, and it is not possible to predict hearing improvement after an attack. OBJECTIVE: To examine whether improvement in hearing in definite MD (DMD) patients could be predicted using inner ear contrast magnetic resonance imaging (IEC-MRI) and pure tone audiometry (PTA) at the time of an attack. METHODS: Between April 2020 and March 2022, seven DMD outpatients were enrolled based on the Bárány Society DMD criteria. Patients were divided into two groups: a low-tone hearing loss (LTL) group and a low-to-mid-tone hearing loss (LMTL) group. Hearing improvement rates were examined. We also examined whether endolymphatic hydrops and hearing improvement were related. RESULTS: Endolymphatic hydrops was found in two of four LTL cases. One of three LMTL cases had prominent lymphedema. All LTL patients showed hearing improvements. Only one LMTL patient showed hearing improvement. Endolymphatic hydrops did not correlate with hearing improvement. CONCLUSIONS: It is not possible to estimate hearing improvement using IEC-MRI. PTA showed that LTL had a better hearing prognosis than LMTL. Therefore, it is possible to estimate hearing improvement using PTA.

This article is devoted to the study of the existence of an exponential attractor for a family of problems, in which diffusion $d_{\lambda}$ blows up in localized regions inside the domain \begin{equation*} \begin{cases} u_t^\lambda-\mathrm{div}(d_\lambda(x)(|\nabla u^\lambda|^{p(x)-2}+\eta ) \nabla u^\lambda)+ |u^\lambda|^{p(x)-2}u^\lambda=B(u^\lambda), & \mbox{ in } \Omega \\ u^\lambda = 0, & \mbox{ on } \partial\Omega\\ u^\lambda(0)=u^\lambda_0 \in L^2(\Omega),& \end{cases} \end{equation*} and their limit problem via the $l$-trajectory method.

There are real life situations in our lives where the things are changing continuously or from time to time. It is a very important problem for one whether to continue the existing relationship or to form a new one after some occasions. That is, people, companies, cities, countries, etc. may change their opinion or position rapidly. In this work, we think of the problem of changing relationships from a mathematical point of view and think of an answer. In some sense, we comment these changes as power changes. Our number theoretical model will be based on this idea. Using the convolution sum of the restricted divisor function $E$, we obtain the answer to this problem.

Continuous effort is dedicated to the discovery of potential drugs for the novel coronavirus-2 both clinically and computationally. Computer-Aided Drug Design CADD is the backbone of drug discovery, and shifting to computational approaches has become a need. Quantitative Structure-Activity Relationship QSAR is a widely used approach in predicting the activity of potential molecules and is an early step in drug discovery. 3CLpro is a highly conserved enzyme in the coronaviruses characterized by its role in the viral replication cycle. Despite the existence of various vaccines, the development of a new drug for SARS-CoV-2 is a necessity to provide cures to patients. In the pursuit of exploring new potential 3CLpro SARS-CoV-2 inhibitors and contributing to the existing literature, this work opted to build and compare three models of QSAR to correlate between the molecules’ structure and their activity: IC50, through the application of MLR, SVR, and SVR-PSO algorithms. The database was selected based on its novelty and proven activity, and its representative descriptors were obtained by the GA algorithm. The built models were plotted and compared following various internal and external validation criteria, and applicability domains for each model were determined. The results demonstrated that the SVR-PSO model performed best in terms of predictive ability and robustness, followed by SVR, and finally MLR. These outcomes prove that the SVR-PSO model is robust and concrete and paves the way for its prediction abilities for future screening of larger inhibitors’ datasets.

The patient was a 64-year-old woman, who stabbed her neck with a kitchen knife in an attempt to commit suicide. The tip of the knife was chipped and lodged into the first thoracic vertebra. It was removed using a drill.

Background The safe consumption of foods depends on their allergen content in relation to patient Low Observed Adverse Effect Level (LOAEL) and No Observed Adverse Effect Level (NOAEL), and other factors. In the case of milk, data on LOAEL and NOAEL is limited and conflicting. Objective To determine the threshold dose distribution and the lowest individual ED for milk in a large group of milk allergic patients Methods Individuals with confirmed cow’s milk allergy who underwent either a diagnostic or pre-oral immunotherapy (OIT) open milk oral food challenge in The Institute of Allergy, Immunology, and Pediatric Pulmonology at Shamir Medical Center, between 2010 and 2015 were included. A subgroup of patients with severe milk allergy underwent a modified challenge with 90-120 minute-interval following a dose of 0.3 mg cow’s milk protein. Results A total of 866 participants (193 with diagnostic challenges and 673 with pre-OIT challenges) were included in the study. The discrete ED 01 and ED 05, or values derived where 1% or 5% of the respective allergic population would be predicted to experience an allergic reaction, were 1.1-1.9 and 4.7-5.6 mg milk protein, respectively, and the values for cumulative doses for ED 01 and ED 05 were 0.9-1.8 and 5.2-6.2 mg milk protein, respectively. None of the patients, including the most severe milk allergic individuals who underwent the modified challenge, reacted to the first 0.3 mg protein dose. Discussion This report provides valuable information on milk NOAELs, LOAELs and EDs which might assist regulators in their decisions on food labeling in general, and for milk in particular. CLINICAL IMPLICATIONS The current study, using the largest studied population, demonstrates that milk NOAELs and LOAELs are higher than previously described. No patient reacted to <1mg milk protein. CAPSULE SUMMARY The finding of higher LOAEL and NOAEL and of a “safe dose” is important for mainly for regulators but as well as milk allergic patients and families in their decisions on milk labeling.

Advancing the construction of the proposed Zhe-Gan Canal in China would connect the major water systems of Poyang Lake and Qiantang River, opening up new channels for low-cost freight transportation, guiding industrial trade, and forming a new pattern of inland shipping. Here we analyze the regional environment, resources, and ecology in the proposed development zone of the Zhe-Gan Canal, to assess the potential for ecological protection of the river basin while promoting industrial transfers. We will also explore construction solutions for channel locks, water supply, environmental protection practices, and project investment. Thus, this study aims to give a holistic analysis of the comparative advantages of water transportation and the coordinated development of regional economies with the proposed construction of the Zhe-Gan Canal.

In order to control NOx in low-temperature flue gas in non-power industry and reduce the preparation cost of denitration catalyst. Using low-value solid waste, blast furnace slag, as raw material. After cooling, drying and grinding, the blast furnace slag becomes a powder with considerable fineness and meets the requirements of activity index, which is called GGBS (ground granulated blast furnace slag). Using GGBS as denitration catalyst carrier, and the active component n (n = Fe, Co, Ni, Cu and Ce) was loaded on Mn-based GGBS catalyst by impregnation method. It was studied that the effects of different active components on denitration and sulfur resistance of Mn-based GGBS catalyst. The denitration mechanism was analyzed by BET (Brunner-Emmet-Teller measurements), XRD (X-ray diffraction), XPS (X-ray photoelectron spectroscopy), SEM (scanning electron microscope) and FT-IR (Fourier transform infrared spectroscopy). The results show that: Mn-Ce/GGBS catalyst has better denitration and sulfur resistance.