Laparoscopic surgery is the standard of care for various abdominal pathologies due to apparent advantages. Nevertheless, the initial steps of the Veress needle or trocar are inserted blindly in laparoscopic surgeries, which may cause major vascular, bowel, or urinary tract injuries. We report two cases of vascular laparoscopic entry injuries.

Sweet Syndrome, or acute febrile neutrophilic dermatosis, is characterized by tender erythematous skin lesions (Figure 1 and 2) frequently associated with fever and leukocytosis. Despite being an uncommon inflammatory disease, it is triggered by infections, pregnancy, drugs and malignancy. We report a case of a man diagnosed with Sweet Syndrome.

Suturing the retroperitoneum is a common technique in laparoscopic hysterectomy, which is reported to reduce vaginal cuff infection and organ evisceration in case vaginal cuff dehiscence occurs. However, physicians should take into account that it may cause internal hernia.

One of the serious side effects of COVID-19 vaccines is vaccine-induced immune thrombotic thrombocytopenia (VITT). A young man presented with pulmonary thromboembolism 7 days after receiving inactivated COVID-19 vaccine BIBP developed by Sinopharm/China. Close surveillance of possible adverse reactions a crucial step to encourage population to participate in vaccine campaign.

We report a case of radiation-induced myofibroblastoma of the right nasal cavity in a patient with a remote history of radiotherapy for pediatric retinoblastoma. The patient required maxillectomy and ethmoidectomy. To our knowledge, a rare number of cases have been reported in this location.

Mitigating Esophageal Injury after Atrial Fibrillation Ablation Guided by Ablation Index; CLOSEr to goalJason S. Chinitz, MD1 and Eli Q. Harris, MD21.South Shore University HospitalNorthwell HealthBay Shore, NY2. Nassau University Medical CenterEast Meadow, NYFinancial support : none.Disclosures : Dr. Chinitz serves on the scientific advisory board for Biosense Webster and has received consulting fees

Aim Antidepressants are well-established fall-risk increasing drugs(FRIDs) and therefore falls should be considered an important adverse drug event(ADE) of antidepressants. However, not all antidepressant users experience fall incidents and factors associated with increased fall risk among antidepressant users are incompletely understood. Our objective was to explore whether antidepressant plasma concentrations are associated with falls in older antidepressant users. Methods For this study, we included antidepressant users of the multicenter B-PROOF study. Fall incidents were recorded prospectively using fall calendars. Antidepressant plasma concentrations were analyzed by Liquid chromatography-mass spectrometry(LC-MS) at baseline and at 2 years follow-up. The associations between the observed antidepressant concentration, or concentration change over time (delta) and fall risk were assessed using Cox proportional hazard and logistic regression models and adjusted for potential confounders. Results In total 93 selective serotonin reuptake inhibitor(SSRI) and 41 antidepressant(TCA) users were identified. There was a significant association between baseline TCA plasma concentration and fall risk within users (HR 2.50, 95% CI 1.07-5.87, crude model). Adjusted there were no significant associations between concentrations of SSRIs and fall risk. Also, for delta concentrations there was no association with fall risk in users. Conclusion There might be an association between plasma concentrations of TCAs and the risk of falling in older users. However, these results needs to be interpreted with caution considering the small sample size and accompanying limitation of confinement to crude analyses. Therefore, replication in a larger cohort, preferably including adjustment for potential confounders and more frequent measures of plasma concentrations is needed.

Invasive species can successfully and rapidly colonize new niches and expand ranges via founder effects and enhanced tolerance towards environmental stresses. However, the underpinning molecular mechanisms (i.e., gene expression changes) facilitating rapid adaptation to harsh environments are still poorly understood. The red seaweed Gracilaria vermiculophylla, which is native to the northwest Pacific but invaded North American and European coastal habitats over the last 100 years, provides an excellent model to examine whether enhanced tolerance at the level of gene expression contributed to its invasion success. We collected G. vermiculophylla from its native range in Japan and from two non-native regions along the Delmarva Peninsula (Eastern United States) and in Germany. Thalli were reared in a common garden for four months at which time we performed comparative transcriptome (mRNA) and microRNA (miRNA) sequencing. MRNA-expression profiling identified 59 genes that were differently expressed between native and non-native thalli. Of these genes, most were involved in metabolic pathways, including photosynthesis, abiotic stress, and biosynthesis of products and hormones in all four non-native sites. MiRNA-based target-gene correlation analysis in native/non-native pairs revealed that some target genes are positively or negatively regulated via epigenetic mechanisms. Importantly, these genes are mostly associated with metabolism and defense capability. Thus, our gene expression results indicate that resource reallocation to metabolic processes is most likely a predominant mechanism contributing to the range-wide persistence and adaptation of G. vermiculophylla in the invaded range. This study therefore provides a novel molecular insight into the speed and nature of invasion-mediated rapid adaption.

Exploring the driving forces promoting speciation is a key question in evolutionary biology. Cycas bifida and C. micholitzii are two leaflets dichotomously divided Cycas species that have morphological similarities. Their distribution areas are separated by the RRFZ, a biogeographical barrier for Cycas species. The hypothesis for explaining their divergence is geographical isolation or convergent evolution. Three chloroplast DNA fragments, five low copy nuclear genes and 16 microsatellite loci were used to test this hypothesis and also to reveal their population genetics. The two species had high genetic differentiation but low gene flow with a deep divergence occurred in the late Miocene. The long-term geographical isolation not convergent evolution could explain for the divergence of the two species revealed from significant IBD testing, Barrier analysis and Niche consistency detection. Subsequently, each species made its own response to the Pleistocene climate fluctuations: a weak bottleneck effect in C. bifida and a population expansion in C. micholitzii. These findings imply that the role of geographic isolation rather than convergent evolution facilitates them divergence by constraining gene flow. Maybe they have gene flow or introgression with their neighboring distribution of Cycas species, making them genetically closer to neighboring Cycas species.

A modified range-Doppler algorithm (M-RDA) for high squint synthetic aperture radar (SAR) imaging is proposed in this letter. In the M-RDA, the range walk (RW) is removed firstly by multiplying a preprocessing function in range frequency-azimuth time domain, which is the dominant component of the totle range cell migration (RCM). There is no interpolation operation in the proposed M-RDA, which greatly improves its computational efficiency. To obtain a well-focused SAR image, the fourth-order phase error is considered to achieve accurate azimuthal compression. Finally, the effectiveness of the proposed algorithm is proved by the point target simulation results.

In this paper, we study a class of doubly nonlinear parabolic equations (1.1). The nonlinearity B(u) brings great difficulties to the study of the problem. First we show that the problem has a unique solution. Then we prove that the process corresponding to the problem is norm-to-weak continuous. After that, by using Legendre transform, we obtain uniform estimates and asymptotic compactness properties that allow us to ensure the existence of pullback D-attractors for the associated process to the problem

The purpose of this paper is to investigate a class of nonconvex constrainted differential hemivariational inequalities consisting of nonlinear evolution equations and evolutionary hemivariational inequalities. The admissible set of constraints is closed and star-shaped with respect to a certain ball in a reflexive Banach space. We construct an auxiliary inclusion problem and obtain the existence results by applying a surjectivity theorem for multivalued pseudomonotone operators and the properties of Clarke subgradient operator. Moreover, the existence of solution of original problem is established by hemivariational inequality approach and a penalization method in which a small parameter does not have to tend to zero. Finally, an application of the main results is provided.

Spherical particle catalysts (PILs-XSS) were synthesized by suspension polymerization, which was characterized by SEM-EDS, FT-IR, TG, and BET-BJH. The characterization results showed that PILs-XSS had a specific core structure, a certain pore size (14.3nm), and surface area size (71.5m2/g), and remained stable at 293.4 °C. The catalyst performance was evaluated by a one-pot synthesis of dimethyl carbonate. The process conditions were optimized in detail. The optimal reaction conditions were as follows: the dosage of PILs-XSS was 2.5 wt %, the CO2 pressure was 1.5 MPa, the reaction temperature was 100 °C, the reaction time was 4 h, the molar ratio of methanol to propylene oxide （PO）was 3: 1, and the dosage of cocatalyst Na2CO3 was 3 wt %. Under the optimum conditions, the conversion of PO was up to 98.8 % and the yield of DMC reached 53.7 %.

Oblique collisions of two spherical particles coated with a thin layer of viscous liquid are considered. Experimental measurements are performed using particle tracking velocimetry. Comprehensive experimental data for collisions with an impact angle between 0° - 60° are presented. Collisions are characterised by the Stokes’ number, the coefficient of restitution, and the rotational velocity. The experiments are compared to numerical simulations using the discrete element method (DEM). The translational velocities predicted by the simulations were in good agreement with the experiments at high Stokes’ number, where the models are dominated by the normal components. As the tangential forces become more significant (i.e. at low to medium Stokes’ number, and high collision angle), agreement between the simulations and experiments is poorer. At low Stokes’ number the translational velocities were in good agreement with the experiments, but was poorer at high Stokes’ number.

Discovery of remarkable porous materials for CO2 capture from wet flue gas is of great significance to reduce the CO2 emissions, but elucidating the most critical structure features for boosting CO2 capture capabilities remains a great challenge. Here, machine learning assisted computational screening on 516 experimental covalent organic frameworks (COFs) identify the superior secondary building units (SBUs) for wet flue gas separation, which are tetraphenylporphyrin unit in sql-type COFs and functional groups. Accordingly, 1233 COFs are assembled using the superior SBUs. Combined with DFT calculations, the “electron-donating induced vdW interaction” effect is discovered to design better-performing COFs with superior CO2 uptake, which can achieve 4.4 mmol·g-1 with CO2/N2 selectivity of 104.8; while the “electron-withdrawing induced vdW+electrostatic coupling interaction” effect is proposed to design better-performing COFs with superior CO2/N2 selectivity, which can arrive 277.6 with CO2 uptake of 2.2 mmol·g-1, in this case, H2O contributes to improving the CO2/N2 selectivity.

An EMI-reduction charge pump circuit with hybrid modulation is proposed for the motor driver circuits. Periodic modulation technique changes the range of spread spectrum as coarse modulation. Random modulation technique, as fine-tuning, changes its edge delay to slow the speed of switch-edge. Simultaneously, the proposed buffer circuit can limit the charge and discharge current of the charge pump and reduces the variation of the current peak. Compared with the circuit without modulation, EMI is reduced by up to 28dB. The proposed design fabricated in a 0.18um BiCMOS process occupies an area of 0.173mm$^{2}$, and its power consumption is 5.677mW.

Background: Whether Lung ultrasound (LUS) can be used for pathogenic diagnosis is still controversial. This was conducted to test the accuracy and reliability of ultrasound in the diagnosis of pneumonia and to clarify whether ultrasound has diagnostic value for the etiology. Methods: A total of 135 neonatal pneumonia patients with an identified pathogen and 50 newborns with normal lungs in the newborn intensive care unit of 10 tertiary hospitals in China were enrolled. The study ran from November 2020 to December 2021. The infants were divided into various groups according to pathogens, the time of infection, the gestational age, the severity of the disease. The distribution of pleural line abnormalities, pulmonary edema, and pulmonary consolidation, as well as the incidence of air bronchogram and pleural effusion based on LUS, were compared between the above groups and between the pneumonia and healthy control groups. Results: There were significant differences in pulmonary consolidation. The sensitivity and specificity of the diagnosis of severe pneumonia based on the extent of pulmonary consolidation were 83.3% and 85.2%, respectively. The area under the receiver operating characteristic curve for the identification of mild or severe pneumonia based on the distribution of pulmonary consolidation was 0.776. Conclusion: Lung ultrasound has good performance in differentiating the severity of neonatal pneumonia, but cannot be used for pathogenic diagnosis.

Objective: To investigate the regulatory role of microRNA-34a-5p on vascular endothelial growth factor (VEGF) in the course of bronchopulmonary dysplasia (BPD). Methods: Build the SD rats BPD model. 10 rats were randomly selected on postnatal days 1, 7, 14 and 21 to observe the morphological changes of rat lung tissue. Quantitative Real-time PCR (qRT-PCR) technique detection of miR-34a-5p and VEGF mRNA expression. Elisa was used to detect VEGF expression levels in lung tissues. RLE-6TN cells were divided into the miR-34a-5p-mimic group, miR-34a-5p-inhibitor group, NC group, and inhibitor-NC group. QRT-PCR technique was used to detect the expression of miR-34a-5p and VEGF mRNA levels, and Western blot was used to detect VEGF protein expression levels. Results: As the number of days increased, the lung tissues of rats in the experimental group showed pathological changes of “new BPD”. The expression levels of miR-34a-5p in experimental group were significantly higher than those in control group on day 14 and day 21, and the expression of VEGF mRNA and protein in experimental group were significantly lower than those in control group from day 14 onwards. The differences were all statistically significant (P<0.05). In the cell model, the expression of VEGF mRNA and protein levels in miR-34a-5p-mimic group decreased compared to the NC group, while the expression of VEGF mRNA and protein levels in miR-34a-5p-inhibitor group increased compared to inhibitor-NC group, and the differences were statistically significant (P<0.05). Conclusion: MiR-34a-5p may be involved in the pathogenesis of “new BPD” through the regulation of VEGF.

Introduction Previous generations of CFTR modulation have been shown to temporarily decrease the frequency of culture positivity of P. aeruginosa and other respiratory pathogens. Recently, a three-drug combination Trikafta (elexacaftor/ivacaftor/tezacaftor) was approved for individuals with at least one F508del mutation. There is limited data on the effect of CFTR modulators on bacterial density and CF microbiome. Methods Our study included 2 separate forms of data collection: Firstly, a retrospective chart evaluation of routine respiratory cultures 1.5 years before and after initiation of Trikafta. Respiratory culture density was recorded based upon the growth fraction of standard respiratory plate: none (0/4), scant (1/4), light (2/4), moderate (3/4), and large (4/4). The second data measurement included obtaining next-generation sequencing (NGS) for bacterial and fungal abundance of post-Trikafta initiation patients only. Results There was a significant density decrease in P. aeruginosa (1.5 vs 1.19, p= 0.01), S. aureus (2.47 vs 1.9, p= 0.002), A. denitrificans (1.39 vs,1.14, p=0.02), E. coli (1.09 vs 1.00, p=0.045) before and after initiation of Trikafta. On the NGS the 5 most abundant bacteria after Trikafta initiation were : S. salivarius, S. parasanguinis, R. mucilaginosa, V. atypica, and P. histocola. Conclusion Our study results demonstrate that there is a significant decrease in the density of known CF pathogenic bacteria. NGS post-Trikafta has shown abundance of anaerobic bacteria ( S. salivarius, S. parasanguinis, R. mucilaginosa, V. atypica, and P. histocola) that have been linked to improved clinical lung stability, lower airway inflammation and increased polymicrobial diversity.

The authors herewith present a case of a non-conventional use of endotracheal tube-based IONM in a second-stage total thyroidectomy for metastatic papillary cancer incidentally detected after OPHL Type IIa + ary left for SCC. The use of the IONM in such case was effective avoiding the RLN accidental injury.

Extensive ecological projects, including terracing engineering and vegetation rehabilitation, have been implemented in many water-limited mountains across the world, aiming to combat drought and control water erosion. Nevertheless, due to the complexities of climate, terracing, and vegetation types in actuality, knowledge gaps regarding the role of terracing on water balance remain. Therefore, to better understand the influence of terraces on water budget in a normal (2015) year and dry (2016) year, a field experiment was conducted in a typical dry loess hilly area of China. The effects of adverse grade tableland terraces, fish-scale pits and the natural slope on water content change were analyzed on the slope of Platycladus orientalis by the water-balance technique and equations. The results showed that, compared with natural slope, terraces had higher water budget benefits both in dry year (+ 1.08~12.24 mm) and normal water year (+ 15.71~27.29 mm), and adverse grade tableland terrace had the best performance. Although precipitation was the primary factor affecting water inputs, terraces can significantly increase soil water content. Evapotranspiration and runoff were the main water loss terms, but terrace also can help to reduce runoff water loss. Overall, transformation of terraced fields can optimize the forest structure and improve the eco-benefits at the slope scale.

In order to explore the possibility of C2HF3Cl2 (R123) for the fire extinguishing agent of aircraft cargo compartment, this paper conducted experimental and theoretical research on the fire extinguishing performance and mechanism of R123, furthermore, the analogous C2HF5 (R125) was compared to explore the in-depth fire extinguishing mechanism. The minimum extinguishing concentration (MEC) of R123 in methane/air flames is 7.31 %, which is lower than 8.91 % of R125. And the experimental results reveal interesting examples of flame height and temperature changed with the addition of R123. The flame height had a phenomenon to increase first and then decrease, in comparison, the flame height kept rising with R125 adding. And the change in height reflected the addition of R123 to affect the movement of the reaction kernel, so that the temperature at different heights changed, but the temperature as a whole showed the tendence of decreasing. In addition, theoretical calculations indicated that R123 and pyrolysis products could affect the combustion reaction, such as CF3CHCl2+H=CF3CHCl+HCl, HCl + OH = Cl + H2O, CF3CH2Cl=CF3+CH2Cl, these fluorine-containing or chlorine-containing groups generated had an excellent effect on the suppression of combustion chain reactions. The in-depth experimental and theoretical study of R123 boost the development of ideal halon replacement in aircraft cargo compartment.

A new PES-C/emodin ultrafiltration membrane was prepared by blending natural emodin with phenolphthalein polyethersulfone (PES-C), and it was used to purify [acanthopanax](javascript:;) [senticosus](javascript:;) injection in this study. For the purified [acanthopanax](javascript:;) [senticosus](javascript:;) injection, its color became lighter and its clarity increased. On the contrary, for [acanthopanax](javascript:;) [senticosus](javascript:;) injection containing macromolecules, its color deepened and its turbidity increased. Thermal stability of the purified [acanthopanax](javascript:;) [senticosus](javascript:;) injection was the best, followed by the original solution of [acanthopanax](javascript:;) [senticosus](javascript:;) injection, and [acanthopanax](javascript:;) [senticosus](javascript:;) injection containing macromolecules was the worst. The finger-print spectrum of the purified [acanthopanax](javascript:;) [senticosus](javascript:;) injection was similar with the original solution of [acanthopanax](javascript:;) [senticosus](javascript:;) injection, the relative peak area of each single peak was greater than 0.95, and the relative peak area of the total peak was greater than 0.96. Compared with the original solution of [acanthopanax](javascript:;) [senticosus](javascript:;) injection, the histamine release amount and cell degranulation rate of [acanthopanax](javascript:;) [senticosus](javascript:;) injection containing macromolecules increased more, while those of the purified [acanthopanax](javascript:;) [senticosus](javascript:;) injection decreased, which reduced the risk of allergic reaction at a certain extent. “Inverse proof” confirmed that the [acanthopanax](javascript:;) [senticosus](javascript:;) injection containing macromolecules had certain liver and kidney toxicity, which indirectly proved that the liver and kidney toxicity of the purified [acanthopanax](javascript:;) [senticosus](javascript:;) injection was effectively reduced.

A 48-year-old woman was diagnosed with right-sided Grade 2 invasive breast carcinoma. Prior to initiation of chemotherapy, transthoracic echocardiogram (TTE) demonstrated normal systolic function with left ventricular ejection fraction (LVEF) 64% and global longitudinal strain (GLS) 21%. Following adjuvant chemotherapy with four cycles of anthracycline, twelve cycles of Paclitaxel, and two cycles of Trastuzamab chemotherapies, TTE demonstrated reduction in LVEF to 56% and GLS of -18% (14% relative reduction compared to baseline). Further investigation revealed recent symptomatic COVID-19 infection coinciding with functional impairment and decision was made to continue Trastuzumab therapy without cardioprotective agents. Subsequent TTE demonstrated improved systolic function, indicating the importance of taking history of significant viral infections during chemotherapy standard of care.