1. Landscape change is a key driver of biodiversity declines due to habitat loss and fragmentation, but spatially shifting resources can also facilitate range expansion and invasion. Invasive populations are reproductively successful, and landscape change may buoy this success. 2. We show how modelling the spatial structure of reproductive success can elucidate the mechanisms of range shifts and sustained invasions for mammalian species with attendant young. We use an example of white-tailed deer (deer; Odocoileus virginianus) expansion in the Nearctic boreal forest, a North American phenomenon implicated in severe declines of threatened woodland caribou (Rangifer tarandus). 3. We hypothesized that deer reproductive success is linked to forage subsidies provided by extensive landscape change via resource extraction. We measured deer occurrence using data from 62 camera-traps in northern Alberta, Canada, over three years. We weighed support for multiple competing hypotheses about deer reproductive success using multi-state occupancy models and generalized linear models in an AIC-based model selection framework. 4. Spatial patterns of reproductive success were best explained by features associated with petroleum exploration and extraction, which offer early seral vegetation resource subsidies. Effect sizes of anthropogenic features eclipsed natural heterogeneity by two orders of magnitude. We conclude that deer populations are likely buffered from overwinter mortality by landscape change, wherein early seral forage subsidies support high springtime reproductive success to offset or exceed winter losses. 5. Synthesis and Applications. Modelling spatial structuring in reproductive success can become a key goal of remote camera-based global networks, yielding ecological insights into mechanisms of invasion and range shifts to inform effective decision-making for global biodiversity conservation.

Food habits are important factors for wild nonhuman primates’ environment adaptation. White-headed langurs (Trachypithecus leucocephalus) are endemic to the limestone forest and face to the habitat fragmentation, which have to adjust the food habits to adapt the special environment. In this study, we compared the dietary data for white-headed langurs living in Chongzuo White-headed Langur National Nature Reserve over two separate study periods to evaluate interannual variations in diet. Our results indicated that young leaves were the preferred major food for the langur. The plant parts consumption pattern was similar between the two separate study periods. The consumption of young leaves was varied with the availability of young leaves, whereas the consumption of mature leaves was negative correlated with the young leaf’s availability. The consumption of plant species and diet diversity varied in the two separate study periods, which were higher in 2013 than 2016. In both 2013 and 2016, the diet diversity varied with the consumption of mature leaves, but negative correlated with the consumption and availability of young leaves. Dietary interannual variation probably linked to the phenology variations, or probably mean that the white-headed langurs has a flexible ecological adaptation coping with habitat fragmentation.

Triazolic fungicides are widely applied in crop production to protect plants against fungal pathogens. However, they may influence the biochemical processes in plants and other non-target species. This paper is aimed at the effect of triazoles (namely tebuconazole, cyproconazole and penconazole) single/mixed applications on the phenolics production in tomato (Solanum lycopersicum L.) fruit peel, amount of chlorophyll a and b in tomato leaves as well as on basic plant growth parameters. For this purpose, cherry tomatoes were planted in the pot experiment and foliarly treated weekly, with the same total triazoles dose of 3.52 µmol per plant (in mixtures of 1.71 or 1.17 µmol of each in two or three components, respectively). The treatments increased the weight of fruits in the 1st harvest about 43%, however, this effect was not observed in the next harvest. Increased oxidative stress in the triazoles presence was observed, based on the elevated production of antioxidant phenolics in the 1st harvest. Most alarming is the decrease of the weight of thin stems and foliage and the concentration of chlorophyll a (b) in leaves in all triazoles-treated variants. The non-target impacts on plant biochemical processes (related to the phenolics or chlorophylls production and functionality) were confirmed.

Bufonid herpesvirus 1 (BfHV1) was initially described in 2018 from cases of severe dermatitis in Swiss populations of the common toad (Bufo bufo). We identified a closely related herpes virus strain in a German toad population affected by an epidemic of multifocal proliferative to ulcerative dermatitis.

Mitral valve repair is the preferred treatment option in primary mitral valve disease especially degenerative mitral valve disease. Surgical results are quite successful with appropriate surgical techniques in suitable patients. But technically, surgery may result in any degree of narrowing of the orifice of the mitral valve. Also, surgical repair of rheumatic mitral valve disease is technically more demanding however, mitral repair is preferred over mechanical valve implantation if possible. İn this case report we presented the case of functional mitral stenosis after surgical mitral valve repair and annuloplasty ring implantation for rheumatic mitral regurgitation. Written and verbal consents of the patient were obtained prior to this case report.

Isolated congenital pulmonary valve regurgitation (IPVR) is very rare. Etiologies of absent pulmonary valve and bicuspid/dysplastic pulmonary valve are among the more common congenital causes of this condition. Here we present a rare cause of IPVR caused by absent single pulmonary cusp. Review of literature to establish timing and management of isolated pulmonary regurgitation is also attempted.

KeywordsDiabetes Mellitus; Parkinson’s disease; Glucose kineticsIntroduction Patients with Diabetes mellitus type 2 (T2DM) have a higher risk of developing Parkinson’s disease (PD) [1]. Parkinson’s disease and Diabetes mellitus (DM) share common pathophysiological pathways, such as oxidative stress and inflammation [2]. Results from experimental models revealed that persistent hyperglycemia causes dopaminergic dysfunction [3]. The presence of DM may also induce cognitive dysfunction in the elderly [4]. Since PD, like all neurodegenerative diseases, doesn’t start suddenly, the diagnosis of PD typically occurs when the disease has already progressed to a relatively late stage in which motor features are clearly evident and significant neurological damage has already occurred [5]. Thus characterization of non-motor features is potentially valuable for early identification of the disease [6]. The Movement Disorders Society (MDS) has recently published the Research Criteria for Prodromal PD [7]. Prodromal PD was defined as the presence of early signs and symptoms before PD diagnosis is possible [8]. The best characterized early non-motor feature for PD is REM sleep behavior disorder (RBD). The RBD is relatively specific for neurodegeneration, with high conversion rates, RBD is found in up to 60% in PD patients [9]. The time between RBD diagnosis and PD onset varies from 5 to 15 years, which allowing PD prediction [10]. The REM sleep behavior disorder screening questionnaire (RBDSQ) is widely used as an effective diagnostic screening tool for RBD in the general population, it can assess several features of RBD including the features of dreams, the movements during sleep, the relationship between dreams and the corresponding actions and sleep quality [11]. Not only DM, but also oral anti-diabetic agents (OADs) may modify the risk for PD [12]. Metformin is a well-known antidiabetic drug with a high safety profile, compound that targets both mitochondrial energy production and insulin signaling, it has neuroprotective activity but its therapeutic use in PD is not yet accepted [13]. On the other hand, high prevalence of abnormal glucose metabolism was observed in patients with PD [14]. DM was found to affect the clinical presentation and progression of PD [15]. DM has been previously associated with cognitive decline, gait difficulty, and faster motor abnormalities in PD [16]. The hyperglycemic condition caused by T2DM leads to dopaminergic neurons damage by several signaling pathways [17]. Thus, the effects of levodopa may be reduced in diabetic parkinsonian patients and additionally, these patients could be at higher risk for the development of motor impairment [18]. The present study was designed to evaluate the effect of DM on RBD as premotor features that may precede PD, the role of Metformin-inclusive Sulfonylureas therapy in DM-PD linkage, the glucose metabolism in non-diabetic idiopathic Parkinson’s disease (IPD) patients and the association between blood glucose and levodopa-induced motor complications in IPD patients.MethodsEthicsThe present study was approved by the Neurology department, Faculty of Medicine, Al-Azhar University and the Research Ethics Committee for Experimental and Clinical Studies, Faculty of Pharmacy, Ain-Shams University. The study was carried out in accordance with the regulations and recommendations of Declaration of Helsinki, where all the subjects signed a written informed consent for participation in the study.Design and Subjects A cross-sectional observational study was conducted in Al-Azhar University Hospital, on 120 participants: 60 diabetic patients (30 received Metformin-inclusive Sulfonylureas therapy, 30 received Sulfonylureas monotherapy), 30 IDP patients (22 of them are diabetic free, while the other 8 are diabetic) and 30 volunteers of the same age and sex, non-diabetic and non-parkinsonian were used as a control group. Idiopathic Parkinson’s disease patients included were being diagnosed according to the modified United Kingdom Parkinson Disease Society Brain Bank criteria. Secondary Parkinsonism and drug induced Parkinsonism were excluded. Diabetic patients included were treated with either Sulfonylureas monotherapy or combined with metformin with no modification of treatment over three months before assessment.Methodology All the participants were subjected to full investigations through history taking (age, sex, diseases history, drug history, family history and allergy history), laboratory data included: estimation of fasting blood glucose level (FBG) and serum glycated hemoglobin (HbA1c).Assessment of RBD as a premotor feature of PDFor (60) diabetic Patients, the RBDSQ score was recorded for evaluation of RBD risk compared with (30) controls and evaluation of metformin inclusive Sulfonylureas therapy versus Sulfonylureas monotherapy. The total score was 13 points, where a score of 5 points was considered the threshold for screening RBD [19].Glucose kinetics in PD” diabetic free” patientsThe kinetics of blood glucose levels during a 75-g Oral Glucose Tolerance Test (OGTT) was evaluated for (22) non-diabetic PD patients and (10) controls. Patients and controls were required to refrain from smoking 30 min before the test, with the withdrawal of all antiparkinsonian drugs for at least 10 h before the test (only for PD) and fasting overnight. Glucose values were recorded at fasting (T0), immediately followed by the oral administration of 75-g of glucose diluted in 250 ml of water. The patients had to drink the solution within 5 min. The test was discontinued if vomiting occurred. Then, blood glucose levels were subsequently assessed at 0.5 hr. (To.5), 1 hr. (T1), 1.5 hr. (T1.5) and 2 hr. (T2). The total area under time curve (AUC) mg.hr. / dL was calculated according to the trapezoidal approximation of Plasma glucose (PG) levels measured every 0.5 hour. The reference PG AUC was calculated as AUC =  \(\frac{\text{PG\ }\left(0\right)\ +\ 2\ X\ PG\ \left(\ 0.5\right)\ +\ 2\ X\ PG\ \left(\ 1\ \right)\ +\ 2\ X\ PG\ \left(\ 1.5\ \right)\ +\ PG\ (\ 2\ )\ }{4}\)Association between glucose level and motor complication of L-dopa among Parkinson’s patients The unified Parkinson’s disease rating scale (UPDRS) was assessed in all PD patients, comparison was made between Diabetics and diabetic free parkinsonian patients then a correlation between PG levels and motor abnormalities was done.Statistical analysis Recorded data were analyzed using the statistical package for social sciences, version 20.0 (SPSS Inc., Chicago, Illinois, USA). Quantitative data were expressed as mean ± standard deviation (SD). Qualitative data were expressed as frequency and percentage. P-value <0.05 was considered significant and P-value <0.001 was considered highly significant.ResultsDemographic dataThere were no significant differences between groups for demographic data, while hypertension was significantly higher in diabetics than controls and significantly higher in PD patients than controls. The demographic data of patients is represented in Table (1).Main outcomesThe RBDSQ score was recorded in (30) diabetics who received Sulfonylureas monotherapy and another (30) patients who received Sulfonylureas combined with metformin compared with (30) control. RBDSQ score presented as Median (IQR) gave the following results; “Sulfonylureas + Metformin group” 5.5 (6), Sulfonylureas group 5(6) and Control 2 (4). Analysis of the data by using Kruskal Wallis-H showed that there is a statistically significant difference between the groups (P<0.001). Where p-value of the Kruskal- Wallis test was <0.05, Mann-Whitney tests (corrected with Bonferroni’s method for multiple comparisons) were conducted to assess pair-wise relationships. The results revealed that RBDSQ is significantly higher in both diabetic groups than the control group, while no difference found between the (Sulfonylureas + Metformin) group and the (Sulfonylureas) group. The data are shown inFigure (1) . Positive and significant association between glucose level and RBDSQ score is presented in Supplementary data, A.Blood glucose kinetics after 75-g OGTT in diabetic free PD patientsAnalysis of the data by using Independent Sample t-test, blood glucose level was significantly higher in (22) non-diabetic PD patients at T1 (p <0.001) and T1.5 (p = 0.047) compared to (10) controls. Moreover, the total (AUC) for the blood glucose levels was significantly higher in PD patients (281.22 ± 52.25) compared to controls (245.65 ± 48.63) mg.hr. / dl; (p = 0.013). The data are shown in Figure (2).Association between glucose level and motor complication of L-dopa among IPD patients Motor abnormalities scores presented as Median (IQR) gave the following values; Idiopathic Parkinson’s Disease patients (n=22) recorded 1.5 (1) while Diabetic Idiopathic Parkinson’s Disease patients (n=8) recorded 4 (1). The results showed a statistically significant difference between subgroups according to motor abnormalities (P<0.001), The results are shown in Figure (3). Positive and significant association between glucose level and motor abnormalities is presented in Supplementary data, B.DiscussionMuch epidemiological evidence supports the positive association between DM and PD risk [20,21]. In the present study, several lines of evidence for a correlation between idiopathic Parkinson’s disease (IPD) and DM were found. They included the following; a) Diabetes was linked with Probable REM sleep behavior disorder (pRBD). However, OADs didn’t modify this risk, patients who received combination of Sulfonylureas and metformin recorded similar risk scores to those who received sulfonylureas monotherapy. b) PD patients had impaired glucose metabolism after OGTT. C) Further results showed that diabetic parkinsonian patients recorded higher UPDRS scores. No previous studies were conducted on Egyptian patients. The study investigated both the risk for diabetics to get Parkinson’s disease and the risk for IPD patients to get diabetes which may be a novel non-motor feature for PD. In the present study, the diabetic patients recorded higher scores of RBDSQ, which reflected higher risk for premotor symptoms; Patients who received metformin inclusive Sulfonylureas didn’t modify the risk of premotor symptoms compared with those who received only Sulfonylureas monotherapy. These findings agreed with a previous cohort study that was conducted to determine the effect of T2DM on PD incidence From the Taiwan National Health Insurance database, it concluded that Incident PD risk in T2DM increased 2.2-fold. However, current findings disagreed with the Taiwan study concerning the effect metformin inclusive Sulfonylureas [22]. Some studies give evidence that metformin can beneficially affect neurodegenerative disorders. The suggested mechanism is that metformin, the drug which causes sensitization to insulin, apart from diabetes treatment, beneficially affect serum lipid profiles, possess anti-inflammatory, anti-apoptotic action and anti-oxidative properties [23, 24]. However, in another previous study, anti-diabetic drugs such as metformin, sulfonylureas, and thiazolidinediones (rosiglitazone and pioglitazone) failed to reduce the risk of restoring the observed impairment in learning and cognition probably because of their: (i) rapid degradation; (ii) poor penetrance of the blood brain barrier (BBB); and (iii) inability to reduce insulin resistance in vivo [25]. The 75-g (OGTT) gives a prediction for future diabetes risk in addition to being considered the gold standard for diagnosing DM [26].  The current results supported the concept for impaired glucose metabolism in PD patients. Current results are consistent with those from a previous study that proved the dysregulation of blood glucose in PD patients following an OGTT [14]. Supposed mechanisms could include excessive endogenous glucose production (EGP) and/or insufficient glucose uptake [27]. Impaired glucose metabolism detected in PD patients could have been due to failure of beta cell to secrete insulin in response to the elevated blood glucose. Both beta cell proliferation and function are controlled by the autonomic system [28]. Thus, dysautonomia in PD may lead to beta cell dysfunction and insufficient insulin levels in response to high glucose levels.In the current study, higher scores of Levodopa-induced motor complications were associated with diabetes mellitus . Results from previous studies confirmed the association of L-dopa induced motor complications and DM [18, 30]. The proposed mechanism is that chronic dopamine stimulation has been suggested to trigger levodopa-induced motor complications [29]. Since chronic hyperglycemia reduces striatal dopaminergic activity in mice [30], it is possible that it may facilitate the development of levodopa-induced motor complications in diabetic parkinsonian patients [18], so diabetes mellitus may be an additional risk factor for levodopa-induced motor complications in PD patients.ConclusionDiabetics have higher RBD scores which may be a premotor feature of PD; metformin inclusive Sulfonylureas didn’t modify this risk in comparison with Sulfonylureas monotherapy. Glucose metabolism is impaired in PD patients which may be a novel non-motor complication of PD. Diabetes negatively affects levodopa induced motor complications.

Background The increase in the prevalence of aortic stenosis due to an aging population has led to an increasing number of surgical aortic valve replacements. Over the past 20 years, there has been a major shift in preference from mechanical to bioprosthetic valves. However, despite efforts, there is still no “ideal” bioprosthesis. It is crucial to understand the structure, biology, and function of native heart valves to design more intelligent, strong, durable and physiological heart valve tissues. Methods A comprehensive review of the literature was performed to identify articles reporting the basic mechanisms of bioprosthetic valve dysfunction and the biology of native valve cells. Searches were run in PubMed, MEDLINE® and Google Scholar. Search terms included subject heading and keywords for the following terms: “biological heart valve dysfunction”, “bioprosthesis dysfunction”, “bioprosthesis degeneration” and “tissue heart valves” Results All the relevant findings are summarized in specific illustrations and tables within the appropriate subsections. Structural dysfunction is a logical and expected consequence of the chemical, mechanical and immunological processes that occur during fixation, manufacture, and implantation. Conclusion Biological prosthesis valve dysfunction is a clinically significant process. It has become a major issue considering the growing rate of bioprosthesis implantation and improved long-term patient survival. Research on the field has improved in the past few years but there is still not an ideal bioprosthesis. Understanding bioprosthetic aortic valve degeneration from a basic science perspective is a key point to improve technologic advances and specifications that lead to new generation of bioprosthesis.

In order to provide a significantly richer representation of non-stationary signals appearing in various disciplines of science and engineering, we introduce here a novel fractional nonuniform multiresolution analysis (FrNUMRA) on the spectrum $\Lambda$ given by $\Lambda = \left\{0,\frac{r}{N}\right\}+2\mathbb{Z}$, where $N \geqq 1$ is an integer and $r$ is an odd integer with $ 1 \leqq r \leqq 2N-1,$ such that $r$ and $N$ are relatively prime. The necessary and sufficient condition for the existence of nonuniform wavelets of fractional order is derived and an algorithm is also presented for the construction of fractional NUMRA starting from a fractional low-pass filter $h_{0}^{\alpha}$ with appropriate conditions. Moreover, we provide a complete characterization for the biorthogonality of the translates of the scaling functions of two fractional nonuniform multiresolution analyses and the associated fractional biorthogonal wavelet families.

There is evidence of increased incidence, rapid progression, and poor prognosis of Covid-19 in patients with underlying comorbidities such as diabetes and epilepsy. It is crucial to develop effective treatment regimens for these patients. Multiple organ failure is the most common cause of death in Covid-19 patients.

White esophagus is an extremely rare disease and recognized to be the result of chronic ischemic injury. We report here successful treatment of a case of white esophagus accompanying multiple areas of circumferential duodenal erosion extending to the upper jejunum in a middle-aged male.

Phenotype of an unbalanced translocation is characterized by mutations in the translocated chromosome. We present the case of a fetus with a paternally derived unbalanced 46, XY, der(10)t(6;10)(p22;q26.1) translocation, detected following growth retardation and cardiac malformation. Our findings expand the known spectrum of unbalanced translocations for improved clinical management.

We experienced a unilateral alveolar hemorrhage associated with negative pressure pulmonary edema that occurred after long history of asthma patient bit the endotracheal tube during posture change at the end of surgery. We describe herein perioperative and intensive care management of unilateral pulmonary hemorrhage caused by biting endotracheal tube.

Sentiment analysis of social media posts and texts can provide information and knowledge that is applicable in social settings, business intelligence, evaluation of citizens’ opinions in governance and mood triggered devices in Internet of Things. Feature extraction and selection is a key determinant of accuracy and computational cost of machine learning models for such analysis. Most feature extraction and selection techniques utilize bag of words such as N-grams and frequency-based algorithms especially Term Frequency-Inverse document frequency (TF-IDF). However, these approaches suffer shortcomings such as; they do not consider relationships between words, they ignore words’ characteristics and they suffer high feature dimensionality. In this paper we propose and evaluate an approach that utilizes a fixed hybrid N-gram window for feature extraction and Minimum Redundancy Maximum Relevance feature selection for sentence level sentiment analysis. The approach improves the existing feature extraction techniques specifically the N-gram by generating a tri-gram vector from words, Part of speech tags and word semantic orientation. The N-gram vector is extracted by employing a static 3-gram window identified by a lexicon where a sentiment word appears in a sentence. A blend of the words, POS tags and the sentiment orientations of the 3N-gram are used to build the feature vector. The optimal features from the vector are then selected using Minimum Redundancy Maximum Relevance (MR2) algorithm. Experiments were carried out with a publicly available yelp tweets dataset to evaluate the performance of four supervised machine learning classifiers (Naïve Bayes, K-Nearest Neighbor, Decision Tree and Support Vector Machines) when augmented with the proposed model. The results showed that the proposed model had the highest accuracy (86.85%), recall (86.85%) and precision (86.96%).

Background: There is an urgent need to improve health outcomes among severe COVID-19 patients. Therefore, this study aimed to demystify efficacy and safety of tocilizumab among those patients based on the best available evidence. Methods: Nine electronic databases were searched for relevant studies by three authors in July using search terms “tocilizumab”, “COVID”, “SARS”. The last date checked was 26 August, 2020. Eligible studies were assessed through an inclusion criterion focused on cohort studies and severe COVID-19 adult patients. Any disagreement between the authors was resolved by discussions. Primary outcomes were mortality and clinical improvement, while secondary outcomes were tocilizumab-related adverse effects. Results: Tocilizumab reduced the mortality rate by 41%, 40%, 28%, and 37% in 7, 14, 21, and 28 days. There was neither statistically significant difference between the tocilizumab group and the control group in the clinical improvement (pooled risk ratio1.21 [0.89, 1.64]) nor in respiratory support change. There were no difference between the two groups in the occurrence of serious adverse events (pooled risk difference 0.00 [-0.02, 0.03]), bacteremia (pooled risk ratio 1.25 [0.80, 1.97]), elevation of liver functions (pooled risk difference -0.00 [-0.03, 0.02]) and infusion related reactions (pooled risk difference 0.01 [-0.02, 0.03]). However, the occurrence of neutropenia (pooled risk ratio 9.23 [1.06, 80.24]) and new infections (pooled risk difference 0.07 [0.00, 0.14]) were more likely in the tocilizumab group. Conclusion: Because of the reported adverse effects of tocilizumab in treating severe COVID-19 patients, the use of that biological agent should be limited to selected patients based on the best available evidence.

Background: Myocardial bridging (MB) is commonly treated in patients with hypertrophic cardiomyopathy (HCM). However, whether and how MB should be treated in patients with hypertrophic obstructive cardiomyopathy (HOCM) who underwent septal myectomy remain unclear. Methods: A total of 823 adults with HOCM who underwent septal myectomy at the Fuwai Hospital from 2011 to 2017 were retrospectively studied. Results: Overall, 31 events occurred: 24 patients died and 7 had nonfatal myocardial infarction (MI). The 3-year cumulative event-free survival of all-cause death (97.9% vs 100% vs 100% vs 98.4%, p=0.89) and cardiovascular death (98.3% vs 100% vs 100% vs 98.4%, p=0.63) were similar among the four groups (non-MB, CABG, unroofing, untreated, respectively). The 3-year cumulative event-free survival of nonfatal MI (100% vs 97.5% vs 98.0% vs 89.9%, p<0.001) and combined endpoints (97.9% vs 97.5% vs 98.0% vs 88.4%, p=0.02) were significantly lowest in untreated MB. Cox regression analysis indicated that untreated MB was a significant independent predictor of combined endpoints (hazard ratio [HR]: 4.06, 95% confidence interval [CI]: 1.60–10.32, p<0.001). Moreover, 49 patients underwent coronary artery computed tomography after surgery. The patency rate of the saphenous vein graft (SVG) was significantly higher than that of the left internal mammary artery (LIMA) (13.3% vs 84.2%, p<0.001). No MB was detected in the unroofing group. Conclusions: Surgical MB treatment could be beneficial and performed safely during septal myectomy. Myocardial unroofing is the recommended treatment for MB, and unroofing when technically possible may be preferable for long-term outcomes.

Severe fever with thrombocytopenia syndrome (SFTS), caused by the SFTS virus (SFTSV), is a new acute infectious disease transmitted by ticks. Rickettsiosis is caused by Rickettsia spp. carried by ticks. Here, we conducted case analyses and molecular biological diagnosis of some patients with suspected SFTS in Liaoning Province in 2019 to identify rates of SFTSV and Rickettsia coinfection. Molecular diagnostic results confirmed SFTSV infection in 5 out of 17 suspected SFTS patients. Two strains of genotype A SFTSV were successfully isolated from patient blood. Ticks collected from the patient’s locations had high positivity rates for SFTSV, which was highly similar to SFTSV from patients. Antibody testing of 7 patient serum samples revealed all samples to be positive for Rickettsia antibodies. These results indicate coinfection of SFTSV with Rickettsia that may complicate disease presentation and diagnosis. Therefore, coinfection of tick-borne disease should be considered for correct diagnosis and treatment.

Angiosperms show remarkable floral diversity. However, the ecological processes involved in flower diversification remain poorly understood. In this article I propose that different plant species abundance drives adaptation to different pollinators and promotes different degrees of specialization. In this view, interspecific variation in species abundance can foster floral diversification. I develop a mathematical model of pollen transfer considering the interaction of several pollination processes---pollen removal and carryover, intra- and interspecific competition for pollinator visitation, and interspecific pollen transfer---that are linked to floral abundance. To assess if and how floral abundance can generate floral diversity, I use the model to assemble plant-pollinator networks from simulated plant and pollinator communities. The model shows that evolution of flowers towards highly specialized pollinators and pollinators with high pollen carryover capacity is favoured at low floral abundance, while evolution on more abundant pollinators is favoured at higher abundance. Furthermore, floral specialization is favoured at low floral abundance, while generalization is favoured at high abundance. In simulated plant communities of variable floral abundance, different pollinator systems evolve among the different plant species. The model demonstrates a new mechanism by which floral diversity can be generated, contributing to our understanding of floral evolution and diversification.

The recent upsurge in the edible insect market has seen industrialisation and intensification without adequate regulatory policy guidelines in place. The species being reared and sold are often non-native, in rearing centres not equipped to contain the species, and in areas without regional or national pre-entry regulations, post-entry monitoring guidelines and early response programs to address escapee species. Such unregulated transport, trade and rearing of species, compounded by the policy and implementation loopholes at the regional, national and international levels will most likely lead to new biological invasions, as has been witnessed with other unregulated trade practices. To avoid this, it is necessary to monitor and regulate the species to be reared, to improve the quarantine guidelines of the rearing centres, and to be more stringent about the policies and practices that allow movements of non-native species across international borders.

A bone regeneration scaffold is typically designed as a platform to effectively heal a bone defect while preventing soft tissue infiltration. Despite the wide variety of scaffold materials currently available, such as collagen, critical problems in achieving bone regeneration remain, including a rapid absorption period and low tensile strength as well as high costs. Inspired by extracellular matrix protein and topographical cues, we developed a polycaprolactone-based scaffold for bone regeneration using a soluble eggshell membrane protein (SEP) coating and a nanotopography structure for enhancing the physical properties and bioactivity. The scaffold exhibited adequate flexibility and mechanical strength as a biomedical platform for bone regeneration. The highly aligned nanostructures and SEP coating were found to regulate and enhance cell morphology, adhesion, proliferation, and differentiation in vitro. In a calvarial bone defect mouse model, the scaffolds coated with SEP applied to the defect site promoted bone regeneration along the direction of the nanotopography in vivo. These findings demonstrate that bone-inspired nanostructures and SEP coatings have high potential to be applicable in the design and manipulation of scaffolds for bone regeneration.

L-cysteine is a ubiquitous and unique sulfur-containing amino acid with important physiological functions. The efficient L-cysteine production via microbial fermentation is interesting and has been paid great attention. In this study, different Escherichia coli K-12 strains (JM109, BW25113, MG1655, W3110) were investigated on their suitability to cysteine-producing plasmid pLH03. The enhancement of precursor synthetic pathway and thiosulfate assimilation pathway resulted in the good performance of BW25113. The expressions of synthetic pathway genes were optimized by two constitutive promoters to assess their effects on L-cysteine production. Main degradation pathway genes were also deleted coordinately for more efficient production of cysteine. The L-cysteine production was further increased through the manipulation of sulfur transcription regulator cysB and sulfur supplement. After the process optimization in a 1.5 L bioreactor, the final engineered strain LH2A1M0B△YTS-pLH03 [BW25113Ptrc2-serA-Ptrc1-cysM- Ptrc-cysB△yhaM△tnaA△sdaA-(pLH03)] accumulated 8.34 g/L of cysteine, laying a certain foundation for cysteine fermentation industry.

Attempting a comprehensive examination of the fetal heart remains challenging for unexperienced operators as it emphasizes the acquisition and documentation of sequential cross-sectional and sagittal views and inevitably results in diminished detection rates of fetuses affected by congenital heart disease. The introduction of three-/four-dimensional spatial-temporal image correlation 3D/4D STIC technology facilitated a volumetric approach for thorough cardiac anatomic evaluation by the acquisition of cardiac 4D datasets by analyzing and correlating numerous images from different heart cycles obtained during an automated sweep and subsequently displaying them in an endless cine loop sequence. However, postanalysis with manipulation and repeated slicing of the volume usually requires experience and in-depth anatomic knowledge, which limits the widespread application of this advanced technique in clinical care and unfortunately leads to the underestimation of its diagnostic value to date. Fetal intelligent navigation echocardiography (FINE), a novel method that automatically generates and displays 9 standard fetal echocardiographic views in normal hearts, has shown to be able to overcome these limitations. Very recent data on the detection of congenital heart defects (CHDs) revealed a sensitivity and specificity of 98 % and 93 %, respectively. In this two-part manuscript, we focused on the performance of FINE in delineating abnormal anatomy of typical right and left heart lesions and thereby emphasized the educational potential of this technology for more than just teaching purposes. We further discussed recent findings regarding these morphological changes seen in a pathophysiological and/or functional context.

Introduction: Lemierre’s syndrome, a rare complication of oropharyngeal infections, is caused by infective thrombophlebitis of the internal jugular vein and subsequent development of multisystem septic emboli. Case: A 16-year old male presented with two weeks of fever, myalgia, malaise, nausea/vomiting/diarrhea with weight loss, and a dry cough. He had previously been treated for pneumonia with three days of azithromycin. Chest imaging demonstrated bilateral cavitary lung nodules and blood cultures grew Fusobacterium necrophorum. Right jugular thrombophlebitis was later confirmed. Discussion: Lemierre’s syndrome is most common among previously healthy adolescents. It often presents following mild oropharyngeal infection and may be associated with multiple pulmonary complications including septic emboli, abscesses, necrotizing pneumonia, empyema, pneumothorax, pulmonary embolism, and acute respiratory distress syndrome. Delayed diagnosis may result in life-threatening morbidity or mortality, so pediatric pulmonologists must be aware of this rare disease and maintain a high index of suspicion in cases consistent with Lemierre’s syndrome.

Plastic bronchitis in a toddler born preterm Jinfang Yuan M.D, Ling Liu M.D, Wei Zhou M.D, Xiaomei Tong M.D, Tongyan Han M.D Department of Pediatric, Peking University Third Hospital, Beijing, China