Although, great achievements have been made in the synthesis of heterocycles using radical addition/cyclization strategy, developing versatile alkyl radical precursors, especially the non-stabilized ones for this method still remains a huge challenge. Herein, we report an efficient annulation cascade reaction between cyclosulfonium salts and alkenes for the synthesis of sulfur-containing N-heterocycles by visible light/copper catalysis under mild conditions. The C−S bond cleavage/radical cascade reaction delivers a variety of corresponding N-heterocycles containing aryl alkyl thioether motifs with good functional group tolerance. Significantly, the current system could be used for the late-stage functionalization of complex bioactive molecules.

The intestinal mucosal immune system is a specialized immune system that interacts closely with commensal microorganisms. The intestinal mucosal tissues are characterized by the way they generate immune responses to pathogens. The symbiotic flora in turn regulates the host's mucosal immunity, maintaining a dynamic balance. The disruption of the equilibrium between the two can result in intestinal disorders. This paper summarises in depth the relationships between the two and serves as a resource for future research.

This paper proposes a fully integrated low dropout (LDO) regulator with gate-couple flipped voltage follower(GC-FVF). The proposed GC-FVF addresses the limited output swing issue of conventional PMOS FVF in LDOs while maintaining a low output impedance. Besides, this LDO introduces a cascode compensation loop, which, along with the low output impedance of GC-FVF, pushes the output pole far away from the unity-gain bandwidth under both light and heavy load conditions. Consequently, the LDO becomes a stable two-pole system, supporting a high loop gain of up to 100dB and significantly enhancing the load and line regulation. Key specifications include a preset output voltage of 1.8V, a minimum unregulated input voltage of 2V, a maximum output current of 100mA, a ground current of 32μA, and an active chip area of 260μm×180μm. Notably, this LDO achieves high load regulation of 4.8μV/mA and high line regulation of 13.8μV/V without the need for off-chip capacitors.

A Case Report: Concurrent Treatment Challenges and Outcomes in Patients with Pulmonary Tuberculosis coexisting Lung CancerWANG Na1, SHU Cao 1, WANG Yajiao2, LIU Ke1.The First People’s Hospital of Zigong 1. Cancer Center 2. Tuberculosis Department, Zigong, China.Corresponding author: SHU Cao,Deputy Chief Physician, Cancer Center of The First People’s Hospital of Zigong,[email protected]: Although the coexistence of pulmonary tuberculosis and lung carcinoma is rare, it poses challenges to treatment strategies. Understanding the clinical features and treatment outcomes of such patients is clinically significant. Objective: To analyze the clinical characteristics and treatment outcomes of coexisting pulmonary tuberculosis and lung carcinoma, aiming to enhance clinicians’ comprehensive understanding of this condition. Methods: A retrospective analysis was conducted on a patient diagnosed with pulmonary tuberculosis coexisting with lung carcinoma at the First People’s Hospital of Zigong City. Pathological and microbiological diagnostics were employed, and the diagnostic and treatment experiences were summarized. Results: The patient was an elderly male presenting mainly with cough and hemoptysis. Diagnosis of pulmonary tuberculosis with concomitant squamous cell carcinoma of the lung was confirmed through CT, bronchoalveolar lavage fluid targeted next-generation sequencing (tNGS), and pathological biopsy. After anti-tuberculosis treatment, concurrent sequential radiotherapy, and two cycles of chemotherapy, the disease was assessed as partially relieved. Conclusion: Although the coexistence of pulmonary tuberculosis and lung carcinoma is rare, the comprehensive treatment in this case demonstrated favorable outcomes. Currently, there is no standardized treatment protocol for such patients, emphasizing the need for further research in this specific patient population.Keywords: pulmonary tuberculosis; non-small-cell lung cancer; radiotherapy; chemotherapy; anti-tuberculosis treatment.

Introduction: Spontaneous coronary artery dissection (SCAD) is a tear or separation within the coronary artery wall forming an intraluminal hematoma reducing downstream blood flow leading to myocardial ischemia (MI)(Figure 1A-C)1 . Intraluminal hematomas may develop from ”inside-out” due to endothelial-intimal injury or ”outside-in” due to injury within the vasa vasorum leading to bleeding in the wall. The subsequent false lumen from either mechanism can extend and compress the true lumen to cause MI [2]. Unlike other luminal etiologies of MI, SCAD is not caused by atherosclerotic plaque rupture, coronary intervention, or trauma [3]. With significant MI from intraluminal hematoma, patients can present with signs and symptoms that mimic MI including chest pain with and without radiation, dyspnea, nausea and vomiting. It can also include elevated troponin with electrocardiogram (ECG) changes consistent with ST segment elevation or non-ST segment elevation MI. The diagnosis is made when other etiologies of acute coronary syndrome (ACS) are ruled out and there is an angiographic evidence of non-iatrogenic or non-atherosclerotic radiolucent intimal flap and contrast staining [1]. Left anterior descending (LAD) artery is the most commonly affected branch of the left main coronary [4]. Severe stenosis can lead to heart failure as well as cardiogenic shock amongst other post-MI complications including ventricular arrhythmias, ventricular free wall or septal wall rupture. If angiography is inconclusive, then intracoronary imaging with optical coherence tomography or intravascular ultrasound may be considered before repeat angiography [5].The etiology of SCAD is thought to be multifactorial without a clear underlying cause. Risk factors associated include fibromuscular dysplasia (FMD), peri and postpartum period, hormonal fluctuations, and arteriopathies. SCAD is a rare cause of ACS, although when present, there is a higher prevalence in young females without cardiac risk factors [6]. Stable patients are treated conservatively with medication while percutaneous coronary intervention (PCI) and coronary artery bypass graft are reserved for severe stenosis and acute change in hemodynamics. Use of antiplatelet therapy remains controversial as medications such as acetylsalicylic acid (i.e. aspirin) and P2Y12 receptor blockers can worsen intraluminal hematoma. Dual antiplatelet therapy is recommended for those who undergo stent placement [5]. Similarly, guideline directed medical therapy is initiated for new onset of heart failure. Review of literature reveals 90% recovery within one month with coronary computed tomography angiography [5]. Many cases of SCAD have been reported in young females with ischemic symptoms and angiographic findings in the distal LAD but only few cases highlight proximal coronary involvement. We present a case of a young woman with extensive left main and proximal LAD SCAD requiring intervention.

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Title PageCase report title: Chronic Myelomonocytic Leukaemia Primarily Presenting as Life-Threatening Pericardial Effusion, Eldoret, Kenya: A Case reportAuthors: Victor M. Wauye1*, Evangeline Njiru1, Angela K. Amadi1, Mildred N. Hagembe2, Gabriel Kigen3

Insect immune response plays a crucial role in how external threats influence overall fitness through life history traits. An understudied question is how the use of different host plants might affect the ability of herbivorous insects to resist viral pathogens. The Melissa blue butterfly (Lycaeides melissa) has colonized the exotic legume Medicago sativa as a larval host within the past 200 years. Here we investigate how novel host plant use affects the immune response of L. melissa when infected with the lepidopteran virus, Junonia coenia densovirus (JcDV). We measured immune strength in response to JcDV in two ways: 1) direct measurement of phenoloxidase activity and melanization, and 2) transcriptional sequencing of individuals exposed to different viral and host plant treatments. Viral infection caused total phenoloxidase (total PO) to increase. We detected an interaction between viral infection and host plant for total PO: for control larvae, host plant use had no effect on total PO, whereas for infected larvae, total PO was significantly higher for larvae consuming the native host. Within the exotic host plant treatment, few genes were differentially regulated due to viral infection. Approximately two times more genes were differentially regulated in response to infection for larvae eating the native or exotic host, with differential expression of few putative immune genes. These results demonstrate that consumption of a novel host plant can alter both physiological and transcriptional responses to infection, emphasizing the importance of understanding diet when studying the molecular basis of immune function.

Background: We aimed to compare the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) in people living with human immunodeficiency virus (HIV) (PLWH) with those in the general population. Methods: This nationwide descriptive epidemiological study was conducted in South Korea between January 2020 and February 2022. The National Health Insurance claims data covering the whole nation were collected through the Health Insurance Review and Assessment Service. Results: Among 3,653,808 individuals who were diagnosed with COVID-19, 1,311 (0.04%) were PLWH. All the PLWH received antiretroviral therapy, and 26.47% had more than one underlying disease other than HIV infection. The overall in-hospital mortality rates of PLWH and the general population were 0.76% and 0.25%, respectively (P=0.002). According to the Cox proportional hazard model, no significant difference was observed in the in-hospital mortality rate [hazard ratio (HR): 1.80, 95% confidence interval (CI): 0.70–4.67] between PLWH and the general population. However, progression to severe or critical COVID-19 was more common in PLWH (HR: 2.70, 95% CI: 1.37–5.33). In PLWH diagnosed with COVID-19, a multivariable Cox regression analysis found old age (≥60 years old) (HR: 6.9; 95% CI 2.57–18.56) and diabetes mellitus (HR: 5.13; 95% CI: 2.02–13.00) as the independent risk factors for severe or critical COVID-19. Conclusions: PLWH had a significantly higher risk of severe or critical COVID-19 than that of the general population. Our findings suggest the need for applying differentiated strategies to decrease the impact of COVID-19 on PLWH.

Recreational boats are common in many coastal waters, yet their effects on cetaceans and other sensitive marine species remain poorly understood. To address this knowledge gap, we used drone videos to quantify how harbour porpoises (Phocoena phocoena) responded to a small motorboat approaching at different speeds (10 or 20 knots). The experiment was carried out in shallow waters near Funen, Denmark (55.51° N, 10.79° E) between July and September 2022. Porpoises moved further away from the boat path during approaches at both boat speeds. In addition, porpoises swam faster when approached at 20 knots but not when approached at 10 knots, and they had a higher likelihood of moving away from the boat path when approached at 10 knots but not at 20 knots. Importantly, the received sound level did not depend on how fast the boat approached, suggesting that differences in porpoise responses were related to the speed of the boat’s approach rather than to sound itself. The porpoises’ behaviour during the minute where the boat was closest did not differ from their behaviour before boat exposure, indicating that the direct impact of small vessels on porpoise behaviour was most likely small. Nevertheless, repeated exposure to noise from small vessels could influence porpoises’ foraging efforts and cause them to relocate from disturbed areas. The approach used in this study increases our understanding of recreational boats’ impact on harbour porpoises and can be used to inform efficient mitigation measures to help conservation efforts.

A document by Aasir Suliman. Click on the document to view its contents.

Modern technologies of computing cloud are showing great promise, but at the same time create new security challenges that hinder full acceptance. Given that most of these services often use cloud networks as channels for communication, securing data transmission is crucial. This paper proposes a hybrid encryption algorithm, the proposed two-layered PRC6 cipher, developed to achieve high security in cloud computing environments with minimal resource constraints. The PRC6 cipher incorporates enhancements from Cha-cha into an extension of the RC6 cipher. PRC6 implements double encryption. At the first level, the plain text is divided into four equal parts, each encrypted by processes derived from RC6, which include shifting, summation, modulo arithmetic, and XOR with a generated key. The second level incorporates a Quarter round function, among others, to further obscure the encoded message. PRC6 is implemented in a parallel computing model to significantly reduce overall computation time, especially important for lightweight applications. Experimental results show that the algorithm can achieve a high level of security for cloud workloads in only a few encryption rounds. Performance evaluations against popular encryption standards also indicate that PRC6 offers promising security benefits when computational resources are limited. This hybrid approach presents a viable solution for strengthening data protection in modern cloud systems.

A comprehensive understanding of the hydrochemical evolution and spatial patterns of shallow groundwater systems is essential for water resource management and wetland ecological restoration. The Baiyangdian Wetland is one of the most concerning areas because of the development of the Xiong’an New Area. The spatial characteristics of groundwater hydrochemistry and potential controlling factors associated with hydrochemical evolution remain unclear. In this study, hydrogeochemistry together with the hierarchical cluster analysis were used to elucidate the hydrochemical processes and hydrological zoning patterns of shallow groundwater systems in the Baiyangdian Wetland, North China Plain. The results showed that hydrochemical compositions of shallow groundwater had considerable spatial variations, which was closely related to the inflow rivers hydrochemistry and the dynamics of groundwater–surface water interactions. A significant increase in SO 4 2- concentration occurring at the cone of the depression was related to extensive pumping caused by anthropogenic activities. Anthropogenic activities were also a major factor controlling the spatial distribution patterns of shallow groundwater hydrochemistry. Ca 2+, Mg 2+, and SO 4 2- in the wetland and shallow groundwater were primarily derived from carbonate and gypsum dissolution, while Na + and Cl - originated from halite and silicate dissolution. Rock weathering predominated the geochemical evolution of shallow groundwater in conjunction with carbonate precipitation and cation exchange. The hydrochemistry of the shallow groundwater system presented distinct spatial zonation patterns that were classified into four clusters corresponding to seven subzones. In Zones Ⅰ–Ⅳ, water-rock interaction was the dominant factor controlling shallow groundwater chemistry, which was driven by the positive groundwater–surface water exchange. The coupled effects of anthropogenic activities and river infiltration and mixing caused the high levels of dissolved components in Zones Ⅴ–Ⅶ. This study provides deeper insight into the water cycle and hydraulic connections among different bodies, and will benefit the rational evaluation of hydrochemical evolution and wetland ecological restoration in the Baiyangdian Wetland.

In this paper, we study the stability and convergence of a conservative Crank-Nicolson finite difference scheme applied to the Korteweg-De Vries (KdV) equation endowed with initial data. We design a three-point average scheme associated to the convective term and the dispersion term is discretized by certain discrete operators along with the Crank-Nicolson scheme for the temporal discretization to establish that the proposed scheme is L 2 -conservative. The convergence analysis reveals that utilizing inherent Kato’s local smoothing effect, the proposed scheme converges to a classical solution for sufficiently regular initial data u 0 ∈ H 3 ( R ) and to a weak solution in L 2 ( 0 , T ; L loc 2 ( R ) ) for non-smooth initial data u 0 ∈ L 2 ( R ) . Optimal convergence rates in both space and time for the devised scheme are derived. The theoretical results are justified through several numerical illustrations.

Objective: This study aims to evaluate the effectiveness and patient satisfaction of Group Schema Therapy-Day Treatment (GST-d) in treating individuals with cluster B/C personality disorders. Method: The study utilized a naturalistic design with 39 patients undergoing 34 weeks of combined group and individual schema therapy. This included weekly full-day GST-d sessions, 15 individual sessions, and two group follow-ups. Results: Significant reductions were observed in psychological symptoms, personality issues, and dysfunctional schemas, with effect sizes (Cohen d’s) ranging from .77 to .87. Healthy modes showed a smaller effect size of .24. The dropout rate was 17.9%, but overall patient satisfaction remained high. Conclusions: The findings suggest the potential effectiveness of GST-d in treating personality disorders. Despite some limitations, the study recommends further research with a larger sample and randomized control trials to better understand the relationship between patient satisfaction and treatment outcome, as well as cost-effectiveness.

Bowen’s disease (BD) is a relatively rare early-stage squamous cell carcinoma in situ, most commonly affecting the middle-aged and elderly, and occurring on the skin or mucous membranes of various parts of the body. Its onset is concealed, the course of the disease is chronic, and some patients are accompanied by malignant tumors outside the skin, so it is necessary to diagnose and evaluate the disease in its early stage. This study aims to investigate the application of reflectance confocal microscopy (RCM) in diagnosing Bowen’s disease. We performed RCM imaging on the lesion site of 113 patients initially diagnosed with Bowen’s disease in clinic, of which 92 patients underwent skin biopsy for histological diagnosis. A retrospective analysis of the RCM result as well as the histological examination revealed that after analyzing RCM images, 69 out of 113 patients were diagnosed with Bowen’s disease; out of 92 biopsy lesions, 61 were Bowen’s disease, of which 54 were consistent with RCM diagnosis. Among 59 cases diagnosed with Bowen’s disease by RCM, 54 cases were consistent with histological diagnosis. Afterwards, we analyzed the RCM characteristics in patients with Bowen’s disease verified by biopsy, and compared the RCM images of two different lesions, Classic Bowen’s Disease (CBD) and Pigmented Bowen’s Disease (PBD), and further summarized the key points of Bowen’s disease under RCM. Finally, we focused on the differential characteristics between Bowen’s disease and other skin diseases under RCM. It is found that RCM is of great value in diagnosing Bowen’s disease.

Computationally efficient frequency-domain models can play a very important role in facilitating conceptual design optimization of floating wind turbines (FWTs). However, achieving sufficient accuracy in such models is challenging due to the nonlinear variation of the aerodynamic loads, particularly the interaction between the floating platform motions and the controller. Building on previously proposed approaches from the literature, this work implements and improves upon three methods to evaluate the influence of rotor dynamics on FWTs dynamics in frequency domain. The investigated methods rely on: coupled fixed-nacelle simulations in turbulent wind; decay tests in steady wind; and linearized analytical expressions of the steady state aerodynamic loads. The main objective is to assess the suitability of these methods for future optimization of the floating platform and the mooring system. The various techniques are compared through a case study of three semi-submersible FWTs with increasing rotor size. While all approaches have good accuracy below-rated wind speed, only the decay test approach provide good estimates of the wind-induced global responses across all tested conditions.

The lack of recovery of Chinook salmon (Oncorhynchus tshawytscha) in the Pacific Northwest has been blamed in part on predation by pinnipeds, particularly the harbor seal (Phoca vitulina). Previous work at a limited number of locations has shown that male seal diet contains more salmon than that of female seals and that sex ratios at haul-out sites differ spatiotemporally. This intrapopulation variation in predation may result in greater effects on salmon than suggested by models assuming equal spatial distribution and diet proportion. To address the generality of these patterns, we examined the sex ratios and diet of male and female harbor seals from 13 haul-out sites in the inland waters of Washington State and the province of British Columbia during 2012-2018. DNA metabarcoding was conducted to determine prey species proportions of individual scat samples. The sex of harbor seals was then determined from each scat matrix sample with the use of quantitative polymerase chain reaction. We analyzed 2,045 harbor seal scat samples using Generalized Linear Mixed Models (GLMMs) to examine the factors influencing harbor seal sex ratio at haul-out sites and permutational multivariate analysis of variance (PERMANOVA) to examine the influence of sex and haul-out site on harbor seal diet composition. We found that the overall sex ratio was 1:1.02 (female:male) with notable spatiotemporal variation. Salmoniformes were about 2.6 times more abundant in the diet of males than females, and Chinook salmon comprised ca. three times more of the average male harbor seal’s diet than the average female’s diet. Based on site-specific sex ratios and diet data, we identified three haul-out sites where Chinook salmon appear to be under high predation pressure by male harbor seals. Our study indicates that combining sex-specific pinniped diet data with the sex ratio of haul-out sites can help identify priority sites of conservation concern.