Biofilm communities cause many infectious diseases. Biofilms are diverse microbial species found either attached to a surface or aggregated into an extracellular matrix. Bacteria form biofilms as a default mode of growth or as a response mechanism to environmental conditions like stress. As such, biofilm strains are increasingly virulent causing a wide variety of chronic persistent diseases, are typically antibiotic-resistant and known to improve host mortality rate. Most biofilms contain polysaccharides, proteins, extracellular DNA (eDNA), RNA, and water. Determining and quantifying the major components of a biofilm may indicate an appropriate treatment for biofilm eradication. Burkholderia pseudomallei is a Gram-negative, motile bacillus typically found in surface water and/or soil in endemic regions. It is the etiologic agent of melioidosis and is capable of forming both surface adherent and air-liquid interface biofilms (pellicle) in broth cultures. This study evaluates the components of established biofilms using B. pseudomallei and Burkholderia thailandensis, a closely related nonpathogenic species. Using assays, fluorescent dyes and microscopy, we quantified the major components of biofilms produced by five genetically related B. pseudomallei strains and compared them to B. thailandensis E264. Our data show that biofilm produced by the B. pseudomallei 1026b derivatives and B. thailandensis E264 significantly differ. The molecular composition of the surface adherent biofilm is similar to the molecular composition of the air-liquid pellicle. Finally, the eDNA quantity biofilm produced by JW270 which bears a CPS I deletion, is significantly increased in comparison to 1026 and Bp82 biofilm.

This work discusses the results from tests conducted to investigate the uniaxial compression and creep behavior of red sandstone. The original untreated sample and the 800 ℃ treated sample have been selected to carry out the experiments. It has been found that high temperature has obvious influence on the mechanical properties of red sandstone. The relationship between creep strain and instantaneous strain, as well as instantaneous deformation modulus and creep viscosity coefficient have been analyzed. It has been found that high temperature reduces the ability of red sandstone to resist instantaneous deformation and creep deformation. Acoustic emission (AE) technology has been also used in the loading process of uniaxial compression and creep tests, providing a powerful means for damage evolution analysis of red sandstone.

Water resource management in ungauged catchments is complex due to the uncertainties around the hydrological parameters that dominate the streamflow behaviour. These parameters are usually defined by regionalization approaches in which hydrological response patterns are transferred from gauged to ungauged basins. Regression-based methods using physical properties derived from cartographic data sources are widely used. The current remote sensing techniques offer us new standpoints in regionalisation processing since the hydrological response depends on the physical attributes related to the spectral responses of the territory. Moreover, machine learning approaches have not been specifically applied to the regionalization of hydrologic parameters. This work studies the capability of a catchment’s spectral response based on Sentinel-1 and Sentinel-2 data to address a regression-based regionalization of hydrological parameters using a machine learning approach. Hydrological modelling was conducted by the HBV-light model. We tested the random forest algorithm in several regionalization scenarios: the new approach using the catchments’ spectral signature, the traditional method using physical properties and a fusion of them. The calibration results were excellent (median KGE = 0.83), and the regionalized parameters obtained with the random forest algorithm achieved good performance in which the three scenarios showed almost the same goodness of fit (median KGE = 0.45 to 0.50). We found that the effectiveness depends on the climatic environment and that predictions in humid catchments exhibited better performance than those in the driest catchments. The physical approach (median KGE= 0.71) exhibited better performance than the spectral approach (median KGE= 0.64) in humid catchments, whereas spectral regionalization (median KGE= 0.33) outperformed the physical scenario in the driest catchments (median KGE= 0.25). Herein, our results confirm that regionalization is still challenging in Mediterranean climate variants where the new spectral approach showed promising results and time series of satellite data could improve seasonal regionalization methodologies.

This work deals with the analysis in the frequency domain of the temperature signal and mechanical energy rate of C45 steel under two different fatigue stepwise loading series at stress ratios of 0.1 and -1. It was first investigated the energy distribution among the harmonic components of the signals to understand possible variations caused by a different stress ratio. In addition, the second amplitude harmonic (SAH) of heat dissipated and mechanical energy rates have been considered in the analysis and their relationship was investigated. It has been shown as it depends only on the material, hence it is valid whatever the kind of the test is without any assumption on the energy supplied to the material or material hysteresis loop stabilisation. The adopted approach allows the analysis of intrinsic dissipations by means of rapid, full-field and contactless techniques without any specific requirement on loading condition or temperature signal stabilisation.

Laser powder bed fusion (L-PBF) is an additive manufacturing (AM) process which offers several advantages over conventional manufacturing techniques, including material savings and design possibilities. For these reasons several industrial sectors such as biomedical, aerospace and automotive, are considering L-PBF for customized parts production. Among the processable material palette, Ti6Al4V gained increasing interest due to the high specific strength, and stiffness, and excellent bio-compatibility, and corrosion resistance. However, to include L-PBF Ti6Al4V parts in load bearing applications it is important to properly understand the mechanical properties of AM’ed materials with a specific focus on fatigue behaviour. In this study the fatigue notch sensitivity of Ti6Al4V L-PBF manufactured specimens is investigated in depth. Samples with different notches were subjected to stress relieving heat treatment to generate a fine α+β microstructure. The results were used to define a relation between the perturbed stress field generated by the geometrical discontinuity, the microstructure size and the notch sensitivity. Moreover, the critical distance has been calculated using the theory of critical distance formulated with the line method (LM). The estimated value were adopted to predict fatigue properties of notched components with different notch radii.

The cis-1,1,1,4,4,4-hexafluoro-2-butene (DR-2 or HFO-1336mzz(Z)) is a novel environmentally friendly working fluid with appropriate physicochemical characteristics. The present work firstly investigates decomposition mechanism and thermal stability of DR-2 under the atmosphere containing oxygen (O2) and high temperature experimentally. The oxidative degradation features of DR-2 were explored at the temperature of 473-1073 K and the products were monitored by GC-MS and IC. The experimental and ReaxFF-based molecular dynamics results demonstrated the promotion effects of O2 on the DR-2 decomposition. The participation of O2 molecules was supposed to lower the initial thermal decomposition temperature by 240 K approximately and also would increase the number of products such as hydrogen fluoride (HF), but the enhancement effect was weakened by the increasing reaction temperature. The reasonable Arrhenius parameters calculated from the first-order kinetic analyses-based reactive molecular dynamics (RMD) simulations. Combined with density functional theory, the pathways of initial oxidation decomposition product firstly observed in the experimental and RMD simulations were proposed in this study. These results may pave the way for further study of DR-2 as a working fluid with lower global warming potential.

Renal allograft aspergillus is a rare entity with a high mortality due to life-threatening complications. We report a case of renal aspergilloma causing obstructive uropathy after two months of transplantation in a 64 -year- old patient who was managed successfully with antifungal therapy without surgical intervention.

Abstract: Background： Naïve T and T memory cell subsets can provide important information for the diagnosis and treatment of immunological and hematological disorders. Lymphocyte compartment undergo dramatic changes during adulthood; age-related reference values derived from healthy individuals are crucial. However, extensively detailed immunophenotyping reference values of peripheral blood lymphocytes in whole spectrum of adulthood performed by flow cytometry-based single-platform method are rare. Methods: 309 healthy adult volunteers were recruited from Tianjin in China. The absolute counts and percentages of CD3+CD4+ T cells, CD3+CD8+ T cells, naïve T cells (Tn), T memory stem cells (Tscm), central memory T cells (Tcm), effector memory T cells (Tem), terminal effector T cells (Tte) were determined by flow cytometry with single platform technologies. Results: Reference range of absolute counts and percentage of lymphocyte subsets were formulated by different age and gender. We also find out the changing regularity of them: the cells which have stem cell properties, Tn and Tscm cells, decrease with aging; memory cell subsets, Tcm and Tem increase with aging, which increase from 18 to 64 years old and present no significant change over the 65 years old. Gender have influence on the fluctuation of lymphocyte subsets, absolute count of CD3+CD8+, CD8+ Tcm, CD8+ Tem in male are higher than that in female. Conclusion: The reference values of percentages and absolute numbers of naïve T and T memory cell subsets can help doctors to understand the immune state of patients and to evaluate conditions of prognosis then adjust treatment for patients.

Pulmonary embolism is a major cause of death worldwide. Recurrences are mainly observed in patients with coagulation disorders or cancers. We describe the case of a brain tumor (Glioblastoma) revealed by behavioral disorder in a young patient admitted for a recurrent pulmonary embolism

Introduction: Nowadays micro-invasive procedures (off-pump, beating heart) for mitral valve repair (MVRe) are abruptly expanding with the potential to be adopted as a valuable alternative to surgery. In the present manuscript, the Authors review the available technologies intended to treat mitral regurgitation (MR) through transapical approach, including annuloplasty and chordal repair options. Annuloplasty: To date, Valcare Amend is the only transapical mitral valve (MV) ring to have been implanted in patients. The device allows for stabilization of the annulus through a complete semirigid D-shaped ring. The first-in-human successful procedure was performed in 2016 by our Group and subsequent clinical experience included a total of 14 implanted patients. Currently the technology is under clinical trial evaluation to validate the efficacy and safety profile of the device. Chordal Repair: Beating heart chordal implantation via trans-apical approach is a current feasible, safe and reproducible option. Neochord DS1000 is the most widely used technology in the field, with a solid procedural experience and good results in well-selected patients. Its clinical use has been validated in Europe since 2012, while it is still under clinical investigation in the United States. Harpoon TDS-5 system is a novel technology, recently CE mark approved for clinical use. Conclusions: Transapical micro-invasive technologies are current viable therapies to treat MR in selected patients. Embracing transcatheter MVRe therapies should guide the cardiac surgeon through the new revolution of micro-invasive MV tailored repair.

Warming climates provide many species the opportunity to colonise newly-suitable regions at higher latitudes and elevations. Despite becoming warmer, higher latitudes and elevations nevertheless offer novel climatic challenges, such as greater thermal variability and altered frequency of weather events, and these challenges exert selection on expanding populations. However, high gene flow and genetic drift during the expansion phase may limit the degree to which species can adapt to novel climatic conditions at the range front. Here we examine how landscape topographic complexity influences the opportunity for local adaptation to novel conditions during a range shift. Using RAD-seq data, we investigated whether elevation, latitude, climatic niche differentiation, and gene flow across a complex landscape were associated with signatures of adaptation during recent range expansion of the damselfly Ischnura elegans in Northeast Scotland. Our data revealed two distinct routes of colonisation, with admixture between these routes resulting in increased heterozygosity and population density. Expansion rates, assessed as directional rates of gene flow, were greater between more climatically similar sites than between climatically divergent sites. Significant genetic structure and allelic turnover was found to emerge near the range front at sites characterised by high elevation, low directional gene flow, and high spatial differentiation in climate regimes. This predictive combination of factors suggests that landscape complexity may be a prerequisite for promoting differentiation of populations, and providing opportunities for local adaptation, during rapid or contemporary range shifts

A novel integrated rotary reactor for NOx reduction by CO and air preheating (iNA reactor) was proposed. NOx removal performance was investigated in a fixed-bed reactor, which was used to simulate the working conditions change in iNA reactor. Lab-synthesized Cu/FeCeOx were used as catalyst. Two different modes were tested with iNA reactor: short cycles and long cycles. Excellent NOx removal efficiencies of over 95% and 90% for short cycles and long cycles were observed in iNA reactor. Moreover, compared with the constant-temperature rotary reactor, better H2O and SO2 resistances were also found in iNA reactor. The reaction mechanism was proposed based on in-situ DRIFT study. NOx was stored as nitrates in the adsorption zone, and then decomposed rapidly by both high temperatures and CO, leading to the deep catalyst regeneration. Therefore, temperature swinging and the feed of CO were key to having high iNA reactor performance for NOx removal.

Atopic eczema (AE) is an inflammatory skin disease with involvement of genetic, immunological, and environmental factors. One hallmark of AE is a skin barrier disruption on multiple, highly interconnected levels: filaggrin mutations, increased skin pH, and a microbiome dysbiosis towards Staphylococcus aureus overgrowth are observed in addition to an abnormal type 2 immune response. Extrinsic factors seem to play a major role in the development of AE. As AE is a first step in the atopic march, its prevention and appropriate treatment is essential. Although standard therapy remains topical treatment, powerful systemic treatment options emerged in the last years. However, thorough endotyping of the individual patients is still required for ideal precision medicine approaches in the future. Therefore, novel microbial and immunological biomarkers were described recently for the prediction of disease development and treatment response. This review summarizes the current state of the art in AE research.

Background: Chemotherapy-induced cardiotoxicity (ChC) is an important complication among patients receiving anthracyclines. Biomarkers and imaging parameters have been studied for their ability to identify patients at risk of developing this complication. Left ventricle global longitudinal strain (LV-GLS) has been described as a sensitive parameter for detecting systolic dysfunction, even in the presence of preserved left ventricle ejection fraction (LVEF). Objective: to evaluate the role of the LV-GLS as a predictor of ChC. Methods: This study is a post-hoc analysis of CECCY trial (Carvedilol for Prevention of Chemotherapy-Related Cardiotoxicity) that evaluated the primary prevention of cardiotoxicity with carvedilol during doxorubicin chemotherapy in a population with breast cancer. Cardiotoxicity was defined as a reduction >10% in LVEF. LV-GLS was obtained before chemotherapy in patients with no prior cardiovascular disease or echocardiogram abnormalities. Results: Thirty-one patients who had a complete echocardiography study including measurement of LV-GLS before chemotherapy were included in this analysis. An absolute LV-GLS <16.9% before chemotherapy showed 100% sensitivity and 73% specificity for predicting cardiotoxicity (AUC=0.85; 95%CI 0.680 – 0.959, p<0.001). In this population, LVEF values before chemotherapy did not predict ChC (95%CI 0.478 to -0.842, p=0.17). The association of low LV-GLS (<17%) and BNP serum levels (>17 pg/mL) two months after chemotherapy increased the accuracy for detecting early onset ChC (100% sensitivity, 88% specificity, AUC=0.94; 95%CI 0.781 – 0.995, p<0.0001). Conclusions: Our data suggest that LV-GLS is a potential predictor of chemotherapy-induced cardiotoxicity. Larger studies are needed to confirm the relevance of this echocardiographic parameter in this clinical setting.

Tracheobronchial injuries following blunt trauma have a low incidence due to the high mortality rate before reaching hospitals. This case report advocates for conservative management in a hemodynamic patient with a large longitudinal tracheal laceration with no signs of acute complication.

The ulnar nerve compressed in the cubital tunnel is called Cubital tunnel syndrome in the clinic.we also found that there are cysts compress the ulnar nerve in cubital tunnel through preoperative ultrasonograhy. This case report is the description of heterotopic cysts that compress the ulnar nerve in our clinical practice.

Background: Ventricular tachycardia (VT) remains a leading cause of morbidity and sudden death. Improvements in catheter ablation have significantly advanced this option as a treatment method for refractory VT. Despite advances, use and impact of inotrope and vasodepressor medicines as part of intraprodcedural management during VT ablation have been understudied. Methods: We conducted a exploratory, retrospective analysis of consecutive patients undergoing VT ablation. Patient, intra and peri-procedural data, focusing on pressor use and hemodynamics through ablation, and procedural endpoint data were collected. Results: From 2014-2017, 149 patients underwent VT ablation of which 67% exhibited cardiomyopathy (53% ischemic). Most procedures (71%) were conducted under general anesthesia. In those with cardiomyopathy, steady-state use of dobutamine and dopamine was more common though substantial use of phenylephrine was noted. In adjusted analyses, (1) dobutamine was associated with increased procedure time (402.5±18.8 vs 347.2±14.0 min, p = 0.03), (2) dopamine was associated with increased number of distinct VTs (2.8 vs. 2.2, p<0.001) while both dopamine and dobutamined resulted in increased intra-procedural cardioversions (1.3 vs. 0.6, p<0.001 and 1.34 vs. 0.66, p=0.001, respectively) and (3) dobutamine dose exhibited a linear correlation with post-ablation length of stay. Conclusions: In this exploratory work, we sought to understand effects of hemodynamic drug use on short-term, procedural outcomes of VT ablation. Salient findings include: (1) arrhythmogenic nature of inotropes resulting in an increase in intraprocedural cardioversions, (2) greater propensity for induction of non-clinical VTs with use of intraprocedural dopamine and (3) substantial use of phenylephrine in those with underlying cardiomyopathy.

Introduction: Early recognition of critical patients is crucial in emergency departments. Many scoring systems are used for it. This study aim determining the prognostic values of these scoring systems for Covid 19 patients. Method: This retrospective study was performed between March 2020 -May 2020. 212 patient who have Covid 19 pneumonia were enrolled the study. National Early Warning Score (NEWS), Modified Early Warning Score (MEWS) and quick Sequential Organ Failure Assessment (qSOFA) scores were calculated according to patients’ admission data. Receiver operating characteristic (ROC) analysis was used to determine the diagnostic values of scores and the optimum cut-off values were determined by using Youden Index.Results: 23 (10.8%) of 212 patients died and 34 (16%) were admitted to ICU. The AUC values of MEWS, NEWS, and qSOFA for predicting mortality in < 65 years old were 0.852 (95% confidence interval 0.708-0.997), 0.882(0.741-1.000) and 0.879(0.768-0.990) and >65 years old 0.854(0.720-0.987), 0.931(0.853-1.000), 0.776(0.609-0.944) respectively. For ICU admission AUC values of MEWS, NEWS and qSOFA in <65 years old followed as; 0.882(0.783-0.981), 0.914(0.817-1.000), 0.868(0.764-0.973) and 0.845(0.725-0.965), 0.926(0.854-0.998), 0.815(0.676-0.954) in ≥ 65 years old. MEWS and qSOFA’s optimal cut-off values for mortality were ≥2 with %90.0 sensitivity %74.7 specificity and ≥1 with %90.0 sensitivity %74.7 specificity for <65 years, NEWS optimal cut-off is ≥6 with 91.7% sensitivity and 76.7% specificity for ≥ 65 years old.Conclusion: These scores have good predictive value for mortality and ICU admission, but NEWS is better especially in ≥ 65 years old patient with Covid 19 pneumonia.Keywords: Early warning scores, NEWS, MEWS, qSOFA, Covid 19 pneumonia, mortality