Atypical Hemolytic Uremic Syndrome Triggered by COVID-19 Infection in a Pediatric Patient with CD46 MutationParisa Maleki Dana1, Parsa Lorestani2, Mohamad Reza Tohidi3

Cold Ceramic for Repairing Perforations: A Case Series

Transgenerational plasticity in plants is an increasingly recognized phenomenon, yet it is mostly unclear whether transgenerational plasticity is relevant to both the fitness of the plant and its interacting species. Using monoclonal strains of the giant duckweed (Spirodela polyrhiza) and its native herbivore, the waterlily aphid (Rhopalosiphum nymphaeae), we assessed whether pre-treating plants with copper excess, both indoors and outdoors, induces transgenerational plasticity in plant defences that alter plant and herbivore fitness. Outdoors, copper pre-treatment tended to increase plant growth rates under recurring copper excess. Indoors, copper pre-treatment either increased or decreased plant growth rates under recurring conditions, depending on the plant genotype. Copper pre-treatment induced anthocyanins that protected plants against copper toxicity, and these elevated levels were transgenerationally retained. Copper pre-treatment also transgenerationally increased the levels of 12-oxo-phytodienoic acid (OPDA), a jasmonate precursor. Nevertheless, aphids grew up to 50% better when the plants were pre-treated with copper. The increased aphid growth was likely caused by transgenerationally elevated OPDA levels, as aphids grew better when jasmonates were externally applied to plants. Taken together, this study shows that transgenerational plasticity is relevant to both plant and herbivore fitness, which highlights the role of transgenerational plasticity in plant evolution and species interactions.

Investigating resource selection patterns of declining species is critical to developing effective conservation strategies and mitigating negative population trends. We trapped and radio-collared northern bobwhite (Colinus virginianus) and recorded the location of each individual three times per week during the northern bobwhite breeding season (April – September) to infer resource selection by non-brooding adults. We defined 13 vegetation communities with varying fire histories and assessed their relative use via a distance-based logistic regression model within a Bayesian framework. We found reliable evidence that non-brooding northern bobwhite preferred supplemental feed lines, recently burned natural pine stands, one-year rough in shrub/scrub, and one-year rough in hardwood-pine stands. Conversely, we found they avoided one-year rough in natural pine stands, recently burned shrub/scrub, and recently burned hardwood-pine stands. Our data suggest that non-brooding bobwhite’s successional stage preference may vary between vegetation communities within the same study area and adds further evidence to the importance of fire and vegetation interspersion in bobwhite management. Results from our study may be applied to enhance habitat for non-brooding northern bobwhite and potentially increase adult survival, an important metric correlated with bobwhite population growth.

The lifespan of a converter depends on component reliability. In non-redundant designs like buck converters, a single component failure can shut down the circuit. Capacitors are more prone to failure than inductors or semiconductors. Monitoring parameters such as equivalent series resistance, rather than manual data, better assesses a converter’s useful life. This article compares two parameter estimation methods: recursive state space and non-linear least squares, with R² values and residuals analysis ensuring reliable results that closely correlate with real converter values.

Understanding how metacommunities respond to natural and anthropogenic disturbances is a key objective in ecology. In this study, we introduce a robust analytical framework to identify communities whose extirpation triggers stronger (hereafter keystone communities) or weaker (hereafter idle communities) cascading effects on extinction and colonization events that ultimately drive temporal changes in compositional patterns of the remaining communities. These cascading dynamics reflect the impact of extirpated communities on connectivity and subsequent dispersal dynamics. Since the framework uses spatial information on compositional similarities to infer changes that would unfold over time due to the extirpation of one or more communities, we describe it as a space-for-time approach. Through mechanistic simulation models that replicate removal experiments, we demonstrate that our framework accurately estimates ”keystoneness”, ranking local communities by their role in maintaining the metacommunity’s compositional patterns. As such, our models demonstrate that the relationship between patch characteristics and our keystoneness metric is closely linked to the structure and dynamics of their metacommunities. A key feature of our framework is its ability to generate community keystoneness estimates that are statistically independent of local diversity, providing a valuable tool for assessing the relevance and conservation value of local communities. This is particularly important in cases where high local diversity reflects an influx of individuals into demographic sinks, a common consequence of human activities near natural areas. To showcase the unique insights of this framework, we examined and contrasted the effects of artificial light at night on the diversity and keystoneness of a moth metacommunity sampled over two decades. We conclude with a discussion of the framework’s potential applications and underlying assumptions, emphasizing its relevance for addressing both conceptual and applied ecological questions, particularly its potential to assess the conservation value of local communities under ecological stress.

In [2] M. Jaoua et al. studied the linear approximation of Robin problem on Ω an open bounded domain of R d , and they given some important results. In this paper, we study a nonlinear approximation of an elliptic problem with a nonlinear Robin boundary condition in a domain of R 2 . We prove the existence and uniqueness of solution by an iterative construction method with admissible condition on ∂Ω.

Studying neurological disorders in vitro is still challenging due to the human brain’s complexity and the difficulty of obtaining primary neural cells. However, tissue engineering and tridimensional (3D) cell culture have become increasingly important tools for disease modeling. By providing an extracellular matrix (ECM) substrate that closely resembles physiological conditions, 3D cell culture offers several advantages over standard monolayer cell culture, including enhanced cell-cell and cell-matrix interactions. This results in a microenvironment that more accurately reflects in vivo biology. In this study, we performed an in-depth analysis of the proteome and matrisome of 3D tissue-engineered dermis, made from human primary dermal fibroblasts cultivated in 3D and embedded in a self-produced ECM. Interestingly, in silico analysis revealed that neurogenesis and associated functions were predicted to be strongly activated in this tissue-engineered 3D model. Indeed, we showed that ECM proteins involved in neuronal development and maintenance, typically produced by cerebral cells, were also expressed by dermal fibroblasts. Of particular interest, the 3D co-cultivation of dermal fibroblasts with iPSC-derived motor neurons readily enabled long-lasting culture periods without costly media supplementation with exogenous additives. Patient-derived dermal fibroblasts, cultivated in 3D, could therefore become valuable models for the study of neurological diseases. This approach offers a cost-effective and a less invasive alternative to brain biopsies for modeling complex neurological disorders in vitro.

Aims CYP2D6 is a key enzyme for metabolizing tamoxifen into active metabolites, but polymorphisms in this enzyme lead to varying metabolic capacities. Increasing the tamoxifen dose in patients with deficient CYP2D6 metabolism can elevate endoxifen levels to those of patients with normal phenotypes. This study examines the impact of increasing the dose of tamoxifen on toxicity in poor metabolizers of the CYP2D6 enzyme. Methods Eighty-six breast cancer patients treated with tamoxifen were classified by CYP2D6 metabolizer phenotype according to Clinical Pharmacogenetics Implementation Consortium guidelines. All patients started with a 20 mg/day dose of tamoxifen, with poor metabolizers having their doses increased to 60 mg/day. Side effects, including osteoarticular pain, hot flashes, asthenia, and uterine changes, were analyzed using Kaplan-Meier analysis and the Cox proportional hazards regression model to assess the relationship between CYP2D6 metabolizer type and these side effects. Results Significant differences were found only in uterine changes among CYP2D6 metabolizer types in both the overall cohort and a subgroup selected via Propensity Score Matching (PSM). Rapid metabolizers exhibited a lower incidence of uterine changes (p < 0.001 in Kaplan-Meier analysis; HR 0.195, 95% CI: 0.07 - 0.52, p = 0.001) in the complete cohort. In the PSM cohort, Kaplan-Meier analysis showed a p-value of 0.001 with an HR of 0.07 (95% CI: 0.01 - 0.54, p = 0.011). Conclusion Tamoxifen dose scalation in patients with poor CYP2D6 metabolism may increase the occurrence of uterine changes but does not significantly affect the incidence of osteoarticular pain, hot flashes, or asthenia.

Dispersal is a fundamental process driving many ecological patterns. During transfer, species often make large-scale displacements resulting in significant energetic losses with implications for fitness and survival, however generalising these losses across different taxonomic groups is challenging. We developed a bioenergetic dispersal model based on fundamental processes derived from species traits. By balancing energy storage and energy loss during active dispersal, our mechanistic model can quantify energetic expenditures depending on landscape configuration and the species in focus. Moreover, it can be used to predict the maximum dispersal capacity of animals, which we compare with recorded maximum dispersal distances (n = 1571). Due to its foundation in bioenergetics it can easily be integrated into various ecological models, such as food-web and meta-community models. Furthermore, as dispersal is integral to ecological research, the quantification of dispersal capacities provides valuable insight into landscape connectivity, species persistence, and distribution patterns with implications for conservation research.

IntroductionMethadone, a synthetic opioid agonist, has been widely used for the treatment of opioid dependence and chronic pain management for several decades (1). Methadone maintenance treatment (MMT) has proven to be an effective strategy in reducing illicit opioid use, improving patient outcomes, and decreasing the risk of HIV transmission among individuals with opioid use disorders (2). However, despite its therapeutic benefits, methadone can cause significant adverse effects, particularly in opioid-naive individuals or those who consume it recreationally (3).Methadone overdose can lead to severe respiratory depression, cardiac arrhythmias, and death (4). The risk of overdose is particularly high in individuals who are not tolerant to opioids, as they may be more sensitive to the drug’s effects (5). In addition to its well-known respiratory and cardiovascular side effects, methadone can also cause rare neurological and ocular manifestations, such as strabismus (6).Strabismus, a misalignment of the eyes, can occur due to various etiologies, including congenital factors, nerve palsies, and pharmacological agents (7). Opioid-induced strabismus is an uncommon but documented consequence of opioid toxicity, with most cases reported in the context of heroin use (8). The exact mechanism underlying opioid-induced strabismus remains unclear, but it is thought to involve the drug’s effects on the central nervous system and the oculomotor nerve (9).In this case report, we present a rare instance of methadone-induced loss of consciousness and subsequent strabismus in a patient who consumed methadone for the first time. This case underscores the importance of recognizing the potential dangers associated with methadone use, especially in opioid-naive individuals, and the need for healthcare providers to be aware of the uncommon ocular manifestations of opioid toxicity. Prompt identification and appropriate management of methadone overdose and its associated complications can prevent long-term morbidity and mortality (10).

Blockchain technology has the potential to transform the education system in various ways, including the verification of certificates and digital identity management. The use of blockchain-based systems can eliminate the need for manual verification of certificates, which is time-consuming and labour-intensive. Instead, blockchain-based systems can enable instant and secure verification of certificates, making the process more efficient and reliable.This proposed work focuses on implementing the Plonk system in the education sector to enhance the security, privacy, and efficiency of blockchain-based verifiable certificate (VC) digital identity verification and management systems (DIVMS). The methodology involves designing and developing the Plonk system, integrating it with existing DIVMS, testing and evaluating its functionality and performance, deploying and implementing it in the education sector, and monitoring and maintaining its effectiveness. The Plonk system is based on zero-knowledge proof technology, identity provider verification, and digital signature verification. Simulation data is used to compare the transaction throughput of the Plonk system with Ethereum, a well-known blockchain platform. The results demonstrate that the Plonk system outperforms Ethereum in terms of transaction processing speed, security, privacy, scalability, verification speed, and cost-effectiveness. Additionally, a response time dataset is created for both the Plonk system and Ethereum under different user load scenarios, and statistical measures such as average response times and standard deviations are calculated. The analysis shows that the Plonk system exhibits lower response times and variability compared to Ethereum, indicating faster and more consistent transaction processing. Overall, the Plonk system shows the promising potential for enhancing the security, privacy, and performance of blockchain-based DIVMS in the education sector.

A document by Muhammad Nadeem Ahmad. Click on the document to view its contents.

Aim: Research has shown that people from ethnic minority backgrounds living with psychosis are less likely to seek support from healthcare professionals (e.g. GP), but more likely to seek support from non-healthcare professionals (e.g. faith leaders). This systematic review assessed the impact of community-level interventions aimed at improving help seeking and access to support for psychosis in non-secondary care settings among ethnic minority populations. Methods: The EMBASE, PsychINFO, Medline Ultimate, CINAHL Ultimate and Scopus databases were searched in December 2023. Studies were included if published in English, conducted in high-income countries, reported on psychosis and minority ethnic groups aged 18-65 years, and interventions targeted at people from minority ethnic groups with or at risk of psychosis, caregivers, or the general public. Outcomes of interest were changes in help-seeking behaviours, pathways to care characteristics and barriers and facilitators of intervention implementation. Results: Five studies reporting two interventions met the inclusion criteria. All studies were conducted in the United States. Narrative synthesis revealed mixed results about the effectiveness of interventions on help seeking and duration of untreated psychosis. However, the results show promise for professional help-seeking recommendations post-intervention across the studies. Barriers and facilitators were identified for intervention implementation. Conclusions: Community-level interventions have some success in promoting help-seeking for psychosis in ethnic minority populations. However, research in this area was limited. Future research could include studies across different countries, ethnicities, genders and socioeconomic status to ensure generalisable results.

Background Currently, there is no reliable endpoint for the conclusion of atrial fibrillation (AF) ablation. Atrial burst pacing and/or isoproterenol challenge are poor diagnostic tools. A newly proposed Vagal AF Induction Test(VAFIT) uses effective atrial refractory period measurement, simultaneously with extra-cardiac vagal stimulation(ECVS) to study AF inducibility pre and post-ablation. Objective Prospective study in patients submitted to radiofrequency catheter pulmonary vein isolation(PVI) plus cardioneuroablation(CNA) evaluating the VAFIT result before and at the end of the procedure with AF recurrence. Methods Prospective study of 142 patients, 57.5[48.9-70.2] years-old, 71% males, with symptomatic AF (79.6% paroxysmal/20.4% persistent), left atrium diameter of 38.0[35.0-41.2] mm, and left ventricular ejection fraction of 63.0 [62.0-68.2]. VAFIT was considered positive or negative depending on whether AF induction occurred. It was performed at baseline and after PVI+CNA, with a single atrial extra stimulus during ECVS (5s/50Hz/1V/kg up to 70V/Pulse Width=50 µs). Patients were followed for a median of 15.0[7.0-20.0] months. The association of VAFIT-positive status at the end of the procedure with AF recurrence was investigated by univariate and multivariate Cox regression analysis. Results Pre-ablation VAFIT was positive in all cases and became negative in 62.9% of patients. AF recurrence: 18.7% in VAFIT-positive and 5.6% in VAFIT-negative patients(p=0.012). VAFIT-positivity was associated with AF recurrence (HR: 4.56(1.37-15.23,p=0.014). Conclusion A VAFIT-positive status following PVI+CNA was strongly and independently associated with AF recurrence. It remains to be investigated in randomized studies whether achieving VAFIT-negativity at the end of the procedure, as demonstrated in this study, would lead to better clinical outcomes.

This paper proposes novel fractional cosine and sine matrix functions derived from a determining matrix. It introduces a new controllability criterion based on the controllability Gramian for achieving exact controllability in oscillating fractional linear systems with damping term. We present Cayley-Hamilton type theorem for determining matrix. Finally, we prove a novel Kalman type rank criterion for controllability in oscillating fractional linear systems with damping, which is a novel contribution even in systems without damping. Numerical examples are provided to validate these findings.

The integration of optogenetic techniques with traditional behavioral paradigms has provided novel insights into the neural mechanisms underlying olfactory-based fear conditioning. Olfactory cues are potent triggers for fear responses, and understanding the intricate neural dynamics involved in olfactory fear learning is crucial for unraveling the complexities of aversive memory formation. In this study, a robust method is presented that combines optogenetic stimulation of olfactory bulb glomeruli with foot shock fear conditioning to investigate olfactory-based fear learning in mice. By merging optogenetic manipulation with behavioral assays, a comprehensive framework for studying the mechanisms of olfactory fear conditioning is provided. This method offers new avenues for exploring the neural dynamics of adaptive responses to olfactory threats and may have implications for understanding fear-related disorders.

Cardiovascular diseases caused 20.5 million deaths in 2021, accounting for nearly one-third of global mortality 1. This underscores the importance of identifying practical prognostic markers for effective patient stratification and treatment, particularly in ischemic heart disease (IHD). Transthoracic echocardiography (TTE) is a fundamental and accessible, non-invasive imaging tool widely used in clinical cardiology for diagnosis and management concerning patients with a broad spectrum of cardiovascular diseases. It is the first level non-invasive imaging method and the most widely used in clinical practice for the diagnosis and follow-up of patients with acute coronary syndrome (ACS). Alongside established echocardiographic prognostic parameters, new measurements have shown their predictive relevance for adverse events in IHD patients, including three-dimensional (3D) imaging, tissue Doppler (TDI) and speckle tracking technology. The aim of this review is to identify the current diagnostics echocardiographic tools in the literature that may provide new prognostic parameters applicable in the acute phase and at follow-up in patients following an acute myocardial infarction. We focused on the latest imaging methods such as TDI, Myocardial Work Index, Speckle-Tracking Strain and 3D technologies evaluated using TTE, given its ease of use, and widespread accessibility at all stages of coronary artery disease.