Imaginal exposure is a standard procedure of cognitive behavioural therapy for the treatment of anxiety and panic disorders. It is often used when in vivo exposure is not possible, too stressful for patients, or would be too expensive. The Bio-Informational Theory implies that imaginal exposure is effective because of the perceptual proximity of mental imagery to real events, whereas empirical findings suggest that propositional thought of fear stimuli (i.e., thinking about the stimuli without seeing them in the mind’s eye) could be sufficient. To investigate whether mental imagery or propositional thought is crucial for the success of imaginal exposure, participants with the rare state of aphantasia (= absence of sensory mental imagery) and two control groups were subjected to a fear conditioning paradigm followed by imaginal exposure and a reinstatement procedure. During imaginal exposure, a control group (N = 30) stared at a bright screen to disrupt visual imagery by incoming luminance (= simulated aphantasia), while a second control group (N = 30) and participants with actual aphantasia (N = 30) kept their eyes closed. Results showed successful extinction in all groups, thus demonstrating that imaginal extinction is possible using propositional thought. Moreover, results indicate that people with aphantasia experience less emotional distress during the fear conditioning procedure, most likely due to similar mechanisms as in alexithymia, i.e., a decoupling between physiological arousal and emotional experience.

Analyzing the temporal dynamics of ecological communities can shed light on coexistence mechanisms and help understand how populations and communities will behave in the face of climate change. However, little is known about how frog communities respond to climate in urban ecosystems, especially in the Global South. Here, we analyzed how frog species richness and abundance are influenced by microclimate both intra- and inter-annually. We surveyed a peri-urban area in central Brazil, monthly for three years. To test the effect of microclimate on species richness and abundance, we used Generalized Additive Mixed-effects Models. We assessed seasonality using circular statistics. We also tested for differences in temporal beta diversity within and among years by estimating species disappearance and temporal rank shift, in addition to a multivariate model-based method to test the effect of year on species composition. Finally, we tested how taxonomic and phylogenetic alpha diversity changed through time using a novel approach based on Hill numbers. We found that species richness varied little among years and was affected only by photoperiod, while species abundance was more variable both between and within years, being mostly affected by humidity, temperature, and photoperiod. Species composition varied little between years, mostly between the first and subsequent years. Conversely, beta diversity was highest within years. Only the effective taxonomic richness changed significantly through time. Our results help not only understand temporal mechanisms that allow species coexistence, but also allow to make inferences about the impact of urbanization on biodiversity in recently urbanized landscapes, showing that species composition in peri-urban sites remains unaltered in a mid-timescale, especially when climate conditions changes little across years.

Oral Ulceration with Bone Sequestration.

This research compares decision-making techniques for diagnosing diabetes, including Bayesian decision theory, rough set theory, and fuzzy soft set theory. It discusses applying Bayesian decision theory and rough set theory, utilizing the latter to approximate three-way regions for patient classification. The study aims to provide effective medication plans by considering uncertainty. It concludes that the Bayesian rough set theory-based method identifies boundary regions for further investigation. It suggests decision-making based on minimum overall cost and provides a framework for more precise medical diagnoses for diabetic patients.

Cauchy matrix approach for the discrete Ablowitz-Kaup-Newell-Segur equations is reconsidered, where two ‘proper’ discrete Ablowitz-Kaup-Newell-Segur equations and two ‘unproper’ discrete Ablowitz-Kaup-Newell-Segur equations are derived. The ‘proper’ equations admit local reduction, while the ‘unproper’ equations admit nonlocal reduction. By imposing the local and nonlocal complex reductions on the obtained discrete Ablowitz-Kaup-Newell-Segur equations, two local and nonlocal discrete complex modified Korteweg-de Vries equations are constructed. For the obtained local and nonlocal discrete complex modified Korteweg-de Vries equations, soliton solutions and Jordan-block solutions are presented by solving the determining equation set. The dynamical behaviors of 1-soliton solution are analyzed and illustrated. Continuum limits of the resulting local and nonlocal discrete complex modified Korteweg-de Vries equations are discussed.

The efficacy and reliability of super-resolution (SR) imaging for evaluating urethral vasculature (UV) in females remains uncertain. This study evaluates the Super Resolution for Greater Accuracy and Resolution (SUGAR) method, an SR modality, for visualizing UV in female pigs within clinical ultrasound settings, aiming to establish its clinical feasibility and accuracy for potential human application. Female pigs (40-45 kg) were used to investigate UV blood flow dynamics, with data collected via a handheld ultrasound probe at 100 fps. The images were processed using SUGAR to achieve a resolution of 30 μm and validated against computed tomography angiography (CTA) and histopathological analyses. SUGAR demonstrated superior capability in visualizing urethral blood flow compared to CTA, allowing for detailed multiparametric analysis of UV, including fractal dimension, vessel density, tortuosity, diameter, and blood flow velocity. Strong correlations between SUGAR imaging and histopathological findings underscore its potential clinical applicability for diagnosing and managing urological conditions in humans.

Climate change and biodiversity loss are severe and intertwined global threats. Land-based efforts to address both require an understanding of the spatial relationships between carbon storage and biodiversity. Here, we present a systematic review and meta-analysis of the strength of these spatial relationships across the literature. We synthesize the estimated spatial correlations and infer how different factors (spatial scale, metrics, biome, human pressure) impact these strengths using linear mixed-effect models. Our results show that spatial scale is a significant factor, and the combination of metrics used to express carbon storage and biodiversity plays a more important role. While relationships are moderately positive across all conditions, the strength of the relationships decreases significantly from global to local scales. We find large variations in the strength for different metrics, across different biomes, and in the presence or absence of human pressure. We find a stronger relationship in natural rather than human-dominated landscapes for temperate forests, grasslands and deserts, but the opposite for tropical and subtropical forests. Ecosystem-level biodiversity proxies (habitat quality) show strong relationships to the total carbon pool, while taxonomic metrics (species richness) show a weaker relationship. The largest negative relationship is between total carbon and flora & fauna species richness. Our results suggest different synergies for different dimensions of carbon storage and biodiversity and shed light on where further effort is needed.

A mysterious umbilical swelling: Primary Umbilical Endometriosis

Crossed renal ectopia with rectal cancer: a Case ReportZhenwei Tang 1 Huifeng Yang 2 Zhaoyu Wu 3 Changyou Wang4*1.North China University of Science and Technology Affiliated Hospital,Tangshan 063000, Hebei Province,ChinaE-mail: [email protected]. North China University of Science and Technology Affiliated Hospital,Tangshan 063000, Hebei Province,ChinaE-mail：[email protected] North China University of Science and Technology Affiliated Hospital,Tangshan 063000, Hebei Province,ChinaE-mail：[email protected] *Corresponding author:North China University of Science and Technology Affiliated Hospital,Tangshan 063000, Hebei Province,ChinaE-mail: [email protected]

Malignant Peripheral Nerve Sheath Tumor and Epitheloid Sarcoma Associated with Von Recklinghausen Disease: A Case ReportShriya Sharma,1 Pasang Sherpa,2Ganesh Giri2 1Division of Advanced Heart Failure and Transplant, Mayo Clinic, Jacksonville, FL, USA2Division of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USAkey clinical messageNeurofibromatosis type 1(NF-1) is an autosomal hereditary neurocutaneous syndrome marked by clinical features of neurofibromas, cafe-au-lait spots, osseous lesions, optic path glioma, axillary or inguinal freckles and lisch nodules. Malignant peripheral nerve sheath tumor (MPSNT), often associated with NF-1, is a soft tissue sarcoma originating from peripheral nerve sheath, known for its aggressive nature and low survival rates. Epitheloid sarcoma, a soft tissue sarcoma mostly occurring in extremities with potential distant and local metastasis also poses significant risk in individuals with NF-1.A 23-year-old male with NF-1 presented with right leg pain and gluteal swelling, ultimately diagnosed with epitheloid leiomyosarcoma and malignant peripheral nerve sheath tumor. Clinical examination revealed NF-1 features and a biopsy confirmed the diagnosis, leading to wide local excision and adjuvant radiotherapy. We present this case to emphasize the necessity of robust monitoring to ensure early detection and treatment intervention of this orphan malignant tumors in NF-1 patients.

not-yet-known not-yet-known not-yet-known unknown Raptors, with their specialized adaptations, often target a diverse array of prey, frequently including primates, but their primary predation tends to focus on non-anthropoid species. We report a case of harpy eagle Harpia harpyja, one of the Earth’s largest eagle, attack on adult human beings, in French Guiana, in the Amazon rainforest. We analyze the raptor’s aggression patterns and the incidents’ context. We examined both published and unpublished records of raptors attacking anthropoids—including humans—offering a comprehensive single-reference into these rare interactions.

Beta class glutathione S-transferase (GST) activity is known to be associated with antibiotic resistance, one of the most serious threats to global health. In this research, the study of antibiotic resistance developed by beta class GST was conducted using KKSG6, one of the GST isozymes found in Acidovorax sp. KKS102. The KKSG6 gene has been successfully expressed in Escherichia coli BL21 Star™ (DE3) using pET101/D-TOPO®-KKSG6 as an expression vector, resulting in the presence of a protein band of approximatly 20 kDa after purification using GSTrap™ HP column. Over-expression of KKSG6 made Escherichia coli BL21 Star™ (DE3) to be less susceptible towards kanamycin, streptomycin, gentamycin, tetracycline and chloramphenicol, suggesting the antibiotics binding with KKSG6. Our study has revealed the KKSG6 conjugation activity towards chloramphenicol, but not with kanamycin and tetracycline. The inhibition of protein conjugation activity towards CDNB by the presence of chloramphenicol has also been demonstrated. An in-silico study using protein-ligand docking predicted that antibiotics binding could take place at the protein dimer interface and H-site depending on their properties.

Objectives: This study aims to examine the effects of autologous platelet-rich plasma (PRP), which increases new connective tissue synthesis and revascularization, on healing in parotid surgery wound, prevention of salivary fistula formation, drain removal time, and hospitalization in the postoperative period. Materials and Methods: Fifty-four patients who had an operation on superficial parotidectomy were randomized, and then two groups were created. PRP was gained by centrifuging the blood taken from the patients at the end of the surgery in the study group. This gained PRP was injected into the surgical site, and then the wound flap was closed by suturing. Patients were evaluated for the parameters such as the development of salivary fistula, duration of drain removal, discharge time, all other complications during the postoperative 4 weeks. Results: Drain removal time and discharge time of the PRP group cases were statistically shorter than those in the control group. The rate of development of salivary fistula according to the groups was remarkably high in the control group, but it was not statistically significant. Statistically significant correlation was found between the location of the compared tumor, and volume of material removed, and the incidence of all complications. Conclusions: PRP reduced the duration of drain removal and discharge time for those who had an operation on superficial parotidectomy. Thus, the decreased discharge time provides both reduced health costs and the risk of developing nosocomial infections. Although it was not statistically significant, a significant difference was observed in the rates of salivary fistula development.

Background: Despite ongoing debate about reliable prognostic factors, this study aimed to develop and validate a novel nomogram for predicting cancer-specific survival (CSS) in patients with ependymoma. Methods: Clinical data from the Surveillance, Epidemiology, and End Results database spanning 2000 to 2018 were used for the analysis. Data were randomly categorized into development and validation groups in a 7:3 ratio. Univariate and multivariate Cox regression analyses and LASSO regression were conducted to identify independent risk factors for CSS. Predictive models were evaluated using calibration plots,  concordance index (C-index),  and area under the receiver operating characteristic curve (AUC). Additionally, decision curve analysis and clinical impact curves were conducted. Results: The final sample comprised 2,340 patients. Multivariate analysis identified race, age, histological type, surgery, and tumor site as independent predictors of CSS. A nomogram incorporating these risk factors was developed to predict CSS  in patients with ependymomas. Calibration plots demonstrated a high level of consistency between predicted and actual values. The C-index for the training cohort was 0.746 (95% CI: 0.715–0.777), and for the validation cohort, it was 0.743 (95% CI: 0.698–0.788). Additionally, both AUC and decision curve analysis analyses indicated robust performance and clinical significance benefits. Kaplan–Meier curves further demonstrated the nomogram’s strong ability to predict patient outcomes. Conclusions: Our nomogram has the potential to offer significant value in predicting the outcomes of patients with ependymomas aged > 1, 5, and 8 years. This predictive model will assist doctors and patients in devising effective clinical strategies.

Cell barrier function is, on the one hand, of outmost importance in our lungs, as the respiratory tract is exposed to a hostile environment from both sites: the airways and the vasculature. On the other hand, however, an efficient gas exchange of oxygen (O 2) and CO 2 is only possible through a very thin alveolo-capillary membrane. On the vascular site, endothelial cells form a natural barrier, while in the airways epithelial cells are most important for protection of the lung tissues. Moreover, fibroblasts, by transforming to myofibroblasts, are essential for wound closure after mechanical and chemical microinjuries in the respiratory tract. Along this line, loss of cell resistance in vascular endothelial and lung epithelial cells enhances invasion of pathogens (e.g. SARS-CoV-2) and results in pulmonary edema formation, while increasing barrier function of pulmonary (myo)fibroblasts blocks gas exchange in patients with pulmonary fibrosis (PF). Therefore, electrical cell-substrate impedance sensing (ECIS)-based quantification of changes in cell barrier function in lung endothelial and epithelial cells as well as fibroblasts after application of harmful triggers (e.g. hypoxia, receptor agonists and toxicants) is a convenient and state-of-the-art technique. After isolation of primary cells from mouse models and human tissues, changes in cell resistance can be detected in real time. By using lung cells from gene-deficient mouse models, micro (mi) RNAs or the small-interfering (si) RNA technology essential proteins for cell adhesion e.g. ion channels of the transient receptor potential (TRP) family are identified in comparison to wild type control cells. In the future, these proteins may be useful as drug targets for novel therapeutic options in patients with lung edema or pulmonary fibrosis.

A better understanding of headwater hydrogeology in the semi-arid Andes is critical because high-elevation basins are considered water towers for the main valleys, where water demand is the highest. Geophysical surveys and a pumping test were carried out to obtain information on aquifer structures and properties. Radioactive and stable isotopes were used to characterize the hydrological functioning of the headwater basins. Low electromagnetic velocities and resistivities reveal the presence of liquid water beneath a rock glacier, which could be the upper limit of a proglacial aquifer. The downstream valley aquifer appears fairly transmissive (3.2 10 -3 m 2s -1) and dominated by old waters (several decades) that are a mix of high-glacierized and low-glacierized basins. Additionally, stable isotopes point out a different signature for high-glacierized and low-glacierized basins, which could result from isotope fractionation. These results indicate that water isotopes could be used to discriminate waters originating from high-glacierized and low-glacierized basins. The study identifies the presence of old waters in a priori low-glacierized basins, which indicates long term storage. This finding is important for understanding late season baseflow and streamflow evolution in the context of climate change. As the contribution of such basins to total streamflow is significant, studies that aim to predict streamflow should not only focus on basins containing large glaciers.

Background: Adherence to follow-up visits is crucial for optimizing clinical outcomes in paediatric patients with sickle cell disease (SCD). This study aimed to evaluate compliance with follow-up visits among paediatric SCD patients over a five-year period. Methodology: A retrospective analysis was conducted using data from the sickle cell disease clinic of Nnamdi Azikiwe University Teaching Hospital, spanning from January 2015 to December 2019. A total of 271 unique paediatric patients with SCD and 1117 follow-up visits were included. Compliance with follow-up visits, defined as attendance within 100 days of the previous visit, was assessed using Kaplan-Meier curves and Cox regression analysis. Results: During the study period, a total of 1117 follow-up visits were documented among 271 children diagnosed with sickle cell anaemia. The median age of the study cohort was 8 years (IQR: 4 to 12 years). Male patients constituted 57% of the study population. Fifty percent of subjects remained compliant with follow-up visits at 14.2 months (95% CI = 8.9-24.1 months) and this compliance decreased to 40% at 24 months (95% CI = 31-49 months). Males showed a lower likelihood to be compliant to follow-up visits than females (HR: 0.83; CI: 0.56-1.23). Following adjustments, patients who were sicker and young adolescents (10 to 14 years) had an increased likelihood of complying to follow up visits (HR: 1.05; CI: 0.71-1.57 vs HR: 1.15; CI: 0.682-1.940 respectively) but this was not statistically significant. Conclusion: The overall poor compliance rate to follow up visits underscores the urgent need for interventions aimed at improving adherence to follow-up visits in this vulnerable population. Counselling interventions and further exploration of factors influencing compliance are warranted to enhance the management and outcomes of children living with sickle cell anaemia.

Introduction: Early intervention Services (EIS) in psychosis are the gold standard to treat patients after a first episode of psychosis (FEP). However, the understanding of the evolution and the long-term effects of such type of intervention is limited. This study aims to gain insight into the long-term evolution of physical and mental health, as well as the neurobiological outcomes of the patients treated for a FEP. Methods: The Long-term Follow-up of TIPP (LOFT) is an up to 20-year study within a cohort of patients who completed a three-year EI treatment at Treatment and early Intervention in Psychosis Program (TIPP, in Lausanne, Switzerland) and went through a deep phenotyping prospective multimodal assessment. 720 patients will be contacted and asked to participate in LOFT. Once they are assessed they will be allocated to a timepoint at either 5(+2), 10(±2), 15(±2), and 20(-2) years after TIPP entry. A follow-up visit will be proposed every 5 years. All participants will be evaluated on psychopathological, functional, and physical health outcomes including metabolic disturbances. A subsample of the patients who previously took part in a biomarker research program (n = 168) whilst at TIPP will be invited to undergo additional assessments (cognition, brain imaging, biofluids collection). Both traditional group level and machine learning analyses will be conducted. Conclusion: Ethical approval has been obtained and recruitment started in 2024. LOFT will help reshape and redefine current interventions for subgroups of patients at risk of poorer long-term outcome and to understand the underlying neurobiological mechanisms influencing psychosis evolution.