Background: Spirometry is the gold standard for assessing airway function for clinical studies; however, obtaining high quality data in young children remains challenging. Since the forced oscillation technique (FOT) requires less subject cooperations, there has been increasing interest in FOT, particularly in young children. We evaluated whether spirometry and FOT in young children provides comparable ability to detect a treatment effect. Methods: We recently reported in a randomized controlled trial that vitamin C compared to placebo treatment of mothers who smoked during pregnancy (MSDP) results in the offspring having significantly higher forced expiratory flows at 5-years of age, as well as significantly less wheeze at 4-6 years of age. In these same offspring, we also measured FOT at 8-Hz impedance at 3, 4, and 5 years of age. Results: Although spirometry demonstrated significantly increased forced expiratory flows (FEFs) in the vitamin C compared to placebo treatment group at 5-years of age (p < 0.001), we were not able to detect a similar treatment effect using FOT impedance. Conclusions: It may be challenging to obtain technically successful spirometry in pre-school children; however, forced expiratory flows may provide a better outcome than single frequency FOT impedance to assess improvements in airway function in these young subjects.

not-yet-known not-yet-known not-yet-known unknown 1) DNA metabarcoding has been successful for the rapid identification of species in ecological assemblages, including identifying interspecific interactions among species. However, advances in metabarcoding plants have been hampered due to a lack of universal gene regions that work across all taxa, limiting the applications of metagenomics in ecology more broadly. 2) To circumvent these limitations, we propose a spatio-temporal approach that combines multi-gene barcoding with existing plant occurrence databases, species distribution models, and phenological analyses to generate a shortened list of candidate species to increase metabarcoding accuracy. To validate the ecological accuracy of our methodological framework, we compared the results of the DNA metabarcoding from pollen loads of wild bumble bees to long-term field observations of bee-plant interactions, and visual pollen identification. 3) We show that DNA metabarcoding of the plant species included in bumble bee pollen loads was most accurate when combined with a candidate taxa list of plant species flowering in the area when the bumble bees were foraging, which improved the accuracy and taxonomic precision of 77.5% of samples. 4) With the recent proliferation of species occurrence and phenology data in tandem with advances in computing and software development, we believe that spatio-temporal filtering provides a simple approach for interpreting metagenomic studies globally. Additionally, we demonstrate that the Angiosperms 353 probes offer significant promise for metagenomics projects globally, including metabarcoding to reveal species interactions within complex communities. Further, our approach demonstrates that integrating DNA metabarcoding is most accurate and powerful when combined with local ecological data.

Carnivores play a vital role in ecosystem health and are thus an important focus for conservation management. Non-invasive methods have gained traction for carnivore monitoring as they are often elusive and wide-ranging, making visual counts particularly difficult. Faecal mini-barcoding combines field collection of scats with genetic analysis for species identification. Here we assessed the applicability of a mini-barcode based on the mitochondrial ATP6 gene in southern Africa. We predicted amplification success based on in silico evaluation of 34 of the 42 terrestrial carnivore species existing in southern Africa, including the Congo clawless otter (Aonyx congicus) for which we contributed a mitochondrial assembly, and tested amplification success on available reference samples of 23 species. We expanded the existing ATP6 mini-barcode reference database by contributing additional sequences for 22 species including the Cape genet (Genetta tigrina) and the side-striped jackal (Lupulella adusta), for which no complete mini-barcode sequences were available on GenBank to date. We furthermore applied the ATP6 mini-barcode to a scat-based carnivore survey conducted in 2009 in a grassland habitat in Namibia, showing a 94.9% identification success. Six carnivore species were detected from157 samples and were predicted to account for 75% of species assemblage. Black-backed jackals (Canis mesomelas) contributed the majority of faecal samples (87.2%) and were distributed evenly throughout the area. Scat samples of the remaining species, including leopard (Panthera pardus), were distributed along the edge, in proximity to dense bushland.

The gut microbiome can be one pathway by which a host rapidly acclimates and adapts to its ecological environment. Exploring how the microbiome has evolved to differ between hosts with different diets provides insights into the profound interactions between hosts and microbes within these systems. In this study, we used DNA metabarcoding techniques and macrogenomic prediction techniques to study the gut microbes of four desert rodent species with different feeding strategies in the same habitat. One species is herbivorous (Spermophilus alashanicus), one is seed-eating (Phodopus roborovskii), another is omnivorous (Dipus sagitta), and the last (Orientallactaga sibirica) has a diet with a relatively high proportion of meat. Diets rich in plants and insects can be challenging to digest due to the abundance of indigestible fiber and stable chitin, respectively. Out of the species studied, the herbivorous Spermophilus alashanicus has the highest density of UCG-005 genes and the highest predicted abundance of genes related to digestive complexity. The composition of Phodopus roborovskii’s microbiome has the highest variation between individuals, yet Phodopus roborovskii has the highest predicted abundance of genes associated with simple sugars—reflecting this species’ potential adaptability to the fiber within plant seeds and its constraints brought about by its smaller body size. The most insectivorous species, Orientallactaga sibirica, exhibits the highest predicted abundance of genes related to chitin degradation. This study has enhanced our understanding of the gut microbiota in the intestines of rodents as they adapt to various dietary strategies.

Insulin Resistance vs Dysregulation – A Distinction without a DifferenceEleanor M. Kellon, VMDEquine Cushing’s and Insulin Resistance Group, Inc.2307 Rural Road, Tempe, AZ 85282, [email protected] 2014, the term insulin dysregulation was introduced in an article by Frank and Tadros, published in EVE. It purported to cover all causes of “excessive insulin response to oral sugars, fasting hyperinsulinemia and insulin resistance” 1 . This was precipitated by interest in the enteroinsular axis and whether incretins might play a role in the excessive response to oral sugars, as well as decreased insulin clearance contributing to hyperinsulinemia. The paper also mentioned the stress response to illness, sepsis and injury as causing hyperinsulinemia but this is well recognized to be a physiological insulin resistance response to preserve glucose for critical tissues like heart and brain. Similarly, the hyperinsulinemia of pregnancy was recognized as a physiological response to allow ample access of the glucose to the fetus. The hyperinsulinemia of PPID is also recognized to be a combination of genetic predisposition and insulin resistance in response to the POMC hormones. This leaves only incretins and reduced insulin clearance as possible causes of hyperinsulinemia without insulin resistance.Higher insulin response to oral than intravenous glucose is a well recognized physiological response in all species, including the horse. Interest in incretins traces back to a 2001 study which determined higher insulin response to oral glucose than intravenous in both horses and Shetland ponies. There was one pony in the study with an exaggerated insulin response and higher GIP incretin (glucose-dependent insulinotropic polypeptide). However, that pony also had elevated absorption of glucose and insulinresistance status was unknown. In a 2016 study 2 , 31 ponies previously identified as hyperinsulinemic were evaluated to determine their active GLP-1 (glucagon-like peptide-1 incretin) and insulin responses to feeding glucose and compare that to the response to intravenous glucose. In phase one of the trial, 22 ponies determined to have hyperinsulinemic responses to oral feeding were subjected to a CGIT (combined insulin-glucose tolerance test). Only 15 of the 22 were determined to be IR by CGIT criteria. However, it has been shown that the diagnostic sensitivity of the insulin phase of CGIT is only 28.5%3 . In phase two, 9 other ponies were utilized. Those that had previously been identified as high responders to oral glucose were found to have the same insulin response to intravenous glucose as the normal ponies. However, they were also found to absorb more glucose orally than the normal ponies i.e., higher AUC glucose. AUC insulin following the oral tests was not correlated with AUC GIP but was correlated with AUC active GLP-1 while total GLP-1 did not change. Given the increased glucose absorption in those ponies, elevated GLP-1 is not an unexpected finding but rather was a normal and appropriate physiologic response to the enhanced glucose absorption, as was the higher insulin – not a dysregulation.Four studies since then have looked for a correlation between elevated levels of GLP-1 or GIP and a hyperinsulinemic response to oral carbohydrates in both normal and hyperinsulinemic horses but failed to find a significant difference. Most notably, one study 4 found the 75 minute insulin response to oral glucose was negatively correlated to GLP-1 and adiponectin levels were positively correlated to GLP-1, the exact opposite of what would be expected if exaggerated incretin responses could cause hyperinsulinemia without insulin resistance or could lead to insulin resistance.To further add to the confusion, both a GLP-1 mimetic and GLP-1 receptor antagonist have been reported to decrease the insulin response to a meal. Interestingly, in the case of the mimetic, the reduced insulin response was due to an increase in whole body insulin sensitivity, again directly contradicting the idea that incretins could cause hyperinsulinemia without there being insulin resistance.As for reduced insulin clearance, one study has documented reduced insulin clearance in horses with metabolic syndrome and hyperinsulinemia. This is a well-recognized component of human insulin resistance in metabolic syndrome and type 2 diabetes mellitus. The reduced insulin clearance helps spare the beta cells and compensate for cellular insulin resistance by maintaining higher circulating insulin levels and is thus an adaptive physiological response, not a dysregulation. There are no studies in any species documenting reduced insulin clearance without concurrent insulin resistance.In contrast, since the 2005 publication of insulin sensitivity quintiles using minimal model analysis of FSIGT (frequently sampled intravenous glucose tolerance test) data, over 40 articles have been formally published describing diagnosis of insulin resistance by intravenous response to glucose, insulin or their combination in various protocols, sometitmes with greater sensitivity than oral testing.It appears possible, but by no means proven, that some animals, particularly ponies, may over-absorb glucose, possibly under the influence of GLP-2, leading to exaggerated GLP-1 and insulin responses to meals and that this repeated exposure to high levels of insulin would lead to insulin resistance. However, even if this is shown to be true, it is not the insulin response that is dysregulated but rather glucose absorption. The GLP-1 and insulin responses to the enhanced glucose load are appropriate and physiological. The end result is likely insulin resistance from repeated exposure to high levels of insulin, as also described by Frank and Tadros, and could be considered an early stage of insulin resistance. They certainly wouldn’t be treated any differently than an animal with insulin resistance confirmed by intravenous testing.By creating an artificial distinction between horses and all other species with insulin resistance there is the potential to reduce interest in collaboration and funding. It also encourages avenues of research which are unlikely to ever benefit the horse or increase understanding of equine insulin resistance. The term insulin dysregulation should be abandoned as the other proposed mechanisms for hyperinsulemia have either not been proven, lead to insulin resistance or are known to be an inherent physiological response to insulin resistance.References:1. N. Frank and E.M. Tadros, Insulin dysregulation, Equine Vet J 46 (2014), pp. 103-112.2. M.A. de Laat, J.M. McGree and M.N. Sillence, Equine hyperinsulinemia: investigation of the enteroinsular axis during insulin dysregulation,Am J Physiol Endocrinol Metab 310 (2016), pp. E61-72.3. L.K. Dunbar, K.A. Mielnicki, K.A. Dembek, R.E. Toribio and T.A. Burns, Evaluation of Four Diagnostic Tests for Insulin Dysregulation in Adult Light-Breed Horses, J Vet Intern Med 30 (2016), pp. 885-891.4. N. Frank and D.M. Walsh, Repeatability of Oral Sugar Test Results, Glucagon-Like Peptide-1 Measurements, and Serum High-Molecular-Weight Adiponectin Concentrations in Horses, J Vet Intern Med 31 (2017), pp. 1178-1187.5. K.H. Treiber, D.S. Kronfeld, T.M. Hess, R.C. Boston and P.A. Harris, Use of proxies and reference quintiles obtained from minimal model analysis for determination of insulin sensitivity and pancreatic beta-cell responsiveness in horses, Am J Vet Res 66 (2005), pp. 2114-2121.

not-yet-known not-yet-known not-yet-known unknown Projecting how climate change will reshape global patterns of forest carbon storage is paramount to investigate the future of the global carbon cycle. Advances in machine learning and the proliferation of remote-sensing missions have stimulated the development of statistical models for the estimation of carbon storage on a global scale. However, existing models present two major limitations. First, they are not suitable for forecasting because they are trained on variables that cannot be projected. Second, they are based on large numbers of predictors, which hinders the interpretability and explainability of their results from a biological and ecological perspective. In this manuscript, we present a machine learning model for the global mapping of potential Aboveground Biomass Density that overcomes the above mentioned limitations. On the one hand, our model is based exclusively on bioclimatic variables and is therefore suitable for forecasting and interpretable from a biological perspective. On the other hand, we calibrated our model with a state-of-the-art predictor selection process to identify the optimal subset of predictors for the maximization of model accuracy. We found that a minimal model based solely on four bioclimatic variables performed the best. Furthermore, our model reproduces field measurements from experimental forest plots equally well than a state-of-the-art model trained on $190$ predictors. In conclusion, we provide a simple and computationally cheap model that can be coupled with climate projections to investigate how climate change will reshape carbon storage on a global scale.

1 INTRODUCTIONPancreatitis is associated with a range of local and systemic complications (1,2). However, fistula formation is noted in only a very small proportion of patients with acute pancreatitis (3). These fistulas are generally a result of disruption of the pancreatic duct, which may be due to several etiologies such as trauma, surgical trauma, pancreatic resection, or those causing pancreatitis (4). Pancreatic duct disruption results in fluid leakage, which causes erosion and formation of pathways, the locations of which depend on the anatomic location of the duct disruption (4). Management of pancreatic fistulas includes medical and nutritional optimization, surgical interventions, endoscopic treatments, and catheter drainage (3, 5-7).Pseudocysts associated with acute pancreatitis are loculated fluid collections that are rich in amylase and usually develop within 2 weeks of onset of pancreatitis (8). They may be intra- or extra-pancreatic, are inflammatory, and lack a true epithelial lining. Just like pancreatic fistulae, pancreatic pseudocysts generally develop secondary to disruption of the pancreatic duct, and resolve spontaneously unless they develop complications (8). The management of pancreatic pseudocysts includes but is not limited to, percutaneous, endoscopic, and surgical drainage among others (9-11).Among these complications, pancreatic pseudocyst stands as a rare but significant entity. A pancreatic pseudocyst represents an abnormal fluid collection originating from the pancreas and can arise as a consequence of acute or chronic pancreatitis and remains relatively uncommon in clinical practice.The clinical presentation of pancreatic pseudocyst may include abdominal pain, fever, and biochemical abnormalities indicative of pancreatic injury.In this report, we present a case of pancreatic pseudocyst formation secondary to pancreatitis in a 42-year-old male, highlighting the clinical presentation, diagnostic evaluation, therapeutic interventions, and outcomes. Through this case, we aim to underscore the importance of early recognition and appropriate management of pancreatic pseudocysts to prevent complications and optimize patient outcomes.

Photoelectrochemical conversion of glycerol into high-value dihydroxyacetone offers a sustainable approach via BiVO4, which manifests highly photoactive properties, but poor charge transport ability. Herein, we fabricated N2-annealed BiVO¬4 through a simple spin-coating method and N2 annealing process. The effect of N2 treatment did not significantly impact the surficial catalytic efficiency, while the bulk efficiency was increased, resulting from changes in oxygen vacancy concentration and carrier density. Owing to simultaneous improvement in bulk electron-hole separation efficiency, N2-annealed BiVO4 at 150 ℃ exhibited an enhanced photoelectrochemical dihydroxyacetone production rate of 160 mmol m-2 h-1 at 1.0 V vs. RHE, which was about more than 2 times higher than pristine BiVO4. This work not only makes biodiesel production more profitable and sustainable but also achieves advanced production of dihydroxyacetone.

A document by Pei Tao. Click on the document to view its contents.

Case Report: Hypertensive Anaphylaxis Misdiagnosed as COPD-Asthma Overlap SyndromeSunil Kumar Das1 , Bibek Bhandari21Patan Academy of health sciences, General practice and emergency medicine2Tribhuvan University Institute of Medicine, Internal medicineAuthors :Dr. Sunil Kumar Das, GPEM Rampur Hospital ,Nick Simons institute, Rampur, Palpa

Present antimicrobial susceptibility testing technologies generate data at a single time point over 24 hours of a day, which are considered to represent the susceptibility profile of the antibiotic in question. By questioning the epistemological value of the single time-point susceptibility testing, a time-dependent antimicrobial susceptibility study was designed. Time-dependent antimicrobial susceptibility testing was realized at six different hours of the same day to reveal the time-dependent variation of in vitro interaction between antibiotics and bacterium. The study data revealed a significant daily time-dependent oscillation in antimicrobial susceptibility testing in terms of inhibition zone value. The bacterium seems to be most susceptible to antibiotics in the dark phase (or transition to the dark phase) of the day.

[In abstract, the text “The most potent inhibition of MERS‐CoV plaque formation was seen by G (1.5)‐16COONa (40.5% inhibition), followed by G(5)‐128SA ( 39.77% inhibition)” is incorrect. This should have read “The most potent inhibition of MERS‐CoV plaque formation was seen by G (1.5)‐16COONa (40.5% inhibition), followed by G(5)‐128SA ( 39.67% inhibition)”].

Purpose: Record linkage based on quasi-identifiers remains an important approach as not every data source provides a comprehensive unique identifier. In this study, reasons for the failure of a linkage based on quasi-identifiers were examined. Furthermore, informed algorithms using information on gold-standard links were developed to investigate the potentially achievable linkage quality based on quasi-identifiers. Methods: Linkage algorithms were applied on German claims and cancer registry data using information on gold-standard links. Informed linkage algorithms based on deterministic linkage, logistic regression, random forests, gradient boosting and neural networks were derived and compared. Descriptive analyses were performed to identify reasons for failure of linkage such as discrepancies between data sources. Results: A linkage approach based on gradient boosting performed best and reached a precision of 77%, a recall of 81% and an F*-measure of 64%. Of 641 patients in GePaRD, 8% were not uniquely identifiable using birth year, sex, area of residence, year and quarter of diagnosis, whereas 33% of 42,817 cancer registries patients of Bremen and Lower Saxony were not uniquely identifiable with these quasi-identifiers. Conclusions: Linkage of German claims and cancer registry data based on quasi-identifiers does result in insufficient linkage quality since subjects cannot be uniquely identified. It is advisable to use unique identifiers from a subsample, if available, to derive informed linkage algorithms for the entire sample. In this case the machine learning technique gradient boosting has been found to outperform other methods.

Introduction: The non-recurrent laryngeal nerve (NRLN) is a known anatomical variation of the normal recurrent laryngeal nerve (RLN). Its prevalence is estimated <1% and is prone to higher risk of iatrogenic injury. The risk of injury during thyroid surgery have been reported as variable in current literature, from 0% up to 12%. This study aimed to systematically review the incidence of NRLN injury and present the results through meta-analysis. The incidence of injury to NRLN and RLN was compared and analysed to determine its statistical significance. Methods: The PRISMA protocol was followed for an online search of prominent literatures. Studies were selected and excluded according to specific criteria. Quality assessment was performed, and data was extracted. Meta-analysis was conducted for the incidence of injury of the NRLN, and its comparison to the RLN. Results were presented in the form of a systematic review and discussed. Results: 17 studies were included in the final analysis. It was found that the pooled risk of NRLN injury was 7% and the risk ratio of injury in comparison to the RLN was 3.8, showing a statistically significant difference. Conclusion: This is the first study to report the overall risk of injury to the NRLN and found a statistically significant difference in comparison to the injury of RLN. This evidence provides grounds for future surgical guidelines to prevent injury to the NRLN. It is suggested that intra-operative nerve monitoring (IONM) should be performed in all patients found to have NRLN pre-operatively and intra-operatively.

Background: Beta-blockers are frequently used anti-hypertensive agents. It has been proposed that beta-blocker usage can potentially impact outcomes among cancer patients. While there is existing literature on the matter, studies have yielded conflicting results. The aim of this systemic review and meta-analysis is to further investigate the effect of beta-blockers on survival and recurrence among those diagnosed with cancer. Methods: We systematically searched PubMed, Web of Science, Embase, and Cochrane Library for relevant studies published until October 16 th, 2023. Hazard ratios (HR) and their corresponding 95% confidence intervals were extracted from the studies. Subgroup analysis and sensitivity analysis were performed to investigate heterogeneity and make results more reliable. Results: Data from fifty-four studies was included in this meta-analysis. A subgroup analysis was conducted based on the type of beta blockers and the type of cancer to assess the overall survival (OS) outcome. It was found that beta-blockers had no significant impact on overall survival, based on the type of cancer (HR=0.99; 95% CI: 0.94-1.04; P=0.70), and the type of beta-blockers (HR=0.99; 95% CI: 0.91-1.04; P=0.23). However, statistically significant results were observed for the outcome of cancer recurrence, favoring the beta-blocker group over the control group. A sensitivity analysis was conducted on both the outcomes to assess the heterogeneity in the results, reducing it considerably. Conclusion: According to our results, it can be concluded that the usage of beta-blockers generally has no significant impact on survival outcomes, however, a positive impact on recurrence was observed. There was a downward, yet non-significant, trend in pancreatic and ovarian cancer, indicating that further studies should investigate this.

s: In riverine, marsh, coastal, and other environments, vegetation communities are widely distributed and interact with the flow system to produce more complicated flow structures. Four sets of indoor flume vegetation flow experiments were conducted using a typical Beach trough structure in the lower sections of the Yangtze River as an example. The compound channel was divided into the main channel zone, side slope zone, and side beach zone, and simulated vegetation such as reed, sedge, and dwarf grass was used. The emphasis was on the hydrodynamic properties under semi-covered submerged rigid vegetation and semi-covered non-submerged rigid vegetation. This research focuses on the Shiono and Knight equations (SKM model) to clarify the distribution characteristics of cross-section flow velocity and the ”equivalent diameter D” of gradual vegetation in water. We also propose a new secondary flow model using a genetic algorithm and investigate the relationship between the parameters of the vegetation the flow structure and the distribution pattern of the secondary flow coefficient values. Finally, it employs the Taylor method to demonstrate that the proposed ”equivalent diameter D” of the vegetation has some value within a reasonable threshold range. Eventually, the depth-averaged velocity of the compound channel was accurately predicted by combining the experimental data with the novel SKM model. The proposed model can provide technical support for river flooding.

Pleistocene glaciation events had a dramatic impact on temperate taxa by displacing animal and plant populations south of ice sheets into glacial refugia. Genetic variation often reflects these histories of isolation within glacial refugia and subsequent recolonization. The highly speciose rodent genus Peromyscus, in particular, is well known for its rapid diversification during the Pleistocene. Peromyscus are also significant reservoirs for a myriad of zoonoses, and many cosmopolitan species are undergoing range expansions due to human land use and climate change. This study focused on the range-wide phylogeography of the white-footed mouse (Peromyscus leucopus), a common species found in eastern North America that is one the primary reservoirs for Lyme Disease (Borrelia burgdorferi). We used two mitochondrial genes, cytochrome b and control region, to identify evolutionary lineages of white-footed mice and characterize patterns of expansion of each lineage across their geographic range. Overall, we found evidence for four evolutionary lineages with a Southwest lineage largely restricted to grassland and desert habitats. Time since recent common ancestors placed all lineages diverging within the Last Glacial Maximum (~19-25k years ago). All lineages exhibited signatures of expansion, particularly the two northern lineages known to host Lyme Disease. Overall, white-footed mice underwent rapid diversification similar to other Peromyscus species and potentially exhibit habitat-based divergence within the Southwest lineage. Signatures of expansion also indicate that white-footed mice will continue to facilitate increased spread of zoonoses like Lyme Disease, but further study is needed to clarify how these evolutionary dynamics interact with other factors associated with human disease incidence.

This study marks the first identification and genomic characterization of Comamonas kerstersii isolates from diarrheal patients in Bangladesh. C. kerstersii is a gram-negative opportunistic bacterium that has also been reported in several clinical samples, including urine, blood, stool, peritoneal liquid, and sputum. We carried out the whole genome sequencing of three C. kerstersii isolates with the aim of analyzing genomic features in 3 different strains isolated from Bangladesh for the first time. Phylogenetic analysis suggests that these three strains share a clonal relationship. Seven AMR genes, aph(6)-Id, aph(3”)-Ib, mph(E), mph(F), msr(E), sul2, and tet(A), have been observed in all the strains. We identified several virulence factors, including copper homeostasis genes, type IV pili, and type VI secretion system. Phage regions and IncQ1 plasmid were also detected. These initial findings highlight the need for extensive genomic surveillance of C. kerstersii in different diarrheal patients, along with investigating their genotype-phenotype correlation to understand the molecular pathogenesis in detail.