Background: Necrotizing enterocolitis (NEC) is a severe inflammatory gastrointestinal disease that affects premature neonates with high morbidity and mortality. We aimed to evaluate the potential of IgG anti-tissue transglutaminase antibodies (IgG tTG) as biomarkers for NEC and to explore their applicability in the early diagnosis, monitoring prognosis. Method: We conducted a prospective observational study on 60 neonates with abdominal distension, dividing into the NEC(n=30) and the control(n=30) groups according to the follow-up results. We collected plasma samples within 48 h of the onset of abdominal distension, and used the autoantigen microarray to screen for NEC-associated autoantibodies. Additionally, an Enzyme-linked immunosorbent assay (ELISA) was utilized to measure the levels of IgG tTG in a validation study that included 43 neonates with NEC and 20 gestational age- and weight-matched controls. Results: The autoantibody microarray analysis indicated that plasma levels of IgG tTG were significantly higher in neonates with NEC compared to controls ( P< 0.001). ELISA confirmed the significant elevation of plasma IgG tTG in neonates with NEC ( P<0.001). Plasma IgG tTG were able to distinguish NEC from the control group, with an area under the curve (AUC) of 0.8674 (95% confidence interval (CI): 0.7794 - 0.9555, sensitivity of 72.09% and specificity of 95%). Encouragingly, IgG tTG levels were significantly higher in NEC stage I than in the controls ( P < 0.001). Furthermore, as neonates with NEC showed clinical improvement, the levels of IgG tTG decreased ( P=0.0159). Conclusion: IgG tTG may serve as a biomarker for diagnosis early NEC and predict its prognosis.

Letter to the EditorComment on: van der Rijst LP et al

Delayed diagnosis of Granulomatosis with Polyangiitis in a 39-year-old woman with situs inversus totalis: A Case Report   Authors: Hanie Forouzandeh¹Ahmadreza Rajabi¹, Abbas Ali Torfeh Esfahani², Farzin Khorvash², Mansoor Karimifar³  Affiliations: ¹ School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. ² Department of Infectious Diseases and Tropical Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. ³ Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.Corresponding author: Abbas Ali Torfeh Esfahani Department of Infectious Diseases and Tropical Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Email Address: [email protected] Full postal address: P.O. Box 791 – Al-Zahra Hospital – Soffe St. – Isfahan - Iran Tel: (+98) 31-36202086 https://orcid.org/[email protected] Ahmadreza Rajabi : https://orcid.org/[email protected] Abbas Ali Torfeh Esfahani : https://orcid.org/[email protected] Farzin Khorvash : https://orcid.org/[email protected] Mansoor Karimifar: https://orcid.org/[email protected] with Ethical Standards Data availability statement: Data sharing is not applicable to this article as no new data were created or analyzed in this study.Funding statement: None.Conflict of interest disclosure: None.Ethics approval statement: not applicable.Patient consent statement: Written informed consent was obtained from all individual participants included in the study.Permission to reproduce material from other sources: not applicable.Clinical trial registration: not applicableAuthor Contributions Hanie Forouzandeh: Writing – original draft, Data curation, study design, Supervision, Project administration Ahmadreza Rajabi: Writing – original draft, Data curation Abbas Ali Torfeh Esfahani: Supervision, Writing – review & editing, Conceptualization, Project administration Farzin Khorvash: Writing – review & editing, Conceptualization Mansoor Karimifar: Writing – review & editing, ConceptualizationAcknowledgments Conflict of interest All the authors have declared no competing interests.Human and Animal Rights This article does not contain any studies with human participants or animals performed by any of the authors.Informed consent Informed consent was obtained from all individual participants included in the study. Author’s contribution All authors contributed to the study design, data collection, and writing the draft of the study. All read and confirmed the final version of the manuscript.AbstractSitus inversus totalis (SIT) is a rare congenital condition characterized by the transposition of both abdominal and thoracic organs. Individuals with Situs inversus totalis (SIT) may also have Kartagener syndrome, which is characterized by a triad of situs inversus, bronchiectasis, and recurrent sinusitis. Granulomatosis with polyangiitis (GPA), also known as Wegener’s granulomatosis, is a rare condition. GPA involves granulomatous inflammation in tissues and blood vessels, potentially leading to organ damage. To date, no cases of Situs inversus totalis (SIT) individuals with Wegener’s granulomatosis have been reported in the literature. Our study aims to report a case with misleading information in medical history, leading to a delayed diagnosis of Granulomatosis with polyangiitis (GPA). Keywords: situs inversus totalis, Kartagener syndrome, Granulomatosis with polyangiitis, Wegener’s granulomatosiskey clinical message: The main clinical point in this article is being aware of all possible differential diagnoses despite all misleading data on the patient’s history. It is also very interesting that we have a patient who has a rare congenital condition with a diagnosis of a rare disease.IntroductionSitus inversus totalis (SIT) is an extremely rare congenital condition characterized by the transposition of both abdominal and thoracic organs. This rare condition occurs in approximately 1:10,000 individuals(1). Even most professional surgeons may encounter only 1 to 2 cases throughout their entire career(2). Typically, these cases are discovered incidentally during medical procedures or imaging tests(3). Sometimes these people have Kartagener Syndrome which is defined by a triad of situs inversus, bronchiectasis, and recurrent sinusitis(1). Granulomatosis with polyangiitis (GPA), also known as Wegener’s granulomatosis, is a rare condition with an unknown cause. It affects approximately 3 in every 100,000 people and typically occurs around the age of 45 in both males and females. Granulomatosis with polyangiitis (GPA) is characterized by inflammation in the tissues, known as granulomatous inflammation, as well as inflammation in the blood vessels (vasculitis), which can lead to organ damage. While the sinuses, lungs, and kidneys are the most commonly affected areas, GPA can impact any part of the body(4).We herein present a patient with situs inversus totalis who has been diagnosed with GPA (Wegener’s granulomatosis) at Alzahra Medical & Educational Center \RL of Isfahan.Case presentationWe present a case of a 39–year–old woman with situs inversus totalis and a previous history of Kartagener syndrome and hypothyroidism. She came to the emergency department with intermittent petechiae and purpura in her lower limbs and intermittent high-grade fever and true chills from 3 months ago. She was giving a history of traveling to the Malaria-endemic region. Rashes and fever started right after her trip. She was giving a history of mild weight loss, nausea, and vomiting. Vital signs demonstrated a fever of 38.5°C, blood pressure (BP) 95/60, pulse rate (PR) 100, respiratory rate (RR) 24, and O2sat 88%. In the physical examination, we found a mild crackle in lung auscultation. Rashes were non-blanching. Laboratories were remarkable for leukocytosis of 14.05 with left shifting and thrombocytosis of 535. ESR was 101 and CRP was 88. Serum creatinine was 1.4 at first and then rose to 1.7 in three days. CXR showed evidence of mild infiltration in the lower lobe of the left lung and mild pleural effusion on the left side (Figure1). We tapped the pleural effusion. It had an exudative pattern in analysis. With a suspicion of Malaria, we performed PBS but it didn’t confirm Malaria. We requested blood culture, sputum culture, wright test, PPD skin test, Widal test, and viral markers, which all were negative. U/A was remarkable for protein (++), blood (+++), RBC (many, 40% dysmorphic), and granular casts (1-2). Urine culture was negative. The stool exam was normal and the stool culture was negative. Endoscopy was performed for continuous nausea and vomiting and food intolerance, too. It showed erosive gastropathy. We also ruled out endocarditis with a normal echocardiography with no evidence of vegetation. Then we changed our approach from infectious diseases that were related to her travel, to rheumatologic diseases. So, we requested rheumatologic tests, and C-ANCA (Anti PR3) and ANA and RF were positive among them (The results are in Table1). We also performed a Chest M.D.C.T that showed cystic bronchiectasis(Figure2), mild infiltration in the lower lobe of the left lung, and mild pleural effusion on the left side (figure3) and we did a normal Abdominal M.D.C.T Scan.Differential diagnosis:Differential diagnoses of fever and rash included infectious diseases like mononucleosis, Meningitis, Endocarditis, Malaria, Dengue fever, Scarlet fever, malignancies like Lymphoma, or autoimmune diseases like Vasculitis, SLE, and Still’s.Treatment plan:At first, we had started antibiotics for her because of our suspicion of infectious diseases but she had a fever for the next 3 days despite antibiotic therapy, then after the positivity of autoimmune tests, we changed our treatment. First, the patient was started on three consecutive pulse doses (1gr) of Methylprednisolone Sodium Succinate then she received 1gr Rituximab, and this dose was repeated fourteen days later. We continued her therapy with a Prednisolone Tab (10mg/three times a day), Azathioprine Tab (daily), and Calcium D Tab (daily). Then a month after the second dose of Rituximab, we increased the dose of Azathioprine Tab to 50mg twice a day and we slowly tapered Prednisolone. This is important to mention that we chose Rituximab among other common treatments because the patient was of reproductive age and treatments like Cyclophosphamide could lead to infertility. We also added Cotrimoxazole 400/80mg Tab for prevention of Pneumocystis Carinii.Follow up:To date when we write this report, the patient’s signs and symptoms are improved. Serum creatine decreased to 1.3 and urine analysis turned to normal.DiscussionAntineutrophil cytoplasmic antibody ANCA-associated vasculitis (AAV) encompasses a group of multisystem disorders that cause inflammation in the small blood vessels. This group includes granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA)(5)\RL. As described in the classification criteria for granulomatosis with polyangiitis, PR3-ANCA is most frequently linked with granulomatosis with polyangiitis (GPA), but MPO-ANCA is more prevalent in microscopic polyangiitis (MPA)(6)\RL. Advances in the diagnosis and treatment of ANCA-associated vasculitis (AAV) have significantly improved outcomes, changing it from a rapidly fatal disease with an untreated 1-year mortality rate of 80% to a condition that has relapsing and remitting episodes, albeit with ongoing morbidity and mortality in the long term. Pulmonary complications, both acute and chronic, are common in ANCA-associated vasculitis (AAV), affecting 25% to 80% of cases according to references. Lung involvement is increasingly recognized as a key contributor to the persistent morbidity and mortality in ANCA-associated vasculitis (AAV), with early pulmonary manifestations being linked to severe organ damage and poor outcomes in GPA(6)\RL.Conclusion Although there are few articles about the association between ANCA-associated vasculitis (AAV) and pulmonary involvements such as bronchiectasis(6), there is no published article about situs inversus individuals with GPA or association between Kartagener syndrome and ANCA-associated vasculitis (AAV). Additionally, our case had a history of traveling to malaria-endemic regions, which misled us in our approach to limb petechiae and fever and it made our case more noteworthy to report. However, further tests led to the diagnosis of ANCA-associated vasculitis (AAV).

This paper provides a review of research on robotics in search and rescue operations in caverns, underground coal mines, disaster zones, and environments where the Global Navigation Satellite System (GNSS) is unavailable. The majority of applications for Simultaneous Localization and Mapping (SLAM), despite its maturity, are still restricted to indoor structured scenes or outside conventional weather conditions. The standard SLAM technology will experience malfunctions and perhaps fail as the robot encounters increasingly complicated environments. Three main issues that robots encounter in search and rescue (SAR) environments are outlined in this review, along with an introduction to the classic SLAM framework and a range of sensors used for SLAM. These issues include robots encountering increasingly complex terrain, changing environments and visibility, and autonomous exploration requirements. A thorough analysis of methods for resolving these problems is also included; they include multi-sensor fusion, active SLAM, and SLAM on uneven terrain. Also, a prospective path for future study is presented.

Subserosal Ectopic Pregnancy: A Rare Case ReportAhmed Sabry 1,2, Gamal Sayed 3,4, Reda Youssef, 1,2,3, Samah Kohla 2,5, Sana Badr 1, Hashem Alakshar 1, Thomas Farrell 4, and Amal Alobaidly 1.1-Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar2- Weill Cornell Medical College, Doha, Qatar.3- Clinical Department, Qatar University, College Of Medicine, Doha, Qatar4- Department of Obstetrics & Gynecology, Women’s Wellness and Research Center, Doha, Qatar5- Department of Laboratory Medicine and Pathology, Hematology Division, Hamad Medical Corporation, Doha, Qatar

Plants are naturally affected against wide range of human diseases. They were used from ancient times for several purposes including cooking, preserving food, for treating a wide range of health conditions including cold, dysentery, anemia, wound heeling, curing insect bites and injuries. Nowadays people prefer products derived from natural sources more then products that are made from chemical methods. The plant Ocimum basilicum has a very range of health benefits including its potency to cure several skin conditions. This study aims to develop ,evaluate ,and determine the effectiveness of the herbal ointment made from Ocimum basilicum without alcohol and bees wax, using chea butter as thickening agent with the main focus on determining its outcome on common dermatological conditions such as acne(bacterial infection),eczema, inflammation, minor cuts, scrape wound. The prepared ointment was then evaluated for physiochemical characteristics including safety assessment of skin and stability tests. Then In Vivo experiments were carried in a group of volunteers including teenage and adults(two boys and three girls) skin, it reduced redness, inflammation and cured acne. The results showed the wound heeling ,anti-inflammatory and anti-bacterial activity of this ointment .In conclusion ,no adverse reaction of this ointment was observed on skin , The thorough evaluation of this ointment has confirmed its anti-bacterial activity because of its ability to kill bacterial strains causing acne. Further research is needed for its commercial usage and clinical trials to use for Post surgery wounds, serious bacterial and fungal infections.

Calculations can be made over time to determine the reliability of modern machinery and equipment, as well as each of their separate sections and components. This study emphasizes how crucial it is to examine the industry's data analysis and reliability. With the help of this study, it is possible to identify the pattern of damage that has taken place and choose the best course of action. The D 320-50 centrifugal pump in the TPU's IRT-T reactor was used for this study. Since the centrifugal pump that is the focus of this work has already had multiple substantial failures, the primary objective of this research is to evaluate the reliability of centrifugal pumps utilizing recurrent data analysis for failure modes. Using data from the daily operating report, it is possible to determine each pump component's dependability and assess its maintenance requirements.

The dynamics of virulence evolution in vector-born plant pathogens can be complex. Here we use individual-based simulations to investigate how virulence evolution depends on genetic trade-offs and population structure in pathogen populations. Although quite generic, the model is inspired by the ecology of the plant-pathogenic bacterium Xylella fastidiosa, and we use it to gain insights into possible modes of evolution of virulence in that group. In particular, we aim to sharpen our intuition about how virulence may evolve over short time scales in response to decreases in vector efficacy. We find that even when pathogens find themselves much more often in hosts than vectors, selection in the vector environment can cause correlational and potentially non-adaptive changes in virulence in the host. The extent on such correlational virulence evolution depends on many system parameters, including the pathogen transmission rate, the relative proportions of the pathogen population occurring in hosts versus vectors, the strengths of selection in host and vector environments, and the extent of virulence per se. But there is a statistical interaction between the strength of selection in vectors and the predominance of pathogens in hosts, such that if within-vector selection is strong enough, the predominance of pathogens within hosts has little effect on the evolution of virulence.

(1) Invasive predators pose a serious threat to native biodiversity, with trapping being one of several methods developed to manage and monitor their populations. Many individuals in these predator populations have been found to display trap-shyness, which hinders eradication and results in inaccurate estimates of population size. Lures are used to help overcome trap-shyness by increasing the probability of interaction with the device but the extent of this behavioural trait in wild populations, and the best timing for the introduction of a new lure or combination of lures, are uncertain. A key challenge for wildlife managers is maximising the efficacy of invasive predator control, particularly in relation to baiting and trapping, so that pests are extirpated, or survivors are reduced to a minimum. (2) We first use a Bayesian estimation method to quantify the trap-shyness trait in a population of brushtail possum in a New Zealand forest; the resulting estimated parameters are then used to calibrate a stochastic, individual-based model simulating the outcomes of different luring scenarios. (3) We show that the brushtail possum (Trichosurus vulpecula) population analysed was likely split into a smaller, very trappable group, and a larger trap-shy group, with low mean nightly probability of interaction with traps of 28% [14%-56%]. (4) Synthesis and applications: Our results show that using multiple lures can result in a greater population knock-down than using a single lure, and that it is more efficient to use a combination of lures for the entire duration of a kill-trap operation than to switch from one lure to another.

Title PageTitle： Leukemia Cutis Presenting as a Sole Sign of Relapsed in Adult Philadelphia chromosome-positive acute B-lymphoblastic leukemia: a case report with literature review

Clinical Case Reports – Case Image

The Arctic environment plays a critical role in the global climate system and marine biodiversity. The region’s ice-covered expanses provide essential breeding and feeding grounds for a diverse assemblage of marine species, who have adapted to thrive in these harsh conditions and consequently are under threat from global warming. The bearded seal (Erignathus barbatus) is an ice-obligate Arctic species using sea-ice for many aspects of its life-history, rendering it particularly vulnerable to sea-ice loss. It is one of the least studied and hence enigmatic of the Arctic marine mammals, with little knowledge regarding genetic structure, diversity, adaptations and demographic history, consequently hampering management and conservation efforts. Here, we sequenced 70 whole nuclear genomes from across most of the species’ circumpolar range, finding significant genetic structure between the Pacific and the Atlantic subspecies, which diverged during the Penultimate Glacial Period (~192 KYA). Remarkably, we found fine-scale genetic structure within both subspecies, with at least two distinct populations in the Pacific and three in the Atlantic. We hypothesize sea-ice dynamics and bathymetry had a prominent role of in shaping bearded seal genetic structure and diversity. Resulting genomic data can be used to complement the health, physiological, and behavioral research needed to conserve this species. In addition, we provide recommendations for management units that can be used to more specifically assess climatic and anthropogenic impacts on bearded seal populations.

To produce viable seeds, plants must simultaneously allocate mass to other reproductive tissues; however, it remains unclear how big these investments are, relative to seeds, and how much the balance of investment across diverse species reflects broader variation in their life history strategies. In particular, species are known to vary in their seed mass, and the amount they invest in pollen attraction versus seed provisioning. We quantified overall reproductive investment and its partitioning among different reproductive tissues for 14 perennial species in a recurrent-fire heath community. Integrating two lineages of evolutionary theory led to the prediction that relative investment in different reproductive tissues would be correlated with a species’ seed size, and the data supported this. Species with larger seeds were found to mature a smaller proportion of ovules, to expend more of pre-zygotic investment on discarded tissues, and to invest more in seed provisioning compared to pollen attraction. A little more than half of this correlation is phylogenetically conservative, reflecting the tendency for many species in Proteaceae to have large seeds, low seed set and relatively lower investment in pollen attraction. The total cost of accessory tissues – reproduction-related mass not directly invested in the seed – ranged from 95.8% to 99.8% of total investment for species in this study. Counting only seeds thus substantially underestimates total reproductive investment. Many studies have established that the seed size of a species positions it along a colonization-competition life-history spectrum. Here we have shown that relative investment in pollen-attraction versus provisioning tissues and in successful versus discarded ovules are also associated with seed size. The seed size spectrum among angiosperms is therefore connected with a spectrum of reproductive allocation strategies.

Shiitake mushrooms (Lentinula edodes) hold significant cultural and economic value, particularly in Asia where they are extensively cultivated. The diversification of shiitake cultivars, driven by the need to adapt to various climatic conditions and cultivation methods, has resulted in over 200 distinct cultivars. Reliable identification of these cultivars is crucial for breeding, intellectual property protection, and effective genetic resource management. Traditional morphological methods are inadequate due to their subjectivity and labor-intensive nature. This study leverages nanopore high-throughput sequencing to comprehensively analyze the rDNA regions (SSU, ITS, LSU, IGS) of 41 shiitake strains from Taiwan’s Bioresource Collection and Research Center (BCRC), comprising 5 wild strains, 33 commercial strains, and 3 wild-commercial hybrids. Our results identified the IGS1 region as the most variable and suitable for cultivar differentiation. Consequently, we developed an interactive online database that integrates 317 IGS1 sequences from Taiwan, Japan, and China. This platform allows users to upload their IGS1 sequences and identify similar cultivars through a user-friendly interface, enhancing the precision and efficiency of shiitake cultivar identification.

A document by Kenneth Egwu. Click on the document to view its contents.

Throughout the COVID-19 pandemic, effective risk communication emerged as pivotal in fostering positive behavioral changes that aligned with the evolving evidence and stages of the pandemic. It stood alongside key strategies like enhanced surveillance, extensive testing, stringent quarantine, and strategic case management in Bhutan's response. Over the past three years of the pandemic, we have gained profound insights into risk communication's impact. This article aims to illuminate diverse approaches in managing public information during the pandemic. The authors also suggest potential research agendas, and policy and system-level reforms in the realm of risk communication.

The development of new efficient strategies for the construction of the C-S bond has attracted considerable interest due to its presence in various crucial biological systems and pharmaceutical compounds. Alkene hydrothiolation is one of the simplest and most atom-economic methods for organosulfur synthesis. This review focuses on transition-metal-catalyzed C-S bond formation via alkene hydrothiolation with thiols and is divided into three sections covering 3d, 4d, and 5d transition-metal-catalyzed hydrothiolation re-ported from 2013 to the present. Synthetic methods, substrate scope, and reaction mechanisms are discussed. We aim to provide a concise overview of recent advances in the hydrothiolation of alkenes and hopefully encourage further exploration to fill the gaps. The current landscape suggests considerable potential for future innovation and discovery in this field.

In this manuscript, we elucidate essential connections associated with the ( α , k ) − gamma and ( α , k ) − beta functions, initially introduced by Sarikaya et al. in their work as referenced in [14]. Our investigation includes the establishment of numerous conformable fractional integral inequalities, extending those previously established for the k−gamma and k−beta functions. Furthermore, we provide rigorous proofs affirming the log-convex nature of both the ( α , k ) − gamma and ( α , k ) − beta functions.