The Global Methane Pledge declared at the 2021 United Nations climate change conference (COP26) marked the world’s commitment to eradicate methane emissions. Most of these emissions are generated by the oil-gas industry, waste landfills, and agriculture sectors, and are lean in composition. This work explores the use of an intensified reactor that implements the chemical looping principle to handle lean methane emissions. A model-based framework is used to showcase the baseline performance of the proposed reactor in converting methane emissions using nickel-based oxygen carriers. Then, sensitivity analysis of the reactor performance with respect to operating conditions is performed. The reactor is subsequently optimized to minimize the methane emitted, using a dynamic program with safety and operability constraints for the alternating redox process. With the optimal cycle strategy, we demonstrate that near-complete methane conversion can be achieved by the reactor without external heating.

One of the core challenges to achieve Land Degradation Neutrality (LDN) is to spatially identify, and strategically prioritise, the areas to implement actions to avoid, reduce and reverse land degradation. To achieve this, a tool for a participatory and data-driven assessment considering both the biophysical, and socio-economic dimensions of land degradation across scales was developed for Ecuador. In this paper, we present the methodology and results obtained, including the spatially explicit interactive tool developed to integrate indicators that support the scaling-up of sustainable land management (SLM). The process involved specialists from various national and international institutions, as well as decision makers from the public sector and other relevant stakeholders. Cloud computing allowed the integration of five main sources of data: (1) the results of a participatory land degradation assessment based on an expert knowledge questionnaire following the Land Degradation Assessment in Drylands (LADA) and World Overview of Conservation Approaches and Technologies (WOCAT) methodology; (2) the Hand-in-Hand Initiative Ecuador typology maps based on poverty maps and estimated agricultural potential and efficiency scores using household surveys on agricultural production; (3) National data sets on land cover and land use, soil properties, and hydro climatic indicators; (4) global satellite-derived LDN indicators, such as Land Productivity Dynamics; and (5) Documented SLM practices from WOCAT Global SLM Database. The tool is based on a Google Earth Engine application and allows decision makers to easily compare results and obtain statistics at different spatial scales and landscapes, including 647 Land Use Systems delimited by experts. It also includes a multi-criteria module to identify areas with specific characteristics to prioritise different types of interventions to achieve the country´s LDN targets. Convergence of local and global evidence allowed the identification of hotspots of degradation as well as areas of false positives/negatives - if only global or remote sensing indicators were considered. The participatory process contributed to strengthening multi-sector cooperation mechanisms and to guaranteeing ownership of the tool and the results. The system will support Ecuador’s efforts to monitor and report progress towards LDN to the United Nations Convention to Combat Desertification. The system´s code is shared as a repository at Earth Engine and can be adapted to and used by other countries and regions.

Coronavirus disease is a viral infection affecting different organs with various morbidities and mortality. Vaccines are used to control the disease. COVID-19 vaccines have brought many benefits but their adverse effects should not be ignored. Here, we report a case of Guillain-Barré Syndrome Following Sinopharm COVID-19 Vaccine.

Many populations of long-distance migrant shorebirds are declining rapidly. Since the 1970s, the Lesser Yellowlegs (Tringa flavipes) has experienced a pronounced reduction in abundance of ~63%. The potential causes of the species’ decline are complex and interrelated yet understanding the timing of migration and seasonal routes used by this species will aid in directing conservation planning to address potential threats. During 2018–2021, we tracked 118 adult Lesser Yellowlegs using GPS satellite tags deployed on birds from five breeding and two migratory stopover locations spanning the boreal forest of North America from Alaska to eastern Canada. Our objectives were to quantify migratory connectivity and identify key stopover and non-breeding locations. Individuals tagged in Alaska and central Canada followed similar southbound migratory routes through the Prairie Pothole Region of North America, whereas birds tagged in eastern Canada completed multi-day transoceanic flights covering distances of >4,000 km across the Atlantic between North and South America. Upon reaching their non-breeding locations, Lesser Yellowlegs populations overlapped, resulting in weak migratory connectivity. Lastly, freshwater and agricultural habitats of the Prairie Pothole region supported the highest proportion of Lesser Yellowlegs during southbound migration. Our findings suggest that while Lesser Yellowlegs travel long distances and traverse numerous political boundaries each year, the breeding population from which an individual originates likely has the greatest influence on which threats birds experience during migration. Further, the species’ dependence on wetlands in agricultural landscapes during migration may make them vulnerable to threats related to agricultural practices, such as pesticide exposure.

Rupture of ovarian dermoid-cyst is rare case. We report the case of a woman admitted for acute post-traumatic abdominal pain due to ruptured ovarian cyst. The patient was operated and we found a very abundant peritoneal effusion with left ovarian cyst which was broken. we performed a left adnexectomy.

Most instances of Guillain-Barré syndrome (GBS) are caused by immunological stimulation and are discovered after vaccinations for tetanus toxoid, oral polio, and swine influenza. This systematic study investigated GBS cases reported after receiving the COVID-19 vaccination.

Sneddon syndrome (SS) is a clinical entity corresponding to a non-inflammatory thrombotic vasculopathy that includes livedo reticularis (typical skin lesions) and cerebrovascular lesions. We present here a case of autoimmune SS with dementia and psychosis as the main features that revealed the disease, in a 45-year-old Tunisian man

Background Optimal occlusion of pulmonary vein (PV) is essential for atrial fibrillation (AF) cryoballoon ablation (CBA). The aim of the study was to investigate the performance of two different tools for the assessment of PV occlusion with a novel navigation system in CBA procedure. Methods In consecutive patients with paroxysmal AF who underwent CBA procedure with the guidance of the novel 3-dimentional mapping system, the baseline tool, injection tool and pulmonary venography were all employed to assess the degree of PV occlusion, and the corresponding cryoablation parameters were recorded. Results In 23 patients (mean age 60.0 + 13.9 years, 56.5% male), a total of 149 attempts of occlusion and 122 cryoablations in 92 PVs were performed. Using pulmonary venography as the gold standard, the overall sensitivity, specificity of the baseline tool was 96.7% (95% CI 90.0% - 99.1%), and 40.5% (95% CI 26.0% - 56.7%), respectively, while the corresponding value of the injection tool was 69.6% (95% CI 59.7% - 78.1%), and 100.0% (95% CI 90.6% - 100.0%), respectively. Cryoablation with optimal occlusion showed lower nadir temperature (baseline tool: -44.3 + 8.4 ℃ vs -35.1 + 6.5 ℃, p < 0.001; injection tool: -46.7 + 6.4 ℃ vs -38.3 + 9.2 ℃, p < 0.001) and longer total thaw time (baseline tool: 53.3 + 17.0 s vs 38.2 + 14.9 s, p = 0.003; injection tool: 58.5 + 15.5 s vs 41.7 + 15.2 s, p < 0.001) compared with those without. Conclusions Both tools were able to accurately assess the degree of PV occlusion and predict the acute cryoablation effect, with the baseline tool being more sensitive and the injection tool more specific.

Previous reports of clinical course of Angelman syndrome (AS) described typical histories of choking, dysphagia, and severe pneumonia, but there were few bedridden cases or none requiring laryngotracheal separation surgery (LTS) were existed. We report a severe bedridden case of AS requiring LTS involving a 19.3 Mb deletion on 15q11.2–q14.

Clinician perspectives may inform health service strategies to meet optimal nutrition needs for infants with cystic fibrosis (CF). We conducted a qualitative study with CF-specialized dietitians (RDs) and physicians between July to December 2020 to characterize the current state of infant nutrition care delivery and organize input into a conceptual model to inform CF care program strategies. Among 42 participants, 36 completed survey responses and 6 completed interviews; 93% were RDs. Three global themes emerged in the current care model: nutrition management, family-centered connections, and collaborative care delivery. Within nutrition management clinicians emphasized providing education, setting goals, and maintaining adequate follow-up with families. Under family-centered connections clinicians expressed the need to foster relationships with families and link families to resources for assistance to social stressors such as food insecurity. Collaborative care delivery for clinicians interviewed was defined by sharing expertise from across the interdisciplinary team. Based on the timing of this study, clinicians reported compelling examples for various modes of telehealth and home weight monitoring to facilitate and support these domains of nutrition care, including potential advantages for education, supporting family needs, and communication. We integrate these themes to propose a conceptual model for integration of in-person and telehealth activities to enhance quality infant CF nutrition care delivery. Future implementation can refine this model through testing of practical telehealth interventions to optimize nutrition outcomes for infants with CF.

Abstract Questions: Most clustering methods assume data are structured as discrete hyper-spheroidal clusters to be evaluated by measures of central-tendency. If vegetation data do not conform to this model, then vegetation data may be clustered incorrectly. What are the implications for cluster stability and evaluation if clusters are of irregular shape or density? Location: Southeast Australia Methods: We define misplacement as the placement of a sample in a cluster other than (distinct from) its nearest neighbour and hypothesise that optimising homogeneity incurs the cost of higher rates of misplacement. The Chameleon algorithm emphasises interconnectivity and thus is sensitive to the shape and distribution of clusters. We contrasted its solutions with those of traditional non-hierarchical and hierarchical (agglomerative and divisive) approaches. Results: Chameleon-derived solutions had lower rates of misplacement and only marginally higher heterogeneity than those of k-means in the range 15–60 clusters, but their metrics converged with larger numbers of clusters. Solutions derived by agglomerative clustering had the best metrics (and divisive clustering the worst) but both produced inferior high-level solutions clusters to those of Chameleon by merging distantly-related clusters. Conclusions: Our results suggest that Chameleon may have an advantage over traditional algorithms at when data exhibit discontinuities and variable structure, potentially producing more stable solutions (due to lower rates of misplacement), but scoring lower on traditional metrics of central-tendency. Chameleon’s advantages are less obvious in the partitioning of data from continuous gradients, however its graph-based partitioning protocol facilitates hierarchical integration of solutions.

Olanzapine pamoate is an intramuscular depot injection for the treatment of schizophrenia. Approximately 1.4% of patients develop a serious adverse event called Post Injection Delirium/Sedation Syndrome (PDSS); characterised by drowsiness, anticholinergic and extrapyramidal symptoms. The objective is to investigate olanzapine PDSS presentations including clinical features and treatment approach. This is a retrospective review of olanzapine PDSS patients from three toxicology units and the NSW Poisons Information between 2017 and 2022. Adult patients were included if they had intramuscular olanzapine then developed PDSS criteria. Clinical symptoms, treatment, timing and length of symptoms were extracted into a preformatted Excel database. There were 18 patients included in the series, with a median age of 49 years (IQR: 38-58) and male predominance (89%). Median onset time post injection was 30 minutes (IQR: 11-38). PDSS symptoms predominate with drowsiness, confusion and dysarthria. Median length of symptoms was 24 hours (IQR: 20-54). Most common treatment included supportive care without any pharmacological intervention (n=10), benzodiazepine (n=4) and benztropine (n=3). In one case, bromocriptine and physostigmine followed by oral rivastigmine were given to manage anti-dopaminergic and anti-cholinergic symptoms respectively. This proposed treatment combination could alleviate some of the symptoms. In conclusion, this case series supports the characterisation of PDSS symptomology predominantly being anti-cholinergic with similar onset (<1 hour) and duration (<72hours). A combination of bromocriptine and physostigmine followed by rivastigmine is proposed to manage PDSS if patients develop severe dopamine blockade or anti-cholinergic delirium.

Abstract Background: We report a 62-year-old patient who received redo-orthotopic Heart transplantation due to worsening severe aortic regurgitation after 19 months of continuous flow LVAD (cf-LVAD) and temporary RVAD support for one month. Case Report: The patient received a heartware LVAD (HVAD) and annuloplasty of the tricuspid valve due to end-stage heart failure (as a consequence of dilated cardiomyopathy) and severe tricuspid regurgitation in addition to right-sided ECMO implantation. Postoperatively due to the inability to wean the implanted ECMO, a temporary RVAD was implanted after which the patient’s condition improved so that it had been explanted later and the patient was discharged after nine-month. In immediate post-operative echo, minimal aortic regurgitation was noted but in the follow-up transthoracic echocardiograms, there was a gradual increase in the severity of aortic regurgitation with worsening both right and left ventricular functions. TAVI was not an option due to unfavourable anatomical issues. That’s why the patient was listed for urgent heart transplantation, performed 19 months after the LVAD implantation. The postoperative course was complicated due to acute renal failure. After recompensation, dialysis, and intensive physiotherapy, the patient could be discharged home after three months. Conclusion: severe aortic regurgitation is a recognizable complication after cf-LVAD implantation which in our case was managed successfully with orthotopic heart transplantation in this high-risk patient.

Acute Myeloid Leukemia (AML) patients have a wide array of cytogenetic and molecular aberrations which can influence response to therapy. Monosomy7 (Mono7) is a rare subset within pediatric AML (prevalence of 4-5%), that is highly associated with poor outcomes. Fusions involving the ALK gene (14.3%) were exclusively identified within this high-risk cohort while absent across all other AML. Given the dismal outcomes of Mono7, we evaluated the use of crizotinib, an FDA-approved tyrosine kinase inhibitor, used to treat patients with ALK fusions. Our findings suggest that crizotinib may serve as a novel therapy for these patients.

N6–methyl adenosine (m6A) is the most abundant internal modification on eukaryotic mRNA and has been implicated in a wide range of fundamental cellular processes. This modification is regulated and interpreted by a set of writer, eraser, and reader proteins. To date, there have been no reports on the potential of mRNA epigenetic regulators to influence recombinant protein expression in mammalian cells. In this study we evaluated the potential of manipulating the expression of the m6A YTH domain-containing readers, YTHDF1, 2, and 3 to improve recombinant protein yield based on their role in regulating mRNA stability and promoting translation. Using siRNA-mediated gene depletion, cDNA over-expression and methylation-specific RNA immunoprecipitation, we demonstrate that (i) knock-down of YTHDF2 enhances (~2-fold) the levels of recombinant protein derived from GFP and EPO transgenes in CHO cells; (ii) the effects of YTHDF2 depletion on transgene expression is m6A-mediated and (iii) YTHDF2 depletion or over-expression of YTHDF1 increases viral protein expression and yield of infectious lentiviral particles (~2-3 fold) in HEK293 cells. We conclude that various transgenes can be subjected to regulation by m6A regulators in mammalian cell lines and that these findings demonstrate the utility of epi-transcriptomic-based approaches to host cell line engineering for improved recombinant protein and viral vector production.

In this paper, we design two parametric classes of iterative methods without memory to solve nonlinear systems, whose convergence order is four and seven, respectively. From their error equations and to increase the convergence order without performing new functional evaluations, memory is introduced in these families of different forms. That allows us to increase from four to seven the convergence order in the first family and from seven to eleven in the second one. We perform some numerical experiments with big size systems for confirming the theoretical results and comparing the proposed methods along other known schemes.

We consider the scattering of a plane wave by a locally perturbed periodic (with respect to x_1) medium. If there is no perturbation it is usually assumed that the scattered wave is quasi-periodic with the same parameter as the incident plane wave. As it is well known, one can show existence under this condition but not necessarily uniqueness. Uniqueness fails for certain incident directions (if the wavenumber is kept fixed), and it is not clear which additional condition has to be assumed in this case. In this paper we will analyze three concepts. For the Limiting Absorption Principle (LAP) we replace the refractive index n=n(x) by n(x)+iε in a layer of finite width and consider the limiting case when ε tends to zero. This will give an unsatisfactory condition. In a second approach we require continuity of the field with respect to the incident direction. This will give the same satisfactory condition as the third approach where we approximate the incident plane wave by an incident point source and let the location of the source tend to infinity.

The arterial vascular system exchanges blood gases using pulmonary capabilities. In humans, hemodynamic flows are subjected to periodic velocity modulations. Fluid mechanics and transport of blood gases play an important role in understanding how constitutive relations of the arterial system contribute to human functioning within physiological limits. Assuming the hemodynamic system as a finite dissipative system, the nonlinear evolution equation is perused to understand dynamical challenges under physiological conditions. The infinitesimal component of the vessel wall with concentric thickening in tunica media is considered as a nonaxisymmetric bulge in an elastic-compliant artery. Using the Lie group of transformations method, we discuss the implications of traveling wave solutions to describe their impact on hemodynamic flow in an elastic-compliant artery. We find that cumulative accretion of potential energy contributes to the creation of bright soliton at the apex of the bulge. The wave speed is maximum at the peak of the bulge and progressively retards with the antegrade flow.