Extracorporeal membrane oxygenation (ECMO) has been adopted to support patients with acute severe cardiac or pulmonary failure that is potentially reversible and unresponsive to conventional management. In the presence of pulmonary embolism, mesenteric ischemia (MI) can present as a life-threatening disorder that leads to intestinal ischemia. Due to the nature and acuity of these conditions, determining adequate perfusion upon surgical intervention is challenging for the operating surgeon, especially in the presence of cardiogenic shock despite ECMO support. Indocyanine green fluorescent angiography (ICG-FA) has proven to be useful for real-time vascular perfusion assessment, which may potentially decrease the rate of development of perfusion-related complications. The case report here-in presented, breaks the paradigm of performing noncardiac surgical procedures on ECMO support via a pioneering visual aid technique. Learning objective Indocyanine green fluorescent angiography (ICG-FA) is a promising visual trans-operatory technique providing real-time feedback for the adequate identification and assessment of target tissue/organs. The high morbidity and mortality rates associated to MI and CS – particularly when concomitantly present – hinders salvage surgical therapy. The use of acute ECMO provides stabilization yet lacks any curative solutions. This case report highlights the importance of adequate surgical intervention under extracorporeal life support in the presence of both CS and MI. To the authors’ knowledge, said approach has never been attempted, yet trails a promising therapy for the improvement of associated mortality rates.

“Letter to the Editor: Cardiac Surgery in patients with atrial isomerism : Long-term results and outcomes.”Dr Sara AhmedShalamar medical college, Lahore, PakistanDr Muhammad SohaibAllama Iqbal medical college, Lahore, Pakistan.

Glacial and proglacial erosion are important sediment sources in a river basin. The retreat of many glaciers on the Tibetan Plateau has important implications on the supply of fresh water and sediment dynamics for downstream river basins. Despite the importance of water and sediment dynamics at these catchments, existing quantification of suspended sediment fluxes from glacial catchments on the Tibetan Plateau is limited due to poor accessibility and challenging environments. This study presents the results of in-situ investigations of water discharge and suspended sediment fluxes from the Ming Yong glacial catchment in Yunnan, Southwest China, between August 2013 and July 2017. The results show that the variation in water discharge and suspended sediment was highly seasonal. The variation of average suspended sediment concentration was large – 69±45 mg/L; 119±104 mg/L; 94±97 mg/L in 2013, 2015, 2016, respectively. We estimate that the sediment yield from Ming Yong catchment was highly variable ranging from 1104 t/km 2/year in 2013to 2281 t/ km 2/year in 2016, with 65-78% of the total annual sediment load occurring during summer (June to August). These annual variations in the sediment yield can be attributed largely to precipitation patterns, or otherwise, extreme melting events. This study has provided a benchmark dataset that can be used for further works that investigate the impact of climate change on sediment dynamics in glacierized catchments in the Tibetan Plateau. Subsequently, the study let us better understand the increasing sediment supply to the Upper Mekong River from glacierized catchments.

Species-level taxonomy is derived from methodological sources (data and techniques) that assess the existence of spatio-temporal evolutionary lineages via various species concepts. These concepts determine if observed lineages are independent given a particular methodology supposedly connected to ontology, which relates the metaphysical concept to what “kind” of thing a species is. Often, species concepts fail to link methodology and practice back to ontology. This lack of coherence is in part responsible for the persistence of the rank of subspecies, which in modern usage often functions as a placeholder between the evolutionary events of divergence or collapse. Thus, prospective events like lineage merger or collapse determine if a subspecies is subsumed into an existing species, or achieves species rank given unknowable future information. This is conditioned on evidence that the lineage already has a detectably distinct evolutionary history. Ranking these lineages as subspecies seems attractive given the observation that many lineages do not exhibit intrinsic reproductive isolation. We argue that the use of subspecies is indefensible on philosophical and empirical grounds. Ontologically, the rank of subspecies is either identical to that of species or undefined in the context of evolutionary lineages representing spatio-temporally defined individuals. Some species concepts more inclined to consider subspecies, like the Biological Species Concept, are disconnected from ontology and do not consider genealogical history. Even if ontology is ignored, methods addressing reproductive isolation are often indirect and fail to capture the range of scenarios linking gene flow to species identity over space and time. The use of subspecies and reliance on reproductive isolation as a basis for an operational species concept can also conflict with ethical issues governing the protection of species. We provide a way forward for recognizing and naming species that links theoretical and operational species concepts regardless of the magnitude of reproductive isolation.

Wild bees form diverse communities that pollinate plants in both native and agricultural ecosystems making them both ecologically and economically important. The growing evidence of bee declines has sparked increased interest in monitoring bee community and population dynamics using standardized methods. Here, we studied the dynamics of bee biodiversity within and across years by monitoring wild bees adjacent to four apple orchard locations in Southern Pennsylvania, USA. We collected bees using passive Blue Vane traps continuously from April to October for six years amassing over 26,000 bees representing 144 species. We quantified total abundance, richness, diversity, composition, and phylogenetic structure. There were large seasonal changes in all measures of biodiversity with month explaining an average of 72% of the variation in our models. Changes over time were less dramatic with years explaining an average of 44% of the variation in biodiversity metrics. We found declines in all measures of biodiversity especially in the last 3 years. Analyses of population trends over time for the 40 most abundant species indicate that about one third of species showed at least some evidence for declines in abundance. Bee family explained variation in species-level seasonal patterns but we found no consistent family-level patterns in declines, though bumble bees and sweat bees were groups that declined the most. Overall, our results show that season-wide standardized sampling across multiple years can reveal nuanced patterns in bee biodiversity, phenological patterns of bees, and population trends over time of many co-occurring species. These datasets could be used to quantify the relative effects that different aspects of environmental change have on bee communities and to help prioritize conservation efforts.

Chesnaux (2018) distinguished between the pressure front displacement pulse and the groundwater displacement during a pumping test in a confined aquifer. The physical interpretation of the expression that Chesnaux (2018) adopted for the radial distance traveled by the pressure front is explored. It is shown that the expression adopted by Chesnaux (2018) is an implicit statement regarding the magnitude of the head change caused by pumping. The statement is consistent with the integrated effect of a continuous sequence of pulses. Alternative expressions for the migration of the pressure front and celerity are derived that are consistent with the conception of the migration of a pulse.

Channel banks can contribute a significant proportion of fine-grained (<63 µm) sediment to rivers, thereby also contributing to riverine total particulate phosphorus loads. Improving water quality through better agricultural practices alone can be difficult since the contributions from non-agricultural sources, including channel banks, can generate a ‘spatial mismatch’ between the efficacy of best management applied on farms and the likelihood of meeting environmental objectives. Our study undertook a reconnaissance survey (n=76 sites each with 3 profiles sampled) to determine the total phosphorus (TP) concentrations of channel banks across England and to determine if TP content can be predicted using readily accessible secondary data. TP concentrations adjacent field topsoils and local soil soil type/texture and geological parent material were examined as potential predictors of bank TP. Carbon and nitrogen content were also analysed to explore the impacts of organic matter content on measured TP concentrations. The results suggest that channel bank TP concentrations are primarily controlled by parent material rather than adjacent topsoils, but significant local variability in concentrations prevents the prediction of bank TP content using mapped soil type or geology. A median TP concentration of 873 mg kg -1 was calculated for the middle section of the sampled channel bank profiles, with a 25 th percentile of 675 mg kg -1, and 75 th percentile of 1159 mg kg -1. Using these concentrations and, in comparison with previously published estimates, the estimated number of inland WFD waterbodies in England for which channel bank erosion contributes >20% of the riverine total PP load increased from 15 to 25 (corresponding range of 17 to 35 using the 25 th and 75 th percentiles of measured TP concentrations). Collectively, these 25 waterbodies account for 0.2% of the total inland WFD waterbody area comprising England.

The response of communities to climate change is expected to vary among feeding guilds. To evaluate the response of guilds to environmental factors without considering the taxonomic specificities, it is useful to examine Aculeata bees and wasps, which consist of closely related taxa including different guilds, pollinators, predators, and parasitoids. In this study, we evaluated changes in species diversity (SD) and functional traits of each feeding guild along an elevational gradient in a boreal forest in northern Japan. We used yellow pan traps to collect Aculeata bees and wasps at 200–1600 m above sea level. We investigated six functional traits (trophic level, flight duration, body size, elevational range, nesting position, and soil dependency) and the horizontal distribution of the species. The SD of all Aculeata predators and parasitoids decreased with an increase in elevation; however, the SD of pollinators did not show any specific trend. Although the functional trait composition of all Aculeata species did not show any trend, that of each feeding guild responded to elevation in different ways. Pollinators increased in body size and showed a decrease in flight duration with increasing elevation, suggesting that tolerance and seasonal escape from physical stress at high elevations are important for shaping pollinator communities. Predators showed increased elevational range and above-ground nesting species with increasing elevation, suggesting that the ability to live in a wider range of environments and avoid unsuitable soil environments at high elevations might be important. Parasitoids changed their hosts and variable traits with increasing elevation, suggesting that brood parasitoids have difficulty in surviving at high elevation. The traits for each guild responded in different ways, even if they were dominated by the same environmental factors. Differences in the response of functional traits would produce different patterns of community formation in different guilds during further climate change.

Soil microorganisms are crucial contributors to the function of permafrost ecosystems, as well as the regulation of biogeochemical cycles. However, little is known about the distribution patterns and drivers of high-latitude permafrost microbial communities subject to climate change and human activities. In this study, the vertical distribution patterns of soil bacterial communities in the Greater Khingan Mountain permafrost region were systematically analyzed via Illumina Miseq high-throughput sequencing. Bacterial alpha diversity varied significantly at different soil depths, and the bacterial diversity and richness in the active layer were significantly higher than in the permafrost layer. The relative abundance of the dominant phyla Chloroflexi (17.92%–52.79%) and Actinobacteria (6.34%–34.52%) was significantly higher in the permafrost layer than in the active layer, whereas that of Acidobacteria (4.98%–38.82%) exhibited the opposite trend, and the abundance of Proteobacteria (2.49%–22.51%) generally decreased with depth. More importantly, the abundance of microorganisms linked to human infectious diseases was significantly higher in the permafrost layer according to Tax4Fun prediction analysis. Redundancy analysis (RDA) showed that NH4+-N, TOC and TP were major factors affecting the bacterial community composition. Collectively, our findings provide insights into the soil bacteria at different depths in high-latitude permafrost regions, as well as their vertical distribution patterns and major environmental drivers, which is key to grasping the response of cold region ecosystem processes to global climate changes.

Association is the basic unit of plant community classification. Exploring the distribution of plant associations can help improve the understanding of biodiversity conservation. Different associations depend on different habitats. Studying the association level is significant for ecological restoration, regional ecological protection, regulating the ecological balance, and maintaining biodiversity. However, previous studies have focused only on the suitable distribution areas of species and not on the distribution of plant associations. Larix gmelinii is a sensitive and abundant species spread in the southern margin of Eurasian boreal forests, and its distribution is closely related to permafrost. In this study, 420 original plots of L. gmelinii forests were investigated. We used Maxent model and ArcGIS software to project the potential geographical distribution of L. gmelinii associations in the future (by 2050 and 2070) according to the climate scenarios RCP 2.6, RCP 4.5, and RCP 8.5. The causes for the changes in spatial distribution were analyzed using multinomial logistic regression analysis. The results revealed that temperature is the most important factor affecting the distribution of L. gmelinii forests and most of its associations under different climate scenarios. Further, the suitable areas for each association type are shrinking by varying degrees, especially due to habitat loss at high altitudes in special terrains. For different L. gmelinii associations, management measures should also be different based on the different site conditions, composition structure, growth, development, and renewal succession trends. Furthermore, subsequent research should consider data on biological factors to obtain more accurate prediction results.

The rapid urbanization has caused changes in climate and environment and threatened the ecosystem with multiple risks. The ecological service capacity has shown a downward trend accordingly. It is significant to explore the spatio-temporal evolution of land use and ecological service value in mountainous counties at small scales, as it coordinates economic growth and ecological protection, and promotes sustainable and high-quality development. Based on the SD-PLUS model, taking Qianshan city as an example, the study simulated three scenarios of land use change: ecological protection, coordinated development, and economic priority, and studied the impacts of land use change on the value of ecosystem services. Results showed that: ① Under the three scenarios, the construction land in the study area increased significantly, the forest and water area have a decreasing trend, and the scale of gardens has partly increased. ② Construction land expands in clusters in the urban built-up areas and dots in mountainous areas; land use changes are primarily affected by roads, followed by areas where artificial facilities are relatively sparse, and DEM has the greatest impact on land use changes. ③ The overall ecosystem service value shows a downward trend, with the comprehensive coordination type dropping the least (8.79%). The value distribution changes little at space scale, and different regions demonstrate different degrees of changes. From the perspective of value type, the service values of climate regulation and water conservation are significantly reduced, while that of food production is relatively stable; and from the perspective of various lands with their ecological service values, cultivated land and forest remain stable. The study results can provide technical ideas for the coordinated economic development and ecological protection of mountainous cities, and boost the implementation of green development.

Background: Three-dimensional echocardiography (3DE) is an emerging method for volumetric cardiac measurements; however, few vendor-neutral analysis packages exist. Ventripoint Medical System Plus (VMS3.0+) proprietary software utilizes a validated MRI database of normal ventricular and atrial morphologies to calculate chamber volumes. This study aimed to compare left ventricular (LV) and atrial (LA) volumes obtained using VMS3.0+ to Tomtec echocardiography analysis software. Methods: Healthy controls (n=98) aged 0 to 18 years were prospectively recruited and 3D DICOM datasets focused on the LV and LA acquired. LV and LA volumes and ejection fractions were measured using TomTec Image Arena 3D LV analysis package and using VMS3.0+. Pearson correlation coefficients, Bland-Altman’s plots and intraclass coefficients (ICC) were calculated, along with analysis time. Results: There was a very good correlation between VMS and Tomtec LV systolic (r 2 = 0.88, ICC 0.89 [95% CI 0.81,0.94]), and diastolic (r 2 = 0.88, ICC 0.90 [95% CI 0.77,0.95]) volumes, and between VMS and Tomtec LA diastolic (r 2 =0.75, ICC 0.89 [95% CI 0.81,0.93]) and systolic (r 2 =0.88, ICC 0.91 [95% CI 0.78,0.96]) volumes on linear regression models. Natural log transformations eliminated heteroscedasticity, and power transformations provided best fit. The time (mins) to analyze volumes using VMS were less than using Tomtec (LV VMS 2.3±0.5, Tomtec 3.3±0.8, p<0.001; LA: VMS 1.9±0.4, Tomtec 3.4±1.0, p<0.001). Conclusions: There was very good correlation between knowledge-based (VMS3.0+) and 3D (Tomtec) algorithms when measuring 3D echocardiography derived LA and LV volumes in pediatric patients. VMS was slightly faster than Tomtec in analyzing volumetric measurements.

The state estimation and sensor placement for a continuous pulp digester with delayed measurements are investigated. The underlying model of interest is heat transfer in a pulp digester modeled by two coupled hyperbolic partial differential equations and an ordinary differential equation. Output measurements are considered with delay due to the possible low sampling rate. The Cayley-Tustin transformation is utilized to realize model time discretization in a late lumping manner which does not account for any type of spatial approximation or model reduction. The discrete Kalman filter is applied to estimate the system states using the delayed measurements. The selection of sensor location is addressed along with estimator design accounting for the delayed measurements and investigated by minimizing the variance of estimation error. The performance of the state estimator is evaluated, and the sensor placement is analyzed through simulation studies, which provide guidance for sensor location selection in industrial applications.

Background: The nucleoprotein (N protein) of respiratory syncytial virus (RSV) is a candidate antigen for new RSV vaccine development. The aim of the present study was to investigate the association between maternal antibody titers against the RSV N protein at birth and the newborns’ risk of developing very-severe lower respiratory tract infection (VS-LRTI). Methods: In this single-center prospective cohort study, 578 infants born during the RSV epidemic season in France were included. Among these, 36 were hospitalized for RSV VS-LRTI. A generalized linear model was used to test the occurrence of a VS-LRTI in function of sex, mode of delivery, parity of the mother, type of pregnancy, date of birth in relation to the peak of the epidemic, and antibody titer against N protein. Results: All cord blood samples had detectable antibodies against N protein. The mean titers were significantly lower in newborns with risk factors for RSV severe LRTI (preterm infants, birth before the peak epidemic, multiparous mother). There was no association between antibody titer against the N protein and a protection against VS-LRTI. Conclusions The present study found that transfer of maternal antibodies against the RSV N protein may not provide a significant immune protection early in infancy. Clinical Trials Registration. NCT04144816.

Our current understanding of ecological and evolutionary processes underlying island biodiversity is heavily shaped by empirical data from plants and birds, although arthropods comprise the overwhelming majority of known animal species. This is due to inherent problems with obtaining high-quality arthropod data. Novel high throughput sequencing approaches are now emerging as powerful tools to overcome such limitations, and thus comprehensively address existing shortfalls in arthropod biodiversity data. Here we explore how, as a community, we might most effectively exploit these tools for comprehensive and comparable inventory and monitoring of insular arthropod biodiversity. We first review the strengths, limitations and potential synergies among existing approaches of high throughput barcode sequencing. We consider how this can be complemented with deep learning approaches applied to image analysis to study arthropod biodiversity. We then explore how these approaches can be implemented within the framework of an island Genomic Observatories Network (iGON) for the advancement of fundamental and applied understanding of island biodiversity. To this end, we identify seven island biology themes at the interface of ecology, evolution and conservation biology, within which collective and harmonised efforts in HTS arthropod inventory could yield significant advances in island biodiversity research.

Following surgery for thyroid carcinoma, tracheal necrosis is extremely rare with few reports in literature. We report a patient who underwent a thyroid lobectomy for potential papillary carcinoma, followed by a completion thyroidectomy due to follicular variant papillary carcinoma pathology. Management was successful after debridement and tracheostomy, followed by decannulation.

Length of anticoagulation for thrombotic events related to COVID-19 is unknown. We present a patient with COVID-19 complicated by a thrombotic anterior STEMI and multiple left ventricular (LV) thrombi that resolved after 8 weeks of anticoagulation. We suggest a shorter length of anticoagulation with COVID-19 related LV thrombus.

Peripheral odontogenic fibroma (POdF) is a rare, benign, and ectomesenchymal tumor. We report a case of a 15-year-old girl who developed POdF in the mandible. The lesion was resected, including the periosteum. Histopathological findings revealed a small mass and cord-like epithelium. No sign of post-operative recurrence appeared after 16 months.