In the last decade, real time PCR has been increasingly adopted for bluetongue diagnosis with both broadly reactive and serotype-specific assays widely used. The use of these assays and nucleic acid sequencing technologies have enhanced bluetongue virus detection, resulting in the identification of a number of new serotypes. As a result, more than 30 different serotypes are proposed. Rapid identification of the virus serotype is essential for matching of antigens used in vaccines and to undertake surveillance and epidemiological studies to assist risk management. However, it is not uncommon for multiple serotypes to circulate in a region either concurrently or in successive years. It is therefore necessary to have a large suite of assays available to ensure that the full spectrum of viruses is detected. Nevertheless, covering a large range of virus serotypes is demanding from both a time and resource perspective. To overcome these challenges, real time PCR assays were optimised to match local virus strains and then combined in a panel of quadriplex assays, resulting in 3 assays to detect 12 serotypes directly from blood samples from cattle and sheep. These multiplex assays have been used extensively for bluetongue surveillance in both sentinel animals and opportunistically collected samples. A protocol to adapt these assays to capture variations in local strains of bluetongue virus and to expand the panel is described. Collectively these assays provide powerful tools for surveillance and the rapid identification of bluetongue virus serotypes directly from animal blood samples.

There are different dynamic characteristics in each stage of rail transit network development. It can provide guidance for rail transit network planning and phased construction,Evaluating the evolution degree of urban rail transit network and accurately dividing the evolution stages. Starting from the allometric growth relationship between transfer nodes and ordinary nodes in urban rail transit network, this paper defines the evolution level of rail transit network and the growth rate difference between transfer and ordinary nodes, and deduces the logistic dynamic equation of urban rail transit network evolution level with the help of mathematical derivative and logarithmic relationship, This paper reveals the dynamic law of the evolution process of urban rail transit network from the theoretical level, analyzes the evolution dynamic process on this basis, finds the Threshold for phasing the evolution stage, and divides it into four evolution stages. Finally, the theoretical derivation results are verified with the evolution data of Beijing Rail Transit Network (1984-2020) for 45 years. The verification results are highly consistent with the theoretical derivation results, which proves the correctness of the theoretical model and its practical guiding significance for the construction of rail transit network.

In this paper we present a new discrete retarded Gronwall-Bellman type inequality. As applications, the dynamics of some delay difference equations are studied. First, the asymptotic behavior of solutions for scalar difference equation $\Delta x(n)=-a(n)x(n)+B(n,x_n)$ is discussed, and some new criterion on the asymptotic stability of the zero solution are obtained under weaker assumptions. Then the dissipativity of a nonautonomous delay difference system with superlinear nonlinearities is investigated. By using the inequalities established here, it is shown that the discrete set-valued process generated by the system possesses a unique global pullback attractor.

In this work, we study the very weak solution for the stationary exterior Stokes problem with Navier slip boundary condition. We try to investigate some results of the existence and the uniqueness of solutions related to this problem in an exterior domain in $L^p-$theory where $1

Harlequin syndrome corresponds to unilateral dysfunction of sympathetic system, characterized by flush and unilateral hyperhidrosis associated with hypo or anhidrosis and paleness of the opposite side. It is, usually, idiopathic. Rarely, it may be associated with compressive organic processes, iatrogenic causes and general diseases. It is a real therapeutic challenge.

Phantosmia is the sensation of a fragrance intermittently or continuously when no odorant trigger is available. Without any further complaints, COVID-19 individuals may experience olfactory hallucination. Phantosmia was unnoticed for a long time sinc

This report describes a case of spontaneous cerebrospinal fluid leak through a narrow canal-like fistula in the lateral wall of the sphenoid sinus, which was managed through rigid reconstruction. Rigid reconstruction of the skull base was performed by fitting a pile-shaped bone into the fistula like the pile-driving technique.

Background: Cystic fibrosis is a common cause of pancreatic exocrine insufficiency. Clinically pancreatic insufficiency is treated as a permanent problem. However, new cystic fibrosis transmembrane conductance regulator (CFTR) protein modulator therapies, like ivacaftor, can change pancreatic function in children. Also, children with residual CFTR function mutations may be pancreatic insufficient in infancy and spontaneously become pancreatic sufficient. Aims: To evaluate the benefit of reviewing pancreatic function, testing and diagnosis, of a cohort and repeat testing to patients with the potential to change function. Methods: all children with cystic fibrosis managed at Perth Children’s Hospital at the end of 2019 were reviewed for pancreatic function testing at diagnosis, genotype and current modulator and pancreatic enzyme replacement therapy use. Children with the potential to change pancreatic function were offered repeat testing. Results: 204 children were included. 11 children were prescribed ivacaftor and four of these became pancreatic sufficient. Five children with a residual CFTR function mutation were pancreatic insufficient at diagnosis. Four became pancreatic sufficient. Conclusion: there is benefit in re-evaluating pancreatic function in children with cystic fibrosis regularly, especially if on ivacaftor or pancreatic insufficient with a residual CFTR function mutation.

Large bird species, such as cranes are involved in human-wildlife conflicts as they often forage in croplands. The Eurasian crane (Grus grus) is a large iconic bird species, protected across Europe, which, thanks to conservation programs and its ability to utilize croplands for foraging, shows a strongly increasing population trend. This exaggerates the already existing conflicts between crop farmers and cranes spilling over to natural habitats, where foraging by large flocks can lead to land degradation. To date, no studies have evaluated the effects of biopedturbation by cranes in grasslands, despite these habitats provide important feeding grounds for this large bird across its whole range. Here we evaluated the effect of biopedturbation by foraging Eurasian cranes on the vegetation of dry grasslands in Hungary. We used indicators of vegetation naturalness, forage quality and floral resource provision to evaluate the ecosystem state from multiple aspects. We sampled 100 quadrats in disturbed patches and 100 in intact grasslands in two seasons and two years (800 observations). We found that cranes created distinct habitat patches with different species composition compared to undisturbed areas. These early-successional patches that increased the plant diversity and floral resources but decreased the area of intact grasslands. Although crane-disturbed patches could provide forage for livestock early in the season, the forage quality of the vegetation became poor later in the year. Given the strong increase of the global crane population, monitoring the landscape-level extent of the disturbed areas, and developing a complex prevention and mitigation strategy would be important.

Fournier's gangrene, a rapidly progressive necrotizing fasciitis of the perineum and external genitalia remains a medical-surgical emergency. The authors present a case of coverage of a scrotal loss of substance with testicular exposure by a medial fasciocutaneous flap in a fifty years male patient.

A 38-year-old female developed chronic joint pain one month after testing positive for SARS-CoV2. Physical examination revealed warmth and tenderness of the wrists and small joints of the hands. Rheumatoid factor and anti-CCP were elevated. Hands MRI showed synovitis of small joints. The patient was diagnosed with rheumatoid arthritis (RA).

Abstract Background This study aimed to evaluate whether changes in practice and patient behaviour due to the covid-19 pandemic impacted the presentation, management, and outcomes of patients with deep neck space infections (DNSI). Design Retrospective cohort study including all adults presenting to the otolaryngology department at a tertiary UK centre with a DNSI during the first 12 months of the covid-19 pandemic (n = 27), and those from the previous 12 month period (n = 26). Patients with peritonsillar abscess which did not involve deep neck spaces radiologically were excluded. Results The covid-19 pandemic cohort tended to present later after onset of symptoms (5.96 days vs 3.25 days, p = 0.0277), have abscess formation rather than inflammation only (77.8% vs 34.6%, p < 0.01), and develop complications (33.3% vs 7.7%, p = 0.0394). Not reaching statistical significance, the covid-19 pandemic cohort also had larger volume abscess (25.18cm3 vs 14.5cm3, p = 0.291), longer hospital stay (14.48 days vs 6.35 days, p = 0.114), and longer intensive care stay (7.88 days vs 1.78 days, p = 0.0992). Non-significant changes were noted in management, with the covid-19 pandemic cohort being seven times more likely to undergo tracheostomy (25.9% vs 3.8%, p = 0.0504), and more likely to undergo transcervical drainage (37% vs 19.2%, p = 0.224) and hot tonsillectomy (11.1% vs 0%, p = 0.236). Conclusion This study demonstrates the covid-19 pandemic led to delayed presentation and more severe infection, requiring more radical management in patients with DNSI.

Abstract: Background: Fluid overload (FO) and acute kidney injury (AKI) after CABG surgery are due to multiple perioperative etiologies associated with high failure to rescue rates (FTR) and associated with poor outcomes  1-,3. Diuretics, fluid restriction, ultrafiltration (UF) and renal replacement therapies are the treatment modalities implemented as monotherapy or in combination to address this severe complication. There is limited data on the use of simplified UF therapy as a fluid management strategy in post-operative cardiac surgery patients. Methods: A retrospective review of our post operative isolated CABG patients was done from Jan 1 st, 2020 to July 31 st, 2021. Those subjected to a simplified UF protocol incorporating Goal Directed Therapy (GDT) to treat fluid overload and/or acute kidney injury were evaluated for 30-day survival and readmission rates. Results: A total of 254 isolated CABG procedures were performed during this period. Ultrafiltration was used in 17 (6.7%) patients. The 30-day mortality for the entire CABG cohort was 5/254 (2.0%) patients and in the UF group 0/17 (0%). The mean age of UF therapy patients was 65.8 years (Range 41-89). The mean Society of Thoracic Surgeons STS mortality score of UF patients was 5.7% (Range 0.6-50.0). The 30-day survival for the 17 patients placed on UF therapy was 100% and their readmission rate was 2/17 (11.7%). Conclusions: The use of ultrafiltration in this patient population with relatively high STS scores provided a safe and effective modality to manage fluid balance but further studies are needed.

Explaining food web dynamics, stability, and functioning depend substantially on understanding of feeding relations within a community. Bulk stable isotope ratios (SIRs) in natural abundance are well-established tools to express direct and indirect feeding relations as continuous variables across time and space. Along with bulk SIRs, the SIRs of individual amino acids (AAs) are now emerging as a promising and complementary method to characterize the flow and transformation of resources across a diversity of organisms, from microbial domains to macroscopic consumers. This significant AA-SIR capacity is based on empirical evidence that a consumer’s SIR, specific to an individual AA, reflects its diet SIR coupled with a certain degree of isotopic differences between the consumer and its diet. However, many empirical ecologists are still unfamiliar with the scope of applicability and the interpretative power of AA-SIR. To fill these knowledge gaps, we here describe a comprehensive approach to both carbon and nitrogen AA-SIR assessment focusing on two key topics: pattern in AA-isotope composition across spatial and temporal scales, and a certain variability of AA-specific isotope differences between the diet and the consumer. On this basis we review the versatile applicability of AA-SIR to improve our understanding of physiological processes as well as food web functioning, allowing us to reconstruct dominant basal dietary sources and trace their trophic transfers at the specimen and community levels. Given the insightful and opportunities of AA-SIR, we suggest future applications for the dual use of carbon and nitrogen AA-SIR to study more realistic food web structures and robust consumer niches, which are often very difficult to explain in nature.

Incomplete obliteration of urachus during the fetal period can lead to urachal abnormalities, such as urachal sinus. Therefore, it should be considered as a significant differential diagnosis in abdominal pain or umbilical discharge patients. This article presents a young patient with a urachal sinus mimicking umbilical pilonidal sinus symptoms.

This study updates information on the evolution of glacier shrinkage in Cocuy-Güican mountains since the maximum glacier extent of the Little Ice Age (LIA), and presents the first mass balance data of Ritacuba glacier since 2009, that is compared to the available mass balance for the Conejeras Glacier (Los Nevados National Park). This study also discusses the hydrological significance of Colombian glaciers which is still largely unknown because of the very limited information available. Glaciers in Cocuy-Güican covered 13.2 km2 in 2019 that compared to the 127.8 km2 during the maximum LIA represents a shrinkage of 89.7%. Glacier cover observations in 1955, 1994, 2010 and 2019, reveal that the rate of ice loss was the largest from 1994 to 2010 (0.59 km2 yr-1) and was then more than halved from 2010 to 2019 (0.34 km2 yr-1). This slowdown in glacier retreat is in line with a moderate negative mass balance measured for 2009-2019, with an accumulated loss of 1,766 mm w.e. The progressive confinement of glaciers to higher elevation and optimal topographic context together with a lack of recent marked climatic anomalies, could explain that Cocuy-Güican glaciers have temporally reached near equilibrium state condition. This is in stark contrast with Conejeras glacier where 47,000 mm w.e. has been lost in the same period. The available data on runoff and isotopic traces of streamflows and precipitation suggest a primary control of precipitation on the hydrological variability of the high elevated sites, compared to glacier melt water.

We report a case of primary malignant melanoma of the esophagus.

Glomus tumours are infrequent benign tumours originate from the glomus body and can be found anywhere in the body. We report the case of a 61 year-old patient who presented with massive upper GI bleeding secondary to an ulcerated gastric glomus tumour that eventually treated with surgical wedge resection.