Background: Cystic fibrosis (CF) is an autosomal recessive disease affecting multiple organ systems, including the liver, leading to cystic fibrosis-related liver disease (CFLD). It was noted that CFLD in Egyptian children with CF is more common than in non-Egyptian people with CF (pwCF). The present study aimed to determine the incidence of CFLD and the potential risk factors for developing CFLD in Egyptian children. The correlation between CFLD and the various genotypes prevalent in Egyptian CF children and the comparison of CFLD in Egyptian and non-Egyptian CF patients will be done. Methods: The current cross-sectional study included 50 CF cases from Ain Sham University’s Pediatric Pulmonology Clinic in Children‘s Hospital, Cairo, Egypt. The sweat chloride test and genetic studies were done at the time of diagnosis. All patients’ caregivers provided informed consent. Additionally, all subjects underwent detailed history taking, laboratory investigations, clinical assessment, and pelviabdominal ultrasound for evaluation of hepatic involvement. Results: Male sex, severe genetic mutation (class I and II), long duration, and early onset of the disease were independent risk factors for CFLD development. In addition, pancreatic insufficiency, as well as meconium ileus history, were predictors of CFLD. Diabetes mellitus and severe lung disease were proven to significantly elevate the risk of CFLD development. Conclusion: CFLD is not uncommon in Egyptian CF patients as one-third of the patients were found to have liver affection. CF patients with multiple risk factors are at increased risk of developing liver disease.

Anaplastic meningioma rarely involves organs outside the brain. In our case a patient with cerebral meningioma developed lung metastases after 19 years from the initial appearance. This unusual tumor presentation could make complex the diagnosis.

The exponential rise in the incidence of peri-mitral flutter has paralleled the increasing use of more extensive atrial substrate ablation for atrial fibrillation (AF). Given the relative paucity of randomised evidence to support its role in AF management, mitral isthmus ablation should largely be reserved for patients with peri-mitral flutter. Catheter ablation for peri-mitral flutter is challenging due to complex anatomic relationships. The aim of this report is to review the anatomic considerations and approaches to catheter ablation for peri-mitral flutter.

Genotoxicity assessment is a critical component in the development and evaluation of chemicals. Traditional genotoxicity assays (i.e., mutagenicity, clastogenicity, aneugenicity) have been limited to dichotomous hazard classification, while other toxicity endpoints are assessed through quantitative determination of points-of-departure (PODs) for setting exposure limits. The more recent higher-throughput in vitro genotoxicity assays, many of which also provide mechanistic information, offer a powerful approach for determining high-precision PODs for potency ranking and risk assessment. In order to obtain relevant human dose context from the in vitro assays, in vitro to in vivo extrapolation (IVIVE) models are required to determine what dose would elicit a concentration in the body demonstrated to be genotoxic using in vitro assays. Previous work has demonstrated that application of IVIVE models to in vitro bioactivity data can provide PODs that are protective of human health, but there has been no evaluation of how these models perform with in vitro genotoxicity data. Thus, the Genetic Toxicology Technical Committee, under the Health and Environmental Sciences Institute, conducted a case study on 31 reference chemicals to evaluate the performance of IVIVE application to genotoxicity data. The results demonstrate that for most chemicals (20/31), the PODs derived from in vitro data and IVIVE are highly health protective relative to in vivo PODs from animal studies. PODs were also protective by individual assay type: mutations (8/13 chemicals), micronuclei (9/12) and aneugenicity markers (4/4). It is envisioned that this novel testing strategy could enhance prioritization, rapid screening, and risk assessment of genotoxic chemicals.

The integration of a transgene expression construct into the host genome is the initial step for the generation of recombinant cell lines used for biopharmaceutical production. The stability and level of recombinant gene expression in Chinese hamster ovary (CHO) can be correlated to the copy number, its integration site as well as the epigenetic context of the transgene vector. Also, undesired integration events, such as concatemers, truncated and inverted vector repeats, are impacting the stability of recombinant cell lines. Thus, to characterize cell clones and to isolate the most promising candidates it is crucial to obtain information on the site of integration, the structure of integrated sequence and the epigenetic status. Current sequencing techniques allow to gather this information separately but do not offer a comprehensive and simultaneous resolution. In this study, we present a fast and robust nanopore Cas9-targeted sequencing (nCats) pipeline to identify integration sites, the composition of the integrated sequence as well as its DNA methylation status in CHO cells that can be obtained simultaneously from the same sequencing run. A Cas9-enrichment step during library preparation enables targeted and directional nanopore sequencing with up to 724x median on-target coverage and up to 153 Kb long reads. The data generated by nCats provides sensitive, detailed and correct information on the transgene integration sites and the expression vector structure, which could only be partly produced by traditional Targeted Locus Amplification-Seq data. Moreover, with nCats the DNA methylation status can be analyzed from the same raw data without prior DNA amplification.

The COVID-19 pandemic has pushed health policy frontstage and exposed the stark differences in government capacities to respond to the crisis. This has created new demands for comparative heath policy to support knowledge creation on a large scale. However, comparative health policy has been ill prepared; studies have focused on health systems and used typologies together with descriptive, quantitative methods. This clouds the view for the multi-level nature of health policy, the diverse actors involved and the many societal facets of governance performance. We argue for health policy as a bottom-up process with diverse interests and suggest researching these processes comparatively to support policy learning. This calls for expanding the methodology of comparative health policy to include approaches that make greater use of explorative, qualitative research. We introduce possible developmental pathways to illustrate what this may look like. Firstly, the Pan-European Commission points to novel transnational and cross-sectoral collaborations, and a coordinated policy response to global challenges like the pandemic. Secondly, feminist networks show how to shift the focus towards social inequalities and the health needs of women and vulnerable populations. Thirdly, researchers demonstrate the value of new knowledge emerging from small-scale bottom-up comparisons based on structured assessment frameworks. Together, these developmental pathways demonstrate the potential to refocus comparative health policy towards greater responsiveness to the societal performance of governments, such as social inequalities created by the COVID-19 pandemic. This also opens opportunities for strengthening the global outlook of comparative health policy.

This work is concerned with the global existence of large solutions to the three-dimensional dissipative fluid-dynamical model, which is a strongly coupled nonlinear nonlocal system characterized by the incompressible Navier–Stokes–Poisson–Nernst–Planck equations. Making full use of the algebraic structure of the system, we obtain the global existence of solutions without smallness assumptions imposed on the third component of the initial velocity field and the summation of initial densities of charged species. More precisely, we prove that there exist two positive constants c 0 , C 0 such that if the initial data satisfies ( ∥ u 0 h ∥ B _ p , 1 − 1 + 3 p + ∥ N 0 − P 0 ∥ B _ q , 1 − 2 + 3 q ) exp { C 0 ( ∥ u 0 3 ∥ B _ p , 1 − 1 + 3 p 2 + ( ∥ N 0 + P 0 ∥ B _ r , 1 − 2 + 3 r + 1 ) exp { C 0 ∥ u 0 3 ∥ B _ p , 1 − 1 + 3 p } + 1 ) } ≤ c 0 , then the incompressible Navier–Stokes–Poisson–Nernst–Planck equations admits a unique global solution.

By evaluating genetic variation across the entire genome, one can address existing questions in a novel way while new can be asked. Such questions include how different local environments influence both adaptive and neutral genomic variation within and among populations, providing insights not only into local adaptation of natural populations, but also into their responses to global change and the exploitation-induced evolution. Here, under a seascape genomic approach, ddRAD genomic data were used along with environmental information to uncover the underlying processes (migration, selection) shaping European sardines (Sardina pilchardus) of the Western Mediterranean and adjacent Atlantic waters. This information can be relevant to the (re)definition of fishery stocks, and their short-term adaptive potential. We found that studied sardine samples form two clusters, detected using both neutral and adaptive (outlier) loci suggesting that natural selection and local adaptation play a key role in driving genetic change among the Atlantic and the Mediterranean sardines. Temperature and especially the trend in the number of days with sea surface temperature (SST) above 19oC was crucial at all levels of population structuring with implications on species’ key biological processes, especially reproduction. Our findings provide evidence for a dynamic equilibrium where population structure is maintained by physical and biological factors under the opposing influences of migration and selection. Given its dynamic nature, such a system postulates a continuous monitoring under a seascape genomic approach that can benefit by incorporating a temporal as well as a more detailed spatial dimension.

A middle-aged female veteran artistic gymnast sustained an avulsion-injury of the latissimus dorsi and teres major. The case reveals unclarity in the current classification system and illustrates how a non-operative approach, in opposition to interpretation of recommended guidelines, was adequate for an excellent clinical outcome.

A Coronavirus Disease 2019 (COVID-19) epidemiological model incorporating a boosted infection-acquired immunity and heterogeneity in infection-acquired immunity among recovered individuals is designed. The model is used to investigate whether incorporating these two processes can induce new epidemiological insights. Analytical findings reveal co-existence of multiple endemic equilibria on either regions divided by the fundamental threshold (control reproduction number). Numerical findings conducted to validate analytical results show that heterogeneity in infection-acquired immunity among recovered individuals can induce various bifurcation structures such as reversed backward bifurcation, forward bifurcation, backward bifurcation and reversed hysteresis effect. Moreover, numerical results show that reversed backward bifurcation is annihilated or switches to the usual forward bifurcation if infection-acquired immunity among recovered individuals with strong immunity is assumed to be everlasting. However, this is only possible if primary infection is more likely than reinfection. In case reinfection is more likely to occur than primary infection, reversed backward bifurcation structure switches to a backward bifurcation phenomenon. Further, longer duration of infection-acquired immunity does lead to COVID-19 decline over time but does not lead to flattening of the COVID-19 peak.

Increased access to genome-wide data provides new opportunities for plant conservation. However, information on neutral genetic diversity in a small number of marker loci can still be valuable because genomic data are not available to most rare plant species. In the hope of bridging the gap between conservation science and practice, we outline how conservation practitioners can more efficiently employ population genetic information in plant conservation. We first review the current knowledge about the within-population genetic variation and among-population differentiation in neutral genetic variation (NGV) and adaptive genetic variation (AGV) in seed plants. We then introduce the estimates of among-population genetic differentiation in quantitative traits (QST) and neutral markers (FST) to plant biology and summarize conservation applications derived from QST–FST comparisons, particularly on how to capture most AGV and NGV on both in-situ and ex-situ programs. Based on a review of published studies, we found that, on average, two and four populations would be needed for woody perennials (n = 18) to capture 99% of neutral and adaptive genetic variation, respectively, whereas four populations would be needed in case of herbaceous perennials (n = 14). On average, QST is about 3.6, 1.5, and 1.1 times greater than FST in woody plants, annuals, and herbaceous perennials, respectively. We suggest using maximum QST rather than average QST among trait comparisons. Hence, conservation and management policies or suggestions based solely on inference on FST could be misleading, particularly in woody species. We recommend conservation managers and practitioners consider this when formulating further conservation and restoration plans for plant species, and for woody species in particular.

Conversion of the North American prairies to cropland remains a prominent threat to grassland bird populations. Yet, a few species nest in these vastly modified systems. The thick-billed longspur (Rhynchophanes mccownii) is an obligate grassland bird whose populations have declined 4% annually during the past 50 years. Thick-billed longspurs historically nested in recently disturbed or sparsely vegetated patches within native mixed-grass prairie, but observations of longspurs in crop fields during the breeding season suggest such fields also provide cues for habitat selection. Maladaptive selection for poor quality habitat may contribute to ongoing declines in longspur populations, but information on thick-billed longspur breeding ecology in crop fields is lacking. We hypothesized that crop fields may function as ecological traps; specifically, we expected that crop fields may provide cues for territory selection but frequent human disturbance and increased exposure to weather and predators would have negative consequences for reproduction. To address this hypothesis, we compared measures of habitat selection (settlement patterns and trends in abundance) and productivity (nest density, nest survival, and number of young fledged) between crop fields and native sites in northeastern Montana, USA. Settlement patterns were similar across site types and occupancy ranged from 0.52 ± 0.17SE to 0.99 ± 0.01 on April 7 and 30, respectively. Early season abundance differed by year and changes in abundance during the breeding season were associated with precipitation-driven vegetation conditions, rather than habitat type. Standardized nest density (0.19 ± 0.27SD nests/plot/hour), the number of young fledged per successful nest (2.9 ± 0.18SE), and nest survival (0.24 ± 0.03 SE; n=222 nests) were similar for crop and native sites. Collectively, the data did not support our hypothesis that crop fields are ecological traps: longspurs did not exhibit a clear preference for cropland and reproductive output was not significantly reduced. Our results indicate that crop fields provide alternative breeding habitat within a human-dominated landscape.

Wolf spiders are typically the most common group of arthropod predators on both lake and marine shorelines, because of the high prey availability in these habitats. However, shores are also harsh environments due to flooding and, in proximity to marine waters, to toxic salinity levels. Here, we describe the spider community, prey availabilities and spider diets between shoreline sites with different salinities, albeit with comparatively small differences (5 vs. 7‰). Despite the small environmental differences, spider communities between low and higher saline sites showed an almost complete species turnover. At the same time, differences in prey availability or spider gut contents did not match changes in spider species composition but rather changed with habitat characteristics within region, where spiders collected at sites with thick wrack beds had a different diet than sites with little wrack. These data suggest that shifts in spider communities are due to habitat characteristics rather than prey availabilities, and the most likely candidate restricting species in high salinity would be saline sensitivity. At the same time, species absences from low-saline habitats remain unresolved.

Pachydermoperiostosis (PDP) is a rare genetic disorder with unclear etiopathogenesis. We report a case of a 38-years-old male who presented with classic features of PDP. Patient showed a good initial response to Etoricoxib therapy but the safety and efficacy over long-term use are yet to be determined in further studies.

Background: Chemotherapy induced nausea and vomiting (CINV) is a distressing adverse effect in children receiving cancer treatment. There are evidence-based pediatric clinical practice guidelines (CPG) on chemotherapy emetogenicity and acute CINV prevention, but adherence to these guidelines is low. Procedure: A quality improvement-based study was conducted at McMaster Children’s Hospital. The SMART aim was to increase adherence to guidelines on prevention of acute CINV in hospitalized patients receiving high (HEC) and moderately (MEC) emetogenic chemotherapy from baseline 25% to >70% by June 2021. Barriers were identified by process mapping and a series of interventions were implemented. Results: Guideline adherence (GA) was assessed in 270 inpatient chemotherapy administrations (HEC, MEC). Data was collected on 131 charts pre-interventions and 139 charts post-interventions. Interventions included education, addition of guideline recommended anti-emetics to the inpatient formulary and implementation of a standardized CPG tool. Initial rates of total CINV GA were 25%, which improved to 72% post-intervention (p <0.001). In subgroup analysis, GA in the MEC group improved from 13% to 34% (p=0.015), and in the HEC group from 32% to 93% (p<0.001). The most common reason for non-adherence in the HEC group was failure to use aprepitant as anti-emetic, and in MEC was option for ondansetron monotherapy prophylaxis. Conclusion: Using quality improvement methodology, barriers to guideline adherence were identified and interventions implemented. Guideline adherence for prevention of CINV improved, particularly in the HEC group but less for the MEC group. Future steps will include sustainability of interventions and addressing adherence in the MEC group.

We report the case of a 14-year-old girl with pain and protrusion of the left eye and treated with Diclofenac. Clinical and paraclinical examinations revealed a cerebral empyema and a left retro-orbital abscess complicating an acute ethmoiditis. The delay in diagnosis would have led to the occurrence of these complications.

Lung adenocarcinoma (LA) is the most common subtype of lung cancer with non-significant manifestations. Some benign conditions can mimic LA in symptoms and even chest imaging. In this case report, we are discussing a young man without any significant past medical history with metastatic LA, initially presumed military TB.

Preparation of coemissive luminescent nanoparticles in continuous-flow microreactors for efficient light-harvesting systemsAndrea Pucci