We herein report the cases of three patients with chest symptoms or fever and diffuse wall thickening of the trachea and main bronchi on chest CT. They were diagnosed with various causes of inflammations of the trachea and main bronchi using bronchial or tracheal biopsy specimens and flexible bronchoscopy.

A Riemann-Liouville fractional Robin boundary-value problem is proposed to describe the fast heat transfer law both within isotropic materials and through the boundary of the materials in high temperature environment. The variational formulation of the fractional model is given, and further the energy estimation of the weak solution is deduced. The uniqueness theorem of weak solution is proved. A valid finite difference scheme is developed for the fractional model and numerical experiment is implemented. Numerical results indicate that the fractional model is applicable to discover the thermal superdiffusion in the thermal protective clothing(TPC) system and numerical algorithms are effective to improve the intelligence of TPC design.

Introduction Thoracic endovascular aortic repair (TEVAR) became the standard of care for treating type B aortic dissections and descending thoracic aortic aneurysms. We aimed to describe the racial/ethnic differences in TEVAR utilization and outcomes. Methods The National Inpatient Sample was reviewed for all TEVARs performed between 2010 and 2017 for Type B aortic dissection and descending thoracic aortic aneurysm (DTAA). We compared groups stratifying by their racial/ethnicity background in whites, black, Hispanic, and others. A mixed-effects logistic regression was performed to assess the relationship between race/ethnicity and the primary outcome, in-hospital mortality. Results A total of 25,260 admissions for TEVAR during 2010–2017 were identified. Of those, 52.74% (n= 13,322) were performed for aneurysm and 47.2% (n= 11,938) were performed for type B dissection. 68.1% were white, 19.6% were black, 5.7% Hispanic, and 6.5% were classified as others. White patients were the oldest (median age 71 years; <0.001), with TEVAR being performed electively more often for aortic aneurysm (58.8% vs. 34% vs. 48.3% vs. 48.2%; p<0.001). In contrast, TEVAR was more likely urgent or emergent for type B dissection in black patients (65.6% vs 41.1% vs 51.6% vs 51.7%; p<0.001). Finally, the black population showed a relative increase in the incidence rate of TEVAR over time. The adjusted multivariable model showed that race/ethnicity was not associated with in-hospital mortality. Conclusion Although there is a differential distribution of thoracic indication and comorbidities between race/ethnicity in TEVAR, racial disparities do not appear to be associated with in-hospital mortality after adjusting for covariates.

A 62-year-old man presents to the Cardiology Department with a two years history of angina on exertion. Invasive coronary angiography revealed a severe three vessels coronary artery disease. The “Hybrid Heart Team” successfully performed a fully robotically-assisted hybrid revascularization combining RE-MIDCAB on the LAD and R-PCI on non-LAD lesions.

Venous thrombosis associated with pacemaker implant is a known phenomenon. We present a clinical video emphasizing on an important physical exam finding suggesting propagation of thrombus in Internal Jugular vein secondary to pacemaker insertion, which would be educational and help readers visualize the Sign on Physical Exam

TITLE: Letter to the Editor: Anatomical reasons for failure of dual‐filter cerebral embolic protection application in TAVR: A CT‐based analysisARTICLE TYPE: letter to the editorCORRESPONDENCE: 1. Muhammad Ali MuzammilContact; +92 3313657590 Email; [email protected]: Dow University of Health Sciences, karachiAddress: A-49 Street No.8 Block:2 Chapal Sun city near kiran Hospital Scheme#33 Gulzar-e-hijriCo-Authors ; 2. Rahat Ahmed MemonEmail: [email protected] Contact: +12677091949Institute: Abington Memorial Hospital

In long-lived species, reproductive skipping is a common strategy whereby sexually mature animals skip a breeding season, potentially reducing population growth. This may be an adaptive decision to protect survival, or a non-adaptive decision driven by individual-specific constraints. Understanding the presence and drivers of this behaviour is key to effective population management, yet in many species such as the endangered African penguin (Spheniscus demersus), these factors remain unknown. This study uses multistate mark-recapture methods to estimate African penguin survival and breeding probabilities at two colonies between 2013 and 2020. Overall, survival was higher at Stony Point (0.82) than Robben Island (0.77). Inter-colony differences were linked to food availability; under decreasing sardine (Sardinops sagax) abundance, survival decreased at Robben Island and increased at Stony Point. Additionally, reproductive skipping was evident across both colonies; at Robben Island ~22% of breeding individuals skipped reproduction each year, versus ~10% at Stony Point. Penguins skipping reproduction had a lower probability of future breeding than breeding individuals; this lack of adaptive benefit suggests reproductive skipping is driven by individual-specific constraints. Lower survival and breeding propensity at Robben Island places this colony in greater need of conservation action. However, further research on the drivers of inter-colony differences is needed.

In light of ongoing climate change, it is increasingly important to know how nutritional requirements of ectotherms are affected by changing temperatures. Here, we analyse the wide thermal response of phosphorus (P) requirements via elemental gross growth efficiencies of Carbon (C) and P, and the Threshold Elemental Ratios in different aquatic invertebrate ectotherms such as the freshwater model species Daphnia magna, the marine copepod Acartia tonsa, the marine heterotrophic dinoflagellate Oxyrrhis marina, and larvae of two populations of the marine crab Carcinus maenas. We show that they all share a non-linear cubic thermal response of nutrient requirements. Phosphorus requirements decrease from low to intermediate temperatures, increase at higher temperatures, and decrease again when temperature is excessive. This universality in the thermal response of nutrient requirements is of great importance if we aim to understand or even predict how ectotherm communities will react to global warming and nutrient-driven eutrophication.

Protein-based condensates have been proposed to accelerate biochemical reactions by enriching reactants and enzymes simultaneously. Here, we engineered those condensates into a Photo-Activated Switch in E. coli (PhASE) to regulate enzymatic reactions via tuning the spatial correlation of enzymes and substrates. In this system, scaffold proteins undergo liquid-liquid phase separation (LLPS) to form light-responsive compartments. Tethered with a light-responsive protein, enzymes of interest (EOIs) can be recruited by those compartments from cytosol within only a few seconds after a pulse of light induction and fully released in 15 minutes. Furthermore, we managed to enrich small molecular substrates simultaneously with enzymes in the compartments and achieved the acceleration of luciferin and catechol oxidation by 2.3 folds and 1.6 folds, respectively. We also developed a quantitative model to guide the further optimization of this de-mixed regulatory system. Our tool can thus be used to study the rapid redistribution of proteins, and reversibly regulate enzymatic reactions in E. coli.

Asthma 17q21 Polymorphism Associates with COVID-19 in Children

Hydropeaking (the release of water pulses at hydropower plants) results in temporary reductions in river channel water-covered area downstream, which may cause fish mortality through stranding. We used a mechanistic modelling approach to examine how, both, the form of the hydropeaking cycle, and the characteristics of the affected fish, control how hydropeaking may cause stranding mortality of fish. We modelled the response of Atlantic parr to hydropeaking in a regulated watercourse in central Norway (the River Nidelva) using an individual-based population model designed explicitly to examine fish behavior and stranding mortality during hydropeaking. A response to hydropeaking, involving migration from the river banks toward the mid-channel on down-ramping, and a return to the river banks on up-ramping, was based on individuals being parameterized to migrate to habitat properties that spatially changed throughout the hydropeaking cycle. We found that stranding mortality was strongly dependent on both the form of the hydropeaking cycle and on the fish response. Total stranding mortality was more dependent on the down-ramping speed than the duration of the minimum flow period. Total stranding mortality was greatest when there was a low movement speed, leading to individuals being stranded, combined with a high probability of dying per unit of time when stranded. Given the sensitivity of mortality to the fish response, and the lack of detailed field studies quantifying this, we conclude that this area requires further controlled studies for parameterizing models used to predict effects of hydropeaking on fish.

As invasive species spread, the ability of local communities to resist invasion depends on the strength of biotic interactions. Evolutionarily unused to the invader, native predators or herbivores may be initially wary of consuming newcomers, allowing them to proliferate. However, these relationships may be highly dynamic, and novel consumer-resource interactions could form as familiarity grows. Here, we explore the development of effective biotic resistance towards a highly invasive alga using multiple space-for-time approaches. We show that the principal native Mediterranean herbivore learns to consume the invader within less than a decade. At recently invaded sites, the herbivore actively avoided the alga, shifting to distinct preference and high consumptions at older sites. This rapid strengthening of the interaction contributed to the eventual collapse of the alga after an initial dominance. Therefore, our results stress the importance of conserving key native populations to allow communities to develop effective resistance mechanisms against invaders.

This is an invited editorial of an article to be published in the Jouranl of Cardiac Surgery

A potential immunological silver bullet for COVID-19: the trivalent chimpanzee adenoviral serotype-68 vector (Tri:ChAd)

Background: World-wide incidence and prevalence of both asthma and type 1 diabetes mellitus (T1DM) in children has been increasing in past decades. Association between the two diseases has been found in some but not other studies. Objective: We conducted a meta-analysis to verify such an association, and bidirectional Mendelian randomization analysis to examine the potential cause-effect relationships. Methods: Three databases (PubMed, Embase and Web of Science) were searched from their inception to February 1, 2021. Pooled hazard ratios (HR) or odds ratios (OR), and 95% confidence intervals, were calculated. Associations between single-nucleotide polymorphisms with childhood asthma and T1DM were selected based on genome-wide association studies. The outcome datasets were obtained from FinnGen study. We used the inverse variance-weighted, weighted median and MR-Egger methods to estimate causal effects. To assess robustness and horizontal pleiotropy, MR-Egger regression and MR pleiotropy residual sum and outlier test was conducted. Results: In meta-analysis, childhood asthma was associated with an increased risk of T1DM (HR=1.30, 95% CI 1.05-1.61, P=0.014), whereas T1DM was not associated with the risk of asthma (HR=0.98, 95% CI 0.64-1.51, P=0.941; OR=0.84, 95% CI 0.65-1.08, P=0.168). MR analysis indicated increased genetic risk of T1DM in children with asthma (OR=1.308; 95% CI 1.030-1.661; P =0.028). Analysis using the IVW method indicated not associated between T1DM and genetic risk of asthma (OR=1.027, 95%CI 0.970-1.089, P=0.358). Conclusion: Both meta-analysis and MR study suggested that childhood asthma was a risk factor for T1DM. No epidemiological or genetic evidence for an association of T1DM with asthma incidence. Further studies could be carried out to leverage this newfound insight into better clinical and experimental research in asthma and T1DM. Further studies could be carried out to leverage this newfound insight into better clinical and experimental research in asthma and T1DM.

Ameloblastoma is a benign jaw tumor that can grow to a very huge size with high rate of recurrence. The large tumours pose a challenge during resection and reconstructive surgery. We present a massive ameloblastoma of the mandible that was surgically treated with the aid of 3D printed model.

We report on a child with prenatal findings of increased nuchal translucency, polydramnios, ascites and overgrowth. At birth she presented length >97° centile, minor facial anomalies, megalencephaly and Wolff-Parkinson-White syndrome. Whole Exome Sequencing showed a pathogenic variant in the NRAS gene, but no mutations were found in PI3K/AKT/mTOR pathway genes.

A document by Muhammad Haris Farooq. Click on the document to view its contents.