Obstructive uropathy is one of the leading causes of urosepsis. In the patients with severe hydronephrosis, underlying sepsis and renal dysfunction should be treated with caution. Each additional hour of delay in antibiotics administration was found to lower the survival rate.

Type of Study : Letter to EditorFull Title : High Flow Nasal Cannula (HFNC) during flexible bronchoscopy, is it cost-effective?Gaurav Gautam MD, Prawin Kumar MD, Jagdish P. Goyal MDDepartment of Pediatrics, All India Institute of Medical Sciences Jodhpur, Rajasthan, IndiaAbbreviated title: HFNC during flexible bronchoscopy

In this paper, we study the symmetry on a class of multiparameter Markov Processes in Khoshnevisan (2002), and obtain some important and interesting results.

Hypohidrotic ectodermal dysplasia is a heritable disease, characterized by hypodontia, hypotrichosis, and anhidrosis. This clinical report demonstrates prosthetic rehabilitation of a patient complaining of impaired mastication and the odd appearance of her jaws. Maxillary telescopic-overdenture and implant-supported mandibular prostheses were fabricated to improve mastication, speech, and aesthetics of the patient.

Recently, the rovibronic absorption and emission spectra of diatomic molecules dressed by medium-intensity laser fields have been discussed. By computing the total absorption probability as a function of dressing wavelength an asymmetric line shape has been obtained strongly resembling to the well-known Fano line shape. Applying two-state analytical and three-state numerical models the shape of the total absorption probability function is explained. Further confirmation of the model based results is provided by high resolution accurate numerical computations using large number of basis functions.

In this paper, we investigate the decay properties of the thermoelastic Bresse system in the whole space. We consider many cases depending on the parameters of the model and we establish new decay rates. We need to mention here that, in some cases we don't have the regularity-loss phenomena as in the previous works in the literature. To prove our results, we use the energy method in the Fourier space to build a very delicate Lyapunov functionals that give the desired results.

A case with non-small cell lung cancer exhibited extreme hyperglycemia after lorlatinib treatment, whose adverse effects on hyperglycemia is little known. But, the lorlatinib could be continued by intensifying diabetes treatment, indicating the importance of glucose monitoring during lorlatinib administration, and of adequate intensification of treatment for such hyperglycemia.

Oxylipins are lipid-derived molecules that are ubiquitous in eukaryotes and whose functions in plant physiology have been widely reported. They appear to play a major role in plant immunity by orchestrating reactive oxygen species (ROS) and hormone-dependent signalling pathways. The present work focuses on the specific case of fatty acid hydroperoxides (HPOs). Although some studies report their potential use as exogenous biocontrol agents for plant protection, evaluation of their efficiency in planta is lacking and no information is available about their mechanism of action. In this work, the potential of 13(S)-hydroperoxyoctadeca-(9Z,11E)-dienoic acid (13-HPOD) and 13(S)-hydroperoxy-(9Z,11E,15Z)-octadecatrienoic acid (13-HPOT), as plant defence elicitors and the underlying mechanism of action are investigated. Arabidopsis thaliana leaf resistance to Botrytis cinerea was observed after root application with HPOs. They also activate early immunity-related defence responses, like ROS. As previous studies have demonstrated their ability to interact with plant plasma membranes (PPM), we have further investigated the effects of HPOs on biomimetic PPM structure using complementary biophysics tools. Results show that HPO insertion into PPM impacts its global structure without solubilizing it. Relationship between biological assays and biophysical analysis suggests that lipid amphiphilic elicitors that directly act on membrane lipids might trigger early plant defence events

Toward Better Risk Stratification of Asymptomatic Brugada Syndrome Patients? Najla Beydoun MD1 , Charbel Gharios MD2 , Marwan M. Refaat MD3 1 Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA2 Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA3 Department of Internal Medicine, Division of Cardiology, and Department of Biochemistry and Molecular Genetics, American University of Beirut Faculty of Medicine and Medical Center, Beirut, LebanonShort Title: Risk Stratification in Asymptomatic BrSWord Counts: 602

Is Multipoint Pacing Superior to Optimized Single-Point Pacing?Rodolfo San Antonio1, MD; Jose María Tolosana2, MD, PhD; Lluís Mont2, MD, PhD.1Heart Institute, Teknon Medical Center, Barcelona, Spain; University of Barcelona, Spain2Institut Clínic Cardio-Vascular, Hospital Clínic, University of Barcelona, Spain; Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.Word count: 434

Background: The optimal treatment of high-risk PE with cardiac arrest is still controversial although various treatment approaches have been developed and improved. Here, we present a serie of patients with high-risk PE showing hemodynamic collapse, who were successfully treated with extracorporeal membrane oxygenation (ECMO) as an adjunct to EKOS™ acoustic pulse thrombolysis. Method: From April 2016 to June 2020, 29 patients with high-risk PE with cardiac arrest were retrospectively included. The mean age was 55.3 ± 9.2 years. Twelve (41.3%) patients were female. All patients had cardiac arrest, either as an initial presentation or in-hospital after the presentation. All patients exhibited acute symptoms, computed tomography (CT) evidence of large thrombus burden, and severe right ventricular dysfunction. Primary outcome was all-cause 30-day mortality. Results: Twenty-two patients survived to hospital discharge, with a mean ICU stay of 9.9 ± 1.6 days (range, 7 to 22 days) and mean length of hospital stay of 23.7 ± 8.5 days (range, 11 to 44 days). Six patients died from refractory shock. Ninety-day mortality was 24.1% (7/29). The Mean ECMO duration was 3.5 ± 1.1 days and the mean RV/LV ratio decreased from 1.31 ± 0.17 to 0.92 ± 0.11 in patients who survived to discharge. The mean tissue plasminogen activator (tPA) dose for survivor patients was 20.5 ± 1.6 mg. Conclusion: Patients with high-risk pulmonary embolism who suffer a cardiac arrest have high morbidity and mortality. APT complemented by ECMO could be a successful treatment option for patients who have high-risk PE with circulatory collapse.

Multisystem Inflammatory Syndrome is a rare and novel clinical presentation described during the evolving Covid- 19 pandemic. The condition is usually presenting as a sepsis-like syndrome leading to secondary multiorgan dysfunction post-COVID-19 infection. Although the syndrome has been mainly described in children, rare adults' form has been similarly described.

Difficulties during surgery are uncommon situations in appendectomy. For granulomatous appendicitis, literature is insufficient about surgical findings. The procedure of a 17-year-old male patient was a struggle due to adhesions. I thought a surgeon could expect granulomatous diseases by evaluating the macroscopic appearance of the appendix during surgical procedure.

Psoriasis is a chronic inflammatory disease with characteristic skin manifestations. Several pathogens can cause flare-ups of psoriasis. The risks of skin infections are increased in patients receiving immunomodulators. A patient with chronic psoriasis presented with human papillomavirus infection and anogenital warts and was treated surgically with acceptable results.

In this paper, the link between combinatorial structures and alternative algebras is studied, determining which configurations are associated with those algebras. Moreover, the isomorphism classes of each 2-dimensional configuration associated with these algebras is analyzed, providing a new method to classify them. In order to complement the theoretical study, two algorithmic methods are implemented: the first one constructs and draws the (pseudo)digraph associated with a given alternative algebra and the second one tests if a given combinatorial structure is associated with some alternative algebra.

In this paper, we investigate vector Lakshmanan-Porsezian-Daniel (VLPD) model which can be used to describe the ultrashort pulses in the birefringent optical fiber. Based on the unified transformation method, the Riemann-Hilbert problem is introduced and initial-boundary value problems of the VLPD model are studied. By solving the formulated matrix Riemann-Hilbert problem, the potential function solutions of the VLPD model can be reconstructed. Moreover, that the spectral functions are not independent but meet the so-called global relation is shown.

The access of drugs into the central nervous system (CNS) is regulated by the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB). A large body of evidence supports perturbation of these barriers in neurodegenerative diseases, including Alzheimer’s disease and Parkinson’s disease. Modifications to the BBB and BSCB are also reported in amyotrophic lateral sclerosis (ALS), albeit these modifications have received less attention relative to those in other neurodegenerative diseases. Such alterations to the BBB and BSCB have the potential to impact on CNS exposure of drugs in ALS, modulating the effectiveness of drugs intended to reach the brain and the toxicity of drugs that are not intended to reach the brain. Given the clinical importance of these phenomena, this review will summarise reported modifications to the BBB and BSCB in ALS, discuss their impact on CNS drug exposure and suggest further research directions so as to optimise medicine use in people with ALS.

1. Kānuka (Kunzea serotina, Myrtaceae) dryland shrubland communities of the lowland plains of South Island (Te Wai Pounamu) New Zealand (Aoteoroa) contain a ground cover largely consisting of mosses, predominantly Hypnum cupressiforme. There has been no previous study of the role of mosses in this threatened habitat which is currently being restored within a contemporary irrigated and intensively-farmed landscape that may be incompatible with this component of the ecosystem. 2. The aim of the present study was to investigate the influence of moss ground cover on hydrology, nitrogen (N) availability and vascular plant interactions, and in relation to nutrient spillover from adjacent farmland. Experimental work was a combination of glasshouse experiments and field-based studies. 3. Extremes of soil temperature and moisture were found to be mediated by the moss carpet, which also influenced N speciation; available N declined with moss depth. The moss layer decreased the amount of germination and establishment of vascular plants but, in some cases, enhanced their growth. Spillover of mineral nitrogen and phosphate from farmland enhanced invasion of exotic grasses which may have benefited from conditions provided by the moss carpet. 4. Synthesis: We found the moss layer to be crucial to ecosystem functioning in these dry habitats with low nutrient substrate. However, when the moss layer is accompanied by nutrient spillover it has the potential to increase exotic weed encroachment. Our results emphasise the importance of non-vascular plant inclusion in restoration schemes but also highlights the importance of mitigating for nutrient spillover.