Cesarean section by a transverse uterine fundal incision is applied for patients with placenta previa to reduce blood loss. We describe a case of uterine rupture in a pregnant women with previous cesarean section by its procedure who had recovered from cardiac arrest by multidisciplinary management.

In response to: Spurr R, Ng E, Onchiri FM, Rapha B, Nakatumba-Nabende J, Rosenfeld M, Najjingo I, Stout J, Nantanda R, Ellington LE. Performance and usability of a new mobile application for measuring respiratory rate in young children with acute lower respiratory infections. Pediatr Pulmonol. 2022 Aug 22. doi: 10.1002/ppul.26125.

Over the last few years cardiac changed radically and so has the average age of the heart disease population progressively increased. Mitral valve surgery has a significant margin for progress in conservative vs replacement strategy. Mitral disease due to insufficiency in the elderly population has historically suffered from lower repair rates but deficiency alone should not limit repair operations in a specialized environment ensuring good survival.

A document by Anthony Dorr. Click on the document to view its contents.

The present work argues the involvement of zinc chelation ability of some non-steroidal anti-inflammatory drugs as an additive mechanism able to increase their efficacy against COVID-19.

Hyperbaric oxygen should not be used routinely for carbon monoxide poisoning: CONDavid N. Juurlink, MD, PhDDepartments of Medicine, Pediatrics, and Health Policy, Management and Evaluation, University of Toronto, the Ontario Poison Centre, and Sunnybrook Research InstituteWord count: 2036

a) | k ( w ) | ≥ 0 is a piecewise continuous and bounded function in R = ( - ∞ , ∞ ) . The coefficients b ( w ) and q ( w ) are continuous functions in R and can be unbounded at infinity. The operator L admits closure in the space L 2 ( Ω ) and the closure is also denoted by L. Taking into consideration certain constraints on the coefficients b ( w ) q ( w ) , apart from the above-mentioned conditions, the existence of a bounded inverse operator is proved in this paper; a condition guaranteeing compactness of the resolvent kernel is found; and we also obtained two-sided estimates for singular numbers ( s-numbers). Here we note that the estimate of singular numbers ( s-numbers) shows the rate of approximation of the resolvent of the operator L by linear finite-dimensional operators. It is given an example of how the obtained estimates for the s-numbers enable to identify the estimates for the eigenvalues of the operator L. We note that the above results are apparently obtained for the first time for a mixed-type operator in the case of an unbounded domain with rapidly oscillating and greatly growing coefficients at infinity.

In this paper, we propose a unified non-conforming least-squares spectral element ap- proach for solving Stokes equations with various non-standard boundary conditions. Ex- isting least-squares formulations mostly deal with Dirichlet boundary conditions and are formulated using ADN theory based regularity estimates. However, changing boundary conditions lead to a search for parameters satisfying supplementing and complimenting con- ditions [4] which is not easy always. Here we have avoided ADN theory based regularity estimates and proposed a unified approach for dealing with various boundary conditions. Stability estimates and error estimates have been discussed. Numerical results displaying exponential accuracy have been presented for both two and three dimensional cases with various boundary conditions.

A 57-year-old male known case of diabetes mellitus presented with gradually bilateral decreased vision accompanied by ocular pain two weeks after SARS-CoV-2 infection. Ophthalmic examination and imaging were indicative of bilateral anterior ischemic optic neuropathy and secondary angle-closure glaucoma associated with increased choroidal thickness and hypercoagulable state following COVID-19 infection.

Seed limitation can narrow down the number of coexisting plant species and limit plant community productivity. It is also likely to constrain community responses to changing environmental and biotic conditions. In a 10-year full-factorial experiment of seed addition, fertilisation, warming and herbivore exclusion, we tested how seed addition alters community richness and biomass, and how its effects depend on seed origin and environmental and biotic context. We found that seed addition increased richness in all treatments, and increased community biomass depending on nutrient addition and warming. Novel seeded species, originally absent from the communities, increased biomass the most, especially in fertilised plots and in the absence of herbivores, while adding seeds of local species did not affect biomass. Our results show that dispersal limitation can constrain the invasion of novel species and their effects on community biomass, and demonstrate that these relationships are contingent on trophic interactions and environmental conditions.

The present case report illustrates the rehabilitation of a 12-day old neonate with cleft palate. Since the palatal arch of the neonate was very small, a feeding spoon was innovatively modified to obtain the impression. The obturator was fabricated on the same day and delivered in one appointment.

This study employs landscape genetics to investigate the environmental drivers of a deadly vector-borne disease, malaria caused by Plasmodium falciparum, in a more spatially comprehensive manner than any previous work. With 1,804 samples from 44 sites collected in western Kenya in 2012 and 2013, we performed resistance surface analysis to show that Lake Victoria acts as a barrier to transmission between areas north and south of the Winam Gulf. In addition, Mantel correlograms clearly showed significant correlations between genetic and geographic distance over short distances (< 70 km). In both cases, we used an identity-by-state measure of relatedness tailored to highly-related individuals in order to focus on recent gene flow that is more relevant to transmission. To supplement these results, we also performed conventional population genetics analyses, including Bayesian clustering methods and spatial ordination techniques. These revealed some differentiation on the basis of geography and elevation and a cluster of genetic similarity in the lowlands north of the Winam Gulf of Lake Victoria. Taken as a whole, these results indicate low overall genetic differentiation in the Lake Victoria region, but with some separation of populations north and south of the Winam Gulf that is explained by the presence of the lake as a geographic barrier to gene flow. We recommend similar landscape genetics analyses in future molecular epidemiology studies of vector-borne diseases to extend and contextualize the results of traditional population genetics.

A previously healthy 9-year-old girl was referred to us for the evaluation of a murmur on routine clinical examination. Routine electrocardiogram and chest X-ray were normal. The cardiac enzymes were normal. Combining ultrasound and CCTA, it was confirmed that the hemodynamics of the heart was a left-to-right shunt and that RVOT stole blood from the left ventricle through the single coronary artery (SCA).

Background and Purpose Incubation of craving is associated with temporal changes in the activity of several structures involved in drug-seeking behavior. Hypodopaminergic activity, responsible for negative emotional states, has been reported in the ventral tegmental area (VTA) during cocaine abstinence. The neuroadaptations underlying the VTA hyperdopaminergic state after chronic cocaine is not well understood. In this work, we investigated the potential involvement of a VTA inhibiting circuit (amygdala-ventral pallidum (VP) pathway) in the hypodopaminergic state during abstinence from chronic cocaine. Experimental Approach In a model of cocaine self-administration, we performed in vivo electrophysiological recordings of DA VTA neurons and basolateral amygdala (BLA) neurons from anesthetized rats during early and protracted abstinence and evaluated the involvement of the BLA-VP pathway using a pharmacological approach. Key Results We found a significant decrease of VTA DA population activity and a significant increase of BLA activity after 30 days of abstinence from chronic cocaine but not one day. The decrease in VTA DA activity was restored by pharmacological inhibition of the activity of either the BLA or the VP. Conclusion and Implications Our study sheds new lights on neuroadaptations occurring during incubation of craving leading to relapse. In particular, we described the involvement of the BLA-VP pathway in cocaine-induced decreases of DA activity in the VTA. This study adds an important building block to the characterization of specific brain network dysfunctions underlying hypodopaminergic activity during abstinence.

Revegetation projects face the major challenge of sourcing the optimal plant material. This is often done with limited information about plant performance and increasingly requires to factor resilience to climate change. Functional traits can be used as quantitative indices of plant performance and guide provenancing, but trait values expected under novel conditions are often unkown. To support climate-resilient provenancing efforts, we develop a trait prediction model that integrates the effect of genetic variation with fine-scale temperature variation. We train our model on multiple field plantings of Arabidopsis thaliana and predict two relevant fitness traits -- days-to-bolting and fecundity -- across the species' European range. Prediction accuracies were high for days-to-bolting and moderate for fecundity, with the majority of trait variation explained by temperature differences between plantings. Projection under future climate predicted a decline in fecundity, although this response was heterogeneous across the range. In response, we identified novel genotypes that could be introduced to genetically offset the fitness decay. Our study highlights the value of predictive models to aid seed provenancing and improve the success of revegetation projects.

Innovations in ancient DNA (aDNA) preparation and sequencing technologies have exponentially increased the quality and quantity of aDNA data extracted from ancient biological materials. The additional temporal component from the incoming aDNA data can provide improved power to address fundamental evolutionary questions like characterising selection processes that shape the phenotypes and genotypes of contemporary populations or species. However, utilising aDNA to study past selection processes still involves considerable hurdles such as how to eliminate the confounding effect of genetic interactions in the inference of selection. To circumvent this challenge, in this work we extend the method introduced by He et al. (2022) to infer temporally variable selection from the data on aDNA sequences with the flexibility of modelling linkage and epistasis. Our posterior computation is carried out through a robust adaptive version of the particle marginal Metropolis-Hastings algorithm with a coerced acceptance rate. Moreover, our extension inherits their desirable features like modelling sample uncertainties resulting from the damage and fragmentation of aDNA molecules and reconstructing underlying gamete frequency trajectories of the population. We assess the performance and show the utility of our procedure with an application to ancient horse samples genotyped at the loci encoding base coat colours and pinto coat patterns.

Background: The management of aortic arch pathologies represents a great challenge and is associated with high rates of mortality and morbidity. A superior endovascular approach via thoracic endovascular aortic repair (TEVAR) has been introduced to treat arch pathologies with specifically designed endografts. This approach was shown to benefit patients who are deemed ‘high risk’ for undergoing OSR as it is a greatly less invasiveness option and thus, yields lower rates of morbidity and mortality. Aims: This commentary aims to discuss the recent study by Tan et al. which reports original data on the neurological outcomes after endovascular repair of the aortic arch using the RELAY™ Branched device. Methods: We carried out a literature search on multiple electronic databases including PubMed, Ovid, Google Scholar, Scopus and EMBASE in order to collate research evidence on the neurological outcomes of endovascular aortic arch repair with TEVAR. Results: Tan and colleagues showed through their original clinical data that the RELAY™ Branched device has a high rate of technical success and favourable neurological outcomes. There were no reported neurological deficits in patients who received the triple-branched RELAY™ Branched device. Conclusion: The RELAY™ Branched endograft is well-established for candidates for aortic arch endovascular repair with favourable neurological outcomes. Multiple considerations can help control the incidence of stroke following endovascular repair. These include optimization of the supra-aortic vessels’ revascularization, weighting the embolic risk in patients with atheromatous disease, and careful preoperative assessment to select the best candidates for arch endovascular repair

This paper presents decoupled second-order accurate algorithms based on Crank-Nicolson LeapFrog (CNLF) scheme for the evolution Boussinesq equations. The proposed algorithms deal with the spatial discretization by finite element method and treat the temporal discretization by CNLF method. For the nonlinear term in the Boussinesq equations, the semi-implicit method is used. Unconditional stability and error estimate of the numerical algorithm are proven. Some numerical tests are presented to justify the theoretical analysis.