This study compares the U.S. National Water Model (NWM) reanalysis snow outputs to observed snow water equivalent (SWE) and snow-covered area fraction (SCAF) at SNOTEL sites across the Western U.S. SWE was obtained from SNOTEL sites, while SCAF was obtained from MODIS observations at a nominal 500 m grid scale. Retrospective NWM results were at a 1000 m grid scale. We compared results for SNOTEL sites to gridded NWM and MODIS outputs for the grid cells encompassing each SNOTEL site. Differences between modeled and observed SWE were attributed to both model errors, as well as errors in inputs, notably precipitation and temperature. The NWM generally under-predicted SWE, partly due to precipitation input differences. There was also a slight general bias for model input temperature to be cooler than observed, counter to the direction expected to lead to under-modeling of SWE. There was also under-modeling of SWE for a subset of sites where precipitation inputs were good. Furthermore, the NWM generally tends to melt snow early. There was considerable variability between modeled and observed SCAF as well as the binary comparison of snow cover presence that hampered useful interpretation of SCAF comparisons. This is in part due to the shortcomings associated with both model SCAF parameterization and MODIS observations, particularly in vegetated regions. However, when SCAF was aggregated across all sites and years, modeled SCAF tended to be more than observed using MODIS. These differences are regional with generally better SWE and SCAF results in the Central Basin and Range and differences tending to become larger the further away regions are from this region. These findings identify areas where predictions from the NWM involving snow may be better or worse, and suggest opportunities for research directed towards model improvements.

Background. Whether small airway dysfunction (SAD), which is prevalent in asthma, helps to characterize wheezing phenotypes is undetermined. The objective was to assess whether SAD parameters obtained from impedance measurement and asthma probability are linked. Methods. One hundred and thirty-nine preschool children (mean age 4.7 years, 68% boys) suffering from recurrent wheeze underwent impulse oscillometry that allowed calculating peripheral resistance and compliance of the respiratory system (markers of SAD) using the extended RIC model (central and peripheral Resistance, Inertance and peripheral Compliance of the respiratory system). Children were classified using the probability-based approach of GINA guidelines (few, some, most having asthma). A principal component analysis (PCA) that determined the dimensions of wheezing disease evaluated the links between SAD and asthma probability. Results. Forty-seven children belonged to the few, 28 to the some and 64 to the most having asthma groups. Whereas their anthropometrics and measured parameters were similar, the most having asthma group exhibited the lowest mean value of airway inertance after bronchodilator probably due to airway inhomogeneities. PCA characterized nine independent dimensions including a peripheral resistance (constituted by baseline peripheral resistance, AX, R5-20Hz, X5Hz), a central resistance (baseline central resistance, R20Hz) and an airway size dimension (post-bronchodilator inertance and central resistance). PCA showed that the SAD markers were independent from clinical dimensions (control and asthma probability were two other dimensions) and did not help to define wheezing phenotypes. Conclusions. Lung function parameters obtained from impulse oscillometry and asthma probability were belonging to independent dimensions of the wheezing disease.

Geographic parthenogenesis (GP), a phenomenon where parthenogens and their close sexual relatives inhabit distinct geographic areas, has been considered an interesting topic to understand the adaptation to marginal habitats and the role of hybridization in evolution. Reports of GP from land and freshwater are numerous, however, this occurrence has been rarely reported on from the sea. Brown algae are mostly marine and are thought to include numerous obligate parthenogens; still, little is known about the distribution, origin, and evolution of parthenogens in this group. Here we report a novel pattern of GP in the isogamous brown alga Scytosiphon lomentaria. Sex ratio investigation demonstrated that, in Japan, sexual populations grew in the coast along warm ocean currents, whereas female-dominant parthenogenetic populations grew mainly in the coast along a cold ocean current. In the two localities where sexual and parthenogenetic populations were parapatric, parthenogens grew in more wave-exposed areas than sexuals. Population genetic and phylogenetic analyses, including those based on genome-wide single nucleotide polymorphism data, suggested that: (1) parthenogens evolved at least twice in S. lomentaria, (2) parthenogens did not originate from inter-species hybridization, (3) new parthenogenetic lineages have arisen from hybridizations between parthenogens and sexuals, and (4) parthenogens have a wider distribution than sexuals. We also showed that the production of sex pheromones, which attract male gametes, has been independently suppressed/lost in two parthenogenetic lineages. This parallel suppression/loss of the sexual trait may represent the direct origin of parthenogens, or the regressive evolution of a useless trait under asexuality.

Background: Transvenous implantable cardiac defibrillators (TV ICD) provide life-saving therapy for millions of patients worldwide. However, they are susceptible to several potential short- and long- term complications including cardiac perforation and pneumothorax, lead dislodgement, venous obstruction, and infection. The extravascular ICD (EV ICD) system’s novel design and substernal implant approach avoids the risks associated with TV ICDs while still providing pacing features and similar generator size to TV ICDs. Study Design: The EV ICD pivotal study is a prospective, multi-center, single-arm, non-randomized, pre-market clinical study designed to examine the safety and acute efficacy of the system. This study will enroll up to 400 patients with a Class I or IIa indication for implantation of an ICD. Implanted subjects will be followed up to approximately 3.5 years, depending on when the patient is enrolled. Objective: The clinical trial is designed to demonstrate safety and effectiveness of the EV ICD system in human use. The safety endpoint is freedom from major complications, while the efficacy endpoint is defibrillation success. Both endpoints will be assessed against prespecified criteria. Additionally, this study will evaluate antitachycardia pacing (ATP) performance, electrical performance, extracardiac pacing sensation, asystole pacing, appropriate and inappropriate shocks, as well as a summary of adverse events. Conclusion: The EV ICD pivotal study is designed to provide clear evidence addressing the safety and efficacy performance of the EV ICD System.

Enzymatic detachment of cells might damage important features of cells and could affect subsequent function of cells in various applications. Therefore, non-enzymatic cell detachment using thermosensitive polymer matrix is necessary for maintaining cell quality after harvesting. In this study, we synthesized thermosensitive PNIPAm-co-AAc-b-PS and PNIPAm-co-AAm-b-PS copolymers and LCST was tuned near to body temperature. Then, polymer solutions (5% w/v, 10% w/v, and 20% w/v) were spin coated to prepare films for cell adhesion and thermal-induced cell detachment. The apha-step analysis and SEM image of the films suggested that the thickness of the films depends on the molecular weight and concentration which ranged from 206 nm to 1330 nm for PNIPAm-co-AAc-b-PS and 97.5 nm to 497 nm for PNIPAm-co-AAm-b-PS. The contact angles of the films verified that the polymer surface was moderately hydrophilic at 37°C. From cell attachment and detachment studies, RAW264.7 cells, were convincingly proliferated on the films to a confluent of >80 % within 48 days. However, relatively more cells were grown on PNIPAm-co-AAm-b-PS (5%w/v) films and thermal-induced cell detachment was more abundant in this formulation. As a result, commercial cytodex 3 microcarrier was coated with PNIPAm-co-AAm-b-PS (5%w/v) and interestingly enhanced cell detachment with preserved potential of recovery was observed at low temperature during 3D culturing. Thus, surface modification of microcarriers with PNIPAm-co-AAm-b-PS could be vital strategy for non-enzymatic cell dissociation and able to achieve adequate number of cells with maximum cell viability, and functionality for various cell-based applications. Keywords: surface coated microcarriers; thermosensitive polymer; non-enzymatic cell detachment

Since December 2019, Coronavirus disease-19 (COVID-19) has spread rapidly across the world, leading to a global effort to develop vaccines and treatments. Despite extensive progress, there remains a need for treatments to bolster the immune responses in infected immunocompromised individuals, such as cancer patients who recently underwent a haematopoietic stem cell transplantation. Immunological protection against COVID-19 is mediated by both short-lived neutralising antibodies and long-lasting virus-reactive T cells. Therefore, we propose that T cell therapy may augment efficacy of current treatments. For the greatest efficacy with minimal adverse effects, it is important that any cellular therapy is designed to be as specific and directed as possible. Here, we identify T cells from COVID-19 patients with a potentially protective response to two major antigens of the SARS-CoV-2 virus, Spike and Nucleocapsid protein. By generating clones of highly virus-reactive CD4+ T cells, we were able to confirm a set of 9 immunodominant epitopes and characterise T cell responses against these. Accordingly, the sensitivity of T cell clones for their specific epitope, as well as the extent and focus of their cytokine response was examined. Moreover, by using an advanced T cell receptor (TCR) sequencing approach, we determined the paired TCR sequences of clones of interest. While these data on a limited population require further expansion for universal application, the results presented here form a crucial first step towards TCR-transgenic CD4+ T cell therapy of COVID-19.

Remote communication in ENT has been expanding, spurred by the COVID-19 pandemic. Conferences and teaching have moved online, enabling easier participation, and reducing financial and environmental costs. Online multi-disciplinary meetings have recently been instigated in Africa to discuss management of cases in head and neck cancer, or cochlear implantation, expanding access and enhancing patient care. Remote patient consultation has also seen an explosion, but existing literature suggests some caution, particularly because many patients in ENT need an examination to enable definitive diagnosis. Ongoing experience and more research is needed to better understand how remote communication will fit into our future working lives, both during and after the pandemic.

Population bottlenecks associated with founder events strongly impact the establishment and genetic makeup of populations. In addition to their genotype, founding individuals also bring along symbionts that can manipulate the phenotype of their host, affecting the host population establishment, dynamics and evolution. Thus, to understand introduction, invasion, and spread, we should identify the roles played by accompanying symbionts. In 1991, the parasitoid wasp, Hyposoter horticola, and its associated hyperparasitoid were accidentally introduced from the main Åland islands, Finland, to an isolated island in the archipelago, along with their host, the Glanville fritillary butterfly. Though the receiving island was unoccupied, the butterfly was present on some of the small islands in the vicinity. The three species have persisted as small populations ever since. A strain of the endosymbiotic bacterium Wolbachia has an intermediate prevalence in the H. horticola across the main Åland population. The infection increases susceptibility of the parasitoid to hyperparasitism. We investigated the establishment and spread of the parasitoid, along with patterns of prevalence of its symbiont using 323 specimens collected between 1992 and 2013, from five localities across Åland, including the source and introduced populations. Using 14 microsatellites and one mitochondrial marker, we suggest that the relatively diverse founding population and occasional migration between islands might have facilitated the persistence of all isolated populations, despite multiple local population crashes. We also show local near-fixation of Wolbachia, where the hyperparasitoid is absent, and selection against infected wasp genotypes is relaxed.

5 succinct/key points 1. There is a considerable burden to outpatient head and neck cancer (HaNC) surveillance, and it is unclear to what extent the current recommendations facilitate the detection of HaNC. 2. Our 100 patient retrospective analysis demonstrated three asymptomatic recurrences (all within the first year of follow up) and 20 symptomatic recurrences (mean time to recurrence of 21.4 months). 3. Seventy-four percent of those patients who recurred did so within the first two years following primary treatment, increasing up to 83% by three years. 4. We believe the value of routine follow up is more apparent within the first two to three years following primary treatment as this is when the rate of recurrence is highest. 5. We anticipate larger trials investigating the efficacy of an initial two years of frequent follow up followed by longer-term patient-led follow up.

CFTR (cystic fibrosis transmembrane conductance regulator) modulators are small molecules that directly change the CFTR protein, improving function of the CFTR chloride channel. Beginning in 2012 with the FDA approval of the first CFTR modulator, ivacaftor, this class of medication has had largely positive effects on many outcomes in people with cystic fibrosis (pwCF), including lung function, quality of life, and growth. There have been continued exciting developments in the current research on CFTR modulators, expanding beyond original studies. This first part of a three-part Cystic Fibrosis (CF) Year in Review 2020 will focus on research on CFTR modulators. Subsequent parts of the CF year in review will cover pulmonary and infectious inflammatory aspects, and the multisystem effects of CF in the 2020 literature. The review focuses on articles from Pediatric Pulmonology, but it includes articles from other journals that are of particular interest to clinicians. New developments in CF research continue to be brought forth to the CF community, deepening the understanding of this disease and improving clinical care.

The study investigates the case of a total thyroidectomy, where after dissection multiple nodules showed two malignant patterns by immunohistochemistry. Molecular analysis based on DNA methylation profile was used to further inspect the origin of the coexisting neoplasms. We confirmed the presence of malignant skin melanoma involving medullary thyroid cancer.

Point 1: Camera traps have become an extensively utilized tool in ecological research, but the processing of images created by a network of camera traps rapidly becomes an overwhelming task, even for small networks. Point 2: We used transfer training to create convolutional neural network (CNN) models for identification and classification. By utilizing a small dataset with less than 10,000 labeled images the model was able to distinguish between species and remove false triggers. Point 3: We trained the model to detect 17 object classes with individual species identification, reaching an accuracy of 92%. Previous studies have suggested the need for thousands of images of each object class to reach results comparable to those achieved by human observers; however, we show that such accuracy can be achieved with fewer images. Point 4: Additionally, we suggest several alternative metrics common to computer science studies to accurately evaluate the performance of such camera trap image processing models, as well as methods to adapt the model building process to two targeted purposes.

1. The receiver operating characteristic (ROC) and precision-recall (PR) plots have been widely used to evaluate the performances of species distribution models. Plotting ROC/PR curves requires a traditional test set with both presence and absence data (namely PA approach), but species absence data are usually not available in reality. Plotting ROC/PR curves from presence-only data while treating background data as pseudo absence data (namely PO approach) may provide misleading results. 2. In this study we propose a new approach to calibrate the ROC/PR curves from presence and background data with user-provided information on a constant c, namely PB approach. An estimate of c can also be derived from the PB-based ROC/PR plots given that a model with good ability of discrimination is available. We used three virtual species and a real aerial photography to test the effectiveness of the proposed PB-based ROC/PR plots. Different models (or classifiers) were trained from presence and background data with various samples sizes. The ROC/PR curves plotted by PA approach were used to benchmark the curves plotted by PO and PB approaches. 3. Experimental results show that the curves and areas under curves by PB approach are more similar to that by PA approach as compared with PO approach. The PB-based ROC/PR plots also provide highly accurate estimations of c in our experiment. 4. We conclude that the proposed PB-based ROC/PR plots can provide valuable complements to existing model assessment methods, and they also provide an additional way to estimate the constant c (or species prevalence) from presence and background data.

Amphibian skin secretions (substances produced by the amphibian plus microbiota) plausibly act as a first line of defense against pathogen attack, but may also provide chemical cues for pathogens. To clarify the role of skin secretions in host-parasite interactions, we conducted experiments using cane toads (Rhinella marina) and their lungworms (Rhabdias pseudosphaerocephala) from the range-core and invasion-front of the introduced anurans’ range in Australia. Depending on the geographic area, toad skin secretions can reduce the longevity and infection success of parasite larvae, or attract lungworm larvae and enhance their infection success. These striking differences between the two regions were due both to differential responses of the larvae, and differential effects of the skin secretions. Our data suggest that skin secretions play an important role in host-parasite interactions in anurans, and that the arms race between a host and parasite can rapidly generate spatial variation in critical features of that interaction.

Many large rivers worldwide are enriched with high levels of suspended solids (SS), which are known to be hotspots of many nitrogen (N) transformation processes (e.g., denitrification, nitrification). However, the influence of SS on microbial ammonium (NH4+) recycling remains unclear. Water column NH4+ regeneration rates (REGs) and potential uptake rates (Upots) as well as community biological NH4+ demand (CBAD) was measured in the river-estuary continuum of the third longest river in the world—Yangtze River, where shows dramatic SS gradients. We found that, REGs, Upots, and CBAD all showed increasing trends along the river flow, with higher REGs, Upots, and CBAD in the estuary than in the river sections. The regeneration and uptake of NH4+ were nearly balanced in the river sections, while the positive CBAD in the estuary indicated obvious NH4+ demand of microbes. Concentrations of SS, which also controls the content of chemical oxygen demand and particulate N, were the main factor influencing NH4+ recycling rates and CBAD. SS induced regenerated NH4+ in the river-estuary continuum of Yangtze River was estimated to be 21.81 × 108 kg N yr−1 and accounted for about 25% of total N inputs, suggesting that regenerated NH4+ is an important N source for microbes and may influence nutrient dynamics in lower coasts. To our knowledge, this is the first to report NH4+ recycling in Yangtze River with an emphasis on its influencing factors and contribution to N budgets.

The era of "big data'' promises to provide new hydrologic insights, and open web-based platforms are being developed and adopted by the hydrologic science community to harness these datasets and data services. This shift accompanies advances in hydrology education and the growth of web-based hydrology learning modules, but their capacity to utilize emerging open platforms and data services to enhance student learning through data-driven activities remains largely untapped. Given that generic equations may not easily translate into local or regional solutions, teaching students to explore how well models or equations work in particular settings or to answer specific problems using real data is essential. This paper introduces an open web-based learning module developed to advance data-driven hydrologic process learning, targeting upper level undergraduate and early graduate students in hydrology and engineering. The module was developed and deployed on the HydroLearn open educational platform, which provides a formal pedagogical structure for developing effective problem-based learning activities. We found that data-driven learning activities utilizing collaborative open web platforms like HydroShare and CUAHSI JupyterHub computational notebooks allowed students to access and work with datasets for systems of personal interest and promoted critical evaluation of results and assumptions. Initial student feedback was generally positive, but also highlights challenges including trouble-shooting and future-proofing difficulties and some resistance to open-source software and programming. Opportunities to further enhance hydrology learning include better articulating the myriad benefits of open web platforms upfront, incorporating additional user-support tools, and focusing methods and questions on implementing and adapting notebooks to explore fundamental processes rather than tools and syntax. The profound shift in the field of hydrology toward big data, open data services and reproducible research practices requires hydrology instructors to rethink traditional content delivery and focus instruction on harnessing these datasets and practices in the preparation of future hydrologists and engineers.

Background and objectives Breast cancer is one of the most common malignant tumors in women. Herein, we compared the analgesic efficacy of ultrasound-guided rhomboid intercostal nerve block , erector spinae plane block and serratus plane block after modified radical mastectomy of unilateral breast cancer. Methods: A total of 90 patients who underwent modified radical mastectomy for unilateral breast cancer were selected. patients were randomly allocated into three groups receiving ultrasound-guided serratus plane block, erector spinae plane block, and the rhomboid intercostal block group. All groups received 20 mL 0.5% ropivacaine. Within 24 hours after operation, the patient received intravenous injection of tramadol 1-2 mg/kg to relieve pain in the surgical ward. Results: The dosage of tramadol 24-hours postoperatively in the rhomboid intercostal block and erector spinae plane block groups was significantly lower than that in serratus plane block group (P < 0.001). There was no statistical difference in tramadol consumption between the erector spinae plane block and rhomboid intercostal block groups within 24 hours (P = 0.676). The numerical rating scale scores in the erector spinae plane block and rhomboid intercostal block groups at 0.5, 1, 3, 6, 12, 18, and 24 hours postoperatively once patients were active were significantly lower than in the serratus plane block group (P < 0.05 for all comparisons); however, The numerical rating scale scores between rhomboid intercostal block and erector spinae plane block groups did not differ significatively within 24 hours after surgery when patients were active. Conclusions: Ultrasound-guided rhomboid intercostal block and erector spinae plane block can reduce the dosage of tramadol and NRS score compared with serratus plane block after modified radical mastectomy.

Background: Primary and secondary malignant tumors of the spine are relatively uncommon in the pediatric population but are associated with high morbidity and significantly decreased quality of life due to pain. Local management of these tumors is often challenging due to the importance of maintaining vertebral mechanical integrity as well as the spinal growth potential. Typically, surgery and/or radiation therapy have been used in the primary management of these tumors. However, treatment options become more limited when there is relapse or refractory disease, with re-resection or additional radiotherapy often not being viable therapies. The purpose of this study was to assess the feasibility of percutaneous vertebroplasty as a palliative treatment for intractable pain secondary to malignant tumors affecting the spine. Procedure: A retrospective review of all cases of vertebroplasty performed at a single institution between 2003 and 2020. Results: A total of 11 vertebral levels were treated in 3 children with relapsed cancers (two with alveolar rhabdomyosarcoma, and one with Wilms tumor). All three had clinical benefit with sustained significant improvement in their pain. Conclusions: Vertebroplasty is a currently underutilized modality that might provide excellent pain palliation in cases of relapsed cancer in the spine. Future prospective studies of its use in pediatric oncology are needed.