In this work, methods based upon nonequilibrium thermodynamics are elucidated to predict stationary states of chemical reactions in nonequilibrium plasma, and limits for energy conversion efficiency. Two example reactions are used: CO2 splitting and NH3 synthesis, with emphasis on CO2 splitting. Expectations from the theoretical framework are compared to experimental results for both reactions, and reasonable agreement is obtained. The conclusion is that the probability of observing either reactants or products increases with the amount of energy dissipated by that side of the reaction as heat through collisions with hot electrons. The side of the reaction that dissipates more energy as heat has a higher probability of occurrence. Furthermore, endergonic chemical reactions in nonequilibrium plasma, such as CO2 splitting at low temperature, require an intrinsic energy dissipation to satisfy the 2nd law of thermodynamics – a sufficient and necessary waste. This intrinsic dissipation limits the maximum theoretical energy conversion efficiency

Background: Pneumonia is one of the most common serious infections in children. Scoring systems have been adopted to quantify the severity of the disease, but they were based on clinical findings that can vary according to the subjective assessment of the clinician. We hypothesized that diaphragm ultrasound (DUS) parameters may be a new useful tool to objectively score the severity of the disease and predict outcomes in children with pneumonia. Methods: Children diagnosed with pneumonia, aged between 1 month and 18 years, were prospectively evaluated in the pediatric emergency department. The Pediatric Respiratory Severity Score was used to indicate the severity of the disease and DUS was performed. Diaphragm thickness at the end of inspiration and expiration, thickening fraction (TF), diaphragm excursion, inspiratory slope (IS), expiratory slope (ES), and total duration time of the respiratory cycle were calculated. Results: There were 96 patients enrolled in the study. Inspiratory slope and ES measurements had positive correlations with respiratory rate and length of stay in the hospital and negative correlations with oxygen saturation levels. Furthermore, TF values were negatively correlated with respiratory rate and length of stay in the emergency department. Patients with higher clinical scores had increased IS and ES and decreased TF values. Conclusion: Diaphragm ultrasound can be a promising and useful tool to assess diaphragmatic dysfunction in patients diagnosed with pneumonia. Diaphragm parameters, especially TF, IS, and ES, may provide objective and reliable information to predict the severity of the illness, the need for respiratory support, and outcomes.

Background: Bronchiolitis obliterans syndrome (BOS) is a life-threatening respiratory complication of allogeneic hematopoietic stem cell transplant (HSCT). Even though a lung function test is crucial in monitoring BOS, little information exists on the test’s association with prognosis in children with BOS. Objectives: The purpose of this study was to determine the correlation between changes in lung function after BOS diagnosis and long term outcomes. Methods: A total of 428 children received allogeneic HSCT from January 2006 to December 2017 at Asan Medical Center. Twenty-three of those children (5.4%) were diagnosed with BOS after allogeneic HSCT, and their clinical data were reviewed. Twenty-one subjects underwent regular pulmonary function tests for 24 months after the occurrence of BOS. Results: Among the 21 children with BOS, eight died, five underwent a lung transplant (TPL), and 15 required oxygen (O2) therapy. The FEV1% predicted (pred), FVC% pred, and FEF25-75% pred were 37.8±12.7% (mean±SD), 62.2±16.2%, and 16.4±9.6%, respectively, upon BOS diagnosis. Changes in the FEV1% pred were greater in the death and lung TPL group (-24.8±22.3%) than the survival without lung TPL group (5.7±21.8%), and greater in the O2 therapy (-19.4±23.4%) group than the group without O2 therapy (14.2±20.0%) during the first three months after BOS diagnosis. Conclusion: The change of FEV1 during the first three months after BOS correlated with the prognosis including survival, lung transplantation, and O2 therapy. These results suggest more active intervention in the first three months after BOS diagnosis may be needed to improve prognosis.

Infection with African swine fever virus (ASFV) causes a highly lethal hemorrhagic disease in domestic and Eurasian wild pigs. Thus, it is a major threat to pig populations worldwide and a cause of substantial economic losses. Recently, less virulent ASFV strains emerged naturally, which showed higher experimental virulence in wild boar than in domestic pigs. The reason for this difference in disease progression and outcome is unclear but likely involves different immunological responses. Unfortunately, besides the importance of CD8α+ lymphocytes, little is known about the immune responses against ASFV in suids. Against this background, we used a multicolor flow cytometry platform to investigate the T-cell responses in wild boar and domestic pigs after infection with the moderately virulent ASFV strain “Estonia2014” in two independent trials. CD4–/CD8α+ and CD4+/CD8α+ αβ T-cell frequencies increased in both subspecies in various tissues, but CD8α+ γδ T cells differentiated and responded in wild boar only. Proliferation in CD8α+ T cells was found 10 days post infectionem only. Frequencies of T-bet+ T cells increased in wild boar but not in domestic pigs. Of note, we found a considerable loss of perforin expression in cytotoxic T cells, 5 and 7 dpi. Both subspecies established a regulatory T-cell response 10 dpi. In domestic pigs, we show increasing levels of ICOS+ and CD8α+ invariant Natural Killer T cells. These disparities in T-cell responses might explain some of the differences in disease progression in wild boar and domestic pigs and should pave the way for future studies.

Bone marrow necrosis (BMN) is a rare pathologic finding, but when encountered is most often associated with malignancy. In adults its presence correlates with an inferior prognosis, however in children the prognostic implication is unclear. We performed a retrospective review of 3,760 bone marrow specimens in patients ≤ 18 years over a ten-year period. BMN was identified in less than 1% of specimens and only in patients with leukemia, lymphoma or neuroblastoma. BMN contributed to a delay in diagnosis; however, advanced medical imaging may serve as a tool to localize non-necrotic areas for bone marrow sampling, facilitating an expedited diagnosis.

Deep learning has emerged as a revolutionary technology for protein residue-residue contact prediction since the 2012 CASP10 competition. Considerable advancements in the predictive power of the deep learning-based contact predictions have been achieved since then. However, little effort has been put into interpreting the black-box deep learning methods. Algorithms that can interpret the relationship between predicted contact maps and the internal mechanism of the deep learning architectures are needed to explore the essential components of contact inference and improve their explainability. In this study, we present an attention-based convolutional neural network for protein contact prediction, which consists of two attention mechanism-based modules: sequence attention and regional attention. Our benchmark results on the CASP13 free-modeling (FM) targets demonstrate that the two attention modules added on top of existing typical deep learning models exhibit a complementary effect that contributes to predictive improvements. More importantly, the inclusion of the attention mechanism provides interpretable patterns that contain useful insights into the key fold-determining residues in proteins. We expect the attention-based model can provide a reliable and practically interpretable technique that helps break the current bottlenecks in explaining deep neural networks for contact prediction. The source code of our method is available at https://github.com/jianlin-cheng/InterpretContactMap.

This paper considers minimizers of the following inhomogeneous $L^2$-subcritical energy functional \[E(u):=\int_{\R^N}|\nabla u|^{2}dx-\frac{2}{p+1}\int_{\R^N}m(x)|u|^{p+1}dx,%\ u\in H^{1}(\R^N), \] under the mass constraint $\|u\|^{2}_{2}=M$. Here $N\geq1$, $p\in(1,1+\frac{4}{N})$, $M>0$ and the inhomogeneous term $m(x)$ satisfies $0

Early and long term Clinical outcome after Minimally Invasive Direct Coronary Bypass Grafting versus off pump Coronary Surgery via Sternotomy In this retrospective study by Cichon Romuald et al (1), 194-patients met the inclusion criteria and were divided into the MIDCAB group (n=111) and OPCAB via median sternotomy group (n=83). The conclusion was that short as well as long-term outcomes of MIDCAB in terms of mortality, myocardial infarction, stroke, and target vessel revascularization were satisfactory, and as safe and effective as OPCAB via sternotomy This retrospective study by Cichon Romuald et al (1), undoubtedly will generate interest for surgeons who want to perform minimally invasive coronary surgery. It is clear that, in order to attract patients to undergo surgery, surgeons must learn to perform minimally invasive coronary surgery. Advantages of minimally invasive coronary surgery include less post-operative discomfort, faster healing times, less risk of infection and avoidance of trauma associated with OPCAB Surgeons must also take the initiative and play an active role in the Hybrid Revascularization Procedures Current surgeons, and those in residency training programs, should learn wire skills and participate in placement of stents. There is a lot to learn from our interventional cardiologists who embrace new technology and procedures. Surgeons will have to adapt to the new reality, and move some of his/her practice outside the operating room.

NADPH:protochlorophyllide (Pchlide) oxidoreductase (POR) is a key enzyme of chlorophyll biosynthesis in angiosperms. It is one of few known photoenzymes, which catalyzes the light-activated trans-reduction of the C17-C18 double bond of Pchlide’s porphyrin ring. Due to the light requirement, dark-grown angiosperms cannot synthesize chlorophyll. No crystal structure of POR is available, so to improve understanding of the protein’s three-dimensional structure, its dimerization, and binding of ligands (both the cofactor NADPH and substrate Pchlide), we computationally investigated the sequence and structural relationships among homologous proteins identified through database searches. The results indicate that α4 and α7 helices of monomers form the interface of POR dimers. On the basis of conserved residues, we predicted 11 functionally important amino acids that play important roles in POR binding to NADPH. Structural comparison of available crystal structures revealed that they participate in formation of binding pockets that accommodate the Pchlide ligand, and that five atoms of the closed tetrapyrrole are involved in non-bonding interactions. However, we detected no clear pattern in the physico-chemical characteristics of the amino acids they interact with. Thus, we hypothesize that interactions of these atoms in the Pchlide porphyrin ring are important to hold the ligand within the POR binding site. Analysis of Pchlide binding in POR by molecular docking and PELE simulations revealed that the orientation of the nicotinamide group is important for Pchlide binding. These findings highlight the complexity of interactions of porphyrin-containing ligands with proteins, and we suggest that fit-inducing processes play important roles in POR-Pchlide interactions.

Understanding trade-offs in wild populations is difficult, but important if we are to understand the evolution of life histories and the impact of ecological variables upon them. Markers that reflect physiological state and predict future survival would be of considerable benefit to unravelling such trade-offs and could provide insight into individual variation in senescence. However, currently used markers often yield inconsistent results. One underutilised measure is haematocrit, the proportional of blood comprising of erythrocytes, which relates to the blood’s oxygen-carrying capacity and viscosity, and to individual endurance. Haematocrit has been shown to decline with age in cross-sectional studies (which may be confounded by selective appearance/disappearance). However, few studies have tested whether haematocrit declines within-individuals or whether low haematocrit impacts survival in wild taxa. Using longitudinal data from the Seychelles warbler (Acrocephalus sechellensis), we demonstrated that haematocrit increases with age in young individuals (<1.5 years) but decreases with age in older individuals (1.5–13 years). In breeders, haematocrit was higher in males than females and varied relative to breeding stage. High haematocrit was associated with lower survival in young individuals, but not older individuals. Thus, while we did not find support for haematocrit as a marker of senescence, high haematocrit is indicative of poor condition in younger individuals. Possible explanations are that these individuals were experiencing dehydration and/or high endurance demands prior to capture, which warrants further investigation. Our study demonstrates that haematocrit can be an informative metric for life-history studies investigating trade-offs between survival, longevity and reproduction.

Aging effects of off-gas streams including dry air and humid air on reduced silver exchanged mordenite (Ag0Z) were studied. Aged Ag0Z was prepared by exposing Ag0Z to dry air and humid air at different aging temperatures, time, and water vapor concentrations. Iodine loading capacity on the aged Ag0Z was obtained through a continuous-flow adsorption system. Significant iodine loading capacity losses were observed after the Ag0Z was exposed to dry air and humid air. Physical and chemical analyses were conducted to observe the physical and chemical changes of Ag0Z after being aged. From iodine adsorption data and sample analyses, it was found that iodine loading capacity on the aged Ag0Z in dry air and humid air decreases with increasing aging temperatures, time and water vapor concentrations. The pseudo reaction model describes experimental data well and the oxidation of Ag0 is the rate determining step in the aging process.

Cysteinyl leukotrienes (CysLTs) are inflammatory lipid mediators that play a central role in the pathophysiology of several inflammatory diseases. Recently, there has been an increased interest in determining how these lipid mediators orchestrate tumor development and metastasis through promoting a pro-tumoral microenvironment. Upregulation of CysLTs receptors and CysLTs production is found in a number of cancers and has been associated with increased tumorigenesis. Understanding the molecular mechanisms underlying the role of CysLTs and their receptors in cancer progression will help investigate the potential of targeting CysLTs signaling for anti-cancer therapy. This review gives an overview of the biological effects of CysLTs and their receptors, along with current knowledge of their regulation and expression. It also provides a recent update on the molecular mechanisms that have been postulated to explain their role in tumorigenesis and on the potential of anti-CysLTs in the treatment of cancer.

Peste des Petits Ruminants (PPR) is a highly contagious viral disease that mainly affects goats and sheep in Asia, Africa and the Middle East. The PPR virus (PPRV) can be classified into four genetically distinct lineages (I, II, III, and IV). All have been historically present in Africa, except the Asian lineage IV that has been spreading across the globe and Africa for the last decades. Previous studies have identified the presence of the lineage IV in Nigeria since 2010. In this study, samples were taken from 268 small ruminants with PPR symptoms across Nigeria in 2017-2018 to provide an update on the distribution and genetic diversity of the lineage IV in the country. Sequence from a portion of the PPRV nucleoprotein (N) gene could be obtained from 72 samples, and all but one belonged to lineage IV. Phylogenetic analysis identified at least 5 lineage IV sub-clusters in Nigeria, re-grouping samples across multiple regions. Our results suggest an extensive endemic circulation of PPRV lineage IV across Nigeria and across borders with neighbouring countries, highlighting the difficulty of the control of this disease in the region.

Objective: To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology: The centers participating in the study were divided into three groups as tertiary referral centers, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated; also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results: A total of 51 centers participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the third week of pandemics in state hospitals and tertiary referral centers; however the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared; a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared to normal life. Conclusions: Covid-19 pandemic significantly effected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.

The control of nutrient availability is critical to large-scale manufacturing of biotherapeutics. However, the quantification of proteinogenic amino acids is time-consuming and thus is difficult to implement for real-time in situ bioprocess control. Genome-scale metabolic models describe the metabolic conversion from media nutrients to proliferation and recombinant protein production, and therefore are a promising platform for in silico monitoring and prediction of amino acid concentrations. This potential has not been realized due to unresolved challenges: (1) the models assume an optimal and highly efficient metabolism, and therefore tend to underestimate amino acid consumption, and (2) the models assume a steady state, and therefore have a short forecast range. We address these challenges by integrating machine learning with the metabolic models. Through this we demonstrate accurate and time-course dependent prediction of individual amino acid concentration in culture medium throughout the production process. Thus, these models can be deployed to control nutrient feeding to avoid premature nutrient depletion or provide early predictions of failed bioreactor runs.

Despite the great promises that artificial intelligence (AI) holds for health care, the uptake of such technologies into medical practice is slow. In this paper, we focus on the epistemological issues arising from the development and implementation of a class of AI for clinical practice, namely clinical decision support systems (CDSS). We will first provide an overview of the epistemic tasks of medical professionals, and then analyse which of these tasks can be supported by CDSS, while also explaining why some of them should remain the territory of human experts. Clinical decision-making involves a reasoning process in which clinicians combine different types of information into a coherent and adequate ‘picture of the patient’ that enables them to draw explainable and justifiable conclusions for which they bear epistemological responsibility. Therefore, we suggest that it is more appropriate to think of a CDSS as clinical reasoning support systems (CRSS). Developing CRSS that support clinicians’ reasoning process therefore requires that: 1) CRSSs are developed on the basis of relevant and well-processed data; and 2) the system facilitates an interaction with the clinician. Therefore, medical experts must collaborate closely with AI experts developing the CRSS. In addition, responsible use of an CRSS requires that the data generated by the CRSS is empirically justified through an empirical link with the individual patient. In practice, this means that the system indicates what factors contributed to arriving at an advice, allowing the user (clinician) to evaluate whether these factors are medically plausible and applicable to the patient. Finally, we defend that proper implementation of CRSS allows combining human and artificial intelligence into hybrid intelligence, were both perform clearly delineated and complementary empirical tasks. Whereas CDRSs can assist with statistical reasoning and finding patterns in complex data, it is the clinicians’ task to interpret, integrate and contextualise.

The dynamic of fractional covid-19 epidemic model with a convex incidence rate is studied in this article. Under Caputo operator, existence and uniqueness for the solutions of the fractional covid-19 epidemic model have been ana- lyzed using xed point theorems. We study all the basic properties and results including local and global stability. We show the global stability of disease free equilibrium using the method of Lyapunov function theory while for disease endemic, we use the method of geometrical approach. Moreover, sensitivity analysis complemented by simulations are performed to determine how changes in parameters affect the dynamical behavior of the system.

Understanding the processes that enable species coexistence has important implications for assessing how ecological systems will respond to global change. Morphology and functional similarity increase the potential for competition, and therefore, co-occurring morphologically similar but genetically unique species are a good model system for testing coexistence mechanisms. We used DNA metabarcoding and High Throughput Sequencing to characterise for first time the trophic ecology of two recently-described cryptic bat species with parapatric ranges, Myotis escalerai and Myotis crypticus. We collected faecal samples from allopatric and sympatric regions and locations to describe the diet both taxonomically and functionally and compare prey consumption with prey availability. The two bat species had similar diets characterised by high arthropod diversity, particularly Lepidoptera, Diptera and Araneae, and a high proportion of prey that is not volant at night, which points to extensive use of gleaning. Diet overlap at the prey-item level was lower in locally sympatric than allopatric locations, supporting trophic shift under fine-scale sympatry. Furthermore, locally sympatric samples of M. escalerai had a marginally lower proportion of not nocturnally volant prey, suggesting that the shift in diet may be driven by a change in foraging mode. Our findings suggest that fine-scale coexistence mechanisms can have implications for maintaining broad-scale diversity patterns. This study highlights the importance of including both allopatric and sympatric populations and choosing meaningful spatial scales for detecting ecological patterns. We conclude that a combination of high taxonomic resolution with a functional approach helps identify patterns of niche shift.