Earthworms can variously affect soil properties and resource availability by feeding, burrowing, and casting activities. Figuring out the relationship among earthworms, soil and plant properties is beneficial for understanding the ecological functions of earthworms. Different densities of earthworms (high density, HDE; medium density, MDE; low density, LDE; control, CK) in soil columns were studied to reveal how earthworms influence soil physical and chemical properties and clover plant growth. The results showed that earthworms increased the large and medium aggregate content and decreased the microaggregate content. Soil aggregates in MDE were the most stable. Both the mean mass diameter (MWD) and geometric mean diameter of soil aggregates increased with the densities of earthworms. The average contents of soil organic carbon (SOC) in large-, medium-, and micro-aggregates were 5.5, 4.2, and 4.2 g kg-1 in the treatments with earthworms. There was a significant correlation between SOC content and macroaggregate organic carbon content. The root characteristic values of earthworm-treated clover were significantly higher than those of the control. The clover root indexes were positively correlated with the SOC content and soil aggregates. We considered that earthworms altered the soil aggregate contents and promoted soil organic carbon storage, and thus promote the development of vegetation roots. This study provides scientific supports for a deeper understanding of the mechanism of earthworms on soil carbon storage.

After mitral valve replacement in an 81-year-old woman, there was evidence of an important communication between the esophagus and the right pleura. Diagnosis was confirmed with Oral Gastrografin radiography and esophagoscopy. Thoracic computed tomography scans better indicated fistula location and extension, but also showed the close relationship and the compression of huge left atrium on the oesophagus. Our hypothesis was that the lesion was induced by transoesophageal echocardiography probe in a favourable setting. An enlarged left atrium should be recognized as a risk factor for TEE-induced esophageal perforation, especially in fragile patients, with marked esophagus distortion.

Ecologists often rely on observational data to understand causal relationships. Although observational causal inference methodologies exist, model selection based on information criterion (e.g., AIC) remains a common approach used to understand ecological relationships. However, such approaches are meant for predictive inference and is not appropriate for drawing causal conclusions. Here, we highlight the distinction between predictive and causal inference and show how model selection techniques can lead to biased causal estimates. Instead, we encourage ecologists to apply the backdoor criterion, a graphical rule that can be used to determine causal relationships across observational studies.

Ultrasound-guided thyroid FNAB is a safe procedure even under antiplatelet drugs, such as clopidogrel. Although massive hematomas after FNAB are very rare, they may be fatal and must be promptly recognized and treated. Here, we present a well-resolved case of massive bilateral hematoma after ultrasound-guided FNAB using compression and ice.

33-year-old Sudanese male patient with type one diabetes presented with progressive, severe bilateral thigh pain with low grade fever. The patient was diagnosed initially as diabetic ketoacidosis with pyomyositis and receive analgesic and insulin the patient partially improved. Diagnosis of diabetic myonecrosis was made based on MRI of the thigh.

The scale-up synthesis of covalent organic frameworks (COFs) with uniform structure and properties is of great importance for their practical applications. Here, we proposed a facile way to massively produce phthalocyanine-like COFs (COFBTC) via high-gravity intensified synthesis. Alcoholic solvent and basic catalyst were discovered synergically improved the formation of COFBTC. High concentration and reaction temperature were beneficial for high production as well. The intensified mass and heat transfer at high gravity (HiGee) environment promoted the scaling-up of COFBTC with homogeneous structures and properties. A high space time yield of 305.9 kg∙(m3∙D)-1 was achieved for Fe-COFBTC under optimized condition. The massively produced Fe-COFBTC presented good solubility in alkaline and polar organic solvents, thus allow to process as homogeneous or heterogenous electrocatalyst for oxygen reduction reaction. The catalyst exhibited good performance of 0.79 V (vs. RHE, half-wave) and >95% recovery in homogeneous electroreduction of O2 in 0.1 M KOH.

Due to the emerging rise of multi-drug resistant bacteria, the discovery of novel antibiotics is of high scientific interest. Through their high chemodiversity of bioactive secondary metabolites, cyanobacteria have proven to be promising microorganisms for the discovery of antibacterial compounds. These aspects make appropriate antibacterial screening approaches for cyanobacteria crucial. Up to date, screenings are mostly carried out using a phenotypic methodology, consisting of cyanobacterial cultivation, extraction, and inhibitory assays. However, the parameters of these methods highly vary within the literature. Therefore, the common choices of parameters and inhibitory assays are summarized in this review. Nevertheless, less frequently used method variants are highlighted, which lead to hits from antimicrobial compounds. In addition to the considerations of phenotypic methods, this review provides an overview of developments in the genome-based screening area, be it in-vivo using PCR technique or in-silico using the recent genome-mining method. Though, up to date these techniques are a lot less applied than phenotypical screening.

Viruses of veterinary significance such as African swine fever virus, are known to survive for extended periods in plant-based feed ingredients imported into North America. To reduce the likelihood of virus introduction, high-risk ingredients, such as oil seed meals, are stored in designated facilities for extended periods under controlled environmental conditions to minimize viral infectivity prior to use in diets. While 30 days has become a standard storage period, the required ambient temperature to inactivate viruses during this time is not known. To address the question, 1-metric ton totes of conventional soybean meal were inoculated with PRRSV 144 lineage 1C variant and SVA prior to storage for 30 days at 23.9º C, 15.5º C, or 10º C, and feeding to pigs. Virus infectivity was evaluated through detection of viral RNA in oral fluid samples, along with clinical signs. Results indicated that inactivation of both viruses occurred in soy stored at 23.9º C. In contrast, SVA infectivity was observed in soy stored at both 15.5º C and 10º C, while PRRSV 144 L1C variant infectivity was only observed in soy stored at 10º C. These results suggest that a storage period of 30-days and a temperature of 23.9º C are required to reduce the risk of virus contaminated plant-based feed ingredients, such as soybean meal.

Lynch syndrome (LS) is the most common hereditary colon cancer syndrome caused by germline mutations in mismatch repair (MMR) genes. In this series, we outline 3 pediatric patients who presented with vague symptoms due to colorectal cancer who were eventually diagnosed with Lynch syndrome with multiple gene mutations. The diagnosis of colorectal cancer in pediatrics warrants timely recognition, inclusion of Lynch syndrome in the differential diagnosis, multi-gene testing, and genetic counseling for the patient and family.

A 69-year-old woman presented to the emergency department for symptoms of acute right heart failure including progressive exertional dyspnea and limbs weakness. Physical examination showed slight cyanosis and cold limbs. She underwent percutaneous transcatheter closure of a secundum ASD through femoral vein eight months before. On further investigation, transthoracic echocardiography (TTE) revealed severe tricuspid regurgitation and the migrated ASD device (Figure 1), and the embolization seemed to be located near the left ventricular inflow tract. Computed tomography (CT) and three-dimensional reconstruction confirmed the left-side migration of the device, and revealed obstruction of RPV caused by the embolization (Figure 2).

Spatial and temporal heterogeneity, or messiness, is a broadly desirable characteristic of river corridors and an indicator of many of the geomorphic processes that sustain fluvial ecosystems. However, quantifying geomorphic heterogeneity is complicated by a lack of consistent metrics, classification schemas for dividing the river corridor into the patches that form the basis for those metrics, and guidance on interpreting metrics. Drawing from both geomorphic and landscape ecology concepts, we offer ideas and guidance intended to help investigators, from researchers to restoration practitioners, more effectively and reliably use heterogeneity to describe river corridor processes and characteristics. We define geomorphic heterogeneity both spatially and temporally. Spatially, heterogeneity can be described by diversity, or the evenness and richness of geomorphic units, and spatial configuration, or the arrangement and shape of geomorphic units. Temporally, heterogeneity can be described by turnover rate, or the rate of change of geomorphic units. Interpretation of heterogeneity metrics depends integrally on the definition of the geomorphic unit schema on which metrics are based. Contextual information, such as measurements of process space (i.e., how much room a river has to move), disturbance frequency, and geomorphic trajectory, can also be key to interpreting measurements of heterogeneity. Geomorphic applications of heterogeneity require carefully defined geomorphic unit schemas that reflect processes and characteristics of interest, robust metrics of heterogeneity whose meaning is appropriate to the question at hand, and interpretation of those metrics based on the context of expected geomorphic processes and the disturbance regime.

In patients with Uveal melanoma, cardiac metastases can present without any symptoms and carries a poor prognosis. It is becoming more common than previously thought and highlights the importance of routine surveillance after definitive treatment.

We experienced the case of a patient with advanced breast cancer who failed to receive comprehensive care despite regular video conferencing with her physician during the COVID-19 pandemic, resulting in delayed detection of liver metastasis. Inter-hospital collaboration is required to provide uninterrupted cancer care to those disproportionately affected by crises.

In total arch replacement, using frozen elephant trunk (FET) or elephant trunk techniques ensures proximalization of the distal anastomosis. However, in some cases, the left subclavian artery (LSCA) is deeply located and difficult to visualize. Therefore, surgeons face technical challenges during the LSCA reconstruction. We report an end-to-side anastomosis technique that enables safer and easier anatomical reconstruction of the LSCA.

Acclimations of Oreochromis mossambicus to elevated salinity were conducted with multiple rates of salinity increase and durations of exposure to determine the rate-independent maximum salinity limit and the incipient lethal salinity. Quantitative proteomics of over 3000 gill proteins simultaneously was performed to analyze molecular phenotypes associated with treatments representative of key zones in the salinity-level x duration matrix. For this purpose, a species- and tissue-specific data-independent acquisition (DIA) assay library of MSMS spectra was created. From these DIA data, protein networks representing complex molecular phenotypes associated with salinity acclimation were generated. Organismal performance indicators of salinity tolerance were then correlated with salinity-regulated protein networks. O. mossambicus was determined to have a wide “zone of resistance” from approximately 75g/kg salinity to 120g/kg, which fish survive for a limited period with eventual loss of function. Crossing the critical threshold salinity into the zone of resistance corresponds with blood osmolality increasing beyond 400 mOsm, significantly reduced body condition factor, and cessation of feeding. Gill protein networks impacted at extreme salinity levels both above and below the critical salinity threshold include increased energy metabolism, especially upregulation of electron transport chain proteins, and regulation of specific osmoregulatory proteins. Cytoskeletal, cell adhesion, and extracellular matrix proteins are enriched in regulation network patterns that are sensitive to the critical salinity threshold. Network analysis of these patterns provides deep insight into specific mechanisms of energy homeostasis during salinity stress.

Eruptive xanthomas are skin manifestations associated with hypertriglyceridemia. Accordingly, improvement of hypertriglyceridemia can ameliorate this condition. We report a case of a patient with type 2 diabetes mellitus who was diagnosed with this skin lesion. Clinicians should be aware that eruptive xanthomas could indicate metabolic disorders associated with atherosclerosis.

Light-derived signals from the shoot tissue promote root growth. Brassinosteroids (BRs), which are phytohormones, are crucial for root growth and leaf expansion. We previously revealed that photoreceptor-dependent signals promote the expression of DWARF4 ( DWF4), which encodes a key BR biosynthesis-related enzyme, in the root tips. Furthermore, auxin is indispensable for root growth. In this study, we focused on the relationships among light-derived signals, auxin, and BR in the root tips. Polar auxin transport (PAT) in the root tips was undetectable in plants grown on medium lacking sucrose for 24 h in darkness; however, a BR treatment restored PAT in darkness. We also observed that PAT was non-existent in the cell division zones under BR-deficient conditions, even under light. On the basis of these results, we propose that the light-dependent cooperative effects of auxin and BR in the root tip cell division zone are necessary for sustaining root growth.

Aims: To update our previously reported systematic review and meta-analysis of observational studies on cardiovascular drug exposure and COVID-19 clinical outcomes by focusing on newly published randomized controlled trials (RCTs). Methods: More than 500 databases were searched between 1-Nov-2020 and 2-Oct-2021 to identify RCTs that were published after our baseline review. One reviewer extracted data with other reviewers verifying the extracted data for accuracy and completeness. Results: After screening 22,414 records, we included 24 and 21 RCTs in the qualitative and quantitative syntheses, respectively. The most investigated drug classes were angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blocker (ARBs) and anticoagulants, investigated by 10 and 11 studies respectively. In meta-analyses, ACEI/ARBs did not affect hospitalization length (mean difference/MD -0.42, 95% CI -1.83; 0.98 days, n=1183), COVID-19 severity (risk ratio/RR 0.90, 95% CI 0.71; 1.15, n=1661) and mortality (RR 0.92, 95% CI 0.58; 1.47, n=1646). Therapeutic anticoagulation also had no effect (hospitalization length MD -0.29, 95% CI -1.13 to 0.56 days, n=1449; severity RR 0.86, 95% CI 0.70;1.04, n=2696; and, mortality RR 0.93, 95% CI 0.77;1.13, n=5689). Other investigated drug classes were antiplatelets (aspirin, 2 trials), antithrombotics (sulodexide, 1 trial), calcium channel blockers (amlodipine, 1 trial) and lipid modifying drugs (atorvastatin, 1 trial). Conclusion: Moderate- to high-certainty RCT evidence suggests that cardiovascular drugs such as ACEIs/ARBs are not associated with poor COVID-19 outcomes, and should therefore not be discontinued. These cardiovascular drugs should also not be initiated to treat or prevent COVID-19 unless they are needed for an underlying currently approved therapeutic indication.

We experienced a patient with Legionella Pneumonia immediately after discharge from COVID-19. It is very important to accurately detect pathogens of infectious diseases particularly in the time of COVID-19 pandemic.

We present a case in which lung Ultrasound was relevant to reach an early diagnosis of lung tuberculosis and to manage the patient in the right setting. Moreover, ultrasound allowed to detect and treat massive pleural effusion through an ultrasound-guided thoracentesis.

This is a case of retained bronchial foreign body identified by Computed tomography (CT) scan after 29 years of initial chest trauma in a patient with long standing history of shortness of breath and recurrent pulmonary infections eliciting the importance of CT scan in identifying such foreign bodies.

In patients with inherited bleeding disorders, thrombus development poses a challenge in balancing the management of thrombosis and bleeding. Pediatric antithrombotic therapy guidelines do not address the treatment of a thrombus in the setting of a bleeding disorder. We present a case series of four children with inherited bleeding disorders presenting with cerebral sinus venous thrombosis and bleeding, in order to summarize the different therapeutic approaches and outcomes of these patients.

Comment on: Primary Cutaneous Lymphomas in Children and Adolescents

Background The incidence of thyroid cancer is increasing globally due to the increase in detection of subclinical, low volume papillary thyroid microcarcinomas (PTMC) (<1cm). Several international groups have recommended an active surveillance approach for this low-risk disease. In contrast to many other countries, the UK’s approach to thyroid nodules is to avoid detection of incidental lesions where appropriate. Objective This study aims to establish the proportion of patients with thyroid cancer in the UK that would benefit from active surveillance. Design, participants, and outcome measures: Individuals with PTMC in NHS Lothian from 2009-2020 were reviewed from a local thyroid cancer database. The mode of detection of PTMC and proportion of patients who might benefit from active surveillance were established. Results From 651 individuals with differentiated thyroid cancer managed over 12-year period, 185 individuals with PTMC were identified (28.4%). The majority of PTMC 151/185 (81.6%) were either diagnosed post-operatively following thyroidectomy for benign disease or with nodal disease. Only 24 individuals with PTMC were identified following palpable thyroid nodule, incidental finding on imaging and surveillance screening. Therefore, when the indication for surgery was considered, only 24/651 (3.7%) patients were identified pre-operatively and would therefore be realistic candidates for active surveillance. Conclusion Less than 4% of patients with thyroid cancer in the UK would be appropriate for active surveillance. Rather than developing programs to deal with this minority of patients, focus should be maintained on minimizing detection of these low-risk cases.