Differences in analytical standardization may lead to misinterpretation and medical flawsJacquelien J. Hillebranda*, Marleen. E. de Langeb, Norah M. van Mellob , Edwin ten Boekelc, Annemieke C. Heijboera,dAffiliations:a Amsterdam University Medical Centers, University of Amsterdam, Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology Endocrinology Metabolism Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. j.j.hillebrand@amsterdamumc.nlb Amsterdam University Medical Centers, University of Amsterdam, Department of Obstetrics and Gynecology, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. m.e.delange@amsterdamumc.nl, n.vanmello@amsterdamumc.nl.c Northwest Clinics Alkmaar, Department Laboratory for Clinical Chemistry, Hematology and Immunology, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. E.ten.boekel@nwz.nld Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. a.heijboer@amsterdamumc.nl

Objective To characterize pregnant women with or without pre-existing chronic kidney disease (CKD) and to describe changes in renal filtration during and after pregnancy. Design Descriptive study. Setting UK-based Clinical Practice Research Datalink GOLD linked to hospital data (2000-2019). Population Pregnancies of women with or without pre-existing CKD, categorized by median baseline eGFR [ml/min/1.73m2] based on serum creatinine (SCr [mg/dl]) measurements (proteinuria under-recorded). Methods Description of median SCr levels within two-week periods during and within one year after pregnancy. Results Of 14’401 pregnancies, 84% had a normal baseline eGFR≥90. In 1’932 women (13%) with a low-normal eGFR=75-89, SCr patterns during and after pregnancy followed the pattern of women with normal eGFR, although at higher starting levels (median baseline SCr=0.92, IQR=0.88-0.96). SCr levels returned to baseline by week 3/4 postpartum. In 388 women (3%) with a moderately low baseline eGFR=60-74, median baseline SCr levels were 1.05 (IQR=1.01-1.10) and patterns also followed those of women with normal eGFR. However, SCr levels increased slower in trimester 3 and reached baseline levels at week 9/10 postpartum. 53 women (<1%) with a low baseline eGFR=15-59 (median baseline SCr levels=1.43, IQR=1.26-1.72) showed renal adaptation in trimester 1/2, but increased SCr levels of 1.71 (IQR=1.32-2.36) in trimester 3 (small sample size, 10-week periods). Conclusion The observed prolonged hyperfiltration in women with baseline eGFR<75 may warrant closer medical surveillance. Future studies should evaluate individual risk factors with focus on subgroups of women with eGFR=60-74 and eGFR<60. Funding Non. Key words Disease progression, pregnancy, nephrology, renal filtration

When it comes to tracking goods from manufacturers to consumers, barcodes are useful instruments for monitoring and certifying their legitimacy. Because of its capacity to self-validate all generated codes, the EAN-13 is the most extensively used barcode for processed consumable products. Further investigations into the construction of the EAN-13 barcode revealed that several additional components were required to make the EAN-13 more credible for consumer use. Country code, production code, product code, and check digit make up the present EAN-13 format. Meanwhile, the type of product and the number of times it has been manufactured are key components that must be included in the EAN-13 barcode structure for barcode analysts to interpret. The study presented the GHBS-13, an upgraded barcode structure that captured the two new components, namely the product type and production count. The paper proposed a universal method called Tabiri Check Digit (TCD) as a mathematical means of easily computing the check digit of the two barcodes. The formula was validated using EAN-13 and GHBS-13 barcodes, and the results were correct. The study also established a central point platform for customers to use to validate processed consumable products they buy in Ghana

Generalized eruptive histiocytoma is a rare disease. GEH belongs to the family of non-Langerhans-cell histiocytoses. An 18-year-old man presented with disseminated papules on his trunk. Pathological studies confirmed the diagnosis of GEH. We administered systemic PUVA treatment and a significant response was observed after 20 sessions.

We consider the least energy solutions of Hatree-Fock system with the coupling term Φu,v in the two equations, and the nonlinearity are general subcritical with a small perturbation. By Nehari’s manifold approach, the existence of non-trivial ground state solutions is obtained. The asymptotic behaviors with respect to parameters λ and β are also studied.

Low-grade gliomas (LGG) are the most frequent pediatric tumors associated with epilepsy. Molecular sequencing analyses have defined the genomic landscape of these tumors leading to the use of targeted therapies, which have proven to be efficacious. Ongoing clinical trials are testing the incorporation of these drugs, especially in unresectable LGG that progress after standard treatment. Nevertheless, this strategy is not extended in the field of tumor-induced epilepsy. We present a patient with drug-resistant epilepsy secondary to a BRAF V600E-mutated ganglioglioma treated with dabrafenib who showed a dramatic radiological and clinical response with marked improvement in her quality of life.

Social determinants of health (SDoH) may impact outcomes in sickle cell disease (SCD). We conducted a comprehensive literature review of five electronic databases to elucidate the relationship between SDoH and SCD and identify gaps in the literature. Our search yielded 59 articles which we organized into five SDoH areas: Neighborhood and Built Environment, Health and Healthcare, Social and Community Context, Education, and Economic Stability. We found that social determinants, such as access to healthcare, were inconsistently evaluated. Improved recognition and understanding of SDoH should enhance the development of programs that directly address its detrimental effects on patients with SCD.

We are interested in problems of diffraction of an acoustic or electromagnetic wave by a perfectly conducting planar obstacle coated with thin multilayers of dielectric materials. The aim is to obtain boundary condition that replaces the effect of dielectric thin layers. This condition is constructed from an approximation of the Dirichlet-to-Neumann operator. In this paper, we analyze the construction and the approximation of this operator.

In this paper, a new fourth-order compact difference scheme based on the reduction order method is proposed for solving the regularized long wave (RLW) equation. The compact finite difference scheme is three-level and linear. The discrete mass and discrete energy, boundedness and uniqueness of the present compact scheme are proved. Convergence and stability of the compact scheme are also analyzed by using the discrete energy method. Our compact scheme has the rates of convergence of second-order in temporal direction and fourth-order in spatial direction, respectively. Numerical examples are carried out to verify the reliability of the theory analysis.

In this paper we investigate the uniform exponential stability of the system $\frac{dx(t)}{dt}=Ax(t)-\rho Bx(t), \; (\rho >0), $ where the unbounded operator $A$ is the infinitesimal generator of a linear $C_0-$semigroup of contractions $S(t)$ in a Hilbert space $X$ and $B$ is a Desch-Schappacher operator. Then we give sufficient conditions for exponential stability of the above system. The obtained stability result is then applied to show the uniform exponential stabilization of bilinear partial differential equations.

Magnetically targeted drug delivery system is gaining importance over recent years due to its efficiency and minimum side effects. There are many techniques proposed for delivering drugs to targeted sites within the human body. But magnetically targeted drug delivery surpasses because of its unique character and high efficiency. There are only few theoretical analyses done by researchers addressing the hydrodynamic models of magnetic fluids in the blood vessel. This paper presents a mathematical model on hydrodynamics of the fluid, blood flow and convective diffusive mass transfer of the species. Here we have tried to analyze a drug delivery method for delivering drug to a specific site in the body. For this analysis, we have considered a channel bounded by the tissue region where the drug is targeted. An exact analysis of unsteady convective diffusive solute transfer in a channel bounded by tissue region under the influence of magnetic field.

The impact of the Dufour and Soret numbers on a hybrid nanofluid in a boundary layer area across a spinning sheet is presented in this paper. The collection of flow governing (PDEs) partial differential equations was turned into a system of (ODEs) ordinary differential equations, which are then solved utilising BVP4C code in MATLAB . The impact of the flow governing parameters on flow properties was analysed and were presented graphically. The Soret factor influences the thermal efficiency at the surface, while the Dufour effect reduces the mass transfer at the surface.

A novel neurological disorder disease, shaking mink syndrome (SMS), emerged in Denmark and Sweden since 2000. The SMS has seldom been reported in China, and the causative agent is uncertain. SMS outbreaks occurred in multiple provinces in 2020, A total of 44 brain samples from minks associated with SMS were collected from Heilongjiang, Liaoning, and Shandong provinces, of which 28 samples (63.3%) were SMS-Astrovirus (SMS-AstV) positive by reverse transcription PCR. Moreover, the complete coding region sequences (CDS) of a sample collected from a two-month-old mink (termed SMS-Astv-H1) were amplified by PCR. The complete CDS and ORF2 sequences of SMS-AstV-H1 were 94.3% and 96.4% identical to an SMS-AstV strain (GenBank accession number: GU985458). Phylogenetically, SMS-Astv-H1 was closely related to an SMS-AstV strain (GU985458). Based on the above results, we describe the SMS-AstV infections related to SMS among farmed minks in China. Future studies need to focus on epidemiology, virus isolation, and potential interspecies transmission of SMS-AstV.

Background and objectives:Exosomes therapy is a promising technique that can decrease the concern related to the fate of transplanted stem cells to the fistula location. The unique properties of mesenchymal stem cells (MSCs)-derived exosomes can improve fistula healing because of their high ability to regulate and modify immune responses. This project aims to examine the safety and efficacy of implementing MSCs-exosomes in treating refractory fistulas in inflammatory bowel disease (IBD) patients.Methods:The exosomes were isolated from umbilical cord-derived MSCs and characterized using flow cytometry, western blotting, and transmittance electron microscope (TEM). Five patients (three men and two women) with refractory perianal Crohn's disease with an average age of 35.4 years old were included. The patients did not match the exclusion criteria, and the presence of refractory fistulas was the main inclusion criteria. These patients have their exosomes injections in the operation room. The therapy responses of patients were assessed using physical examination, face-to-face interviews, computerized tomography (CT) scan, and magnetic resonance imaging (MRI) six months later.Result:The Following injection, patients reported a 70% improvement on average. Two patients claimed complete healing after exosome injections, while one patient reported no improvement and active discharge from the fistula site. In addition, five patients reported no adverse effects, both systemic or on the injection site.Conclusion: Injection of exosomes extracted from MSCs shows total safety and a satisfactory therapeutic impact, as shown in this and other research, and could play a significant role in the treatment of gastrointestinal fistulas in the future.

The encroachment of freshwater territories by invasive species is a global issue with its associated co-existence, displacement and facilitation of native species. The blackchin tilapia, Sarotherodon melanotheron is one of the most successful biological invasive species. Data on its apparent ecological consequences on native species are rare in Nigerian inland waters. Based on stomach contents analyses, diets, feeding strategies, and dietary niche breadths of two sympatric invasive S. melanotheron and native Nile tilapia Oreochromis niloticus populations in a tropical domestic water supply were assessed for possible convergence. Both species exhibited generalist feeding strategies subsisting mostly on algae but fish eggs and larvae were conspicuous preys of S. melanotheron. Dietary niche of S. melanotheron was wider than that of O. niloticus. Dietary niche overlap was high and significant between these sympatric species. These findings imply that competitive feeding interactions-including predations on vulnerable early life stages may potentially promote invasion success of S. melanotheron in Eleiyele Reservoir.

The four variables Mohr-Coulomb model was established to study the ductile fracture of metal sheets under plane stress states. Beginning with the recorded minor and major strain distributing on the deformation area of uniaxial tension samples, a series of key parameters relative to the M-C model, including strain ratio, stress triaxiality, Lode angle parameter and equivalent strain during all the loading period have been studied for their inherent relationship, by utilizing Moving Regression algorithm. Then the determined M-C model could be described as the function of equivalent ultimate strain against the stress triaxiality. In the present study, three types of samples including 0° pure shear, 45° shear-tension and regular tension were testified suitable to numerically resolve the W-shaped M-C curve. M-C model and its transformed curve constructed in the minor/major strain Cartesian-coordinate could extend the conventional FLC into the field of shear loading, providing a guide to assess the material resistance against the ductile failures under various plane stress conditions.

Breeding drought stress tolerance is an integral part of our current and future goals of sustainable agricultural production. In the present study, we examined the natural variation of HvP5cs1 and demonstrated the utility of a wild barley allele for drought stress adaptation in cultivated barley. Sequencing the 5-end regulatory region among 49 barley accessions identified a genetically distinct allele of HvP5cs1 promoter from a wild barley ISR42-8. Allele mining of HvP5cs1 indicated quantitative variation in proline accumulation which was associated with promoter polymorphisms across the cluster of abscisic acid-responsive elements (ABRE), ABRE-related coupling elements, and MYB binding motifs. A near-isogenic line (NIL-143) harboring the HvP5cs1 allele from the highest proline accumulating wild barley ISR42-8 was developed in cultivated barley Scarlett through marker-assisted backcrossing (BC6). NIL-143 preserved the genetic competence of ISR42-8 to accumulate proline in higher concentrations under drought conditions at seedling and reproductive stages. Under drought stress, NIL-143 maintained superior membrane integrity, reduced pigment damage, and sustained photosynthetic health compared to Scarlett. NIL-143 presented a remarkable improvement in drought stress recovery than Scarlett. Further, the introgression line exhibited improved yield attributes, especially superior grain weight compared to Scarlett under field drought conditions. In conclusion, the present data uncover the genetic regulation of HvP5cs1 mediated proline accumulation and elucidate its role in drought stress adaptation and yield stability in barley.

While protein medications are promising for treatment of cancer and autoimmune diseases, challenges persist in terms of development and injection stability of high-concentration formulations. Here, the extensional flow properties of protein-excipient solutions are examined via dripping-onto-substrate (DoS) extensional rheology, using a model ovalbumin protein (OVA) and biocompatible excipients polysorbate 20 (PS20) and 80 (PS80). Despite similar PS structures, differences in extensional flow are observed based on PS identity in two regimes: at moderate total solution concentrations where surface tension differences drive changes in extensional flow behavior, and at small PS:OVA ratios, which impacts the onset of weakly elastic behavior. Undesirable elasticity is observed in ultra-concentrated formulations, independent of PS identity; higher PS contents are required to observe these effects than with analogous polymeric excipient solutions. These studies reveal novel extensional flow behaviors in protein-excipient solutions, and provide a straightforward methodology for assessing the extensional flow stability of new protein-excipient formulations.

Evidence-based medicine has shown for many years that homozygous mutations of the HFE gene H63D are by no means negligible. Not only can it cause, usually after a second hit, rather mild classical hemochromatosis, but it can also cause numerous other disorders of iron metabolism, such as hypotransferrinemia, changes in binding capacity, and others. In addition, it may lead-among other symptoms-to damages of the heart and the substantia nigra via a causal relationship that remains to be investigated, most likely via a cascade dysfunction in iron metabolism. The clinical facts are compelling. Any physician who dismisses mutations of the HFE gene H63D as clinically irrelevant risks the health and life of his patient. Therefore all main researcher working on H63D Syndrome decided to raise awareness for the "iron brother" of Morbus Wilson by renaming H63D Syndrome.

Cardiac hypertrophy is an adaptive response to increased overload, which is induced by various physiological or pathological stimuli. It is a common pathological process of a variety of cardiovascular diseases, which eventually leads to heart failure. Several lines of evidence suggested that autophagy as a double-edged sword was involved in cardiac hypertrophy. Autophagy, with a typical feature of double-membrane vesicle called the autophagosome, is a highly conserved lysosomal degradation process and plays an important role in the regulation of diverse physiologic and pathologic processes. However, the exact mechanism underlying the role of autophagy in regulating cardiac hypertrophy remains largely unknown. Here, we comprehensively characterize the dual effects of autophagy in promoting or inhibiting cardiac hypertrophy under different conditions. Moreover, we summarize the potential therapeutic effects of autophagy modulators on pathological cardiac hypertrophy. Finally, we discuss the advantages and challenges of autophagic modulators for the therapy of pathological cardiac hypertrophy.

Background: Head and neck cancer (HNC) have a considerable mortality and morbidity rate. Surgery is one of the most effective treatments, however it may compromise the independence of patients after its performance. The Rehabilitation Nurse (RN) intervention is essential for recovery. Objective: To compare the dependence degree between patients who underwent RN intervention versus general health care after HNC surgery. Methods: Patients submitted to different types of HNC surgery, were divided into two groups intervention by the RN versus general health care, the outcome was the Barthel Index Discharge categorized as dichotomic to assess the patient independence at discharge and their differences calculated by statistical analysis. To analyze the effect of the RN intervention on dependence, a Poisson regression model was used, adjusting the confounding factors Initial Barthel Index and Age in the variable Barthel Index Discharge>91. Results: In middle/late postoperative period, in the group with RN intervention (n=79) the hospitalization time was reduced by 4.29 days versus general health care (n=72). At discharge, the Barthel Index (p<0.005) improved significantly in the RN intervention group compared to the general health care group. The intervention of the RN after surgery had a positive effect on the functional capacity of the patients, after adjusting the confounding factors (RR:1.47; 95%CI[1.02; 2.12]). Conclusion: The RN intervention is an added value in the independence of the patient submitted to HNC surgery. It is an innovative study in patient after diagnosis HNC, showing that intervention of RN through rehabilitation programs allows independence after his surgery. 5 succinct Key points: Independence of the patient submitted to HNC surgery; early rehabilitation in postoperative period; rehabilitation nursing programs; self-care optimization; regression model.

Objectives To assess the efficacy and implementation of an epistaxis symptom diary in the management of a child with de-novo HHT type 1. HHT is a cause of chronic, severe epistaxis which can lead to significant physical and psychogical morbidity. We propose that the use of symptom diaries can reduce associated patient morbidity and aid physicians in treatment planning. Participants We discuss an independently developed symptom diary for a 10-year-old girl with HHT, Patient x (“xxx”), and its subsequent impact. Including its uses for surgical and medical treatment planning. Design A patient developed epistaxis symptom diary was designed to including nosebleed timing and side of onset, estimated severity, exacerbating / trigger factors and use of medications. A phenomenological qualitative approach was taken to assessing the impact of the diary on “xxx’s” physical and psychological wellbeing. Setting “xxx’s” diary is a novel symptom diary for patients with of chronic epistaxis and HHT which can improve patient engagement with treatment, foster lifestyle changes, and aid clinicians in promoting tailored patient-centred care. Main outcome measures “xxx’s” diary has proved to be an extremely useful tool for patient xxx, her parents and her ENT team, having improved both her physical and psychological wellbeing. Results and Conclusions We would recommend detailed symptom monitoring for all patients with severe epistaxis and HHT and suggest “xxx’s” diary as a template for this.

A 51-year-old woman with stump pain was hospitalized in our department. After discussion with our medical team, a spinal cord stimulation treatment plan was developed. The operation went smoothly. After 12 mo of follow-up, the pain was significantly relieved and good results were achieved.

Considering that the correct quantification of fatigue damage involves two load parameters, the available load ratio data on polymeric materials are analyzed. It is shown that crack growth can be characterized by two parameters, ΔK and K max, without the need for any crack closure concept. The crack growth rates, starting from the threshold can be represented by the L-shaped curves in the ΔK-K max plane defining two limiting variables, ΔK* and K max*. Crack growth trajectory maps for various materials are developed by plotting ΔK* versus K max*, as a function of crack growth rate. The trajectory defines the crack growth resistance curve providing a measure of material resistance to increasing crack tip driving forces.