A document by Tsyon Asfaw. Click on the document to view its contents.

Article type: Editorial

To relax the requirement of the filter and reduce the control complexity of the SMPA, this paper proposes a 5-level RF-PWM method for all-digital transmitters with 3rd and 5th harmonic elimination. The method is achieved by changing the threshold signal to control the pulse width of the 3-level sub-pulses. Finally, the feasibility of the method is verified by simulation. For the 16QAM signal with a carrier frequency of 200MHz, the proposed method can achieve -46.24dBc and -54.05dBc respectively when the coding efficiency reaches 77.51%.

Abstract Objective: To determine whether Betahistine dihydrochloride is effective in treating primary tinnitus in adults. Design: Intention-to-treat, randomized, triple-blinding, monocentric clinical trial Setting: Botucatu Medical School – State University of São Paulo (Unesp) in Brazil. Participants: 62 adults with primary tinnitus for at least six months (both sexes), and a Tinnitus Handicap Inventory score above 18 were randomized in two equal study groups: betahistine (24 mg of oral betahistine 12/12hs for 90 days), control group (a matched placebo). Main outcomes measures: Primary outcome measure - change in Tinnitus Handicap Inventory score; secondary outcome - Clinical Global Impression Improvement and participants’ perceived improvement after the intervention. Results: Participants had a median age (interquartile range) of 54 (48 to 60) years, with a balanced number of men and women. There was no significant difference in Tinnitus Handicap Inventory change before and after treatment between the study group and control (median difference of -2 points; 95% CI, -8 to 6 points); the Tinnitus Handicap Inventory after intervention was a median (interquartile range) of 4 (-4 to 14) lower in the betahistine group, and a median (interquartile range) of 2 (-6 to 10) lower in the placebo group. The secondary endpoint, covariate adjustment, and per-protocol analysis provided similar results, and side effects were without difference between both groups. Conclusion: Betahistine was ineffective when compared to the placebo in the treatment of the primary tinnitus .

Interferon-beta, the most widely prescribed medication for multiple sclerosis, is generally considered safe. Nevertheless, rarely serious and/or life-threatening side effects have been reported such as thrombotic microangiopathy. A few mechanisms have been proposed to explain how interferon causes thrombotic microangiopathy, but insufficient immunological studies have been unable to pin this phenomenon down to a single pathophysiologic pathway. We report thrombotic microangiopathy due to acquired complement factor I deficiency in a male receiving interferon-beta treatment for multiple sclerosis. After three years of starting the therapy, the 28-year-old patient presented with malignant hypertension causing seizures, rapidly progressive renal failure requiring hemodialysis, and hemolytic anemia. Corticosteroid and plasma exchange sessions permitted hemolysis control. Nonetheless, the patient remained hemodialysis-dependent. Exploration of the complement system found a complement factor I deficiency whose activity normalized at the control carried out after two years. We concluded that IFNβ treatment may cause complement factor I deficit, which can lead to thrombotic microangiopathy and severe renal failure.

Abstract:According to an estimate, protein consumed by people globally constitutes 20% of their total calorie intake. However, the ‘building blocks of life’, proteins are not only lacking in the diet of people of most developed and developing nations but are often overlooked. Today there is an unprecedented challenge to produce and feed adequate protein to over 8 billion people in an environmentally friendly and affordable way. Interestingly, health and climatic conditions, especially the Covid 19 pandemic have led to a paradigm shift in consumer eating habits and mindset. They are reconsidering diets, viewing foods as medicine, and are inclined toward paying an added amount for sustainable healthy foods. Plant-based proteins present exciting opportunities to meet the food challenges of the future and deliver healthy and responsible food choices. They are a potential solution to our nutritional needs due to their long history of crop use and cultivation, lower cost of production, and easy access But, the poor techno-functional and bio-functional properties of plant proteins such as low solubility, poor foaming, emulsifying, and gelling properties, along with low bioactivity and digestibility limit their use in food products and formulations. Relative to animal proteins, including dairy products, plant protein manufacturing, and processing requirements are still at a nascent stage and small businesses or startups fail to find a steady start. To mitigate such issues, technological advances are required in the development of plant protein ingredients and foods. This review focuses on the challenges and opportunities in the process of implementing plant protein ingredients in foods. It elucidates the functional properties of plant-derived proteins, the technical challenges behind incorporating them in food systems, and some novel physical, chemical, and biological processing operations that can be employed to improve their extraction, functionality, nutritional profile, and sensory attributes. Finally, the science behind formulating innovative plant-based meat, egg, and dairy alternative products is also discussed to present a roadmap for creating future foods with plant proteins.1. Introduction- Apart from meeting our calorie requirement, the most crucial nutrition imperative for body metabolism is protein. With the global population expected to rise above 9 billion people by 2050, we face an unprecedented challenge to manufacture and feed adequate protein to an ever-growing population. A 2017 survey shows that 73 percent of South Asians suffer from protein deficiency while above 90 percent are unaware of the daily protein requirement. Also, protein manufacturing and processing is a major concern because conventional animal protein production requires an intensive amount of land and resources [1]. Alternative proteins like plant-based proteins provide a viable solution to overcome these difficulties. Owing to their long history of crop use and cultivation, lower cost of production and easy access, the manufacturing of plant protein-based foods is also environmentally sustainable and affordable [2]. However, lower protein quality and poor functional properties of plant proteins like poor solubility, foaming, emulsifying, and gelling properties, along with low bioactivity and digestion problems limit their use as food ingredients and whole food products. Relative to animal proteins, including dairy products, plant protein manufacturing, and processing requirements are still at a nascent stage and small businesses or startups fail to find a steady start. To mitigate such issues, technological advances and knowledge creation are required in the development of plant protein ingredients and foods. This review focuses on the challenges and opportunities in the process of implementing plant protein ingredients in foods. It elucidates the functional properties of plant-derived proteins, the technical challenges behind incorporating them in food systems, and some novel physical, chemical, and biological processing operations that can be employed to improve their extraction, functionality, nutritional profile, and sensory attributes. Finally, the science behind formulating plant-based meat, egg, and dairy alternatives is also discussed to present a roadmap for creating future foods with plant proteins. Although the focus of this review on plant proteins is in a global scenario it is essential to recognize the manufacturing and commercialization challenges of plant-based protein foods in less developed nations, especially in South Asia and Africa. This review is therefore expected to stimulate food scientists in developing countries to consider creating low-cost and environmentally sustainable alternative protein sources for consumption.

Advances in human reproductive science are allowing women to get pregnant even at advanced ages. Thus, the incidence of arrhythmic events in pregnancy is rising and represents a significant cause of hospitalization and morbidity for mother and fetus. The most common arrhythmias in this context are atrial fibrillation and supraventricular tachycardia, which acutely can be managed, as usual, with adenosine or cardioversion, and beta blockers in the long-term. For recurrent cases, sodium blockers, such as propafenone, or even fluoroless cardiac ablation can be used. In the context of maternal congenital heart disease, ventricular tachycardia can occur, demanding a specific approach including cardiac defibrillator implant. Unfortunately, the medical evidence in this context is scarce, and most available reviews don't have the objectivity needed to guide daily's practice. This review aims to be a straightforward guide to the approach to tachyarrhythmias in pregnancy.

Background: Desmoid tumor (DT) is rare and challenging, often affects head neck (HN) region in children, and its appropriate treatments are under discussed. This study aimed to retrospectively evaluate long-term effectiveness and safety of 125I seed brachytherapy for pediatric DT in HN. Procedure: Seven pediatric patients with median age of 3 years old suffered from DT in HN treated with 125I brachytherapy from January 2008 to June 2018 were included. Among which, 5 underwent sole brachytherapy and the others combined with surgery under a prescription doses ranging from 10 000 cGy to 12 000 cGy. The rate of local control (LC), complete response (CR) and partial response (PR) were calculated after evaluation by radiological and pathological means. The radiation-associated toxicities were also evaluated Results: The LC rate was 7/7 during the follow-up time ranging from 43 to 135 months and with a mean of 57 months. No recurrent lesion was found in the patients receiving surgery combined with brachytherapy. In patients treated with sole brachytherapy, the radiological PR rate and CR rate were 4/5 and 1/5, respectively. In those reaching radiological PR, 3/4 were pathological CR. Slight acute radiation-associated toxicities were observed in all patients, and no late or severe acute toxicity was observed. Conclusion: 125I brachytherapy is effective and safe in the management of pediatric DT in HN as sole modality or combined with surgery in long term.

Title pageTitle : Letter to the editor: Septal myectomy in the era of genetic testingArticle type : Letter to the editor

Objective Explore the difference of oncology outcome of laparotomy and laparoscopy in the new FIGO2018 stage of early cervical squamous cell carcinoma without any high risk pathological factors. Methods The 5-years OS and DFS of cervical squamous cell carcinoma undergoing laparotomy and laparoscopy from 2004 to 2018 were compared by the total study population and propensity score from China. Result There was no difference in 5-year OS between laparotomy (2,478 cases) and laparoscopy (1,504 cases), but the 5-year DFS of laparotomy was higher (92.2 %vs. 90.4%, P=0.022). Cox analysis showed that laparoscopy was not an independent risk factor for the death of cervical squamous cell carcinoma (OS: P=0.598), but it was an independent risk factor for the recurrence/death (HR = 1.468,95% CI 1.131 ~ 1.906, P=0.004). There was no difference in 5-year OS between laparotomy (2,391 cases) and laparoscopy (1,495 cases) after 1:2 PSM, but the 5-year DFS of laparotomy was higher (92.7% vs. 90.8%, P = 0.006), Cox analysis showed that laparoscopy was not an independent risk factor for the death of cervical squamous cell carcinoma (OS： P=0.521), but it was an independent risk factor for the recurrence/death (HR=1.512, 95%CI 1.151~1.971, P=0.002). Conclusion There is no difference in 5-year OS between these groups for early cervical squamous cell carcinoma in new stage of FIGO2018 without any high-risk pathological factors, the 5-year DFS of laparotomy is higher than that of laparoscopy group, and laparoscopy is an independent risk factor for recurrence/death, so laparoscopy has a higher risk of recurrence.

Primula, well known for its heterostyly, is the largest genus in the family Primulaceae with more than 500 species. The considerable species number has introduced a huge challenge for taxonomy. Although several phylogenetic constructions have been carried out thoroughly, the relationships between Primula species were remained incompletely understood, especially for the relationship among sections within Chinese species. P. wilsonii Dunn is a PSESP (plant species with extremely small populations) with very limited genetic information to explore its endangered mechanism and conservation. In this study, we sequenced and assembled the complete chloroplast genomes of P. wilsonii using Illumina sequencing and compared its genomic sequences with those of four related Primula species. The chloroplast genomes of Primula species were similar in the basic structure, gene order and GC content. The detected 38 SSRs loci and 17 hyper-variable regions had many similarities in P. wilsonii, P. anisodora, P. miyabeana and P. poissonii, but showed a significant difference compared with those in P. secundiflora. Slight variations were observed among Primula chloroplast genomes, in consideration of the relatively stable patterns of IR contraction and expansion. Phylogenetic analysis based on chloroplast genomes confirmed three major clades in Chinese Primula, but the infrageneric sections were not in accordance with morphological traits. The P. poissonii complex was confirmed here and P. anisodora was the species that was most closely related to P. wilsonii. Overall, the chloroplast genome sequences provided useful genetic and evolutionary information for phylogeny, population genetics and conservation studies on Chinese Primula species.

Progressive familial intrahepatic cholestasis (PFIC) is an abnormality in the formation and secretion of bile components and bile acids.We present a case of a 6-years-old female with Type 3 of PFIC which was confirmed via detecting pathogenic variants in the ABCB4 gene.

Colonisation of freshwater habitats by marine animals is a remarkable evolutionary event that has enriched biodiversity in freshwater ecosystems. For successful freshwater colonisation, high physiological plasticity is presumed to be necessary, but its evolutionary basis has not been detailed. Marine-originated amphidromous species, which regularly migrate between freshwater and marine environments, have repeatedly lost migratory behaviour in many lineages, which sometimes triggered species radiation in freshwater habitats. Since amphidromous species typically visit the sea during the larval period, the difficulty in the evolution of larval freshwater tolerance is a bottleneck for freshwater colonisation. To elucidate the key evolutionary changes that enhance the physiological plasticity for freshwater colonisation, we compared larval gene expression changes depending on salinity conditions among three congeneric amphidromous goby species (Gymnogobius) with varying dependences on freshwater habitats. First, an otolith microchemical analysis and rearing experiment under laboratory conditions confirmed the presence of freshwater residents only in G. urotaenia and higher larval survivorship of this species both in seawater and freshwater conditions than the obligate amphidromous G. petschiliensis and G. opperiens. Larval whole-body transcriptome analysis revealed that G. urotaenia exhibited the greatest differences in the expression levels of several osmoregulatory genes, including aqp3, which is critical for water discharge from their body during early fish development. Thus, we obtained the results that consistently support the importance of enhanced osmoregulatory plasticity for establishing freshwater forms, and further identified some important evolutionary changes for larval freshwater adaptation and colonisation in the goby group.

The analytic signal is a useful mathematical tool. It separates qualitative and quantitative information of a signal in form of the local phase and local amplitude. The Clifford Fourier transform (CFT) plays a vital role in the representation of multidimensional signals. By generalizing the CFT to the Clifford linear canonical transform (CLCT), we present a new type of Clifford biquaternionic analytic signal. Due to the advantages of more freedom, the envelop detection problems of 3D images, with the help of this new analytic signal, can get a better visual appearance. Synthesis examples are presented to demonstrate these advantages.

Mechanical prosthetic valves, like all foreign bodies, are thrombogenic, requiring anticoagulation to avoid thrombosis and reduce the risk of catastrophic stroke. We reported a case of a 42-year-old female that developed mechanical valve thrombosis and was successfully treated with low infusion thrombolytic therapy using Alteplase (Tpa).

Most researches interested in finding the bounds of the cumulative standard normal distribution Φ(x) are not tight for all positive values of the argument x. This paper mainly proposes new simple lower and upper bounds for Φ(x). Over the whole range of the positive argument x, the maximum absolute difference between the proposed lower bound and Φ(x) is less than 3×〖10〗^(-4), while it is less than 4.8×〖10〗^(-4) between the proposed upper bound and Φ(x). Numerical comparisons have been made between the proposed bounds and some of the other existing bounds, which showed that the proposed bounds are more compact than most alternative bounds found in the literature.

A century ago, the energy quantization hypothesis and wave-particle duality have been proposed as the foundations of the quantum theory, but still lacking complete theoretical proof and interpretation. For the first time, the "quantized wave particle duality equation" is expressed by a way of physical and mathematical formulas, which simply compose of three factors: the quantized resonant eigenvalue, interaction or transition time, and sum of translational kinetic energy; and accompanied by a full interpretation of the related physical laws. From now on, they are no longer the premise hypothesis of quantum theory, but the inevitable conclusion. The long-term conflict between quantum theory and classical physics has been resolved, which is actually a self-consistent and coherent theoretical system.

Despite the growing number of dam removals, very few have been studied to understand their impacts on stream fish communities. An even smaller proportion of dam removal studies focus on the impacts of low-head dam removals, although they are the most common type of dam. Instead, the majority of removal studies focus on the impacts of larger dams. In this study, two previously impounded Illinois rivers were monitored to assess the impacts of low-head dam removal on the functional assemblage of stream fishes. Study sites were sampled each fall from 2012-2015 (pre-dam removal) and 2018-2020 (post-dam removal) in three habitat types: downstream of the dam, impounded areas, and runs of rivers. Fishes were aggregated into habitat and reproductive guilds, relating community changes to habitat, environmental metrics, and stream quality. Prior to removal, the slackwater guild was the most prevalent habitat guild throughout both rivers, while nest builders and benthic spawners were the most abundant reproductive guilds. During the two years following removal, habitat conditions and fish assemblages improved throughout both rivers, with improvements in QHEI, IBI, water temperature, and dissolved oxygen, as well as a shift to more evenly distributed representation of habitat and reproductive guilds. The improvements in environmental metrics and overall stream quality, particularly in the formerly impounded habitats, indicate diminished habitat homogeneity, and a shift towards natural habitat diversity. This habitat diversification likely led to the restoration of a range of potential niches, thereby increasing the array of guild types inhabiting these rivers, while simultaneously preventing single-guild dominance.

Objectives Chronic rhinosinusitis is a heterogenous disease with variation in the endotypes of nasal polyps, with type 2 inflammation being more prevalent in Caucasian populations and papers describing as many as 5 different types of inflammation in Chinese populations. We aim to describe the variation in endotypes for patients with chronic rhinosinusitis with nasal polyposis in our unique multiracial population, together with associated demographic and clinical biomarkers. Design: Retrospective analysis Setting and Participants: Demographic, clinical and structured histopathological data of 67 patients who underwent sinus surgery for nasal polyposis by a single surgeon in Singapore General Hospital were evaluated. Results: In our population, 46.2% had eosinophil-predominant disease, and 53.7% had lymphoplasmacytic disease, with no significant demographic differences between the 2 populations. There were significantly higher peripheral eosinophil levels in patients with eosinophil predominant inflammation on tissue histology (absolute eosinophil count 0.69 ± 0.17 x 109) vs lymphoplasmacytic disease (0.22 ± 0.09 x 109) (p = 0.00). Structured histopathological reporting revealed that patients with eosinophilic disease tended to have more severe inflammation and basement membrane thickening, though this did not reach statistical significance. Conclusion: Understanding the underlying inflammatory patterns of patients with nasal polyposis paves the way to personalised therapy and better prognostication of disease. Our population is shown to have a slight preponderance toward lymphoplasmacytic disease, especially amongst the Chinese majority. Serum eosinophilia and the presence of asthma seems to correlate well with tissue eosinophilia, which can potentially be utilised as a marker of type 2 inflammatory disease.

Reports of preserved cells and other soft tissues in pre-Pleistocene vertebrates, including dinosaurs, have been met with controversy within the field of vertebrate paleontology. To explain such reports, Schweitzer et al. (2014) hypothesized that iron-mediated radical crosslinking preserves ancient soft tissues in a manner somewhat analogous to histological tissue fixation. In 2018, Wiemann et al. proposed a second hypothesis that these soft tissues were preserved as advanced glycation/lipoxidation end products (AGEs/ALEs). The biogeochemistry underlying these hypotheses, however, remains poorly described for fossil vertebrates. This review posits a novel chemical framework describing the persistence of biological "soft" tissues into deep time. The prior iron-mediated radical crosslinking and AGE/ALE mechanisms are re-described in context of established chemistry from a diversity of scientific fields. Significantly, this framework demonstrates the hypotheses presented by Schweitzer et al. (2014) and Wiemann et al. (2018) are, in many cases, subsequent steps of a single, unified reaction mechanism, and not separate hypotheses. Knowledge of the chemical mechanisms underlying vertebrate soft tissue preservation has direct implications for molecular paleontology and archeology, including efforts at molecular sequence recovery within the ancient DNA and paleoproteomic communities. Such implications that are immediately apparent from examining the chemical framework are discussed.

A document by W John Martin. Click on the document to view its contents.

Ductus arteriosus aneurysm (DAA) is characterized by a saccular or fusiform dilatation of the ductus arteriosus. The formation of a thrombus at that level is infrequent and potentially lethal. We present a case of a fetus with a DAA diagnosed during fetal life by 2-D, 3-D, and 4-D STIC echocardiography. Although a thrombus in the ductus and hypertrophy of the right ventricle was identified in postnatal echocardiography, a conservative approach was adopted with good outcome. The features of our case highlight the importance of serial ultrasound in the fetal and neonatal period to assess fetal aneurysm growth as well as to notice any modification of the flow within.

Purpose: Left ventricular diastolic dysfunction (LVDD) is associated with poor outcomes in intensive care unit (ICU). Nonetheless, precise reporting of LVDD in COVID-19 patients is currently lacking and assessment could be challenging. Methods: We performed an echocardiography study in COVID-19 patients admitted to ICU with the aim to describe the feasibility of full or simplified LVDD assessment and its incidence. We also evaluated the association of LVDD or of single echocardiographic parameters with hospital mortality. Results: Between 06.10.2020 and 18.02.2021, full diastolic assessment was feasible in 74% (n=26/35) of patients receiving full echocardiogram study. LVDD incidence was 46% (n=12/26), whilst the assessment produced different results (incidence 81%, n=21/26). Nine patients were hospital-survivors (39%); incidence of LVDD (full assessment) was not different between survivors (n=2/9, 22%) and non-survivors (n=10/17, 59%; p=0.11). Also, the E/e’ ratio lateral was lower in survivors (7.4 [3.6] vs non-survivors 10.5 [6.3], p=0.03). We also found that s’ wave was higher in survivors (average, p=0.01). Conclusion: In a small single-center study, assessment of LVDD according to latest guidelines was feasible in three quarter of COVID-19 patients. Non-survivors showed a trend towards greater LVDD incidence; moreover, they had significantly worse s’ values (all) and higher E/e’ ratio (lateral).

A document by João Gama Monteiro. Click on the document to view its contents.