The main objective of this research is to determine the influence of micro-crack on the propagation of a semi-infinite crack. This study is mainly based on the determination of the strain energy during the interaction between the semi-infinite crack and the neighboring microcrack. The problem is formulated by a plane element, having a micro-crack varies around itself and around a semi-infinite crack. The cracked element is subjected to a uniform load according to mode I. The theoretical analysis of the strain energy is based on the stress found during the propagation of the semi-infinite crack. During the positioning of the micro-crack with respect to the semi-infinite crack, according to the strain energy results, the presence of the micro-crack can amplify, reduce and sometimes arrest the propagation of the semi-infinite crack.

Surgery in patients diagnosed with COVID-19 infection carries significant mortality and morbidity but the appropriate waiting period before surgical intervention after recovering from COVID-19 is not known. We analysed the outcomes of patients who underwent cardiac surgery after having been diagnosed of COVID-19 on pre-operative screening between March and July 2020. Depending on the clinical urgency we delayed surgery until negative testing and/or radiological clearance or postponed the operation where possible. As a result of waiting until COVID-19 resolution, all of our patients survived surgery without complications.

Metabolic syndrome (MS) is caused by genetic and environmental factors, thromboxane A synthase 1 (TBXAS1) gene polymorphism is associated with metabolic disease. This study would explore the relationship between TBXAS1 gene polymorphism and MS. A total of 3072 eligible subjects were obtained, of which 1079 cases were normal controls, 1993 cases were MS patients. subjects were followed up for 5 years and the endpoint events were recorded. The gene polymorphism of TBXAS1 was detected by using Sequenom MassARRAY methods. The results showed that significant differences were observed in ischemic stroke and the genotypes of NC_000007.14:g.139985896C>T (all P < 0.05). The incidence of ischemic stroke was significantly higher in T allele carriers than in C allele carriers (all P < 0.05). C allele was the protective factor of the onset of ischemic stroke. The interaction effects showed there were negative interactions between C allele and waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), TG, HDL-C and FPG; These findings suggest that NC_000007.14:g.139985896C>T was related to the incidence of ischemic stroke in the whole and MS population, individuals who carry the C allele have a reduced risk of stroke.

Direct skin contact with chemical or physical substances is predisposed to allergic contact dermatitis (ACD), in which the skin contact area develops various allergic reactions. ACD can be triggered by extremely complicated adverse outcome pathways. A variety of non-animal in vitro tests such as direct peptide reactivity assay (DPRA), KeratinoSens™, human cell line activation test (h-CLAT), U-SENSTM, and SENS-IS based on different mechanisms have been developed to identify the sensitizers. Additionally, a broad spectrum of in silico models to predict skin sensitization have emerged based on various animal and non-animal data using assorted modeling schemes.

Background Reliable diagnostics are key to identifying influenza infections. Our objectives were to describe detection of influenza among severe acute respiratory infection (SARI) cases, to compare test results from the FTD-33 kit for influenza detection to the Centers for Disease Control (CDC) human influenza virus detection and characterization panel, and to assess seasonality of influenza in Burkina Faso. Methods: Nasopharyngeal and oropharyngeal specimens from SARI cases (hospitalized patients with fever, cough, and onset in the previous 10 days) were tested using the FTD-33 kit and the CDC rRT-PCR influenza assays. We assessed sensitivity and specificity of the FTD-33 kit for detecting Influenza A, Influenza B, and the influenza A(H1N1)pdm09 strain using the CDC human influenza rRT-PCR panel as the gold standard. Results: From December 2016 to February 2019, 1706 SARI cases were identified, 1,511 specimens were tested, and 211 were positive for influenza A (14.0%) and 100 for influenza B (6.6%) by either assay. Higher influenza circulation occurred between November and April with varying peaks of influenza A and B. Sensitivity of the FTD-33 assay was 91.9% for influenza A, 95.7% for influenza B, and 93.8% for A(H1N1)pdm09 subtype. Specificity was over 99% for all three tests. Conclusions: Our study indicates that Burkina Faso has one peak of influenza each year which is similar to the Northern Hemisphere and differs from other countries in West Africa. We found high concordance of influenza results between the two assays indicating FTD-33 can be used to reliably detect influenza among SARI cases.

BACKGROUND: Food allergies are usually managed by food avoidance. Hidden allergens in food, due to cross-contamination and/or allergenic additives added during production, place an important concern in today’s increasing food allergy cases worldwide. Previous studies showed that introduction of new food components, in an inflamed intestine, results in sensitization to this food. Thus, our aim was to evaluate the kinetics of multiple food allergy induction. METHODS: Adult male C57BL/6 mice were divided into five groups, four of which were submitted to an intestinal inflammation induction protocol to peanuts. Egg white (OVA) diluted 1:5 v/v in distilled water was instilled by gavage 6h-before (EXP-1), concomitant (EXP-2) and 6h-after (EXP-3) the onset of the peanut challenge diet. Positive control (POS CONT) and NEG CONT received saline per gavage. Finally, animals were challenged with subcutaneous injections of OVA. RESULTS: No changes in diet intake were observed. Anti-OVA total IgG antibody titers significantly increased in EXP-2. Flow cytometry revealed significant decrease in CD4+CD25+Foxp3+ and significant increase in TCD8+ in EXP-2. Histomorphometrically, EXP-2 and EXP-3 were classified as Infiltrative and Partial Destruction stages. EXP-1 was classified as Infiltrative, while POS CONT was classified as Partial Destruction. NEG CONT was classified as Normal. CONCLUSION: The introduction of a new food only a few hours before the initiation of a gut inflammation is able to induce oral tolerance, however the introduction of a new dietary protein concomitant to the onset or during an ongoing gut inflammation may induce multiple allergies.

Background Accurate estimates of SARS-CoV-2 infection in different population groups are important for the health authorities. In Norway, public infection control measures have successfully curbed the pandemic. Military training and service are incompatible with these measures, and therefore stricter infection control measures were necessary in the Norwegian Armed Forces. We present the measures, and discuss the results and their value. We report on the seroprevalence of SARS-CoV-2 and the changes in antibody levels over six weeks. Methods In April 2020, 1170 healthy conscripts (median age 20 years) were enrolled. The infection control measures included a pre-enrollment telephone interview and self-imposed quarantine. Questionnaire data and serial SARS-CoV-2 PCR and serology testing were used to estimate the incidence of confirmed SARS-CoV-2, describe symptoms and monitor titer levels over a six week period. Results The seroprevalence of SARS-CoV-2 was 0. 6 %. Only 0. 2 % had a positive PCR for SARS-CoV-2 at the enrollment day. Serological titer levels increased up to nearly five-fold over the observation period. Eighteen conscripts reported mild respiratory symptoms during the 14 days prior to enrollment (all were PCR negative, one had positive serology), whereas 17 conscripts reported respiratory symptoms and nine had fever at the day of enrollment (all were PCR and serology negative). Conclusions The prevalence of SARS-CoV-2 in young adults in Norway is less than 1%. Testing of asymptomatic conscripts seems of no value in times of low COVID-19 prevalence. SARS-CoV-2 antibody titer levels increased substantially over time in youths with mild symptoms.

Objectives: To assess the characteristics and forecasting of respiratory viruses epidemic among young children with acute respiratory tract infection (ARTI) in west China. Methods: This study retrospected the epidemic characteristics of respiratory viruses among 11813 pediatric patients with ARTI between March 2018 and March 2020. Results: 11813 samples were collected, with a mean age of 2.25 years. The ratio of the boy: the girl was 1.36. The two predominant viruses were influenza (Flu) A and respiratory syncytial virus (RSV), with Flu A accounting for 47.3% (n=1099), 47.5% (n=1333) and RSV accounting for 32.7% (n=760), 24.7% (n=692) of the positive samples in the two respective years. The positive rate of Flu B was 10.9% and 13.1%, and the other four viruses were <7%. The most common virus was RSV in the <5 years group and Flu A in the 5-10 years group. Flu A and RSV demonstrated pronounced seasonality, and their infection rates increased from October. During the pandemic of SARS-CoV-2, isolation measures led to a decline in the number of ARTI. Conclusions: The study provided surveillance of respiratory viruses in west China. It will provide guidance for medical staff to implement the necessary prevention and management strategies before the outbreak of the virus in the future.

Background: Rigid bronchoscopy is the procedure of choice for removal of inhaled foreign bodies, with certain complication rate. Aim: to assess whether flexible bronchoscopy is an efficient and safe procedure in extraction of foreign bodies in children, compared to rigid bronchoscopy. Then, to further assess if it is associated with a shorter procedure time, and shorter length of stay in the hospital (LOS). Methods: a retrospective study including patients aged 0-18 years, that were hospitalized in Soroka University Medical Center throughout 2009-2019, and underwent flexible or rigid bronchoscopy for the removal of inhaled foreign body. The data were analyzed according to two time periods; 2009-2016 and 2017-2019. Results: from 2009-2019, 182 patients (median age of 24 months, 58% males) underwent an interventional bronchoscopy; 40 (22%) by flexible and 142 (78%) by rigid bronchoscopy. 88.73% of rigid and 95% of flexible bronchoscopies were successful in the removal of foreign bodies (p value=0.24). The rate of major complications was higher among rigid bronchoscopy (9.2 % vs. 0%, p =0.047). From 2017 onwards, after implementation of the flexible bronchoscopy for removal of foreign bodies, 64 procedures were performed; 33 (51.6%) flexible and 31 (48.4%) rigid. Procedure length was found to be shorter via flexible bronchoscopy (42 vs 58 minutes, p = 0.016). No significant difference was found in LOS. Conclusion: Flexible bronchoscopy is an efficient and safe method for removal of inhaled foreign bodies in children, with shorter procedure time. It may be the primary procedure for removal of inhaled foreign bodies.

Pulmonary haemorrhage in children is rare. Respiratory infections, foreign body aspiration, cystic fibrosis and congenital heart diseases remain the leading causes. We present a 7- week-old male infant, previously fit and well who developed pulmonary haemorrhage while breastfeeding in a sling strapped to mother. We hypothesise that accidental asphyxiation during breast feeding, generated forced inspiratory effort against an obstructed upper airway and led to negative pressure pulmonary oedema (NPPE) and pulmonary haemorrhage. Accidental asphyxiation should be considered in the differential diagnosis of children presenting with pulmonary haemorrhage.

Background and Purpose: Depletion of the enzyme cofactor, tetrahydrobiopterin (BH4) in T-cells was shown to prevent their proliferation upon receptor stimulation in models of allergic inflammation in mice suggesting that BH4 drives autoimmunity. Hence, the clinically available BH4 medication (sapropterin) might increase the risk of autoimmune diseases. Experimental Approach: The present study assessed the implications for multiple sclerosis (MS) as a model autoimmune disease in MS patients and in immunization-evoked autoimmune encephalomyelitis (EAE), a model of multiple sclerosis in mice. Key Results: Plasma levels of biopterin were persistently low in MS patients, and the bypass product, neopterin tended to be increased suggesting a relative deficiency of BH4. Ex vivo stimulation of human whole blood indeed led to a drop of biopterin pointing to high consumption. Hence, BH4 replenishment might either further drive the immune response or beneficially restore the BH4 balance. To answer this question, mice were treated with sapropterin in the EAE model. Sapropterin-treated mice had higher EAE disease scores associated with higher numbers of T-cells infiltrating the spinal cord, but normal T-cell subpopulations in spleen and blood, suggesting that BH4 facilitated the invasion of the central nervous system (CNS). Sapropterin-treated EAE mice had increased plasma levels of long-chain ceramides and low levels of the poly-unsaturated fatty acid, linolenic acid (FA18:3). These lipid changes are known to contribute to disruptions of the blood brain barrier in EAE mice. Conclusion and Implications: Sapropterin might aggravate autoimmune disease of the CNS through permissive effects at the brain barrier.

Introduction Children with tracheostomy have an increased risk of bacterial colonization and infections of the lower respiratory tracts. This study aimed to investigate the effects of nebulized antibiotics on the bacterial load, the need for oral antibiotic courses, the number of hospitalizations, and the length of stay in the intensive care unit in children with tracheostomy. Methods Children with tracheostomy and persistent bacterial colonization who were started on nebulized antibiotic therapy after a lower respiratory tract infection were included to the study. Nebulized gentamicin or colistin were used according to the results of tracheal aspirate cultures. Demographic and clinic characteristics were recorded from one year before until 12 months after initiating nebulized antibiotic treatment. Results Nebulized antibiotic treatment was initiated in 22 patients. Inhaled gentamicin was administered to 14 patients (63.6%) and colistin to 8 patients (36.4%). The median duration of treatment was 3 months (2-5 months). Following nebulized antibiotic treatment, median number of hospitalizations decreased from 2 (1-3.5) to 1 (0-1.5) (p=0.04). The median length of stay in the intensive care unit reduced significantly from 89.5 days (43-82.5) to 25 days (7.75-62.75) after starting nebulized antibiotics (p = 0.028). Following nebulized antibiotic treatment colony count also decreased (105 CFU/ml (105-106) vs. 6x104 CFU/ml (104-105); p=0.003). Conclusions Nebulize antibiotics are a reasonable treatment option for lower respiratory tract infections for tracheotomized children with persistent colonization. Further studies are needed to determine the main indications and the optimal duration and doses of the long-term nebulized antibiotic treatment in these patients.

Implementation of effective conservation planning relies on a robust understanding of the spatio-temporal distribution of the target species. In the marine realm, this is even more challenging for cryptic species with extreme diving behaviour like the sperm whales. Our study aims at investigating the movements and predicting suitable habitat maps for this species in the Mascarene Archipelago in the South-West Indian Ocean. Using 21 satellite tracks of sperm whale and 8 environmental predictors, 14 supervised machine learning algorithms were tested and compared to predict the whales' distribution during the wet and dry season, separately. Fourteen of the whales remained in close proximity to Mauritius while a migratory pattern was evidenced with a synchronized departure for 8 females that headed towards Rodrigues Island. The best performing algorithm was the random forest, showing a strong affinity for Sea Surface Height during the wet season and for bottom temperature during the dry season. A more dispersed distribution was predicted during the wet season whereas a more restricted distribution to Mauritius and Reunion waters was found during the dry season. The results of our study fill a knowledge gap regarding seasonal movements and habitat affinities of this vulnerable species, for which IUCN regional assessments are still lacking in the Indian Ocean. Our findings also confirm the great potential of machine learning algorithms in conservation planning and provide concrete tools to support dynamic ocean management.

Background: Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) and Transesophageal Bronchoscopic Ultrasound-guided fine-needle aspiration (EUS-B-FNA) are established modalities for evaluation of mediastinal/hilar lymphadenopathy in adults. Limited literature is available on the utility of these modalities in the pediatric population. Herein, we perform a systematic review and meta-analysis on the yield and safety of EBUS-TBNA and EUS-B-FNA in children. Methods: We performed a systematic search of the PubMed and EMBASE databases to extract the studies reporting the utilization of EBUS-TBNA/EUS-B-FNA in children (<18 years of age). Pooled diagnostic yield and sampling adequacy (proportions with 95% confidence intervals) were calculated using the random-effects model. Details of any procedure-related complications were noted. Results: The search yielded 12 relevant studies (five case series and seven case reports on EBUS-TBNA/EUS-B-FNA, 173 patients). Data from five case series (164 patients) were summarized for the calculation of sampling adequacy and diagnostic yield. Safety outcomes were extracted from all publications. The pooled sampling adequacy and combined diagnostic yield of EBUS TBNA/EUS-B-FNA were 98% (95% CI, 92-100%) and 61% (95% CI, 43-77%) respectively. A procedure-related major complication was reported in 1 patient (1/173, Major complication rate 0.6%), and minor complications occurred in 6 patients (6/173, Minor complication rate 3.5%). Conclusions: EBUS-TBNA and EUS-B-FNA are safe modalities for evaluation of mediastinal lymphadenopathy in the pediatric population. EBUS-TBNA/EUS-B-FNA may be considered as the first-line diagnostic modalities for this indication as they have a good diagnostic yield and can avoid the need for invasive diagnostic procedures.

Gene therapy is an attractive approach being intensively studied to prevent muscle deterioration in patients with Duchenne muscular dystrophy. While clinical trials are only in early stages, initial reports are promising for its effects on ambulation. Cardiopulmonary failure, however, is the most common cause of mortality in DMD patients, and little is known regarding the prospects for gene therapy on alleviating DMD-associated cardiomyopathy and respiratory failure. Here we review current knowledge regarding effects of gene therapy on DMD cardiomyopathy and discuss respiratory endpoints that should be considered as outcome measures in future clinical trials.

From April 2018 to December 2019, we recruited 31 volunteers with mild cognitive impairment and 33 volunteers in the healthy control group from the residents of Wuxi City’s community. Relevant researches on resting state functional magnetic resonance and human plasma markers were done respectively; Studies have shown that there are differences in brain function between the MCI group and the healthy control group, which is similar to previous studies[1]; It is worth noting that most plasma markers and cerebrospinal fluid, apolipoprotein gene E have no significant difference, Most previous studies of the same kind have shown anomalies[2], and we speculate that this difference may be related to ethnic or regional differences[3, 4]. Next, we will expand the sample size to further verify this guess

In this short paper, we focus on the blowup phenomenon of stochastic parabolic equations. We first discuss the probability of the event that the solutions keep positive. Then, the blowup phenomenon in the whole space is considered. The probability of the event that the solutions blow up in finite time is given. Lastly, we obtain the probability of the event that blowup time of stochastic parabolic equations larger than or less than the deterministic case.

In this paper we investigate the existence of the pseudo almost periodic solutions for evolution equations by using Schaffer theorem. Moreover, we study the exponential stability of these solutions. As application, we give examples in biology models to illustrate the main results of this work.

Understanding the evolution of sexual vs asexual reproduction and their consequences in population genetics is a central tenet of evolutionary biology. Nevertheless, until now, it has proved unachievable to assess partially clonal reproduction when the rate of clonality is less than 95%, especially without the use of genome-wide data or temporal samples. Here, we investigate the genomic signatures of partial clonality in the deep water kelp Laminaria rodriguezii, known to reproduce by both sexual and asexual means. The results of these investigations have been interpreted by comparison with the sexually reproducing congeneric species Laminaria digitata. Genome-wide variation was assessed by dd-RAD sequencing using 4077 SNPs in L. rodriguezii and 7364 SNPs in L. digitata. As predicted for partially clonal populations, the distribution of FIS within populations of L. rodriguezii was centered in negative values, with heterozygote excess at most loci along the genomes. This finding is the opposite of what we reported within sexual populations of L. digitata, characterized by a generalized deficit in heterozygotes. Furthermore, two distinct distribution patterns of FIS were reported among populations of L. rodriguezii, consistent with the results predicted by the theoretical model for different levels of clonality. These findings highlight that the investment in clonal growth could differ among populations of L. rodriguezii, confirming that the full distribution of FIS is a promising feature to take into account for the study of asexuality in natural populations. We discuss the implications of these results for the conservation of the rare deep water kelp L. rodriguezii.

In this work, we give an exact solution to nonlinear system of coupled time-fractional Boussinesq-Burger equation using the Fractional Natural Decomposition Method (FNDM). Also, we find approximate solutions to nonlinear fractional system of ordinary differential equations and exact solutions in the case when $\alpha=\beta=\gamma=1$. The numerical computations in the tables show that our analytical solutions converge very rapidly to the exact solutions

In this paper, we establish the existence and uniqueness of a time periodic solution to the full compressible quantum Euler equations. First, we prove the existence of time periodic solutions under some smallness assumptions imposed on the external force in a periodic domain by a regularized approximation scheme and the Leray-Schauder degree theory. Then the result is generalized to $\mathbb{R}^{3}$ by adapting a limiting method and a diagonal argument. The uniqueness of the time periodic solutions is also given. Compared to classical Euler equations, the third-order quantum spatial derivatives are considered which need some elaborated treatments thereof in obtaining the highest-order energy estimates.

Abstract Introduction: Tachycardia-induced cardiomyopathy (TCM) is a reversible cause of heart failure (HF) with impaired left ventricle (LV) function. However, the diagnosis is difficult before treatment or control of the arrhythmia for the first time. Methods: In this retrospective observational study, we observed 32 patients with paroxysmal or persistent atrial fibrillation (AF) who had impaired LV function without structural heart disease and who underwent catheter ablation. We defined impaired LV function as LV ejection fraction (LVEF) <50%. After ablation, the LVEF became <60% (Group 1; n = 11) or 60% (Group 2; n = 21). We compared the differences in baseline characteristics between the two groups. The patients in Group1 had no ischemic disease. A receiver operating curve (ROC) with area under the curve (AUC) was used to evaluate the prediction efficiency. Results: There were significant differences in left atrial (LA) volume (LAV) and LAV adjusted by body surface area (LAVI) measured by computed tomography (p < 0.05 for both). The AUCs were 0.810 and 0.823, respectively. The points at which sensitivity and specificity were maximum were 147 ml and 79. Small LAV and LAVI were predictors of LVEF improvement. Conclusion: Small LAV measured by computed tomography (CT) before ablation may be useful for diagnosis of TCM with AF.

Abstract Objectives: To assess the efficacy and safety of oral glucokinase activator (GKA) in the treatment of type 2 diabetes mellitus(T2DM). Methods: We searched PubMed, ClinicalTrails, Cochrane Library, Web of Science, and CNKI and collected randomized controlled trials (RCTs) of glucokinase activator in the treatment of T2DM. Revman5.3 software was used to do the meta-analysis. And the risk of bias in the included RCTs was evaluated according to the Cochrane tool. Results: Seven double-blind RTCs were included in the final analysis, with a total of 762 patients. Regarding the efficacy, GKAs significantly reduced fasting blood glucose (mean difference -0.71, 95% CI: -1.11 to -0.31, based on 459 patients from 5 literatures), and glycated hemoglobin also significantly reduced (mean difference: -0.65%, 95% CI: -0.82 to -0.48, based on 570 patients from 4 literatures). Regarding safety, GKAs did not affect the total rate of adverse events(AEs) (relative risk(RR) 1.11, 95% CI: 0.95 to 1.30, P = 0.19), but increased the risk of hypoglycemia (RR 1.81, 95% CI: 1.35 to 2.42, P < 0.0001). And the risk of diarrhea (RR 1.59, 95% CI: 0.7 to 3.65, P = 0.26), headache (RR 0.96, 95% CI: 0.41-2.21, P = 0.60) and nausea (RR 2.23, 95% CI: 0.55-9.12, P = 0.24) were not significantly increased in GKAs group. Conclusions: Oral GKAs combined with metformin has an obvious hypoglycemic effect on T2DM and good tolerance. Further clinical studies are still necessary to explore its long-term efficacy and safety. Keywords: Glucokinase; Glucokinase activator; Type 2 diabetes; Meta-analysis

In this paper, first, we introduce a concept of mixed multivalued contraction mapping. Then, we present some best proximity point results for such mappings on 0-complete partial metric spaces. Hence, we extend and generalize some famous and nice results existing in the literature such as Abkar and Gabeleh, Gabeleh and Aydi et al. Also, we provide some nontrivial illustrative examples to support our results and to compare with the results mentioned before. Finally, the first time, we give some applications to homotopy theory via new best proximity point results. Hence, we obtain some best proximity point results for homotopic mappings