We extend the well-known Halanay inequality to the fractional order case in presence of distributed delays and delays of neutral type (in the fractional derivative). Both the discrete and distributed neutral delays are investigated. It is proved that solutions decay toward zero in a Mittag-Leffler manner under some rather general conditions. Some large classes of kernels and examples satisfying our assumptions are provided. We apply our findings to prove Mittag-Leffler stability for solutions of fractional neutral network systems of Cohen-Grossberg type.
Interstitial pneumonia with autoimmune features is a concept to identify patients with idiopathic interstitial pneumonia and features suggestive of a connective tissue disease. There is no specific treatment which consists mainly of corticosteroids and immunossupressive agents. Rituximab is an effective rescue therapy for refractory interstitial lung disease.
A 56-year-old woman was found to have retroperitoneal hemorrhage secondary to isolated posterior inferior pancreaticoduodenal artery (PIPDA) dissection. She had chronic abdominal pain and celiac artery stenosis, suggesting that PIPDA dissection was associated with celiac artery compression syndrome (CACS). Clinicians may consider CACS as the cause of visceral dissection.
It was recently reported that due to the COVID-19 pandemic, in the European winter 2020-2021, bronchiolitis had practically disappeared. But early reports from the southern hemisphere (Australia) raised concerns about a late spring / summer peak. After a full winter season and now ending the summer, we report that there was no peak of common respiratory viruses in late spring / summer in South America.
COVID-19 cases are increasing worldwide. With such emerging disease the medical community should be aware of atypical clinical presentations in order to help with correct diagnosis, and to take the proper measures to isolate and treat patients to avoid healthcare professionals being infected and to limit its spread (SARS-CoV-2).
Indwelling arterial catheters are used routinely for continuous haemodynamic monitoring during major surgery and in critically ill patients. Major complications are rare. We describe two cases of patients in which arterial catheterisation was associated with acute radial arterial thrombosis and radial ischaemic neuropathy. Timely recognition was paramount to successful management.
Objectives: In this study, we aimed to compare the outcomes and complication rates of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in geriatric patients according to Charlson comorbidity index (CCI). Materials and Methods: Between April 2011 and January 2020, patients who underwent PCNL and RIRS for renal stone between 10 and 30 mm in geriatric patients were retrospectively evaluated. All patients’ Pre-surgery comorbidities were recorded and the CCI was calculated. The two groups’ perioperative values, stone free rates and complication rates were compared. Postoperative complications were noted according to the Clavien scoring system. Results: There were 89 and 72 patients in the PCNL and RIRS group, respectively. The median age was 67 years in both of groups (p=0.192). The stone size were 22.2 ± 3.5 and 19.9 ± 7.1 in the PCNL and RIRS group, respec¬tively ( p = 0.082). CCI scores were similar in both groups (p=0.098). Stone free and complication rates were significantly higher in PCNL group (p = 0.021, p = 0.034). Also we found that overall complication and major complication rates were statistically significant difference with especially Charlson comorbidity index score ≥2 in PCNL group (p = 0,016, p = 0,029). According to correlation analysis of intraoperative and postoperative results with Charlson comorbidity index, there was positive correlation between total complication with PCNL and RIRS group, respectively (p < 0,001, p = 0.024). In addition, there was positive correlation between lenght of hospital stay with PCNL and RIRS group, respectively (p = 0,007, p < 0,001). Also there was positive correlation between blood transfusion requirement with PCNL group (p=0,009). Conclusion: Despite there was higher stone clearence in PCNL, the complication rates were higher compared to RIRS. So RIRS might be a safe alternative treatment method to PCNL in older patients with a high CCI score.
Paraganglioma is a very rare extraadrenal nonepithelial tumor. The number of cases of laparoscopic surgery in Paraganglioma is small and controversial. This study encountered a case of successful transperitoneal laparoscopic surgery for a 56mm paraganglioma . Moreover, previous reports on laparoscopic surgery for paraganglioma are reviewed .
A recent Molecular Ecology editorial made a proactive statement of support for the “Nagoya Protocol” and the principle of benefit-sharing (Marden et al. 2020) by requiring authors to provide a “Data Accessibility and Benefit‐Sharing Statement” in their articles. Here, we encourage another step that enables Indigenous communities to provide their own definitions and aspirations for access and benefit-sharing alongside the author’s “Statement”. We invite the Molecular Ecology research community to use Biocultural-, Traditional Knowledge-, and Cultural Institution Notices to help Indigenous communities gain visibility within our research structures. Notices are one of the tools offered by the Biocultural Labels Initiative (part of the Local Contexts system) designed specifically for researchers and institutions. The Notices are highly visible, machine-readable icons that signal the Indigenous provenance of genetic resources, and rights of Indigenous communities to define the future use of genetic resources and derived benefits. The Notices invite collaboration with Indigenous communities and create spaces within our research systems for them to define the provenance, protocols, and permissions associated with genetic resources using Labels. Authors contributing to Molecular Ecology can apply Notices to their articles by providing the persistent unique identifier and an optional use-statement associated with the Notice in their “Data Accessibility and Benefit‐Sharing Statement”. In this way, our research community has an opportunity to accelerate support for the principles of the Nagoya Protocol, to alleviate concerns regarding Indigenous Data Sovereignty and equitable outcomes, and to build better relationships with Indigenous collaborators to enhance research, biodiversity, and conservation outcomes.
Free light chains (FLC), considered a biomarker of B cell activity, are frequently elevated in different systemic inflammatory-autoimmune diseases. As systemic sclerosis (SSc) clinical course may be variable, this study aimed to assess FLCs levels in serum and urine of affected individuals, as biomarkers of disease activity. We assessed FLC levels in serum and urine of 72 SSc patients and 30 healthy controls (HC). Results were analyzed in comparison with overall clinical and laboratory findings, disease activity index (DAI) and disease severity scale (DSS). SSc patients displayed increased levels of k and λ FLC in serum, significantly higher than HC (p=0.0001) alongside with the mean levels of free k/λ ratio and of the k+λ sum (p=0.0001). In addition, SSc patients had significant higher levels in the urine of free k and of k/λ ratio than HC (p=0.0001). SSc patients with increased k+λ sum in serum showed a statistically higher levels of erythro-sedimentation rate (p=0.034), C-reactive protein (p=0.003), higher DAI (p=0.024) and DSS (p=0.015) than SSc patients with normal levels of FLC. A positive linear correlation was found between serum levels of free k and DAI (r=0.29, p=0.014). SSc patients with increased free k in urine had statistically higher DAI (p=0.048) than SSc patients with normal level of free k. The significant increased levels of FLC correlated with disease activity in SSc patients. Our results strengthen the role of FLC as useful biomarkers in clinical practice to early diagnosis and monitor disease activity with an improvement of SSc patients’ management.
Quantifying how multiple ecosystem services and functions are affected by different drivers of Global Change is challenging. Particularly in African savanna regions, highly integrated land-use activities created a landscape mosaic with flows of multiple resources between land use types. A framework is needed that quantifies the effects of climate change, management and policy interventions on ecosystem services that are most relevant for rural communities, such as provision of food, feed, carbon sequestration, nutrient cycling and natural pest control. In spite of progress made in ecosystem modelling, data availability and stakeholder interactions, these elements have neither been brought together in an integrated framework, nor evaluated in the context of real-world problems. Here, we propose and outline such framework as developed by a multi-disciplinary research network, the Southern African Limpopo Landscapes network (SALLnet). Components of the framework such as the crop model APSIM and the vegetation model aDGVM2 had already been parameterized and evaluated using data sets from savanna regions of eastern, western and southern Africa, and were fine-tuned using novel data sets from Limpopo. A prototype of an agent-based farm household model was developed using comprehensive farm survey information from the Limpopo Province of South Africa. A first test of the functionality of the integrated framework has been performed for alternative policy interventions on smallholder crop-livestock systems. We discuss the versatile applicability of the framework, with a focus on smallholder landscapes in the savanna regions of southern Africa that are considered hotspots of global change impacts.
Background: Left ventricular assist devices (LVAD) are standardly implanted via full sternotomy. Non-sternotomy approaches are gaining popularity, but potential benefits of this approach have not been well-studied. We hypothesized that LVAD implantation by bi-thoracotomy (BT) would demonstrate smaller and more consistent inflow cannula angles leading to improved postoperative outcomes compared to sternotomy. Methods: Charts of patients who underwent LVAD implantation between June 2018 and June 2020 at a single academic institution were retrospectively reviewed. Patient demographics, surgical approach (sternotomy vs. BT), laboratory values, and postoperative course were compared. The inflow cannula angle was measured on the first chest radiograph available postoperatively. Results: Of 40 patients studied, BT approach was used in 17 (42.5%). Mean inflow cannula angles were smaller in BT patients (23.0 vs. 37.1 degrees, p=0.018) and had a smaller standard deviation (13.8 vs. 20.3). Excluding patients who went on to receive heart transplant or died in the same hospitalization, there was no difference in median length of hospital stay after surgery (16.0 vs. 17.5 days, p=0.768). However, BT patients required fewer days of postoperative inotrope support (4.0 vs. 7.0 days, p=0.012). Conclusions: Our data suggest inflow cannula angles are smaller and more consistent with the BT approach, which leads to shorter duration of postoperative inotropic support. This finding may suggest improved right heart function following LVAD implant via BT approach. Further study is warranted to determine additional benefits of the BT approach.
Friedreich ataxia is the most common inherited ataxia in the world, but yet to be reported in black African. We report the first genetically confirmed case in a West African family. Studying genetic diseases in populations with diverse backgrounds may give new insights into their pathophysiology for future therapeutic targets.
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused substantially more infections, deaths, and economic disruptions than the 2002-2003 SARS-CoV. The key to understanding SARS-CoV-2’s higher infectivity lies partly in its host receptor recognition mechanism. Experiments show that the human ACE2 protein, which serves as the primary receptor for both CoVs, binds to the receptor binding domain (RBD) of CoV-2’s spike protein stronger than SARS-CoV’s spike RBD. The molecular basis for this difference in binding affinity, however, remains unexplained from X-ray structures. To go beyond insights gained from X-ray structures and investigate the role of thermal fluctuations in structure, we employ all-atom molecular dynamics simulations. Microseconds-long simulations reveal that while CoV and CoV-2 spike-ACE2 interfaces have similar conformational binding modes, CoV-2 spike interacts with ACE2 via a larger combinatorics of polar contacts, and on average, makes 45\% more polar contacts. Correlation analysis and thermodynamic calculations indicate that these differences in the density and dynamics of polar contacts arise from differences in spatial arrangements of interfacial residues, and dynamical coupling between interfacial and non-interfacial residues. These results recommend that ongoing efforts to design spike-ACE2 peptide blockers will benefit from incorporating dynamical information as well as allosteric coupling effects.