1. Cattle grazing profoundly affects abiotic and biotic characteristics of ecosystems. While most research has been performed on grasslands, the effect of large managed ungulates on forest ecosystems has largely been neglected. 2. Compared to a baseline semi-natural state, we investigated how long-term cattle grazing of birch forest patches affected the abiotic state and the ecological community (microbes and invertebrates) of the soil subsystem. 3. Grazing strongly modified the soil abiotic environment by increasing phosphorus content, pH and bulk density, while reducing the C:N ratio. The reduced C:N-ratio was strongly associated with a lower microbial biomass, mainly caused by a reduction of fungal biomass. This was linked to a decrease in fungivorous nematode abundance and the nematode channel index, indicating a relative uplift in the importance of the bacterial energy-channel in the nematode assemblages. 4. Cattle grazing highly modified invertebrate community composition producing distinct assemblages from the semi-natural situation. Richness and abundance of microarthropods was consistently reduced by grazing (excepting collembolan richness) and grazing-associated changes in soil pH, Olsen P and reduced soil pore volume (bulk density) limiting niche space and refuge from physical disturbance. Anecic earthworm species predominated in grazed patches, but were absent from ungrazed forest, and may benefit from manure inputs, while their deep vertical burrowing behaviour protects them from physical disturbance. 5. Perturbation of birch forest habitat by long-term ungulate grazing profoundly modified soil biodiversity, either directly through increased physical disturbance and manure input or indirectly by modifying soil abiotic conditions. Comparative analyses revealed the ecosystem engineering potential of large ungulate grazers in forest systems through major shifts in the composition and structure of microbial and invertebrate assemblages, including the potential for reduced energy flow through the fungal decomposition pathway. The precise consequences for trophic interactions and biodiversity-ecosystem function relationships remains to be established, however.

Livestock trading through live animal markets are potential pathways for the introduction and spread of economically important pathogens like the African swine fever virus (ASFV) to new areas in several countries. Due to the high demand for live pigs in Nigeria both for restocking and slaughter, live pigs are sold at designated live pig markets (LPM) in the country. This involves movement of pigs over long distances. Despite, reports of ASF outbreaks following restocking of pigs bought from LPMs, there is paucity of information on the role of LPMs in the epidemiology of ASF. In this study, data and pig samples (whole blood, sera, tissue) were collected from 4 selected LPMs in Nigeria (Dawaki, Katsit, Numan & Pandam) between 2019 and 2020. Samples were analysed by polymerase chain reaction (PCR) and Enzyme-linked Immunosorbent Assay (ELISA). Four genes of ASFV positive samples were characterized to identify the circulating genotypes. Results revealed trade activities involving transportation of pigs from these selected markets to 42 major cities and towns in thirteen (13) States of Nigeria. PCR results revealed an overall ASF prevalence of 10.77% (66/613). ASFV was confirmed by PCR in all the selected LPMs with a prevalence rate of 3.13%-23.81%. The phylogeny revealed genotype I and serogroup 4 based on the p72 protein that encodes the B646L gene and the EP402R gene encoding the CD2V. While sequence analysis of CVR of B602L gene revealed 8 tetrameric repeats variants, six of which have never been reported in Nigeria. Analysis of sera samples recorded a seroprevalence of 6.9% (16/217) within the study period. Findings from this study show that LPM are hotspots and channels for transmission and continuous spread of ASFV in Nigeria. Therefore, for ASF to be controlled in Nigeria, disease surveillance and regulation at LPMs are critical.

To the Editor,Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE) mediated food allergy that predominantly affects infants and is characterized by repetitive vomiting that occurs 1–4 h after the ingestion of causative food. The etiology and underlying mechanisms of FPIES are not well understood. Recently, egg yolk (EY) has been recognized as a major causative food of FPIES.1,2 Most FPIES patients achieve tolerance with age;3 however, the practice management of EY-associated FPIES (EY-FPIES) has yet to be established. In a preliminary analysis of EY-FPIES, we found that the patients who acquired tolerance to EY had been diagnosed at a significantly younger age than non-tolerated patients despite no difference in the age of onset between both patients. This suggested that the early diagnosis and intervention is beneficial for tolerance acquisition in EY-FPIES. To investigate this further, we compared clinical outcomes between the early and late diagnosis of EY-FPIES.The present study enrolled 21 patients with EY-FPIES (1) diagnosed by positive oral food challenge (OFC) tests at our hospital between April 2018 and April 2021 who (2) subsequently underwent OFC to evaluate tolerance acquisition (re-OFC) at least once. The open OFC was performed by ingestion of a single dose once or three divided doses every 30 minutes. OFC was considered positive for FPIES based on delayed abdominal reactions without immediate skin or respiratory reactions. After confirmation by OFC, we instructed all patients to continue complete elimination of EY, regardless of threshold doses of OFC. We retrospectively collected data from electronic medical records on sex, age of first ingestion of EY, disease onset, first visit to our hospital, diagnosis, specific IgE (sIgE) to EY measured by ImmunoCAP test at diagnosis, asymptomatic histories of EY consumption before onset, the number of symptomatic episodes before diagnosis, the period between the first ingestion of EY and diagnosis of EY-FPIES, and age of tolerance acquisition. Tolerance acquisition was defined by (1) negative OFC and (2) the ability of daily EY consumption without FPIES reactions for three months at home. We divided the patients into the following two groups according to their age at the time of diagnosis: the early diagnosis (ED) group (<12 months) and the late diagnosis (LD) group (≥12 months), and compared the clinical features between both groups. A sIgE value higher than 0.35 UA/ml was defined as positive. Statistical analyses were performed using GraphPad Prism 9. The Mann-Whitney U test was used to compare nonparametric independent samples between the groups. Tolerance acquisition during follow-up was analyzed using a Kaplan–Meier survival curve and the log-rank test. P-value <0.05 was considered statistically significant. This study was approved by the Institutional Review Board of the KKR Sapporo Medical Center (2021-06).Patients’ characteristics are shown in Table 1. The ED group consisted of 12 patients (57.1%), 10 (83.3%) of whom acquired tolerance to EY, and the LD group consisted of nine patients (42.9%), three (33.3%) of whom acquired tolerance to EY. Among 21 patients with EY-associated FPIES, a total of 35 re-OFCs were performed, with a median interval of seven months (interquartile range [IQR], 6–11 months) (Figure 1). The median ages that re-OFC proved negative in ED and LD groups were 16 and 26 months, respectively (p = 0.014) (Table 1). The time to tolerance acquisition was significantly longer in the LD group than that in the ED group, as shown in the Kaplan–Meier analysis (log-rank, p = 0.0015) (Figure 2). The median ages of onset and first visit to our hospital were significantly younger in the ED group than those in the LD group (Table 1). All patients had a history of three episodes (IQR 2–6) of asymptomatic consumption before onset. Although the median age of the first introduction of EY in the ED group was younger than that in the LD group (six months vs. eight months, p = 0.004), there was no significant difference in the median number of asymptomatic consumptions before onset and the period between the first introduction and onset between the groups. The period between the first introduction of EY and FPIES diagnosis was shorter in the ED group than that in the LD group (2.5 months vs. 7 months, p = 0.0002).We demonstrated that the ED group achieved tolerance at a higher rate than the LD group, suggesting that early diagnosis and intervention predict favorable prognosis in EY-FPIES. Consistent with a previous report,4 all patients with EY-FPIES had histories of asymptomatic consumption before disease onset. Involvement of both innate and adaptive immunities with resultant proinflammatory cytokine production has been suggested in the pathology of acute FPIES.5 Our results suggest that the development of EY-FPIES requires sensitization of the adaptive immune system. T helper (Th)2 and Th17 cells are considered as key players of the immune response in FPIES,6 which is reflected by local infiltration of eosinophils and neutrophils, respectively. Adaptive immunity of infants shows dynamic changes with a rapid decline of regulatory T cells and maturation of Th17, while Th2 dominance is preserved.7 Additionally, the intestinal barrier function immaturity was also observed, resulting in a higher permeability of antigens across the intestines.8 Thus, early infants may be predisposed to FPIES because of immunological as well as anatomical immaturity. Although both ED and LD groups shared a similar interval between the first introduction of EY and onset, the period between the onset and diagnosis in the ED group was significantly shorter than that in the LD group. Our results suggest that an earlier elimination of EY after onset prevents the complete development of EY-FPIES.The median age at onset in the 21 patients with EY-FPIES was 8 months (IQR, 7–9 months), which is comparable to previous reports.9 Similar to another report,9 13 patients (65.0%) achieved tolerance at the median age of 16 months. This is earlier than the median age reported in a European series that demonstrates a 50% cumulative probability of resolution at the age of 41 months.10Notably, the median age of diagnosis is older (12 months) in that study compared with that in our series. Thus, the different clinical courses may attribute to differences in age of diagnosis. Otherwise, the clinical course may depend on ethnicity. In 2017, the Japanese Society of Pediatric Allergy and Clinical Immunology recommended the early introduction of EY to infants with a high risk for IgE-mediated egg allergy. This might have increased the number of early-onset EY-FPIES in Japan. Our results suggest that a first re-OFC seven months after the diagnosis is reasonable for preventing unnecessary food avoidance in EY-FPIES.Our study is limited by a retrospective review of a small number of patients from a single institute. Additionally, accidental exposures after diagnosis occurred in one patient in the LD group, influencing the scheduling of re-OFC. Moreover, we evaluated solely patients with a confirmational diagnosis by OFC, which might be insufficient to reflect the whole heterogeneity of EY-FPIES.Conclusively, the ED group achieved tolerance in EY-FPIES earlier compared with the LD group. Early diagnosis and complete elimination of EY may be beneficial for EY-FPIES.

This article investigates the fractional Peyrard-Bishop DNA model. The construction of soliton solutions have been successfully obtained by utilizing two versatile analytical methods, namely, the Jacobi elliptic function method and the tanh-coth method. Furthermore, the Painlev´e test (P-test) has been employed on the proposed model for investigating integrability. The proposed model is proved to be integrable. Some of the obtained solutions have been examined graphically to study the dynamical behavior.

Abstract Objectives To explore the long-term efficacy and possible mechanism of endolymphatic sac decompression (ESD) in the treatment of Meniere’s disease(MD) by electrocochleography. Design Prospective cohort study. Setting “Blinded for review” Participants A total of 85 patients with MD who underwent unilateral ESD between June 2015 and November 2019 at“Blinded for review”were enrolled. Main outcome measures The Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), pure tone audiometry, and electrocochleography were used for assessment. The mean follow-up time was 26 months (range: 7–60 months). Results The number of vertigo episodes was significantly reduced following ESD compared to before the surgery (P<0.005), and all patients achieved complete or basic control of vertigo as evidenced by a decrease in DHI score (P<0.005). THI scores of patients with tinnitus were also lower after as compared to before ESD (P<0.005), whereas no significant change in average hearing threshold of the affected side was observed (P>0.05). The cochlear summating potential (SP)/auditory nerve action potential (AP) area ratio in the electrocochleogram of the affected side was negatively correlated with DHI score (rs=−0.159, P=0.0074). Conclusions ESD achieved effective long-term control of vertigo in MD patients and improved the associated tinnitus without any obvious damage to hearing. Electrocochleography was useful for postoperative monitoring; the SP/AP area ratio of the affected side was closely related to the improvement of postoperative vertigo, possibly reflecting greater relief of pressure in the endolymphatic sac. Keypoints •ESD provided long-term control of vertigo in MD patients and improved the accompanying tinnitus without obviously damaging hearing. •ECochG is useful for monitoring the postoperative outcome of ESD. •The SP/AP area ratio of the affected side was closely related to the improvement of postoperative vertigo. •The endolymphatic sac is a “decompression reservoir” of the membranous labyrinth. •ESD may provide space for expansion of the endolymphatic sac and relieve pressure within the membranous labyrinth caused by endolymphatic hydrops, thereby reducing the risk of sac rupture and restoring pressure balance to reduce the sensation of vertigo.

Objective: The aim of this study was to evaluate the audiological performance of the ADHEAR system and to compare it with a softband BAHA system in adults with middle ear disease. Study Design: Prospective, single-subject, repeated-measures study Setting: Monocentric study Participants: In 23 patients with mild to moderate isolated conductive or combined hearing loss (CHL) the ADHEAR system was tested, where 12 of them were outside of the ADHEAR indication. In ten patients, testing was performed with the ADHEAR system and a softband BAHA system. A control group consisted of 10 patients with bilateral artificial occluded ear canal. Main outcome measures: Air and bone conduction thresholds and free-field monosyllable speech intelligibility thresholds in quiet and in noise were measured and evaluated in an unaided situation and aided situation. Furthermore, an ADHEAR questionnaire was assessed. Results: In patients with a middle ear disease compared to the unaided situation, the aided situations with the ADHEAR system and the softband BAHA system led to a significant improvement of speech intelligibility in quiet and in noise. In terms of the ADHEAR questionnaire, using the ADHEAR system patients reported about an improvement in sound localization, sound quality and speech intelligibility. Conclusions: The results show that patients with middle ear disease can benefit from the ADHEAR system, even if their hearing loss is outside of its indication. Outside the indication criteria of the ADHEAR system, it can be an option.

Background: Valve-sparing aortic root replacement such as the re-implantation (David) procedure is becoming increasingly popular. Despite the fact that the procedure is technically more complex, long-term studies demonstrated that excellent clinical outcomes in selected patients with durable repair are achievable. Benefits of minimal access cardiac surgery have stimulated enthusiasm in the use of this approach for valve-sparing aortic root replacement. Methods: We have reviewed available literature on the topic of valve-sparing aortic root replacement (David procedure) via minimally invasive approach through upper hemisternotomy in an attempt to assess current trends and to recognize potential advantages of this technique. Patient selection and preoperative work-up play important role in performing minimally invasive David procedure safely. Surgical technique is similar to the standard David procedure, with several exceptions, and is performed via upper hemisternotomy. Results and Conclusion: Evidence from non-randomized observational and comparative studies demonstrated excellent clinical outcomes of minimally invasive David procedure in selected patients with comparable perioperative mortality to the conventional technique. To date, elective David procedure with a minimal access technique has been performed in low- and intermediate-risk patients. We believe that minimally invasive David procedure could be particularly useful in young patients (Marfan syndrome, bicuspid AV) as it allows faster recovery with improved cosmesis. A decision to perform minimally invasive David procedure should be individualized to each patient and based on the experience of the team. Further large prospective randomized studies with long-term follow-up are still needed to confirm durability of minimal access technique.

Objectives: To evaluate changes in intrinsic atrioventricular (AV) conduction associated with exercise and atrial pacing among heart failure patients with cardiac resynchronization therapy (CRT). Methods: RAVE was a multicenter prospective trial of CRT patients. Heart rate was increased with incremental atrial pacing up to 130 beats/min and with submaximal exercise without atrial pacing. According to maximal heart rate achieved during exercise, patients whose maximal heart rate < 100 bpm or 75% of 85% of age predicted max heart rate were diagnosed with chronotropic incompentence(CI). Others were classified as patients with chronotropic compentence(CC). For CI patients, an additional symptom limited exercise with rate adaptive pacing activated was performed. Intracardiac intervals were measured from the implantable lead electrograms. Results: There were 12 subjects with CI and 24 with CC. With atrial pacing, AV interval immediately increased and gradually increased with incremental atrial pacing in all patients. However, the changes in the atrial to right ventricular (ARV) and atrial to left ventricular (ALV) intervals with increasing atrial pacing rates were about 3-fold greater in CI patients compared to CC patients (28.3±29.5 vs. 10.8±8.9 ms/10 bpm for ARV and 25.5±22.1 vs. 9.9±8.8 ms/10 bpm for ALV in the supine position, p < 0.05). In CI pacing with rate-adaptive pacing during exercise, AV interval changes with paced heart rate were variable. Conclusions: AV response to overdrive atrial pacing at rest may provide a simple means of identifying chronotropic competence in CRT patients. For patients with CI, who often require rate-adaptive atrial pacing, rate-adaptive AV algorithms should be adjusted individually.

Aims The treatment with the wearable cardioverter defibrillator (WCD) may protect against sudden cardiac death (SCD) as a bridging therapy until a cardioverter-defibrillator may be implanted. We analyzed in a multicenter setting a consecutive patient cohort wearing WCD to explore gender differences. Methods and results We analyzed 708 consecutive patients, 579 from whom were males and 129 females (age, 60.5±14 vs. 61.6±17 years old; p=0.44). All patients were divided into age quartiles for analysis. While the rate of ischemic cardiomyopathy (ICM) as a cause of prescription of WCD was significantly higher in males as compared to females (42.7% vs. 26.4%; p=0.001), females received it more frequently due to non-ischemic cardiomyopathy (NICM) (55.8% vs. 42.7%); p=0.009). The wear time of WCD was equivalent in both groups (21.1±4.3 hours/days in males vs. 21.5±4.4 hours/days in females; p=0.27; and 62.6±44.3 days in males vs. 56.5±39 days in females; p=0.15). Mortality was comparable in both groups at 2-year-follow-up (6.8% in males vs. 9.7% in females; p=0.55). Appropriate WCD shocks and the incidence of device implantations were similar in both groups (2.4% in males vs. 3.9% in females; p=0.07) (35.1% in males vs. 31.8% in females; p=0.37), respectively. In age quartile analysis, compliance was observed more in older patients as compared to adult patients (87.8% vs. 68.3%; p<0.001). Conclusion Compliance for wearing WCD was excellent regardless of gender. Furthermore, mortality and the incidence of device implantations were comparable in both groups. Appropriate WCD shocks tended to be higher in females as compared to males.

Background: Atelectasis and attic retraction pocket are two common tympanic membranes changes. However, general practitioners, pediatricians and otolaryngologists showed low diagnostic accuracy for these ear diseases. Therefore, there is a need to develop a deep learning model to detect atelectasis and attic retraction pocket automatically. Method: 6393 OME otoscopic images from 3 centers were used to develop and validate a deep learning model to detect atelectasis and attic retraction pocket. 3-fold random cross validation was adopted to divided dataset into training set and validation set. A team of otologists were assigned to diagnose and label. Receiver operating characteristic (ROC) curve, 3-fold average classification accuracy, sensitivity and specificity were used to assess the performance of deep learning model. Class Activation Mapping (CAM) was applied to show the discriminative region in the otoscopic images. Result: Among all the otoscopic images, 3564 (55.74%) images were identified with attic retraction pocket, and 2460 (38.48%) images were identified with atelectasis. The automatically diagnostic model of attic retraction pocket and atelectasis achieved 3-fold cross validation accuracy of 89% and 79%, AUC of 0.89 and 0.87, sensitivity of 0.93 and 0.71, and specificity of 0.62 and 0.84 respectively. Bigger and deeper atelectasis and attic retraction pocket showed more weight with red color in the heat map of CAM. Conclusion: Deep learning algorithm could be used to identify atelectasis and attic retraction pocket, which could be used as a tool to assist general practitioners, pediatricians and otolaryngologists. Key words: deep learning, otoscopic images, atelectasis, attic retraction pocket

As an essential regulator of photosynthesis and hormone signaling, light plays a critical role in leaf senescence and yield gain in crops. Previously, numerous studies have shown that the narrow-wide-row planting pattern, especially under intercropping systems, is more beneficial for crops to enhance light interception, energy conversion, and yield improvement. However, the narrow-wide-row planting pattern inevitably leads to a heterogeneous light environment for crops (i. e., maize in maize-based intercropping systems) on both sides of the plant. The mechanism by which it affects leaf senescence and yield of maize under a narrow-wide-row planting pattern is still unclear. Therefore, in this study, we compared the leaf senescence and yield formation process of maize under homogeneous (normal light, NL and full shade, FS) and heterogeneous (partial light, PL) light conditions. Results revealed that partial light treatment influenced the homeostasis of growth and senescence hormones by regulating the expression of ZmPHYA and ZmPIF5. Compared to normal light and full shade treatments, partial light delayed leaf senescence by 3.6 and 5.9 days with 2.2 and 3.3 more green leaves and 1.1 and 1.4 fold nitrogen uptake, respectively. Partial light reduced oxidative stress by enhancing antioxidant enzyme activities of PS (shade side of partial light) leaves, which improved photosynthetic assimilation, balanced sucrose, and starch ultimately maintaining the similar maize yield to NL. Overall, these results are important for understanding the mechanism of leaf senescence in maize, especially under heterogeneous light environments, which maize experienced in maize-based intercropping systems. Furthermore, these findings are providing proof of getting a high yield of maize with less land in intercropping systems. Thus, we can conclude that maize-based intercropping systems can be used for obtaining high maize yields maintained under the current climate change scenario.

Introduction and aim of the study: Long QT syndrome is a life threatening genetic arrhythmia syndrome which is characterized by ventricular arrhythmias with few children often having their initial clinical presentation as sudden cardiac arrest. This condition poses a very high risk of sudden death demanding proper management of such children. Many treatment modalities are available in this era, with each one of them carrying advantages and disadvantages. Materials and methods: We present a series of four children suffering from Long QT syndrome, who were successfully managed with left cardiac sympathetic denervation (LCSD) combined with device implantation (permanent pacemaker implantation in two children and implantable loop recorder in one child). Results: All four children are asymptomatic since hospital discharge with no episodes of syncope or presyncope, or device-detected ventricular tachyarrhythmia till to-date. Conclusion: Left cardiac sympathetic denervation is an underutilized simple surgical procedure, for Long QT syndrome. When combined with other treatment strategies (like device implantation in our case series), outcome is far better than a single technique. Beta-blockers play a very important role both in pre-operative and immediate post-operative period and have to be continued for the rest of life.

The aim of this article is to investigate the well-posedness and stability problems of the so-called Kawahara equation under the presence of an interior delayed damping. The system is shown to be well-posed. Furthermore, we prove that the trivial solution is exponentially stable in spite of the delay effect. Specifically, local and semi-global stability results are established according to the properties of the spatial distribution of the delay term.

The Ocean covers two-third of our planet and has great biological heterogeneity. Marine organisms like algae, vertebrates, invertebrates, and microbes are known to provide many natural products with biological activities as well potent sources of biomaterials for therapeutic, biomedical, biosensors, and climate stabilization. Over the years, the field of biosensors have gained huge attention due to their extraordinary ability in providing early diseases diagnosis and treatment as well as environmental pollutants. This review focuses on various biomaterials (Carbohydrtae polymers, proteins, polyacids etc) of marine origin such as Alginate, Chitin, Chitosan, Fucoidan, Carrageenan, Chondroitin Sulfate (CS), Hyaluronic acid (HA), Collagen, marine pigments, marine nanoparticles, Hydroxyapatite (HAp), Biosilica, lectins, and marine whole cell. Further, it mentions the source of such marine biomaterials and their promising evolution for the development of biosensors that are potent to be employed in the biomedical, environmental science and agricultural sciences domains.

In this paper, we studied the existence and uniqueness result of solutions for boundary value problems for Hilfer-Hadamard type fractional differential inclusions with multi-point boundary conditions, in the first approach we deal with a non-convex valued right hand side and in the second approach we consider the Carath\’eodory case. Finally the compactness of solution sets is also obtained.

The biodiversity in mountainous ecosystems is high but is threatened by rapid environmental change. Urbanization and other anthropogenic factors in the mountains surrounding cities can affect land use and spatial fragmentation. Moreover, patterns of habitat are closely related to elevation and have a major effect on montane biodiversity. The aim of this study was to analyze the effects of spatial fragmentation on the vertical distribution pattern of bird diversity by characterizing the structure of the bird community, species diversity, and landscape factors at different altitudes. From 2016 to 2019, this study made a four-years continuous monitoring of the breeding biric belts. The result indicated Mount Tai harbored a high bird diversity. Bird richness, abundance and Shannon-Wiener index decreased with latitude in Mount Tai. Moreover, the composition of bird communities varied along altitudinal gradients and supported some special species in different elevational bands. Road density, number of habitat patches, patch density, and the percentage of forest significantly affected bird diversity. The effect of patch density was higher compared with other landscape factors. Sufficient habitat and more patches in the low-mountain belt supported higher bird diversity. The middle-mountain belt and high-mountain belt showed contrasting patterns. Our results highlight the effects of ongoing urbanization and human activities on montane biodiversity and emphasize the need for artificial habitats in the mountains surrounding cities to be managed.

Coral reef ecosystems have been rapidly altered by anthropogenic warming, posing significant threats to marine biodiversity. However, alterations of the benthic configurations of coral reefs under global warming likely vary through space given local-scale variation in environmental conditions and ecosystem processes. Here, we examine the responses of coral reef benthic configurations under global warming in two independent coral reef ecosystems from Honduras and Indonesia. Using Monte Carlo Markov Chain Generalised Linear Mixed models, our findings reveal that at the Honduras sites, global warming significantly drove reductions in sand, sponge and coral rubble coverage, while bare rock coverage increased. Conversely, the Indonesia sites only showed increases in sponge coverage and decreases in rock coverage associated with water warming. These strong disparities seem to have been driven by global warming only at the Honduras sites, but not at the Indonesia sites. This suggests that the Indonesia sites of the Wakatobi National Park (WNP) may be resistant to compositional changes under global warming. We suspect the resistance to compositional change at the WNP is driven by disparate ecosystem processes between the Honduras and Indonesia sites which enhances resilience to disturbance, such as water warming. Furthermore, there is potential indication that abiotic processes comparatively shelter coral reefs of the WNP from rising temperatures, however, this facet would need further exploration. Given the resistance to compositional change of coral reefs within the WNP, this region could potentially harbour critical biodiversity as global warming continues to decimate coral reefs throughout the tropics.

Marine microbial ecosystems underpin global biogeochemical cycles and play a central role in the regulation of Earth's climate. These communities are extremely diverse, and their taxonomic composition varies considerably across ocean basins. It has however been difficult to establish links between taxonomic diversity and ecosystem function, and the ecological and evolutionary mechanisms underpinning taxonomic variation are not well understood. Here we use an individual-based eco-evolutionary model in which taxonomic diversity emerges as a consequence of evolutionary history. Using this model we are able to show that virtually unlimited genetic divergence can be supported in highly abundant and rapidly evolving assemblages, even in the absence of niche separation. With a steady stream of genetic, epigenetic and plastic heritable changes to phenotype, competitive exclusion may be weakened, allowing sustained coexistence of nearly neutral phenotypes with highly divergent lineages. This response may help to explain observed patterns of taxonomic diversity and functional redundancy - without recourse to hidden dimensions of niche partitioning. In light of these results we suggest that individual-level variability is a key driver of species coexistence and the maintenance of microbial biodiversity.

A document by Xueqin Peng, written on Authorea.

Understanding the traits mediating species' responses to climate change is a cornerstone for predicting future community composition and ecosystem function. Although species' eco-physiological properties determine their response to environmental change, most trait-based studies focus on a small subset of easily-measured morphological traits as proxies for physiology. This choice may limit our ability to predict the impacts of climate change on species' demography, and obscure the underlying mechanisms. We conducted a transplantation experiment along a 1000 m Alpine elevation gradient to quantify the degree to which plant demographic responses to climate were predicted by eco-physiological performance versus common morphological traits. Although physiological measurements revealed that warming favored species with a conservative water use strategy, the predictive power of physiological traits did not exceed that of morphological traits. Our results show that while easily-measured morphological traits can successfully predict demographic responses to climate, eco-physiological approaches are needed to understand mechanism.

Background: Transcatheter Aortic Valve Replacements (TAVR) has become widespread throughout the world. To date there are no echocardiographic study of TAVR patients from Southeast Asia (SEA). We sought to evaluate 1) changes in echocardiographic and strain values pre and post TAVR 2) relationship between aortic stenosis (AS) severity and strain values, 3) left ventricle geometry in severe AS 4) relationship of flow rate to dimensionless index (DVI) and acceleration time (AT) and 5) effect of strains on outcome. Methods: Retrospective study of 112 TAVR patients in our center from 2009 to 2020. The echocardiographic and strain images pre (within 1 months), post (day after) and 6 months post TAVR were analyzed by expert echocardiographer. Results: The ejection fraction (EF) increased at 6 months (53.02 ± 12.12% to 56.35 ± 9.00%) (p=0.044). Interventricular septal thickness in diastole (IVSd) decreased (1.27 ± 0.21cm to 1.21 ± 0.23cm) (p=0.038) and left ventricle internal dimension in diastole (LVIDd) decreased from 4.77 ± 0.64cm to 4.49 ± 0.65cm (p = 0.001). No changes in stroke volume index (SVI pre vs 6 months p =0.187), but the flow rate increases (217.80 ± 57.61mls/s to 251.94 ± 69.59mls/s, p<0.001). Global Longitudinal Strain (GLS) improved from -11.44 ± 4.23% to -13.94 ± 3.72% (p <0.001), Left Atrial Reservoir strain (Lar-S) increased from 17.44 ± 9.16% to 19.60 ± 8.77% (p=0.033). 8 patients (7.5%) had IVSd < 1.0cm, and 4 patients (3.7%) had normal left ventricle (LV) geometry. There was linear relationship between IVSd and mean PG (r=0.208, p=0.031), between GLS to aortic valve area (AVA) and aortic valve area index (AVAi) (r = – 0.305, p=0.001 and r= – 0.316, p = 0.001). There was also relationship between AT (r=-0.20, p=0.04) and DVI (r=0.35, p< 0.001) with flow rate. Patients who died late (after 6 months) had lower GLS at 6 months. (Alive; -13.94 ± 3.72% vs Died; -12.43 ± 4.19%, p= 0.001) Conclusion: At 6 months TAVR cause reverse remodeling of the LV with reduction in IVSd, LVIDd and improvement in GLS and LAr-S. There is linear relationship between GLS and AVA and between IVSd and AVA.

Objective: There is a need for the immunogenicity of different boosters after widely used inactivated vaccine regimens. We aimed to determine the effects of BNT162b2 and CoronaVac boosters on the humoral and cellular immunity of individuals who had two doses of CoronaVac vaccination. Methods: The study was conducted in three centers (Koc University Hospital, Istanbul University Cerrahpasa Hospital, and Istanbul University, Istanbul Medical School Hospital) in Istanbul. Individuals who had two doses of CoronaVac and no history of COVID-19 were included. The baseline blood samples were collected three to five months after two doses of CoronaVac. Follow-up samples were taken one and three months after third doses of CoronaVac or one dose of mRNA BNT162b2 boosters. Neutralizing antibody titers were detected by plaque reduction assay. T cell responses were evaluated by Elispot assay and flow cytometry. Results: We found a 3.38-fold increase in neutralizing antibody titers (Geometric Mean Titer [GMT], 78.69) one month after BNT162b2 booster and maintained at the three months (GMT, 80). However, in the CoronaVac group, significantly lower GMTs than BNT162b2 after 1 month and 3 months (21.44 and 28.44, respectively) indicated the weak immunogenicity of the CoronaVac booster (p<0.001). In the ELISpot assay, IL-2 levels after BNT162b2 were higher than baseline and CoronaVac booster (p<0.001) and IFN-γ levels were significantly higher than baseline (P<0.001). The CD8+CD38+CD69+ and CD4+CD38+CD69+ T cells were stimulated significantly at the 3 rd month of the BNT162b2 boosters. Conclusion: The neutralizing antibody levels after three months of the BNT162b2 booster were higher than the antibody levels after CoronaVac. On the other hand, specific T cells might contribute to immune protection. By considering the waning immunity, we suggest a new booster dose with BNT162b2 for the countries that already have two doses of primary CoronaVac regimens.

Introduction: The surface EKG of typical atrioventricular nodal reentrant tachycardia (AVNRT) shows simultaneous ventricular-atrial (RP) activation with pseudo R’ in V1 and typical heart rates ranging from 150-220/min. Slower rates are suspicious for junctional tachycardia (JT). However, occasionally we encounter typical AVNRT with slow ventricular rates. We describe a series of typical AVNRT cases with heart rates under 110/min. Methods: A total of 1972 patients with AVNRT who underwent slow pathway ablation were analyzed. Typical AVNRT was diagnosed when; 1) evidence of dual atrioventricular nodal conduction, 2) tachycardia initiation by atrial drive train with A-H-A response, 3) septal ventriculoatrial (VA) time < 70 ms, and 4) ventricular-atrial-ventricular (V-A-V) response to ventricular overdrive (VOD) pacing with post pacing interval-tachycardia cycle length (PPI-TCL) > 115ms. JT was excluded by either termination or advancement of tachycardia by atrial extrastimuli (AES) or atrial overdrive (AOD) pacing. Results: We found 11 patients (Age 20-78 years old, 6 female) who met the above-mentioned criteria. The TCL ranged from 560ms to 782ms. Except for one patient showing tachycardia termination, all patients demonstrated a V-A-V response and PPI-TCL over 115ms with VOD. AES or AOD pacing successfully excluded JT by either advancing the tachycardia in 10 patients or by tachycardia termination in one patient. Slow pathway was successfully ablated, and tachycardia was not inducible in all patients. Conclusions: This case series describes patients with typical AVNRT with slow ventricular rate (less than 110/min) who may mimic JT. We emphasize the importance of using pacing maneuvers to exclude JT.

Aim: In our study we examined whether anthropometric and body composition parameters, i.e. body surface area (BSA), lean body mass (LBM) and total body weight (TBW), are correlated with docetaxel clearance and exposure. In addition, LBM, TBW and a fixed dose were compared to BSA as dosing parameters for dose individualisation of docetaxel. Methods: Thirty-six patients affected by breast or castration-resistant prostate carcinoma receiving docetaxel chemotherapy entered the study. LBM was measured by a Dual Energy Xray Absorptiometry (DEXA) scanner before treatment. Blood samples were collected up to 180 minutes after dosing to analyse docetaxel concentrations and to determine individual pharmacokinetic (PK) parameters. Results: No significant correlations were found between the docetaxel pharmacokinetic parameters clearance and volume of distribution and the anthropometric and body composition variables BSA, LBM and TBW. AUC was significantly but poorly correlated with BSA (r=0.452 [p=0.016]) and with TBW (r=0.476 (p=0.011]). The Mean Absolute Percentage Error and Mean Error of simulated dosing based on LBM and fixed dosing ME were not significant different compared to BSA. For TBW, only the MAPE of dosing was significant higher compared to BSA (24.1 vs. 17.1, P=0.001). Conclusion: There is no correlations between docetaxel pharmacokinetics and the anthropometric and body composition variables BSA, LBM and TBW. Dose individualisation of docetaxel based on LBM or TBW or fixed dosing cannot be recommended over BSA based dosing.