The concept of depth of an almost strictly sign regular matrix is introduced and used to simplify some algorithmic characterizations of these matrices.

The purpose of this article is to introduce an application to draw the asymptotes of Bode diagram module and phase from each constituent elementary factors of any transfer function for minimum and non-minimal phase systems without transport delay. The Bode diagram is the most used tool in the frequency response method. Python was used to program the application to perform the operations as well as the Qt5 Design for the simple graphical interface for the application and all this in the Linux operating system. The application purpose is to assist students in learning the concept and drawing of Bode diagram. For students the non-minimum phase system Bode diagram is more difficult to draw than a minimum phase system due to the presence of zeros and/or poles on right half of s-plane. The phase asymptotes of a quadratic factor was closest to the real phase curve around the corresponding undamped natural frequency and this can be observed in the example showed in this article. This example must be used as a help and not a simply to solve a problem.

Alveolar bone grafting is a complex procedure utilized in alveolar cleft repair, however, the ideal site of bone graft material remains highly debated. In this paper, we describe the management of a 14 year old female with bilateral alveolar clefts using alternative intra-oral donor sites for bone graft harvest.

Cemento-Osseous dysplasia(COD) is a condition where normal bone is replaced by fibrous connective tissue and cementum-like deposits. Implant rehabilitation of a posterior mandibular edentulism in presence of a COD can be a challenging situation due to the lack of vascularization and the high risk of infection of such lesions.

A cutaneous sinus tract of dental origin may easily be misdiagnosed and incorrectly treated. This paper reported a case of a 20-years-old male patient referred for a productive cutaneous sinus tract misdiagnosed by medical doctors for more than 4 years. The clinical and radiographic examinations confirmed the odontogenic origin

Riparian vegetation provides many noteworthy functions in river and floodplain systems including its influence on hydrodynamic processes. Traditional methods for predicting hydrodynamic characteristics in the presence of vegetation involve the application of static roughness ( ns) values, which neglect changes in roughness due to local flow characteristics. The objectives of this study were to: (1) implement numerical routines for simulating dynamic hydraulic roughness ( nd) in a two-dimensional (2D) hydrodynamic model; (2) evaluate the performance of two dynamic roughness approaches; and (3) compare vegetation parameters and hydrodynamic model results based on field-based and remote sensing acquisition methods. A coupled vegetation-hydraulic solver was developed for a 2D hydraulics model using two dynamic approaches, which required vegetation parameters to calculate spatially distributed, dynamic roughness coefficients. Vegetation parameters were determined by field survey and using airborne LiDAR data. Water surface elevations modeled using conventional and the proposed dynamic approaches produced similar profiles. The method demonstrates the suitability in modeling the system where there is no calibration data. Substantial spatial variations in both n and hydraulic parameters were observed when comparing the static and dynamic approaches. Thus, the method proposed here is beneficial for describing the hydraulic conditions for the area having huge variation of vegetation. The proposed methods have the potential to improve our ability to simulate the spatial and temporal heterogeneity of vegetated floodplain surfaces with an approach that is more physically-based and reproducible than conventional “look up” approaches. However, additional research is needed to quantify model performance with respect to spatially distributed flow properties and parameterization of vegetation characteristics.

Objective: Identify the proportion of infants reclassified if sex-specific birthweight charts were used, and if this reclassification has an impact on the correlation between birthweight centile and adverse perinatal outcome. Design: Retrospective cohort study Setting: Victoria, Australia. Population: All infants born from 2005-2015 (529,261) Methods: We applied GROW centiles, either adjusted or unadjusted for fetal sex. We compared proportions of small for gestational age (SGA, <10th centile) infants, then the populations of males considered small only by sex-specific charts and females considered small only by unadjusted charts. Main Outcome Measures: Stillbirth, combined perinatal mortality, NICU admissions, Apgars <7 at 5 minutes, emergency caesarean sections. Results: Of those <10th centile by unadjusted charts, 39.6% were male, and 60.5% female. Using sex-specific charts, 50.3% <10th centile were male and 49.7% female. 9,449 (19.2%) females that were SGA according to unadjusted charts were appropriate for gestational age (AGA,>10th-<90th centile) using sex-specific charts. These reclassified newborn females were not at increased risk of adverse outcomes compared with an AGA infant, but were at increased risk of being iatrogenically delivered for suspected growth restriction (RR 4.90, 95%CI 4.39–5.48). 8,048 male infants were reclassified as SGA by sex-specific charts (25% SGA increase). Compared with AGA infants, these reclassified male newborns were at greater risk of stillbirth (RR 1.94, 95%CI 1.30-2.90) and all other adverse perinatal outcomes. Conclusions: Sex-specific growth standards classify a new high-risk cohort of male infants as SGA, and exclude a cohort of females, whose risk is no greater than appropriately grown infants.

Revegetation projects seeking to restore degraded ecosystems face a major challenge in sourcing appropriate plant material, as identifying plants adapted to future climates requires knowledge of plant performance under novel conditions. In order to support climate-resilient provenancing efforts, we develop a quantitative trait model that integrates genetic and microenvironmental variation. We train our model with multiple natural plantings of Arabidopsis thaliana and predict days-to-bolting and fecundity across the species' European range. Model prediction accuracy was high for days-to-bolting and moderate for fecundity, with the majority of trait variation being explained by temperature variation. Concerningly, fecundity was predicted to decline under future conditions, although this response was heterogeneous across regions, and could be offset through the introduction of specific genotypes. Our study highlights the value of predictive models to aid seed provenancing and improve the success of revegetation projects.

Cardiac angiofibroma is a very rare diagnosis when a patient develops an intracardiac mass. It is a primary benign cardiac tumor with a scarcity of information in the literature.  This case report illustrates a 26-year-old man with a complaint of chronic chest tightness who was firstly diagnosed with right ventricle tumor by echocardiography then underwent cardiac MRI which confirmed the presence of a highly-vascular tumor with radiologically benign behavior. Then his tumor was excised, his postoperative course was uncomplicated and he was well within almost 2 months after discharge. Ultimately the histopathologic findings demonstrated vascular and stromal tissue in favor of angiofibroma and excluded the other diagnoses with IHC and trichrome staining.  Angiofibroma is a benign, highly vascular tumor, mostly discovered in the nasopharynx. When it is found in the heart, CMR and pathology are pivotal to rule in its diagnosis. It is isointense in T1 weighted and hyperintense in T2 weighted sequences with intense enhancement following contrast injection. Its pathology contains an admixture of vasculatures with CD31 positive immunoreactivity for endothelial cells and fibrotic tissue with bluish coloration in trichrome staining. Eventually, its treatment includes merely surgical excision given its benign nature.

Alternative splicing is a molecular mechanism that enables a single gene to encode multiple transcripts and proteins by post-transcriptional modification of pre-RNA molecules. Changes in the splicing scheme of genes can lead to modifications of the transcriptome and the proteome. This mechanism can enable organisms to respond to environmental fluctuations. In this study, we investigated patterns of alternative splicing in the liver of the coral reef fish Acanthochromis polyacanthus in response to the 2016 marine heatwave on the Great Barrier Reef. The differentially spliced (DS; n=40) genes during the onset of the heatwave (i.e. 29.49°C or +1°C from average) were related to essential cellular functions such as the MAPK signaling system, Ca(2+) binding and homeostasis. With the persistence of the heatwave for a period of one month (February to March), 21 DS genes were detected, suggesting that acute warming during the onset of the heatwave is more influential on alternative splicing than the continued exposure to elevated temperatures. After the heatwave, the water temperature cooled to ~24.96°C, and fish showed differential splicing of genes related to cyto-protection and post-damage recovery (n=26). Two-thirds of the DS genes detected across the heatwave were also differentially expressed, revealing that the two molecular mechanisms act together in A. polyacanthus to cope with the acute thermal change. This study exemplifies how splicing patterns of a coral reef fish can be modified by marine heatwaves. Alternative splicing could therefore be a potential mechanism to adjust cellular physiological states under thermal stress and aid coral reef fishes in their response to more frequent acute thermal fluctuations in upcoming decades.

Introduction: Echocardiography plays an important role in the diagnosis of heart disease. However, sometimes misdiagnosis information is also provided. Methods and Results: We report a rare case of preoperative echocardiography misdiagnosed as a primary mitral valvular tumor with severe regurgitation. During the surgery procedure, the true lesion was found to be mitral valve leaflet prolapse due to degenerative mitral valve disease. Conclusions: For individual patient, it may need to combine clinical symptoms and wide use of echocardiography and CT or MRI to make the optimal clinical decision.

Augmentation genioplasty is a common surgical procedure with extremely low infection rates. We present the case of a healthy middle-aged woman who experienced years of chronic infection after chin implantation due to a fractured mandibular canine root, which is exceedingly rare. Awareness of this potential complication will reduce patient morbidity.

In this paper, we treat an application of a optimal control problem to the stochastic dynamic system in epidemic. We consider a HIV/AIDS stochastic dynamic model with anti retro viral (ARV)-therapy. This model is formulated and is analyzed previously in [11]. Our objective is to minimize the newly infection cases. ARV-therapy is a curative measure of HIV/AIDS patients. It presents until there the therapeutic effect efficient, even in the cases of resistances. This treatment measure associated to the preventive measures as HIV-Testing and Counseling (HTC), i.e. test technology and education, sensitization campaign on change sexual behavior among people that run the risk, especially, the strategy of quick-alert by Short Message Service (SMS) to patients by the care service, for to ensure that these take their treatment effectively, are again the optimal strategies of the control that permits to reduce the new cases of infection. Thus, we introduce three additional variables in a stochastic dynamic proposed in [11] to act on the proportions of HIV/AIDS patients under ARV by the optimal strategies for the purpose to reduce the prevalence and the incidence. A minimization problem of newly infection cases of HIV/AIDS is formulated and solved analytically and numerically via Bellman’s principle. The numerical results of this controlled dynamics are also described.

1) As temperatures rise across the globe, many species may approach or even surpass their physiological tolerance to withstand high temperatures. Thermal performance curves, which depict how vital rates vary with temperature, are often measured under ideal laboratory conditions and then used to determine the physiological or demographic limits of persistence. However, this approach fails to consider how interactions with other factors (e.g. resources, water availability) may buffer or magnify the effect of temperature change. Recent work has demonstrated that the breadth and shape of a consumer’s thermal performance curve change with resource densities, highlighting the potential for temperature interactions and leading to a potential ‘metabolic meltdown’ when resources decline during warming (Huey and Kingsolver 2019). 2) Here, we further develop the basis for the interaction between temperature and resource density on thermal performance, persistence, and population dynamics by analyzing consumer-resource dynamic models. We find that the coupling of consumer and resource dynamics relaxes the potential for metabolic meltdown because a reduction in top-down control of resources occurs as consumers approach the limits of their thermal niche. However, when both consumers and resources have vital rates that depend on temperature, asymmetry between their responses can generate the necessary conditions for metabolic meltdown. 3) Moreover, we define the concept of a ‘realized’ thermal performance curve that takes into account the dynamic interaction between consumers, resources and temperature, and we describe an important role for this concept moving forward. 4) Synthesis. A better understanding of the link between temperature change, species interactions, and persistence allows us to improve forecasts of community response to climate change. Our work elucidates the importance of thermal asymmetries between interacting species, and resource limitation as a key ingredient underlying realized thermal niches.

Rabies is a fatal zoonotic disease that can affect all mammals. Following the directives of the rabies ordinance of the Government of Hong Kong, all wild macaques captured under an ongoing sterilization program (since 2000) were vaccinated against rabies. The main objective of this study was to assess the serological response to rabies vaccination in the population of Hong Kong macaques. An inactivated rabies vaccine was subcutaneously administered to captured macaques under anesthesia. In a 2015 field survey, blood samples from the animals were collected and stored in -80℃ freezer. In July 2021, all frozen sera from vaccinated animals were prepared and tested for antibodies against rabies virus using a commercial enzyme-linked immunosorbent assay (ELISA) test. The test results were dichotomized at the recommended cut-off point of the test kit. Sixty-five samples from the vaccinated macaques were available for this study. All of these animals had received at least one dose of vaccine (1 st vaccination) between 2008 and 2015. The interval between the 1 st vaccination and blood sampling dates ranged from 21 to 2,779 days. Only five of the 65 macaques had a second vaccination record at the time of sampling; all five had high antibody levels. Among the remaining macaques, 77% (46/60) were positive for rabies antibodies. No specific association was observed between the post-vaccination period and the antibody titer of these macaques and no adverse reactions to vaccination were reported. The current vaccination strategy in Hong Kong macaques appears to effectively elicit rabies antibodies in a high proportion of macaque populations in the wild (78-87%). However, reaching the precise level of protection against a potential challenge with the virus should further be investigated.

Hereditary hemorrhagic telangiectasia (HHT) is a rare disorder affecting skin and body’s internal organs with tendency for bleeding. We reports a case of Sudanese 42-year-old with family history of HHT presented with recurrent epistaxis and telangiectasias

AIM: To explore the level of agreement on drug-drug interaction (DDI) information listed in three major online drug information resources (DIRs) in terms of: (1) interacting drug pairs; (2) severity rating; (3) evidence rating and (4) clinical management recommendations. METHODS: We extracted DDI information from the British National Formulary (BNF), Thesaurus, and Micromedex. Following drug name normalisation, we estimated the overlap of the DIRs. We annotated clinical management recommendations either manually, where possible, or through application of a machine learning algorithm. RESULTS: The DIRs contained 51,481 (BNF), 38,037 (Thesaurus), and 65,446 (Micromedex) drug pairs involved in DDIs. The number of common DDIs across the three DIRs was 6,970 (13.54% of BNF, 18.32% of Thesaurus, and 10.65% of Micromedex). Micromedex and Thesaurus overall showed higher levels of similarity in their severity ratings, while the BNF agreed more with Micromedex on the critical severity ratings and with Thesaurus on the least significant ones. Evidence rating agreement between BNF and Micromedex was generally poor. Variation in clinical management recommendations was also identified, with some categories (i.e. Monitor and Adjust dose) showing higher levels of agreement compared to others (i.e. Use with caution, Wash-out, Modify administration). CONCLUSIONS: There is considerable variation in the DDIs included in the examined DIRs, together with variability in categorisation of severity and clinical advice given. DDIs labelled as critical are more likely to appear in multiple DIRs. Such variability in information could have deleterious consequences for patient safety, and there is a need for harmonisation and standardisation.

This work proposes a new strategy for the scaling of bubbling fluidized bed reactors. This strategy is based on the bubble size distribution, bubble coalescence phenomenon, and the chemical reactivity, allowing to deduct the dimensionless number Chejne-Macias-Maya that must remain constant at different scales to guarantee the fluidization regime. The proposed strategy is validated from computational simulations carried out at different operating conditions. Additionally, limits for the validity of this scaling strategy were determined, which agrees with those reported in the literature.

ABSTRACT Aims: This study aimed to develop a PBPK model for tacrolimus incorporating CYP3A5 and CYP2C19 polymorphisms to predict the DDIs between tacrolimus and voriconazole. Methods: Pharmacokinetic (PK) data in rats and healthy subjects receiving tacrolimus with and without voriconazole were used for model development and evaluation. Then, we used the final model to simultaneously investigate the effect of CYP3A5 and CYP2C19 polymorphisms on the PK data of tacrolimus when combined with voriconazole. Results: The final results showed that the predicted Cmax in CYP3A5 nonexpressers was 1.5-fold higher than expressers, and the predicted AUC0-∞ was 1.92 to 1.96-fold higher in nonexpressers. However, the Cmax and AUC0-∞ of tacrolimus both have no significant difference between different CYP2C19 metabolizers. Conclusions: A physiologically-based pharmacokinetic (PBPK) model for tacrolimus integrated with CYP3A5 and CYP2C19 polymorphisms was successfully established, providing more insights regarding the DDIs between tacrolimus and voriconazole in patients with different CYP3A5 and CYP2C19 genotypes. Furthermore, this study highlights the feasibility of PBPK modeling to predict DDIs between these two drugs and the need to include CYP3A5 polymorphisms but not CYP2C19 polymorphisms.

Rapid-onset hyponatremia as well as rhabdomyolysis are rare, but potential, complications of olanzapine treatment. We report a case of sudden-onset hyponatremia associated to a sever rhabdomyolysis resulting in a coma necessitating intensive care unit admission. His evolution was favorable after correction of all his metabolic disorders and Olanzapine suspension.

Although Mobitz type II atrioventricular block is an arrhythmia based on a permanent organic disorder of the His-Purkinje system, reversible factors should be considered. Here, we report the association between a rare reversible Mobitz type II atrioventricular block and antipsychotic medication in a 75-year-old patient with schizophrenia.

A 27-year-old female presenting palpitation without ECG documentation underwent electrophysiology study. EP study revealed atrioventricular accessory pathway with poor and unidirectional pathway conduction, and a fasciculoventricular pathway. During isoproterenol infusion, delta wave promptly became prominent, after which an antidromic AV reentrant tachycardia was induced. When the pathway was mapped, widely split double pathway potentials were observed at 12 o'clock site of tricuspid annulus during mild preexcitation, demonstrating an example of intra-pathway conduction delay, which can be reversed by isoproterenol. Ablation at the site caused accelerated pathway rhythm and eliminated the pathway, rendering the tachycardia non-inducible.

We proved the existence and uniqueness of comporessible subsonic impinging jet flow in the work \cite{WX}. As a continuation, in this paper, we investigate the shape of free boundary to the impinging jet flow established in \cite{WX}. More specifically, if the nozzle wall is concave to the fluid, then the free boundary of flow will be convex to the fluid. On another hand, the higher regularity of free boundary at separation point is obtained, provided that the nozzle satisfies corresponding hypotheses.

A sound ecological security network (ESN) promotes the interconnection of ecological sources, improves the pattern of ecological security, and alleviates the degradation of an ecosystem. Rapid urbanization and land use changes may lead to serious fragmentation and islanding of landscape patches and further to deep disturbance of regional ESNs. However, most studies in the recent years focused on the methodological development of ESN identification, reconstruction, and optimization, but lacked the systematic assessment of the network after its construction. The purpose of this study is to use complex network analysis to systematically assess the constructed ESN for the urban agglomeration around Hangzhou (UAHB), a rapid urbanization region in China. By integrating landscape ecology theory, graph theory, and complex network analysis, we abstracted the ESN into a topological network and developed an index system to assess the abstracted network, which was based on the structural elements of the topological network (nodes, edges, and the overall network). Our results show that the connectivity and stability of the UAHB’s ESN have been improved in the last 20 years, although isolated nodes are still existing in the ESN. Our study also shows that the network’s robustness under human disturbance has been affected more than that under non-human disturbance. Finally, we proposed five optimization strategies from the perspective of topological structure and ecological function to maintain a sustainable and well-protected ecological system.