We report a case of 22 years old male who presented with headache,bodyaches,cough,fever,vomiting,and diarrhea for short duration. investigations showed features of hypogonadism due to pituitary macroadenoma.He had long history of recurrent attacks of anemia and diarrhea, his anemia was due to MAHA. serial endoscopies and colonoscopies showed features of IBD.

Based on complex conformal mapping and Duhamel’s integral method the steady and transient dynamic stress distribution around an elliptical cavity subjected to plane P-wave was obtained. The influence of incident angle(θ0), axial ratio(k) and normalized wave length (t0) on the dynamic stress concentration factor (DSCF) was evaluated. Further, the finite element method (FEM) software LS-DYNA was utilized to validate the analytical solution. The results indicated that the maximum compression DSCF increased with θ0, except θ0=0, and decreased with k. When θ0=0 the maximum tensile DSCF increase with the decrease of k. The position of maximum compression and tensile DSCF varied with incident θ0. Under the transient incident condition DSCF was affected by normalized wave length t0, with the increasing of t0 the DSCF gone up then down finally gone closed to the static stress concentration factor. Further, the stress state around the elliptical cavity under transient impact loading was compared with the experimental results of elastic stress distribution and plastic failure and got a good agreement, and possible dynamic failure modes of elliptical cavity were discussed.

With the improvement of surface passivation, bulk recombination is becoming an indispensable and decisive factor to assess the limiting efficiency ( η lim ) of crystalline silicon (c-Si) solar cells. In simultaneous consideration of surface and bulk recombination, a modified model of η lim   evaluation is developed. Surface recombination is directly depicted with contact selectivity while bulk recombination is revised on the aspects of ideality factor and wafer thickness. The η lim of cutting-edge photovoltaic technologies, double-side tunneling-oxide passivating contact (TOPCon) and silicon heterojunction (SHJ) solar cells, are numerically simulated using the new model as 28.73% and 29.00%, respectively. Hybrid solar cells consisting of n-type TOPCon contact and p-type SHJ contact can approach an η lim as high as 29.18% at the optimal wafer thickness ( W opt ) of 103 μm . Our results are instructive in accurately assessing efficiency potential and accordingly optimizing design strategies of c-Si solar cells.

Sediment is an important factor affecting the growth of aquatic plants. The effects of sediment substrate application on aquatic plants and rhizosphere microorganisms are poorly understood. In this study, we investigated the effects of four substrates (maifanite, vermiculite, ceramsite, and volcanic rock gravels) on the growth and rhizosphere microorganisms of Vallisneria natans (Lour.) Hara (V. natans) by Illumina high-throughput sequencing technology. The results showed that the maximum increase in plant height (20.5 cm) was observed in vermiculite group during the whole experiment period (day 1-40). The root activity of V. natans in the four treatment groups (34.78~85.28 U g-1) was higher than that in CK (28.48 U g-1). The maximum mean total chlorophyll content in maifanite group was 2.40 mg g-1, followed by vermiculite group (1.1 mg g-1). Catalase activity in leaves in all the treatment groups except maifanite group was significantly different during different periods (P<0.05). The maximum mean superoxide dismutase activity in maifanite group was 273.78 U g-1 min. All four treatment groups exhibited faster reduction in malondialdehyde content in leaves than CK group, indicating that substrate addition could rapidly enhance plant stress adaptation. Redundancy analysis showed that root vitality was positively correlated with biomass, plant height, and root length, and that different substrates had different effects on the growth of V. natans. Dominant bacterial phyla in rhizosphere sediments in each group were roughly the same, and the top two bacterial phyla were Proteobacteria and Chloroflexi. Relative abundance of Desulfobacterota and Nitrospirota were higher in four treatment groups than in CK group. Our results showed that substrate addition, especially maifanite, into lake sediments could promote the growth of submerged plants and improve the rhizosphere microbial community structure. Our findings provide theoretical basis for lake sediment improvement and aquatic vegetation restoration.

Designing and selecting cell culture media and their feeding are a key strategy to maximize culture performance in industrial biopharmaceutical processes. However, mammalian cells are very sensitive to their culture environment, requiring specific nutritional needs to grow and produce high-quality proteins such as antibodies, depending on cell lines and operational conditions. In this regard, previously we developed data-driven and in-silico model-guided systematic framework to investigate the effect of growth media on Chinese hamster ovary (CHO) cell culture performance, allowing us to design and reformulate basal media. To expand our exploration for media development research further, we evaluated two chemically defined feed media, A and B, in ambr15 bioreactor runs using a monoclonal antibody-producing CHO K1 cell line. We observed a significant impact of feed media on cell growth, longevity, viability, productivity and toxic metabolites production. Specifically, concentrated feed A was not sufficient to support prolonged cell culture and high titer compared to feed B. The framework systematically characterized the major metabolic bottlenecks in the TCA cycle and its related amino acid transferase reactions, thereby identifying key design components, such as asparagine, aspartate, and glutamate, which are needed for highly productive cell cultures. Based on our results, we subsequently reformulated the feeds by adjusting the amounts of those amino acids and successfully validated their effectiveness in promoting cell growth and/or titer.

Introduction : Pulsed field ablation (PFA) is a non-thermal ablative strategy that achieves cell death via electroporation. Herein, we investigated the preclinical safety and efficacy of PFA using two novel 8-French, 16-electrode spiral PFA/mapping catheters (ElePulse, CRC EP, Inc). M ethods : Bipolar PFA (>1.8 kV) was performed using 30 sec, single-shot, QRS-gated applications. Altogether, 94 atrial structures were ablated in 23 swine, 1 canine, and 1 ovine, including right and left atria and atrial appendages, pulmonary veins, and superior and inferior (IVC) vena cavae. We also examined the impact of PFA on phrenic nerve (14 swine) and on a deviated esophagus after delivery of PFA from inside the IVC (5 swine). Results: All applications were single-shot without catheter repositioning. Minimal microbubbling was observed without significant skeletal muscle twitching/activation (mean acceleration: 0.05 m/s 2). There was marked reduction in post- versus pre-PFA atrial electrogram amplitude (0.17±0.21 mV vs. 1.18±1.08 mV; P<0.0001). Durable conduction block was demonstrated up to 3 months in all targeted tissues. Lesions were contiguous and transmural, measuring 25±9 mm x 21±7 mm without any thermal effects. Magnetic resonance, gross, and histologic examinations of the brain, rete mirabile, and kidneys revealed no thromboembolism. No acute/long-term phrenic nerve dysfunction was encountered. Though within 2 hours of ablation, histologic examinations of the esophagus revealed acute PFA-related changes in the muscular layer, these completely resolved by 21±5 days. Conclusion : A novel, single-shot, spiral PFA system is capable of safely creating large, durable atrial lesions without significant adverse effects on the phrenic nerve or the esophagus.

Aim: Early intervention services are the established and evidence-based treatment option for individuals with first-episode psychosis. They are time-limited, and care pathways following discharge from these services have had little investigation. We aimed to map care pathways at the end of early intervention treatment to determine common trajectories of care. Methods: We collected health record data for all individuals treated by early intervention teams in two NHS mental health trusts in England. We collected data on individuals’ primary mental health care provider for 52 weeks after the end of their treatment and calculated common trajectories of care using sequence analysis. Results: We identified 2224 eligible individuals. For those discharged to primary care we identified four common trajectories: Stable Primary Care, Relapse and return to CMHT, Relapse and return to EIP, and Discontinuity of Care. We also identified four trajectories for those transferred to alternative secondary mental health care: Stable Secondary Care, Relapsing Secondary Care, Long-term Inpatient, and Discharged Early. The Long-term Inpatient trajectory (1% of sample) accounted for 29% of all inpatient days in the year follow-up, with Relapsing Secondary Care (2% of sample and 21% of inpatient days), and Relapse and return to CMHT (5% of sample, 15% of inpatient days) the second and third most frequent. Conclusions: Individuals have common care pathways at the end of early intervention in psychosis treatment. Understanding common individual and service features that lead to poor care pathways could improve care and reduce hospital use.

As 5G networks become more widely accepted and executed all through the world, networks and academics have begun to investigate 6G interconnections.1upon to be founded on pervasive AI to give information ML arrangements in dissimilar and enormous scopes and domains. Customary AI draws near, then again, need incorporated information assembling and preparing by a server, which is turning into a boundary for enormous scope application in daily existence because of rising security concerns. As 5G networks become all the more broadly carried out all through the world, networks and scholastic have started to take a gander at 6G intersections. 6G is relied upon to be based on omnipresent AI to give information ML arrangements in heterogeneous and wider infrastructure and networks. Conventional AI draws near, then again, need concentrated information assembling and preparing by a server, which is turning into a hindrance for huge scope application in regular daily existence because of rising protection concerns. Albeit the vision and significant parts of the 6Th era (6G) biological system presently can’t seem to be totally analyzed, the vision and fundamental components of the fifth era (5G) environment have recently been examined. To assist with these endeavors and to characterize the security and protection components of 6G networks, we check out what security could mean for the imagined 6G remote frameworks, just as the issues and likely arrangements. We center around the security and protection gives that might emerge because of the 6G requirements, just as imaginative network plan, applications, and supporting innovations.

1. INTRODUCTIONOsteochondromas (OC) are benign tumors that account for 20-50% of benign and 10% of all bone tumors. The incidence rate of OC in males is twice that of females and its peak is usually in the second decade of life (1). These lesions are inherited in an autosomal dominant manner and cause the formation of isolated lesions or multiple exostoses during the development of bones in the process of enchondral ossification in the long bones (2). Also, OC is associated with the mutation of some tumor suppressor genes, including EXT1 or EXT2 genes. OC have a periosteal origin and are formed in the active parts of bones, including the metaphysis of long bones and the cartilage at their ends. Studies show that OC can be caused after surgery/radiation-induced injury and hematopoietic stem cell transplantation (3).Osteocartilaginous exostosis is mainly detected in childhood and in the form of palpable masses, with chronic pain and sometimes with edema (4). The presence of misplaced bone masses in the joint capsule and sometimes with cartilaginous coating in radiographic images is one of its common manifestations. The most common joints involved in OC are the hip and knee joints. Patellar OC is rare and mostly affects the patellar bursa. Moraes et al. (2014) reported a patellar OC measuring 8 × 6 × 3 cm anterior to the patella in a 60-year-old man who was painless and without limitation of flexion-extension in the knee joint (5). In the present case, rare retro-patellar OC was observed in the area of the patellar ligament.

The linearized of the Poisson-Nernst-Planck (PNP) equation under closed ends around a neutral state is studied. It is reduced to a damped heat equation under non-local boundary conditions, which leads to a stochastic interpretation of the linearized equation as a Brownian particle which jump and is reflected, at Poisson distributed time, to one of the end points of the channel, with a probability which is proportional to its distance from this end point. An explicit expansion of the heat kernel reveals the eigenvalues and eigenstates of both the PNP equation and its adjoint. For this, we take advantage of the representation of the resulvent operator and recover the heat kernel by applying the inverse Laplace transform.

Soft materials or soft condensed matter are being globally developed for various technological applications for chemical, consumer goods, pharmaceutical, agri-business, and petroleum industries. Hence, research interest is consistently growing in experimental studies of the dynamics, structure, and morphology of soft materials as well as soft interfacial materials. This review focuses on atomic force microscopy (AFM), one of the many analytical tools conventionally used for solid matter research studies, and presently being expanded into the research area of soft materials. When appropriately utilised, AFM provides a suitable alternative to soft matter investigation. The main AFM modes discussed are contact, non-contact, and tapping modes. This review also provides discussions on the working principle of each AFM mode and its applications in soft matter analysis in recent years. Finally, a critical analysis and comparison of the imaging modes is carried out to identify the advantages and disadvantages of the aforementioned modes applied in relevance to soft matter analysis.

Uncertain fractional differential equation (UFDE) is an useful tool for studying complex systems in uncertain environments. In this paper, we study the extreme value theorems of the solution to Caputo-Hadamard UFDEs and applications. A numerical algorithm for solving the numerical solution of a nonlinear Caputo-Hadamard UFDE is presented, the feasibility of the numerical algorithm is validated by numerical experiments. The extreme value theorems are applied to the financial markets, and the pricing formulas of the American option based on the new uncertain stock model are given. Considering the properties of the American option pricing, the algorithms for computing the expected value of the extreme values based on the Simpson’s rule are designed. Finally, the price fluctuation of the American option is illustrated by numerical experiments.

In this paper, we study several problems of the fifth-order Camassa-Holm type (FOCHT) equation. The local well-posedness and blow-up scenario are established at first. Then we prove the global existence under some conditions and analyze the large-time behavior of the support of momentum density. Finally, we discuss the persistence property in Sobolev space.

Chemically, N1 nitrogen of piperazic acid is more nucleophilic than N2 nitrogen, but amide bonds predominantly formed at N2 nitrogen are prevalent in piperazic acid-containing natural products, with only one exception of sanglifehrin. Thus two orthogonal protecting groups of nitrogen are often employed to realize selective coupling of N2 nitrogen, resulting in increased synthetic steps and low synthetic efficiency. However, we developed selective deprotection of N2-Cbz from the N1,N2-diCbz piperazic acid-containing peptide to form the N2 amide exclusively, avoiding the tedious orthogonal protection strategy commonly applied to the easily-accessible N1,N2-diCbz piperazic acid as the building block. We employ this method to achieve an efficient synthesis of piperazic acid-containing cyclodepsipeptide core of verucopeptin with an overall yield of 21%. The key steps include late stage coupling of piperazic acid with 3-hydroxyleucine derivatives, and HATU-mediated macrolactamization of 19-membered macrocycle at N9 and C10. The selective deprotection of N2-Cbz from the N1,N2-diCbz-piperazic acid at late-stage would greatly facilitate the total syntheses of piperazic acid-containing cyclodepsipeptides of biological interest.

In this article, we study one a nonlocal problem of p-Kirchhoff type with Hardy nonlinearities. We obtain some existence results of solutions using variational methods and Nehari manifold under different cases.

During the Covid-19 pandemic, the morbidity of anorexia increased both in its scope and in its severity. Research conducted thus far, has raised questions regarding the unique influences that the pandemic imposed on individuals with anorexia and those at risk for developing it. This opinion article offers a psychoanalytic understanding for the increased morbidity of anorexia following the outbreak of COVID-19. It argues that the encounter between an external reality saturated with restrictions and prohibitions and the anorexic internal reality intensified the anorexic symptomology. The authors present explanations regarding the ways in which the pandemic undermined the anorexic defenses and contributed to the increase of anorexia. They conclude that COVID-19 has led to the exacerbation of anorexia through employment of two key defense mechanisms of anorexia, which are: 1. Implementation of prohibitions, reductions, and restrictions. 2. Having an omnipotent sense of self, in which the body is regarded as controllable.

Background : The parent stress is as ‘the experience by a mother of unpleasant emotions, such as tension, frustration, anxiety, anger, and depression, specially when they see their child admitted in NICU of neonate as a parent. Objectives :To assess the stress level & coping strategies of mothers of neonates admitted in N.I.C.U.To establish the correlation between the stress & coping strategies among mother of neonates. Materials & methods : A descriptive design was used for this research which was done in selected tertiary care hospital in Bhubaneswar, Odisha. The sample consisted of 106 mothers whose baby admitted in NICU. The standardized tool and including modified likert scale used for data collection. In this study non-probability purposive sampling technique was used . After collection of the data, the selected samples was analysed by using Karl Pearson’s Coefficient of Correlation and chi-square test. and SPSS software version 20 and Microsoft Excel, 2007 used for statistical analysis . Results : After statistical analysis the result was found that majority (86.8 %) mother comes under severe stress and (13.2 %) of mothers comes under moderate stress. In case of coping strategies maximum mothers 96(90.6 %) were undergone moderate coping strategies to reduce the stress, and only few mothers 10 (9.4%) with poor coping strategy & did not find any relationship between the stress level & coping strategies ( r = 0.065, P=0.618). Here, the null hypothesis was rejected. The final table revealed that there is negative significant association between the stress level of mothers & socio demographic variables such as mothers age, Education qualification, family Income per month, mode of delivery, living area, Number of Children, and treatment pattern except four variables and these are education (p < 0.005), Income (p < 0.33) , mode of delivery ( p < 0.001) & family type (p < 0.001) etc.

This work provides the generalized fractional differential quadrature method, which is focused on the generalized Caputo kind and has been utilized for the first time for solving nonlinear fractional equations. The cardinal sine shape function is one of the effective shape functions of this method that is used in conjunction with the fractional operator of the generalized Caputo kind to convert nonlinear fractional equations into a nonlinear algebraic system. The nonlinearity problem is then solved using an iterative approach. Numerical simulations for a variety of chaotic systems are introduced using the MATLAB program and compared with previous theoretical and numerical results to ensure their reliability, convergence, accuracy, and efficiency. As a result, numerical simulations show that the cardinal sine shape function outperforms other techniques in terms of accuracy, convergence, and reliability. We confidently predict that the presented generalized fractional differential quadrature method and algorithm will be used to express and simulate many chaotic systems and generalized Caputo-type fractional problems in the future.

Widespread school closures and other non-pharmaceutical interventions (NPIs), used to limit the spread of SARS-CoV-2, significantly disrupted transmission patterns of seasonal respiratory viruses. As NPIs were relaxed, populations were vulnerable to resurgence. This study within a small community assessed acute respiratory illness among kindergarten through grade 12 students as they returned to public schools from September through December 2022 without masking and distancing requirements. The 277 specimens collected demonstrated a shift from rhinovirus to influenza. With continued circulation of SARS-CoV-2 and return of seasonal respiratory viruses, understanding evolving transmission patterns will play an important role in reducing disease burden.

Reproductive isolation plays an important role in maintaining the species integrity of sympatric close relatives. For sympatric Arisaema species, interspecific gene flow is expected to be effectively prevented by pre-pollination barriers, particularly strong pollinator isolation mediated by fungus gnats. However, due to the lack of quantitative studies combining multiple pre- and post-pollination barriers, it is not known whether pre-pollination isolation is complete, and whether post-pollination barriers also contribute to reproductive isolation among some Arisaema species. We studied five pre- and post-pollination barriers (geographic isolation, phenological isolation, pollinator isolation, hybrid fruit production, and hybrid seed formation) among three sympatric Arisaema species (A. bockii, A. lobatum, and A. erubescens). The strength of individual barriers and their contribution to total isolation were quantified.The habitat elevations of the three Arisaema species mostly overlapped. Although phenological isolation and pollinator isolation reduced the frequencies of interspecific pollen transfer among these species, the partial overlap of flowering times and pollinator assemblages resulted in pre-pollination isolation that does not adequately prevent interspecific hybridization. Post-pollination barriers also contributed to reproductive isolation at the hybrid fruit and seed formation stages.We propose that, although pre-pollination barriers are expected to contribute more to total isolation than post-pollination barriers in Arisaema, pre-pollination barriers may not completely prevent interspecific pollen transfer among some Arisaema species. Post-pollination barriers, which are generally ignored, may also have contributed significantly to reproductive isolation in Arisaema.

The Mississippi River channel from New Orleans to the Gulf of Mexico (GOM) is a key deep draft navigation channel and an active deltaic lobe. Natural and engineered lateral exits from this reach into adjacent receiving basins historically has provided mineral sediment for wetland accretion in the face of rising relative sea level and supported estuarine-coastal food webs. However, our analysis indicates water losses from the channel have increased by 25% since 2004 due to (1) bank failures during large floods since 2012 that have created several large exit channels downriver of the flood protection levee, and (2) the opening of an engineered diversion at West Bay in 2004. This has resulted in a 60-80% loss in stream power in the lowermost navigation channel that is accompanied by net shoaling between 2012 and 2022 and an increased dredging need. Our 2022 survey in the GOM exit passes indicates that only 20% of the freshwater, 5% of the total suspended sediment (2% of the sand) at New Orleans now reaches the GOM: this supports previous research indicating the delta front is retreating after centuries of progradation. Together these results indicate that (1) river containment and the sustainability of the navigation channel is threatened, (2) sediment load reaching the seaward end of the delta may be insufficient to avoid major degradation, and (3) the increased freshwater flux into adjacent shallow coastal water bodies has unknown implications for coastal hypoxia and food webs, including commercial species (e.g., oysters) and marine mammals. Future acceleration in sea level rise rates and tropical storm frequency/intensity likely will worsen these trends.

Background. Cortical visual impairment (CVI) is a severe loss of visual function caused by damage to the visual cortex or its afferents, usually as a consequence of hypoxic insults during birth. It is one of the leading causes of vision loss in children, and it is most often permanent. Objective. Several studies have demonstrated limited vision restoration in adults who trained on well-controlled psychophysical tasks, after acquiring CVI late in life. Other studies have shown improvements in children who underwent vision training. However, little is known about the prospects for the large number of patients who acquired CVI at birth but received no formal therapy as children. Methods. We therefore conducted a proof-of-principle study in one CVI patient long after the onset of cortical damage (age 18), to test the training speed, efficacy and generalizability of vision rehabilitation using protocols that had previously proven successful in adults. The patient trained at home and in the laboratory, on a psychophysical task that required discrimination of complex motion stimuli presented in the blind field. Visual function was assessed before and after training, using perimetric measures, as well as a battery of psychophysical tests. Results. The patient showed remarkably rapid improvements on the training task, with performance going from chance to 80% correct over the span of 11 sessions. With further training, improved vision was found for untrained stimuli and for perimetric measures of visual sensitivity. Some, but not all, of these performance gains were retained upon retesting after one year. Conclusion. These results suggest that existing vision rehabilitation programs can be highly effective in adult patients who acquired CVI at a young age. Validation with a large sample size is critical, and future work should also focus on improving the usability and accessibility of these programs for younger patients.

Approximately 10% of the global population identify themselves as penicillin allergic, yet 90% are not truly allergic and could safely tolerate penicillin. There is no simple way to identify these people. Current in vitro diagnostics include specific immunoglobulin E (with a sensitivity of 19% and specificity of 97%) and basophil activation testing (BAT) with undefined sensitivity and specificity. PubMed and EMBASE searched from inception to 03/05/2022 for original studies evaluating the performance characteristics of basophil activation test for penicillin allergy in adults. Study selection, data extraction, risk of bias (RoB) assessment with QUADAS-2 tool and certainty assessment with GRADE methodology were performed independently, in duplicate. Meta-analysis was performed using Reitsma methodology. Twenty-two studies fulfilled the inclusion criteria. Twelve used the same positive threshold giving a summary point sensitivity 51% (95% CI, 46%-56%) and specificity 89% (95% CI, 85%-93%). Significant RoB identified, due to patient selection. GRADE certainty of evidence rated sensitivity “very low” due to imprecision and specificity as “low”. Use of 1000 basophils per test did not improve performance above 500 basophils. BAT has improved sensitivity but lower specificity over other in vitro diagnostics in penicillin allergy. BAT methods need to be standardised to limit heterogeneity in results.

Clinical Validity and Conceptual Interpretation of Impact of alcohol consumption on COVID-19 severityRama Jayaraj 1*, Sameep Shetty 2, A Devi3, Suja S4, Yash Merchant5