Notes

Epidemic and also molecular characterization associated with glucose-6-phosphate dehydrogenase deficit in the Lue ethnic band of north Thailand.
Blood samples were collected from 170 ranging dairy cows in 6 different districts, along a transect extending from the lowlands to the highlands, in both seasons (dry and rainy). Body condition score and milk yield of all cows were also determined for both seasons. Serum urea, creatinine, triglyceride, and nonesterified fatty acid concentrations were quantified spectrophotometrically. Dried serum spots were subject to quantitative electrospray tandem mass spectrometry to estimate changes in nutrient metabolism based on selected free AA and carnitine esters. Based on these measurements, nutritional status varied with season and geographical region. It can also be concluded that extensive metabolite analysis such as mass spectrometry can provide detailed insights, but the simpler spectrophotometric metabolite analysis can estimate the nutritional status of ranging animals.We compared the management and housing of dairy heifers from calf to calving in herds that were very successful versus less successful in preventing mastitis in early lactation primiparous cows. This retrospective observational study included 170 Swedish dairy herds. Eligible herds were identified from the Swedish official milk recording scheme (SOMRS). Each herd had at least 60 cows per year, production data from 3 consecutive years, and at least 10 primiparous cows per year with their first milk recording 5 to 35 d after calving and their second milk recording 20 to 40 d after the first milk recording. In each herd, primiparous cows with a low (≤75,000 cells/mL) cow somatic cell count (CSCC) at both the first and second milk recording were categorized as low-low (LL); those with a high (>100,000 cells/mL) CSCC at both recordings were categorized as high-high (HH). Cows with high CSCC at the first recording and low at the second were categorized as high-low (HL). The annual proportions of LL, HL, and HH cows. A final multivariable model was built from the results of the submodels and univariable analyses. The final model showed that having a standard operating procedure for colostrum feeding was more common in LL and HL herds than in HH herds; the mean bulk milk SCC and overall culling rate due to udder health was higher in HH herds than in LL and HL herds; and automatic milking was less common in LL herds than in HL and HH herds. Several herd and management variables differed between herd categories in the submodels. In conclusion, we identified several success factors for herds with good udder health among early lactation primiparous cows. This knowledge can be used to improve preventive measures in dairy herds to ensure sustainable and economic milk production.Heat stress is detrimental during gestation; however, the effects of heat stress on goat placental characteristics and kid survival remain unclear. The objective of this study was to evaluate the effects of heat stress at final gestation on cortisol concentration, placenta characteristics, and the expression of genes related to placenta. Forty-six primiparous and multiparous Saanen goats were subjected to control (CT; under a thermoneutral environment air temperature between 12°C and 25°C and the relative humidity from 45 to 73%, n = 23) or heat stress (HS; under a climatic chamber air temperature at 37°C and the relative humidity at 60 to 70% from 0800 to 1600 h, n = 23) from the last 60 d of pregnancy until the first colostrum suckling. The heat challenge imposed on HS goats during the prepartum period increased their rectal temperature, respiratory frequency, and cortisol levels in plasma and amniotic fluid versus CT goats. In the placenta, HS treatment also increased the expression of the HSPA1A gene. Head NR3C1 and downregulation of HSD11B2 on placenta caused by heat stress were associated with greater cortisol concentrations in the amniotic fluid of HS goats. Although HS and CT kids had adequate weights and survival rate during the first weeks of life, the heat stress increased the mortality at weaning of HS kids versus CT kids, suggesting that the heat stress effect persists and can change the ability of kids to respond to weaning challenge.The objective of this study was to estimate genetic parameters of predicted N use efficiency (PNUE) and N losses (PNL) as proxies of N use and loss for Holstein cows. Furthermore, we have assessed approximate genetic correlations between PNUE, PNL, and dairy production, health, longevity, and conformation traits. These traits are considered important in many countries and are currently evaluated by the International Bull Evaluation Service (Interbull). The values of PNUE and PNL were obtained by using the combined milk mid-infrared (MIR) spectrum, parity, and milk yield-based prediction equations on test-day MIR records with days in milk (DIM) between 5 and 50 d. After editing, the final data set comprised 46,163 records of 21,462 cows from 154 farms in 5 countries. Each trait was divided into primiparous and multiparous (including second to fifth parity) groups. Genetic parameters and breeding values were estimated by using a multitrait (2-trait, 2-parity classes) repeatability model. Herd-year-season of cal yield). Obtained results showed the complex genetic relationship between efficiency, production, and other traits for instance, more efficient cows seem to give more milk, which is linked to deeper udders, but seem to have lower health, fertility, and longevity. Additionally, the approximate genetic correlations between PNL, lower values representing less loss of N, and the 30 other traits, were from -0.32 (angularity) to 0.57 (direct calving ease). Even if further research is needed, our results provided preliminary evidence that the PNUE and PNL traits used as proxies could be included in genetic improvement programs in Holstein cows and could help their management.Soybean meal is one of the most important protein sources in concentrate feeds for dairy cows. The objective of the present study was to provide knowledge on the effects of using a novel yeast microbial protein source (Candida utilis) in concentrate feed for dairy cows on the production and quality of a Gouda-type cheese. Forty-eight Norwegian Red dairy cows in early to mid lactation were fed a basal diet of grass silage, which was supplemented with 3 different concentrate feeds. The protein source of the concentrates was based on conventional soybean meal (SBM), novel yeast (C. utilis; YEA), or barley (BAR; used as negative control because barley has a lower protein content). The experiment was carried out for a period of 10 wk, with the first 2 wk as an adaptation period where all dairy cows were fed grass silage and the SBM concentrate. The cows were then randomly allocated to 1 of the 3 different compound feeds SBM, yeast, or barley. Cheeses were made during wk 8 and 9 of the experiment, with 4 batches of cheese made from milk from each of the 3 groups. The cheeses made from milk from cows fed SBM concentrate (SBM cheese) had a higher content of dl-pyroglutamic acid and free amino acids than the other cheeses, indicating a faster ripening in the SBM cheeses. Despite these differences, the sensory properties, the microbiota, and the Lactococcus population at 15 wk of ripening were not significantly different between the cheeses. This experiment showed that although the raw materials used in the concentrate feed clearly influenced the ripening of the cheeses, this did not affect cheese quality. Yeast (C. utilis) as a protein source in concentrate feed for dairy cows can be used as a replacement for soybean meal without compromising the quality of Norwegian Gouda-type cheeses.
To evaluate the postoperative magnetic resonance imaging (MRI) findings of intracranial foreign body granulomas (FBGs) and true recurrent tumours (RTs) and thus lead to a basis for management decision-making.

Twenty-two patients with previous brain tumour surgery were diagnosed clinically with RT and underwent surgery. Re-operative pathology revealed FBG in eight patients and RT in 14 patients. MRI findings before the initial operation were compared to those before the re-operation.

Features of FBGs versus RTs on MRI were as follows (1) mean lesion size 1.3±0.7 (0.5-2.6) versus 3.2±1.7 (1.1-6.3) cm (p=0.001, odds ratio [OR]=4.18); (2) hypointensity on T2-weighted imaging (WI) 6/8 (75%) versus 0/14 (0%; p<0.001, OR=75.4); (3) non-restricted diffusion on diffusion-WI (DWI) 6/8 (75%) versus 2/14 (14.3%; p=0.008, OR=18); and (4) "ring and bubble" appearance on contrast-enhanced T1WI 7/8 (87.5%) versus 2/14 (14.3%; p=0.001, OR=42). In comparison with their original tumours, the FBGs in the FBG group showed significantly lower T2 signal intensity, lower signal on DWI, and more cases of non-restricted diffusion on DWI (p=0.04, 0.04, 0.04, respectively).

On brain MRI, FBGs can be differentiated from RTs by their relatively smaller size, hypointensity on T2WI, lack of restricted diffusion on DWI, and "ring and bubble" appearance on contrast-enhanced T1WI. Comparing the MRI findings of the focal lesion in the tumour bed with those of the original tumour is suggested to enhance diagnostic confidence.
On brain MRI, FBGs can be differentiated from RTs by their relatively smaller size, hypointensity on T2WI, lack of restricted diffusion on DWI, and "ring and bubble" appearance on contrast-enhanced T1WI. Comparing the MRI findings of the focal lesion in the tumour bed with those of the original tumour is suggested to enhance diagnostic confidence.
To review the ultrasonographic outcomes of persistent lymph nodes, in the absence of other concerning signs or symptoms, in patients <6 years of age.

A retrospective analysis was undertaken of 98 patients <6 years old who had neck ultrasound for persistent lymph nodes at a single university hospital over a 3.5 year period between January 2016 and June 2019.

There were no cases of malignant disease or serious systemic illness. Ninety-two of the 98 examinations showed normal or reactive lymph nodes. There were three sonographically indeterminate cases and two non-lymph-node structures haemangioma and dermoid cyst. One examination reported an abnormal lymph node, which had resolved by the time of review in clinic.

Persistently enlarged or abnormal lymph nodes should be investigated; however, a distinction should be made between lymph nodes that have regressed to <1 cm but are still palpable and persistently enlarged or abnormal lymph nodes. The findings of the present study indicate that persistence of non-enlarged lymph nodes is not a predictor for malignancy. It is advised that clear guidelines are used, which state the criteria for further investigation, to promote the best use of imaging.
Persistently enlarged or abnormal lymph nodes should be investigated; however, a distinction should be made between lymph nodes that have regressed to less then 1 cm but are still palpable and persistently enlarged or abnormal lymph nodes. The findings of the present study indicate that persistence of non-enlarged lymph nodes is not a predictor for malignancy. It is advised that clear guidelines are used, which state the criteria for further investigation, to promote the best use of imaging.
It has been postulated that video-assisted thoracoscopic surgery (VATS) is superior than conventional thoracotomy for resection of congenital pulmonary airway malformation (CPAM) in terms of shorter hospital length of stay, reduced post-operative complication and better long-term pulmonary outcome. However, there is limited available data concerning the effect of VATS and conventional thoracotomy on musculoskeletal aspects in patients with CPAM. This study aims to compare the long-term effects of both surgical techniques on musculoskeletal outcomes in this group of patients.

Thirty-five patients with mean age of 11.38 years old who underwent VATS or conventional thoracotomy for CPAM resection were recruited in this study. The mean follow-up time was 10.42 years (5.48 to 17.71 years). Musculoskeletal examination included screening of musculoskeletal deformities (elevation of shoulder, asymmetry of nipple level, breast/ pectoral muscle maldevelopment, winging of scapula, scoliosis), measurement of bilateral chest wall in relation to anatomical parameter, and testing of shoulder range of motion and power.

The prevalence of winged scapula was significantly lower in patients who underwent VATS than thoracotomy (13% vs 58%, p=0.008). There is also a smaller reduction in operated-side chest wall vertical distance in VATS patients (0.982vs 0.956, p=0.058). There were no significant difference in prevalence of other musculoskeletal deformities, other chest wall measurements, shoulder range of motion and power between two groups.

Thoracoscopy decreases the incidence of scapular winging but has no effect on effect on other musculoskeletal deformities.
Thoracoscopy decreases the incidence of scapular winging but has no effect on effect on other musculoskeletal deformities.
To date, there is no study about trace metal level increases in hair after stainless steel pectus bar implantation. We aimed to determine whether there was any significant increase in the levels of trace metals in the hair of children who underwent minimally invasive repair of pectus excavatum (MIRPE) and minimally invasive repair of pectus carinatum (MIRPC).

In this prospective study, we collected the data of 223 patients who underwent MIRPE and MIRPC between November 2013 and August 2020. The levels of main components of the stainless steel pectus bar ("PES", Medxpert GmbH, Escbach, Germany) namely Cr, Fe, Ni, and Mo in hair were analyzed. The study involved two study groups A group of patients who underwent MIRPE with a single bar (n=112) and a group of patients who underwent MIRPC (n=71). Both groups were analyzed in two different timelines A group of consecutive patients prior to bar implantation and a group of the same patients who underwent bar removal after a mean time of 34.6±5.1 months.

Statistically significant increases in all studied trace metal levels were observed in the single-bar MIRPE group. In the MIRPC group, the accumulation of studied trace metals was no statistically significant. The double-bar MIRPE group had higher trace metal increase rates compared to single-bar MIRPE group (p>0.05).

In our study; increases in iron, chrome, nickel and molybdenum levels were observed in both MIRPE and MIRPC patients by hair trace metal analysis; but these increases were statistically significant in only MIRPE group.
In our study; increases in iron, chrome, nickel and molybdenum levels were observed in both MIRPE and MIRPC patients by hair trace metal analysis; but these increases were statistically significant in only MIRPE group.
Both homocysteine (Hcy) and asymmetric dimethylarginine (ADMA) induce endothelial dysfunction. However, the impact of both elevations on all-cause death is not known. We investigated the association between elevations of Hcy or ADMA and all-cause death in a general population.

A total of 517 subjects (224 men, 293 women; mean age, 62.8 years) were recruited from a population-based survey in 1999 in Tanushimaru, and we measured fasting plasma Hcy and ADMA levels. We followed them up for over 20 years and examined the effect on mortality using Cox proportional hazard regression model.

The mean follow-up years were 17.7 (1.8-20.8). In this period, 182 subjects have died (35.2%). The correlation between Hcy and ADMA was high (r=0.194; p<0.001). With Cox regression analysis after adjustments for age and sex, elevated log transformed Hcy levels were significantly associated with all-cause death (p=0.028). When Hcy and ADMA levels were divided into quintiles, the hierarchical model showed the synergistic effect of Hcy and ADMA on all-cause death.

This is the first report that we have measured Hcy and ADMA levels simultaneously in this community-dwelling Japanese, and we demonstrated that combined elevations of Hcy and ADMA had big impact on all-cause death in this epidemiological study.
This is the first report that we have measured Hcy and ADMA levels simultaneously in this community-dwelling Japanese, and we demonstrated that combined elevations of Hcy and ADMA had big impact on all-cause death in this epidemiological study.
Multiple stakeholders are interested in improving patient experience after primary total hip arthroplasty due to shifts toward patient-centered care. Patient free-text narratives are a potentially valuable but largely unexplored source of data.

The records of 383 patients who underwent primary total hip arthroplasty between August 2016 and August 2019 were combined with vendor-supplied patient satisfaction data, which included patient free-text comments and the Press Ganey satisfaction survey. A total of 1295 patient comments were analyzed for sentiment, and negative comments were categorized into nine themes. Postoperative outcomes, patient-reported outcome measures, and traditional measures of satisfaction were compared between patients who provided a negative comment vs those who did not. Multivariable regression was used to determine perioperative variables associated with providing a negative comment.

Of the 1295 patient comments 54% were positive, 24% were negative, 10% were mixed, and 12% were neutral. Top two themes of negative comments were room condition (25%) and inefficient communication (23%). There were no differences in studied outcomes (eg. peak pain intensity, length of stay, or improvements in hip injury and osteoarthritis outcome scores Jr. and pain visual analog scale scores at 6-week follow-up) between those who provided negative comments vs those who did not (P > .05). However, patients who made negative comments were less likely to recommend their hospital care to peers (P < .001). Finally, patients who had >2 allergies (P= .024) were more likely to provide negative comments.

The present study demonstrates that patient satisfaction appears not to be a reliable sole proxy for traditional objective outcome measures of pain relief and functional improvement.
The present study demonstrates that patient satisfaction appears not to be a reliable sole proxy for traditional objective outcome measures of pain relief and functional improvement.
Flapless implant placement with immediate functional loadinghas been reported in anterior locations. However, data on posterior locations are lacking.

The purpose of this randomized controlled trial was to determine and compare clinical outcomes of flap versus flapless surgically placed single posterior mandibular dental implants subjected to immediate functional loading.

Participants with missing mandibular first molar teeth were recruited and randomized into 2 groups (n=51) flapped and flapless. Dental implants were surgically placed and loaded immediately with interim restorations following implant protective occlusion. Outcome measures were implant failure, crestal bone loss, and periodontal parameters modified plaque index, modified sulcus bleeding index, and pocket depths. Outcome data were recorded at baseline, 6-month, and 12-month follow-up visits. Cone beam computed tomographyscans were used to calculate crestal bone loss, and periodontal outcomes were recorded by using a resin covered periodotional loading could be considered as an appropriate treatment option for providing functional restorations on the day of implant placement with minimal surgical intervention, reducing crestal bone loss, and periodontal complications.
Flapless implant insertion with immediate functional loading could be considered as an appropriate treatment option for providing functional restorations on the day of implant placement with minimal surgical intervention, reducing crestal bone loss, and periodontal complications.Making an intraoral digital scan of the emergence profile is a clinical challenge. The peri-implant soft tissue collapses after removal of an interim prosthesis, which compromises the correct design of a definitive implant-supported prosthesis. Although techniques are available for digitally reducing such a distortion, achieving a correct alignment of scans to replicate the internal and external characteristics of the peri-implant tissue is still challenging. This article describes an alternative technique for achieving a precise alignment of the peri-implant soft tissue emergence profile generated with an interim prosthesis.
A consensus on the accuracy of additively manufactured casts in comparison with those fabricated by using conventional techniques for fixed dental prostheses is lacking.

The purpose of this systematic review was to determine the accuracy of additively manufactured casts for tooth- or implant-supported fixed dental prostheses in comparison with that of gypsum casts.

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (CDR42020161006). Eight databases were searched in December 2019 and updated in September 2020. Studies evaluating the dimensional accuracy of additively manufactured casts for fixed dental prostheses in comparison with that of gypsum casts were included. An adapted checklist for reporting invitro studies (Checklist for Reporting Invitro Studies guidelines) was used to assess the risk of bias.

Eight studies evaluating tooth-suy, printing settings, and postprocessing procedures plays an essential role in the accuracy of additively manufactured casts. Clinical studies are required to confirm these findings.
Titanium-zirconium (Ti-Zr) alloy (Roxolid) narrow-diameter implants (NDIs) have been widely used for implant-supported prostheses in anterior and posterior regions in the jaws. However, the relationship between implant location and clinical outcome remains unclear.

The purpose of this clinical study was to evaluate and compare the clinical and radiographic outcomes of NDIs placed in different regions of the jaws in both smokers and nonsmokers.

Eighty-four participants scheduled to receive NDIs for tooth rehabilitation were included, and the inserted NDIs were divided into 3 groups depending on their locations implants used to restore anterior teeth, implants used to restore premolars, and implants used to restore molars. Crestal bone loss (CBL), implant survival and success rates, bleeding on probing (BOP), and pocket probing depth (PPD) were evaluated 6 and 12 months after implant loading (α=.017 for implant survival and success rates after Bonferroni correction, α=.05 for other parameters).

Statistione loss. Caution should be taken when restoring molars for smokers with NDIs.
High-performance thermoplastics have been adopted as an alternative restorative material to metal or ceramics. However, a straightforward surface modification process to provide a durable bond strength between the polymer and the veneering material is lacking.

The purpose of this invitro study was to evaluate the shear bond strength (SBS) of different veneering resin materials to polyetherketoneketone (PEKK) after different surface treatments.

Rectangular (7×7×2 mm) PEKK specimens (N=120) were randomly allocated to the following 6 groups (n=20) untreated (Cnt); nonthermal plasma (NTP) treated; tribochemical silica airborne-particle abrasion with 30-μm silica-modified Al
O
(Tbc); abraded with a coarse-grit diamond rotary instrument (Ab); tribochemical silica airborne-particle abrasion+ plasma treated (Tbc_NTP); abraded+ plasma treated (Ab_NTP). After a bonding agent (PEKK Bond) was applied to the specimens, each group was divided into 2 subgroups according to the applied veneering resin materials polyg resin material is recommended over PMMA.
The bonding capacity of PEKK to the PMMA and NHC veneering resin materials can be significantly improved by using tribochemical silica airborne-particle abrasion alone or with nonthermal plasma surface treatment techniques. Furthermore, using NHC veneering resin material is recommended over PMMA.
The effect of repeated firing on the marginal and internal adaptation of copings fabricated with different techniques, thicknesses, and alloy types is unclear.

The purpose of this invitro study was to compare the effects of repeated firing cycles on the marginal and internal adaptation of metal copings with different thicknesses fabricated by using casting, selective laser sintering (SLS), presintered soft metal milling (PSMM), postsintered hard metal milling (PHMM), and titanium millingmethods.

Single-unit implant-supported copings (N=120) were fabricated with 0.5-mm and 1.5-mm thicknesses, and porcelain was applied in accordance with the manufacturer's instructions (n=12). The marginal and internal adaptation of the metal copings were examined before the firing cycles and after the fourth and seventh firing cycles by using a silicone replica technique with a stereomicroscope at×80 magnification. The results were analyzed by using 3-way analysis of variance for repeated measurements on a single factor, 2-way analysis of variance, and an independent samples t test (α=.05).

As a result of the repeated firing cycles, the changes in the marginal discrepancy and internal discrepancyvalues in the PSMM, PHMM, and titanium milling groups and the change in the internal discrepancy value in the casting group were statistically significantly different (P<.05). The effect of the interaction of the firing, method, and thickness difference on the marginal discrepancy and internal discrepancy values was not statistically significantly different (P>.05).

After the firing cycles, the PSMM, SLS, and titanium milling groups were found to have better marginal and internal adaptation for both thicknesses than the casting and PHMM groups.
After the firing cycles, the PSMM, SLS, and titanium milling groups were found to have better marginal and internal adaptation for both thicknesses than the casting and PHMM groups.This clinical report presents the rehabilitation of extensive hard and soft tissue defects caused by rhino-orbital-cerebral mucormycosis as a result of untreated diabetes mellitus. The patient underwent subtotal maxillectomy and was rehabilitated with an implant-supported maxillofacial prosthesis with zygomatic and pterygoid implants by following an immediate loading protocol.
A consensus on whether the use of a complete-denture adhesive provides a clinical benefit remains unclear.

The purpose of this systematic review of randomized controlled trials was to evaluate the use of adhesive in complete dentures in terms of retention and stability, patient-reported outcomes measures, and masticatory performance.

A search was performed in PubMed, Web of Science, and Cochrane Library for articles up to October 2020. The Cochrane collaboration tool was used to analyze the risk of bias. The grading quality of evidence and strength of recommendations (GRADE) tool was used to assess the certainty of the evidence.

Thirteen studies were included with a total of 516 participants with a mean age of 65.5 years. Most studies reported a significant improvement in the retention and stability, patient-reported outcomes measures, and masticatory performance of complete dentures with the use of denture adhesive compared with no-denture adhesive. Newly developed denture adhesives were reported to have promising results. Most studies presented a low risk of bias, but the certainty of the evidence was classified as low to moderate.

Participants had improved treatment outcomes when using denture adhesivesbecause they significantly improve the retention and stability, patient-reported outcomes measures, and masticatory performance. However, further high-quality studies are needed to confirm these results with newly developed denture adhesives.
Participants had improved treatment outcomes when using denture adhesives because they significantly improve the retention and stability, patient-reported outcomes measures, and masticatory performance. However, further high-quality studies are needed to confirm these results with newly developed denture adhesives.
Tissue-level internal connection implants are widely used, but the difference in abutment screw stability because of the shoulder coverage formed by the contact between the shoulder of the implant collar and the abutment remains unclear.

The purpose of this finite element analysis (FEA) and invitro study was to investigate stress distribution and abutment screw stability as per the difference in shoulder coverage of the abutment in tissue-level internal connection implants.

Abutments were designed in 3 groups as per the shoulder coverage of the implant collar, yielding complete coverage (complete group), half coverage (half group), no coverage (no group) groups. In the FEA, a tightening torque of 30.0 Ncm was applied to the abutment screw, a force of 250 N was applied to the crown at a 30-degree angle, and the von Mises stresses and the stress distribution patterns were evaluated. In the invitro study, the groups were tested (n=12). A total of 200 000 cyclic loads were applied at 250 N, 14 Hz, and at a ding reduced the removal torque of the abutment screw.The coronavirus disease-2019 (COVID-19) has been spreading rapidly in South Africa (SA) since its first case on 5 March 2020. In total, 674,339 confirmed cases and 16,734 mortality cases were reported by 30 September 2020, and this pandemic has made severe impacts on economy and life. In this paper, analysis and long-term prediction of the epidemic dynamics of SA are made, which could assist the government and public in assessing the past Infection Prevention and Control Measures and designing the future ones to contain the epidemic more effectively. A Susceptible-Infectious-Recovered model is adopted to analyse epidemic dynamics. The model parameters are estimated over different phases with the SA data. They indicate variations in the transmissibility of COVID-19 under different phases and thus reveal weakness of the past Infection Prevention and Control Measures in SA. The model also shows that transient behaviours of the daily growth rate and the cumulative removal rate exhibit periodic oscillations. Such dynamics indicates that the underlying signals are not stationary and conventional linear and nonlinear models would fail for long-term prediction. Therefore, a large class of mappings with rich functions and operations is chosen as the model class and the evolutionary algorithm is utilized to obtain the optimal model for long term prediction. The resulting models on the daily growth rate, the cumulative removal rate and the cumulative mortality rate predict that the peak and inflection point will occur on November 4, 2020 and October 15, 2020, respectively; the virus shall cease spreading on April 28, 2021; and the ultimate numbers of the COVID-19 cases and mortality cases will be 785,529 and 17,072, respectively. The approach is also benchmarked against other methods and shows better accuracy of long-term prediction.Relying on contraction analysis, this paper addresses the global attitude tracking problem of a spacecraft when angular velocity measurements are corrupted by bias. A nonlinear observer with exponential convergence is designed firstly to estimate the bias in gyro sensors. Then an exponentially convergent attitude tracking controller with gyro bias correction is devised. Next, to remove the topological constraints of unit quaternions for global stability, a switching variable with hysteresis is incorporated in the control loop, enhancing the robustness in the presence of measurement noise and energy efficiency by preventing the unwinding phenomenon. Numeric simulations are shown to illustrate the performance and compare with other similar controllers in terms of tracking error, estimation error and energy efficiency, as well as the robustness to noisy measurements and time-varying bias in gyro sensors.The statistical weakness problem occurring as a result of physical randomness is an important shortcoming of TRNGs. Post-processing techniques are generally used in the literature to overcome this shortcoming. In this study, the hardware implementation of Advanced Encryption Standard (AES) substitution box (s-box)-based novel post-processing technique is presented. The low-cost novel method is based on the substitution s-box transformations and can successfully remove the statistical weakness problem of TRNGs. The real-time verification of the proposed post-processing is done by applying ring oscillator (RO) based TRNG architecture in four different scenarios on Field Programmable Gate Array (FPGA) environment. Successful statistical results obtained from bias, correlation, entropy and NIST 800-22 tests confirm the usability of the proposed method for cryptographic purposes. The low area-energy requirement, practicality and compressionless properties of the post-processing provide better tradeoff for TRNG compared to known methods in the literature. For this reason, TRNG's performance is high. Furthermore, the presented study is important in demonstrating that s-boxes with good mathematical encryption properties can also be used for different cryptographic purposes.Parameters for defining photovoltaic models using measured voltage-current characteristics are essential for simulation, control, and evaluation of photovoltaic-based systems. This paper proposes an enhanced chaotic JAYA algorithm to classify the parameters of various photovoltaic models, such as the single-diode and double-diode models, accurately and reliably. The proposed algorithm introduces a self-adaptive weight to regulate the trend to reach the optimal solution and avoid the worst solution in various phases of the search space. The self-adaptive weight capability also allows the proposed technique to reach the best solution at the earliest phase, and later, the local search process starts, which also increase the ability to explore. A three different chaotic process, including sine, logistics and tent map, is proposed to optimize the consistency of each generation's best solution. The proposed algorithm and its variants proposed are used to solve the parameter estimation problem of various PV models. To show the proficiency of the suggested algorithm and its variants, an extensive simulation is carried out using MATLAB/Simulink software. Two statistical tests are conducted and compared with the latest techniques for validating the performance of the suggested algorithm and its variants. Comprehensive analysis and experimental results display that the suggested algorithm can achieve highly competitive efficiency in terms of accuracy and reliability compared to other algorithms in the literature. This research will be backed up with extra online service and guidance for the paper's source code at https//premkumarmanoharan.wixsite.com/mysite.Successful pregnancy relies on maternal immunologic tolerance mechanisms limit maladaptive immune responses against the semi-allogeneic fetus and placenta and support fetal growth. Preeclampsia is a common disorder of pregnancy that affects 4-10% of pregnancies and is a leading cause of maternal and neonatal morbidity and mortality. Preeclampsia clinically manifests as maternal hypertension, proteinuria, and progressive multi-organ injury likely triggered by hypoxic injury to the placenta, resulting in local and systemic anti-angiogenic and inflammatory factor production. Despite the steady rising rates of preeclampsia in the United States, effective treatment options are limited to delivery, which improves maternal status often at the cost of prematurity in the newborn. Preeclampsia also increases the lifelong risk of cardiovascular disease for both mother and infant. Thus, identifying new therapeutic targets is a high priority area to improve maternal, fetal, and infant health outcomes. Immune abnormalities in the placenta and in the maternal circulation have been reported to precede the clinical onset of disease. In particular, excessive systemic and placental complement activation and impaired adaptive T cell tolerance with Th1/Th2/Th17/Treg imbalance has been reported in humans and in animal models of preeclampsia. In this review, we focus on the evidence for the immune origins of preeclampsia, discuss the promise of immune modulating therapy for prevention or treatment, and highlight key areas for future research.The Human Leukocyte Antigen (HLA) system has a critical role in immunorecognition, transplantation, and disease association. Early typing techniques provided the foundation for genotyping methods that revealed HLA as one of the most complex, polymorphic regions of the human genome. Next Generation Sequencing (NGS), the latest molecular technology introduced in clinical tissue typing laboratories, has demonstrated advantages over other established methods. NGS offers high-resolution sequencing of entire genes in time frames and price points considered unthinkable just a few years ago, contributing a wealth of data informing histocompatibility assessment and standards of clinical care. Although the NGS platforms share a high-throughput massively parallel processing model, differing chemistries provide specific strengths and weaknesses. Research-oriented Third Generation Sequencing and related advances in bioengineering continue to broaden the future of NGS in clinical settings. These diverse applications have demanded equally innovative strategies for data management and computational bioinformatics to support and analyze the unprecedented volume and complexity of data generated by NGS. We discuss some of the challenges and opportunities associated with NGS technologies, providing a comprehensive picture of the historical developments that paved the way for the NGS revolution, its current state and future possibilities for HLA typing.The solid variant of odontogenic keratocyst (SOKC) is an extremely rare odontogenic lesion, which remains poorly defined even in the 2017 World Health Organization odontogenic tumour classification. It is difficult to distinguish between SOKC and so called keratoameloblastoma (KAB), both rare lesions that have similarities in clinical, histological and biological characteristics. Here, we report clinicopathological data and results of molecular analysis of nine cases with a literature review. First, they were compared to previously reported cases of SOKC and/or KAB, and many overlaps were found in clinical and pathological characteristics. Second, we performed PCR analysis for BRAF V600E mutation. Although ameloblastoma-like epithelia were often encountered, none exhibited BRAF V600E mutation, which has been reported to occur frequently in ameloblastomas but not in odontogenic keratocysts (OKCs). One of two cases of SOKC in the present series from which fresh frozen tissue specimens were available was found to harbour PTCH1 mutations, indicating that these were more likely to be a subtype of OKC. Moreover, we also examined the differences between SOKC and primary intraosseous carcinoma (PIOC) with regard to the expression of cytokeratins (pan-CK, CK5/6, CK7, CK8/18, CK10, CK14 and CK19), p53 and Ki-67. The proportions of p53-and Ki-67-positive cells were significantly higher in PIOC than in SOKC. These findings suggest that immunostaining for p53 and Ki-67 would be useful to differentiate between SOKC and PIOC. We also conducted a review of SOKC and KAB cases reported in the English language literature.
Thrombectomy in the carotid artery territory was recently shown to be effective up to 24hours after symptoms onset.

We conducted a retrospective review of a prospective registry of patients treated at our stroke reference centre between November 2016 and April 2019 in order to assess the safety and effectiveness of mechanical thrombectomy performed beyond 6hours after symptoms onset in patients with acute ischaemic stroke and large vessel occlusion in the carotid artery territory.

Data were gathered from 59 patients (55.9% women; median age, 71 years). In 33 cases, stroke was detected upon awakening; 57.6% of patients were transferred from another hospital. Median baseline NIHSS score was 16, and median ASPECTS score was 8, with 94.9% of patients presenting>50% of salvageable tissue. Satisfactory recanalisation was achieved in 88.1% of patients, beyond 24hours after onset in 5 cases. At 90 days of follow-up, 67.8% were functionally independent; those who were not were older and presented higher prevalence of atrial fibrillation, greater puncture-to-recanalisation time, and higher NIHSS scores, both at baseline and at discharge.

In our experience, mechanical thrombectomy beyond 6hours was associated with good 90-day functional outcomes. Age, NIHSS score, puncture-to-recanalisation time, and presence of atrial fibrillation affected functional prognosis. The efficacy of the treatment beyond 24hours after onset merits study.
In our experience, mechanical thrombectomy beyond 6hours was associated with good 90-day functional outcomes. Age, NIHSS score, puncture-to-recanalisation time, and presence of atrial fibrillation affected functional prognosis. The efficacy of the treatment beyond 24hours after onset merits study.
The aim of this study was to adapt and validate the Schizophrenia Caregiver's Quality of Life Questionnaire (S-CGQoL) for use in the Hispanic-American population from the caregiver's perspective.

A cross-sectional instrumental model was used, with a sample of 253 caregivers of patients suffering of Schizophrenia in Bolivia, Peru and Chile. The psychometric properties of the S-CGQoL were tested through construct validity, reliability and some aspects of external validity. In addition, in order to assess the nature of the different items across the three countries, a Differential Performance Analysis (DPA) was conducted.

A confirmatory factor analysis showed that the scale structure was well correlated to the initial structure of the QoL-MDS. The results confirmed the existence of adequate reliability indicators (α>.70 and ω>.80) and the absence of FIDs supporting the invariance of item calibrations among the three Latin American countries.

The adaptation and validation of the S-CGQoL questionnaire demonstrate adequate psychometric properties to assess the quality of life of caregivers in samples of middle-income countries in Latin America.
The adaptation and validation of the S-CGQoL questionnaire demonstrate adequate psychometric properties to assess the quality of life of caregivers in samples of middle-income countries in Latin America.
Some patients in child and adolescent psychiatry present resistance to psychotropic drugs, often resulting in polytherapy, an increased risk of adverse events, and more frequent and longer hospitalisation. Psychotropic drugs are mainly metabolised in the liver, in particular by the CYP2D6 subunit of cytochrome P450. Anomalies such as a duplication of the CYP2D6 gene related to an ultra-rapid metaboliser phenotype has been described to be linked to clinical efficacy. However, little research has been done in child and adolescent psychiatry.

A multi-centric cross-sectional study in the southeast of France explored the relation between pharmaco-resistance to psychotropic drugs and the prevalence of duplications or polymorphisms of CYP2D6 associated with an ultra-rapid phenotype in children and adolescents with severe mental health disease.

Twenty-two patients have been included. The presence of an ultra-rapid phenotype concerns one patient in our study. A second patient presents a slow metaboliser phenotypirmed. An additional pharmacogenetic analysis by a panel of genes applied in the metabolism, transport and action of psychotropic drugs should be considered to answer questions about the resistance and independent effects of CYP2D6.Acute abdomen is a common reason for consultation in the emergency department. A broad spectrum of entities, including diverse diseases of the gastrointestinal tract, can cause acute abdomen. Although computed tomography is the technique most widely used to evaluate acute abdomen in the emergency department, abdominal ultrasound is often performed first and allows bowel disease to be suspected. This article describes the ultrasound features of diverse bowel diseases that can cause acute abdomen, such as acute diverticulitis, bowel obstruction, gastrointestinal perforation, bowel ischemia, intraabdominal fat necrosis, and miscellaneous processes such as endometriosis, foreign bodies, or vasculitis. Radiologists must be familiar with the different features of abnormal bowel that can be detected incidentally in patients without clinical suspicion of bowel disease. This article focuses on ultrasonographic signs of bowel disease; other articles in this series cover the ultrasonographic signs of acute appendicitis, inflammatory bowel disease, and infectious diseases.The main objective in the imaging differential diagnosis of an ovarian mass is to establish whether it is cystic or solid; solid lesions are less common. Ovarian fibromatosis is a benign disease of the ovary that is rarely included in the differential diagnosis of solid ovarian lesions. Characteristic features of masses that have a fibrous component are low signal in T1-weighted MRI sequences and especially in T2-weighted MRI sequences. The presence of peripheral fibrotic tissue around the residual ovarian tissue is specific to ovarian fibromatosis; on MRI, this results in marked hypointensity on T2-weighted images that has been dubbed the "black garland sign". This sign, together with slight peripheral enhancement after the administration of contrast material and the preservation of the ovarian architecture, facilitates the diagnosis, making it possible to avoid unnecessary surgical interventions.
Primary hyperparathyroidism (PHPT) caused by double adenoma may carry a higher risk of failure to cure. We compared outcomes in single adenoma (SA), double adenoma (DA) and four-gland hyperplasia (HP).

Patients undergoing initial parathyroidectomy for PHPT were categorized by diagnosis. The primary outcome was persistent/recurrent disease postoperatively.

Of 3408 patients, 81.3% had SA, 9.5% had DA, and 9.3% had HP. Rates of persistence/recurrence were 2.9%, 5.3%, and 4.5% in SA, DA, and HP, respectively (p=0.281). Patients with persistence/recurrence had higher preoperative calcium (11.0 vs 10.7mg/dl, p=0.028) and PTH (96 vs 77pg/ml, p=0.015), and lower rates of IOPTH normalization (77% vs 96%, p<0.001). On multivariable analysis, DA was associated with increased risk of persistent/recurrent disease (OR 3.0, p=0.017).

Most patients with DA are cured with removal of two glands, but approximately 5% experience disease persistence/recurrence. Low-normal final IOPTH was associated with lower risk of persistent/recurrent disease.
Most patients with DA are cured with removal of two glands, but approximately 5% experience disease persistence/recurrence. Low-normal final IOPTH was associated with lower risk of persistent/recurrent disease.
The effect of three-dimensional (3D) vs. two-dimensional (2D) video on performance of a spatially complex procedure and perceived cognitive load were examined among residents in relation to their visual-spatial abilities (VSA).

In a randomized controlled trial, 108 surgical residents performed a 5-Flap Z-plasty on a simulation model after watching the instructional video either in a 3D or 2D mode. Outcomes included perceived cognitive load measured by NASA-TLX questionnaire, task performance assessed using Observational Clinical Human Reliability Analysis and the percentage of achieved safe lengthening of the scar.

No significant differences were found between groups. However, when accounted for VSA, safe lengthening was achieved significantly more often in the 3D group and only among individuals with high VSA (OR=6.67, 95%CI 1.23-35.9, p=.027).

Overall, 3D instructional videos are as effective as 2D videos. However, they can be effectively used to enhance learning in high VSA residents.
Overall, 3D instructional videos are as effective as 2D videos. However, they can be effectively used to enhance learning in high VSA residents.
Parathyroidectomy is the only curative treatment for primary hyperparathyroidism (pHPT) and is associated with low morbidity. This study examined the severity of disease and outcomes of parathyroidectomy based on patient age at a high-volume institution.

This is a retrospective review of sporadic pHPT patients who underwent initial parathyroidectomy. To study disease severity over time, patients were divided into timeframes 1999-2007, 2007-2012, and 2013-2018. Elderly was defined as age ≥75 years.

Over time, the elderly had progressively lower preoperative calcium (11.0, 10.7, 10.7; p=0.05) and PTH (150.4, 111.9, 107.9; p<0.001) levels. By age, there was no difference in preoperative calcium (10.8, 10.9; p=0.91) or in rates of recurrent laryngeal nerve injury, hypoparathyroidism, or persistent/recurrent pHPT.

Over the 3 time periods of the study, elderly patients had progressively lower calcium and PTH levels. There was no difference in endocrine-specific complications between the age groups, suggesting that parathyroidectomy in the elderly is safe and therefore, age-associated morbidity should not preclude parathyroidectomy.
Over the 3 time periods of the study, elderly patients had progressively lower calcium and PTH levels. There was no difference in endocrine-specific complications between the age groups, suggesting that parathyroidectomy in the elderly is safe and therefore, age-associated morbidity should not preclude parathyroidectomy.
The clinical presentation of reduced pupillary responses in orbital apex syndrome is currently not well understood clinically. The pupillary light reflex (PLR) is determined using dynamic pupillometry.

A newly diagnosed 35-year-old diabetic female patient had ocular symptoms including orbital pain and ptosis, but no visual loss. Cranial nerve autonomic impairment was identified with dynamic pupillometry and compared with cardiac autonomic activity using heart rate variability (HRV).

PLR showed that pupil size and response were severely affected, with a small resting pupil size, and minimal response to a bright white light flash was seen, due to decreased sympathetic activity. However, HRV showed normal cardiac sympathetic activity.

These findings suggest that orbital apex syndrome may lead to changes in pupil size and response due to compression of sympathetic fibers at the apex of the orbit. Quantitative PLR measurements help to reveal relevant information on anatomical reflex pathways.
These findings suggest that orbital apex syndrome may lead to changes in pupil size and response due to compression of sympathetic fibers at the apex of the orbit. Quantitative PLR measurements help to reveal relevant information on anatomical reflex pathways.
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