A Rare Case of Aortic Valve Endocarditis and Acute Meningitis Due to Haemophilus influenzae

HACEK organisms represent a rare but important group of causative pathogens in endocarditis. These bacteria have historically been associated with culture-negative endocarditis;however, modern laboratory techniques have made this less common. In this case, we present a 74-year-old man who presented with acute onset altered mentation, fever, and sepsis. He was ultimately found to have Haemophilus influenzae meningitis, cerebral empyema, aortic valve endocarditis, psoas myositis, and L2 - L3 diskitis with osteomyelitis. Although HACEK organisms are commonly found in the oropharynx and upper respiratory tract in humans, our patient did not report recent preceding dental or ENT procedures. H. influenzae is responsible for approximately 0.16% of all cases of bacterial endocarditis, representing a very limited subset. Although generally considered low virulent pathogens, this case demonstrates the unusual extent of infection from a HACEK organism, H. influenzae, causing aortic valve endocarditis as well as atypical non-cardiac sequelae, including acute meningitis.

Pathological diagnosis and immunohistochemical analysis of minute pulmonary meningothelial-like nodules:A case report

BACKGROUND Minute Pulmonary Meningothelial-like Nodules(MPMNs)are rare benign pulmonary nodules,which are more common in elderly women and have a higher detection rate in lung tissues of patients with lung malignant diseases.Its origin is not yet clear.At present,there are few reports on the diagnostic methods such as imaging and pathological manifestations of MPMNs.This article reports a 70-year-old female patient with pulmonary adenocarcinoma combined with MPMNs and reviews of the relevant literature.CASE SUMMARY A 70-year-old women was admitted to our institution with feeling sour in her back and occasional cough for more than 2 mo.Computerized electronic scanning scan and 3D reconstruction images in our institution showed there were multiple ground-glass nodules in both of her two lungs.The biggest one was in the apicoposterior segment of left upper lobe,about 2.5 mm×9 mm in size.We performed thoracoscopic resection of the left upper lung apicoposterior segment of the patient,and the final pathological report was minimally invasive adenocarcinoma.Re-examination of high resolution computed tomography 21 mo after surgery showed multiple ground-glass nodules in both lungs,and a new groundglass nodule was found in the superior segment of the right lower lobe.We took pathological biopsy of the right upper lung and right lower lung nodules for the patient under thoracoscopy.The histomorphology of the right lower lobe nodule showed multiple lesions in the lung tissue,and the small foci in the alveolar septum were distributed in mild form of the aggregation of short spindle cells.The immunohistochemistry showed that the lesion was epithelial membrane antigen(EMA)(+),somatostatin receptor 2a(SSTR2a)(+),S-100(-),chromogranin A(-),Syn(-),cytokeratin(-)and HMB-45(-).The final diagnosis was minimally invasive adenocarcinoma,accompanied by MPMNs.We recommend that patients continue to receive treatment after surgery and to do regular follow-up observations.CONCLUSION The imaging manifestations of MPMNs are atypical,histomorphology and immunohistochemistry can assist in its diagnosis.This article reviews the relevant literature of MPMNs immunohistochemistry and shows that MPMNs are positive for EMA,SSTR2a,and progesterone receptor.

Role of platelet-rich plasma in the treatment of rotator cuff tendinopathy

Shoulder pain is a common musculoskeletal complaint,and rotator cuff(RC)pathologies are one of the main causes.The RC undergoes various tendinopathic and avascular changes during the aging process.Other degenerative changes affecting its healing potential make it an appealing target for biological agents.Platelet-rich plasma(PRP)has demonstrated the potential to deliver a high concentration of several growth factors and anti-inflammatory mediators,and its clinical use is mainly supported by experiments that demonstrated its positive effect on muscle,ligaments,and tendinous cells.This review aimed to specify the role of PRP and its future applications in RC tendinopathies based on the current clinical evidence.Due to the different characteristics and conflicting outcomes,clinicians should use PRP with moderate expectations until more consistent evidence is available.However,it is reasonable to consider PRP in patients with contraindications to corticosteroid injections or those with risk factors for inadequate healing.Its autologous origin makes it a safe treatment,and its characteristics make it a promising option for treating RC tendinopathy,but the efficacy has yet to be established.

A Brief Review of a Common Clinical Question: Intravenous Diltiazem or Metoprolol for Atrial Fibrillation with Rapid Ventricular Response?

Two classes of rate controlling medications—beta blockers (BBs) and non- dihydropyridine calcium channel blockers (CCBs)—are given to patients who present with atrial fibrillation (AF) with rapid ventricular response (RVR). Both are Class I recommendations from the American Heart Association (AHA), American College of Cardiology (ACC), and Heart Rhythm Society (HRS) for the management of AF with RVR. Multiple studies support the view that diltiazem is more effective than metoprolol, even though data from the AFFIRM trial suggests BBs are more frequently used. CCBs are generally avoided in AF with RVR patients who have concomitant heart failure with reduced ejection fraction (HFrEF) for concern of triggering decompensation. However, some recent studies indicate this idea may be unfounded. The aim of this article is to compare the efficacy of diltiazem and metoprolol for rate control in AF with RVR and examine the use of diltiazem in patients with both AF with RVR and HFrEF.

Therapeutic effects of Astragali Radix on diabetic foot:a clinical randomized controlled trial

Objective:This study was conducted to evaluate the efficacy of Astragalus on diabetic foot,as well as the effects on the levels of serum VEGF,bFGF,MMP-2,and inflammatory factors in patients,and to provide a scientific basis for the treatment of diabetic foot with the traditional Chinese medicine Astragalus.Methods:By taking 100 cases of diabetic foot patients who were admitted to the metabolic internal medicine division of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine and met the criteria of natriuresis during April 2021-April 2023 as the study subjects,and according to the random number method,all patients were divided into the control group and the observation group,with 50 cases in each group.In the control group,only basic treatment was carried out,while in the observation group,Astragalus injection was added based on the control group.After 8 weeks of treatment,the clinical efficacy,serum VEGF,bFGF,MMP-2,and inflammatory factor levels of the patients in the two groups were compared,respectively.Results:The total clinical efficiency of patients in the observation group was significantly better than that in the control group(χ^(2)=5.01,P<0.05).The inflammatory factor indexes decreased substantially in both groups.However,the decrease in the observation group was significantly higher than in the control group(P<0.05).Compared with the control group,serum VEGF and bFGF were considerably higher in the observation group,while MMP-2 was significantly lower(P<0.05).Conclusion:Astragali Radix is clinically effective in the diabetic foot,which can induce vascular endothelial repair and reduce the level of inflammatory factors,to improve the inflammatory state of patients and promote the restoration of ulcerated wound tissue,which is worth promoting in clinical practice.

Repetitive traumatic brain injury–induced complement C1–related inflammation impairs long-term hippocampal neurogenesis

Repetitive traumatic brain injury impacts adult neurogenesis in the hippocampal dentate gyrus,leading to long-term cognitive impairment.However,the mechanism underlying this neurogenesis impairment remains unknown.In this study,we established a male mouse model of repetitive traumatic brain injury and performed long-term evaluation of neurogenesis of the hippocampal dentate gyrus after repetitive traumatic brain injury.Our results showed that repetitive traumatic brain injury inhibited neural stem cell proliferation and development,delayed neuronal maturation,and reduced the complexity of neuronal dendrites and spines.Mice with repetitive traumatic brain injuryalso showed deficits in spatial memory retrieval.Moreover,following repetitive traumatic brain injury,neuroinflammation was enhanced in the neurogenesis microenvironment where C1q levels were increased,C1q binding protein levels were decreased,and canonical Wnt/β-catenin signaling was downregulated.An inhibitor of C1 reversed the long-term impairment of neurogenesis induced by repetitive traumatic brain injury and improved neurological function.These findings suggest that repetitive traumatic brain injury–induced C1-related inflammation impairs long-term neurogenesis in the dentate gyrus and contributes to spatial memory retrieval dysfunction.

Immune cell signatures and causal association with irritable bowel syndrome:A mendelian randomization study

BACKGROUND The mucosal barrier's immune-brain interactions,pivotal for neural development and function,are increasingly recognized for their potential causal and therapeutic relevance to irritable bowel syndrome(IBS).Prior studies linking immune inflammation with IBS have been inconsistent.To further elucidate this relationship,we conducted a Mendelian randomization(MR)analysis of 731 immune cell markers to dissect the influence of various immune phenotypes on IBS.Our goal was to deepen our understanding of the disrupted brain-gut axis in IBS and to identify novel therapeutic targets.AIM To leverage publicly available data to perform MR analysis on 731 immune cell markers and explore their impact on IBS.We aimed to uncover immunophenotypic associations with IBS that could inform future drug development and therapeutic strategies.METHODS We performed a comprehensive two-sample MR analysis to evaluate the causal relationship between immune cell markers and IBS.By utilizing genetic data from public databases,we examined the causal associations between 731 immune cell markers,encompassing median fluorescence intensity,relative cell abundance,absolute cell count,and morphological parameters,with IBS susceptibility.Sensitivity analyses were conducted to validate our findings and address potential heterogeneity and pleiotropy.RESULTS Bidirectional false discovery rate correction indicated no significant influence of IBS on immunophenotypes.However,our analysis revealed a causal impact of IBS on 30 out of 731 immune phenotypes(P<0.05).Nine immune phenotypes demonstrated a protective effect against IBS[inverse variance weighting(IVW)<0.05,odd ratio(OR)<1],while 21 others were associated with an increased risk of IBS onset(IVW≥0.05,OR≥1).CONCLUSION Our findings underscore a substantial genetic correlation between immune cell phenotypes and IBS,providing valuable insights into the pathophysiology of the condition.These results pave the way for the development of more precise biomarkers and targeted therapies for IBS.Furthermore,this research enriches our comprehension of immune cell roles in IBS pathogenesis,offering a foundation for more effective,personalized treatment approaches.These advancements hold promise for improving IBS patient quality of life and reducing the disease burden on individuals and their families.

Health-related quality of life evaluated by tumor node metastasis staging system in patients with hepatocellular carcinoma

AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study. One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection, 73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%), hepatitis C (1.4%) or cryptogenic (0.7%). All subjects were fully aware of their diagnosis and provided informed consent. HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACT-Hep) questionnaire. Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients. One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages. Scores for all FACT-Hep items were analyzed by frequency analyses. The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated. RESULTS: The mean FACT-Hep scores were reduced significantly from TNM StageⅠto Stage Ⅱ, Stage ⅢA, Stage ⅢB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44, P = 0.001). Regarding the physical and emotional well-being subscales, scores decreased gradually from Stage Ⅰ to Stage ⅢB (P = 0.002 vs Stage Ⅰ; P = 0.032 vs Stage Ⅱ; P = 0.033 vs Stage ⅢA). Mean FACT-Hep scores varied by Child-Pugh class, especially in the subscales of physical well-being, functional well-being and the hepatobiliary cancer (P = 0.001 vs Stage I; P = 0.036 vs Stage Ⅱ; P = 0.032 vs Stage ⅢA). For the social and family well-being subscale, only Stage ⅢB scores were significantly lower as compared with Stage Ⅰ scores (P = 0.035). For the subscales of functional well-being and hepatobiliary cancer, there were significant differences for Stages ⅡΙ, ⅢA and ⅢB (P = 0.002vs StageⅠ). CONCLUSION: HRQoL of patients with HCC worsens gradually with progression of TNM stages. The most impaired subscales of HRQoL, as measured by FACT-Hep, were physical and emotional well-being.

Effectiveness of the flipped classroom on the development of self-directed learning in nursing education:a meta-analysis

Objectives: To examine the best practice evidence of the effectiveness of the flipped classroom（FC） as a burgeoning teaching model on the development of self-directed learning in nursing education.Data sources: The relevant randomized controlled trial（RCT） and non-RCT comparative studies were searched from multiple electronic databases including PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature（CINAHL）, Cochrane Central Register of Controlled Trials（CENTRAL）, Wanfang Data, China National Knowledge Infrastructure（CNKI）, and Chinese Science and Technology Periodical Database（VIP） from inception to June 2017.Review methods: The data were independently assessed and extracted for eligibility by two reviewers. The quality of included studies was assessed by another two reviewers using a standardized form and evaluated by using the Cochrane Collaboration’s risk of bias tool. The self-directed learning scores（continuous outcomes） were analyzed by using the 95% confidence intervals（Cls） with the standard deviation average（SMD） or weighted mean difference（WMD）. The heterogeneity was assessed using Cochran’s I;statistic.Results: A total of 12 studies, which encompassed 1440 nursing students（intervention group = 685, control group = 755）, were eligible for inclusion in this review. Of 12 included studies, the quality level of one included study was A and of the others was B. The pooled effect size showed that compared with traditional teaching models, the FC could improve nursing students’ selfdirected learning skill, as measured by the Self-Directed Learning Readiness Scale（SDLRS）, Self-Directed Learning Readiness Scale for Nursing Education（SDLRSNE）, Self-Regulated Learning Scale（SRL）, Autonomous Learning Competencies scale（ALC）, and Competencies of Autonomous Learning of Nursing Students（CALNS）. Overall scores and subgroup analyses with the SRL were all in favor of the FC.Conclusions: The result of this meta-analysis indicated that FCs could improve the effect of self-directed learning in nursing education.Future studies with more RCTs using the same measurement tools are needed to draw more authoritative conclusions.

Effect of bortezomib on migration and invasion in cervical carcinoma HeLa cell

Objective:To explore the effect of bortezomib on migration and invasion of cervical carcinoma HeLa cell and specific molecular mechanism.Methods:The effect of bortezomib on the viability of HeLa cell was measured by MTT assay.The effect of bortezomib on cell migration and invasion was measured by Transwell assay and invasion experiment respectively.The activation of Akt/mTOR signaling pathway and expression level of MMP2,MMP9 were assayed by western blot.Results:MTT assay indicated bortezomib(2.5 μM.5 μM,10 μM)could inhibit HeLa cell viability,and the inhibitory rate was highest at 48 h.Transwell assay and invasion experiment results showed that bortezomib inhibited HeLa cell migration and invasion.Western blotting assays presented bortezomib could suppress the phosphorylation of Akt and mTOR.and down-regulate the expression of MMP2 and MMP9.Conclusions:These results suggested bortezomib could inhibit migration and invasion in cervical carcinoma HeLa cell,which might be related to Akt/mTOR signal pathway.

Significance of mitochondrial activity in neurogenesis and neurodegenerative diseases

Mitochondria play a multidimensional role in the function and the vitality of the neurological system.From the generation of neural stem cells to the maintenance of neurons and their ultimate demise,mitochondria play a critical role in regulating our neural pathways'homeostasis,a task that is critical to our cognitive health and neurological well-being.Mitochondria provide energy via oxidative phosphorylation for the neurotransmission and generation of an action potential along the neuron's axon.This paper will first review and examine the molecular subtleties of the mitochondria's role in neurogenesis and neuron vitality,as well as outlining the impact of defective mitochondria in neural aging.The authors will then summarize neurodegenerative diseases related to either neurogenesis or homeostatic dysfunction.Because of the significant detriment neurodegenerative diseases have on the quality of life,it is essential to understand their etiology and ongoing molecular mechanics.The mitochondrial role in neurogenesis and neuron vitality is essential.Dissecting and understanding this organelle's role in the genesis and homeostasis of neurons should assist in finding pharmaceutical targets for neurodegenerative diseases.

Pattern recognition and data mining software based on artificial neural networks applied to proton transfer in aqueous environments

In computational physics proton transfer phenomena could be viewed as pattern classification problems based on a set of input features allowing classification of the proton motion into two categories： transfer ＇occurred＇ and transfer ＇not occurred＇. The goal of this paper is to evaluate the use of artificial neural networks in the classification of proton transfer events, based on the feed-forward back propagation neural network, used as a classifier to distinguish between the two transfer cases. In this paper, we use a new developed data mining and pattern recognition tool for automating, controlling, and drawing charts of the output data of an Empirical Valence Bond existing code. The study analyzes the need for pattern recognition in aqueous proton transfer processes and how the learning approach in error back propagation （multilayer perceptron algorithms） could be satisfactorily employed in the present case. We present a tool for pattern recognition and validate the code including a real physical case study. The results of applying the artificial neural networks methodology to crowd patterns based upon selected physical properties （e.g., temperature, density） show the abilities of the network to learn proton transfer patterns corresponding to properties of the aqueous environments, which is in turn proved to be fully compatible with previous proton transfer studies.

Multi-target tracking algorithm of boost-phase ballistic missile defense

Considering the problem of multiple ballistic missiles tracking of boost-phase ballistic missile defense, a boost-phase tracking algorithm based on multiple hypotheses tracking （MHT） concept is proposed. This paper focuses on the tracking algo- rithm for hypothesis generation, hypothesis probability calculation, hypotheses reduction and pruning and other sectors. From an engineering point of view, a technique called the linear assignment problem （LAP） used in the implementation of M-best feasible hypotheses generation, the number of the hypotheses is relatively small compared with the total number that may exist in each scan, also the N-scan back pruning is used, the algorithm＇s efficiency and practicality have been improved. Monte Carlo simulation results show that the proposed algorithm can track the boost phase of multiple ballistic missiles and it has a good tracking performance compared with joint probability data association （JPDA）.

Evaluation of the dual vascular supply patterns in ground-glass nodules with a dynamic volume computed tomography

BACKGROUND In recent years,the detection rate of ground-glass nodules(GGNs)has been improved dramatically due to the popularization of low-dose computed tomography(CT)screening with high-resolution CT technique.This presents challenges for the characterization and management of the GGNs,which depends on a thorough investigation and sufficient diagnostic knowledge of the GGNs.In most diagnostic studies of the GGNs,morphological manifestations are used to differentiate benignancy and malignancy.In contrast,few studies are dedicated to the assessment of the hemodynamics,i.e.,perfusion parameters of the GGNs.AIM To assess the dual vascular supply patterns of GGNs on different histopathology and opacities.METHODS Forty-seven GGNs from 47 patients were prospectively included and underwent the dynamic volume CT.Histopathologic diagnoses were obtained within two weeks after the CT examination.Blood flow from the bronchial artery[bronchial flow(BF)]and pulmonary artery[pulmonary flow(PF)]as well as the perfusion index(PI)=[PF/(PF+BF)]were obtained using first-pass dual-input CT perfusion analysis and compared respectively between different histopathology and lesion types(pure or mixed GGNs)and correlated with the attenuation values of the lesions using one-way ANOVA,student’s t test and Pearson correlation analysis.RESULTS Of the 47 GGNs(mean diameter,8.17 mm;range,5.3-12.7 mm),30(64%)were carcinoma,6(13%)were atypical adenomatous hyperplasia and 11(23%)were organizing pneumonia.All perfusion parameters(BF,PF and PI)demonstrated no significant difference among the three conditions(all P>0.05).The PFs were higher than the BFs in all the three conditions(all P<0.001).Of the 30 GGN carcinomas,14 showed mixed GGNs and 16 pure GGNs with a higher PI in the latter(P<0.01).Of the 17 benign GGNs,4 showed mixed GGNs and 13 pure GGNs with no significant difference of the PI between the GGN types(P=0.21).A negative correlation(r=-0.76,P<0.001)was demonstrated between the CT attenuation values and the PIs in the 30 GGN carcinomas.CONCLUSION The GGNs are perfused dominantly by the PF regardless of its histopathology while the weight of the BF in the GGN carcinomas increases gradually during the progress of its opacification.

RESPONSE OF PARAMETRICALLY EXCITED DUFFING-VAN DER POL OSCILLATOR WITH DELAYED FEEDBACK

The dynamical behaviour of a parametrically excited Duffing-van der Pol oscillator under linear-plus-nonlinear state feedback control with a time delay is concerned. By means of the method of averaging together with truncation of Taylor expansions, two slow-flow equations on the amplitude and phase of response were derived for the case of principal parametric resonance, it is shown that the stability condition for the trivial solution is only associated with the linear terms in the original systems besides the amplitude and frequency of parametric excitation. And the trivial solution can be stabilized by appreciate choice of gains and time delay in feedback control. Different from the case of the trivial solution, the stability condition for nontrivial solutions is also associated with nonlinear terms besides linear terms in the original system. It is demonstrated that nontrivial steady state responses may lose their stability by saddle-node （SN） or Hopf bifurcation （HB） as parameters vary. The simulations, obtained by numerically integrating the original system, are in good agreement with the analytical results.

Reliability and validity of the Chinese version of the new fear of hypoglycemia scale: FH-15

Objective:This study aimed to evaluate the reliability and validity of the Chinese version of the Fear of Hypoglycemia scale with 15 items(FH-15).Methods:After obtaining the original author's authorization,the English version of the FH-15 scale was translated,back translated,and culturally debugged to obtain the Chinese version of FH-15.A convenient sampling method was used to extract patients with type 2 diabetes from four tertiary hospitals in Tianjin.A total of 408 patients with type 2 diabetes were investigated in the hospital to test the reliability and validity of Chinese version FH-15 scale.Results:The content validity index of the scale was 0.92,and the content validity index of each item was 0.8-1.0.The exploratory factor analysis extracted three common factors(fear,avoidance,and interference),which contained 15 items,and the cumulative variance contribution rate was 71.245%.The confirmatory factor analysis results showed that the model fit was better at 1.981 x2/df,GFI=0.901,CGI=0.962,TLI=0.952,and RMSEA=0.070.The cut-off value for the total hypoglycemia fear scale was 30.5.The Cronbach'sαcoefficient of the three dimensions of the scale was 0.918,the Cronbach'sαcoefficient of each dimension is 0.876-0.916,the test-retest reliability was 0.903,and the test-retest reliability of each factor was 0.733-0.930.Conclusion:The Chinese version of the FH-15 scale can be considered reliable and valid.The item expression is concise,clear,and easy to understand.It is suitable for clinical practice as an initial screening tool to identify and evaluate the severity of fear of hypoglycemia in patients with type 2 diabetes.

Activating interactions of sulfanilamides with T cell receptors

Activation and expansion of drug reactive T cells are key features in drug hypersensitivity reactions. Drugs may interact directly with immune receptors such as the human leukocyte antigens (HLA) or the T-cell receptors (TCR) itself, the pharmacological interaction [p-i] concept. To analyze whether the drug sulfamethoxazole (SMX) interacts directly with the TCR and thereby contributing to signaling and T cell activation, we analyze two SMX specific T cell clones (TCC “1.3”and “H13”). Proliferation to SMX and 11 related sulfanilamides, Ca++ influx in drug stimulated T-cells and the inhibitory effect of non-reactive sulfanilamides on SMX stimulation were analyzed. In silico docking of SMX and related sulfanilamide to the TCR were used to identify possible drug binding sites, and correlated to in vitro data to find the correct docking. In Ca++ influx assays, reactions occurred as early as 14 sec after adding SMX to TCC and APC. The broadly reactive clone (“H13”) was stimulated by 5 additional sulfanilamide, while one TCC (“1.3”) was reactive exclusively with SMX but not other sulfanilamides. Competition experiments with sulfanilamide inhibited SMX induced Ca++ influx and proliferation of the TCC1.3 ina dose dependent way. Docking experiments with SMX and related sulfanilamides confirmed and explained the in vitro data as docking localized binding sites for SMX and the 5 stimulating sulfanilamides on the CDR2β domain of the clone H13, while the 6 non-stimulatory SA failed to bind. In TCC 1.3, SMX could be docked on the CDR3α of the TCR. The other, non-stimulatory but inhibitory SA could also be docked to the same site. The combined analysis of in vitro and in silico data show that sulfanilamide can bind directly to TCRs. It shows that TCR, like other receptors, appear to be reamenable to manipulations by small molecules.

Treatment of Tannery Wastewater by the Application of Electrocoagulation Process Using Iron and Aluminum Electrodes

Until relatively recently, little has been done of effective technique “zero effluent” to conserve energy and water. Tannery wastewater is known as complex characteristics. In this study batch electrocoagulation experiments were carried out to assess the removal of color and chemical oxygen demand (COD) from tannery wastewater using two types of electrode materials: aluminum and iron. The effects of current density, electrolysis time and initial pH were investigated for tannery wastewater. Therefore, the operating costs for each electrode have been calculated. Based on results, it can be concluded that iron is tremendous to aluminum as electrode material, from COD removal and energy consumption views. All the conclusions of the study revealed that treatment of tannery by EC can be applied as a step of a hybrid treatment.

Delayed diagnosis of arytenoid cartilage dislocation after tracheal intubation in the intensive care unit:A case report

BACKGROUND Arytenoid cartilage dislocation is a rare and often overlooked complication of tracheal intubation or blunt laryngeal trauma.The most common symptom is persistent hoarseness.Although cases of arytenoid dislocation due to tracheal intubation are reported more frequently in otolaryngology,reports on its occurrence in the intensive care unit(ICU)are lacking.We report a case of delayed diagnosis of arytenoid cartilage dislocation after tracheal intubation in the ICU.CASE SUMMARY A 20-year-old woman was referred to the ICU following a fall from a height.Her voice was normal;laryngeal computed tomography showed unremarkable findings on admission.However,due to deterioration of the patient’s condition,tracheal intubation,and emergency exploratory laparotomy followed by laparoscopic surgery two d later under general anesthesia were performed.After extubation,the patient was sedated and could not communicate effectively.On the 10th day after extubation,the patient complained of hoarseness and coughing with liquids,which was attributed to laryngeal edema and is common after tracheal intubation.Therefore,specific treatment was not administered.However,the patient’s symptoms did not improve.Five d later,an electronic laryngoscope examination revealed dislocation of the left arytenoid cartilage.The patient underwent arytenoid closed reduction under general anesthesia by an experienced otolaryngologist.Reported symptoms improved subsequently.The sixmonth follow up revealed that the hoarseness had resolved within four weeks of the reduction procedure.CONCLUSION Symptoms of arytenoid cartilage dislocation are difficult to identify in the ICU leading to missed or delayed diagnosis among patients.

Spatial Zonation and Diversity of Bivalves and Gastropods in Mangrove Forests of Casiguran, Aurora, Philippines

This study generally aimed to determine the spatial zonation and diversity of bivalves and gastropods in mangrove forest of Cozo, Esteves and Tinib in Casiguran, Aurora. Specifically, this aimed to determine the species composition and distribution, and determine the relationship between spatial zonation and diversity of bivalves and gastropods as influenced by ecological factors such as vegetation, soil texture, organic matter, soil salinity, and soil pH. A total of 22 taxa comprising eight species of bivalves and 14 species of gastropods were identified. The high tidal zone of Esteves had high diversity (0.66) of bivalve species compared to other tidal zones and areas. On the other hand, the diversity of gastropods was almost equal in the middle tidal zones of Cozo (0.60), Esteves (0.57), and Tinib (0.42). In terms of bivalve species’ density and abundance, Dendostrea folium was the most dense and abundant in the low tidal zone of Cozo (253,333 ind.ha−1 or 25 ind.m2-1, 97.44%) while Gafrarium tumidum in the low tidal zones of Esteves (46,666 ind.ha−1 or 4 ind.m2-1, 73.68%) and Tinib (126,666 ind.ha−1 or 12 ind.m2-1, 50%). In terms of gastropod species’ density and abundance, Cerithidea cingulata was the most dense and abundant in the low tidal zone (666,666 ind.ha−1 or 66 ind.m2-1, 65.79%) of Cozo and the middle tidal zone (5,280,000 ind.ha−1 or 528 ind.m2-1, 61.40%) of Tinib. It was Terebralia palustris in the low tidal zone (1,263,333 ind.ha−1 or 126 ind.m2-1, 63.06%) of Esteves. All tidal zones within each study area had greater dissimilarities in terms of bivalves but had greater similarities in terms of gastropod species’ compositions. On the other hand, all tidal zones between study areas had greater dissimilarities in terms of bivalve and gastropod species present. Most tidal zones had Gafrarium tumidum as common bivalve species while Neritidae sp. and Cerithidea cingulata were common gastropod species. All these species were found thriving in a wide range of vegetation, soil texture, organic matter, soil salinity and pH.