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Abstract We present the case of a 7-year-old Ecuadorian mestizo girl with multiple orofacial malformations. The patient is the product of a first-degree relationship (father–daughter). A cytogenetic study revealed a normal karyotype. The genetic mapping array study identified 0.73 Gb of alterations, 727,087,295 bp involved in regions of homozygosity (ROH) in all chromosomes (25.2% of the genome) and 764,028 bp in gains in chromosomes 9 and 14. Genes from the TGFB, BMP, FGF, SHH and WNT families, among others, were identified in the ROH. They are related to craniofacial development and their protein products showed a strong association in the interactome analysis.

This paper revisits the Greek *-nthos- and *-ssos/*-ttos names and analyzes them in the context of the language contacts between the Pre-Proto-Greek peoples arriving in Greece and the Pre-Greek populations already in place. It starts overviewing the prehistoric process of formation of the Greek language from Proto-Indo-European. A few concepts are defined, such as Pre-Proto-Greek, Proto-Greek, Common Greek and Pre-Greek. After an update on the main hypotheses regarding the dates of entry into Greece, the author stresses the role of the Pre-Greek substratum in the shaping of Proto-Greek due to the implicit phenomenon of language shift completed by the Pre-Greek population, and proceeds to an initial analysis, on the basis of the limited data available, of the Pre-Greek language(s), making use of Pre-Greek onomastics as the main, albeit indirect, source of information. With these names on the table, it is postulated that the phonological structure of the Proto-Greek plosive consonants (the fact, in particular, that the inherited voiced aspirated plosives appear as voiceless aspirated plosives in Greek) may show the effect of Pre-Greek, whose linguistic affiliation has given rise to several conflicting theories and many doubts. Even if the Anatolian hypothesis has seduced many researchers, a non-Indo-European option seems preferable. After considering different Pre-Indo-European proposals (Beekes, Facchetti, Schrijver), conclusions are drawn about possible coincidences between the Pre-Greek and Etruscan phonological systems and what this may imply. Schrijver’s recent suggestion that perhaps the language of the Minoans could be distantly related to Hattic is also considered. This could constitute an alternative explanation to the toponymic coincidences between the two regions: they could be sharing a pre-Indo-European substratum.

In this study, a nonlinear mathematical SIR system is explored numerically based on the dynamics of the waterborne disease, e.g., cholera, that is used to incorporate the delay factor through the antiseptics for disease control. The nonlinear mathematical SIR system is divided into five dynamics, susceptible X(u), infective Y(u), recovered Z(u) along with the B(u) and Ch(u) be the contaminated water density. Three cases of the SIR system are observed using the artificial neural network (ANN) along with the computational Levenberg-Marquardt backpropagation (LMB) called ANNLMB. The statistical performances of the SIR model are provided by the selection of the data as 74% for authentication and 13% for both training and testing, together with 12 numbers of neurons. The exactness of the designed ANNLMB procedure is pragmatic through the comparison procedures of the proposed and reference results based on the Adam method. The substantiation, constancy, reliability, precision, and ability of the proposed ANNLMB technique are observed based on the state transitions measures, error histograms, regression, correlation performances, and mean square error values.

This work aims to provide the numerical performances of the computer epidemic virus model with the time delay effects using the stochastic Levenberg-Marquardt backpropagation neural networks (LMBP-NNs). The computer epidemic virus model with the time delay effects is categorized into four dynamics, the uninfected S(x) computers, the latently infected L(x) computers, the breaking-out B(x) computers, and the antivirus PC's aptitude R(x). The LMBP-NNs approach has been used to numerically simulate three cases of the computer virus epidemic system with delay effects. The stochastic framework for the computer epidemic virus system with the time delay effects is provided using the selection of data with 11%, 13%, and 76% for testing, training, and verification together with 15 neurons. The proposed and data-based Adam technique is overlapped to execute the LMBP-NNs method's exactness. The constancy, authentication, precision, and capability of the LMBP-NNs scheme are perceived with the analysis of the state transition measures, regression actions, correlation performances, error histograms, and mean square error measures.

Abstract Epithelial-mesenchymal transition (EMT) is a fundamental process for embryonic development during which epithelial cells acquire mesenchymal characteristics, and the underlying mechanisms confer malignant features to carcinoma cells such as dissemination throughout the organism and resistance to anticancer treatments. During the past decades, an entire class of molecules, called non-coding RNA (ncRNA), has been characterized as a key regulator of almost every cellular process, including EMT. Like protein-coding genes, ncRNAs can be deregulated in cancer, acting as oncogenes or tumor suppressors. The various forms of ncRNAs, including microRNAs, PIWI-interacting RNAs, small nucleolar RNAs, transfer RNA-derived RNA fragments, long non-coding RNAs, and circular RNAs can orchestrate the complex regulatory networks of EMT at multiple levels. Understanding the molecular mechanism underlying ncRNAs in EMT can provide fundamental insights into cancer metastasis and may lead to novel therapeutic approaches. In this review, we describe recent advances in the understanding of ncRNAs in EMT and provide an overview of recent ncRNA applications in the clinic.

Resumen: Introducción: Las guías recomiendan el uso combinado del Test de Adherencia a Inhaladores (TAI) y el «% de fármaco retirado con respecto al prescrito (PRR)» para determinar la adhesión terapéutica, pero la evidencia basada en estudios comparativos es limitada. Nuestro objetivo fue determinar el nivel de adhesión mediante el TAI y PRR, así como el grado de correlación y concordancia entre ambos métodos. Métodos: Estudio transversal multicéntrico, en el que se incluyeron los primeros 196 pacientes asmáticos adultos consecutivos, de los cuales 183 estaban en tratamiento de mantenimiento con glucocorticoides inhalados (GCI). Se definió «noadherencia» como un TAI 50%. The concordance results supports, in line with guideline recommendations, that the use of both approaches (TAI and PRR) increases the ability to identify poor adherence compared to TAI or PRR alone.

Abstract Sarcomas are mesenchymal cancers which often show an aggressive behavior and patient survival largely depends on an early detection. In last years, much attention has been given to the fact that cancer patients release specific odorous volatile organic compounds (VOCs) that can be efficiently detected by properly trained sniffer dogs. Here, we have evaluated for the first time the ability of sniffer dogs (n = 2) to detect osteosarcoma cell cultures and patient samples. One of the two dogs was successfully trained to discriminate osteosarcoma patient-derived primary cells from mesenchymal stem/stromal cells (MSCs) obtained from healthy individuals. After the training phase, the dog was able to detect osteosarcoma specific odor cues in a different panel of 6 osteosarcoma cell lines with sensitivity and specificity rates between 95 and 100%. Moreover, the same VOCs were also detected by the sniffer dog in saliva samples from osteosarcoma patients (n = 2) and discriminated from samples from healthy individuals with a similar efficacy. Altogether, these results indicate that there are common odor profiles shared by cultures of osteosarcoma cells and body fluid samples from patients and provide a first proof of concept about the potential of canine odor detection as a non-invasive screening method to detect osteosarcomas.

Determining the languages spoken in the south of the Iberian Peninsula in antiquity, in pre-Roman times and during Romanization, is no easy task. Although we have an important corpus of indigenous inscriptions, the different writing systems identified have not been fully deciphered, which is especially true for the southern varieties of the complex Palaeohispanic family of scripts. This paper opens with a brief introduction to the different epigraphic areas of the southern Iberian Peninsula with a note to the special situation of the southwest, to offer an alternative look on the contours of “Tartessian” topographic layer. The author points out that the Tartessian label should be limited to a territory in a specific region of the central and lower Guadalquivir valley and that the region of southern Portugal (in the Algarve) where an important collection of about 100 large funerary stelae has been found, seems to be outside or at least on the periphery of the Tartessian world, even if these inscriptions are called “Tartessian” by many researchers. To date, there are different ways of interpreting the language(s) reflected in the southern epigraphic texts, especially those from the central and western regions of Andalusia and southern Portugal. The Iberian language inscriptions found in the southeast are comparatively better read and understood. The present paper seeks further arguments in the discussion of southern languages by analysing a set of onomastic elements (personal and place names) distributed over a wide region of the central and lower Guadalquivir valley and southern Portugal, attested in antiquity. Some conclusions are drawn as to what they may imply in terms of the linguistic map of the area, as well as in terms of the different linguistic strata during the centuries before the arrival of the Romans.

High methionine and S-adenosylmethionine serum levels are related with obesity. Here the authors show that knockdown of methionine adenosyltransferase by using antisense oligonucleotides provides beneficial effects in obesity and comorbidities.

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children

Cardiotoxicity due to anthracyclines (CDA) affects cancer patients, but we cannot predict who may suffer from this complication. CDA is a complex trait with a polygenic component that is mainly unidentified. We propose that levels of intermediate molecular phenotypes (IMPs) in the myocardium associated with histopathological damage could explain CDA susceptibility, so variants of genes encoding these IMPs could identify patients susceptible to this complication. Thus, a genetically heterogeneous cohort of mice (n = 165) generated by backcrossing were treated with doxorubicin and docetaxel. We quantified heart fibrosis using an Ariol slide scanner and intramyocardial levels of IMPs using multiplex bead arrays and QPCR. We identified quantitative trait loci linked to IMPs (ipQTLs) and cdaQTLs via linkage analysis. In three cancer patient cohorts, CDA was quantified using echocardiography or Cardiac Magnetic Resonance. CDA behaves as a complex trait in the mouse cohort. IMP levels in the myocardium were associated with CDA. ipQTLs integrated into genetic models with cdaQTLs account for more CDA phenotypic variation than that explained by cda-QTLs alone. Allelic forms of genes encoding IMPs associated with CDA in mice, including AKT1, MAPK14, MAPK8, STAT3, CAS3, and TP53, are genetic determinants of CDA in patients. Two genetic risk scores for pediatric patients (n = 71) and women with breast cancer (n = 420) were generated using machine-learning Least Absolute Shrinkage and Selection Operator (LASSO) regression. Thus, IMPs associated with heart damage identify genetic markers of CDA risk, thereby allowing more personalized patient management.

In this work, a perturbed system of the restricted three-body problem is derived when the perturbation forces are conservative alongside the corresponding mean motion of two primaries bodies. Thus, we have proved that the first and second types of periodic orbits of the rotating Kepler problem can persist for all perturbed two-body and circular restricted three-body problems when the perturbation forces are conservative or the perturbed motion has its own extended Jacobian integral.

The Iberian desman (Galemys pyrenaicus) is a small semi-aquatic mammal that inhabits mountainous areas from the centre to the north of the Iberian Peninsula and the Pyrenees and is listed as endangered because it has suffered a serious decline. Since 1960, only three species of digeneans (Omphalometra flexuosa, Maritrema pyrenaica and Mathovius galemydis) and two nematodes (Aonchotheca galemydis and Paracuaria hispanica) have been reported from the desman, but no further information on health status and no data from Extremadura has been available. The aim of our study was to characterise the diversity and distribution of parasites and microbiomes of desmans in different areas of the Central System of Extremadura. Between 2019 and 2021 we collected 238 fecal samples and one tissue (intestine) sample that was obtained from a dead desman. DNA templates were processed by commercial or customised real-time PCR using TaqMan probes. Representative data were obtained for Cryptosporidium spp., Omphalometra spp., Eimeria spp., Salmonella spp., Staphylococcus spp. and Leptospira spp. Omphalometra spp. was studied using a newly developed PCR test. The screening of the dead desman allowed us to obtain, for the first time, a partial sequence of the 18SrDNA. This study is the most complete study of the desman, allowing us to identify parasites and the microbiome in populations of G. pyrenaicus using non-invasive sampling.

In this paper, perturbed third-body motion is considered under quantum corrections to analyse the existence of periodic orbits. These orbits are studied through two approaches to identify the first (second) periodic-orbit types. The essential conditions are given in order to prove that the circular (elliptical) periodic orbits of the rotating Kepler problem (RKP) can continue to the perturbed motion of the third body under quantum corrections where a massive primary body has excessive gravitational force over the smaller primary body. The primaries moved around each other in circular (elliptical) orbits, and the mass ratio was assumed to be sufficiently small. We prove the existence of the two types of orbits by using the terminologies of Poincaré for quantised perturbed motion.

Objectives Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs.Design A multicentre, international, collaborative cohort study.Setting 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020.Participants Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin’s lymphoma, Hodgkin lymphoma, Wilms’ tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer.Main outcome measure All-cause mortality at 30 days and 90 days.Results 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p

Abstract Background Turner syndrome is a genetic disorder that affects women. It is caused by an absent or incomplete X chromosome, which can be presented in mosaicism or not. There are 12 cases of Turner syndrome patients who present structural alterations in autosomal chromosomes. Case presentation The present case report describes a patient with a reciprocal, maternally inherited translocation between chromosomes 2 and 12 with a mosaicism of X monosomy 45,X,t(2;12)(p13;q24)[95]/46,XX,t(2;12)(p13;q24)[5]. Through genetic mapping arrays, altered genes in the patient were determined within the 23 chromosome pairs. These genes were associated with the patient’s clinical features using a bioinformatics tool. Conclusion To our knowledge, this is the first case in which a translocation (2;12) is reported in a patient with Turner syndrome and confirmed by conventional cytogenetics, FISH and molecular genetics. Clinical features of our patient are closely related with the loss of one X chromosome, however mild intellectual disability can be likely explained by autosomal genes. The presence of familial translocations was a common finding, thus emphasizing the need for familiar testing for further genetic counselling.

In this paper, we present the sine-Gordon expansion method to prepare the mixed dark bright wave patterns to the nonlinear partial differential equations arising in mathematical physics. Then, we apply the proposed method for a credible recourse of two nonlinear physical models: the modified Vakhnenko-Parkes and modified α-equation. These exact solutions comprise the hyperbolic, trigonometric, rational and exponential function with few licentious parameter. The analytical solutions have different physical structures and they are graphically analyzed in order to show their dynamical behavior by means of 2D, 3D and contour plots.

Resumen: El asma grave constituye un síndrome heterogéneo con múltiples variantes clínicas y representa el último peldaño en la patología asmática en relación con su gravedad. La prevalencia del asma grave entre los pacientes asmáticos varía de un país a otro, y se estima que el 50% de estos pacientes graves tienen un mal control de su enfermedad. Para el mejor manejo del paciente es necesario un correcto diagnóstico, el seguimiento y sin duda ofrecerle el mejor tratamiento disponible, incluyendo los nuevos avances farmacológicos, como son los anticuerpos monoclonales. Con este afán nació este proceso de consenso, cuya finalidad última es ofrecer al paciente el mejor manejo posible de su enfermedad para así minimizar su sintomatología. Las recomendaciones que se proponen son el resultado de un consenso de tipo nominal desarrollado a lo largo del año 2019 y fueron validadas en sucesivas revisiones posteriores. Abstract: Severe asthma is a heterogeneous syndrome with multiple clinical variants, and is the last step in terms of disease severity. The prevalence of severe asthma among asthmatic patients varies from country to country and it is estimated that 50% of these severe patients have poor disease control. Optimal management requires correct diagnosis and follow-up, and the patient must be offered the best treatment available, taking into account new pharmacological advances such as monoclonal antibodies. This consensus process emerged from the desire to offer our patients the best possible management and the chance to minimize symptoms. The proposed recommendations are the result of a nominal consensus process performed throughout 2019, and validated in successive revisions.

Resumen: La imposición del estado de alarma por el Gobierno Español como principal medida para evitar el contagio ha supuesto un cambio en la aproximación clínica al paciente crónico. Aunque las nuevas tecnologías de la comunicación nos ofrecen numerosas formas de establecer un contacto directo, pero en la distancia, las peculiaridades del paciente con EPOC hacen que con frecuencia esta atención sanitaria se vea reducida al teléfono. El reto de atender a los pacientes con EPOC por teléfono supone una complejidad añadida a la atención sanitaria. La entrevista se realizará sin la exploración del paciente, sin nuevas pruebas complementarias y sin poder verificar la técnica inhalatoria. Por tanto, los sanitarios que realicen estas entrevistas deben estar entrenados para conseguir realizarla adecuadamente para permitir la toma de decisiones. Este documento va dirigido a profesionales sanitarios que tengan que realizar algún tipo de atención telefónica a pacientes con EPOC durante la pandemia de SARS-CoV-2 y se basa en la experiencia de sus autores en entrevistas telefónicas mantenidas durante esta pandemia. En él se resumen aspectos esenciales sobre cómo debe afrontar esta entrevista, cómo llevarla a cabo, qué aspectos se deben tener presentes, cómo organizarla y cómo informar a los pacientes. Es muy probable que a partir de ahora este tipo de entrevista tenga que generalizarse para la atención de nuestros pacientes, por lo que necesitamos aprender a estructurar muchas de las visitas clínicas que hasta ahora se hacían presenciales en un nuevo modelo de atención sanitaria. Abstract: The state of alarm declared by the Spanish government as the main measure for preventing contagion has involved a change in the clinical management of chronic patients. Although new communication technologies offer us many ways to establish direct but remote contact, the peculiarities of the COPD patient often mean that their healthcare is reduced to telephone calls. The challenge of caring for COPD patients is made even more complex when it has to be delivered over the phone. The interview must be conducted without examining the patient, without performing additional tests, and without checking their inhalation technique. Therefore, healthcare providers who conduct these interviews must be trained to perform them properly in order to make the right decisions. This document is aimed at healthcare professionals who need to provide some form of telephone care to COPD patients during the SARS-CoV-2 pandemic and is based on the authors’ experience in telephone interviews conducted during this period. It summarizes essential aspects of how this interview should be approached, how to conduct it, what factors should be kept in mind, how to organize the interview, and how to keep patients informed. It is very likely that from now on this type of interview will be common practice in the care of our patients, so we need to learn how to structure a new model of healthcare for many of the clinical visits that have until now been conducted face-to-face.

As it is well known, the Mathematics and Symmetry/Asymmetry Section is one of the most active sections of the Symmetry journal [...]

In this study, numerical treatment of liquid crystal model described through Hunter-Saxton equation (HSE) has been presented by sinc collocation technique through theta weighted scheme due to its enormous applications including, defects, phase diagrams, self-assembly, rheology, phase transitions, interfaces, and integrated biological applications in mesophase materials and processes. Sinc functions provide the procedure for function approximation over all types of domains containing singularities, semi-infinite or infinite domains. Sinc functions have been used to reduce HSE into an algebraic system of equations that makes the solution quite superficial. These algebraic equations have been interpreted as matrices. This projected that sinc collocation technique is considerably efficacious on computational ground for higher accuracy and convergence of numerical solutions. Stability analysis of the proposed technique has ensured the accuracy and reliability of the method, moreover, as the stability parameter satisfied the condition the proposed solution of the problem converges. The solution of the HSE is presented through graphical figures and tables for different cases that are constructed on various values of θ and collocation points. The accuracy and efficiency of the proposed technique is analyzed on the basis of absolute errors.

The world is currently experiencing the coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome-2 (SARS-CoV-2). Its global spread has resulted in millions of confirmed infections and deaths. While the global pandemic continues to grow, the availability of drugs to treat COVID-19 infections remains limited to supportive treatments. Moreover, the current speed of vaccination campaigns in many countries has been slow. Natural substrates with biological immunomodulatory activity, such as glucans, may represent an adjuvant therapeutic agent to treat SARS-CoV-2. AM3, a natural glycophosphopeptical, has previously been shown to effectively slow, with no side effects, the progression of infectious respiratory diseases by regulating effects on innate and adaptive immunity in experimental models. No clinical studies, however, exist on the use of AM3 in SARS-CoV-2 infected patients. This review aims to summarize the beneficial effects of AM3 on respiratory diseases, the inflammatory response, modulation of immune response, and attenuation of muscle. It will also discuss its potential effects as an immune system adjuvant for the treatment of COVID-19 infections and adjuvant for SARS-CoV-2 vaccination.

Abstract Background Since 1969, 49 cases have been presented on ring chromosome 4. All of these cases have been characterized for the loss of genetic material. The genes located in these chromosomal regions are related to the phenotype. Case presentation A 10-year-old Ecuadorian Mestizo girl with ring chromosome 4 was clinically, cytogenetically and molecularly analysed. Clinical examination revealed congenital anomalies, including microcephaly, prominent nose, micrognathia, low set ears, bilateral clinodactyly of the fifth finger, small sacrococcygeal dimple, short stature and mental retardation. Cytogenetic studies showed a mosaic karyotype, mos 46,XX,r(4)(p16.3q35.2)/46,XX, with a ring chromosome 4 from 75 to 79% in three studies conducted over ten years. These results were confirmed by fluorescence in situ hybridization (FISH). Loss of 1.7 Mb and gain of 342 kb in 4p16.3 and loss of 3 Mb in 4q35.2 were identified by high-resolution mapping array. Conclusion Most cases with ring chromosome 4 have deletion of genetic material in terminal regions; however, our case has inv dup del rearrangement in the ring chromosome formation. Heterogeneous clinical features in all cases reviewed are related to the amount of genetic material lost or gained. The application of several techniques can increase our knowledge of ring chromosome 4 and its deviations from typical “ring syndrome.”

Introduction: the term risk in the field of health services refers immediately to a hazard for the patient in an unexpected way and almost always having an unfavorable result, the responsible practice of nursing is delimited by the strict compliance with moral and legal standards, quality and efficiency are responsibilities of the nursing personnel, as protective factors in the prevention of errors in the care of patients, in recent times there has been a deeper reflection on the presence of adverse events and the resulting error in the care of patients Objective: to determine the existence of risks and their management in the operating room at 1º de Mayo hospital in Cabinda, Angola, from March to May 2017. Methods: the target group included 17 nurses who worked in the operating room, and the Chief Nurse. Out of the surgical interventions performed in the chosen period, those completed on April were observed. Results: it was found that the largest number of nurses who worked in the operating room completed the proper technical rank and have more than 10 years of experience in the surgical and administrative service, the medical and biological risks were identified, mainly the ones related to disinfection methods, the permanence of open doors and collection of residuals. Conclusions: it is recommended to develop an administrative strategy to increase the safety of patients in the surgical room.

In this paper, we study the extraction of some analytical solutions to the nonlinear perturbed sine-Gordon equation with the long Josephson junction properties. The model studied was formed to observe the long Josephson junction properties separated by two superconductors. Moreover, it is also used to explain the Josephson effect arising in the highly nonlinear nature of the Josephson junctions. This provides the shunt inductances to realize a Josephson left-handed transmission line. A powerful scheme is used to extract the complex function solutions. These complex results are used to explain deeper properties of Josephson effects in the frame of impedance. Various simulations of solutions obtained in this paper are also reported.

IntroductionAsthma with airway mucus hypersecretion is an inadequately characterized variant of asthma. While several studies have reported that hypersecreting patients may carry genetic variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, many of those studies have been questioned for their numerous limitations and contradictory results.Objectives(1) To determine the presence of genetic variants of the CFTR gene in patients with asthma with and without airway mucus hypersecretion. (2) To identify the clinical, inflammatory and functional characteristics of the asthma phenotype with airway mucus hypersecretion.MethodComparative multicentre cross-sectional descriptive study that included 100 patients with asthma (39 hypersecretors and 61 non-hypersecretors). Asthmatic hypersecretion was defined as the presence of cough productive of sputum on most days for at least 3 months in 2 successive years. The patients were tested for fractional exhaled nitric oxide, spirometry, induced sputum cell count, total immunoglobulin E (IgE), peripheral blood eosinophil count, C-reactive protein, blood fibrinogen and blood albumin and underwent a skin prick test. Asthma control and quality of life were assessed by the Asthma Control Test and Mini Asthma Quality of Life questionnaires, respectively. Blood DNA samples were collected from the patients and next-generation sequencing using a MiSeq sequencer and the Illumina platform was used for the CFTR gene analysis.ResultsGenetic differences were observed in the c.1680-870T>A polymorphism of the CFTR gene, significantly more evident in hypersecretors than in non-hypersecretors: 78.94% vs. 59.32% in the majority allele and 21.05% vs. 40.67% in the minority allele (p = 0.036). Clinically, asthma hypersecretors compared to non-hypersecretors were older (57.4 years vs. 49.4 years; p = 0.004); had greater asthma severity (58.9% vs. 23.7%; p = 0.005); experienced greater airway obstruction (FEV1/FVC% 64.3 vs. 69.5; p = 0.041); had poorer asthma control (60% vs. 29%; p = 0.021); had lower IgE levels (126.4 IU/mL vs. 407.6 IU/mL; p = 0.003); and were less likely to have a positive prick test (37.5% vs. 68.85%; p = 0.011).ConclusionThe results suggest that patients with asthma and with mucus hypersecretion (1) may have a different phenotype and disease mechanism produced by an intronic polymorphism in the CFTR gene (NM_000492.3:c.1680-870T>A), and (2) may have a poorer clinical outcome characterized by severe disease and poorer asthma control with a non-allergic inflammatory phenotype.

This research paper focuses on the application of the tanh function method to find the soliton solutions of the (2+1)-dimensional nonlinear electrical transmission line model. Materials used to form a transmitting line are very important to transmit electric charge. In this sense, we find some new voltage behaviors such as dark, trigonometric, and complex function solutions. Choosing some suitable values of parameters, we present some various surfaces of results obtained in this paper. These results play an important role in telecommunications lines used to stand for wave propagations.

We deal with the Hamiltonian system (HS) associated to the Hamiltonian in polar coordinates H=12pr2+pϕ2r2-1r-∊2r2, where ∊ is a small parameter. This Hamiltonain comes from the correction given by the special relativity to the motion of the two-body problem, or by the first order correction to the two-body problem coming from the general relativity. This Hamiltonian system is completely integrable with the angular momentum C and the Hamiltonian H. We have two objectives.First we describe the global dynamics of the Hamiltonian system (HS) in the following sense. Let Sh and Sc are the subset of the phase space where H=h and C=c, respectively. Since C and H are first integrals, the sets Sc,Sh and Shc=Sh∩Sc are invariant by the action of the flow of the Hamiltonian system (HS). We determine the global dynamics on those sets when the values of h and c vary.Second recently Tudoran (2017) provided a criterion which detects when a non-degenerate equilibrium point of a completely integrable system is Lyapunov stable. Every equilibrium point q of the completely integrable Hamiltonian system (HS) is degenerate and has zero angular momentum, so the mentioned criterion cannot be applied to it. But we will show that this criterion is also satisfied when it is applied to the Hamiltonian system (HS) restricted to zero angular momentum.

Similarity measures have a great importance in the decision-making process. In order to identify the similarity between the options, many experts have established several types of similarity measures on the basis of vectors and distances. The Cosine, Dice, and Jaccard are the vector similarity measures. The present work enclosed the modified Jaccard and Dice similarity measures. Founded on the Dice and Jaccard similarity measures, we offered a multiple criteria decision-making (MCDM) model under the dual hesitant fuzzy sets (DHFSs) situation, in which the appraised values of the alternatives with respect to criteria are articulated by dual hesitant fuzzy elements (DHFEs). Since the weights of the criteria have a much influence in making the decisions, therefore decision makers (DMs) allocate the weights to each criteria according to their knowledge. In the present work, we get rid of the doubt to allocate the weights to the criteria by taking an objective function under some constraints and then extended the linear programming (LP) technique to evaluate the weights of the criteria. The Dice and Jaccard weighted similarity measures are practiced amongst the ideal and each alternative to grade all the alternatives to get the best one. Eventually, two practical examples, about investment companies and selection of smart phone accessories are assumed to elaborate the efficiency of the proposed methodology.

Abstract Background Ring chromosome 15 has been associated in previous studies with different clinical characteristic such as cardiac problems, digit and musculoskeletal abnormalities, and mental and motor problems among others. Only 97 clinical cases of ring chromosome 15 syndrome have been reported since 1966 and a common phenotype for these patients has not been established. Case presentation The present case report describes a 15-month-old girl from the Amazon region of Ecuador, of Mestizo ancestry, who after cytogenetic tests showed a 46,XX,r(15) karyotype in more than 70% of metaphases observed. Her parents were healthy and non-related. The pregnancy was complicated and was positive for intrauterine growth retardation. Her birth weight was 1950 g, her length was 43.5 cm, and she had a head circumference of 29.3. In addition to postnatal growth delay, she had scant frontal hair, small eyes, hypertelorism, low-set of ears, flattened nasal bridge, anteverted nostrils, down-turned mouth, three café au lait spots, and delayed dentition. Conclusions Despite the frequency of some phenotypes expressed in the different clinical cases reviewed and the present case, a common phenotype for patients with ring 15 could not be determined and it is restricted to the region of the chromosome lost during the ring formation.

Introducción: la gestión del cuidado de Enfermería se realiza para asegurar la continuidad de la atención de salud, y esencialmente de su cuidado como repuesta a la identificación de necesidades insatisfechas debiendo ser de calidad por lo que se decide compartir la experiencia de la evaluación de esta actividad en un hospital provincial. Objetivo: valorar la gestión del cuidado a partir de la satisfacción de los pacientes en el servicio de cirugía del Hospital Provincial de Cabinda. Método: se realizó un estudio descriptivo prospectivo y transversal en el 2017 utilizando la propuesta metodológica Evaluación de Calidad de Avedis Donabedian incluyendo datos de Resultados. El universo, los 22 pacientes ingresados en el momento del estudio y la muestra, los 16 pacientes operados, y la jefa del servicio. La determinación de la satisfacción de los usuarios incluyó ocho criterios, considerando adecuada la calidad con el cumplimento del 80 %. Resultados: la plantilla de enfermeras estaba distribuida en dos grupos de trabajo de 12 horas, y solo cinco eran Licenciadas en Enfermería, por lo que la competencia técnica no era la más adecuada. De los 13 indicadores evaluados tres fueron inadecuados; se recomendó evaluar el proceso e implementar un programa de mejora continua de la calidad. Conclusiones: en la evaluación de la gestión del cuidado en el salón de operaciones existieron criterios muy importantes a modificarse, para lo que se precisan además de recursos, las capacidades del gestor de Enfermería en función de planear, organizar e implementar acciones seguras, humanísticas y con enfoque social.

Introduction: the varieties of quality control have been transformed over time by Vuori and Donabedian, who have made great contributions to the varieties of quality control, the latter, considered the founder of the study of the quality of care health, defined as: activities aimed at ensuring accessible and equitable services, with optimal professional benefits, bearing in mind the available resources, achieving adherence and user satisfaction with the care received. Objective: to evaluate the quality of medical care at Pedro Borras University Polyclinic in Pinar del Río, in the last quarter of 2016. Method: a descriptive, prospective and cross-sectional study was carried out, through the methodological proposal to evaluate the quality in the Primary Health Care, including Process and Results data. The target group consisted of one thousand 294 patients belonging to a randomly chosen clinic, a sample of convenience was taken including the 152 patients older than 15 years old assigned to perform the analysis of the health situation. Results: the age group that predominated was 65 years and older, the main cause of consultation was upper respiratory infections, the medical care provided was considered of quality, the highest number of the predetermined standards exceeded the established percentage, both in medical performance and in user satisfaction. Conclusions: it was found that the quality of the medical care provided in the chosen clinic was considered satisfactory by both researchers and users.

In this paper, the Aboodh transform is utilized to construct an approximate analytical solution for the time-fractional Zakharov–Kuznetsov equation (ZKE) via the Adomian decomposition method. In the context of a uniform magnetic flux, this framework illustrates the action of weakly nonlinear ion acoustic waves in plasma carrying cold ions and hot isothermal electrons. Two compressive and rarefactive potentials (density fraction and obliqueness) are illustrated. With the aid of the Caputo derivative, the essential concepts of fractional derivatives are mentioned. A powerful research method, known as the Aboodh Adomian decomposition method, is employed to construct the solution of ZKEs with success. The Aboodh transform is a refinement of the Laplace transform. This scheme also includes uniqueness and convergence analysis. The solution of the projected method is demonstrated in a series of Adomian components that converge to the actual solution of the assigned task. In addition, the findings of this procedure have established strong ties to the exact solutions to the problems under investigation. The reliability of the present procedure is demonstrated by illustrative examples. The present method is appealing, and the simplistic methodology indicates that it could be straightforwardly protracted to solve various nonlinear fractional-order partial differential equations.

It is a familiar fact that interval analysis provides tools to deal with data uncertainty. In general, interval analysis is typically used to deal with the models whose data are composed of inaccuracies that may occur from certain kinds of measurements. In interval analysis, both the inclusion relation (⊆) and pseudo order relation (≤p) are two different concepts. In this article, by using pseudo order relation, we introduce the new class of nonconvex functions known as LR-p-convex interval-valued functions (LR-p-convex-IVFs). With the help of this relation, we establish a strong relationship between LR-p-convex-IVFs and Hermite-Hadamard type inequalities (HH-type inequalities) via Katugampola fractional integral operator. Moreover, we have shown that our results include a wide class of new and known inequalities for LR-p-convex-IVFs and their variant forms as special cases. Useful examples that demonstrate the applicability of the theory proposed in this study are given. The concepts and techniques of this paper may be a starting point for further research in this area.

In this review article, the study of the development of relativistic cosmology and the introduction of inflation in it as an exponentially expanding early phase of the universe is carried out. We study the properties of the standard cosmological model developed in the framework of relativistic cosmology and the geometric structure of spacetime connected coherently with it. The geometric properties of space and spacetime ingrained into the standard model of cosmology are investigated in addition. The big bang model of the beginning of the universe is based on the standard model which succumbed to failure in explaining the flatness and the large-scale homogeneity of the universe as demonstrated by observational evidence. These cosmological problems were resolved by introducing a brief acceleratedly expanding phase in the very early universe known as inflation. The cosmic inflation by setting the initial conditions of the standard big bang model resolves these problems of the theory. We discuss how the inflationary paradigm solves these problems by proposing the fast expansion period in the early universe. Further inflation and dark energy in fR modified gravity are also reviewed.

Fuzzy graphs (FGs), broadly known as fuzzy incidence graphs (FIGs), are an applicable and well-organized tool to epitomize and resolve multiple real-world problems in which ambiguous data and information are essential. In this article, we extend the idea of domination of FGs to the FIG using strong pairs. An idea of strong pair dominating set and a strong pair domination number (SPDN) is explained with various examples. A theorem to compute SPDN for a complete fuzzy incidence graph (CFIG) is also provided. It is also proved that in any fuzzy incidence cycle (FIC) with l vertices the minimum number of elements in a strong pair dominating set are M[γs(Cl(σ,ϕ,η))]=⌈l3⌉. We define the joining of two FIGs and present a way to compute SPDN in the join of FIGs. A theorem to calculate SPDN in the joining of two strong fuzzy incidence graphs is also provided. An innovative idea of accurate domination of FIGs is also proposed. Some instrumental and useful results of accurate domination for FIC are also obtained. In the end, a real-life application of SPDN to find which country/countries has/have the best trade policies among different countries is examined. Our proposed method is symmetrical to the optimization.

This paper aims to study fuzzy order bounded linear operators between two fuzzy Riesz spaces. Two lattice operations are defined to make the set of all bounded linear operators as a fuzzy Riesz space when the codomain is fuzzy Dedekind complete. As a special case, separation property in fuzzy order dual is studied. Furthermore, we studied fuzzy norms compatible with fuzzy ordering (fuzzy norm Riesz space) and discussed the relation between the fuzzy order dual and topological dual of a locally convex solid fuzzy Riesz space.

Probabilistic interval-valued hesitant fuzzy sets (PIVHFSs) are an extension of interval-valued hesitant fuzzy sets (IVHFSs) in which each hesitant interval value is considered along with its occurrence probability. These assigned probabilities give more details about the level of agreeness or disagreeness. PIVHFSs describe the belonging degrees in the form of interval along with probabilities and thereby provide more information and can help the decision makers (DMs) to obtain precise, rational, and consistent decision consequences than IVHFSs, as the correspondence of unpredictability and inaccuracy broadly presents in real life problems due to which experts are confused to assign the weights to the criteria. In order to cope with this problem, we construct the linear programming (LP) methodology to find the exact values of the weights for the criteria. Furthermore these weights are employed in the aggregation operators of PIVHFSs recently developed. Finally, the LP methodology and the actions are then applied on a certain multiple criteria decision making (MCDM) problem and a comparative analysis is given at the end.

Two sibling bare-backed bat species (Pteronotus fulvus and P. gymnonotus) have been traditionally differentiated by their size. However, intermediate specimens between the two species have been found in sympatric populations along southern Mexico and it has been suggested that they may be the outcome of a hybridization process between the two species. We used one mitochondrial (COI), three nuclear markers (PRKCL, STAT5A and RAG2) and 13 microsatellites to explore the evolutionary relationships between these two species and elucidate whether the intermediate morphotypes correspond to hybrid individuals. These markers have been analyzed in sympatric and allopatric populations of the two species plus the closely related species Pteronotus davyi. We confirmed the species-level differentiation of the three lineages (P. fulvus, P. davyi and P. gymnonotus), but the phylogenetic hypotheses suggested by the nuclear and mitochondrial markers were discordant. We confirm that the discordance between markers is due to genetic introgression through the mitochondrial capture of P. fulvus in P. gymnonotus populations. Such introgression was found in all P. gymnonotus specimens across its sympatric distribution range (Mexico to Costa Rica) and is related to expansion/retraction species distribution pulses associated with changes in forest distribution during the Quaternary climate cycles. Microsatellite analyses showed contemporary genetic contact between the two sympatric species and 3.0% of the samples studied were identified as hybrids. In conclusion, we found a historical and asymmetric genetic introgression (through mitochondrial capture) of P. fulvus into P. gymnonotus in Mexico and Central America and a limited contemporary gene exchange between the two species. However, no relationship was found between hybridization and the intermediate-sized specimens from southern Mexico, which might likely result from a clinal variation with latitude. These results confirm the need for caution when using forearm size to identify these species in the field and when differentiating them in the laboratory based on mitochondrial DNA alone.

The relative motion of an outline of the rendezvous problem has been studied by assuming that the chief satellite is in circular symmetric orbits. The legitimacy of perturbation techniques and nonlinear relative motion are investigated. The deputy satellite equations of motion with respect to the fixed references at the center of the chief satellite are nonlinear in the general case. We found the periodic solutions of the linear relative motion satellite and for the nonlinear relative motion satellite using the Lindstedt–Poincaré technique. Comparisons among the analytical solutions of linear and nonlinear motions and the obtained solution by the numerical integration of the explicit Euler method for both motions are investigated. We demonstrate that both analytical and numerical solutions of linear motion are symmetric periodic. However, the solutions of nonlinear motion obtained by the Lindstedt–Poincaré technique are periodic and the numerical solutions obtained by integration by using explicit Euler method are non-periodic. Thus, the Lindstedt–Poincaré technique is recommended for designing the periodic solutions. Furthermore, a comparison between linear and nonlinear analytical solutions of relative motion is investigated graphically.

To prevent the emergence of zoonotic infectious diseases and reduce their epidemic potential, we need to understand their origins in nature. Bats in the order Chiroptera are widely distributed worldwide and are natural reservoirs of prominent zoonotic viruses, including Nipah virus, Marburg virus, and possibly SARS-CoV-2. In this study, we applied unbiased metagenomic and metatranscriptomic approaches to decipher the virosphere of frugivorous and insectivorous bat species captured in Guéckédou, Guinea, the epicenter of the West African Ebola virus disease epidemic in 2013–2016. Our study provides a snapshot of the viral diversity present in these bat species, with several novel viruses reported for the first time in bats, as well as some bat viruses closely related to known human or animal pathogens. In addition, analysis of Mops condylurus genomic DNA samples revealed the presence of an Ebola virus nucleoprotein (NP)-derived pseudogene inserted in its genome. These findings provide insight into the evolutionary traits of several virus families in bats and add evidence that nonretroviral integrated RNA viruses (NIRVs) derived from filoviruses may be common in bat genomes.

In this paper, we prove two generalized concentration-compactness principles for variable exponent Lebesgue spaces and as an application study the asymptotic behaviour of low energy extremals.

The term liquid biopsy (LB) refers to the study of circulating tumor cells, circulating tumors nucleic acids free of cells or contained in exosomes, and information about platelets associated with tumors. LB can be performed in different biofluids and allows the limitations of tissue biopsy to be overcome offering possibilities of tumor identification reflecting in real time tumor heterogeneity. In addition, LB allows screening and early detection of cancer, real-time monitoring of therapy, stratification and therapeutic intervention, a therapeutic target and resistance mechanism, and a risk of metastatic relapse. Currently, LB has been shown to be effective for its application in different types of tumors including lung, colorectal, prostate, melanoma, breast and pancreatic cancer, by the determination and identification of biomarkers that with a high probability have the potential to change the way in which medical oncology could predict the course of the disease. These biomarkers make it possible to capture the heterogeneity of the cancer, monitor its clonal evolution, indicate new treatments or retreatments and evaluate the responses to different evolutionary and/or therapeutic pressures in the cancer disease.

In recent years, there has been an increase in knowledge of cancer, accompanied by a technological development that gives rise to medical oncology. An instrument that allows the implementation of individualized therapeutic strategies is the liquid biopsy. Currently, it is the most innovative methodology in medical oncology. Its high potential as a tool for screening and early detection, the possibility of assessing the patient’s condition after diagnosis and relapse, as well as the effectiveness of real-time treatments in different types of cancer. Liquid biopsy is capable of overcoming the limitations of tissue biopsies. The elements that compose the liquid biopsy are circulating tumor cells, circulating tumor nucleic acids, free of cells or contained in exosomes, microvesicle and platelets. Liquid biopsy studies are performed on various biofluids extracted in a non-invasive way, and they can be performed both from the blood and in urine, saliva or cerebrospinal fluid. The development of genotyping techniques, using the elements that make up liquid biopsy, make it possible to detect mutations, intertumoral and intratumoral heterogeneity, and provide molecular information on cancer for application in medical oncology in an individualized way in different types of tumors. Therefore, liquid biopsy has the potential to change the way medical oncology could predict the course of the disease.

This paper applies the sine-Gordon expansion method to the extended nonlinear (2+1)-dimensional Boussinesq equation. Many new dark, complex and mixed dark-bright soliton solutions of the governing model are derived. Moreover, for better understanding of the results, 2D, 3D and contour graphs under the strain conditions and the suitable values of parameters are also plotted.

This paper offers two examples of the applicability of ICT-supported language teaching in two different contexts: social integration and international cooperation. A search for methodologically innovative approaches in this field inspires a series of collaborative international projects involving Egypt and several European countries. The introduction of best practices in this field brings an improvement in the language teaching and learning process in Egyptian universities, as well as meaningful insights on the advantages and shortcomings of the different options available. ICT facilitates the creation of open access materials available to disadvantaged groups (refugees or immigrants) that are outside conventional educational contexts but need tools and resources for a fast acquisition of foreign languages. An example of these tools is the development of a new multilingual smartphone app based on communication needs. The app is currently being developed within an international consortium including 6 European and 6 Egyptian universities. Another example of interesting use of ICT-based methodologies is the MOOC-based teaching and learning of languages at Cairo University, an experience resulting from the collaboration with the European Universities that are partners in different international projects.

During the extraction, transformation and loading processes it is critical to keep updated the data warehouse and data marts. In practice, several techniques that can b e used to capture changes in the data are available. Although from the theoretical point of view these techniques have been studied,in practice its form of use is not visualized in an organized way. Therefore,it is necessary to characterize, compare them and select the most appropriated. Given the simplicity aspects, types of sources that can be used, operations it can detect and no loss of information, it was chosen the technique based on snapshot as the most appropriate d. In addition a set of steps was proposed to follow for application to a real problem, suggesting the use of steps belonging to the data integration tool Pentaho Data Integration.

In this paper, we prove the identity dim H ( F ) = d · dim H ( α − 1 ( F ) ) , where dim H denotes Hausdorff dimension, F ⊆ R d , and α : [ 0 , 1 ] → [ 0 , 1 ] d is a function whose constructive definition is addressed from the viewpoint of the powerful concept of a fractal structure. Such a result stands particularly from some other results stated in a more general setting. Thus, Hausdorff dimension of higher dimensional subsets can be calculated from Hausdorff dimension of 1-dimensional subsets of [ 0 , 1 ] . As a consequence, Hausdorff dimension becomes available to deal with the effective calculation of the fractal dimension in applications by applying a procedure contributed by the authors in previous works. It is also worth pointing out that our results generalize both Skubalska-Rafajłowicz and García-Mora-Redtwitz theorems.