This article briefly reviews tracheal collapse as it is seen in horses, ponies, miniature horses and donkeys. Diagnosis is straightforward with medical management of lower respiratory tract diseases, when possible, an important component of therapy. Surgical correction of the condition is possible with long term outcomes having variable results.

We present a universal technique for non-invasive diagnostics of thin multilayer optically-transparent tissues, based on the polarization-sensitive optical-coherence tomography. To reach higher diagnostic accuracy, we revisit the model of the cornea structure, and re-consider physical features of the interaction of light with the tissue structural elements. In the scheme proposed, the probing beam is algorithmically adjustable such that the x-polarized radiation impinges each consecutive structural layer; the object beam is formed by the reflection and back-scattering. Its characteristics are found analytically and numerically within the framework of the polarized Monte-Carlo model and the Jones matrix formalism. A modified Mach-Zehnder interferometer with orthogonal polarization channels enables to eliminate the object-signal depolarization caused by stochastic scattering, and facilitates evaluation of the refractive indices and bi-refringence of the tissue elements. The technique permits longitudinal (in depth) and transverse scanning of the object, providing a complete 3D mapping of the cornea structure.

The DVB project has been active in maintaining and adapting its specifications to the requirements of modern satellite communications systems. The physical layer specifications, which include DVB-S2X for the forward link and DVB-RCS2 for the return link have been recently updated to support beam-hopping over the forward link and signalling within a VSAT system, including some support of Non- Geostationary Orbit (NGSO) satellites. Last year the DVB Commercial Module issued a new set of requirements for further support of NGSO by the DVB-RCS2 standard. The requirements call for support and analysis of operation within an NGSO system and extending the capabilities of the return link to support higher capacity and enable more symmetric traffic. The DVB Technical Module (satellite working group, TM-S) has produced an enhancement of the specifications and performed a set of analyses to answer the commercial requirements. In the paper, the new features described above will be introduced, as well as the analyses and discussions.

not-yet-known not-yet-known not-yet-known unknown Human Embryonic Kidney 293 (HEK293) cells are currently one of the preferred host cell lines for production of biologics, specifically, AAV−based viral vectors. These fast-growing cells consume significant amounts of nutrients and often convert them into byproducts such as lactate and ammonia. In fed-batch cultures, accumulation of lactate and ammonia to high levels can inhibit cell proliferation. In this study, we demonstrate that lactate and ammonia accumulation alone doesn’t fully explain the growth inhibition observed in HEK293 fed-batch cultures. Growth inhibition was noted even when the levels of these byproducts were well controlled. Instead, we show that several previously unknown compounds accumulate in HEK293 cell fed-batch cultures, some of which can inhibit HEK293 cell growth either individually or synergistically. Many of these newly identified compounds are intermediates or byproducts of amino acid catabolism. When residual levels of the source amino acids for these novel byproducts were controlled in the low concentration range (~1mM) in HEK293 fed-batch cultures, lactate accumulated to higher levels, causing growth inhibition. This prompted the need for employing HIPDOG control strategy for lactate management. In HIPDOG cultures, controlling the source amino acids at low concentrations resulted in lower accumulations of the corresponding growth-inhibitory byproducts when compared to the control HIPDOG conditions with typical levels of amino acids. This led to higher viable cell densities (VCD) and viabilities in low amino acid conditions. Strategies that reduce byproduct accumulation, whether classical or novel byproducts, in HEK293 fed-batch processes can result in enhanced VCDs potentially leading to higher volumetric productivities

Title: Prenatal diagnosis of unbalanced translocation t(5;11)(q21;q22) with a Jacobsen syndrome clinical phenotypeYuri Hasegawa*, Yuriko Kitajima, Koh Nagata, Shoko Miura, Kiyonori MiuraDepartment of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan*Corresponding authorDepartment of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. Fax 81-95- 819-7365; e-mail: haseyuri@nagasaki-u.ac.jp.Yuriko Kitajima: yurikokitajima@nagasaki-u.ac.jp, Koh Nagata: k.nagata@nagasaki-u.ac.jp, Shoko Miura: shokom@nagasaki-u.ac.jp, Kiyonori Miura: kiyonori@nagasaki-u.ac.jpKey words: unbalanced translocation, Jacobsen syndrome, prenatal diagnosis, fetal growth restriction, cardiac malformationFundingThe authors disclose receipt of the following financial support for the research, authorship, and/or publication of this article: YH was supported by JSPS KAKENHI (grant number 22K09622).The authors declare that there are no conflicts of interest regarding the publication of this article.This article was previously presented as a poster at the 28th International Conference on Prenatal Diagnosis and Therapy on 9 July 2024.We obtained written informed consent from the patient regarding the presentation.This article was approved by the Institutional Review Board for Ethical, Legal and Social Issues of Nagasaki University (ID: 12121777).

Objectives: Sleep-disordered breathing (SDB) and cognitive challenges are commonly observed in children living with sickle cell anaemia (SCA). This study investigated the longitudinal change in polysomnographic outcomes and the association with cognitive functions in children living with SCA. Method: Data from the Sleep Asthma Cohort (SAC 1, 2 and 3) included participants living with SCA (aged 4-18 years) who were initially recruited between 2006-2009, with follow-up studies conducted through until 2019. Polysomnographic indices (PSG indices), i.e., obstructive apnoea hypopnoea index (OAHI), central apnoea index (CAI), mean overnight oxygen saturation and total sleep time were assessed over two visits. Additional analyses assessed the impact of PSG indices on cognitive outcomes collected at Visit 3. Results: Ninety-two participants (91 HbSS, 1HbSβ) completed a PSG at Visit 1 and 56 participants returned for Visit 2, 40 of whom returned for the Visit 3 cognitive assessment; mean ages were 9.9 (3.8), 14.7 (3.69), and 17.7 (4.64) years, respectively. Total sleep time significantly decreased between the two visits, while overall PSG indices remained stable. Mean overnight oxygen saturation at Visit 1 significantly predicted working memory at Visit 3. In addition, CAI at Visit 2 was associated with lower scores on the verbal comprehension index and self or caregiver-reported measures of executive function. Conclusions: PSG indices did not change significantly over time; however, routine PSG screening is recommended, given the complexity of sickle pathology. Overnight oxygen saturation levels and central apnoea influence cognitive outcomes for children living with SCA.

not-yet-known not-yet-known not-yet-known unknown Objective: Maternal genotypes may be useful to customize fetal growth assessment, but generalizability across diverse racial and ancestral groups remains uncertain. We assessed the generalizability of a genetic risk score for birth weight (GRS BW), derived from European ancestry participants, within a diverse U.S. cohort. Design: Secondary analysis of a prospective observational cohort of nulliparous patients. Setting: Eight U.S. recruitment centers. Population or Sample: Participants in the parent study with available maternal DNA. Methods: We used log-linear modeling to test the association of maternal GRS BW with fetal weight. We then assessed the robustness of the association by self-identified race and genetically predicted continental ancestry (GPA) groups. Main Outcome Measures: Association between GRS BW and fetal weight. Results: Among 8,147 eligible participants, GRS BW was associated with fetal weight (p<0.001). Across self-identified racial groups, the association was significant in White (p=0.007) and multiracial (p=0.03) groups but not in Black, Asian, or unknown race groups (p>0.09 for all). Among GPA groups, the association was significant among European (p=0.001) and American (p=0.02) ancestry groups but not African, East or South Asian, or unknown ancestry (p>0.05 for all). Conclusions: This GRS BW is not generalizable across races, highlighting the need for globally representative genetic discovery cohorts.

Objectives: There is a notable rise in patient-initiated imaging requests, with one possible reason being the increased availability of online health information. This study specifically examines the impact of patient-initiated radiological exams on radiologists. Exploring their perspectives on how GPs acquiescing to patients’ medical imaging requests impacts healthcare resources and skew patients’ expectations of the capabilities of radiological studies. The findings of this study are crucial for understanding the evolving dynamics of radiology practice and its challenges. Method: A comprehensive cross-sectional survey was administered to radiologists in private medical centres across Australia between November 2023 and February 2024. The survey included structured and open-ended questions distributed via an intranet platform within the same company and reached a wide range of radiologists. Results: Nearly half of the participants (48%) had over 20 years of experience. The majority of radiologists reported X-rays (27%), ultrasounds (25%), and CT scans (24%) as the most commonly requested non-indicated imaging studies. Radiologists attributed these requests to patients’ exposure to online medical information and their desire for reassurance. Approximately 24% of radiological studies were considered unnecessary, with 30% of radiologists reporting feeling pressured by GPs and patients to expedite report completion. Proposed strategies included patient education, communication, and the establishment of clear guidelines. Conclusions: The study underscores the increasing burden of patient-initiated imaging on radiologists. This burden is further compounded by patients’ unrealistic expectations and lack of understanding of diagnostic imaging’s limitations. Radiologists have stressed the crucial role of the broader healthcare context in collaborating with such requests. Patient education was emphasised to reduce unnecessary imaging and manage patient expectations.

Valproate is an antiseizure drug required by many epileptic patients to manage their symptoms. During pregnancy, its use has been shown to increase the risk of neurobehavioral deficits in the offspring. The present study used a rat model of absence epilepsy, Genetic Absence Epilepsy Rat from Strasbourg (GAERS), to investigate effects of gestational valproate exposure on early postnatal brain cortex and lateral choroid plexus transcriptomes. Females were provided with either control diet or a valproate-laced diet (20 g/kg) from 2 weeks prior to mating and throughout gestation. At parturition, all dams received control diet. Pups at postnatal day 5 were used for RNA-sequencing. Differential expression analyses were conducted between transcriptomes from valproate exposed and control animals. In the choroid plexus, 5694 genes significantly altered their expression compared to 214 in the cortex, a difference of nearly 25 times. Dysregulation was identified in choroidal expression of ion channels and metal transporters including 6 members of the Slc4a family, Cacna1h and Kcne2. Several drug transporting ATP-binding cassette transporters and solute carriers were significantly upregulated and drug metabolising enzymes downregulated. In the cortex, 11 genes associated with development of the central nervous system were differentially expressed. Finally, in both tissues, fetal valproate exposure appeared to result in dysregulation of genes related to adaptive and innate immune responses. These results indicated that gestational exposure to valproate resulted in distinct and greater effects on the choroid plexus transcriptome compared to the cortex, potentially suggesting additional targets related to developmental valproate neurotoxicity.

Enoxaparin dosing in burn patients is challenging due to physiological changes following burn injuries that affect drug absorption, distribution, and clearance. The objectives of this study are to develop a population pharmacokinetic (PK) model for enoxaparin in burn patients, evaluate target attainment with current equation-based (EQ) dosing, and propose an optimized dosing regimen. Real-world data from 408 burn patients who received enoxaparin for thromboprophylaxis at the University of Utah Burn Center were analyzed, comprising 15,517 doses and 1,288 antiXa measurements. Only 56% of patients achieved the target antiXa range (0.2 – 0.4 IU/mL) approximately four hours after the third dose. A one-compartment PK model with first-order absorption and elimination best fit the data, with estimated apparent clearance (CL/F), volume of distribution (Vc/F), and absorption rate constant at 1.56 L/h, 22.1 L, and 1.10 1/h, respectively. Total body surface area (TBSA) and body weight significantly influenced clearance and distribution, while glomerular filtration rate had no notable impact. Simulations indicated that EQ dosing failed to achieve target levels after the first dose in 40% of patients, while the proposed regimen improved target attainment by more than 70%. This study underscores the limitations of EQ dosing, especially in patients with larger TBSA or higher body weight. In conclusion, a population PK model of enoxaparin was successfully developed for burn patients using real-world data and used to propose an alternative dosing regimen with higher target attainment in prophylaxis management.

Acoustic communication structures interactions among individuals and species throughout the avian life cycle. The intraspecific diversity of bird vocalisations reflects adaptive strategies to cope with variations in the acoustic environment over time and space. Additionally, the composition of species assemblages can influence how acoustic functions are spatially distributed across the landscape. Using data from 2,427 bird assemblages across France, we tested whether the diversity of acoustic traits in local bird assemblages varies along climate and landscape gradients. We quantified 16 acoustic traits from field recordings expressing the frequency, complexity, rhythm, and duration of vocalisations for 117 species. We employed a five-table ordination analysis to investigate links between acoustic traits and bioclimatic and land-use gradients, accounting for spatial and phylogenetic dependencies. We analysed how the average acoustic trait composition of bird assemblages shifted along environmental gradients for three key acoustic traits. We found that acoustic traits were clustered along environmental gradients, with a phylogenetic signal, supporting the prediction that acoustic strategies are phylogenetically conserved. Our results indicated that bird species share similar acoustic traits in assemblages under the same climatic envelopes (e.g., lower complexity and isochronous rhythms under higher precipitation and temperature seasonality). We found mixed support for the hypothesis that habitat selection shapes the acoustic composition of species assemblages, such that vocalisations are adapted to sound propagation properties of any given habitat. For instance, urbanisation was correlated with complex vocalisations featuring large spectral bandwidths. These wide bandwidths support the prediction that urban assemblages consist of species capable of avoiding acoustic masking caused by noise pollution. However, their complexity may hinder their transmission due to the same noise interference. Overall, our study highlights how bioclimatic and landscape-scale habitat features, alongside niche conservatism, collectively shape acoustic trait assemblages across large spatial extents.

This work studies the tracking control problem of discrete Takagi-Sugeno fuzzy Markovian jump systems with packet losses via dynamic output feedback sliding mode control method. A Bernoulli distributed sequence is used to simulate random data packet losses. An argument system including tracking errors, system state and reference model state is constructed, and an output sliding mode surface is designed. Further, the dynamic output feedback sliding mode control law is designed for the argument system, which can drive that the argument system state into the designated sliding mode region. Finally, two simulation examples are provided to demonstrate the performance and applicability of the suggested approach.

Japanese Encephalitis associated with Quadriplegia: The first reported case of NepalChaudhary, Sumana; Bist, Aayushb

Intracellular bacteria were detected in 1 case of peripheral blood granulocytesJunma You1.2 , Hongsheng Zhang1.2, Dan Zhou1,2Yichang Central People’s Hospital,Yichang 443000,People’s Republic of ChinaThe First College of Clinical Medical Science, China Three Gorges University，Yichang 443000,People’s Republic of China Hongsheng Zhang：ycdrzhs@126.comKeywords: Peripheral blood, morphology, granulocyte, intracellular bacteria

Cofactors are external factors that can lower the threshold dose of an allergen and amplify the severity of allergic reactions, turning mild or moderate responses into severe anaphylaxis. These include exercise, nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, menstruation, and infections. Initially described in relation to food allergens and physical activity or NSAIDs, these reactions have been labeled under various terms, such as food-dependent exercise-induced anaphylaxis (FDEIA), wheat-dependent exercise-induced anaphylaxis (WDEIA), and food-dependent NSAID-induced anaphylaxis (FDNIA). However, cofactor-enhanced food allergy (CEFA), a recently proposed concept, serves as an umbrella term to encompass these conditions and is applied in this text for consistency. Pediatric cofactor-enhanced food anaphylaxis (PCEFA) is a rare but severe condition in which a food allergy becomes significantly more severe in the presence of one or more cofactors. Cofactors are documented in 14–18.3% of pediatric food anaphylactic reactions, however, the true burden is likely higher due to frequent underdiagnosis from variable and unpredictable presentations. Exercise and infections are the most common cofactors in PCEFA, while ω-5 gliadin is the predominant allergen. CEFA is frequently misdiagnosed as idiopathic anaphylaxis, exercise-induced anaphylaxis (EIA), or asthma when subtle or delayed food triggers go undetected. Some cases may represent high-threshold food allergies rather than true cofactor-dependent anaphylaxis, challenging conventional definitions. Research on cofactors in anaphylaxis is still in its early stages, with most studies focusing on adults. More research is needed to improve diagnostic accuracy and treatment strategies for pediatric cases.

Rationale: The isotopic composition of dissolved dinitrogen gas (δ 15N-N 2) in water can offer a powerful constraint on the sources and pathways of nitrogen cycling in aquatic systems. However, due to the large presence of atmosphere-derived dissolved N 2 in these systems, high-precision (order-0.001‰) measurements of N 2 isotopes paired with inert gas measurements are required to disentangle atmospheric and biogeochemical signals. Additionally, the solubility equilibrium isotope fractionation of N 2 and its temperature and salinity dependence are underconstrained at this level of precision. Methods: We introduce a new technique for sample collection, processing, and dynamic dual-inlet mass spectrometry allowing for high-precision measurement of δ 15N-N 2 and δ(N 2/Ar) with simultaneous measurement of δ( 40Ar/ 36Ar) and δ(Kr/N 2) in water. We evaluate the reproducibility of this technique and employ it to redetermine the solubility equilibrium isotope effects for dissolved N 2 across a range of temperatures and salinities. Results: Our technique achieves measurement reproducibility (1σ) for δ 15N-N 2 (0.006‰) and δ(N 2/Ar) (0.41‰) suitable for tracing biogeochemical nitrogen cycling in aquatic environments. Through a series of air-water equilibration experiments, we find a N 2 solubility equilibrium isotope effect [ε=α/1000–1; where α=( 29N 2/ 28N 2) dissolved/( 29N 2/ 28N 2) gas] in water of ε(‰)=0.753–0.004•T [where T is temperature (°C)], with uncertainties of order-0.001‰ over the temperature range of ~2-23°C and salinity range of ~0-30 psu. We find no apparent dependence of ε on salinity. Conclusions: Our new method allows for high-precision measurements of the isotopic composition of dissolved N 2 and Ar, and dissolved N 2/Ar and Kr/N 2 ratios, within the same sample. Pairing measurements of N 2 with inert gases facilitates quantification of excess N 2 from biogeochemical sources and its isotopic composition. This method allows for a wide range of applications in marine, coastal, and freshwater environments to characterize and quantitatively constrain potential nitrogen cycling sources and pathways and to differentiate between physical and biological isotope signals in these systems.

Duffy null phenotype is common in people of African ancestry and is associated with lower baseline white blood cell (WBC) and neutrophil counts. We evaluated whether presence of the Duffy null phenotype had any association with neutropenia in our patients with sickle cell disease on hydroxyurea (HU). We found a statistically significant difference (p=0.006) in HU maximum tolerated dose (MTD) in patients with Duffy null phenotype compared with individuals who are Duffy positive. Our study suggests that careful dose escalation is warranted in those individuals who are Duffy null.

Background: Children treated with platinum chemotherapy agents such as cisplatin and carboplatin are at risk for developing irreversible sensorineural hearing loss. Carboplatin ototoxicity is less prevalent than cisplatin ototoxicity, except when used in high doses. Objective: We sought to investigate risk factors associated with ototoxicity in high dose carboplatin hematopoietic stem cell transplantation (cHSCT) in a pediatric population. Study Design: We accepted audiograms with a minimum requirement of threshold data at 4 kHz in at least one ear, allowing us to assess younger, more difficult to test patients and focus on hearing losses at important speech frequencies that can benefit from amplification. Eligible subjects underwent an autologous cHSCT at our institution from 1/1/2008 – 6/30/2022. Three audiologic outcome measures were evaluated – worsening in SIOP grade, significant change in hearing, and ototoxicity. Results: Forty-three cHSCTs from 29 patients had sufficient audiologic data. Logistic regression analysis revealed that cumulative dose of prior cisplatin (OR = 1.01, 95% CI = 1.002-1.014, p = 0.011), and cumulative dose of carboplatin in the preparative regimen (OR = 1.003, 95% CI = 1.001-1.004, p = 0.001), were associated with ototoxicity. Concurrent furosemide with carboplatin administration resulted in 100% ototoxicity, with patients demonstrating a mean change in SIOP grades by 2.0 SE + .038. Conclusion: This report demonstrates that concomitant furosemide administration with carboplatin in cHSCT is associated with ototoxicity, made possible, using criterion that allowed for evaluation of very young children. Further investigations capturing very young patients is needed.