USE OF INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING(IONM) IN A NEONATE WITH LIMITED DORSAL MYELOSCHISISShyam Duvuru1, Nisha B2, Vivek Sanker3, Yusra Arafeh4, Rnad Alajarmeh5, Wireko Andrew Awuah61Department of Neurosurgery, Apollo Specialty Hospitals, Tamil Nadu, IndiaEmail: drshypy@gmail.com2Neuroanaesthesia & Critical Care, Apollo Specialty Hospitals, Tamil Nadu, IndiaEmail: drnisha_b@apollohospitals.com3Research Fellow, Society of Brain Mapping and Therapeutics, CA, USAEmail: viveksanker@gmail.com4Faculty of Medicine, Jordan University of Science and Technology, Irbid, JordanEmail: theyusraarafeh@gmail.com5Department of Pediatrics and Neonatology, Istiklal Hospital, Amman, JordanEmail: renadnaser5@gmail.com6Faculty of Medicine, Sumy State University, Sumy, Ukraine, andyvans36@yahoo.com

According to GLOBOCAN 2020, breast cancer is the most prevalent cancer and affects many women globally after lung cancer. Detecting and diagnosing breast cancer earlier may decrease the disease’s death rate. A radiologist can use computer-aided detection/diagnosis technologies to help make an early diagnosis of breast cancer. One of the most popular and efficient techniques for identifying and diagnosing breast cancer is mammography. Deep learning architectures called convolutional neural network (CNN) models were developed to classify breast cancer correctly. This paper presents breast cancer classification using a customized deep-learning model. Two custom CNN models are suggested to classify the breast cancer mammography image efficiently. The effectiveness of the suggested classification approach was assessed using three real-time datasets: MIAS, CBIS-DDSM, and INbreast. The outcomes demonstrate that the suggested approach efficiently classifies the image and achieves 98.78%, 96.92%, and 97.84% accuracy for MIAS, CBIS-DDSM, and INbreast datasets.

Metazoa-level Universal Single-Copy Orthologs (mzl-USCOs) are universally applicable markers for DNA taxonomy in animals which can replace or supplement single-gene barcodes. While previously mzl-USCOs from target enrichment data were shown to reliably distinguish species, here we tested whether USCOs are an evenly distributed, representative sample of a given metazoan genome and therefore able to cope with past hybridization events and incomplete lineage sorting. This is relevant for coalescent-based species delimitation approaches, which critically depend on the assumption that the investigated loci do not exhibit autocorrelation due to physical linkage. Based on 239 assessed chromosome-level assembled genomes, we confirmed that mzl-USCOs are genetically unlinked for practical purposes and a representative sample of a genome in terms of reciprocal distances between USCOs on a chromosome and of distribution across chromosomes. We tested the suitability of mzl-USCOs extracted from genomes for species delimitation and phylogeny in four case studies: Anopheles mosquitos, Drosophila fruit flies, Heliconius butterflies, and Darwin’s finches. In almost all instances, USCOs allowed delineating species and yielded phylogenies that correspond to those generated from whole genome data. Our phylogenetic analyses demonstrate that USCOs may complement single-gene DNA barcodes and provide more accurate taxonomic inferences. Combining USCOs from sources that used different versions of ortholog reference libraries to infer marker orthology may be challenging and at times impact taxonomic conclusions. However, we expect this problem to become less severe as the rapidly growing number of reference genomes provides a better representation of the number and diversity of organismic lineages.

Objectives: To define the pathogenic cause of pedigree and provide precise genetic counseling for the pregnant woman, we retrospectively reviewed a pedigree with developmental retardation due to paternal 8q/18q translocation at The Affiliated Taizhou People’s Hospital of Nanjing Medical University. Materials and methods: Karyotype analysis and CMA detection were carried out

Title: Orphan peptide and G protein-coupled receptor signalling in alcohol use disorderRoberta Goncalves Anversa1,2*, Xavier J Maddern1,2*, Andrew J Lawrence1,2and Leigh C Walker1,2*Contributed equally1Florey Institute of Neuroscience and Mental Health, VIC 3052 Australia2Florey Department of Neuroscience and Mental Health, University of Melbourne, VIC 3052 Australia

Papillary fibroelastoma is the rarest of the primary benign cardiac tumors, with the one located in the pulmonary valve being the rarest, even after the one that affects the ventricular endocardium. In the past, this type of tumor was generally a fortuitous finding in surgery or necropsy and with the great availability of transthoracic echocardiography, it is now more likely that they can be diagnosed.

This study examines stable snow formation and distribution in the western Sichuan Plateau's Mamukao and Hanliu river basins using MODIS snow cover data. It analyzes dominant influencing factors using a maximum entropy model. Findings reveal different snow ablation rates between basins during winter and spring, with higher-altitude areas hosting stable snowpack. Influencing factors vary between basins during winter and spring, except for altitude.

Abstract: The incidence of Pseudomonas aeruginosa causing nosocomial infections has increased in recent years, along with the emergence of resistant strains of bacteria causing mortality. Many recent studies have shown increased resistance to colistin, which is the last resort for treating multidrug-resistant P. aeruginosa. A cross-sectional descriptive study and convenience sample were conducted to determine the percentage of infections, rates of seven antibiotics, and colistin resistance in P. aeruginosa strains isolated in Can Tho Central General Hospital and relevant factors from June 2020 to April 2021. P. aeruginosa infection rate was 7.9%. The specimens contained 233 strains of P. aeruginosa isolated. Incident rates in males/females were 9.3%/6.2%, the most of 19-29 years. The highest rate was in urine specimens (9.8%) and sputum (8.8%). The male sex had a higher infection rate than the female, and urine samples accounted for the highest rate of P. aeruginosa infections (13.9%). The rate of P. aeruginosa infections was associated with gender and various species (p<0.05). The prevalence of P. aeruginosa infections showed an association with gender and types of specimens (p<0.05). The highest resistance rate in P. aeruginosa against ciprofloxacin was 60.5%, next to gentamicin and imipenem (52.4% and 50.2%). 3% P. aeruginosa against colistin. Keywords: Pseudomonas aeruginosa; drug resistance; Pseudomonas infection; colistin

In 2019, the Louisiana Department of Health reported an early influenza B/Victoria (B/VIC) virus outbreak. As it was an atypically large outbreak, we deployed to Louisiana to investigate it using genomics and a triplex real-time RT-PCR assay to detect three antigenically distinct B/VIC lineage variant viruses. The investigation indicated that B/VIC V1A.3 subclade, containing a three amino acid deletion in the hemagglutinin and known to be antigenically distinct to the B/Colorado/06/2017 vaccine virus, was the most prevalent circulating virus within the specimens tested. This work underscores the value of portable diagnostics and sequencing platforms for rapid, onsite pathogen characterization.

polysplenia syndrome is a quite rare disease. It's generally happened in children and female with high mortality. Thus, PS happened to a 74-year-old male is extraordinarily rare. Herein, we report the clinical and imaging features of a patient with polysplenia syndrome. We also review the pathogenesis, clinical manifestation and imaging.

Hand pose estimation based on a single RGB image has low accuracy due to the complexity of the pose, local self-similarity of finger features, and occlusion. A multiscale feature fusion network (MS-FF) for monocular vision gesture pose estimation is proposed to address this problem. The network can take full advantage of different channel information to enhance important gesture information, and it can simultaneously extract features from feature maps of different resolutions to obtain as much detailed feature information and deep semantic information as possible. The feature maps are merged to obtain the hand pose results. The InterHand2.6M dataset and Rendered Handpose Dataset (RHD) are used to train the MS-FF. Compared with the other methods (which can estimate interacting hand poses from a single RGB image), the MS-FF obtains the smallest average error of hand joints on RHD, verifying its effectiveness.

A right-sided subdural frontoparietal hemorrhage in a patient after spinal anesthesia for cesarian section surgery. A Case reportSh Shoja MD1*, Sh Zandi MD2, N Soufizadeh MD3, Sh Shoja MD4For this manuscript,written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy. Additionally, if the patient/participant is unable to give written consent or is deceased, the same can be obtained from the patient’s next of kin. If the patient is a child or under the age of 16, written consent should be obtained from a parent/guardian.Department of Anesthesiology, Faculty of Medicine, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran, shshoja@hotmail.com ORCID: 0009-0005-2828-5591Department of Neurosurgery, Faculty of Medicine, Kowsar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran, zandi611@yahoo.com ORCID: 0000-0003-2733-1961Department of Obstetrics and Gynecology, Faculty of Medicine, Besat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran nsoofizadeh@hotmail.com ORCID: 0000-0001-8284-8440Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran, shahoshoja@gmail.com ORCID: 0000-0003-1982-9102*Corresponding Author:Mobile: +989183724633 E-Mail (1): shshoja@hotmail.com E-Mail (2): shahoshoja@gmail.comAbstract:Background : Peridural and subdural hemorrhage are rare but important complications after regional anesthesia.Case presentation: A 29 year old female gravid 1, para 1, with a history of cesarian section, was admitted for headache exacerbation. The patient received spinal anesthesia. The patient didn’t have any specific disease or previous headache. The drug history was negative except for routine pregenetic drugs. Although, at the time of Spinal anesthesia, the patient was slightly nervous. All previous pre-operation tests and exams were normal. The patient experienced a mild headache a day after the surgery; adequate liquid intake was recommended. The patient was discharged 48 hours after the surgery. Furthermore, after about a week, the patient contacted her primary physician for exacerbated headache. The physician recommended her liquid intake, rest, and proper analgesia. Ten days after surgery, the patient visited a clinic for an excruciating headache with vomiting. Therefore, the patient was admitted emergently. The neurosurgery consult and Magnetic Resonance Imaging (MRI) scan was performed. A subdural frontoparietal hemorrhage on the right side was diagnosed. The patient’s hematoma was drained emergently afterward. The patient was discharged four days after the drainage surgery without neurological complications.Conclusion: Peridural and subdural hemorrhages are rare complications of spinal anesthesia that can be lethal. The chief complaint of this complication is headache. It is essential to keep this complication in mind for patients experiencing headaches after spinal anesthesia surgeries.Keywords: Spinal anesthesia, Subdural hematoma, Regional anesthesia, Post dural puncture headache, Cesarian sectionIntroduction: Peridural or subdural hematoma is one of the rare but essential complications of spinal anesthesia(1). The main complaint of this complication is headache. Additionally, the risk of Post Dural Puncture Headache in obstetric patients is higher than in the general population(2).Case: A 29 year old female gravid 1, para 1, with a history of the cesarian section, was admitted on 21 August 2022 at Kowsar Hospital (Sanandaj, Iran) for headache exacerbation. The patient received spinal anesthesia with a gauge 25 needle placed L3-L4. The patient didn’t have any specific disease or previous headache. The drug history was negative except for routine pregenetic drugs. Although, at the time of Spinal anesthesia, the patient was slightly nervous. All previous pre-operation tests and exams were normal. The patient experienced a mild headache a day after the cesarian section surgery; adequate liquid intake was recommended. The patient was discharged 48 hours after the surgery. Furthermore, after about a week, the patient contacted her primary physician for exacerbated headache. The physician recommended her liquid intake, rest, and proper analgesia. Ten days after surgery, the patient visited a clinic for an excruciating headache with vomiting. Therefore, the patient was admitted emergently. The neurosurgery consult and Magnetic Resonance Imaging (MRI) scan was performed. A subdural frontoparietal hemorrhage on the right side was diagnosed (Figure 1). The patient’s hematoma was drained emergently afterward. The patient was discharged four days after the drainage surgery without neurological complications. Furthermore, a follow-up CT was done after two months, and the result was normal (Figure 2). For reporting as a manuscript, written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy

A dynamic model is proposed for photopolymerization of 1,6-hexane-diol diacrylate (HDDA) with bifunctional initiator bis-acylphosphine oxide (BAPO) in the presence of oxygen. This partial-differential-equation (PDE) model predicts time- and spatially-varying vinyl-group conversion as well as concentrations of monomer, initiator, oxygen, and seven types of radicals. Experiments to obtain diffusivities of oxygen, BAPO and HDDA are reported. Oxygen-related parameters are estimated using real-time Fourier-transform infrared (FTIR) conversion data. FTIR experiments were conducted using a range of film thicknesses (8-17 μm), BAPO levels (1-4 wt%) and light intensities (200-6000 W/m^2). The model predicts qualitative trends. Conversion predictions for runs with high intensities (≥5000 W/m^2) and high BAPO (4 wt%) are accurate with a root-mean-squared error (RMSE) of 0.04. Larger RMSE (0.13) for runs with lower intensities and BAPO indicates that improved parameter estimates are required. Parameter estimates will be updated using in future using a model that accounts for shrinkage during polymerization.

Since the 1980´s decade Antarctica has been experiencing enhanced westerly winds. The cause of this phenomenon is frequently attributed to the positive phase of the SAM (Southern Annular Mode - that is an index corresponding to the dynamics of a belt of low-pressure systems surrounding Antarctica moving north or south along the time), the ozone depletion in the stratosphere and probably a manifestation of the modern high levels of the atmospheric GHG (greenhouse gases). Recent publications realize that these enhanced winds have important implications to marine and terrestrial life in Antarctica. Among them, we may cite changes in bird migration patterns and foraging and landing at their cliff nests. In this work we present the record of the southernmost watching of the Antarctic petrel (Thalassoica antarctica) at latitude 84oS (Criosfera 1 remote Brazilian laboratory) in December 2022. In this case there was a very clear association of the bird watching with an abrupt change in wind direction during the migration of a cyclone system at the Weddell Sea sector.

In this paper, we take a fresh look at the determination of the transition matrix for a homogeneous, biisotropic particle employing the Null-field approach. The condition for passivity of the material is discussed. In particular, we focus on some previously unproved properties of the Beltrami spherical vector waves, such as completeness, orthogonality, and linear independence, which are all instrumental in the analysis of the scattering problem with the Null-field approach. Some numerical examples illustrate the approach.

The human digestive system harbors a vast diversity of commensal bacteria and maintains a symbiotic relationship with them. However, imbalances in the gut microbiota, known as dysbiosis, accompany various diseases, such as inflammatory bowel diseases (IBDs) and colorectal cancers (CRCs), which have a significant impact on the well-being of people globally. Glycosylation of the mucus layer is a key factor that plays a critical role in maintaining the homeostatic environment in the gut. This review delves into the ways in which the gut microbiota, gut epithelial barrier, and immune cells work together to establish a balanced gut environment. Specifically, the role of glycosylation in regulating immune cell responses and mucus metabolism in this process is examined. Additionally, the review explores various modulatory approaches used to maintain or restore the functional gut microbiota.

A new mathematical model has been developed to analyze the process of drying food. The model is based on a non-linear function fit of the moisture ratio behavior. To determine the moisture ratio behavior, the Rational Polynomial method of first and second order has been proposed, which allows a simple fit that approximately describes the moisture ratio behavior. The Pearson coefficients obtained for the fitted series were greater than 0.9948. The fitting process has been automated using a simple Wolfram language script. This model has been compared against the most commonly used models and applied to a set of 39 experimental data series. The RP method for the second order showed good agreement in 82.05% of the analyzed series and was the best fit in 61.5% of all the data sets. On the other hand, the first order showed good agreement in only 30.77% of the analyzed series.

This paper discusses the Maxwell system of electrodynamics in the context of distributions. It is used to establish boundary conditions for fields at the interface when the charge and current densities are concentrated measures on the interface. The paper derives the generalized Snell's law from this analysis.

Given the immense volume of textual content being generated on the Internet, encompassing a wide array of materials such as news stories, legal documents, and academic papers, the process of document summarization is becoming increasingly crucial. With the overwhelming amount of text, manual summarization becomes impractical due to the substantial effort, time, and monetary resources it demands. Multi-document summarization (MDS) emerges as a potent solution for aggregating information, offering concise and informative summaries from clusters of interrelated documents. In this context, our pioneering survey systematically reviews the recent advancements in deep learning-based MDS models. We introduce a new taxonomy to efficiently classify the various approaches taken in neural network construction, thereby offering a survey of the present state of the art. At its core, our work consists of introducing a novel deep-learning-based method for extracting summarization of multi-document information with an emphasis on opinions. To measure semantic sentence similarities, we propose an innovative combined approach that leverages determinant point processes. Through the use of filters of varying sizes, a convolutional layer analyses pairs of sentences, capturing foundational attributes. To sift through complex details and eliminate extraneous data, we harness capsule networks, which transform spatial and orientation relationships into sophisticated representations. Additionally, we employ RNN-LSTM for reconstructing sentence pairs, introducing a reconstruction loss to enhance our overarching objective function. The culmination of our efforts is the Opinion Summarizer Model, which achieves remarkable performance, as indicated by the highest AR metric on the dataset (ARS: 0.2548). In essence, our technique significantly surpasses existing state-of-the-art summarization methods like RegManual, PriorSum, and more. This underscores the efficacy of our approach in generating superior summaries that encapsulate the essence of opinion-oriented multi-document content.

Gut microbiota transplantation has been reported to improve the renal function of membranous nephropathy (MN). However, whether there is a causal effect of gut microbiota on MN remained unclear. We performed two-sample Mendelian randomization (MR) analysis. The inverse variance weighted (IVW) method was used as the main approach to evaluate the causal relationship between gut microbiota and MN. Additional methods including MR-Egger regression, weighted median, and MR-weighted mode were also conducted. Cochrane’s Q test, MR-Egger regression, and MR-PRESSO were employed to detect heterogeneity and pleiotropy, respectively. A total of 196 gut microbiota were examined. After IVW and sensitivity analysis, eight gut bacteria taxa were observed causal effects on the risk of MN. Specifically, Genus. Oscillibacter was a protective factor (OR: 0.57; 95%CI: 0.328-0.979; P = 0.042), while Class. Melainabacteria (OR: 1.51; 95% CI: 1.004-2.277; P = 0.048), Genus. Butyricicoccus (OR: 2.16; 95% CI: 1.005-4.621; P = 0.048), Genus. Catenibacterium (OR: 1.49; 95% CI: 1.043-2.134; P = 0.028), Genus.Ruminiclostridium5 (OR: 1.74; 95% CI: 1.053-2.862; P = 0.030), Genus. Ruminococcaceae UCG-003 (OR: 1.73; 95% CI: 1.110-2.692; P = 0.015), Order. Bacillales (OR: 1.52; 95% CI:1.135-2.025; P = 0.0048) and Order. Gastranaerophilales (OR: 1.45; 95% CI: 1.010-2.085; P = 0.044) were risk factors. Heterogeneity was not significant for most single-nucleotide polymorphisms, and no statistical difference in pleiotropy. This study first indicated the causal association between specific gut microbiota and MN, which would be of great significance to guide clinical prevention and treatment in MN.

Interview with Professor Guoqing Zhang

ABSTRACT Background: Conventional echocardiography identifies STEMI by regional wall motion abnormality (RWMA), but it still has a great challenge to identify other types of coronary artery disease (CHD). The Two-dimensional Speckle Tracking Echocardiography (2D-STE) makes up for some of the deficiency, especially by using the myocardial work which combined with the left ventricular pressure condition. By this way, the dysfunctional region of myocardium can be identified more accurately, which is expected to be a new non-invasive prediction method for CHD. Methods: According to the exclusion criteria, 140 patients who had received coronary angiography (CAG) were included in this study. According to the stenosis rate of coronary artery, the patients were divided into CHD group and control group. The predictive efficacy of GLS and GWI for severe coronary artery stenosis were compared by ROC curve. Then, the 140 patients were respectively re-grouped according to the stenosis rate of LAD, LCX and RCA three times. The regional GLS and GWI are recorded as GLS R and GWI R according to the PRI method described in this article. The efficacy of GLS R and GWI R in predicting severe coronary artery stenosis were compared. Certainly the prediction efficiency between PRI method and traditional method (using the value of GLS and GWI directly) were also compared. Results: In predicting severe coronary artery stenosis, compared with GLS R, GWI R showed significantly higher sensitivity (95.2% vs 70.2%) and similar specificity (87.5% vs 91.1%). In the aspect of identification of certain coronary artery with severe stenosis, the sensitivity of GWI R was significantly higher than GLS R in predicting severe stenosis of LAD, LCX, and RCA (LAD: 96.5% vs 64.9%; LCX: 65.6% vs 50.0%; RCA: 50% vs 20%). Compared with traditional method, the “positive region identification” method has higher AUC in the ROC curve. Conclusion: GWI is more sensitive than GLS in identifying patients with CHD that couldn’t be detected by conventional echocardiography and performs better in accurately disclosing the culprit coronary arteries with severe stenosis. Compared with the traditional method, the PRI method can be used to judge whether there is severe stenosis in any coronary artery more accurately and confidently. Keywords: echocardiography, speckle-tracking echocardiography, pressure-strain loop, myocardial work, global longitudinal strain, coronary artery disease, coronary artery stenosis

A document by Leandro A. Passos. Click on the document to view its contents.

Objective: To undertake a cost minimisation study of ST analysis (STan) plus cardiotocograpy (CTG) compared to CTG alone. Design: Cost-minimisation analysis alongside a randomised controlled trial [(1)](#ref-0001). Setting: A tertiary level maternity centre in Adelaide, South Australia. Population: Women in labour ≥36 weeks gestation, with a clinical indication for continuous electronic fetal monitoring. Methods: We utlilised a health service perspective covering randomisation to final maternal and neonatal discharge, including readmissions. Primary analysis was intention to treat, with secondary per protocol analysis. Post hoc analyses were conducted by sub-groups and after exclusion of outliers. Main outcome measure: Average cost per mother/baby dyad. Results: Costs were calculated for 957/968 patients (98.9%) using hospital financial data. There was no statistically significant evidence of difference between the two study arms but lower costs observed in the STan arm. Average cost per mother/baby dyad was AUD12,768 for Stan+CTG, compared with AUD15,027 for CTG alone. Lower costs were mainly due to lower neonatal costs, particularly for critical care. Maternal labour cost was nearly identical in the two arms. The difference was still shown, although with reduced magnitude, when outliers were removed and increased with a per protocol analysis. Conclusion: While not statistically significant, reduced costs were observed in the CTG+STan arm (average reduction per mother / baby dyad = AUD2,259).