A 46-year-old woman with congenitally corrected transposition of the great arteries (ccTGA) associated to dextrocardia, situs viscerus inversus and left superior vena cava persistence presented with an incessant supraventricular tachycardia. Electrophysiological study was not conclusive in differential diagnosis of atrial tachycardia versus atypical atrioventricular nodal reentrant tachycardia, also due to the unconventional anatomy of the coronary sinus. By a comprehensive mapping of cardiac chambers, a double side slow-pathway was localized in both atrial chambers and subsequently ablated by radiofrequency delivery without tachycardia changes. Aortic root and cusps were devoid of electrical activity. The muscular part of the sub-pulmonary ventricle at the level of interatrial septum showed an earliest activation signal of -90ms and ablation of this site was effective in abolish the tachycardia. This is the first case to report technical concerns of septal atrial tachycardia ablation in cc-TGA associated with multiple anatomical malformations. Moreover, some peculiarities have been reported for the first time including the presence of double side atrio-ventricular nodal slow-pathway and atypical localization of the tachycardia origin into the muscular part of the sub-pulmonary ventricle instead of posterior pulmonary cusp.

Substantial wealth of knowledge about anaerobic fungi has accumulated in recent years, which may guide the attention of the biotechnology-oriented scientists towards the possible exploitation of their fascinating capabilities. Very efficient, unique and complex enzyme systems of anaerobic fungi play determining role in the conversion of lignocellulosic fodder to milk and meat in mammalian herbivores. Mitigation of the concomitant greenhouse gas emission by ruminants is a major environmental, climate change issue. In turn, controlled management of the inter-kingdom syntrophic co-operations among the eukaryotic anaerobic fungi, bacteria and archaea can lead to the production of valuable bio-fuels, e.g. bio-methane, bio-hydrogen, bio-ethanol, and organic acids, the latter could serve as building blocks in numerous biosynthetic processes in circular bioeconomy.

A Pediatric Case of Neuromyelitis Optica and Pulmonary Inflammatory Myofibroblastic TumorAlyson Win, BS (winak@tamu.edu)a : Conceptualization; writing- original draft; writing- review and editing.Jesper Jiang, BS (jesper.jiang@tamu.edu)a:Conceptualization; writing- original draft. John Fitzwater, MD (john.fitzwater@BSWHealth.org)b : writing- review and editing; supervision. Edwin Hernandez Caro, MD (Edwin.Caro@BSWHealth.org)c : writing- review and editing. Amy Cruickshank, DO (Amy.Cruickshank@BSWHealth.org)d : writing- review and editing. Duriel Hardy, MD (Duriel.Hardy@austin.utexas.edu)e : writing- review and editing. Ydamis Estrella Perez, MD (Ydamis.Perez@BSWHealth.org)f : writing- review and editing. Michele Prater, PNP (JMichele.Prater@BSWHealth.org)c: writing- review and editing. Malvika Sagar, MD (Malvika.Sagar@BSWHealth.org)c : Conceptualization; writing- review and editing; supervision.a: Texas A&M Health Science Center School of Medicine, Temple, TXb: Department of Pediatric Surgery, Baylor Scott and White McClane Children’s Medical Center, Temple, TXc: Department of Pediatric Pulmonology, Baylor Scott and White McClane Children’s Medical Center, Temple, TXd: Department of Pediatric Hematology/Oncology, Baylor Scott and White McClane Children’s Medical Center, Temple, TXe: Department of Pediatric Neurology, Dell Children’s Medical Center, Austin, TXf: Department of Pathology, Baylor Scott and White Medical Center, Temple, TX

Introduction High flow nasal cannula (HFNC) is commonly used as first step respiratory support in infants with moderate-to-severe acute viral bronchiolitis (AVB). This device, however, fails to effectively manage respiratory distress in about a third of patients, and data are limited on determinants of patient response. The respiratory rate-oxygenation (ROX) index is a relevant tool to predict the risk for HFNC failure in adult patients with lower respiratory tract infections. The primary objective of this study was to assess the relationship between ROX indexes collected before and 1 hour after HFNC initiation, and HFNC failure occurring in the following 48 hours in infants with AVB. Method: This is an ancillary study to the multicenter randomized controlled trial TRAMONTANE 2, that included 286 infants of less than 6 months with moderate-to-severe AVB. Collection of physiological variables at baseline (H0), and 1 hour after HFNC (H1), included heart rate (HR), respiratory rate (RR), fraction of inspired oxygen (FiO 2), respiratory distress score (mWCAS), and pain and discomfort scale (EDIN). ROX was calculated as SpO 2/FiO 2 to RR. Predefined HFNC failure criteria included increase in respiratory distress score or respiratory rate, increase in discomfort, and severe apnea episodes. The accuracy of ROX index to predict HFNC failure was assessed using receiver operating curve analysis. Result: HFNC failure occurred in 111/286 (39%) infants, and for 56 (50% of the failure) of them within the first 6 hours. The area under the curve of ROX indexes at H0 and H1 were, respectively, 0.56 (95% CI 0.48-0.63, p =0.14), 0.56 (95% CI 0.49- 0.64, p =0.09). HFNC failure was associated with higher mWCAS score at H1 (p<0.01) and lower decrease in EDIN scale during the first hour of HFNC delivery (p = 0.02), but none of the physiological variables were predictive of HFNC failure. Conclusion: In this study, neither ROX index, nor physiological variables usually collected in infants with AVB had early discriminatory capacity to predict HFNC failure.

Steady-State Visual Evoked Potentials (SSVEP) have garnered significant attention due to their promising applications in brain-computer interfaces (BCI), medical diagnostics, and several other domains. Enhancing the characteristics of SSVEP signals through intricate signal processing has emerged as a pivotal research focus for more efficient signal extraction. In this work, we introduce a novel layered enhancement algorithm for SSVEP electroencephalogram (SSVEP-EEG) signals based on fractional-order differentiation operators. This innovative approach marries brain signal analysis with image processing methodologies. By utilizing fractional-order differentiation operators in tandem with the Laplace pyramid, the signal undergoes hierarchical enhancement. This amplified signal is then reconstructed, which facilitates an in-depth extraction of image intricacies and attributes, ultimately accentuating the distinctiveness of SSVEP features. To validate the efficacy of the proposed method, we applied it to three recognized target identification algorithms: Canonical Correlation Analysis (CCA), Filter Bank Canonical Correlation Analysis (FBCCA), and Task-Related Component Analysis (TRCA) using a publicly available dataset. Experimental outcomes underscore that, in contrast to contemporary techniques, our proposed algorithm not only effectively attenuates the trend components of SSVEP signals but also substantially elevates the recognition precision of CCA, FBCCA, and TRCA.

A document by Erik Franciscus Maria Koene. Click on the document to view its contents.

In root-nodule symbioses (RNS) between nitrogen (N) fixing bacteria and plants, bacterial symbionts cycle between nodule-inhabiting and soil-inhabiting niches that exert differential selection pressures on bacterial traits. Little is known about how the resulting evolutionary tension between host plants and symbiotic bacteria structures naturally occurring bacterial assemblages in soils. We used DNA cloning to examine soil-dwelling assemblages of the actinorhizal symbiont Frankia in sites with long-term stable assemblages in Alnus incana ssp. tenuifolia nodules. We compared: 1) phylogenetic diversity of Frankia in soil vs. nodules, 2) change in Frankia assemblages in soil vs. nodules in response to environmental variation: both across succession, and in response to long-term fertilization with N and phosphorus, and 3) soil assemblages in the presence and absence of host plants. Phylogenetic diversity was much greater in soil-dwelling than nodule-dwelling assemblages, and fell into two large clades not previously observed. Presence of host plants was associated with enhanced representation of genotypes specific to A. tenuifolia, and decreased representation of genotypes specific to a second Alnus species. The relative proportion of symbiotic sequence groups across a primary chronosequence was similar in both soil and nodule assemblages. Contrary to expectations, both N and P enhanced symbiotic genotypes relative to non-symbiotic ones. Our results provide a rare set of field observations against which predictions from theoretical and experimental work in the evolutionary ecology of RNS can be compared.

1) Clustering is indispensable in the quest for robust vegetation classification schemes which aim to partition continua to summarise and communicate pattern. However, clustering solutions are sensitive to methods and data and are therefore unstable, a feature which is usually attributed to noise. Viewed through a central-tendency lens, noise is defined as the degree of departure from type, which is problematic since vegetation types are abstractions of continua and so noise can only be quantified relative to a particular solution to hand. Graph theory models the structure of vegetation data based on the interconnectivity of samples. Through a graph-theoretic lens, the causes of instability can be quantified in absolute terms via the degree of connectivity among objects. 2) We simulated incremental increases in sampling intensity in a dataset over five iterations and assessed classification stability across successive solutions derived using algorithms implementing, respectively, models of central-tendency and interconnectivity. We used logistic regression to model the likelihood of a sample changing groups between iterations as a function of distance to centroid and degree of interconnectivity. 3) Our results show that the degree to which samples are interconnected is a more powerful predictor of instability than the degree to which they deviate from their nearest centroid. The removal of weakly interconnected samples resulted in more stable classifications, although solutions with many clusters were apparently inherently less stable than those with few clusters, and improvements in stability flowing from the removal of outliers declined as the number of clusters increased. 4) Our results reinforce the fact that clusters abstracted from continuous data are inherently unstable, and that the quest for stable, fine-scale classifications from large regional datasets is illusory. Nevertheless, our results show that using models better suited to the analysis of continuous data may yield more stable classifications of the available data.

Labeling fine-grained objects manually is extremely challenging, as it is not only label-intensive but also requires professional knowledge. Accordingly, robust learning methods for fine-grained recognition with web images collected from Internet of Things have drawn significant attention. However, training deep fine-grained models directly using untrusted web images is confronted by two primary obstacles: 1) label noise in web images and 2) domain variance between the online sources and test datasets. To this end, in this study, we mainly focus on addressing these two pivotal problems associated with untrusted web images. To be specific, we introduce an end-to-end network that collaboratively addresses these concerns in the process of separating trusted data from untrusted web images. To validate the efficacy of our proposed model, untrusted web images are first collected by utilizing the text category labels found within fine-grained datasets. Subsequently, we employ the designed deep model to eliminate label noise and ameliorate domain mismatch. And the chosen trusted web data are utilized for model training. Comprehensive experiments and ablation studies validate that our method consistently surpasses other state-of-the-art approaches for fine-grained recognition task in a real-world scenario. Simultaneously, this introduces a novel pipeline for fine-grained recognition with substantial efficacy in practical applications. The source code and models can be accessed at: https://github.com/NUST-Machine-Intelligence-Laboratory/DDN.

Using the N-back task, we investigated how memory load influences the neural activity of the Chinese character cognitive subprocess (recognition, updating, and maintenance) in Mainland Chinese speakers. Twenty-seven participants completed the Chinese character N-back paradigm while having their event-related potentials recorded. The study employed time and frequency domain analyses of EEG data. Results showed that accuracy decreased and response times increased with larger N values. For ERPs, N2pc and P300 amplitudes decreased, and SW amplitude increased with larger N values. For time frequency analyses, the desynchronization of alpha oscillations decreased after stimulus onset, but the synchronization of alpha oscillations increased during the maintenance phase. The results suggest that greater memory load is related to a decrease in cognitive resources during updating and an increase in cognitive resources during information maintenance. Results of a brain-behavior relevant analysis showed that the ERP indicators in the maintenance phase predicted behavioral performance.

Background: Charles Bonnet syndrome (CBS) is a prototype phenomenon for investigating complex visual hallucination. Our research focuses on resting-state neural networks features of CBS patients with a comparison of patients with equally matched visual loss and healthy subjects in order to investigate the mechanism behind complex visual hallucinations. Methods: Four CBS patients CBS(+), 3 patients with visual loss but no visual hallucinations CBS(-) and 15 healthy controls (HC) undergo resting-state fMRI recordings and their resting-state data is analyzed. Cognitive functions of the participants were also evaluated through MMSE and um-PDHQ Results: Although we found no difference in DMN between CBS(-) and CBS(+), and between CBS(-) and HC groups, we detected decreased connectivity in CBS(+) compared to the HC group especially in visual hetero-modal association centers (bilateral lateral occipital and lingual gyrus, occipital pole, right medial temporal and temporo-occipital cortex) when left angular gyrus was selected as ROI. Similarly, we detected decreased connectivity in CBS(+) compared to HC in right medial frontal, posterior cingulate, supramarginal, left inferior temporal, and angular gyrus when selected right superior frontal gyrus as ROI. In contrast, increased connectivity was detected in CBS+ compared to HC, in bilateral occipital poles, occipital fusiform gyrus, intra-calcarine cortex, right lingual gyrus and precuneus regions when left medial temporal gyrus was selected as ROI. Conclusion: Our findings suggest a combined mechanism in CBS related to increased internal created images caused by decreased visual external input causing visual hallucinations along with impaired frontotemporal resource tracking system that together impairs cognitive processing.

Objective: Audiovisual stimuli during exercise is known to increase pleasure, but the moderating factors impacting this benefit have not been clearly explored. Therefore, two studies were used to explore the moderating effects of exercise intensity and preference for exercise intensity on the improvement of affective responses to audiovisual stimuli, respectively. Methods: In Study 1, 50 participants were randomly assigned to two groups (audiovisual stimuli vs. control) to complete 20-min sessions of exercise at 10% below and above ventilation threshold (VT). Oxygenation of the prefrontal cortex (PFC) during exercise was assessed with near infrared spectroscopy (NIRS). In Study 2, 27 low-preference and 26 high-preference participants completed 20-min sessions of exercise at 10% below and above VT with audiovisual stimuli. Affective valence, arousal, perceived exertion, and attentional focus were measured in each study every 5 minutes during exercise. Results: Study 1 revealed that audiovisual stimuli led to a small improvement in affective responses above VT when compared to below VT at 15 min and 20 min. The neural basis of audiovisual stimuli to improve affective responses during exercise is to slow the decline in PFC activation. Specifically, the higher the right middle PFC activation below VT intensity, the more the pleasure. Study 2 revealed greater benefits of audiovisual stimuli to improve affective responses among high-preference individuals below VT when compared to above VT. Conclusion: The effects of audiovisual stimuli on exercise-related affect appear to be influenced by the characteristics of exercise bout and individual differences, among a sample of physically inactive adults

Purpose: This study aimed to examine the effects of Empagliflozin on the mice model of HFD/STZ-induced T2DM and liver fibrosis, and the correlations with gut microbiota. Methods: The HFD/STZ-induced T2DM and liver fibrosis mice were treated with Empagliflozin for 6 weeks. After the intervention, OGTT and IPGTT were performed to assess glucose tolerance and insulin resistance in mice. The histological chemistry and indicators of liver pathology and liver fibrosis were assessed. Moreover, 16S rRNA amplicon sequencing for gut microbiota was performed to explore the changes of gut bacterial composition. And we analyzed the correlation between alterations in intestinal microbial composition and liver fibrosis score or glucose metabolic indicators. Results: 6-week Empagliflozin intervention improved glucose metabolism, and attenuated liver fibrosis in HFD/STZ-induced mice, which might be related to the alterations of gut microbiota. Furthermore, the abundance of Lactobacillus was increased, while Ruminococcus and Adlercreutzia were reduced in Empagliflozin-treated mice, which were positively associated with liver fibrosis and glucose metabolism in correlation analysis. Conclusion: Empagliflozin ameliorated glucose metabolic dysfunction and liver fibrosis in HFD/STZ-induced mice, whose effects might be due to the beneficial balance of gut microbiota composition. Our study provided evidence and highlighted improvement of gut-liver axis by inhibition of SGLT2 in T2DM and liver fibrosis.

Extreme precipitation events (EPEs) on a sub-daily scale are an important factor in triggering urban flooding and flash flooding. However, corresponding studies on the spatial patterns of sub-daily extreme precipitation in Guangdong Province are lacking. We objectively classified the spatial patterns of extreme precipitation (EPSPs) in Guangdong Province, calculated the importance of influencing factors on EPSPs, and finally analyzed the weather background corresponding to various EPSPs and explained the causes of extreme precipitation. We have found that the incidence of most EPSPs has tended to increase significantly over this 40-year period, and the increase has been particularly pronounced since the 21st century. The Pacific Decade Oscillation (PDO) was the main influence on EPEs in Yangjiang, Maoming and Shanwei, and the weakening of PDO has contributed to the occurrence of EPEs in these areas. Urbanization is the main factor contributing to the increase in EPEs in the PRD, Zhanjiang and coastal areas of Guangdong Province. The cause of the EPSP in central Guangdong Province was the southwest jet stream and topographic uplift. The extreme precipitation in Yangjiang, the PRD, Maoming and Shanwei was mainly triggered by the convergent shear of the southwesterly winds. The cause of the EPSP over Zhanjiang was the low vortex in western Guangdong and the influx of large amounts of water vapour over land from the south over the ocean.

Perforated Meckel’s diverticulum in children: A rare complication

Arrest of Labor Secondary to Large Uterine Fibroid

Integrated Demand Response is increasingly recognized as a crucial tool for maintaining balance between supply and demand in integrated energy systems, and for enhancing the absorption and utilization rate of renewable energy. A prerequisite for implementing IDR effectively is the accurate modeling of consumer characteristics. However, existing models have not accounted for the coupling characteristics of inter-energy comfort and inter-period incentives when consumers participate in IDR; they also overlook the Inter-consumer coupling characteristics. This paper presents an inter-energy comfort coupling matrix and a cross-elasticity coupling matrix for incentives, offering effective modeling of the coupling characteristics between different energies and periods. By introducing a dynamic participation rate, a mathematical model of inter-consumer coupling characteristics is established. Simulation results demonstrate that the model considering inter-energy coupling characteristics produces significant reductions in response power deviations and total costs of IESP, while also enhancing consumer motivation to participate in IDR. The model that incorporates inter-period coupling characteristics not only improves consumer benefits and comfort levels in participating in IDR but also further reduces response power deviations and total costs of IESPs. The model considering inter-consumer coupling characteristics effectively mitigates response power deviations resulting from consumers’ bounded rationality by calculating the mathematical expectation of each consumer’s response power.

Affected by inverter fast control and commutation failure, most protection schemes for AC lines connected to LCC-HVDC inverter station(ACLs) have the problems of complex setting, weak anti-noise and high demand for data synchronization. This paper proposes a pilot protection scheme based on high-frequency transient current waveform similarity. Firstly, with analyzing the fault traveling wave propagation process, the obvious differences are found in the transient current waveforms at both ends of the line when internal and external faults occur. Then the similarity of transient current waveforms is measured with the improved longest common similar subsequence (LCSS) method. And the weak high-frequency current is extracted with the improved synchronous squeezed S-transform (SST) method. Finally, a large number of PSCAD simulation results show that the proposed protection method does not require strict data synchronization, has strong anti-noise performance, and is tolerant to the influence of abnormal point fluctuations.

A document by Hao Qin . Click on the document to view its contents.

A document by Charalampos Lamprou . Click on the document to view its contents.

Understanding the subprocesses of risky decision-making is prerequisite for understanding (dys-)functional decisions. For the present fMRI study we designed a variant of the balloon-analogue-risk task (BART) that allows separating decision making from reward anticipation and feedback processing. 29 healthy young adults completed the BART. We analyzed neural activity and functional connectivity. Parametric modulation allowed assessing changes in brain functioning depending on the riskiness of the decision. Our results confirm involvement of Nacc, Insula, ACC and DLPFC in all subprocesses of risky decision making. In addition, subprocesses were differentiated by the strength of activation in these regions, as well as by changes in activity and Nacc-connectivity by the riskiness of the decision. The presented fMRI-BART variant allows distinguishing activity and connectivity during the subprocesses of risky decision making and shows how activation and connectivity patterns relate to the riskiness of the decision. Hence, it is a useful tool for unraveling impairments in subprocesses of risky decision making in people with high risk behavior.

The aim of this study was to explore the mechanism of the age-related P3 ‘anterior’ shift using high-precision temporal principal components analysis (tPCA). Continuous EEG was recorded from younger and older adults while completing a two-stimulus visual oddball task. We narrowed our tPCA input to the P3 range to enhance precision and reveal potentially overlapping temporal components. eLORETA was used to model group and condition-related differences in component sources to further understanding of the functional relevance and neurobiology of the P3 anterior shift. The target P3a and P3b and the nontarget P3/l-P3 (late P3) evidenced the expected anterior shift. There was a general reduction in P3 component amplitudes in older compared to younger adults across both stimulus types, consistent with the P3 ‘ageing effect’. For all P3 components, eLORETA modelled changes in activation of multiple and diffuse sources with age, suggesting that neural processing is extending beyond frontal regions and that crosstalk between different neural networks is likely. Findings are aligned with the dedifferentiation hypothesis, as reduced P3 target amplitudes reflect attenuated responding to a preferred stimulus, and the anterior shift to nontargets is a form of neural broadening, or decreased selectivity of processing and increased responding to a non-preferred stimulus.

Introduction: A prominent action potential (AP) notch in the epicardium (Epi) of the RVOT is known to predispose to the development of closely-coupled phase 2 reentrant extrasystoles, capable of precipitating ventricular tachycardia and fibrillation (VT/VF) in the setting of BrS. Ablation of this Epi substrate exerts an ameliorative effect. In some BrS patients, Endo ablation of the RVOT is effective as well. The prime objective of this study was to examine the electrophysiological basis for premature beats originating from the endocardium (Endo) of the right ventricular outflow tract (RVOT) in experimental models of Brugada syndrome (BrS). Methods: Canine coronary-perfused cardiac preparations incorporating the RVOT (n=15) were studied using standard microelectrode techniques. Terfenadine, a sodium and calcium channel blocker, was used to pharmacologically mimic the effects of the genetic defects associated with BrS. Results: Under baseline conditions, a prominent AP notch was recorded in Epi and in the deep intra-trabecular structures of RVOT Endo, but not in the smooth Endo surface of the RVOT. Terfenadine markedly accentuated the AP notch in the deep intra-trabecular structures of RVOT Endo leading to the development of closely-coupled phase 2 reentrant extrasystoles capable of triggering polymorphic VT/V. Still, Epi RVOT region was more likely to develop extrasystoles than Endo RVOT. VT/VF was recorded in 12/15 preparations. Conclusions: Our findings suggest that the deep intra-trabecular structures of RVOT Endo harbor the substrate for the development of phase 2 reentrant extrasystoles capable of triggering VT/VF. Our data may help to explain the effectiveness of Endo RVOT ablation in some BrS patients.

In tropical regions, insects face increased predation risks due to warmer temperatures and heightened ecological interactions. However, uncertainties remain in assessing predation risks in large tropical islands with diverse topography and high biological invasions. We conducted studies on Hainan Island, a vast tropical island, selecting 16 diverse locations to evaluate predation risk on the underground pupae of the invasive Bactrocera dorsalis. Findings show higher altitudes correlate with higher predation rates, while elevated temperatures negatively affect predation. This suggests temperature's crucial role in shaping predation risk and activity ranges of non-native insects and native predators, impacting predation and invasive prevalence in coastal regions. Moreover, we observed higher predation rates in organic soil. The study highlights the importance of temperature-induced ecological interactions in shaping insect predation risk, confirming the enemy release hypothesis, and raising concerns about global warming's impact on the expansion of invasive insect populations.