In this study, we first define generalized order Fibonacci and Lucas polynomials. We show that by special choices one can obtain some known sequences of polynomials and numbers such as order Pell polynomials, order Jacobsthal polynomials, order Fibonacci and Lucas numbers and etc. by using the definition of order Fibonacci and Lucas polynomials. Then we consider hybrid numbers and polynomials whose importance is increasing in mathematics, physics and engineering day by day. We generalize the hybrid polynomials by moving them to the order. Hybrid polynomials that are defined with this generalization are called order Fibonacci and Lucas hybrinomials throughout this paper. We define the generalized order Fibonacci and Lucas hybrinomials using generalized order Fibonacci and Lucas polynomials. Besides this, we give the recurrence relations of the generalized order Fibonacci and Lucas hybrinomials. Also, we show that by special choices in this recurrence relations one can obtain some known hybrid polynomials such as Horadam, Fibonacci, Lucas, Pell, Pell-Lucas, Jacobsthal, Jacobsthal-Lucas hybrinomials. Furthermore, we introduce the generating functions of hybrinomials and give some important properties. Finally, we define the matrix representations of the generalized order Fibonacci and Lucas hybrinomials. For this purpose, we derive the matrices of and that play similar role to the matrix for Fibonacci numbers. We show that by special choices of the integers and , one can obtain matrix representations of some known hybrinomials such as Pell, Jacobsthal hybrinomials and etc.

Objective: To evaluate the association between dietary intake and the prevalence of uterine leiomyoma (UL) in Korean women. Design: A retrospective cross-sectional study with dietary intake assessment. Setting: A Health check-up center Population: A cohort of 672 Korean women aged 25–65 years from a previous study. Methods: Dietary intake was assessed using food frequency questionnaire (FFQ), and the presence of UL was evaluated by ultrasonography. Multiple logistic regression models were used to analyze the relationship between dietary intake and the prevalence of UL with adjustment for confounding factors. Main Outcome Measures: Dietary intake and prevalence of UL. Results: A total of 219 (32.6%) women were diagnosed with UL. High intakes of fish and poultry were associated with a high prevalence of UL; ORs (95% CIs) comparing top vs. bottom quartiles were 1.70 (1.02-2.84; p trend = 0.049) for fish intake and 1.85 (1.09 -3.14; p trend = 0.07) for poultry intake. High intake of dairy products was inversely associated with the prevalence of UL (OR 0.59, 95% CI 0.36–0.98; p trend = 0.06). When we examined pre- and post-menopausal women separately, the association for poultry intake was generally limited to postmenopausal women. In premenopausal women, those with higher vegetable intake had a lower prevalence of UL (OR 0.47, 95% CI 0.22 -1.01 for top vs. bottom quartiles; p trend = 0.01). Conclusions: We found that high intakes of fish and poultry, but low intake of dairy products, were associated with a higher prevalence of UL. Vegetable intake was inversely associated with the prevalence of UL in premenopausal women.

Background: Atypical Atrial Flutter (AAFL) prevalence is increasing due to the escalating Atrial Fibrillation (AF) ablations and cardiac surgeries. We wanted to explore the outcome of the AAFL ablation, considering the recent changes in mapping and ablation. Methods: This study was approved by the Institutional Review Board (IRB) of Mayo Clinic hospital. We retrospectively studied 419 patients who had undergone AAFL ablation at Mayo Clinic from January 2017 to June 2022. Thirteen patients declined research authorization, and 19 patients were lost to follow-up during the 90-day blanking period, resulting in a sample size of 387. The median follow-up time for patients was 25.7 months (95% CI 23.7, 32.3). Results: Recurrent symptoms with documentation of atrial arrhythmia Occurred in 226/387 (58.4%) patients, of which 151/226 (66.8%) occurred within the first year. The median time to recurrence was 8.5 months (max 57.8 months). Eleven patients died during the study period, 9 of whom experienced recurrence prior to death. Overall, the median recurrence-free survival (RFS) time was 16.6 months (95% CI 13.2, 20.0) with a 1-year RFS rate of 57.2% (95% CI 52.2, 62.7%). Acute termination occurred 324/387 (83.7%) during the ablation. The 1-year RFS rate was 58.9% (95% CI 53.5%, 64.9%) for patients with acute termination and 49.0% (95% CI 37.9%, 63.4%) for those without acute termination. The rate was not significantly different based on acute termination status (p = 0.11). Conclusions: The one-year RFS rate of 57.2% following AAFL ablation, even though 83.7% achieved acute termination during the procedure, signifies the extent of the underlying substrate abnormalities.

Hybridizing the “Hybrid” OR: A Case Report using Pulsed Electric Field Delivery in Early Stage, Non-Small Cell Lung Cancer, Treat and Resect Study “INCITE ES”Marcelo Jimenez1,2,3, MD, PhD, Jose M Fernandez1, MD, and William Krimsky4, MD

In this letter, an analytical method for the beampattern synthesis of symmetric nonuniform array is proposed. This method consists of two steps. In the first step, it acquires a real symmetric excitation by the convex optimization method to attain a pencil beam. In the second step, it superposes the pencil beams pointing in different directions to synthesize the prescribed beampattern. Numerical results are provided to verify the effectiveness of the proposed method.

A document by Khadija Sellami. Click on the document to view its contents.

A document by Fabian Bernhard. Click on the document to view its contents.

Introduction: In activation mapping of reentrant atrial tachycardia (AT), there was no reference for window of interest (WOI). We assumed that the critical isthmus will exhibit the slowest conduction velocity, and thus, may be located in an isoelectric line after prominent P wave . We examined the timing of a successful termination site from end of the P wave and attempted to determine whether the critical isthmus can be identified using activation mapping when WOI was set as end to end of the P wave. Methods: Forty patients with 54 reentrant ATs who underwent 3D electroanatomic mapping and radiofrequency catheter ablation were evaluated retrospectively. The critical isthmus was defined as a successful termination site. We evaluate critical isthmus timing from end of the P wave and ratio of critical isthmus timing from end of the P wave to tachycardia cycle length. Results: In 54 reentrant ATs, macroreentry was identified in 46 (85.2%) and microreentry was identified in eight (14.8%). The timing of the critical isthmus site from end of the P wave was -4.0 ± 31.1 msec (Macroreentry vs. Microreentry; -8.9 ± 29.4 msec vs. 24.0 ± 26.7 msec; P = 0.005). The ratio of critical isthmus timing from end of the P wave to tachycardia cycle length was -1.4 ± 10.5% (Macroreentry vs. Microreentry; -3.1 ± 9.8% vs. 8.3 ± 9.3%, P = 0.004) Conclusion: The critical isthmus of reentrant AT is located within 10% backward and forward from end of the P wave to tachycardia cycle length. Setting the WOI from end to end of the P wave is useful for identification of the critical isthmus through activation mapping in reentrant AT.

This paper, presents a 4×4 BM based on four direction switch BM antenna array. The proposed design operated at 3.5 GHz. The use of multi-beam antennas or switched-beam antenna arrays (SAAs) promised users of high-gain and large coverage areas for 5G technologies. The BM was implemented by combining 3-dB BLC, two crossovers, and 45 o phase shifters fabricated on the RT5880LZ substrate, with using a triangular slot and T-shape based on the BM design. The proposed design focused on the miniaturization and enhancement of the bandwidth. The return loss and isolation were better than -15 dB at all the ports, according to the simulated and measured result showed that with excellent insertion loss -6.1 ± 2 dB. A fractional bandwidth of 49.7% and the overall dimension were reduced to 56% as compared to the conventional BLC and crossover. Hence, the proposed design of BM performed an excellent size reduction of 80% and improvement bandwidth up to 836 MHz compared to the traditional BM. The switched beam directions were measured at -34 o, -40 o, +32 o and +35 o at 3.5 GHz for each input port of 1-4 excitation. The proposed design BM is suitable of 5G application.

Introduction: Rhabdomyosarcoma (RMS) of the prostate in young adults is exceedingly rare. Case presentation: A 27 year-old male presented with 2-month history of lower urinary tract symptoms. Prostate was enlarged smooth nontender with no nodularities. PET-CT showed prominent iliac chain lymph nodes, enlarged spleen and multiple osseous lytic and blastic lesions.

Objectives: We recently reported that deep learning (DL) using pelvic magnetic resonance imaging is useful for predicting the severity of urinary incontinence (UI) after robot-assisted radical prostatectomy (RARP). However, our results were limited because the prediction accuracy was approximately 70%. We aimed to develop a more accurate prediction system that can be used to inform patients on recovery from UI after RARP using a DL model based on intraoperative video images. Materials and Methods: This study included 101 patients with prostate cancer who underwent RARP. Three snapshots showing the pelvic cavity (before bladder neck incision, just after prostate removal, and after vesicourethral anastomosis) from intraoperative video records, as well as preoperative and intraoperative covariates, were assessed. We evaluated the DL models plus simple or ensemble machine learning, and their sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were analyzed. Results: Sixty-four and 37 patients demonstrated ‘early continence’ and ‘late continence’, respectively, at the 3-month follow-up. The combination of DL and simple machine learning using intraoperative video snapshots with clinicopathological parameters had a notably high performance (AUC, 0.683 to 0.749) for predicting early recovery from post-prostatectomy UI. Notably, the combination of DL and ensemble artificial neural network using intraoperative video snapshots had the highest performance (AUC, 0.882; sensitivity, 92.2%; specificity, 78.4%; overall accuracy, 85.3%) for predicting early recovery from post-prostatectomy UI. In contrast, DL and ensemble ML with clinicopathological parameters (Method 4) achieved no additive effects (AUC, 0.690 to 0.747) compared with DL and simple ML with clinicopathological parameters. Internal validation was performed on additional 30 cases with similar results. Conclusions: Our results suggest that DL algorithms using intraoperative video images can be used to reliably inform patients regarding their recovery from UI after RARP. (287 words)

Introduction Randomised controlled trials show a reduction in acute kidney injury, renal impairment, and acute renal failure after initiation of a sodium glucose cotransporter-2 inhibitor. Observational literature on the association is conflicting, however important to understand for populations with a higher risk of medication-related adverse renal events. We aimed to systematically review the literature to summarize the association between sodium glucose cotransporter-2 inhibitor use and acute kidney injury, renal impairment, and acute renal failure in three at-risk groups: older people aged >65 years, people with heart failure, and people with reduced renal function. Methods Data Sources: A systematic search of Embase (1974–29/03/21) and PubMed (1946–29/03/21) was performed. Study Selection: RCTs and observational studies were included if they reported numbers of acute kidney injury or acute renal failure in people using sodium glucose cotransporter-2 inhibitors, compared to other diabetic therapies. Studies needed to report results by level of renal function, heart failure status, or age. Results Of 858 results, 6 studies were included. The absolute risk of acute kidney injury or acute renal failure was higher in people >65 years compared to those <65 years, higher in people with heart failure (vs. without), and higher in people with reduced kidney function (vs. preserved kidney function), but insufficient evidence to determine if the relative effect of sodium glucose cotransporter-2 inhibitors on this risk was similar for each group. Conclusion At risk cohorts are associated with a higher incidence of acute kidney problems in users of sodium glucose cotransporter-2 inhibitors.

Termites are ancient social insects worldwide. In this research, developmental stages of embryos in the sexual and parthenogenetic eggs of Reticulitermes chinensis and R. aculabialis were observed and categorized. The embryonic development eggs was decteted by DAPI staining, single transcriptome sequencing analysis and RT-PCR . The ovarian development of FF and FM groups in R. flaviceps occurred in the early developmental stages, whilst in R. aculabialis, this occurred mainly in the late developmental stage. The difference was significant in micropyle number between the R. flaviceps FF colony type and the R.aculabialis FF colony type. There were no significant differences in the number of micropyles between other groups. In R. flaviceps, 86% of unfertilized eggs stopped development during the formation of the blastoderm, with the yolk cell gathering extensively at the egg center. Single-cell transcriptome sequencing analysis were annotated many genes in this two species termite. According this answer we analyzed the egg-to-larvae genes expression, and found that the expression levels of PKA, MAP2K1, MAPK1/3, HGK, MKP and Pax6 gene in RaFF were significantly higher than RfFF (P<0.05). We found a significantly lower oocyte cleavage rate in R. flaviceps than in R. aculabialis, resulting in fewer developed oocytes in R. flaviceps. In both species, activation and one or two cleavage events of oocytes occurred during ovulation, but in R. flaviceps the development of unfertilized eggs stopped. We suggest that genes with significant expression differences may play an important role in oocyte and embryonic development in termites.

The molluscan feeding structure is the radula, a chitinous membrane with teeth, which are highly adapted to the food and the substrate. In Polyplacophora and Patellogastropoda, the handling of hard ingesta can be facilitated by high content of chemical compounds containing Fe or Si in the tooth cusps. Other taxa, however, possess teeth that are less mineralized, even though animals have to avoid structural failure or high wear during feeding as well. Here, we investigated the gastropod Gastropteron rubrum, feeding on hard Foraminifera, diatoms and Porifera. Tooth morphologies and wear were documented by scanning electron microscopy and their mechanical properties were tested by nanoindentation. We determined, that gradients of hard- and stiffness run along each tooth, decreasing from cusp to basis. We also found, that inner lateral teeth are harder and stiffer than the outer ones. These findings allowed us to propose hypotheses about the radula-ingesta interaction. In search for the origins of the gradients, teeth were visualized using confocal laser scanning microscopy, to determine the degree of tanning, and analyzed with energy-dispersive X-ray spectroscopy, to test the elemental composition. We found that the mechanical gradients probably have their origin in the degree of tanning, as the teeth did not contain high proportions of metals or other minerals. However, in the tooth surfaces, which interact with the ingesta, high Si and Ca content was determined, which is likely an adaptation to reduce wear.

YbeX of Escherichia coli, a member of the CorC protein family, is a putative Co 2+/ Mg 2+ efflux factor. Here, we describe several ΔybeX phenotypes and report an involvement of YbeX in ribosomal metabolism. E. coli lacking ybeX has a longer lag phase on outgrowth from the stationary phase. This phenotype is heterogeneous at the individual cell level and can be rescued by supplementing the growth media with magnesium. ∆ybeX strain is sensitive to elevated growth temperatures and to several ribosome-targeting antibiotics, which have a common ability to induce the cold shock response in E. coli. ∆ybeX cells accumulate distinct 16S rRNA degradation intermediates present in both 30S particles and 70S ribosomes. We propose that a function of YbeX is maintaining the magnesium homeostasis in the cell, which is needed for proper ribosomal assembly.

This editorial reviews the data to guide the discussion on whether or not to replace implantable cardioverter-defibrillator generator when the left ventricular ejection fraction has improved.

Atrial fibrillation (AF) provides extremel rapid excitation frequency in both atria, and induces several pathophysiological mechanisms by influencing each other to promote AF. This auto-enhancing feature is often described by the well-known concept “AF begets AF”. The cure of AF by creating pulmonary vein (PV) isolation may be able to reverse the spiral and be able to achieve reverse remodeling. Because of the initial focus on PV in the pathogenesis of AF, the effects of reverse remodeling after catheter ablation (CA) have been investigated on improvement of the left-sided cardiac system. On the other hand, tricuspid regurgitation (TR), the most neglected of all valvular diseases, is increasingly recognized as an important prognostic condition in heart failure patients. Previous reports, which tested the role of CA for AF patients with TR, have demonstrated that maintenance of SR provides reverse remodeling of the right-sided cardiac system, but have yet to prove whether this leads to improvement in patient prognosis. What is new and noteworthy about the report by Ukita et al. in this issue is that they found that TR improvement itself improves major event-free survival rate (incidence of heart failure hospitalization and all-cause mortality). However, several issues remain unresolved in their report. They observed a low AF recurrence rate in the TR-improved group, but did not address the possibility that AF suppression itself contributed to improve event-free survival rate. Further investigation is required to clarify whether TR improvement or maintenance of SR is the greater contributor to improved prognosis in AF.

Introduction: Treating patients with CIED infections is often challenging. In general, the infected device, including all leads, needs to be completely removed before a new CIED can be implanted. Especially in pacemaker-dependent patients, it is often impossible to have a device-free interval to treat the infection. In those cases, the question remains when to implant a new CIED and which bridging strategy to use. Methods: In this single-center retrospective analysis, we included 190 patients who received a complete CIED system extraction between 2013 and 2019 due to device-related infection. We compared three different treatment algorithms. Group 1 (SR) included 89 patients who received system removal only (and delayed re-implantation). Group 2 (EL) consisted of 28 patients who were treated with lead extraction and simultaneous epicardial lead implantation, while the 78 patients in Group 3 (SI) received lead removal with simultaneous contralateral implantation of a new device. We retrospectively analyzed the peri- and postoperative course and one-year follow-up. Results: Patients in the SR and EL groups were significantly older, had more comorbidities and a higher percentage of systemic infection compared to the SI group. We found a comparable high number of successful infection treatments in all groups, with complete lead removal in 95.5%, 96.4%, and 93.2% for the SR, EL, and SI groups, respectively. Lead vegetations were removed in 97.7%, 94.1%, and 100%. Device re-implantation was 100% in the EL and SI groups, whereas in the SR group, only 49.4% of patients received a device re-implantation. At one-year follow-up, the percentage of freedom from infection and pocket irritation was comparable between groups (94.7% SR and EL, 100% SI). We observed no procedure-related mortality, while one-year mortality was 3.4% in the SR, 21.4% in the EL and 4.1% in the SI group. Conclusion: We found comparable success rates regarding device removal, successful infection treatment and perioperative course between groups. However, most likely due to the sicker patient collective with a high number of systemic infections, the one-year mortality was significantly higher in the EL group. Treatment algorithm should be selected due to type, severity, location of infection and comorbidities of the patients.

A unique case of hybrid SEF-LGFMS with a EWSR1-CREB3L1 Fusion and robotic-assisted bronchoscopy in an 11-year-old Authors: Leore Lavin, MS1*, Nithya Krishnamurthy, BA1*, Chantal Spencer Grant, MD2, Kayleen Bailey, MD3Affiliations : 1Icahn School of Medicine at Mount Sinai, 2Mount Sinai Hospital Department of Pediatric Pulmonology, 3Mount Sinai Hospital Department of Pediatric Hematology-Oncology* Both authors contributed equally to this workCorresponding author: Leore Lavin,leore.lavin@icahn.mssm.edu.50 East 98th St. New York, NY 10029. 646-709-8909.Running title: Rare pediatric SEF-LGFMS with EWSR1-CREB3L1 FusionKeywords: Robotic Bronchoscopy, Pediatric Oncology, SEF, LGFMS, EWSR1, CREB3L1Abbreviations:

Intracellular bacteria have evolved different strategies to invade, replicate and persist in, and eventually exit from their hosts. The life cycle of the mite-borne, obligate intracellular pathogen Orientia tsutsugamushi (Ot), the causative agent of human scrub typhus, differs in many aspects from that of other members of the Rickettsiales order. Particularly, the non-lytic cellular exit of individual Ot bacteria at the plasma membrane closely resembles the budding of enveloped viruses, but has only been rudimentarily studied at the molecular level. This brief review is focused on the current state of knowledge of escape events in the life cycle of Ot. Also, open research questions and novel experimental approaches are proposed.

Fouling in heat exchangers leads to increased pressure drop, associated with higher energy consumption, utility costs, and CO$_2$ emissions. However, other effects can also take place, threatening process operations and safety. This is the case of ethylene oxide operations, where unplanned outages and decomposition events pose significant safety risks. Therefore, the development of a framework for advanced monitoring and forecasting of heat exchanger fouling is both important and opportune to improve the reliability and safety of the operation. We propose a hybrid approach, where knowledge-based feature generation is integrated with data-driven methods, to forecast a key performance indicator (KPI) that acts as a fouling surrogate. The forecasting model can predict one-month ahead with an accuracy of R$^2$ = 0.7. We also show that long-term forecasting is possible with this model, which can be applied to optimize maintenance scheduling. The solution can be extended to other situations, where fouling takes place.

Background: Atopic dermatitis (AD) is characterised by epidermal barrier impairment, associated with food allergen (FA) sensitisation and AD severity. However, no clinical guidance has been established for evaluations of food sensitisation (FS) in AD patients. This study investigated how AD severity and epidermal barrier impairment are associated with FS, and factors that can predict FS in children with AD. Methods: This cross-sectional study included 100 children (12–60 months) diagnosed with AD. AD severity was determined using the Scoring Atopic Dermatitis (SCORAD) index. FS was evaluated by measuring serum specific IgE antibodies against 31 FAs using an immunoblotting method. Epidermal barrier impairment was assessed by measuring transepidermal water loss (TEWL) and stratum corneum hydration (SCH) levels. Results: 90% of participants were sensitised to at least one tested FA, with cow’s milk, egg white, beef, almond, egg yolk, and peanut being the most common. Children with moderate-severe AD had lower SCH levels than those with mild AD. Children with AD who were sensitised to > 10 FAs had significantly higher TEWL and lower SCH levels, compared with those sensitised to 1–4 FAs and 5–10 FAs. The SCORAD score and SCH level in lesional skin provided moderately predictive value for sensitisation to FAs in children with AD. Conclusion: FS is common in children with AD and closely associate with AD severity as well as epidermal barrier impairment. Evaluations of FS should be considered for children with moderate to severe AD and/or low SCH levels.

Clinical Letter to the EditorConflict of interests’ statement: No potential conflict of interest is declared for any of the authorsTitle: Hemophagocytic lymphohistiocytosis in an adolescent withNLRP12 -related autoinflammatory disorder, a case report

Purpose To compare and evaluate the usefulness of MRI with CT as radiation free alternative To compare the reproducibility of CT and MRI scores To compare MRI and CT scores with pulmonary function tests (PFT) To evaluate the role of DWI in bronchiectasis. Methods In this prospective study, 25 patients between 7-21 years of age with a clinical/radiological diagnosis of bronchiectasis underwent MDCT (with HRCT reconstruction) and MRI chest. MRI and CT scoring was performed using modified Bhalla score -Helbich’s score by two independent radiologists for all parameters. A final consensus score was recorded. both in CT and MRI. The overall image quality of different MRI sequences to identify the pathologies was also assessed. Appropriate statistical tests were used for inter-observer agreements, and correlation amongst CT and MRI; as well as CT, MRI and PFT. Results Strong agreement (ICC 0.80-0.95) between CT and MRI was seen for extent and severity of bronchiectasis, number of bullae, sacculation/abscess, emphysema, collapse/ consolidation, mucus plugging, and mosaic perfusion. Overall CT and MRI scores had perfect concordance (ICC 0.978). Statistically significant (p-value <0.01) intraobserver and interobserver agreement for all CT and MRI score parameters was seen. A strong negative correlation was seen between total CT and MRI severity scores and FEV1, FVC, FEF 25-75%. DWI MR, with an ADC cut-off of 1.62 x 10 -3 mm 3/sec had a sensitivity of 70% and specificity of 75% in detecting true mucus plugs. Conclusion MRI with DWI can be considered in the diagnostic algorithm for assessment of lung changes in bronchiectasis as a radiation-free non-invasive method of imaging in children, especially in follow-up.