Background: This study aimed to explore the clinical characteristics and management of mycoplasma pneumoniae pneumonia (MPP) combined with pulmonary embolism (PE) in children and gain a better understanding of the diagnosis treatment and prognosis of the disease. Methods: We retrospectively reviewed the medical records of 16 children who were diag-nosed with MPP associated with PE and NP between Janunary 2016 and Janunary 2023 at Children’s Hospital, Zhejiang University School of Medicine. Results: All of the cases were diagnosed with refractory mycoplasma pneumoniae pneum-onia (RMPP) and complicated with necrotizing pneumonia(NP). The ages of the patients ranged from 5.3 to 11.5 years old. The main manifestations were cough and fever（n=16, 100%）,chest pain (n=8, 50%) , shortness of breath(n=8,50%), hemoptysis (n=4, 25%). Among them, the pulmonary artery was involved in 12 patients, including 6 cases on the right, 4 cases on the left, and 2 cases on both sides. Besides, the pulmonary vein was suffered in 3 patients. Furthermore, Pulmonary artery and pulmonary vein were involved in 1 patient. The mean D-dimer level was 8.50±4.76mg/L. All patients underwent anticoagulant therapy. After treatment, all patients ’s symptoms were improved, and the lung lesions were significantly improved. Conclusion: For children with RMPP, PE and NP should be considered when chest pain, hemoptysis or high level of d-dimer are present. Chest enhanced CT scan should be perf-ormed as soon as possible, and anticoagulation should be treated once the diagnosis of PEis confirmed. The long-term prognosis of PE was favorable after the timely administrationof anticoagulant therapy.

The purpose of inter-animal communication is to allow signals released by the animal to be perceived by others. Scent marking, with its characteristics of specificity and delay, is thought to be the primary mode of communication in giant pandas (Ailuropoda melanoleuca). The “signal detection theory” predicts that animals choose the substrate and location of their scent marks so that the signals released are transmitted more widely and remain longer. As an energetically marginal species, the cost of generating and marking chemical signals is costly for pandas, so they are predicted to make trade-offs in scent marking. However, existing studies do not account for the selective preferences of pandas for marking, as they are only explained by the density of marks at a certain location. Our study wanted to investigate whether the marking behavior of pandas is indeed consistent with signal detection theory. For the first time, we propose to use fecal counts to reflect the intensity of habitat use by pandas, combined with mark counts to determine the selective preference for marking. Our findings show that the scent marking behavior of pandas is consistent with signal detection theory, and that they go out of their way to ensure that their marks are detected. The results of the study will help us to further develop the conservation of pandas and their habitats.

This review presents a comprehensive examination of fully conjugated covalent organic frameworks (COFs), which constitute an emerging class of porous materials with immense potential for diverse applications. This article focuses on diversified fully conju-gated COFs, including sp2 carbon-carbon linkages, pyrazine linkages, benzobisoxazole linkages, dioxin linkages, β-aminoalkenone linkages, etc. The synthesis techniques and structural attributes of these COFs are expounded upon in great detail, along with their potential applications in various fields. The review thus provides a valuable resource for researchers keen on delving into the synthe-sis and applications of fully conjugated COFs, thereby highlighting their potential for developing novel functional materials with dis-tinctive properties.

Increasing studies have shown the importance of intraspecific trait variation (ITV) on the ecological process. However, the patterns and sources of ITV are still unclear, especially in the propagule of coastal vegetation. Here, we measured fresh weight (FW), fresh length (FL), maximum transverse diameter (TDmax), minimum transverse diameter (TDmin) and the ratio of TDmax to TDmin (RTD) of the hypocotyl (propagule) of Kandelia obovata for 66 genealogies across 26 sites. By combining multiple factors of climate, ocean and maternal tree to analyze their effects on the intraspecific trait variation of mangrove hypocotyl. The results showed that value of establishment traits (FW, FL, TDmax and TDmin which are related to mass) decreased along increasing latitudinal gradients and they were directly positively regulated by temperature. ITV of dispersal trait (RTD) was unstructured along latitudinal gradients, which was constrained by fitness tradeoff. Our findings indicate that establishment traits mainly varied between populations, whereas dispersal traits mainly varied between individuals. This study provides insights into the ITV of propagule in different functional dimensions on a broad scale and that may help integrate ITV into future analyses of mangrove protection.

The Whooping Crane (Grus americana; WHCR) is a large, long-lived bird endemic to North America. The remnant population migrates between Aransas National Wildlife Refuge, USA, and Wood Buffalo National Park, Canada (AWBP), and has recovered from a nadir of 15-16 birds in 1941 to ~540 birds in 2022. Two ongoing reintroduction efforts in Louisiana and the Eastern Flyway together total ~150 birds. Evidence indicates the U.S. Fish and Wildlife Service (USFWS) is strongly considering downlisting the species from an endangered to a threatened status under the Endangered Species Act (ESA). We examined the current status of the WHCR through the lens of ESA threat factors, the USFWS’s Species Status Assessment (SSA) framework, and other avian downlisting actions to determine if the action is biologically warranted. Our research indicates that WHCRs are facing an intensification of most threat drivers across populations and important ranges. The AWBP is still relatively small compared to other crane species and most birds of conservation concern. To date, only one avian species has been downlisted from an endangered status with an estimated population of <3,000 individuals. Representation in terms of WHCRs historic genetic, geographic, and life history variation remains limited. Also, the lack of spatial connectivity among populations, reliance of the reintroduced populations on supplementation, and continued habitat loss suggest that WHCR populations may not be resilient to large stochastic disturbances. Given that reintroduced populations are not self-sustaining, neither supplies true redundancy for the AWBP. Proposed downlisting before recovery plan population criteria have been met is objectively unwarranted and reflects USFWS inconsistency across ESA actions. Only by incorporating basic quantitative criteria and added oversight into ESA listing decisions can we avoid an action as misguided as downlisting the Whooping Crane without consideration of its recovery plan criteria or ostensibly its population ecology.

Breast cancer (BC) is one of the most common malignancies in women and the leading cause of cancer-related death in women. The newly emerged non-coding RNAs tsRNAs (tRNA-derived small RNAs) play an important role in the occurrence and development of BC. The purpose of this study was to comprehensively evaluate the prognostic, diagnostic and clinicopathological roles of tsRNAs in BC. Through literature screening, a total of 13 BC-related tsRNA studies were included in this meta-analysis, all of which passed quality assessment. Prognostic studies showed upregulated tsRNAs to be associated with poor survival outcomes (HR=1.64, 95%CI: 1.51-1.77) and downregulated tsRNAs to be associated with better outcomes (HR=0.58, 95%CI: 0.50-0.68). Results of diagnostic studies showed a combined sensitivity of 72% (95%CI: 68%-76%) and combined specificity of 64% (95%CI: 61-67%); the AUC was 0.72 (95%CI: 0.68-0.75) and the DOR 4.62 (95%CI: 3.76-5.68). Finally, correlation analysis of clinicopathological features showed that downregulation of tsRNAs correlated significantly with age, TNM stage and lymphatic metastasis. Sensitivity analysis and publication bias showed no significant difference. In conclusion, BC-associated tsRNAs are closely related to the prognosis and clinicopathological features of patients with this disease and can be used to assist in early diagnosis of BC. Therefore, tsRNAs are potential targets for the diagnosis and treatment of BC.

Hydrological models require a complete and accurate time series of weather inputs to adequately represent watershed-scale responses. The Global Historical Climatology Network (GHCN) is the most comprehensive ground-based global weather database and is often used in hydrological modeling studies. Since higher density, lower reliability precipitation measurements from private citizens collected by the Community Collaborative Rain, Hail, and Snow (CoCoRaHS) network data were integrated into the GHCN, hydrological modelers in the U.S. have access to a much greater amount of weather data. However, the benefit of using CoCoRaHS data has not been assessed. The objectives of this work were to develop a method for generating a complete weather data time series based on the combination of data from multiple GHCN monitors and to assess several methods for estimation of missing weather data. Weather data from GHCN monitors located within a specific radius of a watershed were obtained and interpolated using three estimation methods (Inverse Distance Weighting (IDW), Inverse Distance and Elevation Weighting (IDEW), and Closest Station), creating a seamless time-series of weather observations. To evaluate the performance of the methodologies, weather data obtained from each estimation method was used to force the Soil and Water Assessment Tool (SWAT) models of 21 U.S. Department of Agriculture-Conservation Effects Assessment Project watersheds in different climate regions to simulate daily streamflow for 2010-2021. Except for three watersheds, all SWAT models had Nash-Sutcliffe Efficiency above 0.5, the ratio of the root mean square error to the standard deviation of observations below 0.7, and percent bias from -25% to 25% with a satisfactory performance rating. Overall, IDEW and IDW performed similarly, and the Closest Station method resulted in the poorest streamflow simulation. A comparison with published SWAT model results further corroborated improved model performance using newly combined GHCN data with all Closest Station, IDW, and IDEW methods.

The urbanization under contemporary capitalism is planetary and it has extended to geographies far beyond the edge of mega-cities and regions. Meanwhile, inherited conceptions of the urban as a bounded, universal settlement type and inherited urban forms are continually transforming and restructuring. This study explores and analyses the pattern and dynamics of extended urbanization in Türkiye. Marmara Region that is one of the most populated and industrialized regions of Türkiye is selected as a case area. Today, the region is extendedly urbanised, and the urbanisation has taken various material forms in space and mining takes the lead spreading throughout the area. As it is illustrated, extended urbanization formations are degrading the Marmara Region’s erstwhile wilderness and rural areas that extends far beyond the concentrated urban areas and megacity İstanbul.

Background: Pemphigus vulgaris (PV) is characterized by pathogenic auto-antibodies targeting interkeratinocytes desmoglein (Dsg) 1 and 3, and by the HLA-DRB1-0402 predisposition allele. Treatment using rituximab (RTX) combined with short-term corticosteroids (CS) allows disease control and long-lasting remission. The aim of this study is to evaluate the impact of RTX on the circulating subpopulations of Dsg-3-specific T lymphocytes that specifically regulate B cell responses: follicular helper (Tfh) and follicular regulatory T (Tfr) lymphocytes. Methods: Using the HLA-DRB1-0402 tetramer loaded with the Dsg-3 immunodominant peptide, we analysed by flow cytometry the frequency, the polarisation and the activation status of blood Dsg-3-specific follicular T cell populations at baseline, Month 6 and long-term follow-up (Month 60-90) from PV patients. Results: At baseline, we observed a predominance of Tfh1* and Tfh17 subsets and an underrepresentation of the Tfh2 subset among autoreactive Dsg-3-specific Tfh cells as compared with non-autoreactive Tfh cells. RTX treatment induced a decrease of autoreactive Tfh cells with no effect on their polarisation during patients’ follow-up. In parallel, we observed the emergence of a Dsg-3-specific Tfr subpopulation with a significant overexpression of the surface activation markers PD1, ICOS, and CD25 that was not observed at the surface of autoreactive Tfh and non-autoreactive Tfr cells of the same PV patients. In contrast, a very few Dsg-3 specific Tfr cells were observed in PV patients treated with CS alone. Conclusion: Here we show that the emergence of activated autoreactive Dsg-3-specific Tfr cells is associated with the long-term efficacy of RTX in PV patients.

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In this paper, an automated high-accuracy acoustic-based drone detection and classification system using a frequency feature extraction method based on the Prony algorithm is proposed. To show the efficiency of the proposed method, the accuracy of detection and classification of the suggested method is evaluated by an experimental dataset composed of recorded drone audio in a natural environment and under different conditions. Results show more than 97.7% and 93.6% accuracy for detection and classification, respectively, while using typical audio features like MFCCs, GTCCs, and FFT provide less than 78.6% accuracy for classification.

This brief presents an energy-efficient Computing-in-Memory (CIM) circuit based on novel Multiplexing-Computing-Cell. The proposed circuit is capable of XNOR-and-accumulation (XAC) operations for binary neural network (BNN). To reduce the delay and power consumption of the result readout circuit, this circuit uses an all-digital adder tree circuit based on an alternating structure of 11T full adder and 28T full adder. This letter builds a 32Kb (512x64) size CIM circuit and achieves 98.3% accuracy in MNIST dataset, with a latency of 3.5ns and an energy efficiency of 56.4TOPS/W.

Cyclophosphamide induced pneumonitis is a rare adverse event in patients receiving adjuvant chemotherapy for breast cancer. It has been infrequently reported in the literature and based on the described cases it appears to be associated with dose dense regimens. We report three cases of cyclophosphamide induced pneumonitis who were treated at our centre. Our cases illustrate that careful attention must be paid to timing of symptoms to ensure the correct causative chemotherapy agent is identified so that potentially curative agents in the chemotherapy regime are not omitted.

Background: Patient satisfaction is the individual’s positive evaluation of distinct dimensions of health care. The rate of cesarean sections is on the rise and being performed more frequently in recent times. Assessment of maternal satisfaction with postoperative pain management is a vital tool for measuring the quality of care in the health center. There is a paucity of data regarding this topic, as it does not previously been studied yet in the study area. Objective: The aim of this study was to assess the level of maternal satisfaction with post-operative pain management after c/s among mothers who deliver at Debre Markos Comprehensive Specialized Hospital, Northwest, Debre Markos Ethiopia, 2022

Early expansion of allergen-responsive LAP+ B regulatory cells in allergic rhinitis but not in allergic asthma subjects during allergen immunotherapyAstrid L. Voskamp1, Nicolette W. de Jong2, Simon P. Jochems1, Arifa Ozir-Fazalalikhan1, Luciën E.P.M. van der Vlugt1, Koen A. Stam1, Gert-Jan Braunstahl3,4, Gertrude M. Möller5, Roy Gerth van Wijk2, Hermelijn H. Smits11Department of Parasitology, Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Center; Leiden, The Netherlands.2Dept of Internal Medicine, Section Allergology and Clinical Immunology, Erasmus University Medical Center; Rotterdam, The Netherlands.3Department of Pulmonology, Franciscus Gasthuis and Vlietland, Rotterdam, 3045 PM, the Netherlands.4Department of Pulmonology, Erasmus Medical Center, Rotterdam, 3015 GD, the Netherlands.5Netherlands Center of Clinical Occupational Medicine, The Netherlands.

Background: Small air filled peripheral subpleural cysts are a well described feature of pulmonary anatomy at computerised tomographic (CAT) scan in children with Trisomy 21, yet only anecdotally described in association with other pathologies. The significance of these cysts is unknown. Objective: To investigate and explore the pathogenesis of these subpleural cysts in children. Materials and Methods: A retrospective review of 16 cases with subpleural cysts diagnosed on CT chest was performed. The distribution, location and ancillary CT findings were recorded. Hospital charts were reviewed for clinical details, especially cardiac abnormalities, pulmonary artery hypertension (PAH) and genetic associations. Histopathological and clinical correlative data were recorded. Results: 11/16 children (69%) were found to have an underlying chromosomal or genetic abnormality, six of whom had Trisomy 21. The remaining 5/16 cases (21%) had miscellaneous disorders without an identifiable genetic basis. The most common co-morbidities were cardiac abnormalities (81%) and PAH (62.5%). Regardless of their underlying etiologies, the cysts were present bilaterally in most cases (14/16, 88%). We observed both the postnatal development and the progression of cysts in our cohort . On long term follow-up, there were five deaths (31%) and six cases (38%) requiring maintenance oxygen therapy due to chronic hypoxia. Two cases (12.5%) became completely asymptomatic after correction of their underlying abnormalities. Conclusion: Subpleural cysts are not exclusive to Trisomy 21 and may be seen in other inherited or acquired causes, likely due to altered alveolar growth. We suspect these cysts are a sign of an underlying developmental disorder with variable clinical effect, especially in children with congenital cardiac disease.

A photo-triggered cascade cyclization of silyl enolate to prepare angularly fused tricyclic scaffold is developed. The reaction demonstrates good substrate scope and stereo-selectivity. The excellent stereo- and regio-selectivity for this cascade reaction is elucidated via conformational analysis and DFT calculation, respectively.

Water supply is one of the largest and most valued ecosystem services from forests. This paper presents a systematization of scientific studies about the effects generated by exotic fast-growing forest plantations of Pinus radiata and of Eucalyptus spp. on water yield in south-central Chilean watersheds (33 - 41º S), at different spatial and temporal scales. We compiled scientific studies that have at least one year of observations on large catchments, small catchments and experimental plots. Studies in experimental plots of Pinus radiata plantations showed that annual evapotranspiration increased from south (41° S) to north (33° S), while in this northernmost site almost the entire incoming precipitation was evapotranspired, and the percolated water was negligible. Studies of water balance in small catchments documented a negative linear relationship between total streamflow and forest plantations coverage. Catchments with forest coverage of Pinus or Eucalyptus spp. stored less water than catchments with mixed species, mainly due to high interception loss, more net evapotranspiration and reduced percolation. Forest plantation management can alter the accumulation of water in the catchment (soil and groundwater) and forest cover is the fundamental factor in the dynamics water accumulation. Long-term studies focused on changes in forest coverage from native to plantation forests in large catchments located in the Mediterranean area (33 - 38º S) of Chile showed a sustained reduction in water yield, especially during summertime.

Background: There is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk factor for disease recurrence after cervical treatment. Objectives: To provide a systematic review and meta-analysis on whether endocervical crypt involvement by high-grade CIN on the excised cervical specimen is associated with high-grade histopathological recurrence during the follow-up of women after cervical excisional treatment. Search Strategy: We searched the Medline, Scopus, Central and Clinical Trials.gov databases from inception till June 2021. Selection Criteria: Studies that reported on women with a single cervical treatment with any method of excision for CIN2 or CIN3 lesion, negative excision margins and whose recurrence was defined histopathologically were included. Data Collection and Analysis: Two reviewers independently evaluated study eligibility. We used the fixed effects model for meta-analysis. Main Results: There were 4 eligible studies included in the present systematic review that evaluated 1088 women treated with either large loop excision of the transformation zone (LLETZ) or with cold knife conization (CKC). The between study heterogeneity was not significant. We found no significant association of endocervical crypt involvement by CIN2-3 with high-grade histopathological recurrence at follow-up after cervical excision (OR:1.93; 95%CI:0.51-3.35). The subgroup analysis of women with LLETZ cervical excision showed again no significant association with high-grade histopathological recurrence at follow-up (OR:2.00; 95%CI:0.26-3.74). Conclusions: Endocervical crypt involvement by high-grade CIN does not seem to be a risk factor for high-grade histopathological recurrence after cervical excision with negative excision margins.

Background: Probiotics may enhance the effects of exogenous oestrogens such as hormone replacement therapy and isoflavones, and may lead to improvements in menopausal symptoms, and cardiovascular, bone and vaginal health. Objectives: To examine the effects of probiotics on oestrogen-related pathologies and explore whether probiotics influence the effects of exogenous oestrogenic substances. Search strategy: Searches of EMBASE, MEDLINE, Cochrane Library, Scopus, and Web of Science were performed. Selection criteria: Studies reported on the effects of probiotics, or probiotics plus oestrogenic substances such as estriol or isoflavones, among perimenopausal or recently postmenopausal women. Data collection & analysis: All findings were narratively synthesised; 7 studies were examined via meta-analysis which examined the effects of probiotics versus placebo. Main results: Thirty-nine studies contributed data from 3,187 women. Probiotics were associated with improvements in menopausal symptoms, urogenital conditions, bone health, and enhancements in the efficacy and safety of estriol and isoflavones. Meta analysis demonstrated large effects of probiotics on menopausal symptoms (total score): [standardised mean difference (SMD)= -0.82, (95% CI -0.52 to -1.09)], vasomotor symptoms: [SMD= -0.96, (95% CI -1.25 to -0.68)], psychological symptoms: [SMD=-0.51, (95% CI -0.95 to -0.08)], vaginal dryness: [SMD=-0.95 (95% CI -1.40 to -0.49)], and vaginal microbiome health (Nugent score): [SMD=-0.91 (95% CI -1.32 to -0.49)]. Meta analysis results were nonsignificant in relation to somatic and sexual symptoms. Conclusions: Findings suggest that probiotics may improve conditions related to low oestrogen levels. Moreover, probiotics may enhance the effects of estriol and isoflavones. While findings are limited by the high risks of bias in the included studies, these results are promising and require further investigation.

Cell localization is still facing two unresolved challenges: 1) the large variability in cell size and shape, coupled with the heterogeneous intensity distribution of lightly stained cells, presents the bottleneck limiting accurate cell localization; 2) existing cell location map is unreasonable, which loses cell scale information and significantly affects the accuracy of cell counting. To address the challenges from the cell shape and heterogeneous intensity distribution, we propose a novel gradient-aware and shape-adaptive Difference-Deformable Convolution (DDConv), which can focus on the gradient information of lightly stained cells for overcoming the challenge of heterogeneous intensity distribution and meanwhile adaptively adjust the shape of the convolutional kernel for overcoming the challenge of the large variability in cell shape. Moreover, to solve the challenge of unreasonable location map, we propose a new cell location map, called Pseudo-Scale Instance (PSI) map. Our PSI map enables adaptively computing the scale information and associating it with each cell’s annotation, which addresses the unreasonable challenges in existing cell location map and advanced makes the model sensitive to the size of cells. We analyze and evaluate DDConv and PSI on two challenging cell localization tasks. Compared with existing methods, our proposed method has significantly improved the localization performance, setting a new benchmark for cell localization tasks.

The commutation failure is the most prevalent fault in line-commutated converter based HVDC systems, which may result in transient overvoltage on the sending-side system. Overvoltage level evaluation has become a crucial task for power industries to assess the tripping risk of large-scale wind turbines and implement effective stability control measures. In this paper, decision tree (DT) model is adopted to extract the mapping relationship between transient overvoltage and massive electrical quantities of power grids. The common DT algorithm is transformed by modifying the error weight assignment, which reflects the error tolerances for different actual overvoltage regions. To compensate for potential inaccuracies in the data-driven method, a derivation of the mathematical relationship between the reactive power consumed by the rectifier and AC voltage is presented, along with an analytical expression for the peak value of transient overvoltage. On this basis, an overvoltage analysis method integrating the model-driven and data-driven techniques is proposed, and the improved DT algorithm is ap-plied to fast error correction, enhancing the interpretability of regression prediction results. Case studies were performed in the actual Northwest China local region hybrid AC/DC power grid with transient overvoltage problems, and the simulation results verified the effectiveness of the proposed method.

The fluctuation and intermittency of the wind and solar power outputs results in the regulation pressure of thermal units in power systems. The adjustable energy-intensive loads (such as the Electrolytic aluminium and Steel plants) have great potentialities to participate in demand response (DR) programs. This paper proposes an optimal scheduling method of the unit commitment (UC) with the consideration of the energy-intensive loads participating in wind and solar power consumption. It adopts the nonparametric kernel density estimation method to model the wind and solar power outputs. And then it uses Frank-Copula function to describe the correlation between the scenarios of wind and solar power outputs. A stochastic unit commitment (SUC) model introduces chance constrained theory of the reserve coefficient to describe time-variant scenarios, on the basis of the deviation between the typical and simulative scenarios. The simulation results based on IEEE 118-bus system shows that the energy-intensive load in the SUC model can flexibly adjust and respond to the change of wind and solar power output, reduce the impact of wind and solar power output’s uncertainty and promote the consumption of wind and solar power.

Phase change materials (PCMs) have gained significant attention as thermal energy storage materials for reducing dependence on fossil fuels. However, the leakage caused by long-term molecular motion has become a bottleneck for the further advances of energy storage density and application value. Herein, a novel PCM composite with good shape stability, thermal conductivity and photothermal conversion capability was designed. Given the synergistic or hybridization effect between metal-organic frameworks (MOFs) and expanded graphite (EG) components offered the composite unique capabilities, even with the merits of both. The combination of ZIF-67 and EG in a hybrid structure can effectively prevent particle agglomeration, while simultaneously providing a high specific surface area and pore volume for the adsorption of paraffin wax. Compared to pristine unsupported PCMs, the as-obtained PCM composite possesses a 3-fold enhancement in thermal conductivity, 95.56% photothermal conversion efficiency and excellent shape stability. It demonstrates the potential of MOFs-enhanced PCM composites for thermal energy storage and highlight the importance of synergistic or hybridization strategies in the development of advanced materials for sustainable energy applications.