The aim of this paper was to investigate effects of inulin and ultrasonic homogenization on particle size distribution and microstructure of oil-in-water emulsion gels stabilized by psyllium husk were investigated. The emulsion gel was assessed their utility in meat puree prepared for people with dysphagia. The results showed that increasing inulin percentage resulted in reduced particle size and improved emulsion stability with the optimum at 20% w/w inclusion. Ultrasonic homogenization further enhanced the emulsion stability by reducing the size of emulsion droplet and improving encapsulation of emulsion droplet. Increasing inulin concentrations in the emulsion gels added into purees also corresponded with decreasing total expressible fluid (TEF). The stability of puree against the action of carbohydrate-hydrolyzing enzymes (α-amylase and α-glucosidase) was improved with the addition of emulsion gels. Therefore, these developed emulsion gels could be beneficial in formulating modified-texture food prepare for people with dysphagia.

Background: Ototoxicity is a common disabling side effect of platinum-based chemotherapy. This study aimed to systematically assess the evidence on the management of platinum-induced ototoxicity in adult cancer patients. Methods: Three databases were searched up to November 1, 2022. Original studies were included if they reported on a pharmacologic or non-pharmacologic intervention to prevent or treat platinum ototoxicity in adults. The articles’ quality was assessed with two grading scales. Results: Eighteen randomized controlled trials and five quasi-experimental studies with 1673 patients were analyzed. Eleven interventions were identified, nine pharmacological and two non-pharmacological. Six of the interventions (sodium thiosulfate, corticoids, sertraline, statins, multivitamins, and D-methionine) showed mild benefit preventing cisplatin-induced ototoxicity. The data must be carefully analyzed due to the low quality and underreporting of side effects. Conclusions: Current interventions have mild benefits preventing cisplatin-induced ototoxicity in adult cancer patients. High-quality research is required to clarify the significance of these findings.

Background: Persistent left superior vena cava is the most common thoracic venous anomaly. It is usually asymptomatic, but it can make it difficult to implant intracardiac devices . Case presentation: We present a novel technique to facilitate right ventricular lead implantation in two patients with persistent left superior vena cava and the absence of the right superior vena cava. We used a fixed-curve Selectra 3D sheath (Biotronik), orienting the sheath towards the tricuspid valve by rotating it in a counter-clockwise direction. During follow-up, the electrodes remained stable. Discussion: Our technique was safe, simple and feasible for patients with this complex venous anatomy.

The limited land is under unprecedented pressure from production, living and ecology. In order to evaluate the land pressure in the Yangtze River Delta region in 1995, 2000, 2005, 2010, 2015, and 2020 from the perspective of production, living, and ecology. This study builds a land pressure evaluation index system based on a fuzzy comprehensive evaluation model using multi-source and multi-scale data. In order to investigate trade-offs and synergies among production, living, and ecology pressures, we use the mechanical equilibrium model in physics. We then analyze land pressure model reliability and uncertainty using Monte Carlo simulations. The results show that (1) Our model can effectively reveal the level of land pressure and reflect the land pressure geographical pattern of “high in the east and low in the west, high in the south and low in the north” that characterizes the Yangtze River Delta region. (2) While living and ecology pressures are tending to rise, production pressures are tending to decrease. (3) Except for Shanghai, the trade-off areas are primarily concentrated in economically successful regions with high production and living pressure and low ecology pressure. The coordinated areas are primarily found in northern Jiangsu Province and northern Anhui Province.

Spectrum sensing based on the covariance matrix algorithm does not need the prior information of the authorized user and is easy to implement. However, at low SNR, the difference between the covariance matrix elements becomes smaller, and the detection performance needs to be improved. To this end, using the similar median value to describe the accuracy of a group of data, an improved spectrum sensing algorithm based on the ratio of the maximum of the covariance matrix to the average of the similar median value is proposed. The proposed algorithm does not need the prior information and noise power of the authorized user signal, and the analytical representation of the decision threshold is derived. The simulation results under Gaussian channel shows that When SNR=-8dB, the detection probability is about 20% higher than MEAM algorithm.

Introduction: Severe Acute Respiratory Syndrome SARS-Cov-2 coronavirus is a member of the coronavirus family. Fever, shortness of breath, and pneumonic infiltrates in both lungs were among the disease’s clinical signs. Along with severe respiratory infections, Covid-19 may also encounter thrombosis complications, and other complications like coronary syndrome, myocardial dysfunction and arrhythmia, acute kidney injury, coronary syndrome, liver cell injury, gastrointestinal symptoms, hyperglycaemia, ocular symptoms, neurological diseases, and dermatological problems. The way in which ophthalmic services were provided changed significantly during this time. Many people, particularly those who suffer from dry eye, are spending a lot of time at home due to continuous spread of coronavirus disease (COVID-19) pandemic. The difficulty for regular follow-up meetings impacting the continuance of glaucoma therapy, cataract surgery, and other eye diseases had been considerably much worse by establishment of strict social distancing and restrictions in travelling during COVID 19 pandemic. Methods: The PubMed, Google Scholar, ResearchGate and healthcare system evidences were searched from 2019 to 2022 for systemic review that were published in English language. Results: Both ocular disease and the overall health care system have been impacted by the result of Covid 19 pandemic. Like other professions, ophthalmology profession has experienced varied degrees of pandemic impact. Ocular problems could develop as a direct result of the SARS infection. The most frequent ocular symptom is viral conjunctivitis, dry-eye problems. During lockdown, the overall symptoms of dry eyes were worse than those who were under normal circumstances. Keywords: COVID-19, Dry-Eye Disease , Eye Diseases, SARS-CoV-2

This article aims to analyze the influence of high cycle fatigue damage on the mechanical properties and low cycle fatigue performance of Q690D. Monotonic tensile and cyclic loading tests were performed on Q690D specimens with different degrees of high cycle fatigue damage. Degradation models were established to describe the declining trending of mechanical properties with the increase of pre-fatigue damage. Manson-Coffin models for Q690D steels of different pre-damage levels were established. Besides, a comparison was presented between Q690D and Q355B. The research work in this article provides a fundamental reference for the appropriate assessment of the mechanical performance of Q690D high-strength steel structures after long-term alternating loading.

Kesterite materials are among the most promising emerging photovoltaic absorbers, despite the number of challenging issues this technology presents. The use of soft thermal post-deposition treatments (PDT) is key to improving the CdS/kesterite interface quality. Thermal treatments can result in a low-temperature phase transition which affects the optoelectronic properties. In this work, the effects of applied voltage during a full device thermal PDT above the critical temperature of the phase transition are explored. The applied voltage modifies the formation energy and drives in-depth migration of ionized defects, which can generate a shallow doping density gradient (SDDG). Supporting the experimental findings, the effects of an SDDG on the current-voltage curves and the external quantum efficiency are modelled using drift-diffusion calculations. The presence of bulk recombination centers in the modelling is a key aspect to precisely reproduce the experimental results. The SDDG in opposite directions precisely matches the experimental results for opposite voltage polarizations. The effects on the band structure of the device are presented proving this as a promising strategy for improving charge carrier selectivity. In this sense, the results and their thorough physical interpretation will potentially open new perspectives in the field of materials engineering.

A 69-year-old man was diagnosed with fulminant myocarditis with circulatory collapse. His cardiac rhythm deteriorated to asystole on the second day; however circulatory status was maintained through extracorporeal membrane oxygenation and intra-aortic balloon pumping. After 38h-lasting asystole, heart resumed beating. He was discharged without neurological deficits on day 25.

Digital holography (DH) has experienced significant advancements in recent years, with improvements in both experimental and algorithmic techniques. This has resulted in an expansion of DH’s applications in biomedicine, as well as other scientific and engineering fields. The introduction of machine learning (ML) and deep learning (DL) has provided a breakthrough in the recognition and prediction of patterns, especially with regards to visual imagery data. This characteristic of ML and DL makes them highly suitable for processing digital holographic data, and they have thus become widely used in digital holography. This review aims to assimilate the research where ML and DL have been employed alongside digital holography in the biomedical field for tasks such as the identification and classification of organelles, diseases, and microbes. The combination of DH and ML/DL has shown significant potential in addressing various challenges in biomedical microscopy, including the identification and classification of cellular and subcellular

SUSTAINED REMISSION OF IPEX-LIKE SYNDROME FOLLOWING FAILED UMBILICAL CORD BLOOD TRANSPLANTATIONIshaq Al Kooheji, MD1, Elizabeth Secord, MD2, Colleen Buggs-Saxton, MD3, Tony Lulgjuraj, MD4, and Süreyya Savaşan, MD1,51 Children’s Hospital of Michigan, Hematology/Oncology Flow Cytometry Laboratory, Central Michigan University2 Wayne Pediatrics, Allergy & Immunology, Wayne State University3 Wayne Pediatrics, Endocrinology, Wayne State University4 Children’s Hospital of Michigan, Gastroenterology5 Children’s Hospital of Michigan, Hematology/Oncology, Bone Marrow Transplant Program, Central Michigan UniversityCorrespondence: Süreyya Savaşan, MDChildren’s Hospital of MichiganDivision of Hematology/OncologyPediatric Blood and Marrow Transplantation Program3901 Beaubien Blvd.Detroit, MI 48201Phone: 313-745-5516Fax: 313-745-2357E-mail: ssavasan@med.wayne.eduWord count (main Text): 825Tables: 0Figures: 0Supplemental files: 0References: 15Running title: Remission after failed UCBT in IPEX-like syndrome

Letter to the editor

This article describes spontaneous globe rupture as a rare but serious complication of retinoblastoma. This warrants acknowledgement and discussion, given the implications for metastatic spread should it not be managed appropriately.

Primary Ewing’s sarcoma (EWS) of non-sacral spine is extremely rare, especially in middle-age. Therapeutic strategy aims: to large tumor resection, to provide spine stability and to avoid recurrence through chemo and radiotherapy. We report a case of thoracic spine EWS in an adult treated by combined approach en bloc vertebrectomy.

So far, various data-driven approaches have been presented to obtain channel state information (CSI) in mmWave multiple-input-multiple-output (MIMO) wireless networks. In almost all previous works, training and testing channels were assumed to have the same distribution, which may not be the case in practice. In this paper, we address this challenge, by proposing a learning framework that is a combination of a long short-term memory (LSTM) network and a deep neural network (DNN) for estimating CSI in a dynamic wireless communication environment. Furthermore, we use federated learning (FL) to train the learning-based channel estimation (CE) model. More specifically, we introduce a two-stage downlink pilot transmission procedure, where in the initial stage, long frame length downlink pilot signals are used to train the introduced RNN-DNN model. Following that, users will receive shorter-frame-length pilot signals that can be used for CSI estimation. To speed up the training procedure of the proposed network, we first generate a pre-trained model and then modify it according to the collected data samples. Simulation results demonstrate that, when the channel distribution is unavailable, the proposed approach performs significantly better than the most recent channel estimation algorithms in terms of estimation performance and computational complexity.

The respiratory tract antimicrobial defense system is a multilayered defense mechanism that relies upon mucociliary clearance and components of both the innate and adaptive immune systems to protect the lungs from inhaled or aspirated microorganisms. One of these potential pathogens, non-typeable Haemophilus influenzae ( NTHi), adopts several, multifaceted redundant strategies to successfully colonize the lower airways and establish a persistent infection. NTHi can impair mucociliary clearance, express multiple multi-functional adhesins for various cell types within the respiratory tract and evade host defenses by surviving within and between cells, forming biofilms, increasing antigenic drift, secreting proteases and antioxidants, and by host-pathogen cross-talk, impair macrophage and neutrophil function. NTHi is recognized as an important pathogen in several chronic lower respiratory disorders, such as protracted bacterial bronchitis, bronchiectasis, cystic fibrosis and primary ciliary dyskinesia. The persistence of NTHi in human airways, including its capacity to form biofilms, results in chronic infection and inflammation, which can ultimately injure airway wall structures. The complex nature of the molecular pathogenetic mechanisms employed by NTHi is incompletely understood but improved understanding of its pathobiology will be important for developing effective therapies and vaccines, especially given the marked genetic heterogeneity of NTHi and its possession of phase-variable genes. Currently, no vaccine candidates are ready for large phase III clinical trials.

A document by Abayomi Ajagbe͓. Click on the document to view its contents.

Background: Congenital bronchobiliary fistula (CBBF) is a rare disease with abnormal connection between the biliary tract and the bronchus. The misdiagnosis rate of CBBF is high, delayed surgery may induce poor outcome. Case presentation: We reported a girl with CBBF who was confirmed via bronchoscopy and chest computed tomography (CT). The girl was 7-month-old admitted to the hospital with “recurrent pneumonia”. Bilirubin crystallization detection was positive in the bronchoalveolar lavage fluid (BALF). CT images showed the abnormal traffic between the biliary tract and the right main bronchus, the girl was diagnosed with CBBF and recovered after surgical operation. Literature search: A total of 27 cases were collected, 14 (51.8%) cases were diagnosed in the neonatal period, 9 (33.3%) patients were diagnosed in infancy. CBBF was more common in female (19/27, 70.3%). The specific manifestations were bilious sputum (24/27, 88.9%) and bilious vomiting (7/27, 22.2%). Recurrent pneumonia (9/27, 33.3%) was common clinical manifestations. The most abnormal fistula originates different location around the carina was right main bronchus (21/27, 77.8%). There were 23(85.2%) cases recovered after surgical operation and 4(14.8%) cases with severe comorbidities/complications died. Conclusions: CBBF should be suspected in infants with bilious sputum. Bronchoscopy plays crucial role in preoperative evaluation and postoperative follow-up. With early diagnosis and surgery, the prognosis is quite well for CBBF patients without severe biliary malformation and/or severe postoperative complications.

A 5-month-old male baby was brought to the emergency room with a one-day history of respiratory distress, wheezing, vomiting, and high fever. Wheezing had been present since birth but had recently become more frequent and intense, occurring even at rest. The baby was born full-term by cesarean delivery and had a medical history of gallbladder agenesis, secundum atrial septal defect (ASD), and cryptorchidism.

Lung transplantation is a recognised therapy for end stage respiratory failure in children and young people. It is only available in selected countries, and is limited by access to suitable organs. Data on disparities in access and outcomes for children undergoing lung transplantation are limited. It is clear that data from studies in adults, and from studies in other solid organ transplants in children, that systemic iniquities exist in this field. While data relating specifically to paediatric lung transplantation are relatively sparse, professionals should be aware of the risk that health care systems may result in disparities in access and outcomes following lung transplantation in children.

Introduction: Surgical ligation for hemodynamically significant patent ductus arteriosus (PDA) is sometimes required in preterm infants; however, some patients experience worsened respiratory status after the surgery. This study aimed to evaluate the risk factors that could predict worsened respiratory outcomes after PDA ligation. Methods: A retrospective cohort study was performed on 57 preterm infants born at less than 32 weeks of gestational age and in whom the PDA was surgically ligated between January 2014 and December 2018 at Seoul National University Children’s Hospital. Participants were divided into two groups: infants with worsened respiratory outcomes 14 days after ligation and control. Worsened respiratory outcome was defined as increase in respiratory severity score (RSS) by 30% or more at 14 days after ligation compared to RSS before ligation, or death at 14 days after ligation. Results: Among the 57 PDA-ligated infants, 12 had worsened respiratory outcomes and 45 did not. The worsened respiratory outcomes were associated with oligohydramnios (adjusted OR 1.373, 95% CI 1.113-1.694.), histologic chorioamnionitis (adjusted OR 1.240, 95% CI 1.016-1.512), and decreased weight on the day of surgery (adjusted OR 0.999, 95% CI 0.999-0.999) compared to that in the control. Conclusion: Worsened respiratory outcomes after PDA ligation appeared to be associated with oligohydramnios, histologic chorioamnionitis, and weight on the day of surgery.

Background: In preschoolers, performing an acceptable spirometry and measuring bronchodilator response (BDR) is challenging; impulse oscillometry (IOS) may be an alternative to spirometry. However, there is still no consensus in standardization of BDR for IOS in young children. Objective: The objective of the study was to identify optimal thresholds to define a positive BDR test with IOS. Methods: Young infants aged 3 to 6 years with suspected asthma were evaluated in a real life setting with both IOS and spirometry pre- and post-BDR. The BDR was defined as positive when the change of FEV1 was ≥12% and/or ≥200 mL. Results: Among 72 patients (age 4.98 ± 0.94 years; 64% boys), 36 (age 5.15 ± 0.99 years; 64% boys) were selected for the subsequent analysis according to ATS / ERS quality criteria of measurements. The spirometric BDR was found positive in seven subjects (19.4%). In IOS, the mean decrease in R5 and AX was 19.86% ± 10.04 and 44% ± 22.10, and the mean increase in X5 was 23.28% ± 17.82, respectively. A decrease in R5 of 25.7% (AUC 0.77, p = 0.03) and an increase in X5 of 25.7% (AUC 0.75, p = 0.04) showed the best combination of sensitivity and specificity to detect an increase of FEV1 ≥12% and/or ≥200 mL. Conclusion: The IOS may present a valid alternative to spirometry to measure BDR in preschool children. We are considering a decrease of 26% in R5 and an increase of 26% in X5 as diagnostic threshold for BDR.

In this study, a detection method based on the Cascaded Hough Transform (or CHT for short) and an improved YOLOV5 model is proposed for the detection of vehicle pressing lines in straight lanes. This method combines traditional image processing with depth learning by integrating background modeling, cascade Hough transform principle and YOLOV5 depth learning framework. The specific process of this method is as follows. First, MOG2 background modeling is used to obtain the road background image, then the CHT principle is used to extract the lane lines in the road background image, and finally the improved YOLOV5 model is used to recognize the position of vehicles and judge whether the vehicles are pressing the line. The experimental results show that this method has good recognition speed and accuracy, can meet the basic requirements of road monitoring vehicle line detection, and also provides some reference experience for the research of vehicle line detection.

Sink-source imbalance causes accumulation of non-structural carbohydrates (NSCs) and photosynthetic downregulation. Despite numerous studies, however, it remains unclear whether NSCs accumulation or N deficiency more directly decreases steady-state maximum photosynthesis and photosynthetic induction, as well as underlying gene expression profiles. We evaluated the relationship between photosynthetic capacity and NSCs accumulation induced by cold-girdling, sucrose feeding, and low nitrogen treatment in Glycine max and Phaseolus vulgaris. In G. max, changes in transcriptome profiles were further investigated focusing on physiological processes of photosynthesis and NSCs accumulation. NSCs accumulation decreased maximum photosynthetic capacity and delayed photosynthetic induction in both species. In G. max, such photosynthetic downregulation was explained by coordinated downregulation of photosynthetic genes involved in Calvin cycle, Rubisco activase, photochemical reactions, and stomatal opening. Furthermore, sink-source imbalance may have triggered a change in the balance of sugar-phosphate translocators in chloroplast membranes, which may have promoted starch accumulation in chloroplasts. Our findings provided an overall picture of the photosynthetic downregulation and NSCs accumulation in G. max, demonstrating that the photosynthetic downregulation is triggered by NSCs accumulation and cannot be explained simply by N deficiency.