Background and Purpose: Blood-brain barrier (BBB) breakdown is one of the most crucial pathological changes of cerebral ischemia-reperfusion (I/R) injury. Trilobatin (TLB), a naturally occurring food additive, exerts neuroprotective effect against cerebral I/R injury as demonstrated in our previous study. This study was designed to investigate the effect of TLB on disruption of BBB after cerebral I/R injury. Experimental Approach: Rats with focal cerebral ischemia caused by transient middle cerebral artery occlusion (MCAO) and brain microvascular endothelial cells along with human astrocytes to mimic blood brain barrier (BBB) injury caused by oxygen and glucose deprivation (OGD) followed by reoxygenation (OGD/R). Key results: The results showed that TLB effectively maintained the integrity of BBB and inhibited neuronal loss following cerebral I/R challenge. Furthermore, TLB dramatically increased tight junction proteins including ZO-1, occludin and claudin 5, as well as decreased the levels of apolipoprotein E (APOE) 4, cyclophilin A (CypA), and phosphorylated nuclear factor kappa B (NF-κB), thereby reduced proinflammatory cytokines. In addition, TLB also decreased Bax/Bcl-2 ratio and cleaved-caspase 3 level along with reduced the number of apoptotic neurons. Intriguingly, molecular docking and transcriptomics predicted MMP9 was a prominent gene evoked by TLB treatment. Furthermore, the protective effect of TLB on OGD/R-induced the loss of BBB integrity in human brain microvascular endothelial cell and astrocyte co-cultures in vitro was markedly reinforced by knockdown of MMP9. Conclusions and implications: Our findings reveal a novel property of TLB: saving BBB disruption following cerebral I/R via targeting MMP9 and inhibiting APOE4/CypA/NF-κB axis.

We describe a case of a 2-month-old female displaying clinical phenotype of HIES related disease with severe eczematous dermatitis recalcitrant to corticosteroids. Genetic panel showed a variant of unknown significance in key immune regulator of PGM3. Patient achieved nearly complete response from off-label use of dupilumab.

Objective To investigate the application value of echocardiography in the preoperative evaluation, intraoperative monitoring and postoperative follow-up of patients with aortic valve disease (AVD) receiving transcatheter aortic valve replacement (TAVR). Methods The clinical data of 79 AVD patients who received TAVR from March 2021 to September 2022 at the Cardiology Centre of Yijishan Hospital, Wannan Medical College, were retrospectively analysed. Twenty-six patients with severe aortic stenosis (AS, including those with pure severe AS and severe AS combined with mild aortic regurgitation (AR)) were included in group I, 31 patients with severe AR (including those with pure severe AR and severe AR combined with mild AS) were included in group II, and the remaining 22 patients with AS combined with AR (AS+AR) were included in group III. The patients’ basic data, preoperative comorbidities, preoperative multislice computed tomography (MSCT) assessment of the aortic root, intraoperative conditions, preoperative and 1-month postoperative echocardiographic parameters, and postoperative complications were collected. Results All patients underwent TAVR through the femoral artery, 79 patients were monitored by transesophageal echocardiography (TEE), 2 patients underwent TEE-guided transseptal puncture for retrograde crossing of the valve, and 6 patients underwent valve-in-valve (VinV) implantation. Immediate postoperative evaluation revealed 1 case of moderate paravalvular leakage (PVL), 4 cases of low-to-moderate PVL, 14 cases of low PVL, 8 cases of trace PVL, and 48 cases of no PVL. Comparing the data obtained at 1 month after surgery with preoperative data, for group I, the maximum aortic valve blood flow velocity (AV Vmax) and mean aortic valve pressure gradient (AVPGmean) significantly decreased (P<0.001), the interventricular septal thickness (IVST) and left ventricular (LV) posterior wall thickness (PWT) decreased (P<0.001), and the left ventricular ejection fraction (LVEF) increased (P<0.05); for group II, the effective regurgitant orifice area (EROA), regurgitant volume (RVol) and AR width significantly decreased (P<0.001), and the left ventricular end-diastolic diameter (LVEDD) significantly decreased (P<0.001); and for group III, AV Vmax and AVPGmean decreased significantly (P<0.001), EROA, Rvol and AR width decreased significantly (P<0.001), IVST decreased (P<0.05), PWT decreased (P < 0.05), LVEDD significantly decreased (P<0.001), and LVEF increased (P<0.05). During the follow-up, 5 patients died, and 13 patients were implanted with permanent pacemakers. Conclusion Echocardiography plays an important role in the preoperative assessment, intraoperative monitoring and postoperative follow-up of patients with different types of AVD receiving TAVR and can provide a basis for the evaluation of efficacy and prognosis of TAVR.

Background: Antineoplastic therapy with the tyrosine kinase inhibitor(TKI) apatinib in patients with advanced or metastatic gastric or gastroesophageal junction adenocarcinoma(GC) has been associated with hypertension (HTN), but little is known about predisposing clinical characteristics. This study describes the real-world association between baseline clinical characteristics and blood pressure (BP) response in patients prescribed apatinib with GC. Methods: 55 GC patients treated with apatinib were collected from the 1st December 2016 to the 1st December 2020 using medical records retrospectively. Outcomes were defined using the National Cancer Institute’s Common Terminology Criteria for Adverse Events v5.0. Univariate and multivariable logistic regression were used to investigate potential clinical risk factors. Results: 45.45% of patients were evaluated for apatinib-related HTN and Grade 3 HTN occurred 16.36% of patients. Median maximal systolic blood pressure (SBP) during apatinib treatment was 153 mmHg with median time to event of 25 days. New-onset HTN occurred in 10/33 (30.30%) patients. pre-existing HTN(odds ratio [OR]: 4.155; 95% confidence interval [CI]: 1.252-13.787; p =0.020 was key independent risk factors associated with apatinib-related HTN. Conclusions: More thorough BP monitor prior to starting apatinib especially in patients with pre-existing hypertension may reduce cardiovascular risk.

By integrating the Four Switch Buck-Boost (FSBB) PFC and full-bridge LLC resonant converter, a novel single-stage FSBB-LLC AC-DC converter is proposed. Moreover, a dual-loop feedback control strategy based on PFM/PWM hybrid modulation is proposed for obtaining the desired bus voltage and stable output voltage. The bus voltage feedback loop is utilized to regulate the bus voltage by selecting the boost or buck-boost mode; the output voltage feedback loop is employed to stabilize the output voltage by adjusting the switching frequency or phase shifting angle. Furthermore, an optimal parameter design based on power balance principle is also derived. The experimental results of an 85~300V input, 12V/25A output prototype demonstrate that: (1) low and narrow bus voltage of 240~340V is achieved under the entire input and output condition; (2) the LLC cell operates as a DCX converter over the whole load range as the input voltage exceeds 120V; (3) the output voltage is well regulated even under the no-load condition; (4) ZVS feature for the shared main switches is still maintained; (5) a peak efficiency of 90.9% and PF values above 0.987 are achieved.

SARS-CoV-2 infection in already-vaccinated individuals is still possible and may require hospitalization. The aim of the present study was to evaluate the clinical evolution of patients with COVID-19 admitted in a public hospital. The outcomes were assessed in relation to the predominant viral variant and the vaccination status. This retrospective study was performed on 1,295 COVID-19-positive patients who attended a 352-bed university hospital between 2021 and 2022. Clinical variables and vaccination status were recorded. Of the patients, 799 had not been vaccinated (NV, 61.7%), 449 were partially vaccinated (PV, 34.7%) and 47 were completely vaccinated (CV, 3.6%). The mean age of the CV patients was significantly higher than that of PV and NV. Also, they had higher percentages of chronic diseases. The outcomes depended on age but not on vaccination status. There were 209 patients admitted during the Omicron-infection period, from which 70 (33.5%) were NV, 135 (64.6%) PV, and 4 (1.9%) CV. In conclusion: Correct vaccination greatly reduces the risk of acquiring severe COVID-19. Partial vaccination does not guarantee protection of the population. This highlights the need for continuous vaccination promotion with all recommended doses, while investigating alternative treatments for those patients who do not respond to the vaccines.

We present a method to use a birefringent crystal for generating two illumination beams in a digital scanned laser light-sheet microscopy (DSLM) system. Upon this, a conventional confocal DSLM can be easily upgraded to a dual-slit confocal DSLM with two-fold imaging speed. We have implemented this method to our bidirectional DSLM system, locating two identical calcite crystals on both illumination paths from both sides of the sample. The neurons of in vivo larval zebrafish have been fast imaged with sterling image quality, especially ~2.5 times higher contrast, compared to the conventional DSLM.

Dopamine, a catecholamine neurotransmitter, has historically been associated with the encoding of reward, whereas its role in aversion has received less attention. Here, we systematically gather the vast evidence for a role of dopamine in the simplest form of aversive learning: passive aversive conditioning and extinction. In the past, crude methods were used to augment or inhibit dopamine in order to study its relationship with fear conditioning and extinction. More advanced techniques such as conditional genetic, chemogenic, and optogenetic approaches now provide causal evidence for dopamine’s role in these learning processes. Dopamine neurons encode fear and extinction-related information and convey the signal via activation of D1, D2, D3, and D4 receptor sites particularly in the amygdala, prefrontal cortex, and striatum in order to continuously form, consolidate, retrieve, and update fear and extinction memory in a dynamic and reciprocal manner. Based on the reviewed literature, we conclude that dopamine is crucial for the encoding of passive aversive conditioning and contributes in a way that is comparable to its role in encoding reward.

Objective: To construct a reproductive risk score (RRS) and an air pollution score (APS) and assess independent and joint associations between the two with incident COPD risk. Design: Population-based prospective cohort study. Setting: UK Biobank. Population: 78,218 female participants aged 40–69 years without baseline COPD recruited between 2006 to 2010. Methods: RRS was constructed by 17 women’s reproductive health-related items, and APS incorporating PM 2.5, PM 2.5-10, PM 10, NO 2, and NO x was calculated to assess the joint exposure level. The associations of RRS and APS with COPD were examined by Cox proportional hazards regression. Main Outcome Measures: The outcome of the incident COPD was identified through the in-patient hospital register. Results: Higher RRS was associated with an increased risk of COPD (adjusted HR: 1.15, 95% CI: 1.12-1.19, P trend < 0.001). A dose-response manner can be observed between higher quintile APS and increased COPD risk (P trend < 0.001). The RERI of 0.030 (95% CI: 0.012-0.048) showed additive interaction between RRS and APS on COPD was significant. In the joint analysis, the combinations of both higher RRS and APS signified higher incident COPD risk. Conclusions: High RRS and high APS were associated with increased COPD risks in a dose-response pattern. Using comprehensive indicators to identify women’s reproductive risk factors, together with the control of air pollution, is effective for COPD prevention.

Objectives: Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection in young children. We aimed to analyze the factors affecting the estimation of RSV-related disease burden, and furthermore, to provide evidence to help establish a surveillance system. Methods: We searched for literature published in English or Chinese between 1 January, 2010 and 2 June, 2022. The quality of the included articles was assessed using the Agency for Healthcare Research and Quality scale. Random-effects models were used for data synthesis and subgroup analyses. This review was registered in the Prospective Register of Systematic Reviews (PROSPERO: CRD42022372972). Results: We included 44 studies (149,321,171 participants), all of which were of medium or high quality. The pooled RSV-associated disease incidence, hospitalization rate, in-hospital mortality, and overall mortality rates in children aged 5 years and younger were 9.0% (95% confidence interval [CI]: 7.0–11.0%), 1.68% (95% CI: 1.30–2.05%), 0.45% (95% CI: 0.38–0.52%), and 0.05% (95% CI: 0.04–0.06%), respectively. Age, economics, surveillance types, case definition, and data source were all influencing factors. Conclusions: A standardized and unified RSV surveillance system is required. Case definition and surveillance types should be fully considered for surveillance of different age groups.

Introduction. Rhinoviruses are known as the leading pathogens of respiratory diseases. Determining the prevalence and phylogeny of rhinoviruses plays a pivotal role in producing vaccines and medications and preventing virus complications. This study investigated the frequency, and genetic variation of rhinoviruses detected in patients referred to Masih Daneshvari Hospital. Materials and Methods. It was a descriptive cross-sectional study. The samples were from all ages whose information was recorded in 2017 according to a clinical diagnosis of acute respiratory infection (ARI) and in 2015 based on a clinical diagnosis of community-acquired pneumonia (CAP) within the HIS system of Masih Daneshvari Hospital. Using a random number table, 202 patients diagnosed with ARI and 51 patients diagnosed with CAP were selected. The real-time PCR method was used for primary screening; nested PCR was performed in VP2/VP4 gene region for phylogenetic investigations, and MEGA software drew a phylogenetic tree. Results. The highest level of rhinovirus infection was seen in subjects under 18 years of age, males, and during the spring season. In this study, the genotypes of HRV-A (including A15, A29, A40, A47, A58, A67, and A80) and HRV-C (including C39 and C44) and two samples of enterovirus D68 were found. Discussion and Conclusion. Like other studies conducted in Asia, the most detected genotypes were HRV-A and HRV-C. Conducting further studies with a larger sample size and in different geographical regions of Iran will provide us with more comprehensive information about the frequency of rhinoviruses and common genotypes.

It is impossible to address the many complex needs of respiratory virus surveillance with a single system. Therefore, multiple surveillance systems and complementary studies must fit together as tiles in a “mosaic” to provide a complete picture of the risk, transmission, severity, and impact of respiratory viruses of epidemic and pandemic potential. Below we present a framework to assist national authorities to identify priority respiratory virus surveillance objectives and the best approaches to meet them; to develop implementation plans according to national context and resources; and to prioritize and target technical assistance and financial investments to meet most pressing needs.

In this work, the local fractional Kamal transform decomposition method is used to solve a nonlinear system of local fractional partial differential equations. The local fractional Kamal decomposition transform method combines the Adomian decomposition method and a local fractional Kamal transform. There are some applications of the nonlinear system of local fractional partial differential equations.

Upside-down stomach accounts for less than 5% of hiatal hernia. It is the rarest form of par oesophageal hernia and characterised by herniation of the most gastric parts or entire stomach into the posterior mediastinum [1]. It is classified as type 3.

This paper investigates the impact of power converter station modeling to high frequency overvoltage based on the on-site experimental test of a fully operational 200 kV MMC-HVDC converter station. Artificial short-circuit faults were generated in the system with hybrid DC circuit breakers along coaxial cables by means of an unmanned aerial vehicle for the first time. Fault transients recorded during the tests are found not to comply with the typical framework where power stations are assumed to present a high impedance, or at least dominated by the reactor inductance. This discrepancy is proven to be caused by parasitic elements at the terminals of the converter station, resulting in a spurious low-frequency resonance dominating fault transients. A wideband converter station model is proposed and validated by the test data. The simulation results show that the proposed wideband model should be adopted avoiding the risk of huge resonance bias in short line distance. When fault distance is 10 km away, converter station model will converge to standard AVM, while the high impedance or reactor model is no longer valid. The experimental data provide a benchmark to validate the converter station model for transient overvoltage or electromagnetic interference under the fault condition.

Ethiopian social protection programs were played big important roles in poverty reductions for the chronically food insecure and vulnerable households. Hence, the objectives of this review were the effects and constraints of social protection. Articles and reports obtained through internet searching are reviewed related to the topic, which was done at national, regional, and district levels. According to the reviewed, Idir, Zakat in Afar, community-based health insurance and productive safety net program were important ones to reducing risk vulnerability of the rural community. Moreover, a productive safety net program has both positive and negative effects on beneficiaries’ social, economic, and environmental development. In a nutshell, social protection services play a vital role in providing to address poverty, hazardous events, and vulnerabilities that affect livelihood. Therefore, concerned bodies should be focused that targeting rural communities to achieve food security and health services through social protection. Keywords: Effect, Constraint, Productive Safety Net Program, Community-based insurance. Rural Ethiopia

A document by Nuh YILDIRIM. Click on the document to view its contents.

Adrenaline, also known as epinephrine, is a hormone and neurotransmitter produced by the adrenal gland. It is an essential component of the fight-or-flight response, a survival mechanism that prepares the body to respond to perceived danger. When the body experiences stress, the hypothalamus activates the adrenal gland's medulla, which releases adrenaline into the bloodstream. However, some people suffer from chronically elevated hyperadrenergic conditions, mostly secondary to another disease. These conditions can lead to a wide range of symptoms, including anxiety, panic attacks, heart disease, tremors, sweating, and difficulty sleeping. In severe cases, it can even lead to heart failure, stroke, and death. The reduction of endogenous adrenaline synthesis is an important part of managing hyperadrenergic situations. Endogenous adrenaline refers to the adrenaline produced by the body, as opposed to exogenous adrenaline, which is adrenaline that is taken as a medication. By reducing the amount of adrenaline produced by the body, it is possible to relieve the symptoms of hyperadrenergic conditions and improve the quality of life for those affected. This preliminary paper presents a new medication regimen which is, to our knowledge, the most effective one so far. 

Objective: To investigate the feasibility and efficacy of a modified V-shaped incision for partial superficial parotidectomy in the treatment of benign parotid tumors, and compare it with a traditional S-shaped incision. Methods: Fifty benign parotid tumor patients who required partial superficial parotidectomy were selected and randomly divided into two groups, treated with the modified V-shaped incision (V-group) and the traditional S-shaped incision (S-group), respectively. Intraoperative, postoperative, and follow-up indicators were compared between these two groups. Results: There were no statistically significant differences ( P > 0.05) between these two groups in drainage volume, postoperative extubation time, postoperative hospital stay, periauricular numbness, fistulas, facial palsy, facial depression, incidence of Frey syndrome, scar score after 1-month follow-up, and 18-month postoperative recurrence rate. In terms of appearance satisfaction score 6 months after surgery, the V-group was superior to the S-group. When the tumor was located at the low part or its diameter was >3 cm, the surgical time in the V-group was longer than that in the S-group. Conclusions: In surgery of benign parotid tumors, when the modified V-shaped incision is applied, the surgical time is prolonged only when the tumors are located at the low part of the parotid gland. For tumors at different sites, the V-shaped incision can achieve a better cosmetic effect than the S-shaped incision without inducing surgical complications.

Vagally mediated heart rate variability is an index of autonomic nervous system activity that is associated with a large variety of outcome variables including psychopathology and self-regulation. While practicing heart rate variability biofeedback over several weeks has been reliably associated with a number of positive outcomes, its acute effects are not well known. Because the strongest association with heart rate variability has been found particularly within the attention-related subdomain of self-regulation, we investigated the acute effect of heart rate variability biofeedback on attentional control using the revised Attention Network Test (ANT-R). Fifty-six participants were tested in two sessions. In one session each subject received a heart rate variability biofeedback intervention, and in the other session a control intervention of paced breathing at a normal ventilation rate. After the biofeedback or control intervention, participants completed the ANT-R using the Orienting Score as a measure of attentional control. Mixed models revealed that higher resting baseline heart rate variability (RMSSD) was associated with better performance in attentional control, which suggests more efficient direction of attention to target stimuli. There was no significant main effect of the intervention on attentional control. However, an interaction effect indicated better performance in attentional control after biofeedback in individuals who reported higher current stress levels. The results point to acute beneficial effects of heart rate variability biofeedback on cognitive performance in highly stressed individuals. Although promising, the results need to be replicated in larger or more targeted samples in order to reach stronger conclusions about the effects.

Executive functions are defined as cognitive regulatory mechanisms and processes that are unique to humans. Extensive research has been conducted to comprehend the factors that influence these functions, the most important of which is age, which correlates with varying executive function performance. However, no research has examined and compared the performance of different age groups on the basic executive functions (inhibition, updating, and shifting) among the Iranian population. The present study used computerized tasks to address this gap by examining individuals aged 16 to 59. Ten distinct age groups were assigned to a total of 479 participants (51% females) using the quota sampling method and compared using the one-way analysis of variance. The analysis revealed that for the inhibition component, there was a significant difference between the scores of the ten age groups on the stop signal and antisaccade tasks but no significant difference on the Stroop task. In addition, also there was a significant difference between the scores of updating component but not for the shifting component. The findings suggest that although the performance of individuals in the Shifting component remains constant from youth to adulthood, youth performance growth in the inhibition and updating component of executive functions is on the rise and reaches a peak in participants aged 20 to 24 before declining slightly until the end of adulthood. Limitations and future direction are discussed.

The field of ecology has undergone a molecular revolution, with researchers increasingly relying on DNA-based methods for organism detection. Unfortunately, these techniques often require expensive equipment, dedicated laboratory spaces, and specialized training in molecular and computational techniques; limitations effectively excluding field researchers, underfunded programs, and citizen scientists from contributing to cutting-edge science. It is for these reasons that we have designed a simplified, inexpensive method for field-based molecular organism detection – FINDeM (Field-deployable Isothermal Nucleotide-based Detection Method). In this approach, DNA is extracted using chemical cell lysis and a cellulose filter disc, followed by two body-heat inducible reactions – recombinase polymerase amplification and a CRISPR-cas12a fluorescent reporter assay – to amplify and detect target DNA, respectively. Here, we demonstrate FINDeM in detecting Batrachochytrium dendrobatidis, the causative agent of amphibian chytridiomycosis, and show that this approach can identify single-digit DNA copies from epidermal swabs in under one hour using low-cost supplies and field-friendly equipment.

This study aimed to investigate where acidification occurred in soil profiles of Guizhou tea gardens, in addition to the influence of acidification on the availability of soil mineral elements in order to inform soil nutrient management and improvement practices in tea gardens. Important tea-producing areas of Guizhou were investigated in this study and samples were collected from tea gardens with similar soil parent material and management measures. The acidification characteristics were investigated in soils from plantations grown for various numbers of years and across different soil layer profiles. Moreover, the pH buffering capacities (pHBC) of soils were evaluated and changes in soil Fe, Mn, Cu, Zn, Mo, B, As, Pb, Cr, and Cd concentrations due to soil acidification were explored. With increased tea plantation age, the acidification rate of 0–20-cm soil layers reached 0.025 pH unit/year. Soil acidification extended from the surface layer downwards through profiles, while the pH of entire soil layers were < 4.5 after 40 years of tea plantation. The pHBC of soils were < 30 mmol/kg, remaining at a weak sensitive level. Fe, Mn, Cu, Zn, Mo, and B concentrations exhibited decreasing trends in soils, while As, Pb, Cr, and Cd exhibited enrichment at the surface. Tea plantation age and soil depth were significantly correlated with the available concentrations of soil mineral elements. Soil acidification gradually increased downward from the surface and soil minerals were lost in acidic environments, while the acid buffering capacity was reduced. These results suggest that organic fertilizers and trace elements should be supplemented as needed in the management of tea gardens to achieve long-term stability of quality and yields.

Manipulation strategies based on the passive dynamics of soft-bodied interactions provide robust performances with limited sensory information. They utilise the kinematic structure and passive dynamics of the body to adapt to objects of varying shapes and properties. However, these soft passive interactions make the state of the robotic device influenced by the environment, making control generation and state estimation difficult. This work presents a closed-loop framework for dynamic interaction-based grasping that relies on two novelties: (i) a wrist-driven passive soft anthropomorphic hand that can generate robust grasp strategies using one-step kinaesthetic teaching and (ii) a learning-based perception system that uses temporal data from sparse tactile sensors to predict and adapt to failures before it happens. With the anthropomorphic soft design and wrist-driven control, we show that controllers can be generated robust to novel objects and location uncertainty. With the learning-based high-level perception system and 32 sensing receptors, we show that failures can be predicted in advance, further improving the robustness of the entire system by more than doubling the grasping success rate. From over 1000 real-world grasping trials, both the control and perception framework are also seen to be transferable to novel objects and conditions. Corresponding author(s) Email:  _ fi224@cam.ac.uk  _