Cardiac implantable electronic device infections often necessitate extraction, which can be complicated by calcified adhesions, leading to increased procedural risk and reduced efficacy. This report presents the first reported case where shockwave intravascular lithotripsy (IVL) was successfully employed to extract a severely calcified lead system after an initial extraction attempt failed due to extensive calcification. Despite prior findings suggesting no significant difference in clinical success rates with IVL, this case demonstrates IVL’s effectiveness in overcoming challenging calcified adhesions, advocating for further research to optimize its use in complex lead extractions.

The strength of a nation's civil infrastructure is a vital component in its ability to achieve global leadership. At city, state, and national levels, infrastructure development is not merely a technical or economic pursuit but also a training ground for governance. This viewpoint explores how domestic infrastructure initiatives shape governance capabilities in cooperation, innovation, resilience, and foresight, enabling nations to extend their influence globally.

We reported a 67-year-old male patient with metastatic castration-sensitive prostate cancer (mCSPC) who developed toxic epidermal necrolysis (TEN) after apalutamide endocrine therapy. This patient was in a life-threatening status characterized by persistent high fever and a rash that spread throughout the body. The examination showed he also had liver injury, systemic inflammatory response syndrome. When the initial glucocorticoid and immunoglobulin treatment does not show significant efficacy, TNF antagonist-adalimumab was promptly applied based on the increased serum level of TNF-. Antibiotics against bacteria and fungi were also positively administrated when secondary fungal and bacterial infections were showed up as a result of skin exfoliation. Moreover, nursing intervention of silver ion gauze add brilliance to this comprehensive medication strategy. The patient improved significantly after 15 days of treatment, and his skin gradually returned to normal and remained stable during the follow-up period of 6 months after discharge. This case underlines apalutamide can cause TEN. Early use of glucocorticoids and immunoglobulin, active application of antibiotics and nursing measures have made great contributions to the effective recovery. However, it is worth emphasizing that TNF- antagonist-adalimumab application and comprehensive strategy are the key for the recovery of TEN, which provides an important therapeutic implication for future treatment of TEN.

Abstract:Menstrual hygiene practices and menstrual disorders should be addressed in developing countries like Bangladesh due to the need for more awareness. Poor menstrual hygiene practices can raise reproductive tract infections. This preventable infection can subsequently lead to severe complications like infertility and subfertility. The aim of the study was to find out the discrepancy in menstrual hygiene practices regarding menstrual disorders among rural college girls in the Dhaka division. This cross-sectional study was carried out from September to November 2021. Consent was collected from each participant before starting the interview. In this study, 204 college girls from the rural areas of the Dhaka division were included through purposive sampling. The mean age of the participants was 27.5, while three-fourths were from nuclear families in urban areas. In rural areas, nearly half of the respondents used a non-reusable pad. Most rural respondents had inadequate preparation for menstrual hygiene management. Most of the respondents in rural areas maintain personal hygiene. Half of the respondents washed their genitalias once a day in rural. Mass respondents from both rural areas had menstrual disorders. Respondents from rural who disposed of sanitary pads in open spaces χ2 =9.253, p =0.010; drying menstrual cloth in the shed inside χ2 =9.416, p =0.02 were associated with menstrual disorders. Differences in menstrual hygiene practices and menstrual disorders would be monitored to identify the source of disparity in ensuring menstrual hygiene practices for school and college girls; thus, rural girls could be treated likewise for their healthy reproductive lives.

Weather forecasting, given the ever-increasing occurrence of climate change induced events, has been widely introduced as a method to offer accurate and timely forecasts for proactive measures and risk mitigation. Artificial intelli gence of things (AIoT) offers promising solutions for short-term weather fore casting, contributing to the advancement of sustainable and efficient weather monitoring technologies. This work presents everWeather 2.0, a significantly enhanced low-cost and self-powered AIoT-based weather forecasting station, which addresses key challenges in power consumption, user engagement and forecasting accuracy. The proposed end-to-end Cloud-Edge-IoT (CEI) solu tion improves upon its predecessor by combining a more robust renewable energy subsystem for complete power autonomy with a series of lightweight, adaptive statistical models for on-device forecasting and an integrated display for on-site user engagement. Deployed in a real-world scenario, the station demonstrated seamless operation and high short-term forecasting accuracy, with model errors ranging from approximately 2% for 30-minute forecasts to 4% for 120-minute forecasts, validating its applicability in real-time and continuous physical weather monitoring.

A 14-year-old gelding in the Southeastern region of Australia was diagnosed with Mycobacterium ulcerans infection, initially presenting as a non-healing wound of the right flank progressing to extensive necrotic ulceration. Ziehl-Neelsen and Wade-Fite stained incisional biopsies revealed large numbers of intralesional acid-fast bacterial rods predominately within the areas of necrosis, supportive of Mycobacterium ulcerans infection. Real-time polymerase chain reaction (PCR) confirmed the presence of mycobacteria. The close relationship between M. ulcerans and M. marinum meant that PCR was unable to distinguish these species. Due to the equine host and non-aquatic environment there was a presumptive diagnosis of M. ulcerans. Multimodal treatment involved surgical debridement, biological debridement with maggots, cryotherapy, systemic antimicrobials and analgesia. The horse had made a full recovery at the time of publication. Infection with M. ulcerans needs to be considered in necrotizing soft-tissue lesions in regions where the organism is endemic, but it also needs further investigation due to the zoonotic nature of M. ulcerans with potential public health concerns.

Voltage Source Converters (VSCs) operating as active rectifiers inherently lack currentlimiting capabilities for faults occurring on the DC side due to the presence of freewheeling diodes in IGBT or MOSFET structures. This limitation leads to uncontrolled fault currents, flowing from the AC to the DC network, that can jeopardize the safety of power electronic components. Additionally, the challenge is compounded in DC networks, where DC circuit breakers must interrupt high fault currents, fed by the AC side, without the benefit of current zero crossings. To address these issues, this paper presents a novel topology that integrates a classical buck DC/DC converter into a VSC to regulate the currents of faults occurring in DC network, thereby improving the protection of the converter and aiding DC circuit breakers in interrupting the fault. The advantage of the proposed topology lies in that under normal operating conditions, the buck converter is totally bypassed, thus improving the efficiency of the topology. When a fault is detected within the DC microgrid, the buck converter is connected in series with the VSC to control the current flowing from the AC to DC network. Simulation results using MATLAB/Simulink validate the effectiveness of the proposed topology in completely controlling the current at the DC side of converter, thus demonstrating significant improvements in fault management, system reliability, and converter protection.

A document by Qiaoyun Zuo. Click on the document to view its contents.

The SARS-CoV-2 pandemic focused attention on the importance of ventilation to limit acute respiratory infection (ARI) transmission. However, because few epidemiologic studies demonstrate a causal effect of building ventilation on ARI transmission investment in solutions remains at risk. We report results of a two-year ARI study of college students living in campus residence halls with a trend toward 54% lower ARI risk with higher ventilation. Our analysis suggests that the most powerful causal analysis can be derived from focusing on roommate pairs. Future studies should prioritize enrolling roommates rather than individuals and confirm transmission events through whole genome sequencing.

This review examines the concurrent infection of Tuberculosis (TB) and Hepatitis B Virus (HBV), with a specific focus on the intricate connections between these pathogens and their effects on public health. The co-infection of TB and HBV poses considerable difficulties in diagnosis and treatment due to the combined immunopathogenic effects of the two diseases and the limitations of existing therapies. Here, we examined the etiology, immunological response, and clinical symptoms of tuberculosis (TB) and hepatitis B virus (HBV) infections, both separately and when they occur together. We emphasized the need for innovative diagnostic biomarkers and sophisticated therapy approaches, such as antibacterial and antiviral medications as well as therapeutic vaccinations, to enhance patient outcomes. We also pointed out that research efforts focusing on personalized medicine strategies and the advancement of novel therapies that specifically target the distinct characteristics of TB and HBV co-infection are imperative. Finally, this review offered a comprehensive impact of dual infection on public health, proposed potential directions for future study and enhancements in clinical management.

Background and Purpose: Kawasaki disease (KD) is an acute, self-limiting vasculitis with an elusive etiology and can cause vascular endothelial injury. Exosomes derived from induced pluripotent stem cells (iPS-EXO) can exhibit anti-inflammatory, anti-oxidation, and anti-apoptosis properties. The objective of study is to explore the therapeutic effects of iPS-EXO on KD, and try to illuminate the underlying mechanisms. Experimental Approach: Mouse KD model with coronary arteritis induced by Candida albicans wall water-soluble fraction (CAWS) and human umbilical vein endothelial cell (HUVEC) injury KD model induced by tumor necrosis factor-alpha (TNF-α) were established to assess the anti-inflammatory and anti-apoptotic effects of iPS-EXO on KD. Key Results: In vivo experiments revealed that iPS-EXO could significantly inhibit the CD45-positive leukocyte infiltration, mitigate tissue fibrosis, down-regulate the expressions of inflammatory cytokines and chemokines, and reduce vascular endothelial cell apoptosis around coronary arteries of KD mice. In vitro results showed that iPS-EXO could also effectively inhibit TNF-α induced HUVEC inflammation and apoptosis by down-regulating inflammatory cytokines and chemokines, reducing TUNEL positive and flow cytometry apoptotic cells, and decreasing BAX/BCL-2 levels. However, these effects could be reversed by the AMPK inhibitor compound C (CC) and hsa-miR-1976-KO iPS-EXO. Conclusions and Implications: The further mechanism study based on bioinformatics analysis and western blotting indicated that iPS-EXO may exert anti-inflammatory and anti-apoptosis effects on KD through endogenous hsa-miR-1976 binding to CD40 to activate the AMPK/mTOR/NF-κB pathway, suggesting that iPS-EXO may be a promising therapeutic candidate for KD. KEYWORDS: Kawasaki disease (KD), Exosomes derived from induced pluripotent stem cells (iPS-EXO), Endothelial cells, Apoptosis, Inflammation

Addition of multi-level technologies to evaluate eggs and embryos and improve endometrial quality applied for in vitrofertilization to achieve pregnancy: a case studyTania G. Rojas-Pérez1*, Yúvika Reyes-Albarracín2*, Ortiz Ginna1, Juan José Suárez1, Vilchis Reyes Diego1, Cordero Oropeza Jacqueline1, Dinorah Hernández-Melchor1,2 and López-Bayghen Esther3**

Background: Despite being a vaccine preventable disease, influenza remains a burden in African countries. In Mauritius, influenza virus activity is year-round but evidence-based data to guide vaccination and pandemic preparedness strategies are lacking. This study aimed to describe the genetic diversity of influenza A viruses detected in Mauritius between 2017-2019. Methods: Influenza A/H1N1pdm09 and A/H3N2 virus isolates were sequenced using Oxford Nanopore technology. Sequence reads assembled by CZ ID and Genome Detective web-based tools were uploaded to the EpiFlu database of the Global Initiative on Sharing All Influenza Data (GISAID). Sequence alignments and phylogenetic analysis were performed using Nextclade and MEGA X software. BioEdit software was used to view amino acid alignments and substitutions compared to annual vaccine strains. Prediction of potential N-linked glycosylation (PNG) sites was determined by NetNGlyc 1.0. Results: Influenza A was predominant (92.6%), with A/H1N1pdm09 prevailing overall (62.5%) but A/H3N2 dominating in 2017 (55.9%). Phylogenetic analysis identified clade 6B dominance for A/H1N1pdm09, with notable substitutions E119K, Q136K and D151E linked to antigenic changes. A/H3N2 exhibited significant genetic diversity, with co-circulation of 3C.2a4 and 3C.2a1 in 2017 while 2018 predominant subclade 3C.2a1b.1 highlights continued antigenic drift. Loss of PNG sites at position 158 (11/21; 52.4%) in HA and position 329 (81.0%, 17/21) in NA of A/H3N2 viruses were observed. Conclusions: Continued evolution of A/H1N1pdm09 and A/H3N2 viruses in Mauritius highlights the need for sustained genomic surveillance to inform vaccine and antiviral strategies. Data from Mauritius will contribute to understanding of influenza viruses’ ecology in the African region and globally.

Pelagic-feeding seabirds deliver nutrient subsidies that enhance the productivity, biodiversity, and resilience of terrestrial and marine ecosystems, particularly in nutrient-poor tropical environments. However, the biogeophysical variables governing the fluxes of these nutrients within and among interconnected ecosystems remain poorly understood. To address this, we examined the spatial distribution of seabird-vectored nutrients in the seascape of Tetiaroa, a semi-enclosed coral atoll in French Polynesia, where seabird populations and associated nutrient cycles are recovering after recent rat eradication. We focus on the nitrogen isotope (δ15N) signatures of a dominant marine alga as evidence of seabird-vectored nutrient uptake. Integrating stable isotope analysis within a seascape ecology framework, we show that breeding seabird biomass, depth, distance to land, geographic location within the atoll, and seafloor curvature drive spatial patterns of nutrient enrichment. Specifically, our models account for up to 88% of the variation in algal δ15N signatures and reveal peak enrichment in shallow, nearshore areas where water flow slows and converges due to localised seafloor curvature. These results extend previous research by highlighting seafloor geomorphology, notably curvature, as a modulator of fine-scale nutrient delivery patterns. Although a complex model incorporating 11 high-resolution biogeophysical variables enhanced spatial predictions by revealing fine-scale variations, a simpler model using only 5 of these variables was comparably effective in capturing overall spatial trends. This study identifies the key seascape configuration and complexity characteristics likely to affect the spatial patterns of recovery potential following the restoration of seabird-driven nutrient cycles, offering valuable guidance for ongoing restoration efforts in this coupled island-reef system. Future investigations could assess how the effects of biogeophysical variables on nutrient delivery vary in magnitude and direction across different geographic, geological, and anthropogenic contexts.

The genetics of phenotypic plasticity in the adaptation of freshwater colonization in anadromous fish can provide important insights into the generating of teleosts diversity and invasion niche. Here, we conducted a comparative population genomic analysis of two lineages of tapertail anchovy (Coilia nasus), the anadromous and the lake-resident populations, which complete their lifecycle independently in freshwater lakes. We tracked C. nasus during their migratory period and compared genome-wide genotyping of the freshwater population with physiological traits that colonization contributes to osmotic adaptation. Through genome scans between anadromous and freshwater populations identified osmoregulation and immunoregulatory pathways evolving by strong natural selection, whereas association mapping revealed loci that contribute to freshwater adaptation. Our findings suggest that patterns of divergence in physiological capabilities are consistent with parallel adaptation to local niches. Notably, a lot of cortisol-regulated genes (e.g., ATP1α1) appeared to mutate and dynamics expression in different forms, which enriched in the ion channels, implying that the reproductive phenomenon of osmoregulation in anadromous is critical for the adaptive divergence of freshwater environments. Taken together, these results enhance our understanding of the genetic architecture variation of teleosts adaptation to novel environments, enabling cross osmotic boundaries, which leads to population divergence and freshwater colonization.

IntroductionPeripheral nervous system tumors, classified by the World Health Organization in 2020 as mesenchymal tumors, are benign in 95% of cases and include schwannomas and neurofibromas [1]. Plexiform schwannomas (PS), representing fewer than 5% of cases, display multifascicular intraneural and multinodular growth along a single nerve fascicle. These tumors typically appear in superficial cutaneous or subcutaneous nerves but can occasionally affect major nerves [2]. While benign, PS often recur locally and rarely transform into malignant peripheral nerve sheath tumors (MPNST). Plexiform neurofibromas, another rare variant, affect major nerves with a ”bag of worms” appearance and may cause deformities, with a 5% risk of malignant transformation [3]. Unlike plexiform neurofibromas, PS are linked to genetic syndromes like neurofibromatosis (NF) or schwannomatosis in only 5% of cases [2].

Background: Selective immunoglobulin E deficiency (sIgED) is a rare immunological condition characterized by low serum IgE levels while maintaining normal levels of other immunoglobulin classes. Despite its underrecognized nature, sIgED has been implicated in immune dysregulation, potentially predisposing individuals to autoimmune and autoinflammatory diseases. Objective: This study aims to investigate the association between sIgED and immune-mediated diseases, exploring its prevalence, clinical implications, and underlying mechanisms. Methods: A retrospective cohort study was conducted over five years at a tertiary university hospital. Among 3,692 patients, individuals with serum IgE ≤ 2.5 kU/L were classified as having sIgED. Autoimmune and autoinflammatory conditions were analyzed in relation to IgE levels. Statistical analyses were performed using SPSS version 22.0. Results: Autoimmune and autoinflammatory diseases were significantly more prevalent in the sIgED group than in controls (25.2% vs. 15.6%, p < 0.001). Specific associations were observed with Hashimoto’s thyroiditis, familial Mediterranean fever, and Behçet’s disease. Mechanistically, sIgED appears to impair mucosal immune barriers and immune regulation, potentially contributing to disease pathogenesis. Conclusion: sIgED is associated with a higher prevalence of autoimmune and autoinflammatory diseases, emphasizing its potential role as a biomarker for immune dysregulation. These findings highlight the need for routine IgE level assessment in patients with suspected immune-mediated conditions and call for further research to elucidate underlying mechanisms.

Background: Patients with vascular anomalies (VAs) experience poor communication and have unmet information needs. Online patient portals could mitigate communication barriers and support communication interventions. However, these portals are often underutilized. Procedure: We retrospectively queried audit-log data from the Electronic Health Record (EHR) of a single large academic healthcare center for all patients seen by clinicians from a multidisciplinary specialist clinic with a diagnosed VA from 1/2020 to 1/2024. We connected audit-log data with patient demographics to examine how patients used the portal, and whether use varied by patient characteristics. Results: We queried portal usage for 315 patients with vascular anomalies, of whom 43% were children, 19% were adolescents, and 38% were adults. Approximately half of patients’ portals were logged into during the study period (51%, n=162). Of users who ever logged into the portal, the median number of logins per year were 35 (interquartile range 15 to 95). Multiple regression results show that portal access was higher for patients who are White, reside in a metropolitan area, and have lower Area Deprivation Index. Of users who ever logged into the portal, 77% viewed clinician notes, 90% viewed test results, and 71% engaged in messaging with a clinician at least once. Conclusion: Half of patients and caregivers never use the portal, and patients from less urban areas with higher deprivation are even less likely to use the portal. As portals become more integrated into patient care, these inequities in portal access could lead to inequities in health outcomes.

Mixing and sharing of genes is essential for population diversity, which contributes to the resilience and, ultimately, the survival of animal and plant communities. However, sharing of genes is antithetical to individual fitness; hence gene mixing is threatened with extinction if selection rewards selfish (clonal) reproduction. To address this dilemma, mechanisms have evolved to enforce a mandate for gene sharing. In most metazoa, the functions of sex and reproduction are tightly entwined, presumably for the purpose of compelling the sharing of genes. In protists, the functions of sex (conjugation) and reproduction (amitosis) are separate. The mandate for gene sharing is enforced, instead, by a form of cellular senescence. Ciliates can reproduce clonally a few hundred times before they senesce and die. Conjugation resets their biological clock, restarting the cycle of clonal reproduction. The question how reproduction in metazoa came to be linked to sex has been explored in the past, but a fully satisfying account in terms of evolutionary ecology is lacking. The question how senescence in protozoa came to be linked to sex has not been addressed, and is the topic of the current study. I present herein two numerical simulations (IBMs) for the evolution of cellular senescence in ciliates. The results shed light not only on the evolution of senescence in higher life forms, but on more general questions concerning the plausibility of group selection.

The distribution of ‘cold-adapted’ plant species is expected to undergo severe range loss in the next future. Species distribution models predicting species’ future distribution often do not integrate species ability to respond to environmental factors through genetic traits or phenotypic plasticity. This especially applies to arctic-alpine species whose present-day range is strongly fragmented because of the cyclic vicissitudes they experienced during the Ice Age. We cultivated plants from four European populations of the arctic-alpine species Viscaria alpina from different geographic provenances. Two of the populations were from northern high-latitude regions in Scandinavia; the remainder two populations were from southern mid-latitude mountains. In both areas one population was from a colder site and the other from a warmer site. We cultivated the plants in controlled thermal conditions with two treatments, the one mimicking temperature conditions at the warmest site and the other adding two day-temperature peaks mimicking short-term heat waves. At the end of the experiment, we measured growth in length and mortality of all plants along with a set of ecophysiological variables. We also assessed genetic variation in the four populations based on plastid-DNA sequences. The plants from northern provenances grew more than those from the southern provenances. The plants of all populations performed overall well, in terms of growth rate and ecophysiology, under the heat spell with the plants of the Swedish population exhibiting the highest phenotypic plasticity. Such pattern was associated with highest genetic variation in the Swedish population. Mortality of the plants cultivated under warm temperatures was overall low, but mortality strongly increased in the plants exposed to the heat spell. We conclude that plants of V. alpina populations from different geographic provenances are generally able to cope with scenarios resulting from global warming but drought hampers resilience to heat waves through increased mortality.

INTRODUCTIONOne of the most frequent cause of spontaneous hemoperitoneum in women of reproductive age is ruptured corpus luteal cyst. The clinical presentation varies, ranging from complete absence of symptoms to excruciating pain in the abdomen as a result of peritoneal irritation.1While woman’s corpus luteum can rupture at any point during her reproductive years, younger women between the ages of 16 and 30 are more likely to experience it.2Depending on the symptoms and laboratory results, care of a ruptured corpus luteum may involve solely on observation or may require an immediate laparotomy or laparoscopy.3We present a case of ruptured corpus luteal cyst masquerading as torsion of ovarian or dermoid cyst and overseen by exploratory laparotomy.

Flexible piezo-driven pressure sensors are crucial for advancing healthcare, especially in muscle activity monitoring and detection. We present graphene oxide (GO) composite hydrogel-based sensors offering high sensitivity, flexibility, and biocompatibility. The piezoelectric GO hydrogel sensor delivers a sensitivity of 0.293 kPa⁻¹ within a 12.5 kPa range, a detection limit of 12.5–150 kPa, and a peak output of 1.0 V under forces of 10–60 N, enabling precise, non-invasive biomechanical monitoring for diagnostics and rehabilitation. Complementing this, the piezoresistive GO hydrogel sensor provides a sensitivity of 0.038 kPa⁻¹ at a 7.5 kPa range, a detection limit of 2.5–35 kPa, and a maximum resistance of 0.9 MΩ under forces of 2–14 N, making it ideal for applications requiring broad pressure detection and consistent performance across variable forces.

Versatile Video Coding (VVC) introduces advanced techniques such as sophisticated intraprediction mechanisms that significantly improve compression efficiency. However, the increased complexity in intraprediction presents new challenges in computational load and power consumption, essential considerations for efficient video coding. This paper proposes a novel framework that combines discrete wavelet transforms (DWT) and histogram analysis to optimise the prediction directions in VVC. Through selective reduction of prediction directions based on dominant texture orientation and minimising residual energy, the framework achieves enhanced computational efficiency while maintaining video quality. Experimental results confirm its effectiveness, showing minimum rate distortion performance and superior encoding efficiency compared to other methods in the literature.

This systematic review analyzes the roles of emotional intelligence (EI) and conflict management (CM) in promoting job satisfaction and collaboration within corporate contexts. The analysis indicates that strong EI helps individuals to identify, control, and express emotions effectively, supporting enhanced interpersonal interactions and resilience against workplace stress. Consequently, those with increased EI are proven to feel greater work satisfaction. Furthermore, effective conflict management approaches, backed by EI, promote constructive responses to interpersonal differences, thereby boosting team cohesiveness and performance. The study draws upon varied research undertaken across many sectors, including healthcare and organizational management, to highlight the universal relevance of EI and CM in establishing a healthy work environment. Key findings imply that firms supporting EI development through training and leadership efforts can promote more harmonious workplaces, resulting in better employee engagement and satisfaction. Additionally, the connection between EI and CM underlines their combined impact on organizational performance, as emotionally intelligent leaders may successfully handle disputes, transforming problems into opportunities for progress. This paper underlines the requirement for firms to integrate EI and CM concepts into their culture, therefore boosting resilience, cooperation, and general employee well-being. The consequences of this research are crucial for organizational leaders striving to promote team relations and provide a supportive work culture conducive to high performance.