Objective: To evaluate the efficacy and safety of a midazolam oral solution used in combination with dexmedetomidine nasal drops in procedural sedation for paediatric pulmonary function testing. Methods: A randomized, double-blind, controlled clinical trial was conducted to assign paediatric patients (aged 6 months to 6 years) undergoing pulmonary function testing under procedural sedation to two groups: one group (M-D group) received 0.25 mg/kg midazolam via oral solution plus 0.2 μg/kg dexmedetomidine nasal drops (n=60), and the other group (C-D group) received 30 mg/kg chloral hydrate via oral solution plus 0.2 μg/kg dexmedetomidine nasal drops (n=60). The modified Ramsay sedation scale was used to assess the depth of sedation. The primary outcomes included the first-time sedation success rate, onset time, sedation duration, recovery time, and incidence of adverse events such as bradycardia, respiratory depression, nausea, vomiting, and medication acceptance. Results: There was no significant difference in the baseline characteristics between the two groups. The first-time sedation success rates did not significantly differ between the M-D and C-D groups (93.3% vs. 96.7%, P=0.679). The onset time of the M-D group was longer than that of the C-D group (25.97 min vs. 19.43 min, P=0.000). There were no significant differences in sedation duration (35.95 min vs. 39.93 min, P=0.129) or recovery time (18.34 min vs. 22.51 min, P=0.122) between the two groups. Moreover, the incidence of adverse events did not significantly differ (11.7% vs. 20.0%, P=0.21). All the children completed the test on the same day. Medication acceptance was significantly greater in the M-D group than in the C-D group (P=0.00). Conclusion: The combination of midazolam oral solution and dexmedetomidine nasal drops is an effective and safe sedation regimen for paediatric pulmonary function testing that improves medication acceptance and parental satisfaction. This study provides robust support for the smooth performance of paediatric pulmonary function testing and merits clinical promotion and application.

Background: Previous studies have suggested an association between chronotype and social functioning, yet the precise mechanism remains underexplored. This study endeavors to address this gap by examining both the distinct mediating roles of sleep quality and anxiety, as well as their combined chain mediating role, in the relationship between chronotype and social functioning among individuals with schizophrenia. Methods: 785 Chinese schizophrenic patients aged 18-60 years were selected to complete the Morningness–Eveningness Questionnaire (MEQ), General Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Interview (PSQI), and Personal Social Performance Scale (PSP) to evaluate chronotype, sleep quality, anxiety, and social functioning, respectively. The relationship between these variables was tested using Hayes’ SPSS process macros. Results: Significant correlations (p < 0.01) were found among chronotype, sleep quality, anxiety, and social functioning in schizophrenic patients. Chronotype exhibited both a direct positive effect on social functioning (effect = 0.8931) and indirect effects through two pathways: firstly, independently mediated by anxiety (effect = 0.2167; SE = 0.0786; 95% CI: LL = 0.0849, UL = 0.3864); and secondly, through a sequential mediation involving both sleep quality and anxiety (effect = 0.0454; SE = 0.0167; 95% CI: LL = 0.0168, UL = 0.0825).Conclusions: Our study offers empirical evidence of the association between chronotype and social functioning in schizophrenia. Findings indicate that this relationship is mediated by both sleep quality and anxiety. These results contribute a novel perspective to the enhancement of social functioning recovery in schizophrenia.

Objective: This article evaluates the reliability and validity of the Grandiose and Vulnerable Narcissism Fluctuation Scale (GVNFS) and its short form (GVNFS-SF), which are Turkish adaptations of the FLUX and g-FLUX scales. These scales measure the oscillation between vulnerable and grandiose dimensions of narcissism. Methods: Two studies were conducted with participants aged 18 to 65. Study 1 involved 307 participants, and Study 2 involved 378 participants. Convergent validity was assessed using various psychological scales. Internal consistency was measured, and confirmatory factor analysis (CFA) was used to evaluate the fit indices. Results: Study 1 found that the GVNFS had satisfactory internal consistency, but CFA revealed inadequate fit indices. Study 2 demonstrated that the GVNFS-SF had strong validity and reliability, indicating that the short form is suitable for measuring the fluctuation between grandiose and vulnerable narcissism. Conclusion: The GVNFS-SF is a valid and reliable tool for assessing the oscillation between grandiose and vulnerable narcissism in the Turkish context. However, the full GVNFS may need further refinement to enhance its psychometric properties.

In the context of the legacy of deficit-focused research and application of theoretical models in research on minoritized groups that are underrepresented in the literature, we explored the strengths-based literature among LGBTQ+ people of color to develop a more inclusive and relevant understanding of how PTG occurs in this population. The intersectional posttraumatic growth (PTG) Model is tailored to the experiences of LGBTQ+ people of color that builds upon previous models of PTG, intersectionality theory, and empirical findings of trauma and PTG among LGBTQ+ people of color. Our intersectional PTG model incorporates the unique intrapersonal, interpersonal, institutional, and cultural factors that are unique to this population and contribute to PTG. We challenge the limited scope of Criterion A traumatic events and emphasize empirical findings that support that LGBTQ+ people of color often experience posttraumatic stress after oppression and discrimination. Our model also recognizes the impact of intersecting risk factors, such as gendered racism, that may occur on various levels. Our model acknowledges that LGBTQ+ people of color have often demonstrated PTG in the face of adversity. Intrapersonal factors such as cognitive flexibility, interpersonal factors such as social support, and institutional and cultural factors such as identity-related activism are identified as key contributors to resilience. We discuss practice implications, highlighting that clinicians should recognize limitations of traditional trauma frameworks and adopt culturally sensitive approaches when working with LGBTQ+ people of color. Overall, our model provides a foundation for strengths-based interventions and research, emphasizing resiliency and potential for PTG in this population.

Respiratory syncytial virus (RSV) is one of the leading causes of severe respiratory diseases in children, especially in infants. The immune responses induced by RSV infection are a fairly complex process that can contribute significantly to disease severity. Despite decades of research on RSV, many immune mechanisms remain to be explored. A full exploration of these immune response can contribute to the discovery of new therapeutic and prophylactic approaches. Despite substantial progress in vaccine development and the development of monoclonal antibodies over the years, there are still not enough effective preventive and therapeutic strategies. This review focuses on how the immune system reacts when children contract the respiratory syncytial virus. We described the biological characteristics of RSV, the pathological process of RSV infection, innate immunity（including Pattern Recognition Receptors and inflammatory cells）, adaptive immunity (including CD4+ and CD8+ T cells and Humoral Immune Response), and immune evasion. Understanding the complicated immune response to RSV infection is essential for developing effective interventions and vaccine developments. This review will enable an appreciation of how RSV affects the immune system and enhance the advancement of pragmatic therapeutic methodologies.

In this paper, we propose a new parametric family of iterative schemes to compute the inverse of a complex nonsingular matrix. It is shown that the members of this family have at least a fourth-order of convergence. A particular element of the class is extended to approximate the Moore-Penrose inverse of rectangular complex matrices, keeping the convergence order. A dynamic analysis is performed to obtain a parameter domain in which stability is assured and to detect which members of the proposed family have good stability properties and which have chaotic behavior. Some numerical examples, with matrices of different sizes, are tested to confirm the theoretical and dynamical results.

This article proposes an implicit-explicit (IMEX) high-order numerical method for pricing European and American options under Merton’s jump diffusion model. We incorporate the convex combination parameter c∈[0,1] of the zero order term into the IMEX third-order and fourth-order semiimplicit backward differentiation formula (SBDF) to improve the stability and efficiency of the solution. In order to comprehensively understand the stability of IMEX methods in time discretization, we use Fourier method for analysis and draw a stability domain graph based on it. To further improve the accuracy of numerical solutions in spatial discretization, a fourth-order compact finite difference scheme is designed. For the linear complementarity problem (LCP) of the American options, we ingeniously combined IMEX high-order methods and operator splitting methods. Several numerical experiments are provided to investigate the accuracy and convergence order of IMEX high-order methods for pricing European and American options in both time and spatial. The experimental results have verified the effectiveness and advantages of the proposed numerical schemes.

In this manuscript new oscillation criteria are given for solutions of h-order delay difference equation in the form ∆ E n + p n E n − α = 0 . Here, four cases of p are considered; for α∈N , as oscillatory periodic sequences with periods 2 α,(2 α+1) and ( α+1) , and a quickly oscillating sequence such that p n p n + 1 < 0 . It is well known that coefficient functions has a very important role in the behavior of the solutions of an equation. The coefficients sequence p has been considered as positive sequences in all oscillation criteria so far. But It is considered as a oscillatory periodic sequences and quickly oscillatory sequences for the first time in this study. We use a new technique to prove our results. Also some examples are provided to demonstrate the effectiveness of the main results.

A document by Shaurya Mahajan. Click on the document to view its contents.

Eicosapentaenoic acid (EPA), an essential omega-3 polyunsaturated fatty acid (PUFA), cannot be produced by the human body. It finds applications in various fields, including health foods, pharmaceuticals, and animal feed. Schizochytrium sp., an oleaginous microorganism rich in PUFAs, holds promise for EPA production. However, its complex metabolic network limits its full potential. To address this challenge, we constructed a detailed enzyme-constrained model of Schizochytrium’s metabolism. This model incorporated 1083 genes, 5236 reactions, and 2989 metabolites. We then used this model to simulate fermentation conditions and validated our predictions through experiments. Our research results indicate that the optimal nitrogen source absorption rate is 0.7692 mmol/gDW/h, and the optimal oxygen absorption rate is 3.41 mmol/gDW/h. When both absorption rates are higher or lower than the optimal values, they will hinder EPA production. By adjusting the nitrogen source concentration and oxygen absorption rate, the highest yield of EPA reached 1.09 g/L in the 5 L fermentor, representing an 89% increase compared to the EPA yield of the original strain. By analyzing protein requirements, we identified 20 potential targets predicted to enhance EPA production. This study provides new ideas for the optimization of medium composition and strain modification for the industrial production of EPA using Schizochytrium.

The preservation of soil health is critical for sustainable agriculture, particularly in the face of global challenges such as soil degradation, climate change and population growth. This study investigates the temporal release patterns of nitrogen and selected soil health indicators –organic carbon (OC), pH, cation exchange capacity (CEC), bulk density (ρ b) and aggregate stability – under various organic amendments – compost (CMP), biochar (BCH), co-composted biochar (C-BCH), and compost + biochar (CMP + BCH). The amendments were applied at a rate of 15 t ha -1 to Alfisols, common in Samaru, Zaria, Nigeria, and their effects on soil health were monitored at four-week intervals for 12 weeks. Sole application of NPK and control were also used for comparison. All treatments were replicated 9 times in a completely randomized design. The result demonstrated that N release in CMP was highest in week 4, and declined over subsequent weeks due to N uptake and fixation. Treatments containing BCH showed a steadily increasing N release over the study period. Overall, the treatments improved soil pH, OC and ρ b by 20.3 – 23.4%, 17.5 – 34.2%, and 2.8 – 10.4% respectively. Aggregate stability and CEC were also significantly improved. CMP + BCH had the highest effect on soil health ( Hs = 0.60), improving its status from poor to good. The contribution of readily available OC in CMP and stability of BCH paired to improve soil fertility and physical condition across the treatments. Further studies recommendation suggests field validation, as well as exploring potential contributions of the various amendments to carbon sequestration.

Objective: The potential risk of inducing ventricular arrhythmias was explored by employing Pulsed Field Ablation (PFA) through the administration of both monophasic and biphasic waveform deliveries. Methods: Pulsed Field Ablation (PFA) was applied to specific locations in the right ventricle (RV, n=5 sites) in swine (n=2), utilizing identical settings with consistent amplitude, pulse width, and number of pulses for both monophasic and biphasic waveforms. PFA deliveries were precisely timed in 10-milisecond intervals across the entire T wave. Results: Using monophasic waveforms, ventricular fibrillation (VF) was induced 7/7 times when PFA pulses were delivered during the T wave. Biphasic waveforms resulted in no ventricular arrhythmias when PFA was delivered across the entire duration of T wave. Conclusions: Our findings indicate that VF can be consistently induced with monophasic pulse waves, but not with biphasic pulse waves in a porcine model.

This scoping review evaluates recent pharmacokinetic models of vancomycin, a critical antibiotic for gram-positive infections. Due to its narrow therapeutic index and significant inter-patient variability, dosing should be guided by blood concentration monitoring rather than standard regimens. A search in PUBMED and EMBASE (January 2020 - July 2023) identified 22 models in adults, 12 of which focused on critical care units. The diverse patient populations included those on continuous renal replacement therapy, pregnant women, and patients with augmented renal clearance. Creatinine clearance was a significant covariate in 80% of models. Larger cohorts are needed to enhance model robustness and applicability.

The ever-increasing renewable sources and advances in electric vehicle (EV) technology have persuaded many researchers to conduct various studies on power system design and operation in the areas of renewable energy and EV industries. Furthermore, pollution and environmental concerns have drawn the attention of the world community to the use of EV and wind renewable sources. In the present study, the optimal location and sizing of EV charging stations are determined in the distribution network and urban transportation network in the presence of wind resources with stochastic generation. By simultaneously considering the distribution and transportation networks, a bi-objective optimization problem is formulated. The EV trip success rate on daily basis is considered as an objective function of the problem and network costs as another objective function. The constraints of the urban network include traffic volume, path length, land price, and transportation network limitations, while distribution network constraints include losses, voltage/current constraints, and maximum loading capacity. The simulation results of the sample distribution and transportation networks based on the bi-objective genetic algorithm and MATLAB software confirm the correctness of the proposed method.

Climate change, inter-annual precipitation variability, recurrent droughts, and flash flooding, coupled with increasing water needs, are shaping the co-evolution of socioeconomic and cultural assemblages, water laws and regulations, and equitable drinking water access and allocation worldwide. Recognizing the need for mitigation strategies for drinking water availability in urban areas, the Isotope Hydrology Section of the International Atomic Energy Agency (IAEA) coordinated a state-of-the-art global assessment to evaluate water sources and distribution of drinking water supply in urban centers, an initiative entitled “Use of Isotope Techniques for the Evaluation of Water Sources for Domestic Supply in Urban Areas (2018-2023)”. Here, we report on a) current research trends for studying urban drinking water systems during the last two decades and b) the development, testing, and integration of new methodologies, aiming for a better assessment, mapping, and management of water resources used for drinking water supply in urban settings. Selected examples of water isotope applications (Canada, USA, Costa Rica, Ecuador, Morocco, Botswana, Romania, Slovenia, India, and Nepal) provide context to the insights and recommendations reported and highlight the versatility of water isotopes to underpin seasonal and temporal variations across various environmental and climate scenarios. The study revealed that urban areas depend on a large spectrum of water recharge across mountain ranges, extensive local groundwater extraction, and water transfer from nearby or distant river basins. The latter is reflected in the spatial isotope snapshot variability. High-resolution monitoring (hourly and sub-hourly) isotope sampling revealed large diurnal variations in the wet tropics (Costa Rica) (up to 1.5‰ in δ 18O) and more uniform diurnal variations in urban centers fed by groundwater sources (0.08 ‰ in δ 18O) ([Ljubljana](https://www.google.com/search?client=firefox-b-1-d&sca_esv=f5a20a2e9138d638&sca_upv=1&sxsrf=ADLYWIKR6-DvBtjaWqFYRhn6VgnegOa8kg:1717189104058&q=Ljubljana&stick=H4sIAAAAAAAAAONgVuLQz9U3SMrNNXnEaMwt8PLHPWEprUlrTl5jVOHiCs7IL3fNK8ksqRQS42KDsnikuLjgmngWsXL6ZJUm5WQl5iUCAAFa64FOAAAA&sa=X&ved=2ahUKEwjMrrz047iGAxWyG9AFHSVwCBgQzIcDKAB6BAgTEAE), Slovenia). Similarly, while d-excess was fairly close to the global mean value (+10 ‰) across all urban centers (10-15‰), reservoir-based drinking water systems show significantly lower values (up to ~ -20 ‰) (Arlington, TX, USA and Gaborone, Botswana), as a result of strong evapoconcentration processes. δ 18O time series and depth-integrated sampling highlighted the influence of the catchment damping ratio in the ultimate intake water composition. By introducing new, traceable spatial and temporal tools that span from the water source to the end-user and are linked to the engineered and socio-economic structure of the water distribution system, governmental, regional, or community-based water operators and practitioners could enhance drinking water treatment strategies (including more accurate surface water blending estimations) and improve urban water management and conservation plans in the light of global warming.

Background: Self-Help Internet Cognitive Behavioural Therapy (iCBT) interventions are highly efficacious and overcome numerous barriers adolescents experience when accessing face-to-face interventions, including stigma, privacy, lengthy wait lists and cost. Despite this, adolescents struggle to engage in Self-Help iCBT, which is problematic given that there is a relationship between higher engagement and better treatment outcomes. The reasons for poor engagement among adolescents are unclear. Using the iCBT program, BRAVE Self-Help as an example, this study explored 1) the barriers to engagement directly from the adolescent’s perspective and, 2) their viewpoints on enhancing engagement in iCBT. Method: Semi-structured interviews were conducted with 14 adolescents aged 12-17 years ( M = 14.36, SD = 2.12) who had participated in BRAVE Self-Help in the previous 12 months. Reflexive thematic analysis was utilised to analyse data. Results: Stigma, program factors (program design, content and length) and environmental factors (competing priorities and distractions), were identified as adolescent barriers to engagement. With respect to strategies to enhance engagement, adolescents identified 1) specific program factors (positive reinforcement and personalisation), and 2) support factors (reminders and optional support). Conclusions: Co-design methods with adolescents at both the design and implementation stages of iCBT programs is imperative for engagement.

In Signal Processing a Filter is a device or process that removes or suppresses some unwanted components or features from a signal. Most often this means removing some frequencies or frequency bands; however, many other targets for filtering exist. The objective of this paper is to connect some filters using developed mathematical concepts, which provides a good picturization of filters in Signal Processing and consequently facilitates the determination of the output of the filter for a given input. We also discuss some special cases of filtering and try to picturize those filters. We also try to extend this idea of filtering to directed graphs.

Introduction: Obsessive-compulsive disorder (OCD) affects 1.1–1.8% of the population, and adult females are more likely to suffer from it. Deep transcranial magnetic stimulation (dTMS) targets the hyperactivity of the dorsomedial prefrontal cortex and anterior cingulate cortex – two frontal brain networks implicated in OCD. This study aims to identify a biological marker for beta rhythm that correlates with the treatment response works following dTMS. Methods: A total of 56 right-handed treatment-resistant OCD patients (35 female and 21 male) were retrospectively included in the study which were treated with FDA-approved dTMS protocol by using H7-coil for OCD. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used before and after dTMS to determine the severity of OCD symptoms and the responsiveness to therapy. To record the quantitative electroencephalogram (QEEG), 19 electrodes were applied to the scalp. Results: When controlling for sex and age, the Y-BOCS decline rate was linked to higher pretreatment beta activity in the parietal and occipital regions. In the second step of our attempt, we used stepwise linear regression analysis to create a model to predict YBOCS decline rate, age (beta = -0.284, p = 0.030) and pretreatment beta parietal power band (beta = 0.312, p = 0.018) were the predictors. Conclusion: Age and pretreatment parietal beta power bands may be used as a biomarker for predicting response to dTMS therapy if confirmed by further studies.

Despite the increasing prevalence of robots in daily life, their navigation capabilities are still limited to environments with prior knowledge, such as a global map. To fully unlock the potential of robots, it is crucial to enable them to navigate in large-scale unknown and changing unstructured scenarios. This requires the robot to construct an accurate static map in real-time as it explores, while filtering out moving objects to ensure mapping accuracy and, if possible, achieving high-quality pedestrian tracking and collision avoidance. While existing methods can achieve individual goals of spatial mapping or dynamic object detection and tracking, there has been limited research on effectively integrating these two tasks, which are actually coupled and reciprocal. In this work, we propose a solution called S 2MAT (Simultaneous and Self-Reinforced Mapping and Tracking) that integrates a front-end dynamic object detection and tracking module with a back-end static mapping module. S 2MAT leverages the close and reciprocal interplay between these two modules to efficiently and effectively solve the open problem of simultaneous tracking and mapping in highly dynamic scenarios. The proposed method is primarily designed for use with 3D LiDAR and offers a solution for real-time navigation in large-scale, unknown dynamic scenarios with a low computational cost, making it feasible for deployment on onboard computers equipped with only a single CPU. We conducted long-range experiments in real-world urban scenarios spanning over 7km, which included challenging obstacles like pedestrians and other traffic agents. The successful navigation provides a comprehensive test of S 2MAT’s robustness, scalability, efficiency, quality, and its ability to benefit autonomous robots in wild scenarios without pre-built maps.

To address the need for interventions targeting social emotional development and mental health of young children in South Africa, the Mazi Umntanakho (‘know your child’) digital tool was co-designed, and piloted with caregivers and 3–5 year-old children involved in home visiting programmes promoting early childhood development. The aim of this study was to qualitatively evaluate the feasibility and acceptability of this tool in four urban and four rural low-income communities, from the perspective of home visitors and caregivers. Focus groups were conducted with home visitors (n=117) and caregivers (n=72). Issues relating to the feasibility of implementing the tool included timing of using the tool, technical and social implementation challenges, WhatsApp as the preferred platform, and participants’ recommendations for future implementation. Overall, the tool was acceptable for home visitors and caregivers, and was perceived to have a positive impact on children’s development, and the relationship between caregivers and children.

Correction to [Anti-PL-12 anti-synthetase syndrome manifesting with multiple digital ischemia: Case report & review of the literature ][Doumeth SA, Petrinec E,Chaudhary H, Mattar M. Anti-PL-12 anti-synthetasesyndrome manifesting with multiple digitalischemia: Case report & review of the literature. ClinCase Rep. 2024;12:e9408. doi:10.1002/ccr3.9408]In the published article,”Anti-PL-12 anti-synthetasesyndrome manifesting with multiple digitalischemia: Case report & review of the literature”, the corresponding author’s name was formatted incorrectly. It should read as Abi Doumeth S.We apologize for this error.

Title : Spontaneous resolution of chronic subdural hematoma after resetting the pressure of programmable Ventriculoperitoneal shunt: A case report.

Terrestrial ecosystems exhibit varied land uses as a result of both anthropogenic activities and natural processes. These variations in land use alter plant composition, soil characteristics, topography, management practices, and hence lead to significant differences in soil microbial communities and their properties. This study evaluated the impact of distinct land use types (riparian, forest, pasture) on soil microbial biomass and stoichiometric indices under uniform climatic and pedological conditions within a micro-basin in the Eastern Mediterranean region. The microbial biomass C (C mic) in the riparian area was observed to be 2.5 and 4 times lower than in the meadow and forest areas, respectively. Additionally, the microbial quotient ( qMic) in the riparian zone was 0.5 times higher compared to the forest and meadow areas. Stoichiometric indices, particularly qMic and metabolic quotient ( qCO 2), across all land uses, indicated that soils within this micro-basin were healthy and exhibited no signs of stress. The study further corroborated that land use exerts significant effects on soil microbial communities, with microbial biomass and activities largely influenced by soil organic matter. Notably, the C mic/N mic ratio remained within the range of 10-12 across all land uses, illustrating a fungal dominance in the microbial biomass. These findings underscore the role of land use patterns in altering soil properties, thereby influencing microbial biomass, microbial respiration, and stoichiometry in soils under similar environmental conditions.

This paper presents a controller based on Model-assisted Extended State Observer, aiming to address the challenge of suppressing parametric disturbances in non-minimum phase systems. By demonstrating the existence of equivalent input disturbance in the system with multiple input channels, it reveals the rationality of the proposed controller and the physical significance of the extended state. This paper derives the characteristic polynomial of the closed-loop system and analyzes the applicability of the proposed controller in two specific conditions. Through two representative case studies, it further substantiates the superiority of the proposed controller over the Full-order Extended State Observer-based control. The introduction of model-assisted techniques effectively resolves the issue of inherent input-parameter disturbances which is in the Full-order Extended State Observer-based control, providing non-minimum phase systems with an enhanced capability to suppress parametric disturbances.