This study examined neural signatures associated conflict-monitoring, recognition and feedback processing in a novel feedback Concealed Information Test (fCIT), and also examined whether all the ERPs can be used to detect concealed autobiographical information. Participants were randomly assigned to one of two groups (guilty or innocent) and then tested in the fCIT while undergoing electroencephalograms (EEGs). Results show that the probe (participants’ name) elicited more negative N200, more positive recognition P300 than irrelevants among guilty participants, and feedback following the probe elicited a larger feedback P300 than feedback following irrelevants. Further, we found that all indicators, including conflict-monitoring N200, recognition P300, and feedback P300, could significantly discriminate between guilty and innocent participants. Combining them is highly effective in discriminating between guilty and innocent participants (AUC = 0.96). These findings not only shed light on the neural processing of fCIT, but also suggest the potential of using fCIT to detect concealed autobiographical information.

A document by fatemeh mohaghegh. Click on the document to view its contents.

Plants maintain iron (Fe) homeostasis under varying environmental conditions by balancing processes such as Fe uptake, transport, and storage. In Arabidopsis, POPEYE (PYE), a basic helix-loop-helix (bHLH) transcription factor (TF), has been shown to play a crucial role in regulating this balance. In recent years, the mechanisms regulating Fe uptake have been well established but the upstream transcriptional regulators of Fe transport and storage are still poorly understood. In this study, we report that ELONGATED HYPOCOTYL5 (HY5), a basic leucine zipper (bZIP) TF which has recently been shown to play a crucial role in Fe homeostasis, interacts with PYE. Molecular, genetic and biochemical approaches revealed that PYE and HY5 have overlapping as well as some distinct roles in regulation of Fe deficiency response. We found that HY5 and PYE both act as a repressor of Fe transport genes such as YSL3, FRD3 NPF5.9, YSL2, NAS4, and OPT3. HY5 was found to directly bind on the promoter of these genes and regulate intercellular Fe transport. Further analysis revealed that HY5 and PYE directly interact at the same region on PYE and NAS4 promoter. Overall, this study revealed that HY5 regulates Fe homeostasis by physically interacting with PYE as well as independently.

The operation of offshore vessels is directly related to the use of flexible pipelines. The article describes in detail the analysis of power, geometric, kinematic and technological parameters that affect the main operational characteristics of these pipes during their operation under water, in rough sea conditions and under wind loads. The article describes the degree of dependence between loads on the pipeline and velocity of the oncoming flow, the geometry of the pipe and the distance to the rigid surface of the ship’s hull or the seabed. It was determined how the flow velocity during parametric oscillations of the pipeline in unrestricted flow and near the surface of the seabed affects the change in its drag and lift coefficients. An estimate of operational limits of flexible pipeline instability was obtained. On the base of changes in distributed load, specific values for safe lengths of pipelines were formulated. It has been stated that the probability of failure-free operation of a flexible pipeline at a level of 0.99 is directly determined by the frequency of its oscillation. Its numerical values should always be at a level that does not exceed 3.7% of the frequency of pipe dynamic oscillations.

A Protocol for Treating Atelectasis in the Chronically Ventilated Pediatric PatientEliezer Be’eri MBBCh, Nitay Fraenkel MD, Orit Bartov BSc. MPt. Ped, Noah Eisenberg BPT, Rachelle Lavi B Physio, Ofra Ginat BPT, Ma’ayan Shoffer BPT.Department of Respiratory RehabilitationAlyn Pediatric Rehabilitation HospitalJerusalem, IsraelPresented at the 2nd meeting of the International Society of Pediatric Respiratory Diseases (INSPiRED), 2024.ORCID ID (Eliezer Be’eri): 0000-0003-4935-6000Email addresses of authors:Eliezer Be’eri: [email protected] Fraenkel: [email protected] Bartov: [email protected] Lavi: [email protected] Eisenberg: [email protected] Ginat: [email protected]’ayan Shoffer: [email protected] should be addressed to:Eliezer Be’eri, MDALYN Hospital84 Shmaryahu Levin Street, Jerusalem, Israel 91090Phone: +972 [email protected] words: Atelectasis, physiotherapy, tracheostomy, mechanical ventilationAbbreviated title: Protocol for treating atelectasisTo the editor,Lung atelectasis is an important complication occurring in children and adolescents who are ventilator-dependent due to neuromuscular respiratory failure. It may occur if a “low tidal volume” ventilation strategy is used, as is commonly done to avoid barotrauma when ventilating subjects with parenchymal respiratory failure. However, the patient in respiratory failure due to neuromuscular disease, in contrast to the subject with parenchymal respiratory failure, is primarily at risk for alveolar de-recruitment, rather than barotrauma. Some authorities have therefore advocated using a “high tidal volume strategy” \RL1. In the short term, atelectasis causes ventilation-perfusion mismatch, but if left untreated it may become a focus of recurrent infection and eventual bronchiectasis. When atelectasis is identified, it is therefore essential to re-recruit the atelectatic lung segment as early as possible, prior to the atelectasis becoming permanent.A standardized protocol for treating newly diagnosed atelectasis in ventilator-dependent children has been developed and implemented in the Respiratory Rehabilitation Department of Alyn Pediatric Rehabilitation Hospital in Jerusalem, Israel. The protocol aims to achieve rational medical and physiotherapy (PT) resource management in a stepwise and time-limited manner. The protocol employs the full spectrum of medical and physiotherapy modalities available at Alyn Hospital, including alveolar recruitment by means of prolonged “sigh” inhalations, mechanical inexsufflation (MIE), intrapulmonary percussive ventilation (IPPV), Vest therapy, negative-pressure cuirass ventilation (RTX), “green-bag” manual hyperinflation and bronchoscopy, and is detailed in diagram 1.The initial step is to maximize the ventilator parameters (peak inspiratory pressure (PIP) or tidal volume (Vti), and peak end expiratory pressure (PEEP)) and add a sigh recruitment manoeuvre of 40 cmH2O for 10 seconds every 20 minutes. In our experience, addition of the sigh recruitment maneuver often succeeds in opening the atelectatic segment, and no further therapy is needed. After 24 hours a chest Xray is performed. If no clinical (oxygen saturation above 94% or return to pre-atelectasis baseline) or radiological improvement has occurred, physiotherapy treatments are then added in a stepwise manner every 48 hours. Our initial physiotherapy protocol comprises manual chest vibration and ventilation-enhancement maneuvers combined with patient positioning to enhance postural drainage. Such positioning may be prone, or lying on the side with the atelectatic lung superior, and may include use of an abdominal belt to improve diaphragmatic function. Manual physiotherapy is combined with MIE and either IPPV (for tracheostomized subjects) or Vest therapies (if the subject is using non-invasive positive-pressure ventilation (NIPPV)), all performed three times a day. Whereas the Vest and IPPV achieve secretion mobilization (essentially, shaking secretions free of the tracheo-bronchial wall), MIE performs secretion removal (moving the secretions up the airways towards the pharynx). The protocol aims to combine mobilization and removal modalities synergistically. If no clinical improvement has occurred after 48 hours, the physiotherapy modality is changed to use of a negative-pressure cuirass (RTX) in secretion removal mode. Our rationale in choosing this technique is that during negative-pressure ventilation, chest wall expansion occurs in a manner that is morphologically different from the manner in which the thorax expands during positive-pressure ventilation, reflecting the difference between “inflating” the lungs from within versus expanding the chest wall from without. We postulate that this morphological difference manifests also at the level of the airways, meaning that there may be differences between positive-pressure and negative-pressure ventilation in terms of how airways physically expand when exposed to these two modalities. If that is in fact true, negative-pressure ventilation may succeed in achieving alveolar recruitment when positive-pressure ventilation has failed to do so. Indeed, in our experience we have witnessed successful recruitment of an atelectatic segment within 24 hours of initiating negative-pressure ventilation, in cases in which the initial positive-pressure ventilation combined with secretion-mobilization methodologies for 72 hours had failed to achieve such. In particularly resistant cases we have also combined RTX ventilation with simultaneous and synchronous positive-pressure ventilation.In children younger than 2 years of age it may be difficult to successfully fit a negative-pressure cuirass to a small thorax, which precludes using that therapy as a next step after failure of first-line PT techniques. In such circumstances, we employ a technique for achieving prolonged lung insufflation using an anesthesiology “green bag” manual resuscitator. In this technique, a slow, prolonged inspiration with a sustained inspiratory pause is followed by rapid release during the expiratory phase. As small children generally still have a pliable chest wall, this technique can often be effective in achieving sustained and high PEEP levels, encouraging alveolar recruitment.We reserve bronchoscopy for those cases in which no ongoing improvement has been achieved after one week of recruitment-enhancing therapies. This is due to a combination of the invasiveness of the procedure with the low likelihood (in our experience) that bronchoscopy alone will achieve re-expansion of an atelectatic lung segment (unless such atelectasis has been caused by a solid, aspirated foreign body that can be removed).In summary, the described protocol is a pathway for opening a newly diagnosed atelectasis in a chronically ventilated child, in a manner that maximizes the number of potentially beneficial treatment modalities employed in a time-limited and rational framework.Abbreviations:PT: physiotherapyMIE: mechanical inexsufflationIPPV: intrapulmonary percussive ventilationNIPPV: non-invasive positive-pressure ventilationRTX: negative-pressure cuirass ventilationPIP: peak inspiratory pressureVti: inspired tidal volumePEEP: peak end expiratory pressure

IntroductionTuberculosis (TB), which is caused by bacteria of the Mycobacterium tuberculosis complex, is one of the oldest diseases known to affect humans and a leading cause of death worldwide (1).Approximately one-third of the global population is infected with a lifetime risk of 10% for developing tuberculosis (TB) disease. In 2017, there were 10.4 million reported cases of TB worldwide, corresponding to an incidence rate of 133 cases per 100,000 individuals. Among these cases, 90% were adults over the age of 15, and 64% were male. (2).Iran is considered a high-burden country for tuberculosis, with a notable incidence rate. The endemicity of TB in this region increases the pretest probability of the disease in patients presenting with compatible symptoms and radiological findings (3). Pulmonary TB is usually a disease having a gradual onset. Fever is the most common observed constitutional symptom which characteristically develops in the late afternoon. There may be other manifestations in up to 75% of cases of pulmonary TB, such as malaise, weakness, unusual fatigue, headache, night sweats and weight loss. This is usually accompanied by caseous necrosis and concomitant caseous liquefaction and cough and purulent sputum which is often associated with mild hemoptysis (4).Sputum smear microscopy and culture are commonly used for the diagnosis of pulmonary TB. However, it’s essential to recognize the limitations of these tests (5, 6). Smear microscopy has a sensitivity ranging from 36.9% to 55.6% and specificity of around 99%, while culture has higher sensitivity (approximately 80-90%) but takes longer for results (7, 8). Importantly, negative smear and culture results do not exclude the diagnosis of TB, especially in cases of paucibacillary disease or extrapulmonary involvement (8).

Fusion imaging (FI) technology using Echo-Navigator that integrates live transesophageal echocardiogram (TEE) and overlays on real-time fluoroscopy. We present our experience placing a right ventricular (RV) support device, a ProtekDuo, in our patient with post-operative RV failure using FI to guide the implantation.

Amoxicillin-induced DRESS syndrome without eosinophilia

Abtract not needed for a response to a Letter to the Editor

Key Clinical MessageThe occurrences of rhabdomyolysis after endoscopic submucosal dissection surgery were rarely reported. This is a case involving rhabdomyolysis affecting the muscles of the left buttocks and left hip following a prolonged endoscopic submucosal surgery.

Objective: Child marriage forces a girl into adult roles before physical and psychological maturity, which can take a toll on women’s health over the life course. This paper aims to assess whether child marriage and adolescent childbearing are associated with elevated risk of gynecologic disorders leading to hysterectomy. Design: Cross-sectional and survival analysis. Setting: India, nationally representative survey. Population: 528,816 ever married women, aged 20-49 years. Methods: Women were grouped in four mutually exclusive categories – i) married adult – not an adolescent mother (reference category), ii) married adult – adolescent mother, iii) married child – not an adolescent mother, and iv) married child – adolescent mother. Multivariable logistic regressions were fitted to assess the odds of hysterectomy for these groups. Non-parametric Kaplan-Meier survivor functions were estimated to evaluate survival rates across the groups. Main outcome measures: Whether had a hysterectomy and age when hysterectomy was performed. Results: Compared to women married as adult – not an adolescent mother, women married in childhood and who gave birth in adolescence were 1.87 (95% CI: 1.78–1.96) times more likely to have a hysterectomy and had the lowest survival rate for hysterectomy. Women married as children but not an adolescent mother also had higher odds of hysterectomy (AOR = 1.40, 95% CI: 1.31–1.50). These results were robust across sub-groups including geographic regions, urban/rural residence, education, and income. Conclusions: Our results, showing a strong relationship between child marriage and hysterectomy, contribute to the literature on later-life health consequences of child marriage and call for strengthening efforts to eradicate child marriage.

A surgical site cellulitis caused by an ant bite on foot 7 years after mastectomy: A Case ReportZhihan Liu1*Shuying Ye1*Zhihao Wei1*Shicheng Su1Yiwen Lu11Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China*These authors contributed equally to this workCorrespondence: Dr Yiwen Lu,Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, ChinaTel: +86-20-87332022Fax: +86-20-81332853Email : [email protected]

Because of the soft dynamic performance of the fuel cell stack, the battery is usually integrated in the power system in fuel cell hybrid electric vehicles. In this paper, a real time energy management strategy considering thermal constraints based on speed prediction with neuron network is proposed. The main principle of the proposed control strategy is to get the future power requirement with model predictive control based on the historic speed information, and then optimize the objective function according to the state variables. The objective function is set to minimize the equivalent fuel consumption of the vehicle and extend the life span of the fuel cell stack based on thermal constraints. Contrasting with the control strategy without thermal constraints under the WLTC driving cycle, the proposed energy management is 0.9% higher, but the temperature of the fuel cell stack and the battery can be limited within an appropriate range. The total equivalent fuel consumption is 3.9% lower than dynamic programming control strategy, which proves the availability of the proposed control strategy can reduce the equivalent fuel consumption while prolonging the fuel cell stack life span. Hardware in loop (HIL) experiment is implemented to testify the real time application of the proposed control strategy.

This study aimed to investigate the impact of seasonal climate change on safflower genotype productivity in Central Anatolian conditions during 2021 and 2022. The research focused on seed yield, oil content, and oil yield, considering variations in Growing Degree Days (GDD) at different growth stages. In both years, seed yield was significantly affected by rainfall deficiency. In 2021, safflower genotypes had an average seed yield of 1540 kg ha -1, while in 2022, it increased to 2390 kg ha -1 due to higher precipitation during critical growth stages. Different genotypes showed distinct performances in seed yield each year, highlighting the importance of selecting drought-tolerant genotypes for breeding programs. Oil content also exhibited significant variations between genotypes and years. Drought stress during flowering and seed filling periods generally led to a decrease in safflower oil content. However, in 2021, despite drought during the seedling stage, there was an increase in average oil content, potentially due to compensatory mechanisms related to reduced seed yield and dry matter content. Moreover, the study explored GDD values at different growth stages, revealing substantial variation among genotypes in GDD accumulation. Genotypes with higher GDD accumulation typically displayed higher seed and oil yields, indicating their better stress tolerance. Conversely, early maturing genotypes with lower GDD values were better suited for regions with lower average temperatures. The findings underscore the importance of considering both rainfall and temperature factors when selecting safflower genotypes for specific regions. In conclusion, the study emphasizes the impact of seasonal climate change on safflower productivity and highlights the need to develop new safflower varieties capable of adapting to predicted hotter and drier conditions due to climate change.

Background: The paracondylar process is of clinical interest due to its proximity to anatomical structures involved in vital functions. There are limited reports describing abnormalities affecting the paracondylar process (PCP), with traumatic fractures being the most prevalent pathology. Affected horses can present with a variety of signs including headshaking, facial paralysis and/or poor performance. In almost all cases reported in the literature to date, computed tomography has been used to diagnose a PCP fracture. Objectives: The aim of this study was to develop a radiographic technique for imaging the PCP, to determine the optimum radiographic projection angle and trial its use in standing sedated horses. Study design: Pilot study conducted in 10 standing sedated horses. Methods: Three tangential radiographs of the left and right paracondylar processes at 5º, 15º and 20º to the transverse plane were obtained in 10 standing sedated horses. Three blinded observers independently ranked each of the three images for clarity of viewing the PCP. The radiographic projection allowed imaging of the ventral portion of the PCP while avoiding superimposition of other osseous structures. Results: The highest grades were obtained for radiographs with a 5º angle from the transverse plane, and the lowest grades were obtained for a 20º angle. Main limitations: Complex anatomy of the PCP with superimposition of osseous and soft tissue structures. Conclusions: The radiographic technique for the PCP can be safely performed in standing, sedated horses. It is suitable for implementation in general veterinary practice before considering referral for advanced imaging techniques in horses presenting with headshaking or facial paralysis.

Rapid dynamics and remarkable proton conduction induced by confined water in nanospaces have attracted much attentions from researchers, which is crucial for advancing the development of innovative proton conductors and deepening comprehension of proton and water transport mechanisms within biological systems. In this aspect, carbon nanotubes (CNTs) are frequently employed as a research platform. However, they possess certain limitations, such as their inherent electronic conductivity and extreme hydrophobicity, which can impede the accurate assessment and precise regulation of proton conduction. We herein prepared two 2D COFs with different hydrophilic fragment, and obtains maximum acid-free proton conductivity of 3.04×10-4 S cm-1 at 70 °C and 100% RH with Grotthuss type activation energy of 0.14 eV. This is mainly due to that the water molecules in the center of channel form strong hydrogen bonds, enhancing proton dissociation and guiding fast directional diffusion.

Delivering in or out of water, the OASI rates in the POOL cohort study are disturbingly highDear Dr Papageorghiou,We have read with interest the POOL study report by Sanders et al. published in your journal.1 We acknowledge that the results of this study are based on a large obstetric cohort of low-risk women.The mere conclusion of the authors is that birth in water is not associated with increased risks for mothers and babies. However, in doing so, they seem to have overlooked an important issue related to the event rate in their comparator group. Indeed, the reported obstetric anal sphincter injury (OASI) rates of 5.0% in nulliparous and 1.3% in multiparous women are remarkably, if not unacceptably high. Particularly, given the risk for serious, often untreatable complications strongly associated with such injury.The reported event rates in the pool study are an outlier when compared to the 1.6% reported in other studies.3 The reported rates in the POOL study are comparable to those reported by Gurol-Urganci et al.4 Nonetheless, 20% of the women in the Gurol-Urganci et al study had operative vaginal births, a strong risk factor for OASI. In contrast, the POOL study cohort were all low-risk spontaneous births.The POOL study describes women delivering in and out of water, but the authors do not comment if manual perineal protection was used or not in either of the groups. Applying interventions, like manual perineal protection at the time of water birth may be challenging and does not tend to be attempted in some healthcare settings.Manual perineal protection was earlier associated with a significant reduction in OASI risk in Norway and Denmark and the UK. Fodstad et al. describe that the OASI prevalence in Norway in all vaginal deliveries has reduced from 4.2% in 2004 to 1.6% in 2023, after introduction of a national program with manual perineal protection.3Gurol-Urganci et al. have also demonstrated a significant reduction OASI rates in a healthcare setting comparable to that of Saunders et al. Moreover, the RCOG and, more recently, the published report from the All-Party Parliamentary Group on Birth Trauma have recommended the roll out and implementation, underpinned by sufficient training, of the OASI care bundle to all hospital trusts to reduce risk of perineal injuries in childbirth.4 Hence, it would have been expected that a UK based study using perineal trauma as its primary outcome would address and discuss what interventions were undertaken to mitigate the risk of trauma.We believe that there is a high risk that the exceptionally high OASI rate in the comparator arm has introduced bias in this non-inferiority RCT. Sanders et al conclude that their “Study findings provide reassurance that birth in water, in the context of UK midwifery practice, is not associated with increased risks for mothers or their babies. However, given the 2015 Supreme Court Montgomery ruling stating that “clinicians should disclose risks of childbirth” one should question, why the risk of childbirth in the POOL study was so unacceptably high and still remained undiscussed?Jan Willem de Leeuw, Department of Obstetrics and Gynaecology, Ikazia Ziekenhuis Rotterdam, the NetherlandsKatariina Laine, Norwegian Research Centre for Women’s Health, Oslo University Hospital, Oslo, Norway, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayMargareta Manresa, Clinic Institute of Gynaecology, Obstetrics and Neonatology, Hospital Clinic of Barcelona, Barcelona, SpainSari Raisanen, Laurea University of Applied Sciences, Vantaa, FinlandVladimir Kalis, Department of Obstetrics and Gynaecology, Faculty of Medicine in Pilsen, Charles University, Center for Pelvic-floor Disorders, Pilsen, CzechiaZdenĕk Rušavý, Department of Obstetrics and Gynaecology, Faculty of Medicine in Pilsen, Charles UniversityRenaud de Tayrac, Obstetrics and Gynaecology Department, Nimes University Hospital, University of Montpellier, Nimes, France

MDMA Abuse leading to Delayed Onset Rhabdomyolysis: A Case Report and Literature Review