Neonatal Direct Rigid Laryngoscopy and Bronchoscopy: A Near Miss

Airway management is a skill necessary for healthcare providers who manage patients. Intubation is a skill that both anesthesiologists and intensivists use daily. We present a case of a neonate that developed significant worsening stridor after a successful intubation for a hernia repair. After 4 intubation attempts, with easy visualization of the vocal cords and unsuccessful placement of the endotracheal tube, the patient was emergently brought to the operating room for evaluation.

“Flow” Transcranial Direct Current Stimulation (tDCS) for Depression Treatment in a Primary Healthcare General Practice—An Open-Label Cohort Study Measuring Montgomery-Åsberg Depression Rating Scale (MADRS-S) Outcomes

Background: Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application delivered wellbeing behaviour therapy training. tDCS has evidence of effectiveness in treating symptoms of depression. Purpose/Aim: This post marketing study evaluated the effect of Flow on depression for primary care general practice patients with depression symptoms. Methods: Open-label patient cohort design with no control group. Inclusion criteria were aged 18 years or over and reporting depression symptoms. Participants self-administered five 30 minute tDCS sessions per week for the first three weeks, and then 3 sessions per week following this. Three, six and ten week assessment with participant self-report measure: Montgomery- Åsberg Depression Rating Scale (MADRS-S). Results: MADRS-S remission rates were between 29% - 30% at three weeks, 33% - 34% at six-weeks and 50% at 10-weeks treatment. There was a significant improvement in MADRS-S with large effect sizes at all time points. Conclusions: Flow tDCS can be delivered through a primary healthcare general practice service and patients will choose to use. Flow tDCS provides an effective depression treatment in addition and as an alternative to antidepressants and psychotherapy. tDCS has evidence as an effective depression treatment, and the widespread availability of tDCS in primary care general practice should be considered.

Unraveling the Impact of Direct-Acting Antivirals on Hepatitis-Linked Cirrhosis: A Comprehensive Analysis of Fibrosis, Child Score, and Disease Progression

The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).

Transcranial Direct Current Stimulation: Effects on Motor and Non-Motor Symptoms of Parkinson’s Disease

Introduction: In the last thirty years, brain neuromodulation techniques have been used as an alternative to pharmacological treatment of neurological disorders. Parkinson’s disease (PD) is a neurodegenerative disorder leading to bradykinesia, rest tremor, postural changes, and non-motor symptoms such as depression, anxiety, sleep disorders, pain, and cognitive decline that compromises executive functions (EFs), responsible for the orderly execution of behaviors and tasks of daily life and intentional and directed actions. To this date, a few studies with transcranial direct current stimulation (tDCS) have shown beneficial effects in PD patients concerning specific motor and non-motor symptoms, targeting the motor cortex and/or prefrontal regions. Objective: The main objective of this study was to evaluate the effects of left prefrontal tDCS across a broad spectrum of motor and non-motor symptoms of PD using established validated scales. Method: Single-blind randomized clinical trial with 18 volunteers with PD, aged between 45 and 80 years (66.1 ± 9.65), who met inclusion and exclusion criteria. Participants were submitted to assessments of motor and non-motor functions employing psychometric scales and tests to evaluate EFs and were randomly divided into two groups: control (sham stimulation) and experimental (active stimulation). All participants were involved in three separate tDCS sessions. The anode was positioned over the left dorsolateral prefrontal cortex and the cathode over the right supraorbital region, with a direct current intensity of 2 mA, lasting 20 minutes. At the end of the three sessions, all participants were reassessed. Results: Significant effects of tDCS on non-motor functions were observed for cognition (verbal fluency of actions, clock copy test, appointment by visual confrontation, and verbal memory with immediate free recall) and subjective assessment of sleep quality (overall restlessness and discomfort in the arms and legs at night, leg and arm cramps at night and distressing dreams). There was also an improvement in the rate of errors and successes for congruent and incongruent stimuli of the Stroop Test. The beneficial effects on motor function were decreased rigidity, improved gait, and greater agility in the finger-tapping test. Conclusion: Three tDCS sessions showed positive results for participants with PD, producing significant improvements in various motor and non-motor functions, including sleep quality, cognition, and EFs. Additionally, the present results indicate that tDCS neuromodulation of the left dorsolateral prefrontal cortex region is feasible, safe, and provides significant objective benefits for PD patients.

Positive Effect of Transcranial Direct Current Stimulation on Visual Verbal Working Memory in Patients with Attention-Deficit/Hyperactivity Disorder

Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of life. The dorsolateral prefrontal cortex (DLPFC) has been a good target site for transcranial direct current stimulation (tDCS) due to its intense involvement in working memory. In our 2018 study, tDCS improved visual-verbal working memory in healthy subjects. Objective: This study examines the effects of tDCS on ADHD patients, particularly on verbal working memory. Methods: We conducted an experiment involving verbal working memory of two modalities, visual and auditory, and a sustained attention task that could affect working memory in 9 ADHD patients. Active or sham tDCS was applied to the left DLPFC in a single-blind crossover design. Results: tDCS significantly improved the accuracy of visual-verbal working memory. In contrast, tDCS did not affect auditory-verbal working memory and sustained attention. Conclusion: tDCS to the left DLPFC improved visual-verbal working memory in ADHD patients, with important implications for potential ADHD treatments.

Unleashing the Potential of Unidirectional Mechanical Materials: Breakthroughs and Promising Applications

The emergence of mechanically one-way materials presents an exciting opportunity for materials science and engineering. These substances exhibit unique nonreciprocal mechanical responses, enabling them to selectively channel mechanical energy and facilitate directed sound propagation, controlled mass transport, and concentration of mechanical energy amidst random motion. This article explores the fundamentals of mechanically one-way materials, their potential applications across various industries, and the economic and environmental considerations related to their production and use.

基于Directionlets变换的偏振图像融合

论文提出一种有效的基于Directionlets变换的偏振图像融合算法。首先采用多方向多尺度的Directionlets变换对多个偏振图像进行分解,对于分解后的低频系数采用加权平均融合算法;根据高频子图边缘分布差异,对于方向高频系数采用2维Teager能量的边缘检测算法以及区域方向对比度算法实现偏振图像的融合处理。实验结果表明,与传统算法相比,提出的算法在保留原始图像边缘和纹理信息的同时,可以有效地取得较好的融合视觉效果。

从“快传”(RapidILL)和“立借”(Borrow Direct)看馆际互借与文献传递服务体系的发展

"快传"(RapidILL)与"立借"(Borrow Direct)分别代表文献传递与馆际互借的最佳实践,两者的共性主要体现在高度自动化和全面的质量控制,其核心是节约用户时间、增强用户粘性。我国馆际互借与文献传递服务体系今后的发展方向也主要体现在时间维度上,具体落实在节约用户时间、优化用户时间和提高用户的等待价值这三个方面。

基于Geomagic Design Direct的残缺数据实体重构

面向实物的逆向工程技术是近几年来研究和发展的热点,已广泛应用于产品设计、文物保护和零件修复等领域。报告了对模型的残缺表面数据进行曲面和实体重构的研究现状,以及结合正向和逆向建模软件进行实体模型重构的局限性。介绍了应用软件Geomagic Design Direct进行实体模型重构的优势以及对残缺表面数据实体模型重构的一般流程。提出了基于软件Geomagic Design Direct的特征识别与提取功能,对残缺表面数据进行实体重构的解决方案,并以某一零部件的残缺表面数据为例进行实体重构验证了该方案的可行性和便利性。

基于Geomagic Design Direct的截面特征提取与逆向建模

当前逆向工程已成为一种消化、吸收先进技术,实现产品的创新设计和快速开发的重要技术手段。随着各种特征技术的不断发展和引进,基于特征的逆向建模方法逐渐成为逆向工程新的发展方向。根据已有的建模方法,提出一种在二维草图模式下截面特征轮廓线提取与参数化设计的逆向建模新思路。并以Geomagic Design Direct软件为平台,实现了二维草图模式下特征轮廓线的提取与参数化再设计的逆向建模方法,为产品的快速建模和创新设计提供了一种新的途径。

基于DIRECT算法的混合动力汽车参数优化研究

研究混合动力汽车参数优化的方法。建立了以油耗最小为目标,以动力性设计指标为约束,以发动机功率、电机功率、电池容量、电池总线电压为变量的混合动力汽车部件参数优化模型,并应用分割矩形(DIRECT)算法,对此模型进行求解,找到了油耗最小的部件参数,进行了仿真验证。结果表明,在EPA城市循环工况(UDDS)和高速公路循环工况(HWFET)下,经过该方法优化后的混合动力汽车百公里油耗分别降低9.3%和14%。

Direct-PCR检测柑橘黄龙病的快速制样方法研究

【目的】开发一种适用于Direct-PCR快速简便、有效的柑橘黄龙病病原DNA提取方法。【方法】从样品制备、提取速度以及DNA纯度等方面,分别比较研究了2种Direct-PCR制样方法与普通试剂盒制样方法提取柑橘黄龙病病原DNA的优缺点,并利用优化的制样技术分别比较了柑橘黄龙病病原16S rDNA的扩增效果。【结果】其中一种Direct-PCR制样方法所提取的柑橘叶片样品经RT-qPCR检测可以检测出黄龙病病原;通过优化制样后,该方法所提取的样品还可以通过常规PCR进行黄龙病病原检测。【结论】开发了一种更为快速简便、有效的柑橘黄龙病病原DNA提取方法,可为大批量快速检测柑橘黄龙病提供技术支撑。

基于Direct 3D的3维自由立体显示软件双视点设置

如何生成具有适当水平位差的左右眼平面图片是自由立体显示软件设计的核心问题。针对该问题,首先以双眼能够舒适地融合显示屏上的最大水平位差为依据,在M icrosoft D irect 3D构建的3维模型空间体系内,寻找模型空间的视点与显示屏上水平位差之间的理论关系;然后,以视者在真实空间浏览3维模型真实感强、视觉舒适为原则来确定模型空间视点位置和投射表面平移量;最后,还提出了调整立体视觉效果的参数,并阐述了它们对立体视觉效果的影响机制。该研究成果已经投入使用,并获得了理想的立体视觉效果。

控制方向未知的受限多智能体系统的预设时间模糊控制

综合考虑受控制方向未知、输入受限和状态时延影响的有领导者多智能体系统的编队控制问题,设计基于模糊逻辑系统的预设时间一致性控制策略.为了保证编队输出误差在预设时间内满足预定的约束范围要求,引入预设时间性能函数,构造Lyapunov-Krasovskii(L-K)泛函解决状态时延问题,将外界干扰和L-K泛函的导数中的部分项定义为未知非线性函数,并利用模糊逻辑系统对其进行估计,利用Nussbaum函数和均值定理分别处理控制方向未知和输入受限问题,基于以上设计,提出预设时间模糊控制策略,并通过Lyapunov稳定性理论,分析闭环系统的有界稳定性,数值对比仿真和两级化学反应器应用仿真说明控制方法的有效性.

基于DirectShow的MPEG4网络视频流处理系统

介绍了一种基于DirectShow的MPEG4网络视频流处理系统。该系统采用Microsoft Di-rectShow框架技术,接收以MPEG4压缩的网络视频流,对视频流进行切帧、实时解码和播放。系统的关键技术是DirectShow Source Filter的设计和实现。

基于提升Directionlet变换的零块嵌入图像编码算法

提出一种新的基于提升Directionlet变换的图像压缩算法,能有效捕捉图像中的多方向各向异性特征,并具备格形可分离的滤波和采样结构.利用四叉树分块寻找局部最优的变换方向,针对Directionlet变换系数分布构造了块集合分裂嵌入编码,并通过改进链表排序方式和设计新的上下文算术编码器,进一步提高压缩性能.仿真实验结果表明,与基于原始Directionlet变换的压缩算法和基于小波变换的SPECK,SPIHT,JPEG2000等经典算法相比,本文算法在性能参数和视觉效果方面均有较大提高,且在低比特率下仍能较完整地保留图像中的边缘和细节信息.

Carba NP试验及Carba NP-direct试验检测产碳青霉烯酶肠杆菌的临床意义

目的:评价Carba NP试验及Carba NP-direct试验对碳青霉烯类耐药的肠杆菌科细菌碳青霉烯酶检测的临床价值。方法:收集南京医科大学附属无锡市第二人民医院2013年1月至2015年12月临床分离的各种标本耐碳青霉烯类抗生素的肠杆菌科细菌112株,同时选取碳青霉烯敏感的菌株100株作为对照组。所有菌株进行碳青霉烯酶耐药基因PCR检测、改良Hodge试验(MHT试验)、Carba NP试验(CNPt)以及Carba NP-direct(CNPt-d)试验检测。结果:碳青霉烯类耐药的肠杆菌科细菌共112株,92株携带blaKPC-2;8株携带blaNDM-1;1株携带blaVIM-2;1株携带blaIMP-4;10株不携带碳青霉烯酶基因;未检测到携带D组碳青霉烯酶基因的肠杆菌科细菌。以PCR检测的结果为标准,Carba NP试验、Carba NP-direct试验诊断菌株是否产碳青霉烯酶的敏感性和特异性均100%;改良Hodge试验诊断菌株是否产碳青霉烯酶敏感性为96%,特异性为98%。Carba NP试验及Carba NP-direct试验均在2 h内完成检测。结论:Carba NP试验和Carba NP-direct试验均能快速、准确筛查出产碳青霉烯酶的肠杆菌科细菌。Carba NP-direct试验相比Carba NP试验成本低、反应快、结果更明确,可作为表型确认实验和耐药监测的手段。

基于Direct UI的界面库设计

详细介绍了Direct UI界面库的概念、特征,论述了Direct UI界面库的设计方法.Direct UI界面库包括界面文档的设计、组件的内存布局、控件库的设计、消息及界面的更新、脚本引擎设计、系统函数的封装等部分.其中在控件库的设计部分着重介绍了动态类生成的设计思想,在脚本部分对Google浏览器的JavaScript脚本引擎V8的使用方法也做了简要介绍.

习近平关于新质生产力重要论述的理论体系和实践指向研究

习近平总书记关于新质生产力重要论述深刻阐明了新质生产力的基本内涵、本质特征、鲜明标志、核心要素、形成规律以及实现路径等重大理论和实践问题,是具有重大原创性、标识性、系统性、实践性的理论创新成果,是习近平新时代中国特色社会主义思想的重要组成部分。习近平总书记关于新质生产力重要论述是在推进中国式现代化进程中形成的新的生产力理论,是指导我国经济社会高质量发展的学理化、体系化的理论体系,是具有深邃而丰富辩证法则的实践指向。

基于direct LDA的幅度谱子空间雷达目标识别

针对高分辨距离像(HRRP)可分性低和维数高的问题,提出一种新的雷达自动目标识别(RATR)方法:dLDA&SVM。先采用直接线性判别分析在HRRP的幅度谱空间进行特征提取,然后在子空间中采用角域均值模板库训练one-against-all支撑向量机(SVM)多类分类器进行目标识别。并设计了最短距离分类器与SVM分类器比较。基于外场实测数据的实验结果表明,与LDA幅度谱子空间法,幅度谱原空间法相比,dLDA&SVM可显著降低数据维数并提高识别性能。