How Referred Patients Influence Cesarean Sections Rate Pattern: Analysis according to the Robson Classification

Objective: To improve the practice of cesarean section by analyzing the cesarean section according to Robson’s classification. Methodology: This was a cross-sectional and descriptive study carried out at the University Hospital of Cocody. It covered the Cesarean sections performed during the year 2015 and ranked according to the 10 groups of Robson. Results: The overall Cesarean section rate in 2015 was 42.8% (3100 cesarean sections for 7229 deliveries). Group 1 was the largest contributor to overall Cesarean section with a rate of 20.5% followed by Group 3 (18.6%), Group 5 (16.4%) and Group 10 (12.2%), unlike other data in the literature where groups were in descending order Groups 5, 1, 3. This difference was driven by medical evacuations and our working conditions. Conclusion: The Cesarean section rate is constantly increasing in our department. Referred patients played a huge role in the distribution of C-section along the Robson’s 10 groups classification.

Simultaneous Occurrence of Myofascial Pain Referred to Tooth and Endodontic Lesions in Patient with Toothache: A Case Report

Toothache is almost always caused by odontogenic toothache, but diagnosis is more difficult in the case of nonodontogenic toothache. We report a case of simultaneous occurrence of odontogenic and nonodontogenic toothache. This manuscript presents a case report for a 35-year-old woman who visited our Orofacial and Head Pain Clinic with the chief complaint of continuous dull pain in left maxillary molar teeth region. It was concluded to be a case of simultaneous odontogenic toothache and nonodontogenic toothache. It was successfully treated by an endodontist and an orofacial pain specialist. The endodontist performed root canal treatment against odontogenic toothache caused by apical periodontitis using a dental operating microscope. The presence of a trigger point (TP) resulting in tooth pain was inferred. A trigger point injection (TPI) was administered by orofacial pain specialist, and toothache relief was confirmed. Myofascial pain was diagnosed definitively. After confirming that the toothache had resolved at multiple TPIs, a crown prosthesis was placed. Following the application of crown prosthesis, we were concerned but did not find recurrence of toothache from myofascial pain due to increased occlusal force. This case suggests that there is no single cause of chronic pain and that multiple causes must be considered for diagnosis, suggesting the need for treatment by multiple specialists.

Prescribed Performance Tracking Control of Time-Delay Nonlinear Systems With Output Constraints

The problem of prescribed performance tracking control for unknown time-delay nonlinear systems subject to output constraints is dealt with in this paper. In contrast with related works, only the most fundamental requirements, i.e., boundedness and the local Lipschitz condition, are assumed for the allowable time delays. Moreover, we focus on the case where the reference is unknown beforehand, which renders the standard prescribed performance control designs under output constraints infeasible. To conquer these challenges, a novel robust prescribed performance control approach is put forward in this paper.Herein, a reverse tuning function is skillfully constructed and automatically generates a performance envelop for the tracking error. In addition, a unified performance analysis framework based on proof by contradiction and the barrier function is established to reveal the inherent robustness of the control system against the time delays. It turns out that the system output tracks the reference with a preassigned settling time and good accuracy,without constraint violations. A comparative simulation on a two-stage chemical reactor is carried out to illustrate the above theoretical findings.

A 16-bit 18-MSPS flash-assisted SAR ADC with hybrid synchronous and asynchronous control logic

This paper presents a 16-bit,18-MSPS(million samples per second)flash-assisted successive-approximation-register(SAR)analog-to-digital converter(ADC)utilizing hybrid synchronous and asynchronous(HYSAS)timing control logic based on an on-chip delay-locked loop(DLL).The HYSAS scheme can provide a longer settling time for the capacitive digital-to-analog converter(CDAC)than the synchronous and asynchronous SAR ADC.Therefore,the issue of incomplete settling or ringing in the DAC voltage for cases of either on-chip or off-chip reference voltage can be solved to a large extent.In addition,the fore-ground calibration of the CDAC’s mismatch is performed with a finite-impulse-response bandpass filter(FIR-BPF)based least-mean-square(LMS)algorithm in an off-chip FPGA(field programmable gate array).Fabricated in 40-nm CMOS process,the proto-type ADC achieves 94.02-dB spurious-free dynamic range(SFDR),and 75.98-dB signal-to-noise-and-distortion ratio(SNDR)for a 2.88-MHz input under 18-MSPS sampling rate.

Polio eradication surveillance in Sri Lanka,2019-2023

Objective:To evaluate the polio laboratory surveillance carried out from January,2019 to May,2023 by the Polio Regional Reference Laboratory,Sri Lanka.Methods:This retrospective study analyzed all stool samples received under the acute flaccid paralysis(AFP)and immunodeficient vaccine-derived poliovirus(VDPV)surveillance at Polio Regional Reference Laboratory,Sri Lanka from January,2019 to May,2023.The results of the testing methodologies were extracted from the laboratory data system,i.e.,poliovirus virus isolation,intra-typic differentiation/VDPV real time reverse transcriptase polymerase chain reaction(ITD/VDPV rRTPCR)and sequencing,along with the data on timing of reporting results,stool adequacy and socio-demographics.Data was analyzed using descriptive statistics.Results:A total of 2141 stool samples from 1644 cases were received for AFP surveillance from Sri Lanka(93.61%),Maldives(1.52%),and immunodeficient VDPV(4.86%)surveillance.Both polioviruses(19/1644,1.15%)and non-polio enteroviruses(73/1644,4.44%)were isolated,while Sabin-like 3 virus was detected in majority(12/19,63.15%)among the poliovirus isolated.Wild polioviruses or circulating VDPVs were not detected among the cases.During all years of the study,the non-polio AFP detection rate was>1/100000 in children aged less than 15 years,whereas stool adequacy rate was>80%.All results were reported within 14 days of receipt,ensuring timely reporting as per global guidelines.Conclusions:The Polio Regional Reference Laboratory,Sri Lanka plays a vital role in maintaining the polio-free status in the country through its robust laboratory surveillance,while adhering to the surveillance indicators.Non-detection of wild polioviruses and circulating VDPV during the study period reinforces the polio-free status in the country.

Alanine aminotransferase predicts incident steatotic liver disease of metabolic etiology: Long life to the old biomarker!

Alanine aminotransferase(ALT)serum levels increase because of hepatocellular damage.Metabolic dysfunction-associated fatty liver disease(MAFLD),which identifies steatotic liver disease(SLD)associated with≥2 metabolic abnormalities,has prominent sexual differences.The Metabolic Syndrome defines a cluster comprising abdominal obesity,altered glucose metabolism,dyslipidemia,and hypertension.Male sex,body mass index,glucose,lipids,ferritin,hypertension,and age independently predict ALT levels among blood donors.Over the last few decades,the reference range of ALT levels has been animatedly debated owing to attempts to update sex-specific reference ranges.With this backset,Chen et al have recently published a study which has two main findings.First,>80%of indi-viduals with MAFLD had normal ALT levels.Second,there was a linear increa-sing trend in the association between cumulative excess high-normal ALT levels and the rate of incident MAFLD.This study has biologically credible findings.However,it inaccurately considered sex differences in the MAFLD arena.Therefore,future studies on SLD owing to metabolic dysfunction should adopt locally determined and prospectively validated reference ranges of ALT and carefully consider sex differences in liver enzymes and MAFLD pathobiology.

Referred Somatic Hyperalgesia Mediates Cardiac Regulation by the Activation of Sympathetic Nerves in a Rat Model of Myocardial Ischemia

Myocardial ischemia(MI)causes somatic referred pain and sympathetic hyperactivity,and the role of sensory inputs from referred areas in cardiac function and sympathetic hyperactivity remain unclear.Here,in a rat model,we showed that MI not only led to referred mechanical hypersensitivity on the forelimbs and upper back,but also elicited sympathetic sprouting in the skin of the referred area and C8–T6 dorsal root ganglia,and increased cardiac sympathetic tone,indicating sympathetic-sensory coupling.Moreover,intensifying referred hyperalgesic inputs with noxious mechanical,thermal,and electro-stimulation(ES)of the forearm augmented sympathetic hyperactivity and regulated cardiac function,whereas deafferentation of the left brachial plexus diminished sympathoexcitation.Intradermal injection of the α_(2) adrenoceptor(α_(2)AR)antagonist yohimbine and agonist dexmedetomidine in the forearm attenuated the cardiac adjustment by ES.Overall,these findings suggest that sensory inputs from the referred pain area contribute to cardiac functional adjustment via peripheral α_(2)AR-mediated sympathetic-sensory coupling.

基于0-1膨胀二项分布的客观贝叶斯分析

在医疗卫生、金融证券等应用领域,经常会同时出现零观测值、一观测值较多的情况。为更好地拟合这类数据,提出一种0-1膨胀二项分布模型并进行客观贝叶斯分析。采用数据扩充策略,基于完全似然函数,得到Jeffreys先验和reference先验。采用WinBUGS软件和R软件进行数值模拟,设定不同的样本量和参数真值,对不同的无信息先验进行评估。对2020年1月28日与2月22日COVID-19死亡人数进行分析,结果表明,在小样本情形下基于客观贝叶斯先验π_(R3)下的拟合效果比π_(R1)和π_(R2)要好。

Evaluating the performance of genomic selection on purebred population by incorporating crossbred data in pigs

Genomic selection(GS)has been widely used in livestock,which greatly accelerated the genetic progress of complex traits.The population size was one of the significant factors affecting the prediction accuracy,while it was limited by the purebred population.Compared to directly combining two uncorrelated purebred populations to extend the reference population size,it might be more meaningful to incorporate the correlated crossbreds into reference population for genomic prediction.In this study,we simulated purebred offspring(PAS and PBS)and crossbred offspring(CAB)base on real genotype data of two base purebred populations(PA and PB),to evaluate the performance of genomic selection on purebred while incorporating crossbred information.The results showed that selecting key crossbred individuals via maximizing the expected genetic relationship(REL)was better than the other methods(individuals closet or farthest to the purebred population,CP/FP)in term of the prediction accuracy.Furthermore,the prediction accuracy of reference populations combining PA and CAB was significantly better only based on PA,which was similar to combine PA and PAS.Moreover,the rank correlation between the multiple of the increased relationship(MIR)and reliability improvement was 0.60-0.70.But for individuals with low correlation(Cor(Pi,PA or B),the reliability improvement was significantly lower than other individuals.Our findings suggested that incorporating crossbred into purebred population could improve the performance of genetic prediction compared with using the purebred population only.The genetic relationship between purebred and crossbred population is a key factor determining the increased reliability while incorporating crossbred population in the genomic prediction on pure bred individuals.

Leveraging the Empirical Wavelet Transform in Combination with Convolutional LSTM Neural Networks to Enhance the Accuracy of Polar Motion Prediction

High-precision polar motion prediction is of great significance for deep space exploration and satellite navigation.Polar motion is affected by a variety of excitation factors,and nonlinear prediction methods are more suitable for polar motion prediction.In order to explore the effect of deep learning in polar motion prediction.This paper proposes a combined model based on empirical wavelet transform(EWT),Convolutional Neural Networks(CNN)and Long Short Term Memory(LSTM).By training and forecasting EOP 20C04 data,the effectiveness of the algorithm is verified,and the performance of two forecasting strategies in deep learning for polar motion prediction is explored.The results indicate that recursive multi-step prediction performs better than direct multi-step prediction for short-term forecasts within 15 days,while direct multi-step prediction is more suitable for medium and long-term forecasts.In the 365 days forecast,the mean absolute error of EWT-CNN-LSTM in the X direction and Y direction is 18.25 mas and 15.78 mas,respectively,which is 23.5% and 16.2% higher than the accuracy of Bulletin A.The results show that the algorithm has a good effect in medium and long term polar motion prediction.

Deciphering the population structure and genetic basis of growth traits from whole-genome resequencing of the leopard coral grouper(Plectropomus leopardus)

The leopard coral grouper(Plectropomus leopardus)is a species of significant economic importance.Although artificial cultivation of P.leopardus has thrived in recent decades,the advancement of selective breeding has been hindered by the lack of comprehensive population genomic data.In this study,we identified over 8.73 million single nucleotide polymorphisms(SNPs)through whole-genome resequencing of 326 individuals spanning six distinct groups.Furthermore,we categorized 226 individuals with high-coverage sequencing depth(≥14×)into eight clusters based on their genetic profiles and phylogenetic relationships.Notably,four of these clusters exhibited pronounced genetic differentiation compared with the other populations.To identify potentially advantageous loci for P.leopardus,we examined genomic regions exhibiting selective sweeps by analyzing the nucleotide diversity(θπ)and fixation index(FST)in these four clusters.Using these high-coverage resequencing data,we successfully constructed the first haplotype reference panel specific to P.leopardus.This achievement holds promise for enabling high-quality,cost-effectiveimputationmethods.Additionally,we combined low-coverage sequencing data with imputation techniques for a genome-wide association study,aiming to identify candidate SNP loci and genes associated with growth traits.A significant concentration of these genes was observed on chromosome 17,which is primarily involved in skeletal muscle and embryonic development and cell proliferation.Notably,our detailed investigation of growth-related SNPs across the eight clusters revealed that cluster 5 harbored the most promising candidate SNPs,showing potential for genetic selective breeding efforts.These findings provide a robust toolkit and valuable insights into the management of germplasm resources and genome-driven breeding initiatives targeting P.leopardus.

Styrax japonicus functional genomics:an efficient virus induced gene silencing(VIGS)system

VIGS(Virus-induced gene silencing),a method for posttranscriptional gene silencing,is an effective technique for investigating the activities of genes in plants.Since there is no report for available VIGS system in Styrax japonicus,the application of a VIGS approach that results in a gene knockdown to study gene function is limited.In this study,we compared the characteristics that could affect the viability of VIGS in S.japonicus,including the acetosyringone(AS)concentration,the Agrobacterium’s optical density and the inoculation method.The stable reference genes of S.japonicus were selected to validate the gene’s knockdown by quantitative PCR.As a result,we successfully constructed 2 VIGS systems based on TRV virus:vacuum with AS concentration of 200μmol·L^(-1)and OD600of 0.5,and friction-osmosis with AS concentration of 200μmol·L^(-1)and OD600of 1.0,which silencing efficiency was 83.33%and 74.19%,respectively.The successfully applied VIGS method provides a rapid and effective reverse gene functional analysis approach in S.japonicus to identify unknown gene functions.

The Application of Permanent Magnet Synchronous Motor with Small Electrical Time Constant in Fiber Positioner

With the development of cutting-edge multi-object spectrographs,fiber positioners located in the focal plane are being scaled down in size,and miniature hollow-cup Permanent Magnet motors are now being considered as a suitable replacement for Faulhaber Precistep stepper motors.However,the small electrical time constant of such coreless motors poses a challenge,as the problem of severe commutation torque ripple in a fiber positioner running a position loop has been tricky.To overcome this challenge,it is advised to increase the Pulse Width Modulation(PWM)frequency as much as possible to mitigate the effects of the current fluctuation.This must be done while ensuring adequate resolution of the PWM generator.By employing a voltage open-loop field-oriented control based on a modulation frequency of 1 MHz,the drive current only costs 25 m A under a 3.3 V power supply.The sine degree of phase current is immaculate,and the repeat positioning accuracy can reach 2μm.Moreover,it is possible to further shrink the bill of devices and the layout area of the Printed Circuit Board,especially in sizesensitive applications.This device has been developed under the new generation of The Large Sky Area MultiObject Fiber Spectroscopic Telescope.

Stepwise Ecological Restoration:A framework for improving restoration outcomes

Ecosystem degradation is one of the critical constraints for the sustainable development of our planet.However,recovering an ecosystem to a pre-impairment condition is often not practical.The International Restoration Standards provide the first framework for practical guidance on what constitutes the process of ecological repair and how this repair process can be influenced to improve net ecological benefits.In these Standards,Restorative Continuum is highlighted and it recognises that many do not,yet there is still value in aspiring to improvements to the highest extent possible,with some sites potentially being able to be improved in a stepwise manner.Here we elaborate on these Standards by providing a cross-ecosystem theoretical framework of Stepwise Ecological Restoration(STERE)for promoting higher environmental benefits.STERE allows the selection of suitable restorative modes by considering the degree of degradation while encouraging a transition to a higher state.These models include environmental remediation for completely modified and degraded ecosystems,ecological rehabilitation for highly modified and degraded ecosystems,and ecological restoration for degraded native ecosystems.STERE requires selecting tailored restorative modes,setting clear restorative targets and reference ecosystems,applying a systematic-thinking approach,and implementing a continuous monitoring program at all process stages to achieve a resilient trajectory.STERE allows adaptive management in the context of climate change,and when the evidence is available,to“adapt to the future”to ensure climate resilience.The STERE framework could assist in initiating and implementing restoration projects worldwide,especially in developing countries.

Fine-grained grid computing model for Wi-Fi indoor localization in complex environments

The fingerprinting-based approach using the wireless local area network(WLAN)is widely used for indoor localization.However,the construction of the fingerprint database is quite time-consuming.Especially when the position of the access point(AP)or wall changes,updating the fingerprint database in real-time is difficult.An appropriate indoor localization approach,which has a low implementation cost,excellent real-time performance,and high localization accuracy and fully considers complex indoor environment factors,is preferred in location-based services(LBSs)applications.In this paper,we proposed a fine-grained grid computing(FGGC)model to achieve decimeter-level localization accuracy.Reference points(RPs)are generated in the grid by the FGGC model.Then,the received signal strength(RSS)values at each RP are calculated with the attenuation factors,such as the frequency band,three-dimensional propagation distance,and walls in complex environments.As a result,the fingerprint database can be established automatically without manual measurement,and the efficiency and cost that the FGGC model takes for the fingerprint database are superior to previous methods.The proposed indoor localization approach,which estimates the position step by step from the approximate grid location to the fine-grained location,can achieve higher real-time performance and localization accuracy simultaneously.The mean error of the proposed model is 0.36 m,far lower than that of previous approaches.Thus,the proposed model is feasible to improve the efficiency and accuracy of Wi-Fi indoor localization.It also shows high-accuracy performance with a fast running speed even under a large-size grid.The results indicate that the proposed method can also be suitable for precise marketing,indoor navigation,and emergency rescue.

Z-Score in Fetal Echocardiography–Is there Still Room for New Studies?

Congenital heart disease(CHD)is the most common type of birth defect,representing a significant cause of peri-natal morbidity and mortality.Early diagnosis of such anomalies is crucial for improving outcomes.Current pro-tocols recommend a qualitative assessment of cardiac structures using two-dimensional ultrasound(2DUS)and color Doppler imaging.In cases of suspected abnormalities,quantitative assessments through cardiac structure measurements and reference curves can aid in accurate diagnosis.Similar to centiles widely employed in obste-trics,Z-scores provide more precise quantification of various cardiac structures,particularly at the extremes of the curve.While the development of reference curves and Z-scores has progressed over the past two decades,a lack of standardization in measurements and statistical methodology for their determination is evident.Establishing reference curves requires adherence to specific recommendations to improve their accuracy.The purpose of this study is to provide a narrative review of the major studies that have generated reference values for cardiac struc-tures using 2DUS and Z-scores,to evaluate their methodology,and to provide a summary of the results.

Defining the We-map Reference Frames and Providing Mathematical Expressions for Transformation Relations

We-map is an interactive mobile map that can be easily communicated and applied on personal electronic devices,such as personal computers and mobile phones.Therefore,the study of direction systems and coordinate systems is critical,and exploring reference frames is essential in direction and coordinate systems.Despite its significance,existing research on We-map lacks specific solutions for the exploration of reference frames is indispensable for the establishment of accurate direction and coordinate systems.In this paper,we endeavor to address this gap by elucidating the significance of We-map reference frames,defining them with mathematical constraints,summarizing their nature and characteristics,deriving their transformation relationships and representing them through mathematical formulars and equations.Our work contributes to the fundamental theory of We-map and provides valuable systems and support for the mathematical foundation of We-map,map production,and platform development.Ultimately,this research serves to advance the development of We-map.

RPLP0/TBP are the most stable reference genes for human dental pulp stem cells under osteogenic differentiation

BACKGROUND Validation of the reference gene(RG)stability during experimental analyses is essential for correct quantitative real-time polymerase chain reaction(RT-qPCR)data normalisation.Commonly,in an unreliable way,several studies use genes involved in essential cellular functions[glyceraldehyde-3-phosphate dehydro-genase(GAPDH),18S rRNA,andβ-actin]without paying attention to whether they are suitable for such experimental conditions or the reason for choosing such genes.Furthermore,such studies use only one gene when Minimum Information for Publication of Quantitative Real-Time PCR Experiments guidelines recom-mend two or more genes.It impacts the credibility of these studies and causes dis-tortions in the gene expression findings.For tissue engineering,the accuracy of gene expression drives the best experimental or therapeutical approaches.We cultivated DPSCs under two conditions:Undifferentiated and osteogenic dif-ferentiation,both for 35 d.We evaluated the gene expression of 10 candidates for RGs[ribosomal protein,large,P0(RPLP0),TATA-binding protein(TBP),GAPDH,actin beta(ACTB),tubulin(TUB),aminolevulinic acid synthase 1(ALAS1),tyro-sine 3-monooxygenase/tryptophan 5-monooxygenase activation protein,zeta(YWHAZ),eukaryotic translational elongation factor 1 alpha(EF1a),succinate dehydrogenase complex,subunit A,flavoprotein(SDHA),and beta-2-micro-globulin(B2M)]every 7 d(1,7,14,21,28,and 35 d)by RT-qPCR.The data were analysed by the four main algorithms,ΔCt method,geNorm,NormFinder,and BestKeeper and ranked by the RefFinder method.We subdivided the samples into eight subgroups.RESULTS All of the data sets from clonogenic and osteogenic samples were analysed using the RefFinder algorithm.The final ranking showed RPLP0/TBP as the two most stable RGs and TUB/B2M as the two least stable RGs.Either theΔCt method or NormFinder analysis showed TBP/RPLP0 as the two most stable genes.However,geNorm analysis showed RPLP0/EF1αin the first place.These algorithms’two least stable RGs were B2M/GAPDH.For BestKeeper,ALAS1 was ranked as the most stable RG,and SDHA as the least stable RG.The pair RPLP0/TBP was detected in most subgroups as the most stable RGs,following the RefFinfer ranking.CONCLUSION For the first time,we show that RPLP0/TBP are the most stable RGs,whereas TUB/B2M are unstable RGs for long-term osteogenic differentiation of human DPSCs in traditional monolayers.

零膨胀威布尔分布的客观贝叶斯分析

为了及时发现金融保险账户被盗的风险,该文构建了零膨胀威布尔分布模型,通过客观贝叶斯分析推导出参数的Jeffreys先验和reference先验,并设计出相应的抽样机制.设置不同的样本容量和参数真值,对参数估计进行数值仿真,实现了较好的估计效果.

Comparison study on measurement of rail weld joint between inertial reference method and multi-point chord reference method

Purpose – Straightness measurement of rail weld joint is of essential importance to railway maintenance. Dueto the lack of efficient measurement equipment, there has been limited in-depth research on rail weld joint with a5-m wavelength range, leaving a significant knowledge gap in this field.Design/methodology/approach – In this study, the authors used the well-established inertial referencemethod (IR-method), and the state-of-the-art multi-point chord reference method (MCR-method). Two methodshave been applied in different types of rail straightness measurement trollies, respectively. These instrumentswere tested in a high-speed rail section within a certain region of China. The test results were ultimatelyvalidated through using traditional straightedge and feeler gauge methods as reference data to evaluate the railweld joint straightness within the 5-m wavelength range.Findings – The research reveals that IR-method and MCR-method produce reasonably similar measurementresults for wavelengths below 1 m. However, MCR-method outperforms IR-method in terms of accuracy forwavelengths exceeding 3 m. Furthermore, it was observed that IR-method, while operating at a slower speed,carries the risk of derailing and is incapable of detecting rail weld joints and low joints within the track.Originality/value – The research compare two methods’ measurement effects in a longer wavelength rangeand demonstrate the superiority of MCR-method.