Cardiovascular involvement in multisystem inflammatory syndrome in children and midterm follow-up from a pediatric tertiary center in India

BACKGROUND In multisystem inflammatory syndrome in children(MIS-C)with coronavirus disease 2019,there was paucity of data from low-income and middle-income countries on cardiovascular involvement and its longitudinal outcomes.We planned to estimate the pattern of cardiovascular involvement among children with MIS-C and its mid-term outcomes.AIM To determine association between cardiovascular abnormalities and clinical and laboratory parameters.To study the time-line for resolution of various abnormalities.METHODS In this prospective study done in a tertiary care hospital,270 were recruited from June 2020 to January 2022.Baseline demographic data and clinical presentation were recorded.Laboratory parameters and echocardiography were done at admission.Follow-up was done at 2 weeks,3 months,6 months and 1 year after diagnosis.Descriptive statistics were used for parametric and non-parametric data.Risk factors were identified by multivariate regression analysis.RESULTS The 211(78.2%)had cardiac involvement and 102 needed intensive care unit(ICU)admission.Cardiovascular abnormalities observed were shock 123(45.6%),coronary dilatation 28(10.4%),coronary aneurysm 77(28.5%),left ventricular(LV)dysfunction 78(29.3%),mitral regurgitation(MR)77(28.5%)and pericardial effusion 98(36.3%).Coronary artery aneurysm/dilatation during follow-up at 2 weeks and 1 year were 25.7%and 0.9%respectively.Multivariate regression analysis revealed breathlessness[odds ratio(OR)=3.91,95%CI:1.25-12.21,P=0.019]and hi-flow nasal cannula(HFNC)support(OR=8.5,95%CI:1.06-68.38,P=0.044)as predictors of cardiovascular involvement.Higher mean age(OR=1.16,95%CI:1.02-1.32,P=0.026),breathlessness(OR=4.99,95%CI:2.05-12.20,P<0.001),gallop(OR=4.45,95%CI:0.41-2.52,P=0.016),MR(OR=3.61,95%CI:1.53-8.53,P=0.004)and invasive ventilation(OR=4.01,95%CI:1.28-12.58,P=0.017)were predictive of LV dysfunction.Altered sensorium(OR=4.96,95%CI:2.23-11.02,P<0.001),headache(OR=6.61,95%CI:1.46-29.92,P=0.014),HFNC(OR=7.03,95%CI:2.04-24.29,P=0.002),non-rebreathing mask usage(OR=21.13,95%CI:9.00-49.61,P<0.001)and invasive ventilation(OR=5.64,95%CI:1.42-22.45,P=0.014)were risk factors for shock.Anemia was a risk factor for coronary involvement(OR=3.09,95%CI:1.79-5.34,P<0.001).CONCLUSION Significant number of children with MIS-C had cardiovascular involvement contributing to higher ICU management.Although shock resolved quickly,resolution of ventricular function and coronary abnormalities were slower,and hence warrants a structured long-term follow-up protocol.

Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Future changes in precipitation and water availability over the Tibetan Plateau projected by CMIP6 models constrained by climate sensitivity

Precipitation projections over the Tibetan Plateau(TP)show diversity among existing studies,partly due to model uncertainty.How to develop a reliable projection remains inconclusive.Here,based on the IPCC AR6–assessed likely range of equilibrium climate sensitivity(ECS)and the climatological precipitation performance,the authors constrain the CMIP6(phase 6 of the Coupled Model Intercomparison Project)model projection of summer precipitation and water availability over the TP.The best estimates of precipitation changes are 0.24,0.25,and 0.45 mm d^(−1)(5.9%,6.1%,and 11.2%)under the Shared Socioeconomic Pathway(SSP)scenarios of SSP1–2.6,SSP2–4.5,and SSP5–8.5 from 2050–2099 relative to 1965–2014,respectively.The corresponding constrained projections of water availability measured by precipitation minus evaporation(P–E)are 0.10,0.09,and 0.22 mm d^(−1)(5.7%,4.9%,and 13.2%),respectively.The increase of precipitation and P–E projected by the high-ECS models,whose ECS values are higher than the upper limit of the likely range,are about 1.7 times larger than those estimated by constrained projections.Spatially,there is a larger increase in precipitation and P–E over the eastern TP,while the western part shows a relatively weak difference in precipitation and a drier trend in P–E.The wetter TP projected by the high-ECS models resulted from both an approximately 1.2–1.4 times stronger hydrological sensitivity and additional warming of 0.6℃–1.2℃ under all three scenarios during 2050–2099.This study emphasizes that selecting climate models with climate sensitivity within the likely range is crucial to reducing the uncertainty in the projection of TP precipitation and water availability changes.

A Follow-Up on Projection Theory: Theorems and Group Action

In this article, we wish to expand on some of the results obtained from the first article entitled Projection Theory. We have already established that one-parameter projection operators can be constructed from the unit circle . As discussed in the previous article these operators form a Lie group known as the Projection Group. In the first section, we will show that the concepts from my first article are consistent with existing theory [1] [2]. In the second section, it will be demonstrated that not only such operators are mutually congruent but also we can define a group action on ?by using the rotation group [3] [4]. It will be proved that the group acts on elements of ?in a non-faithful but ∞-transitive way consistent with both group operations. Finally, in the last section we define the group operation ?in terms of matrix operations using the operator and the Hadamard Product;this construction is consistent with the group operation defined in the first article.

Projecting Spring Consecutive Rainfall Events in the Three Gorges Reservoir Based on Triple-Nested Dynamical Downscaling

Spring consecutive rainfall events(CREs) are key triggers of geological hazards in the Three Gorges Reservoir area(TGR), China. However, previous projections of CREs based on the direct outputs of global climate models(GCMs) are subject to considerable uncertainties, largely caused by their coarse resolution. This study applies a triple-nested WRF(Weather Research and Forecasting) model dynamical downscaling, driven by a GCM, MIROC6(Model for Interdisciplinary Research on Climate, version 6), to improve the historical simulation and reduce the uncertainties in the future projection of CREs in the TGR. Results indicate that WRF has better performances in reproducing the observed rainfall in terms of the daily probability distribution, monthly evolution and duration of rainfall events, demonstrating the ability of WRF in simulating CREs. Thus, the triple-nested WRF is applied to project the future changes of CREs under the middle-of-the-road and fossil-fueled development scenarios. It is indicated that light and moderate rainfall and the duration of continuous rainfall spells will decrease in the TGR, leading to a decrease in the frequency of CREs. Meanwhile, the duration, rainfall amount, and intensity of CREs is projected to regional increase in the central-west TGR. These results are inconsistent with the raw projection of MIROC6. Observational diagnosis implies that CREs are mainly contributed by the vertical moisture advection. Such a synoptic contribution is captured well by WRF, which is not the case in MIROC6,indicating larger uncertainties in the CREs projected by MIROC6.

人工智能背景下Materials Project数据库在计算材料学课程教学中的应用

该文探讨了在人工智能背景下,Materials Project数据库在计算材料学课程教学中的应用和影响。Materials Project数据库是一个集成了AI和大数据技术的开放获取的材料库,能为学生提供海量的材料晶体结构和物性数据,使教学内容更为丰富,让学生能通过亲自操作获取和分析数据,深入理解微观结构与物性之间的关系。这一新兴的教学模式不仅提升了学生的科研能力和创新思维能力,还有助于培养具备计算材料专业知识和多学科交叉的复合型人才。总体来说,人工智能时代下,大数据的引入为计算材料学课程带来新的活力,并对未来教育改革和实践产生了积极影响。

Transcriptional regulation in the development and dysfunction of neocortical projection neurons

Glutamatergic projection neurons generate sophisticated excitatory circuits to integrate and transmit information among different cortical areas,and between the neocortex and other regions of the brain and spinal cord.Appropriate development of cortical projection neurons is regulated by certain essential events such as neural fate determination,proliferation,specification,differentiation,migration,survival,axonogenesis,and synaptogenesis.These processes are precisely regulated in a tempo-spatial manner by intrinsic factors,extrinsic signals,and neural activities.The generation of correct subtypes and precise connections of projection neurons is imperative not only to support the basic cortical functions(such as sensory information integration,motor coordination,and cognition)but also to prevent the onset and progression of neurodevelopmental disorders(such as intellectual disability,autism spectrum disorders,anxiety,and depression).This review mainly focuses on the recent progress of transcriptional regulations on the development and diversity of neocortical projection neurons and the clinical relevance of the failure of transcriptional modulations.

Cascading multi-segment rupture process of the 2023 Turkish earthquake doublet on a complex fault system revealed by teleseismic P wave back projection method

In this study,the vertical components of broadband teleseismic P wave data recorded by China Earthquake Network are used to image the rupture processes of the February 6th,2023 Turkish earthquake doublet via back projection analysis.Data in two frequency bands(0.5-2 Hz and 1-3 Hz)are used in the imaging processes.The results show that the rupture of the first event extends about 200 km to the northeast and about 150 km to the southwest,lasting~90 s in total.The southwestern rupture is triggered by the northeastern rupture,demonstrating a sequential bidirectional unilateral rupture pattern.The rupture of the second event extends approximately 80 km in both northeast and west directions,lasting~35 s in total and demonstrates a typical bilateral rupture feature.The cascading ruptures on both sides also reflect the occurrence of selective rupture behaviors on bifurcated faults.In addition,we observe super-shear ruptures on certain fault sections with relatively straight fault structures and sparse aftershocks.

Recent Ventures in Interdisciplinary Arctic Research:The ARCPATH Project

This paper celebrates Professor Yongqi GAO's significant achievement in the field of interdisciplinary studies within the context of his final research project Arctic Climate Predictions: Pathways to Resilient Sustainable Societies-ARCPATH(https://www.svs.is/en/projects/finished-projects/arcpath). The disciplines represented in the project are related to climatology, anthropology, marine biology, economics, and the broad spectrum of social-ecological studies. Team members were drawn from the Nordic countries, Russia, China, the United States, and Canada. The project was transdisciplinary as well as interdisciplinary as it included collaboration with local knowledge holders. ARCPATH made significant contributions to Arctic research through an improved understanding of the mechanisms that drive climate variability in the Arctic. In tandem with this research, a combination of historical investigations and social, economic, and marine biological fieldwork was carried out for the project study areas of Iceland, Greenland, Norway, and the surrounding seas, with a focus on the joint use of ocean and sea-ice data as well as social-ecological drivers. ARCPATH was able to provide an improved framework for predicting the near-term variation of Arctic climate on spatial scales relevant to society, as well as evaluating possible related changes in socioeconomic realms. In summary, through the integration of information from several different disciplines and research approaches, ARCPATH served to create new and valuable knowledge on crucial issues, thus providing new pathways to action for Arctic communities.

Loss to Specialized Cardiology Follow-Up in Adults Living with Congenital Heart Disease

Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

Essential role of postoperative follow-up in the management of clear cell sarcoma

Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatment for localizedCCS,while radiotherapy and chemotherapy are preferred for metastatic cases.The roles of adjuvant chemotherapy,radiotherapy,and lymph node dissection arecontroversial.Although immunotherapy has emerged as a promising avenue inCCS treatment research,there are no established clinical standards for postoperativefollow-up.This editorial discusses a recent article by Liu et al,with afocus on current diagnostic modalities,treatment approaches,and the challengingprognosis associated with CCS.Our aim is to underscore the importance of longtermpatient follow-up in CCS management.

Diagnosis of indirectly driven double shell targets with point-projection hard x-ray radiography

We present an application of short-pulse laser-generated hard x rays for the diagnosis of indirectly driven double shell targets. Coneinserted double shell targets were imploded through an indirect drive approach on the upgraded SG-II laser facility. Then, based on thepoint-projection hard x-ray radiography technique, time-resolved radiography of the double shell targets, including that of their near-peakcompression, were obtained. The backlighter source was created by the interactions of a high-intensity short pulsed laser with a metalmicrowire target. Images of the target near peak compression were obtained with an Au microwire. In addition, radiation hydrodynamicsimulations were performed, and the target evolution obtained agrees well with the experimental results. Using the radiographic images, arealdensities of the targets were evaluated.

Accelerated Primal-Dual Projection Neurodynamic Approach With Time Scaling for Linear and Set Constrained Convex Optimization Problems

The Nesterov accelerated dynamical approach serves as an essential tool for addressing convex optimization problems with accelerated convergence rates.Most previous studies in this field have primarily concentrated on unconstrained smooth con-vex optimization problems.In this paper,on the basis of primal-dual dynamical approach,Nesterov accelerated dynamical approach,projection operator and directional gradient,we present two accelerated primal-dual projection neurodynamic approaches with time scaling to address convex optimization problems with smooth and nonsmooth objective functions subject to linear and set constraints,which consist of a second-order ODE(ordinary differential equation)or differential conclusion system for the primal variables and a first-order ODE for the dual vari-ables.By satisfying specific conditions for time scaling,we demonstrate that the proposed approaches have a faster conver-gence rate.This only requires assuming convexity of the objective function.We validate the effectiveness of our proposed two accel-erated primal-dual projection neurodynamic approaches through numerical experiments.

Quantum block coherence with respect to projective measurements

Quantum coherence serves as a defining characteristic of quantum mechanics,finding extensive applications in quantum computing and quantum communication processing.This study explores quantum block coherence in the context of projective measurements,focusing on the quantification of such coherence.Firstly,we define the correlation function between the two general projective measurements P and Q,and analyze the connection between sets of block incoherent states related to two compatible projective measurements P and Q.Secondly,we discuss the measure of quantum block coherence with respect to projective measurements.Based on a given measure of quantum block coherence,we characterize the existence of maximal block coherent states through projective measurements.This research integrates the compatibility of projective measurements with the framework of quantum block coherence,contributing to the advancement of block coherence measurement theory.

Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.

REFINEMENTS OF THE NORM OF TWO ORTHOGONAL PROJECTIONS

In this paper,some refinements of norm equalities and inequalities of combination of two orthogonal projections are established.We use certain norm inequalities for positive contraction operator to establish norm inequalities for combination of orthogonal projections on a Hilbert space.Furthermore,we give necessary and sufficient conditions under which the norm of the above combination of o`rthogonal projections attains its optimal value.

The 30th Anniversary of the Hula Reclamation Project: Profitable Agricultural Management Not Threatening Kinneret Water Quality

Until 1957, the Hula Valley was covered by swampy wetlands and a shallow lake, Lake Hula. In the 1950s, the valley was drained and 6000 ha of land was converted to agricultural development. Seven years later, the National Water Carrier was inaugurated, granting the only natural freshwater lake in Israel, Kinneret, a national drinking water reservoir function. Agricultural cultivation in the Hula Valley faced significant challenges. A reclamation project, the “Hula Project” (HP), was implemented. Thirty (1994-2024) years of HP management are summarized. TP and TN migration data from the Hula Valley southward into Lake Kinneret was approved as not threatening its water quality. During 40 years of post-drainage period underground fire, heavy dust storms were frequently followed by soil subsidence. Nevertheless, as a result of the HP renovated management, those nuisances faded away and significantly declined. Immediately after drainage, as a result of organic Peat oxidation, a great stock of nitrates in the upper layers was formed. Since the mid-1990s, when nitrogen deficiency was developed and Cyanobacteria replaced the bloom-forming Peridinium dominancy, surplus nitrate input has not threatened Kinneret water quality. The hydrological-eco-touristic component of the reclamation project (HP), Lake Agmon-Hula (LAH) became a successful tourist attraction and also an additional nutrient source through submerged vegetation. Two Peat soil areas of land have been denied: the central and the eastern blocks. Soil moisture enhancement, especially that of the Peat soil block, initiated the lowering of the TP migration range and consequently extra water allocation was assigned for summer irrigation (the “Peat Convention Agreement”). Surface, underground seepage and river discharge flows of freshwaters from the Golan Heights into the Hula valley diluted the concentration of migrated TP concentration contributed by the eastern Peat block.

Fudan multi-purpose active target time projection chamber(fMeta-TPC)for photonuclear reaction experiments

Active target time projection chambers are state-of-the-art tools in the field of low-energy nuclear physics and are particularly suitable for experiments using low-intensity radioactive ion beams or gamma rays.The Fudan multi-purpose active target time projection chamber(fMeta-TPC)with 2048 channels was developed to studyα-clustering nuclei.This study focused on the photonuclear reaction with a laser Compton scattering gamma source,particularly for the decay of the highly excitedαcluster state.The design of fMeta-TPC is described in this paper.A comprehensive evaluation of its offline performance was conducted using an ultraviolet laser and ^(241)Amαsource.The results showed that the intrinsic angular resolution of the detector was within 0.30°,and the detector had an energy resolution of 6.85%for 3.0 MeVαparticles.The gain uniformity of the detector was approximately 10%(RMS/Mean),as tested by the ^(55)Fe X-ray source.

GLOBAL CONVERGENCE OF A CAUTIOUS PROJECTION BFGS ALGORITHM FOR NONCONVEX PROBLEMS WITHOUT GRADIENT LIPSCHITZ CONTINUITY

A cautious projection BFGS method is proposed for solving nonconvex unconstrained optimization problems.The global convergence of this method as well as a stronger general convergence result can be proven without a gradient Lipschitz continuity assumption,which is more in line with the actual problems than the existing modified BFGS methods and the traditional BFGS method.Under some additional conditions,the method presented has a superlinear convergence rate,which can be regarded as an extension and supplement of BFGS-type methods with the projection technique.Finally,the effectiveness and application prospects of the proposed method are verified by numerical experiments.

Progress of Taiji-2 Project

Taiji-2 project is the second step of Taiji program,which is to verify the required technology for Taiji-3 mission.The feasibility study of Taiji-2 is successfully finished,and some of the main progress is introduced here.