Urodynamic Abnormalities in Patients with Relapsing Remitting Multiple Sclerosis

Background: Multiple sclerosis (MS) is a disease with wide variability in clinical presentation. Bladder dysfunctions are very common in MS patients. Early detection of bladder abnormalities is important to improve the outcome in MS patients. Objectives: The aim of this study is to evaluate the urodynamic detected bladder dysfunctions in relapsing remitting MS patients with mild or without lower urinary tract symptoms. Methods: This is a prospective study for 32 patients with relapsing remitting Multiple Sclerosis from January 2017 to June 2018. We included patients with mild or without lower urinary tract symptoms (LUTS) who had mild to moderate disability. Urodynamic studies were performed for all patients. Results: Urodynamic abnormalities were detected in 22 patients (68.75%). Detrusor overactivity (DO) was present alone in 8 patients (25%);DO combined with detrusor external sphincter dyssynergia in 8 patients (25%);DO with low compliant bladder and impaired contractility in another 4 patients (13%) while DO with low complaint bladder in 2 patients (6%). Bladder dysfunction was correlated to high disability score;longer duration of illness;frequent relapses and the presence of LUTS. Conclusion: Urodynamic abnormalities were found in 68.75% of our patients. This highlights the importance of urodynamic studies in the early evaluation of relapsing remitting Multiple Sclerosis.

Recurrent isochromosome 21 and multiple abnormalities in a patient suspected of having acute myeloid leukemia with eosinophilic differentiation—a rare case from South India

Acute myeloid leukemia (AML) is a phenotypically heterogeneous disorder. The M4 subtype of AML is frequently associated with the cytogenetic marker inversion 16 and/or the presence of eosinophilia. Blast crisis is the aggressive phase of the triphasic chronic myeloid leukemia (CML), which is a disease with Philadelphia (Ph) chromosome as the major abnormality. In the present study, we report a 76-year-old patient suspected of having AML with eosinophilic differentiation (AML-M4), which in clinical tests resembles CML blast crisis with multiple chromosomal abnormalities. Isochromosome 21 [i(21)(q10)] was the most recurrent feature noted in metaphases with 46 chromosomes. Ring chromosome, tetraploid endoreduplication, recurrent aneuploid clones with loss of X chromosome, monosomy 17, monosomy 7, and structural variation translocation (9;14) were also observed in this patient. Fluorescent in situ hybridization (FISH) confirmed the absence of Ph chromosome. This report shows how cytogenetic analyses revealed atypical structural aberrations in the M4 subtype of AML.

Infiltration by monocytes of the central nervous system and its role in multiple sclerosis: reflections on therapeutic strategies

Mononuclear macrophage infiltration in the central nervous system is a prominent feature of neuroinflammation. Recent studies on the pathogenesis and progression of multiple sclerosis have highlighted the multiple roles of mononuclear macrophages in the neuroinflammatory process. Monocytes play a significant role in neuroinflammation, and managing neuroinflammation by manipulating peripheral monocytes stands out as an effective strategy for the treatment of multiple sclerosis, leading to improved patient outcomes. This review outlines the steps involved in the entry of myeloid monocytes into the central nervous system that are targets for effective intervention: the activation of bone marrow hematopoiesis, migration of monocytes in the blood, and penetration of the blood–brain barrier by monocytes. Finally, we summarize the different monocyte subpopulations and their effects on the central nervous system based on phenotypic differences. As activated microglia resemble monocyte-derived macrophages, it is important to accurately identify the role of monocyte-derived macrophages in disease. Depending on the roles played by monocyte-derived macrophages at different stages of the disease, several of these processes can be interrupted to limit neuroinflammation and improve patient prognosis. Here, we discuss possible strategies to target monocytes in neurological diseases, focusing on three key aspects of monocyte infiltration into the central nervous system, to provide new ideas for the treatment of neurodegenerative diseases.

Pegaspargase induced multiple organ failure with acute lymphoblastic leukemia:A case report

BACKGROUND The introduction of pegaspargase has greatly advanced the treatment of acute lymphoblastic leukemia(ALL).In the literature,only one case of pegaspargaseinduced multiple organ failure has been reported,and the patient died due to multiple organ failure.CASE SUMMARY Herein,we present a rare case of a 40-year-old man with ALL who developed multiple organ failure after treatment with pegaspargase.The patient had two rare phenomena reflecting poor prognosis,including the discrepancy between clinical manifestations and liver function and persistently low alpha-fetoprotein(AFP)levels from subacute liver failure.However,the patient was successfully treated using a multidisciplinary team approach.CONCLUSION This is the first case report of successful treatment of pegaspargase-induced multiple organ failure.The findings emphasize the importance of a multidisciplinary team approach in treating pegaspargase-induced multiple organ failure.

Optimizing distribution of multiple tuned mass dampers for building structures with inverse element exchange method

Multiple tuned mass dampers(MTMDs)reduce dynamic response with multiple specified frequencies of building structures.Many optimization algorithms for placement design exist,though they rarely conform to code-based verification nor produce high quality solutions without high computational effort and high complexity.This study proposes an inverse element exchange method(IEEM)with multi-level programming and compares it to a single tuned mass damper(STMD)and uniform distribution of multiple tuned mass dampers in the frequency and time domains.A ten-story shear building is used for the numerical case study.The results show that the proposed method can offer improvement over the STMD,uniform distribution of multiple tuned mass dampers,and distribution optimized by genetic algorithms(GA)with regard to minimizing the interstory drift ratio(IDR)in both the frequency and time domains and the time consumption for optimization.

Design Framework of Unsourced Multiple Access for 6G Massive IoT

In this paper,ambient IoT is used as a typical use case of massive connections for the sixth generation(6G)mobile communications where we derive the performance requirements to facilitate the evaluation of technical solutions.A rather complete design of unsourced multiple access is proposed in which two key parts:a compressed sensing module for active user detection,and a sparse interleaver-division multiple access(SIDMA)module are simulated side by side on a same platform at balanced signal to noise ratio(SNR)operating points.With a proper combination of compressed sensing matrix,a convolutional encoder,receiver algorithms,the simulated performance results appear superior to the state-of-the-art benchmark,yet with relatively less complicated processing.

Multiple Infantile Myofibromatosis with Skeletal Abnormalities

Background: Infantile myofibromatosis is an uncommon disorder characterized by multiple fibromatous tumours involving skin, bone, muscle, viscera and subcutaneous tissue. It is a rare benign mesenchymal tumour;most commonly occurs in infancy or early childhood. The clinical presentation can mimic malignant tumours of infancy or childhood. Case Presentation: We describe a rare case of multicentric Infantile myofibromatosis in a 6-month-old infant presenting with multiple scalp swellings and associated skeletal abnormalities (adducted thumbs, clinodactyly and bilateral hallux valgus deformity of great toes). The case required surgical excision of all scalp lesions and orthopedic manipulation of skeletal abnormalities. Conclusion: Infantile myofibromatosis presenting as multiple lesions in the scalp associated with skeletal abnormalities, is very rare. To best of our knowledge, the unique combination of the distinct skeletal abnormalities in infantile myofibromatosis has not been reported so far. This report emphasizes the possibility of skeletal abnormalities in infantile myofibromatosis.

Clinical features and possible pathogenesis of multiple evanescent white dot syndrome with different retinal diseases and events:a narrative review

●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS.However,as the number of reported cases increases,secondary MEWDS occurs in other related retinal diseases and injuries,exhibiting some special characteristics.The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy(MFC/PIC),acute zonal occult outer retinopathy,best vitelliform macular dystrophy,pseudoxanthoma elasticum,and ocular toxoplasmosis.The related retinal injury is laser photocoagulation,surgery,and trauma.Although primary MEWDS often have a self-limiting course,secondary MEWDS may require treatment in some cases,according to the severity of concomitant diseases and complications.Notably,MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation,needs positive treatment with corticosteroids.The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s membrane.The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances.Its prognosis and treatment depend on the severity of complications.Current studies propose that the etiology is associated with immune factors,including viral infection,inflammation in choroid and Bruch’s membrane,and antigen exposure caused by retinal and/or choroidal insults.More pathogenic studies should be conducted in the future.Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.

Characteristic analysis of 5D symmetric Hamiltonian conservative hyperchaotic system with hidden multiple stability

Conservative chaotic systems have unique advantages over dissipative chaotic systems in the fields of secure communication and pseudo-random number generator because they do not have attractors but possess good traversal and pseudorandomness. In this work, a novel five-dimensional(5D) Hamiltonian conservative hyperchaotic system is proposed based on the 5D Euler equation. The proposed system can have different types of coordinate transformations and time reversal symmetries. In this work, Hamilton energy and Casimir energy are analyzed firstly, and it is proved that the new system satisfies Hamilton energy conservation and can generate chaos. Then, the complex dynamic characteristics of the system are demonstrated and the conservatism and chaos characteristics of the system are verified through the correlation analysis methods such as phase diagram, equilibrium point, Lyapunov exponent, bifurcation diagram, and SE complexity. In addition, a detailed analysis of the multistable characteristics of the system reveals that many energy-related coexisting orbits exist. Based on the infinite number of center-type and saddle-type equilibrium points, the dynamic characteristics of the hidden multistability of the system are revealed. Then, the National Institute of Standards and Technology(NIST)test of the new system shows that the chaotic sequence generated by the system has strong pseudo-random. Finally, the circuit simulation and hardware circuit experiment of the system are carried out with Multisim simulation software and digital signal processor(DSP) respectively. The experimental results confirm that the new system has good ergodicity and realizability.

Downlink network-coded multiple access with diverse power

Normally,in the downlink Network-Coded Multiple Access(NCMA)system,the same power is allocated to different users.However,equal power allocation is unsuitable for some scenarios,such as when user devices have different Quality of Service(QoS)requirements.Hence,we study the power allocation in the downlink NCMA system in this paper,and propose a downlink Network-Coded Multiple Access with Diverse Power(NCMA-DP),wherein different amounts of power are allocated to different users.In terms of the Bit Error Rate(BER)of the multi-user decoder,and the number of packets required to correctly decode the message,the performance of the user with more allocated power is greatly improved compared to the Conventional NCMA(NCMA-C).Meanwhile,the performance of the user with less allocated power is still much better than NCMA-C.Furthermore,the overall throughput of NCMA-DP is greatly improved compared to that of NCMA-C.The simulation results demonstrate the remarkable performance of the proposed NCMA-DP.

A Rare Case of Mycobacterium Avium Combined with Penicillium marneffei (PM) Infection Involving Multiple Bone Joints throughout the Whole Body: A Case Report

Background: Mycobacterium avium complex (MAC) infection case which involves bones and joints are rare scenarios. Here, we report a rare case of Penicillium marneffei (PM), lung infection and systemic multi joint damage reported with positive anti-interferon-gamma at the same time. Case Presentation: A 55-year-old woman with fever for 10 days due to repeated multiple joint pain for more than one month was admitted to our hospital on September 19th 2020. During hospitalization, the patient was confirmed with mycobacterium avium combined with Penicillium marneffei (PM) infection involving multiple bone joints. Antifungal therapy and immunity regulatory agent were given during hospitalization. Following pharmocol-therapy, symptoms gradually improved, and the patient was discharged. Conclusions: The patient was considered disseminated and refractory non-tubercular mycobacterium (NTM) combined with Penicillium marneffei infection. In addition, we found that anti IFN-γ autoantibodies are closely related. Although the current incidence of this patient is related to anti IFN-γ, there is a strong correlation between autoantibody-mediated immunodeficiency in adults.

A Physical Security Technology Based upon Doubly Multiple Parameters Weighted Fractional Fourier Transform

Enhancing the security of the wireless communication is necessary to guarantee the reliable of the data transmission, due to the broadcast nature of wireless channels. In this paper, we provide a novel technology referred to as doubly multiple parameters weighted fractional Fourier transform(DMWFRFT), which can strengthen the physical layer security of wireless communication. This paper introduces the concept of DM-WFRFT based on multiple parameters WFRFT(MP-WFRFT), and then presents its four properties. Based on these properties, the parameters decryption probability is analyzed in terms of the number of parameters. The number of parameters for DM-WFRFT is more than that of the MP-WFRFT,which indicates that the proposed scheme can further strengthen the the physical layer security. Lastly, some numerical simulations are carried out to illustrate that the efficiency of proposed DM-WFRFT is related to preventing eavesdropping, and the effect of parameters variety on the system performance is associated with the bit error ratio(BER).

Ocean-bottom cable data multiple suppression based on equipoise pseudo-multichannel matching filter

The effect of strong reflection interfaces, such as free surface, seabed, is strong; thus, the coupling of multiples and waves reduces the quality of ocean-bottom cable seismic data. Using the different polarity response of hydrophones and geophones to downgoing wave fields, dual-sensor summation can eliminate receiver-side multiples, enhance primaries, and improve the resolution of seismic data. We present a dual-sensor summation method based on the equipoise pseudo-multichannel adaptive matching filter. Compared with traditional methods, the proposed method is totally data driven and does not depend on the reflection coefficient; moreover, good results are obtained using synthetic and real data.

Analysis of the Efficacy of Prenatal B-Ultrasound in Diagnosing Fetal Abnormalities

Objective:To explore the positive significance of using prenatal B-ultrasound in diagnosing fetal abnormalities.Methods:A total of 200 pregnant women who visited Shaanxi Provincial People’s Hospital between January 2023 and January 2024 were recruited as the research subjects.All pregnant women received prenatal examinations.A retrospective analysis was carried out to analyze the positive significance of prenatal B-ultrasound examination in the diagnosis of fetal abnormalities.Results:Prenatal B-ultrasound examination detected 10 cases of fetal abnormalities,with a detection rate of 5.00%.When compared with the postnatal examination results of 5.50%,the difference was insignificant(P>0.05).Moreover,comparing the fetal limb abnormalities and cardiovascular abnormalities in prenatal B-ultrasound examination and postnatal examination,one case of congenital heart disease was missed in the prenatal B-ultrasound examination,and the others were consistent with the postnatal examination results,with a coincidence rate of 90.91%,indicating a high compliance rate.Conclusion:Fetal abnormalities have a great impact on mothers,babies,and families,and it is particularly important to strengthen diagnosis during this process.Prenatal B-ultrasound examination can improve the accuracy of diagnosis of fetal abnormalities and can be promoted in clinical practice as a basis for screening fetal abnormalities.

A 3D convolutional neural network model with multiple outputs for simultaneously estimating the reactive transport parameters of sandstone from its CT images

Porosity,tortuosity,specific surface area(SSA),and permeability are four key parameters of reactive transport modeling in sandstone,which are important for understanding solute transport and geochemical reaction pro-cesses in sandstone aquifers.These four parameters reflect the characteristics of pore structure of sandstone from different perspectives,and the traditional empirical formulas cannot make accurate predictions of them due to their complexity and heterogeneity.In this paper,eleven types of sandstone CT images were firstly segmented into numerous subsample images,the porosity,tortuosity,SSA,and permeability of the subsamples were calculated,and the dataset was established.The 3D convolutional neural network(CNN)models were subse-quently established and trained to predict the key reactive transport parameters based on subsample CT images of sandstones.The results demonstrated that the 3D CNN model with multiple outputs exhibited excellent prediction ability for the four parameters compared to the traditional empirical formulas.In particular,for the prediction of tortuosity and permeability,the 3D CNN model with multiple outputs even showed slightly better prediction ability than its single-output variant model.Additionally,it demonstrated good generalization per-formance on sandstone CT images not included in the training dataset.The study showed that the 3D CNN model with multiple outputs has the advantages of simplifying operation and saving computational resources,which has the prospect of popularization and application.

Maneuvering target tracking using threshold interacting multiple model algorithm

To avoid missing track caused by the target maneuvers in automatic target tracking system, a new maneuvering target tracking technique called threshold interacting multiple model （TIMM） is proposed. This algorithm is based on the interacting multiple model （IMM） method and applies a threshold controller to improve tracking accuracy. It is also applicable to other advanced algorithms of IMM. In this research, we also compare the position and velocity root mean square （RMS） errors of TIMM and IMM algorithms with two different examples. Simulation results show that the TIMM algorithm is superior to the traditional IMM alzorithm in estimation accuracy.

An Algorithm of the Adaptive Grid and Fuzzy Interacting Multiple Model

This paper studies the algorithm of the adaptive grid and fuzzy interacting multiple model （AGFIMM） for maneuvering target tracking, while focusing on the problems of the fixed structure multiple model （FSMM） algorithm＇s cost-efficiency ratio being not high and the Markov transition probability of the interacting multiple model （IMM） algorithm being difficult to determine exactly. This algorithm realizes the adaptive model set by adaptive grid adjustment, and obtains each model matching degree in the model set by fuzzy logic inference. The simulation results show that the AGFIMM algorithm can effectively improve the accuracy and cost-efficiency ratio of the multiple model algorithm, and as a result is suitable for enineering apolications.

Gut flora in multiple sclerosis:implications for pathogenesis and treatment

Multiple sclerosis is an inflammatory disorder chara cterized by inflammation,demyelination,and neurodegeneration in the central nervous system.Although current first-line therapies can help manage symptoms and slow down disease progression,there is no cure for multiple sclerosis.The gut-brain axis refers to complex communications between the gut flo ra and the immune,nervous,and endocrine systems,which bridges the functions of the gut and the brain.Disruptions in the gut flora,termed dys biosis,can lead to systemic inflammation,leaky gut syndrome,and increased susceptibility to infections.The pathogenesis of multiple sclerosis involves a combination of genetic and environmental factors,and gut flora may play a pivotal role in regulating immune responses related to multiple scle rosis.To develop more effective therapies for multiple scle rosis,we should further uncover the disease processes involved in multiple sclerosis and gain a better understanding of the gut-brain axis.This review provides an overview of the role of the gut flora in multiple scle rosis.

A Review on Vibration Control of Multiple Cylinders Subjected to FlowInduced Vibrations

The fatigue damage caused by flow-induced vibration(FIV)is one of the major concerns for multiple cylindrical structures in many engineering applications.The FIV suppression is of great importance for the security of many cylindrical structures.Many active and passive control methods have been employed for the vibration suppression of an isolated cylinder undergoing vortex-induced vibrations(VIV).The FIV suppression methods are mainly extended to the multiple cylinders from the vibration control of the isolated cylinder.Due to the mutual interference between the multiple cylinders,the FIV mechanism is more complex than the VIV mechanism,which makes a great challenge for the FIV suppression.Some efforts have been devoted to vibration suppression of multiple cylinder systems undergoing FIV over the past two decades.The control methods,such as helical strakes,splitter plates,control rods and flexible sheets,are not always effective,depending on many influence factors,such as the spacing ratio,the arrangement geometrical shape,the flow velocity and the parameters of the vibration control devices.The FIV response,hydrodynamic features and wake patterns of the multiple cylinders equipped with vibration control devices are reviewed and summarized.The FIV suppression efficiency of the vibration control methods are analyzed and compared considering different influence factors.Further research on the FIV suppression of multiple cylinders is suggested to provide insight for the development of FIV control methods and promote engineering applications of FIV control methods.

Linear paired electrolysis of furfural to furoic acid at both anode and cathode in a multiple redox mediated system

Implementing a new energy-saving electrochemical synthesis system with high commercial value is a strategy of the sustainable development for upgrading the bulk chemicals preparation technology in the future.Here,we report a multiple redox-mediated linear paired electrolysis system,combining the hydrogen peroxide mediated cathode process with the I2 mediated anode process,and realize the conversion of furfural to furoic acid in both side of the dividedflow cell simultaneously.By reasonably controlling the cathode potential,the undesired water splitting reaction and furfural reduction side reactions are avoided.Under the galvanostatic electrolysis,the two-mediated electrode processes have good compatibility,which reduce the energy consumption by about 22%while improving the electronic efficiency by about 125%.This system provides a green electrochemical synthesis route with commercial prospects.