New complex physiological findings evolve hypothesized mechanisms of Dravet syndrome

Developmental and epileptic encephalopathies(DEEs)are neurological disorders generally involving medically intractable seizures and a diverse array of comorbid neuropsychiatric delays and deficits that may severely affect cognition,mood,sleep,social behavior,movement control,learning,and/or memory.Dravet syndrome(DS),also known as Severe Myoclonic Epilepsy of Infancy.

An Improved Bounded Conflict-Based Search for Multi-AGV Pathfinding in Automated Container Terminals

As the number of automated guided vehicles(AGVs)within automated container terminals(ACT)continues to rise,conflicts have becomemore frequent.Addressing point and edge conflicts ofAGVs,amulti-AGVconflict-free path planning model has been formulated to minimize the total path length of AGVs between shore bridges and yards.For larger terminalmaps and complex environments,the grid method is employed to model AGVs’road networks.An improved bounded conflict-based search(IBCBS)algorithmtailored to ACT is proposed,leveraging the binary tree principle to resolve conflicts and employing focal search to expand the search range.Comparative experiments involving 60 AGVs indicate a reduction in computing time by 37.397%to 64.06%while maintaining the over cost within 1.019%.Numerical experiments validate the proposed algorithm’s efficacy in enhancing efficiency and ensuring solution quality.

Cardiovascular risk burden and disability:findings from the International Mobility in Aging Study(IMIAS)

BACKGROUND The association of cardiovascular risk burden with disability is unclear.We examined the association between trajectories of the Framingham general cardiovascular disease risk score(FGCRS)with the trajectories of limitations of physical function in older adults.METHODS A total of 1219 participants with no disabilities from the International Mobility in Aging Study(IMIAS)study who had up to three repeated measures of FGCRS between 2012–2016 and without a history of stroke or coronary heart disease at baseline and follow-up were included.FGCRS at baseline was assessed and categorized into tertiles.Physical function was evaluated with the Short Physical Performance Battery(SPPB).The data were analyzed using linear mixed-effects models.RESULTS At baseline,FGCRS ranged between 3–94(mean score:24±15.8),participants were 32(2.6%),502(41.2%)and 685(56.2%)in lowest,middle,and highest tertiles,respectively.In the trajectories of limitations of physical function,the lowest FGCRS had no differences,while the middle and highest had a decrease in physical performance between 2012–2014(P=0.0001).Age,being female,living in Andes Mountains,having middle and highest FGCRS,higher alcohol consumption,being obese,lack of exercise and cognitive impairment increase the probability of disability(P<0.05).Alternatively,living in more developed regions and having a higher educational level reduced the probability of disability during the follow-up time(P<0.05).CONCLUSIONS Higher cardiovascular risk burden is associated with decreased physical performance,especially in gait.Results suggest SPPB may provide a measure of cardiovascular health in older adults.

Hepatic organoids: ideal models for non-alcoholic fatty liver disease drug finding and molecular mechanism research

With the improvement of living standards and changes in dietary habits,the non-alcoholic fatty liver disease(NAFLD)has become one of the most common metabolic diseases clinically,with a global prevalence exceeding 25%.NAFLD often presents as a multisystem disease characterized by excessive deposition of triglycerides within hepatocytes,with over 5%of hepatocytes exhibiting steatosis.The clinical progression of NAFLD can mainly be divided into two stages:non-alcoholic fatty liver(NAFL)and non-alcoholic steatohepatitis(NASH).NAFL represents the early stage,primarily characterized by hepatocellular steatosis(which can be reversed with early intervention)and further progression leading to NASH.Besides hepatocellular steatosis,NASH also exhibits hepatocyte inflammation,injury,and fibrosis.Research indicates that 25%of NAFL patients may progress to NASH,and 35%to 50%of NASH patients further develop into liver cirrhosis or even liver cancer.Additionally,NAFLD is closely associated with various chronic diseases and tumors,such as obesity,hyperlipidemia,diabetes,breast cancer,and colorectal cancer.Despite the high and rising incidence of NAFLD,there are currently no clinically proven safe and effective drugs specifically targeting each stage of NAFLD.

Why caution should be applied when interpreting and promoting findings from Mendelian randomisation studies

Introduction In their article entitled‘Investigating genetic causal relationships between blood pressure and anxiety,depressive symptoms,neuroticism and subjective well-being’,Cai and colleagues1 presented the results of a two-sample Mendelian randomisation2(MR)study examining associations between blood pressure traits(systolic,diastolic,hypertension and pulse pressure)and psychological traits(anxiety,depression,neuroticism and subjective well-being).After correction for multiple testing.

Cost-benefit and discriminant validity of a stepwise dementia case-finding approach in an Asian older adult community

Background Case-finding is a recommended approach for dementia early detection in the community.Aims To investigate the discriminant validity and cost-effectiveness of a stepwise dementia case-finding approach in a Singaporean older adult community.Methods The two-phase study was conducted in the community from 2009 to 2015 in Singapore.A total of 3780 participants(age≥60 years)completed phase I(a brief cognitive screening);918 completed phase II and were included in the final analysis.In phase I,all participants were administered the Abbreviated Mental Test(AMT)and the Progressive Forgetfulness Question(PFQ).Those who screened positive on either test were invited to phase II,whereby the Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA)and a formal neuropsychological battery were administered,followed by the research diagnosis of no cognitive impairment,cognitive impairment no dementia(CIND)-Mild(≤2 impaired cognitive domains),CIND-Moderate(>2 impaired domains)or dementia.Receiver operating characteristic curve analyses were conducted for the different cognitive instruments.All discriminant indices were calculated,including sensitivity,specificity,positive and negative predictive values(NPV)and accuracy.Cost-effectiveness analysis was conducted by estimating the amount of screening time needed and the number of older adults requiring re-evaluation in two case-finding scenarios,ie,with or without preselection by the PFQ.Results The stepwise case-finding approach(preselection by the PFQ,then MMSE or MoCA or AMT)showed an excellent NPV(>99%)and accuracy(>86%)for excluding dementia-free cases.Without preselection by the PFQ,screening time for the three cognitive tools were 317.5,317.5 and 254 hours,with 159,302 and 175 screen-positive older adults involved in further evaluation.By adopting the stepwise case-finding approach,total screening time were 156.5,156.5 and 126.2 hours,which decreased by 50.7%,50.7% and 50.3% as compared with those without preselection.Furthermore,after preselection,only 98,167 and 145 screen-positive older adults required further evaluation,corresponding to a reduction of 38.4%,44.7% and 17.1% in the numbers compared with those without preselection.Conclusions A stepwise approach for dementia case-finding should be implemented in the community to minimise the time and resources needed for large-scale early detection of dementia.

A perspective on recent findings and future strategies for reactive aldehyde removal in spinal cord injury

Acrolein in spinal cord injury:The propensity of reactive aldehydes such as acrolein to both initiate and perpetuate tissue damage after spinal cord injury (SCI) is well established.Formed primarily from lipid peroxidation,acrolein is known to be one of the most reactive aldehydes.Acrolein will quickly overwhelm endogenous clearance mechanisms and antioxidants,and form adductswith lipids,proteins,and DNA.

The dynamic relaxation form finding method aided with advanced recurrent neural network

How to establish a self‐equilibrium configuration is vital for further kinematics and dynamics analyses of tensegrity mechanism.In this study,for investigating tensegrity form‐finding problems,a concise and efficient dynamic relaxation‐noise tolerant zeroing neural network(DR‐NTZNN)form‐finding algorithm is established through analysing the physical properties of tensegrity structures.In addition,the non‐linear constrained opti-misation problem which transformed from the form‐finding problem is solved by a sequential quadratic programming algorithm.Moreover,the noise may produce in the form‐finding process that includes the round‐off errors which are brought by the approximate matrix and restart point calculating course,disturbance caused by external force and manufacturing error when constructing a tensegrity structure.Hence,for the purpose of suppressing the noise,a noise tolerant zeroing neural network is presented to solve the search direction,which can endow the anti‐noise capability to the form‐finding model and enhance the calculation capability.Besides,the dynamic relaxation method is contributed to seek the nodal coordinates rapidly when the search direction is acquired.The numerical results show the form‐finding model has a huge capability for high‐dimensional free form cable‐strut mechanisms with complicated topology.Eventually,comparing with other existing form‐finding methods,the contrast simulations reveal the excellent anti‐noise performance and calculation capacity of DR‐NTZNN form‐finding algorithm.

A step towards zero leprosy: Active case finding through community-based approach

Leprosy with multidrug therapy and treatment in the early stages can prevent disability,but it still represents a significant health problem,mainly in vulnerable populations[1].However,if left untreated,leprosy can cause progressive and permanent damage to the skin,nerves,limbs,and eyes.With the constant efforts of the National Leprosy Elimination Programme in India,the implementation of multidrug therapy has lowered the prevalence rate to 0.66/10000 in 2016[1].

Visual Analysis of Research Hotspots and Trends of Benefit Finding in China Based on Citespace

[Objectives]Based on the related literature of benefit finding in China National Knowledge Infrastructure(CNKI),this paper analyzes the research status,hot spots and trends in this field.[Methods]To search for the related literature on benefit finding in China National Knowledge Infrastructure(CNKI),and use Citespace software to visually analyze the number of papers,authors,institutions and keywords.[Results]A total of 204 related papers were obtained,and the annual number of published papers showed a gradual increasing trend.The authors of published papers were represented by Zhang Fenglan,Liu Zhunzhun and Zhang Ting,and the Nursing College of Anhui Medical University published the most papers.The research focus was on social support,coping method and other influencing factors,and qualitative research was the main research type.The key population was breast cancer,stroke patients and their caregivers,and the development trend focused on reliability and validity test and correlation analysis.[Conclusions]The field of benefit finding in China is in the initial exploration stage,and there is little cooperation and exchange between authors and institutions.In the future,academic exchanges and multidisciplinary assistance should be strengthened to promote the rapid development of this field.

Radio Direction Finding Method to Mitigate Tsunami Risk in Sierra Leone

In this study,the Radio Direction Finding method is proposed for the detection of electromagnetic signals,in the VLF band,to try to anticipate the occurrence of potentially destructive geophysical events.The experimentation concerns the interception of electromagnetic anomalies in Sierra Leone,in the five-day time window,associated with seismic events that could potentially generate tsunamis.The area of investigation is Sierra Leone,whose coastline is subjected to tidal wave hazards triggered by earthquakes generated in the Mid-Atlantic Ridge.Although Sierra Leone is not affected by recurrent earthquakes,there is nevertheless a low probability,estimated at 2 percent,of the occurrence of destructive earthquakes in the next 50 years.Also in estimates,the risk of rogue and potentially damaging waves is estimated to strike the Sierra Leone coast at least once in the next 10 years.The Radio Direction Finding experiment carried out continuously 24/7,has shown a close relationship between increased radio-anomalies,in the frequencies of 6,000 Hz,a time window between electromagnetic anomaly detection and the imminence of an earthquake,and higher frequency times for the risk of earthquake occurrence in the Mid-Atlantic Ridge.

Test research and computer simulation analysis of construction state during form finding for suspen-dome system

A novel construction method without scaffold work called as assembly-prestressing form finding loop by loop is presented.Based on the theory of finite displacement,the cycle-forward analysis method is presented for its construction calculation,which adopts the finite element method of generalized geometric nonlinearity combined with the application in the real construction process.By means of the combination of the forward analysis according to real construction sequence and the cycle iteration according to the initial strain increment method of cable force adjustment,the influence of the structural geometric nonlinearity and the loss of prestress are taken into account due to prestressing of tendons in turn and so on.If the initial cable forces derived from the method were used for construction,expected cable forces and shape could be assured easily.Simulation analysis achieved real-time tracking and controlling of the construction status.Finally,according to the procedure and parameters in simulating,a model experimental research on the stage of form finding(namely prestressing)was carried out for suspen-dome structure.The feasibility on the assembly-prestressing form finding method loop by loop was testified.The cycle-forward analysis method was established and numerical simulation was performed,and the results show that it was useful for the design and the construction of similar suspen-dome structure.

Predictive findings forHelicobacter pylori-uninfected, -infected and -eradicated gastric mucosa: Validation study

AIM:To validate the usefulness of screening endoscopy findings for predictingHelicobacter pylori (H. pylori) infection status. METHODS:H. pylori infection status was determined by histology, serology, and the urea breast test in 77 consecutive patients who underwent upper endoscopy. Based on the findings, patients were categorized as H. pylori -uninfected, -infected, or -eradicated cases. Using six photos of certain sites in the stomach per case, we determined the presence or absence of the following endoscopic findings:regular arrangement of collecting venules (RAC), linear erythema, hemorrhage, fundic gland polyp (FGP), atrophic change, rugal hyperplasia, edema, spotty erythema, exudate, xanthoma, and mottled patchy erythema (MPE). The diagnostic odds ratio (DOR) and inter-observer agreement (Kappa value) for these 11 endoscopic findings used in the determination of H. pylori infection status were calculated. RESULTS:Of the 77 patients [32 men and 45 women; mean age (SD), 39.7 (13.4) years] assessed, 28 were H. pylori uninfected, 28 were infected, and 21 were eradicated. DOR values were significantly high (< 0.05) for the following H. pylori cases:uninfected cases with RAC (11.5), linear erythema (24.5), hemorrhage (4.1), and FGP (34.5); for infected cases with atrophic change (8.67), rugal hyperplasia (15.8), edema (14.2), spotty erythema (11.5), and exudate (3.52); and for eradicated cases with atrophic change (32.4) and MPE (103.0). Kappa values were excellent for FGP (0.93), good for RAC (0.63), hemorrhage (0.79), atrophic change (0.74), and MPE (0.75), moderate for linear erythema (0.51), rugal hyperplasia (0.49), edema (0.58), spotty erythema (0.47), and exudate (0.46), and poor for xanthoma (0.19). CONCLUSION:The endoscopic findings of RAC, hemorrhage, FGP, atrophic change, and MPE will be useful for predicting H. pylori infection status.

Unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis

AIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data of 1621 patients (≥ 16 years-old) who underwent appendectomy to treat an initial diagnosis of acute appendicitis between January 1999 and November 2011 were retrospectively assessed. Microscopic findings were used to classify the patients under six categories: appendix vermiformis, phlegmonous appendicitis, gan- grenous appendicitis, perforated appendicitis, supurative appendicitis, and unusual histopathologic findings. The demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and re-analysis of archived resected appendix specimens was carried out. RESULTS: A total of 912 males and 709 females, from16 to 94 years old, were included in the study and comprised 789 cases of suppurative appendicitis, 370 cases of appendix vermiformis, 243 cases of perforated gangrenous appendicitis, 53 cases of flegmaneous appendicitis, 32 cases of gangrenous appendicitis, and 134 (8.3%) cases of unusual histopathological findings. The unusual histopathological findings included fibrous obliteration (n = 62), enterobius vermicularis (n = 31), eosinophilic infiltration (n = 10), mucinous cystadenoma (n = 8), carcinoid tumor (n = 6), granulomatous inflammation (n = 5), adenocarcinoma (n = 4; one of them mucinous), and mucocele (n = 3), adenomatous polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n = 1), appendiceal diverticula (n = 1), and B cell non-hodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy. CONCLUSION: Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.

Potential Toxicological and Cardiopulmonary Effects of PM2,5 Exposure and Related Mortality:Findings of Recent Studies Published during 2003-2013

Air pollution has environmental issue owing become a serious to its diverse harmful effects on the physical and biological environment. According to the Environmental Protection Agency （EPA） and the World Health Organization （WHO）, air pollution affects millions of people worldwide. Hundreds of thousands of deaths each year and a range of diseases, particularly among vulnerable groups （i.e., children, the elderly, and people with special medical conditions）, are attributed to air pollution. These effects are not always caused by single pollutant in the air; rather, they are considered consequences of the multi-pollutants to which people are simultaneously exposed.

A Research of the Finding and Distribution Law of Taisui in Modern China

The academic world is still uncertain about the classification of Taisui. It is debating whether Taisui is living or not, myxomycete complex or fungi. The passage studies the 228 finding reports of Taisui in modern China. It confirms that the first finding time of Taisui in modern China is 1963, and the first reported time is 1992. Taisui has been found in 25 administrative divisions. Taisui occurs the most times in Shandong Province. Besides, provinces where Taisui has been found most times are in northern China. Finding locations of Taisui vary from place to place. Taisui is most often found in normal earth layer, with different burying depth. Taisui is mainly found through seeing, tramping, and digging. Taisui findings lack subjective motivations and are connected with the life and production of the finders. Conclusion: Taisui is an object growing in earth layer.

Blastocystis in ulcerative colitis patients:Genetic diversity and analysis of laboratory findings

Objective:To determine Blastocystis frequency and subtypes(ST) in ulcerative colitis(UC) patients and analyse some laboratory findings between Blastocystis positive and negative cases.Methods:Faecal samples from 150 UC patients in Adnan Menderes University,Training and Research Hospital were examined by direct microscopy and cultivated in Jones medium.Blastocystis positive cultures were subjected to DNA isolation and subtypes were identified by sequencing of barcode region.A retrospective analysis was conducted on C reactive protein(CRP),leukocyte counts(WBC),neutrophil counts,and sedimentation rates.Results:The overall positive rate of Blastocystis was 8%(12 patients) and the most abundant subtype was ST3(eight isolates,66.7%),followed by ST1,ST2 and ST7.Laboratory findings between Blastocystis infected and non-infected UC patients were not significantly different.Blastocystisfrequency was 3.8% among the patients in active stage,while it was 11.8% among the patients in remission stage.Conclusions:The present study confirms previous findings that have indicated the predominance of Blastocystis ST3 in humans and contributes additional evidence that suggests the low colonization of Blastocystis infection in ulcerative colitis patients during active stage.

Dynamic enhanced computed tomography imaging findings of an inflammatory fibroid polyp with massive fibrosis in the stomach

Inflammatory fibroid polyp(IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography(CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of submucosal layer with overlying mucosal hyperenhancement in the gastric antrum. The submucosal layer showed increased enhancement on delayed phase imaging. An antrectomy with gastroduodenostomy was performed because gastric cancer was suspected, particularly signet ring cell carcinoma. The histopathological diagnosis was an IFP with massive fibrosis. The authors suggest that when the submucosal layer of the gastric wall is markedly thickened with delayed enhancement and preservation of the mucosal layer, an IFP with massive fibrosis should be considered in the differential diagnosis.

Direction finding of coexisted independent and coherent signals using electromagnetic vector sensor

The existing direction of arrival （DOA） estimation algorithms based on the electromagnetic vector sensors array barely deal with the coexisting of independent and coherent signals. A two-dimensional direction finding method using an L-shape electromagnetic vector sensors array is proposed. According to this method, the DOAs of the independent signals and the coherent signals are estimated separately, so that the array aperture can be exploited sufficiently. Firstly, the DOAs of the independent signals are estimated by the estimation of signal parameters via rotational invariance techniques, and the influence of the co- herent signals can be eliminated by utilizing the property of the coherent signals. Then the data covariance matrix containing the information of the coherent signals only is obtained by exploiting the Toeplitz property of the independent signals, and an improved polarimetric angular smoothing technique is proposed to de-correlate the coherent signals. This new method is more practical in actual signal environment than common DOA estimation algorithms and can expand the array aperture. Simulation results are presented to show the estimating performance of the proposed method.

Non-alcoholic steatohepatitis and influence of age and gender on histopathologic findings

AIM:To characterize the histopathologic specifications of non-alcoholic steatohepatitis(NASH)according to age and gender.METHODS:An analytical cross-sectional study was conducted in two private gastroenterology clinics on biopsy proven patients suffering from NASH.Biopsy histopathologic findings as well as demographic and laboratory data of the patients at the time of biopsy were gathered retrospectively from clinical records.The grading and staging of histopathologic findings were performed according to the Brunt method after reevaluation of the slides by a pathologist.Patients were divided into two groups according to age(belowand above 55 years).Mean quantitative grade of all pathologic findings were also calculated according to Brunt scoring values.RESULTS:A total number of 77 NASH patients,consisting of 58 males(75.3%)and 19(24.7%)females with a mean age of 41.99±11.80 years(range,18-70 years),were enrolled.The mean age(48.72±13.99 years vs 39.74±10.16 years,P=0.004)and aspartate aminotransferase level(75.11±29.68 U/L vs 52.78± 25.00 U/L,P=0.002)was significantly higher in female patients.Mean quantitative grade of hepatosteatosis was significantly higher in females(2.00±0.82 vs 1.59 ±0.68,P=0.031)compared to males.Fifty four percent(34/65)of young patients had mild hepatosteatosis (GradeⅠ)while only one patient(11.2%)in the older group had gradeⅠhepatosteatosis.Patients aged≥55 had significantly more severe hepatosteatosis(GradeⅢ) (44.4%vs 9.5%,P=0.007)and the mean quantitative grade of hepatosteatosis was significantly higher among them(2.33±0.71 vs 1.56±0.67,P=0.002).Multivariate analysis after omitting the confounding role of age revealed a higher grade of hepatosteatosis in female patients(P=0.010).CONCLUSION:These findings point toward the possible influence of age in the severity of steatohepatitis,portal and lobar inflammation in patients suffering from NASH while gender independently might contribute to the level of steatohepatitis.