Advancements and challenges in neuroimaging for the diagnosis of intracranial aneurysms:Addressing false positive diagnoses and emerging techniques

Despite advancements in neuroimaging,false positive diagnoses of intracranial aneurysms remain a significant concern.This article examines the causes,prevalence,and implications of such false-positive diagnoses.We discuss how conditions like arterial occlusion with vascular stump formation and infundibular widening can mimic aneurysms,particularly in the anterior circulation.The article compares various imaging modalities,including computer tomography angiogram,magnetic resonance imaging/angiography,and digital subtraction angiogram,highlighting their strengths and limitations.We emphasize the im-portance of accurate differentiation to avoid unnecessary surgical interventions.The potential of emerging technologies,such as high-resolution vessel wall ima-ging and deep neural networks for automated detection,is explored as promising avenues for improving diagnostic accuracy.This manuscript underscores the need for continued research and clinical vigilance in the diagnosis of intracranial aneurysms.

Design of insulation support system of 120 keV positive ion source accelerator

In order to support the physical research on the EAST tokamak,a new positive ion source with designed beam energy of 120 keV was proposed to be developed.Accelerator structure is one of the key components of the ion source.Through the finite element analysis method,the electrostatic analyses of insulators and grid plates were carried out,the material and structure parameters of insulators were determined.The maximum electric field around each insulator is about 4 kV/mm,and the maximum electric field between grids is about 14 kV/mm,which can meet the 120 keV withstand voltage holding.The insulation system for the positive ion source accelerator with 120 keV is designed,and the connection and basic parameters of insulators and support flanges are analyzed and determined.

Associations between Rejective Parenting Style and Academic Anxiety among Chinese High School Students:The Chain Mediation Effect of Self-Concept and Positive Coping Style

Background:The phenomenon of academic anxiety has been demonstrated to exert a considerable influence on students’academic engagement,leading to the emergence of a phenomenon known as“learned helplessness”and undermining the selfconfidence and motivation of high school students.Using acceptance-rejection theory,this study elucidated how a rejective parenting style affects Chinese high school students’academic anxiety and explored the urban-rural heterogeneity of this relationship.Methods:Data were analyzed using a stratified whole-cluster random sampling method.There are a total of 30,000 high school students in the three regions of northern and central China(from Shanxi,Hebei and Henan).A sample of 2286 high school students aged 14–19 years was ultimately selected from 2760 respondents for this investigation,which was conducted at the beginning of the 2023 school year.Pearson correlation,ordinary least squares(OLS)regression analysis,path analysis,and Fisher’s permutation test(FPT)were used to examine the effects of rejective parenting style on high school students’academic anxiety.Results:Results indicated a significant positive predictive effect between rejective parenting style and academic anxiety among high school students(β=0.815,t=116.211,p<0.001).Students’self-concept was significantly positively related to positive coping style(β=0.424,t=21.208,p<0.001)and chain-mediated this relationship.Therefore,this parenting style may indirectly mitigate academic anxiety through these mediators.The study also found that the effect of rejective parenting style on academic anxiety varied by students’residential background and was more pronounced in urban areas(0.226)than in rural areas(0.130).Conclusion:The research underscores the imperative for Chinese families to reexamine their utilization of rejection parenting and to prioritize the cultivation of students’intrinsic attributes.These findings offer a theoretical framework and practical evidence for policymakers and educators to develop efficacious and targeted interventions.In particular,greater attention should be directed towards the discrepancies in the manifestation of emotional and academic anxiety between urban and rural students,and prompt guidance should be furnished.

Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders:A case report and review of literature

BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.

Health risk assessment of trace metal(loid)s in agricultural soils based on Monte Carlo simulation coupled with positive matrix factorization model in Chongqing, southwest China

This study aimed to investigate the pollution characteristics, source apportionment, and health risks associated with trace metal(loid)s(TMs) in the major agricultural producing areas in Chongqing, China. We analyzed the source apportionment and assessed the health risk of TMs in agricultural soils by using positive matrix factorization(PMF) model and health risk assessment(HRA) model based on Monte Carlo simulation. Meanwhile, we combined PMF and HRA models to explore the health risks of TMs in agricultural soils by different pollution sources to determine the priority control factors. Results showed that the average contents of cadmium(Cd), arsenic (As), lead(Pb), chromium(Cr), copper(Cu), nickel(Ni), and zinc(Zn) in the soil were found to be 0.26, 5.93, 27.14, 61.32, 23.81, 32.45, and 78.65 mg/kg, respectively. Spatial analysis and source apportionment analysis revealed that urban and industrial sources, agricultural sources, and natural sources accounted for 33.0%, 27.7%, and 39.3% of TM accumulation in the soil, respectively. In the HRA model based on Monte Carlo simulation, noncarcinogenic risks were deemed negligible(hazard index <1), the carcinogenic risks were at acceptable level(10^(-6)<total carcinogenic risk ≤ 10^(-4)), with higher risks observed for children compared to adults. The relationship between TMs, their sources, and health risks indicated that urban and industrial sources were primarily associated with As, contributing to 75.1% of carcinogenic risks and 55.7% of non-carcinogenic risks, making them the primary control factors. Meanwhile, agricultural sources were primarily linked to Cd and Pb, contributing to 13.1% of carcinogenic risks and 21.8% of non-carcinogenic risks, designating them as secondary control factors.

Novel Fractal-Based Features for Low-Power Appliances in Non-Intrusive Load Monitoring

Non-intrusive load monitoring is a method that disaggregates the overall energy consumption of a building to estimate the electric power usage and operating status of each appliance individually.Prior studies have mostly concentrated on the identification of high-power appliances like HVAC systems while overlooking the existence of low-power appliances.Low-power consumer appliances have comparable power consumption patterns,which can complicate the detection task and can be mistaken as noise.This research tackles the problem of classification of low-power appliances and uses turn-on current transients to extract novel features and develop unique appliance signatures.A hybrid feature extraction method based on mono-fractal and multi-fractal analysis is proposed for identifying low-power appliances.Fractal dimension,Hurst exponent,multifractal spectrum and the Hölder exponents of switching current transient signals are extracted to develop various‘turn-on’appliance signatures for classification.Four classifiers,i.e.,deep neural network,support vector machine,decision trees,and K-nearest neighbours have been optimized using Bayesian optimization and trained using the extracted features.The simulated results showed that the proposed method consistently outperforms state-of-the-art feature extraction methods across all optimized classifiers,achieving an accuracy of up to 96%in classifying low-power appliances.

Assessment of Liver Fibrosis in HBsAg-Negative and Anti HBc Positive Patients

Background: Surface antigen (HBsAg) is the mean marker of hepatitis B virus infection. During the course of the infection, some patients lose the HBsAg and only the presence of anti-HBc antibody indicates previous contact with the virus. Among these patients, some have detectable viral load (occult infection) but most without viral replication. There is no guideline regarding these patients. The aim of this study was to assess hepatic fibrosis in patients with only the hepatitis B virus contact marker “total anti-HBc”. Patients and methods: it was a descriptive and analytical cross-sectional study, conducted in three private hospitals from January to August 2022. Were included HBsAg-negative and HBc-positive patients, consulting in Gastroenterology departments. Noninvasive methods (APRI, FIB-4 and FIBROSCAN) were used to evaluate liver stiffness because of their easy accessibility and low-cost. The hepatic fibrosis was considered significant when the score determined by APRI, FIB-4 and FIBROSCAN® tests was respectively greater than 1.5;2.67 and 8 kPa corresponding to fibrosis level 2 (F2). Results: A total of 63 HBsAg-negative/total HBcAg-positive patients were included. The mean age was 49.9 ± 13.4 years. The male/female sex ratio was 1.78. Of the 63 patients, 19 had significant liver fibrosis (30.1%) among which 9 patients had HCC. The FIB-4 score outperformed the APRI score in assessing liver fibrosis, with a sensitivity of 84.2%, a specificity of 100% and a negative predictive value of 93.6%. In univariate analysis, there was a significant association between the occurrence of significant liver fibrosis and age over 40 years, dyslipidaemia, obesity, alcohol consumption, smoking, herbal medicine, negative anti-HBs immunological status and detectable viral load. Conclusion: Our study revealed a high prevalence of significant to severe hepatic fibrosis in anti-HBc positive patients. In most of the cases, the fibrosis was severe. Progression to HCC has also been possible. There is no consensus on the follow-up strategy for those patients. However, screening for hepatic fibrosis using noninvasive methods should be recommended for patients aged over 40 years, alcohol or herbal medicine users, patients with metabolic syndrome or occult hepatitis B. In HBsAg-negative/anti-HBc-positive patients, liver stiffness should be evaluated and if it is greater than F2, HCC screening should be started.

Embedding Perovskite in Polymer Matrix Achieved Positive Temperature Response with Inversed Temperature Crystallization

Organic perovskites are promising semiconductor materials for advanced photoelectric applications.Their fluorescence typically shows a negative temperature coefficient due to bandgap change and structural instability.In this study,a novel perovskite-based composite with positive sensitivity to temperature was designed and obtained based on its inverse temperature crystallization,demonstrating good flexibility and solution processability.The supercritical drying method was used to address the limitations of annealing drying in preparing high-performance perovskite.Optimizing the precursor composition proved to be an effective approach for achieving high fluorescence and structural integrity in the perovskite material.This perovskite-based composite exhibited a positive temperature sensitivity of 28.563%℃^(-1)for intensity change and excellent temperature cycling reversibility in the range of 25-40℃in an ambient environment.This made it suitable for use as a smart window with rapid response.Furthermore,the perovskite composite was found to offer temperature-sensing photoluminescence and flexible processability due to its components of perovskite-based compounds and polyethylene oxide.The organic precursor solvent could be a promising candidate for use as ink to print or write on various substrates for optoelectronic devices responding to temperature.

Amplifying colorectal cancer progression: impact of a PDIA4/SP1 positive feedback loop by circPDIA4 sponging miR-9-5p

Objective:Colorectal cancer(CRC)is a prevalent malignant tumor with a high fatality rate.CircPDIA4 has been shown to have a vital role in cancer development by acting as a facilitator.Nevertheless,the impact of the circPDIA4/miR-9-5p/SP1 axis on development of CRC has not been studied.Methods:Western blot,immunohistochemistry,and reverse transcription-quantitative polymerase chain reaction assays were used to analyze gene expression.The CCK-8 assay was used to assess cell growth.The Transwell assay was used to detect invasion and migration of cells.The luciferase reporter and RNA immunoprecipitation tests were used to determine if miR-9-5p and circPDIA4(or SP1)bind to one another.An in vivo assay was used to measure tumor growth.Results:It was shown that circPDIA4 expression was greater in CRC cell lines and tissues than healthy cell lines and tissues.CircPDIA4 knockdown prevented the invasion,migration,and proliferation of cells in CRC.Additionally,the combination of circPDIA4 and miR-9-5p was confirmed,as well as miR-9-5p binding to SP1.Rescue experiments also showed that the circPDIA4/miR-9-5p/SP1 axis accelerated the development of CRC.In addition,SP1 combined with the promoter region of circPDIA4 and induced circPDIA4 transcription.CircPDIA4 was shown to facilitate tumor growth in an in vivo assay.Conclusions:The circPDIA4/miR-9-5p/SP1 feedback loop was shown to aggravate CRC progression.This finding suggests that the ceRNA axis may be a promising biomarker for CRC patient treatment.

Observation and analysis of positive leader re-illumination in a 10 m ultra-high voltage transmission line gap under switching impulse voltages

The leader propagation is one of the most important stages in long air gap discharge.The mechanism behind leader re-illumination remains unclear.In high humidity conditions(20.0–30.1 g/m^(3)),we have conducted experiments of long sparks in a 10 m ultra-high voltage(UHV)transmission line gap under switching impulse voltages.The positive leaders predominantly propagate discontinuously,with almost no significantly continuous propagation occurring.The leader channels are intensely luminous and each elongation segment is straight,with streamers resembling the“branch type”which differs from the“diffuse type”streamers at the front of continuous propagation leaders.The distribution of the propagation velocities is highly random(3.7–18.4 cm/μs),and the average velocity(9.2 cm/μs)significantly exceeds that of continuous propagation(1.5–2.0 cm/μs).Analysis suggests that the current-velocity models suitable for continuous leader propagation do not align well with the experimental data in re-illumination mode.Based on the discharge current waveforms and optical images,it is speculated that the newly elongated leader in re-illumination mode does not evolve gradually from the stem(about 1 cm)but rather evolves overall from a thermal channel much longer than stem.

Relationships among Social Capital, Positive Aspect, and Caregiver Burden in Dementia Families: A Mediating Model

Objective: To investigate the current situation and influencing factors of care giving burden among family caregivers with dementia and to analyze the Positive Aspect of caregivers between Social Capital and Caregiver Burden. Methods: A total of 205 elderly dementia patients and family caregivers were select from 3 tertiary hospital by convenience sampling method in Zhengzhou. The general information questionnaire. The Social Capital Scale for Caregiver of People with Dementia, The Positive Aspect of Care giving scale and The Caregiver Burden Inventory were utilized for investigation. Results: In this study the scores of the Social Capital Scale of Caregivers with dementia were (48.76 ± 6.44), the scores of the Positive Aspect of Care giving scale were (37.41 ± 4.29), and the scores of the Caregiver Burden Inventory were (64.43 ± 10.89). The results of multiple linear regression analysis showed that patient’s age, patient’s disease duration, social capital, and positive feelings were the main influencing factors of caregiver’s burden of care (P Conclusion: The burden of family caregivers is at a medium-high level, and it is recommended that the medical, social levels fully mobilize the social support system of caregivers from the caregivers’ conditions, increase the level of the caregivers’ social capital, and pay attention to the positive feelings of the caregivers and regulate them in time social alleviate the burden of their care giving.

Positive health:An integrated quantitative approach in patients with chronic gastrointestinal and hepato-pancreatico-biliary disorders

BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of health.This approach is especially relevant for patients with chronic disorders.Chronic gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ systems.The impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ systems.AIM To describe and quantify the dimensions of PH in patients with chronic GI-HPB disorders.METHODS Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient Department of the Maastricht University Medical Center.Validated questionnaires and data from patient files were used to quantify the six dimensions of PH.Internal consistency was tested with McDonald’s Omega.Zero-order Pearson correlations and t-tests were used to assess associations and differences.A P value<0.05 was considered significant.RESULTS The GI-HPB patients scored significantly worse in all dimensions of PH compared to control data or norm scores from the general population.Regarding quality of life,participation and daily functioning,GI-HPB patients scored in the same range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB disorders.Intercorrelation scores between the six dimensions were only very weak to weak,forcing us to quantify each domain separately.CONCLUSION All six dimensions of PH are impaired in the GI-HPB patients.Malnutrition and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.

Predictive value of positive lymph node ratio in patients with locally advanced gastric remnant cancer

BACKGROUND Traditional lymph node stage(N stage)has limitations in advanced gastric remnant cancer(GRC)patients;therefore,establishing a new predictive stage is necessary.AIM To explore the predictive value of positive lymph node ratio(LNR)according to clinicopathological characteristics and prognosis of locally advanced GRC.METHODS Seventy-four patients who underwent radical gastrectomy and lymphadenectomy for locally advanced GRC were retrospectively reviewed.The relationship between LNR and clinicopathological characteristics was analyzed.The survival analysis was performed using Kaplan-Meier survival curves and Cox regression model.RESULTS Number of metastatic LNs,tumor diameter,depth of tumor invasion,Borrmann type,serum tumor biomarkers,and tumor-node-metastasis(TNM)stage were correlated with LNR stage and N stage.Univariate analysis revealed that the factors affecting survival included tumor diameter,anemia,serum tumor biomarkers,vascular or neural invasion,combined resection,LNR stage,N stage,and TNM stage(all P<0.05).The median survival time for those with LNR0,LNR1,LNR2 and LNR3 stage were 61,31,23 and 17 mo,respectively,and the differences were significant(P=0.000).Anemia,tumor biomarkers and LNR stage were independent prognostic factors for survival in multivariable analysis(all P<0.05).CONCLUSION The new LNR stage is uniquely based on number of metastatic LNs,with significant prognostic value for locally advanced GRC,and could better differentiate overall survival,compared with N stage.

A Double Sensitive Fault Detection Filter for Positive Markovian Jump Systems With A Hybrid Event-Triggered Mechanism

This paper is concerned with the double sensitive fault detection filter for positive Markovian jump systems. A new hybrid adaptive event-triggered mechanism is proposed by introducing a non-monotonic adaptive law. A linear adaptive event-triggered threshold is established by virtue of 1-norm inequality.Under such a triggering strategy, the original system can be transformed into an interval uncertain system. By using a stochastic copositive Lyapunov function, an asynchronous fault detection filter is designed for positive Markovian jump systems(PMJSs) in terms of linear programming. The presented filter satisfies both L_-gain(?_-gain) fault sensitivity and L_1(?_1)internal differential privacy sensitivity. The proposed approach is also extended to the discrete-time case. Finally, two examples are provided to illustrate the effectiveness of the proposed design.

Reviewing Stability Criteria for Positive Homogeneous Systems and Adding One for Discrete-Time Cases with Degree Less Than One

The article synthesizes and presents the results regarding the stability of positive homogeneous systems that have been researched and published in recent years. Next, we provide a sufficient condition for global exponential stability in the case of discrete-time positive homogeneous systems with an order less than one with time-varying delays.

Impact of web-based positive psychological intervention on emotions,psychological capital,and quality of life in gastric cancer patients on chemotherapy

BACKGROUND Gastric cancer is a malignant digestive tract tumor that originates from the epithelium of the gastric mucosa and occurs in the gastric antrum,particularly in the lower curvature of the stomach.AIM To evaluate the impact of a positive web-based psychological intervention on emotions,psychological capital,and quality of survival in gastric cancer patients on chemotherapy.METHODS From January 2020 to October 2023,121 cases of gastric cancer patients on chemotherapy admitted to our hospital were collected and divided into a control group(n=60)and an observation group(n=61)according to the admission order.They were given either conventional nursing care alone and conventional nursing care combined with web-based positive psychological interventions,respectively.The two groups were compared in terms of negative emotions,psychological capital,degree of cancer-caused fatigue,and quality of survival.RESULTS After intervention,the number of patients in the observation group who had negative feelings toward chemotherapy treatment was significantly lower than that of the control group(P<0.05);the Positive Psychological Capital Questionnaire score was considerably higher than that of the control group(P<0.05);the degree of cancer-caused fatigue was significantly lower than that of the control group(P<0.05);and the Quality of Life Scale for Cancer Patients(QLQ-30)score was significantly higher than that of the control group(P<0.05).CONCLUSION Implementing a web-based positive psychological intervention for gastric cancer chemotherapy patients can effectively improve negative emotions,enhance psychological capital,and improve the quality of survival.

A Bibliometric Analysis of Positive Mental Health Research and Development in the Social Science Citation Index

Background:This study aimed to conduct a bibliometric analysis of positive mental health,focusing on citation performance,article title,abstract,author keywords,Keyword Plus,and their development trends.The novelty of this study is a pioneer within the field of positive mental health.Therefore,it delivered new ideas for researchers and practitioners who had concerns about positive mental health in terms of trends research which covered recommended articles and the research focus in recent years.Methods:The data were retrieved on 30 April 2024 from the Social Sciences Citation Index(SSCI)of Clarivate Analytics’Web of Science Core Collection for studies published between 1992 and 2023.Results:The distribution of keywords in the article title and keywords chosen by the authors were used to assess research trends.1391 documents in SSCI were found during the search;1221 of these were document-type“articles.”524 journals published these publications.The most frequently used keywords by the writers,according to the articles’analysis,are“depression,”“resilience,”“COVID-19,”“anxiety,”and“social support.”Kristin D.Neff wrote the most frequently cited paper in 2003.Most articles came from Europe(five countries),America(two countries),Asia(two countries),and Oceania(one country),and were published in English.The majority of the research in the field of positive mental health is conducted in Europe and America,two regions where English is the primary language.The main research topics in positive mental health were related to adolescents,children,and college students.Conclusion:Trends research through bibliometric analysis by using data from Web of Science Core Collection should be followed by manual inspection to avoid errors.Therefore,scientists need more careful data examination in bibliometric analysis.

Effects of pulmonary surfactant combined with noninvasive positive pressure ventilation in neonates with respiratory distress syndrome

BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal death in hospitals in China.The main mechanism of the disease is hypoxemia and hypercapnia caused by lack of surfactant AIM To explore the effect of pulmonary surfactant(PS)combined with noninvasive positive pressure ventilation on keratin-14(KRT-14)and endothelin-1(ET-1)levels in peripheral blood and the effectiveness in treating NRDS.METHODS Altogether 137 neonates with respiratory distress syndrome treated in our hospital from April 2019 to July 2021 were included.Of these,64 control cases were treated with noninvasive positive pressure ventilation and 73 observation cases were treated with PS combined with noninvasive positive pressure ventilation.The expression of KRT-14 and ET-1 in the two groups was compared.The deaths,complications,and PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)blood gas indexes in the two groups were compared.Receiver operating characteristic curve(ROC)analysis was used to determine the diagnostic value of KRT-14 and ET-1 in the treatment of NRDS.RESULTS The observation group had a significantly higher effectiveness rate than the control group.There was no significant difference between the two groups in terms of neonatal mortality and adverse reactions,such as bronchial dysplasia,cyanosis,and shortness of breath.After treatment,the levels of PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly higher than before treatment,while the level of PaCO_(2)was significantly lower.After treatment,the observation group had significantly higher levels of PaO_(2)and PaO_(2)/FiO_(2)than the control group,while PaCO_(2)was notably lower in the observation group.After treatment,the KRT-14 and ET-1 levels in both groups were significantly decreased compared with the pre-treatment levels.The observation group had a reduction of KRT-14 and ET-1 levels than the control group.ROC curve analysis showed that the area under the curve(AUC)of KRT-14 was 0.791,and the AUC of ET-1 was 0.816.CONCLUSION Combining PS with noninvasive positive pressure ventilation significantly improved the effectiveness of NRDS therapy.KRT-14 and ET-1 levels may have potential as therapeutic and diagnostic indicators.

Relativistic Mechanics in Positive and Negative Subspace-Time according to the Inverse Relativity Model

In the second paper on the inverse relativity model, we explained in the first paper [1] that analyzing the four-dimensional displacement vector on space-time according to a certain approach leads to the splitting of space-time into positive and negative subspace-time. Here, in the second paper, we continue to analyze each of the four-dimensional vectors of velocity, acceleration, momentum, and forces on the total space-time fabric. According to the approach followed in the first paper. As a result, in the special case, we obtain new transformations for each of the velocity, acceleration, momentum, energy, and forces specific to each subspace-time, which are subject to the positive and negative modified Lorentz transformations described in the first paper. According to these transformations, momentum remains a conserved quantity in the positive subspace and increases in the negative subspace, while the relativistic total energy decreases in the positive subspace and increases in the negative subspace. In the general case, we also have new types of energy-momentum tensor, one for positive subspace-time and the other for negative subspace-time, where the energy density decreases in positive subspace-time and increases in negative subspace-time, and we also obtain new gravitational field equations for each subspace-time.

False Positive HIV “Combo” Screening Test in a Hemodialysis Patient in Saudi Arabia: A Case Report and Review of the Literature

Introduction: HIV screening tests are routinely conducted on dialysis patients as the constant exposure of their blood during the dialysis process makes them a reasonable risk for blood-borne infections. However, in low prevalence settings, where HIV rates are <0.1% of the population, false positive results are more likely. This results in apprehension in the dialysis unit as breaches in infectious disease protocols could be presumed. This is illustrated in the case report below. Case Summary: A 62-year-old male Saudi end-stage kidney disease patient secondary to DM nephropathy began dialysis a year before presentation in a hemodialysis center in Saudi Arabia. Routine screening tests done at the start of dialysis revealed negative Hepatitis C, HIV 1 and 2 screening but a positive Hepatitis B surface antigen screen. The patient went for holiday dialysis at another facility and had a routine fourth-generation HIV test done which was positive. A confirmatory HIV PCR test was negative. Conclusion: This case highlights the need for caution in interpreting highly sensitive and specific HIV screening tests in a low-prevalence setting. Routine screening beyond the national recommendation may not be necessary in low-prevalence areas.