In the United States, type 2 diabetes mellitus (T2DM) disproportionately affects the African American (AA) community, which has not been systematically included in molecular studies of underlying mechanisms. As part o...In the United States, type 2 diabetes mellitus (T2DM) disproportionately affects the African American (AA) community, which has not been systematically included in molecular studies of underlying mechanisms. As part of a gene expression study, we recruited cases with T2DM and matched, unaffected controls at an urban hospital in Washington, DC, with a majority AA population. Here we describe the profile of socio-demographic, behavioral, and health-related associations of the study population. Self-reported data were collected from cases with T2DM (N = 77) and age- and gender-matched controls (N = 80), ages 45 - 65 years. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). As expected, obesity, hypertension, and cardiovascular disease were more prevalent in cases than in controls. Tobacco smoking and working alongside other tobacco smokers were also associated with T2DM. After adjusting for covariates, current tobacco smoking remained statistically associated with the disease (OR per half pack of cigarettes 1.43, 95% CI 1.04 - 1.95;p-value 0.027). HbA1c levels were elevated in T2DM cases who smoked more than a pack of cigarettes daily. These associations highlight the comorbid burdens of T2DM in an AA urban community setting and identify tobacco control as an unmet need for future prevention and control efforts.展开更多
Variability in the location and shape of the dayside magnetopause is attributed to magnetic reconnection,a fundamental process that enables the transfer of mass,energy,and momentum from the solar wind into the magneto...Variability in the location and shape of the dayside magnetopause is attributed to magnetic reconnection,a fundamental process that enables the transfer of mass,energy,and momentum from the solar wind into the magnetosphere.The spatial and temporal properties of the magnetopause,under varying solar and magnetospheric conditions,remain largely unknown because empirical studies using in-situ observations are challenging to interpret.Global wide field-of-view(FOV)imaging is the only means to simultaneously observe the spatial distribution of the plasma properties over the vast dayside magnetospheric region and,subsequently,quantify the energy transport from the interplanetary medium into the terrestrial magnetosphere.Two upcoming missions,ESA/CAS SMILE and NASA’s LEXI will provide wide-field imagery of the dayside magnetosheath in soft X-rays,an emission generated by charge exchange interactions between high charge-state heavy ions of solar wind origin and exospheric neutral atoms.High-cadence two-dimensional observations of the magnetosheath will allow the estimation of dynamic properties of its inner boundary,the magnetopause,and enable studies of its response to changes in the solar wind dynamic pressure and interplanetary magnetic field orientation.This work introduces a statistically-based estimation approach based on inverse theory to estimate the spatial distribution of magnetosheath soft X-ray emissivities and,with this,identify the location of the magnetopause over the Sun−Earth line.To do so,we simulate the magnetosheath structure using the MHD-based OpenGGCM model and generate synthetic soft X-ray images using LEXI’s orbit and attitude information.Our results show that 3-D estimations using the described statistically-based technique are robust against Poisson-distributed shot noise inherent to soft X-ray images.Also,our proposed methodology shows that the accuracy of both three-dimensional(3-D)estimation and the magnetopause standoff distance calculation highly depends on the observational point.展开更多
The Lunar Environment heliospheric X-ray Imager(LEXI)and Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)missions will image the Earth’s dayside magneto pause and cusps in soft X-rays after their respective l...The Lunar Environment heliospheric X-ray Imager(LEXI)and Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)missions will image the Earth’s dayside magneto pause and cusps in soft X-rays after their respective launches in the near future,to specify glo bal magnetic reconnection modes for varying solar wind conditions.To suppo rt the success of these scientific missions,it is critical to develop techniques that extract the magnetopause locations from the observed soft X-ray images.In this research,we introduce a new geometric equation that calculates the subsolar magnetopause position(RS)from a satellite position,the look direction of the instrument,and the angle at which the X-ray emission is maximized.Two assumptions are used in this method:(1)The look direction where soft X-ray emissions are maximized lies tangent to the magnetopause,and(2)the magnetopause surface near the subsolar point is almost spherical and thus RSis nea rly equal to the radius of the magneto pause curvature.We create synthetic soft X-ray images by using the Open Geospace General Circulation Model(OpenGGCM)global magnetohydrodynamic model,the galactic background,the instrument point spread function,and Poisson noise.We then apply the fast Fourier transform and Gaussian low-pass filte rs to the synthetic images to re move noise and obtain accurate look angles for the soft X-ray pea ks.From the filte red images,we calculate RS and its accuracy for different LEXI locations,look directions,and solar wind densities by using the OpenGGCM subsolar magnetopause location as ground truth.Our method estimates RS with an accuracy of<0.3 RE when the solar wind density exceeds>10 cm-3.The accuracy improves for greater solar wind densities and during southward interplanetary magnetic fields.The method ca ptures the magnetopause motion during southwa rd interplaneta ry magnetic field turnings.Consequently,the technique will enable quantitative analysis of the magnetopause motion and help reveal the dayside reconnection modes for dynamic solar wind conditions.This technique will suppo rt the LEXI and SMILE missions in achieving their scientific o bjectives.展开更多
BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare system.Although there have been advances in treatment modali...BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare system.Although there have been advances in treatment modalities,survival rates for TCA patients remain low.This narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating TCA.METHODS:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,2022.The search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English language.Following the search,943 articles were retrieved,and two independent reviewers conducted a screening process.RESULTS:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable rhythm.There were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital epinephrine.Emergency thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt trauma.Resuscitative endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic shock.When implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality rates.Veno-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,respectively.In the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ECLS.CONCLUSION:TCA remains a signifi cant challenge for emergency medical services due to its high morbidity and mortality rates.Pre-and intra-arrest prognostic factors can help identify patients who are likely to benefit from aggressive and resource-intensive resuscitation measures.Further research is needed to enhance guidelines for the clinical use of established and emerging therapeutic approaches that can help optimize treatment effi cacy and ameliorate survival outcomes.展开更多
Resistance to pentavalent antimonial drugs and the lack of vaccines make it urgent to find novel therapeutic options to treat Leishmaniasis, a tropical disease caused by the Leishmania protozoan parasite. The study re...Resistance to pentavalent antimonial drugs and the lack of vaccines make it urgent to find novel therapeutic options to treat Leishmaniasis, a tropical disease caused by the Leishmania protozoan parasite. The study reported here is to investigate if Streptomycin, an aminoglycoside, and Amphotericin B, the second-line treatment drug, exhibit antileishmanial activity through a similar mechanism. By using MOE (Molecular Operating Environment), we performed molecular docking studies on these drugs binding to a range of targets including ribosome targets in Leishmania and H. sapiens. Our study shows that the two drugs do not bind to the same pockets in Leishmania targets but to the same pockets in the human ribosome, with some differences in interactions. Moreover, our 2D maps indicated that Amphotericin B binds to the A-site in the human cytoplasmic ribosome, whereas streptomycin does not.展开更多
Developing a predictive model for detecting cardiovascular diseases (CVDs) is crucial due to its high global fatality rate. With the advancements in artificial intelligence, the availability of large-scale data, and i...Developing a predictive model for detecting cardiovascular diseases (CVDs) is crucial due to its high global fatality rate. With the advancements in artificial intelligence, the availability of large-scale data, and increased access to computational capability, it is feasible to create robust models that can detect CVDs with high precision. This study aims to provide a promising method for early diagnosis by employing various machine learning and deep learning techniques, including logistic regression, decision trees, random forest classifier, extreme gradient boosting (XGBoost), and a sequential model from Keras. Our evaluation identifies the random forest classifier as the most effective model, achieving an accuracy of 0.91, surpassing other machine learning and deep learning approaches. Close behind are XGBoost (accuracy: 0.90), decision tree (accuracy: 0.86), and logistic regression (accuracy: 0.70). Additionally, our deep learning sequential model demonstrates promising classification performance, with an accuracy of 0.80 and a loss of 0.425 on the validation set. These findings underscore the potential of machine learning and deep learning methodologies in advancing cardiovascular disease prediction and management strategies.展开更多
Traditional medicine has garnered significant global recognition,with an estimated 80%of the global population using it.Therefore,it is essential to fully understand the integration of traditional medicines into curre...Traditional medicine has garnered significant global recognition,with an estimated 80%of the global population using it.Therefore,it is essential to fully understand the integration of traditional medicines into current healthcare systems.This review aims to provide a comprehensive overview of the standard process to modernize traditional medicine scientifically in the context of modern biomedicine,further termed here as“scientization”.Specifically,we aim to summarize the advancements made in understanding the efficacy,effectiveness,and underlying mechanisms of herbal medicine.We also examined the transition from experience-to evidence-based medicine during acupuncture.Furthermore,we explore the development of universal safety and quality control standards.Finally,we discuss international trade and export markets for Chinese medical products.The development and integration of traditional medicine have allowed it to further improve human health,resulting in a more comprehensive health solution for the global population.展开更多
As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for u...As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.展开更多
Newborn hearing screening(NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016;however, few ...Newborn hearing screening(NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016;however, few studies have evaluated its status, and none have covered all provinces across the country. This cross-sectional retrospective study provides an overview of the program's status across all provinces, focusing on screening coverage rates, referral/fail rates, and follow-up procedures. In 2021, 199,034 newborns were screened, with a coverage rate of 92.6% and an overall referral/fail rate of 1.87%. These performance measures provide a foundation for future progress and improvements. This study highlights the importance of ongoing efforts to enhance the program's effectiveness and sustainability.展开更多
Neurodegenerative disorders represent a pervasive global health challenge,yet therapeutic options remain conspicuously limited.These disorders are inherently dynamic processes within the central nervous system,unfoldi...Neurodegenerative disorders represent a pervasive global health challenge,yet therapeutic options remain conspicuously limited.These disorders are inherently dynamic processes within the central nervous system,unfolding across distinct sub-stages:initial structural neuronal alterations(sub-stage 1),functional impairment(sub-stage 2),and culminating in neuronal death(sub-stage 3).展开更多
There has been some good news, and some bad news in the controlled fusion community recently. The good news is that the Lawrence Livermore National Laboratory (LLNL) has recently produced a burning plasma. It succeede...There has been some good news, and some bad news in the controlled fusion community recently. The good news is that the Lawrence Livermore National Laboratory (LLNL) has recently produced a burning plasma. It succeeded on several of its shots where ~1.5 - 2 megajoules from its laser (National Ignition Facility, or NIF) has generated ~1.3 - 3 megajoules of fusion products. The highest ratio of fusion energy to laser energy it achieved, defined as its Q, was 1.5 at the time of this writing. While LLNL is sponsored by nuclear stockpile stewardship, this author sees a likely path from their result to fusion for energy for the world, a path using a very different laser and a very different target configuration. The bad news is that the International Tokamak Experimental Reactor (ITER) has continued to stumble on more and more delays and cost overruns, as its capital cost has mushroomed from ~$5 billion to ~ $25 B. This paper argues that the American fusion effort, for energy for the civilian economy, should switch its emphasis not only from magnetic fusion to inertial fusion but should also take much more seriously fusion breeding. Over the next few decades, the world might well be setting up more and more thermal nuclear reactors, and these might need fuel which only fusion breeders can supply. In other words, fusion should begin to color outside the lines.展开更多
This paper presents a system approach of mass balance calculations of ozone and other species under diffusion-convection-reaction processes to study the impacts of major ozone-depleting chemicals, chlorine (Cl) and ch...This paper presents a system approach of mass balance calculations of ozone and other species under diffusion-convection-reaction processes to study the impacts of major ozone-depleting chemicals, chlorine (Cl) and chlorine monoxide (ClO), and the effect of photolysis on ozone concentrations, ozone depletion, total ozone abundance, and ozone layer along the altitude in the stratosphere. The calculated ozone concentrations and profile of the layer followed a similar trend and were generally in good agreement with the measurements above the tropical area. The calculated peak of the layer was at the same mid-stratosphere at Z = 30 km with a peak concentration and total ozone abundance about 20% higher than the measured peak concentration of 8.0 ppm and total abundance of 399 DU. In the presence of Cl and ClO, the calculated ozone concentrations and total abundance were substantially reduced. Cl generally depleted more uniformly of ozone across the altitude, while ClO reduced substantially the ozone in the upper stratosphere and thus shifted the peak of the layer to a much lower elevation at Z = 14 km. Although both ClO and Cl are active ozone-depleting chemicals, ClO was found to have a more pronounced impact on ozone depletion and distribution than Cl. The possible explanations of these interesting phenomena were discussed and elaborated. The approach and calculations in this paper were shown to be useful in providing an initial insight into the structure and behavior of the complex ozone layer.展开更多
An engineering system approach of 2-D cylindrical model of transient mass balance calculations of ozone and other concerned chemicals along with fourteen photolysis, ozone-generating and ozone-depleting chemical react...An engineering system approach of 2-D cylindrical model of transient mass balance calculations of ozone and other concerned chemicals along with fourteen photolysis, ozone-generating and ozone-depleting chemical reaction equations was developed, validated, and used for studying the ozone concentrations, distribution and peak of the layer, ozone depletion and total ozone abundance in the stratosphere. The calculated ozone concentrations and profile at both the Equator and a 60˚N location were found to follow closely with the measured data. The calculated average ozone concentration was within 1% of the measured average, and the deviation of ozone profiles was within 14%. The monthly evolution of stratospheric ozone concentrations and distribution above the Equator was studied with results discussed in details. The influences of slow air movement in both altitudinal and radial directions on ozone concentrations and profile in the stratosphere were explored and discussed. Parametric studies of the influences of gas diffusivities of ozone D<sub>O3</sub> and active atomic oxygen D<sub>O</sub> on ozone concentrations and distributions were also studied and delineated. Having both influences through physical diffusion and chemical reactions, the diffusivity (and diffusion) of atomic oxygen D<sub>O</sub> was found to be more sensitive and important than that of ozone D<sub>O3</sub> on ozone concentrations and distribution. The 2-D ozone model present in this paper for stratospheric ozone and its layer and depletion is shown to be robust, convenient, efficient, and executable for analyzing the complex ozone phenomena in the stratosphere. .展开更多
The phase field method is playing an increasingly important role in understanding and predicting morphological evolution in materials and biological systems.Here,we develop a new analytical approach based on the bifur...The phase field method is playing an increasingly important role in understanding and predicting morphological evolution in materials and biological systems.Here,we develop a new analytical approach based on the bifurcation analysis to explore the mathematical solution structure of phase field models.Revealing such solution structures not only is of great mathematical interest but also may provide guidance to experimentally or computationally uncover new morphological evolution phenomena in materials undergoing electronic and structural phase transitions.To elucidate the idea,we apply this analytical approach to three representative phase field equations:the Allen-Cahn equation,the Cahn-Hilliard equation,and the Allen-Cahn-Ohta-Kawasaki system.The solution structures of these three phase field equations are also verified numerically by the homotopy continuation method.展开更多
Background:Alcohol-related liver disease(ALRD)has emerged as a significant global health concern,primarily attributed to the overconsumption of alcohol.While alcoholism has the potential to impact various organs,it is...Background:Alcohol-related liver disease(ALRD)has emerged as a significant global health concern,primarily attributed to the overconsumption of alcohol.While alcoholism has the potential to impact various organs,it is the liver that is especially vulnerable.Methods:This review comprehensively examines the challenges encountered during the pre-transplant,intra-transplant,and post-transplant phases,a significant number of which are attributable to alcohol misuse.Historically,liver transplant(LT)programmes have excluded patients with alcohol-related liver disease(ARLD)due to mandatory abstinence requirements and apprehensions regarding potential graft shortages for other hepatic diseases.This review counters these concerns by highlighting the minimal usage of grafts for early liver transplantation.It strongly advocates for the incorporation of severe alcoholic hepatitis into the model for end-stage liver disease allocation,devoid of any stigmatization.The selection of ARLD individuals for LT necessitates the critical involvement of a multidisciplinary team,inclusive of addiction specialists.Results:Despite the complexities associated with LT for patients with ARLD,this review underscores its therapeutic advantages,particularly for those anticipated to experience severe adverse effects.This review accentuates the necessity of ensuring equitable access to medical interventions for all patients,irrespective of their lifestyle choices.Conclusion:The examination of genetic and epigenetic variables that play a role in the onset and advancement of ALD.The identification of potential therapy strategies is also an important area of study.The formulation of intricate eligibility rules for LT in patients with a past of alcohol abuse needs essential interactions between medical practitioners and researchers.The use of new technologies such as genomics and epigenomics could boost the accuracy of ALD diagnostic and prognostic approaches.These targeted investigations could potentially lead to major improvements in the management and treatment results of ALD.展开更多
BACKGROUND Patients with diabetes mellitus(DM)are predisposed to an increased risk of infection signifying the importance of vaccination to protect against its potentially severe complications.The Centers for Disease ...BACKGROUND Patients with diabetes mellitus(DM)are predisposed to an increased risk of infection signifying the importance of vaccination to protect against its potentially severe complications.The Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices(CDC/ACIP)issued immunization recommendations to protect this patient population.AIM To assess the adherence of patients with DM to the CDC/ACIP immunization recommendations in Saudi Arabia and to identify the factors associated with the vaccine adherence rate.METHODS An observational retrospective study conducted in 2023 was used to collect data on the vaccination records from 13 diabetes care centers in Saudi Arabia with 1000 eligible patients in phase I with data collected through chart review and 709 patients in phase II through online survey.RESULTS Among participants,10.01%(n=71)had never received any vaccine,while 85.89%(n=609)received at least one dose of the coronavirus disease 2019(COVID-19)vaccine,and 34.83%(n=247)had received the annual influenza vaccine.Only 2.96%(n=21),2.11%(n=15),and 1.12%(n=8)received herpes zoster,tetanus,diphtheria,and pertussis(Tdap),and human papillomavirus(HPV)vaccines,respectively.For patients with DM in Saudi Arabia,the rate of vaccination for annual influenza and COVID-19 vaccines was higher compared to other vaccinations such as herpes zoster,Tdap,pneumococcal,and HPV.Factors such as vaccine recommendations provided by family physicians or specialists,site of care,income level,DM-related hospitalization history,residency site,hemoglobin A1c(HbA1c)level,and health sector type can significantly influence the vaccination rate in patients with DM.Among non-vaccinated patients with DM,the most reported barriers were lack of knowledge and fear of side effects.This signifies the need for large-scale research in this area to identify additional factors that might facilitate adherence to CDC/ACIP vaccine recommendations in patients with DM.CONCLUSION In Saudi Arabia,patients with DM showed higher vaccination rates for annual influenza and COVID-19 vaccines compared to other vaccinations such as herpes zoster,Tdap,pneumococcal,and HPV.Factors such as vaccine recommendations provided by family physicians or specialists,the site of care,income level,DM-related hospitalization history,residency site,HbA1c level,and health sector type can significantly influence the vaccination rate in patients with DM.展开更多
Practical guide:Glucagon-like peptide-1 and dual glucosedependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonists in diabetes mellitus common second-line choice after metformin for treating T2...Practical guide:Glucagon-like peptide-1 and dual glucosedependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonists in diabetes mellitus common second-line choice after metformin for treating T2DM.Various considerations can make selecting and switching between different GLP-1 RAs challenging.Our study aims to provide a comprehensive guide for the usage of GLP-1 RAs and dual GIP and GLP-1 RAs for the management of T2DM.展开更多
文摘In the United States, type 2 diabetes mellitus (T2DM) disproportionately affects the African American (AA) community, which has not been systematically included in molecular studies of underlying mechanisms. As part of a gene expression study, we recruited cases with T2DM and matched, unaffected controls at an urban hospital in Washington, DC, with a majority AA population. Here we describe the profile of socio-demographic, behavioral, and health-related associations of the study population. Self-reported data were collected from cases with T2DM (N = 77) and age- and gender-matched controls (N = 80), ages 45 - 65 years. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). As expected, obesity, hypertension, and cardiovascular disease were more prevalent in cases than in controls. Tobacco smoking and working alongside other tobacco smokers were also associated with T2DM. After adjusting for covariates, current tobacco smoking remained statistically associated with the disease (OR per half pack of cigarettes 1.43, 95% CI 1.04 - 1.95;p-value 0.027). HbA1c levels were elevated in T2DM cases who smoked more than a pack of cigarettes daily. These associations highlight the comorbid burdens of T2DM in an AA urban community setting and identify tobacco control as an unmet need for future prevention and control efforts.
基金supported by NASA Goddard Space Flight Center through Cooperative Agreement 80NSSC21M0180 to Catholic UniversityPartnership for Heliophysics and Space Environment Research(PHaSER)+2 种基金the NASA Heliophysics United States Participating Investigator Program under Grant WBS516741.01.24.01.03(DS)support from the NASA grants 80NSSC19K0844,80NSSC20K1670,and 80MSFC20C0019the NASA GSFC internal fundings(HIF,ISFM,and IRAD)。
文摘Variability in the location and shape of the dayside magnetopause is attributed to magnetic reconnection,a fundamental process that enables the transfer of mass,energy,and momentum from the solar wind into the magnetosphere.The spatial and temporal properties of the magnetopause,under varying solar and magnetospheric conditions,remain largely unknown because empirical studies using in-situ observations are challenging to interpret.Global wide field-of-view(FOV)imaging is the only means to simultaneously observe the spatial distribution of the plasma properties over the vast dayside magnetospheric region and,subsequently,quantify the energy transport from the interplanetary medium into the terrestrial magnetosphere.Two upcoming missions,ESA/CAS SMILE and NASA’s LEXI will provide wide-field imagery of the dayside magnetosheath in soft X-rays,an emission generated by charge exchange interactions between high charge-state heavy ions of solar wind origin and exospheric neutral atoms.High-cadence two-dimensional observations of the magnetosheath will allow the estimation of dynamic properties of its inner boundary,the magnetopause,and enable studies of its response to changes in the solar wind dynamic pressure and interplanetary magnetic field orientation.This work introduces a statistically-based estimation approach based on inverse theory to estimate the spatial distribution of magnetosheath soft X-ray emissivities and,with this,identify the location of the magnetopause over the Sun−Earth line.To do so,we simulate the magnetosheath structure using the MHD-based OpenGGCM model and generate synthetic soft X-ray images using LEXI’s orbit and attitude information.Our results show that 3-D estimations using the described statistically-based technique are robust against Poisson-distributed shot noise inherent to soft X-ray images.Also,our proposed methodology shows that the accuracy of both three-dimensional(3-D)estimation and the magnetopause standoff distance calculation highly depends on the observational point.
基金supported by NASA(Grant Nos.80NSSC19K0844,80NSSC20K1670,80MSFC20C0019,and 80GSFC21M0002)support from NASA Goddard Space Flight Center internal funding programs(HIF,Internal Scientist Funding Model,and Internal Research and Development)。
文摘The Lunar Environment heliospheric X-ray Imager(LEXI)and Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)missions will image the Earth’s dayside magneto pause and cusps in soft X-rays after their respective launches in the near future,to specify glo bal magnetic reconnection modes for varying solar wind conditions.To suppo rt the success of these scientific missions,it is critical to develop techniques that extract the magnetopause locations from the observed soft X-ray images.In this research,we introduce a new geometric equation that calculates the subsolar magnetopause position(RS)from a satellite position,the look direction of the instrument,and the angle at which the X-ray emission is maximized.Two assumptions are used in this method:(1)The look direction where soft X-ray emissions are maximized lies tangent to the magnetopause,and(2)the magnetopause surface near the subsolar point is almost spherical and thus RSis nea rly equal to the radius of the magneto pause curvature.We create synthetic soft X-ray images by using the Open Geospace General Circulation Model(OpenGGCM)global magnetohydrodynamic model,the galactic background,the instrument point spread function,and Poisson noise.We then apply the fast Fourier transform and Gaussian low-pass filte rs to the synthetic images to re move noise and obtain accurate look angles for the soft X-ray pea ks.From the filte red images,we calculate RS and its accuracy for different LEXI locations,look directions,and solar wind densities by using the OpenGGCM subsolar magnetopause location as ground truth.Our method estimates RS with an accuracy of<0.3 RE when the solar wind density exceeds>10 cm-3.The accuracy improves for greater solar wind densities and during southward interplanetary magnetic fields.The method ca ptures the magnetopause motion during southwa rd interplaneta ry magnetic field turnings.Consequently,the technique will enable quantitative analysis of the magnetopause motion and help reveal the dayside reconnection modes for dynamic solar wind conditions.This technique will suppo rt the LEXI and SMILE missions in achieving their scientific o bjectives.
文摘BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare system.Although there have been advances in treatment modalities,survival rates for TCA patients remain low.This narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating TCA.METHODS:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,2022.The search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English language.Following the search,943 articles were retrieved,and two independent reviewers conducted a screening process.RESULTS:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable rhythm.There were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital epinephrine.Emergency thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt trauma.Resuscitative endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic shock.When implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality rates.Veno-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,respectively.In the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ECLS.CONCLUSION:TCA remains a signifi cant challenge for emergency medical services due to its high morbidity and mortality rates.Pre-and intra-arrest prognostic factors can help identify patients who are likely to benefit from aggressive and resource-intensive resuscitation measures.Further research is needed to enhance guidelines for the clinical use of established and emerging therapeutic approaches that can help optimize treatment effi cacy and ameliorate survival outcomes.
文摘Resistance to pentavalent antimonial drugs and the lack of vaccines make it urgent to find novel therapeutic options to treat Leishmaniasis, a tropical disease caused by the Leishmania protozoan parasite. The study reported here is to investigate if Streptomycin, an aminoglycoside, and Amphotericin B, the second-line treatment drug, exhibit antileishmanial activity through a similar mechanism. By using MOE (Molecular Operating Environment), we performed molecular docking studies on these drugs binding to a range of targets including ribosome targets in Leishmania and H. sapiens. Our study shows that the two drugs do not bind to the same pockets in Leishmania targets but to the same pockets in the human ribosome, with some differences in interactions. Moreover, our 2D maps indicated that Amphotericin B binds to the A-site in the human cytoplasmic ribosome, whereas streptomycin does not.
文摘Developing a predictive model for detecting cardiovascular diseases (CVDs) is crucial due to its high global fatality rate. With the advancements in artificial intelligence, the availability of large-scale data, and increased access to computational capability, it is feasible to create robust models that can detect CVDs with high precision. This study aims to provide a promising method for early diagnosis by employing various machine learning and deep learning techniques, including logistic regression, decision trees, random forest classifier, extreme gradient boosting (XGBoost), and a sequential model from Keras. Our evaluation identifies the random forest classifier as the most effective model, achieving an accuracy of 0.91, surpassing other machine learning and deep learning approaches. Close behind are XGBoost (accuracy: 0.90), decision tree (accuracy: 0.86), and logistic regression (accuracy: 0.70). Additionally, our deep learning sequential model demonstrates promising classification performance, with an accuracy of 0.80 and a loss of 0.425 on the validation set. These findings underscore the potential of machine learning and deep learning methodologies in advancing cardiovascular disease prediction and management strategies.
基金supported by the National Science Foundation of China(82204610)the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences(CI2021A04013)+1 种基金Qihang Talent Project of ICMM(L2022046)Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ15-YQ-041,ZXKT21029).
文摘Traditional medicine has garnered significant global recognition,with an estimated 80%of the global population using it.Therefore,it is essential to fully understand the integration of traditional medicines into current healthcare systems.This review aims to provide a comprehensive overview of the standard process to modernize traditional medicine scientifically in the context of modern biomedicine,further termed here as“scientization”.Specifically,we aim to summarize the advancements made in understanding the efficacy,effectiveness,and underlying mechanisms of herbal medicine.We also examined the transition from experience-to evidence-based medicine during acupuncture.Furthermore,we explore the development of universal safety and quality control standards.Finally,we discuss international trade and export markets for Chinese medical products.The development and integration of traditional medicine have allowed it to further improve human health,resulting in a more comprehensive health solution for the global population.
文摘As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.
文摘Newborn hearing screening(NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016;however, few studies have evaluated its status, and none have covered all provinces across the country. This cross-sectional retrospective study provides an overview of the program's status across all provinces, focusing on screening coverage rates, referral/fail rates, and follow-up procedures. In 2021, 199,034 newborns were screened, with a coverage rate of 92.6% and an overall referral/fail rate of 1.87%. These performance measures provide a foundation for future progress and improvements. This study highlights the importance of ongoing efforts to enhance the program's effectiveness and sustainability.
基金supported by the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation)Project-ID 424778381-TRR 295 and the Fondazione Grigioni per il Morbo di Parkinson(to MM).
文摘Neurodegenerative disorders represent a pervasive global health challenge,yet therapeutic options remain conspicuously limited.These disorders are inherently dynamic processes within the central nervous system,unfolding across distinct sub-stages:initial structural neuronal alterations(sub-stage 1),functional impairment(sub-stage 2),and culminating in neuronal death(sub-stage 3).
文摘There has been some good news, and some bad news in the controlled fusion community recently. The good news is that the Lawrence Livermore National Laboratory (LLNL) has recently produced a burning plasma. It succeeded on several of its shots where ~1.5 - 2 megajoules from its laser (National Ignition Facility, or NIF) has generated ~1.3 - 3 megajoules of fusion products. The highest ratio of fusion energy to laser energy it achieved, defined as its Q, was 1.5 at the time of this writing. While LLNL is sponsored by nuclear stockpile stewardship, this author sees a likely path from their result to fusion for energy for the world, a path using a very different laser and a very different target configuration. The bad news is that the International Tokamak Experimental Reactor (ITER) has continued to stumble on more and more delays and cost overruns, as its capital cost has mushroomed from ~$5 billion to ~ $25 B. This paper argues that the American fusion effort, for energy for the civilian economy, should switch its emphasis not only from magnetic fusion to inertial fusion but should also take much more seriously fusion breeding. Over the next few decades, the world might well be setting up more and more thermal nuclear reactors, and these might need fuel which only fusion breeders can supply. In other words, fusion should begin to color outside the lines.
文摘This paper presents a system approach of mass balance calculations of ozone and other species under diffusion-convection-reaction processes to study the impacts of major ozone-depleting chemicals, chlorine (Cl) and chlorine monoxide (ClO), and the effect of photolysis on ozone concentrations, ozone depletion, total ozone abundance, and ozone layer along the altitude in the stratosphere. The calculated ozone concentrations and profile of the layer followed a similar trend and were generally in good agreement with the measurements above the tropical area. The calculated peak of the layer was at the same mid-stratosphere at Z = 30 km with a peak concentration and total ozone abundance about 20% higher than the measured peak concentration of 8.0 ppm and total abundance of 399 DU. In the presence of Cl and ClO, the calculated ozone concentrations and total abundance were substantially reduced. Cl generally depleted more uniformly of ozone across the altitude, while ClO reduced substantially the ozone in the upper stratosphere and thus shifted the peak of the layer to a much lower elevation at Z = 14 km. Although both ClO and Cl are active ozone-depleting chemicals, ClO was found to have a more pronounced impact on ozone depletion and distribution than Cl. The possible explanations of these interesting phenomena were discussed and elaborated. The approach and calculations in this paper were shown to be useful in providing an initial insight into the structure and behavior of the complex ozone layer.
文摘An engineering system approach of 2-D cylindrical model of transient mass balance calculations of ozone and other concerned chemicals along with fourteen photolysis, ozone-generating and ozone-depleting chemical reaction equations was developed, validated, and used for studying the ozone concentrations, distribution and peak of the layer, ozone depletion and total ozone abundance in the stratosphere. The calculated ozone concentrations and profile at both the Equator and a 60˚N location were found to follow closely with the measured data. The calculated average ozone concentration was within 1% of the measured average, and the deviation of ozone profiles was within 14%. The monthly evolution of stratospheric ozone concentrations and distribution above the Equator was studied with results discussed in details. The influences of slow air movement in both altitudinal and radial directions on ozone concentrations and profile in the stratosphere were explored and discussed. Parametric studies of the influences of gas diffusivities of ozone D<sub>O3</sub> and active atomic oxygen D<sub>O</sub> on ozone concentrations and distributions were also studied and delineated. Having both influences through physical diffusion and chemical reactions, the diffusivity (and diffusion) of atomic oxygen D<sub>O</sub> was found to be more sensitive and important than that of ozone D<sub>O3</sub> on ozone concentrations and distribution. The 2-D ozone model present in this paper for stratospheric ozone and its layer and depletion is shown to be robust, convenient, efficient, and executable for analyzing the complex ozone phenomena in the stratosphere. .
基金supported as part of the Computational Materials Sciences Program funded by the U.S.Department of Energy,Office of Science,Basic Energy Sciences,under Award No.DE-SC0020145Y.Z.would like to acknowledge support for his effort by the Simons Foundation through Grant No.357963 and NSF grant DMS-2142500.
文摘The phase field method is playing an increasingly important role in understanding and predicting morphological evolution in materials and biological systems.Here,we develop a new analytical approach based on the bifurcation analysis to explore the mathematical solution structure of phase field models.Revealing such solution structures not only is of great mathematical interest but also may provide guidance to experimentally or computationally uncover new morphological evolution phenomena in materials undergoing electronic and structural phase transitions.To elucidate the idea,we apply this analytical approach to three representative phase field equations:the Allen-Cahn equation,the Cahn-Hilliard equation,and the Allen-Cahn-Ohta-Kawasaki system.The solution structures of these three phase field equations are also verified numerically by the homotopy continuation method.
文摘Background:Alcohol-related liver disease(ALRD)has emerged as a significant global health concern,primarily attributed to the overconsumption of alcohol.While alcoholism has the potential to impact various organs,it is the liver that is especially vulnerable.Methods:This review comprehensively examines the challenges encountered during the pre-transplant,intra-transplant,and post-transplant phases,a significant number of which are attributable to alcohol misuse.Historically,liver transplant(LT)programmes have excluded patients with alcohol-related liver disease(ARLD)due to mandatory abstinence requirements and apprehensions regarding potential graft shortages for other hepatic diseases.This review counters these concerns by highlighting the minimal usage of grafts for early liver transplantation.It strongly advocates for the incorporation of severe alcoholic hepatitis into the model for end-stage liver disease allocation,devoid of any stigmatization.The selection of ARLD individuals for LT necessitates the critical involvement of a multidisciplinary team,inclusive of addiction specialists.Results:Despite the complexities associated with LT for patients with ARLD,this review underscores its therapeutic advantages,particularly for those anticipated to experience severe adverse effects.This review accentuates the necessity of ensuring equitable access to medical interventions for all patients,irrespective of their lifestyle choices.Conclusion:The examination of genetic and epigenetic variables that play a role in the onset and advancement of ALD.The identification of potential therapy strategies is also an important area of study.The formulation of intricate eligibility rules for LT in patients with a past of alcohol abuse needs essential interactions between medical practitioners and researchers.The use of new technologies such as genomics and epigenomics could boost the accuracy of ALD diagnostic and prognostic approaches.These targeted investigations could potentially lead to major improvements in the management and treatment results of ALD.
文摘BACKGROUND Patients with diabetes mellitus(DM)are predisposed to an increased risk of infection signifying the importance of vaccination to protect against its potentially severe complications.The Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices(CDC/ACIP)issued immunization recommendations to protect this patient population.AIM To assess the adherence of patients with DM to the CDC/ACIP immunization recommendations in Saudi Arabia and to identify the factors associated with the vaccine adherence rate.METHODS An observational retrospective study conducted in 2023 was used to collect data on the vaccination records from 13 diabetes care centers in Saudi Arabia with 1000 eligible patients in phase I with data collected through chart review and 709 patients in phase II through online survey.RESULTS Among participants,10.01%(n=71)had never received any vaccine,while 85.89%(n=609)received at least one dose of the coronavirus disease 2019(COVID-19)vaccine,and 34.83%(n=247)had received the annual influenza vaccine.Only 2.96%(n=21),2.11%(n=15),and 1.12%(n=8)received herpes zoster,tetanus,diphtheria,and pertussis(Tdap),and human papillomavirus(HPV)vaccines,respectively.For patients with DM in Saudi Arabia,the rate of vaccination for annual influenza and COVID-19 vaccines was higher compared to other vaccinations such as herpes zoster,Tdap,pneumococcal,and HPV.Factors such as vaccine recommendations provided by family physicians or specialists,site of care,income level,DM-related hospitalization history,residency site,hemoglobin A1c(HbA1c)level,and health sector type can significantly influence the vaccination rate in patients with DM.Among non-vaccinated patients with DM,the most reported barriers were lack of knowledge and fear of side effects.This signifies the need for large-scale research in this area to identify additional factors that might facilitate adherence to CDC/ACIP vaccine recommendations in patients with DM.CONCLUSION In Saudi Arabia,patients with DM showed higher vaccination rates for annual influenza and COVID-19 vaccines compared to other vaccinations such as herpes zoster,Tdap,pneumococcal,and HPV.Factors such as vaccine recommendations provided by family physicians or specialists,the site of care,income level,DM-related hospitalization history,residency site,HbA1c level,and health sector type can significantly influence the vaccination rate in patients with DM.
文摘Practical guide:Glucagon-like peptide-1 and dual glucosedependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonists in diabetes mellitus common second-line choice after metformin for treating T2DM.Various considerations can make selecting and switching between different GLP-1 RAs challenging.Our study aims to provide a comprehensive guide for the usage of GLP-1 RAs and dual GIP and GLP-1 RAs for the management of T2DM.