Intussusception in adults is quite rare. The computed tomography scan has proved to be more accurate.The surgical approach is influenced by the prevalence of associated malignancy, the anatomic site, and various local factors. Primary surgical resection without prior reduction is the treatment of choice in colocolic adult intussusception.

Background: Pediatric brain tumor survivors can experience detrimental effects from radiation treatment. Proton radiation therapy (PRT), which enables better targeting of radiation to tumors, may result in fewer sequelae. This follow-up cross-sectional study examined psychosocial and executive functioning in children and young adults treated with PRT. Procedure: Psychosocial and executive functioning was assessed by standardized parent rating scales for 187 patients. The sample was divided by age at baseline (<6 years [35.8%] and ≥6 years [64.2%]) and PRT field (craniospinal irradiation (CSI [36.9%]) and focal [63.1%]). Rates of impairment were calculated. Results: Mean age was 8.49 years at baseline; mean follow-up interval was 3.84 years. All mean scores were within the normal range and within normative expectation. Younger CSI group had significantly more problem behaviors and lower adaptive skills compared to older CSI or focal groups; however, no significant differences were found between younger PRT groups. There were no significant differences in executive functioning between the four age-by-PRT-field groups. Rates of impairment exceeded expected rates in social withdrawal, somatic concerns, activities of daily living, and metacognitive executive functioning. Age group was not significantly related to impairment rates, although the younger group had more problems with withdrawal, anxiety, activities of daily living, and executive functioning with relatively higher anxiety and withdrawal in the younger CSI group. Conclusions: Psychosocial and executive functioning was within the normal range at follow-up. Younger patients, particularly those treated with CSI, appeared more vulnerable. Screening and proactive intervention are needed to support psychosocial well-being and executive functions.

Objective Measuring serum and cerebrospinal fluid human chorionic gonadotropin (hCG) is essential for the diagnosis of intracranial germ cell tumors. There are three types of hCG-related markers in clinical use: hCGβ, intact hCG, and total hCG. The best marker for the diagnosis of intracranial germ cell tumors, especially germinoma, is currently unknown. This study aimed to evaluate the usefulness of these hCG-related markers. Materials and Methods We report six patients with histologically diagnosed germinoma treated at our institute. Serum hCGβ, intact hCG, and total hCG were measured before, during, and after treatment. Results The positivity rates of serum hCGβ, intact hCG, and total hCG were 6% (1/17), 47% (7/15), and 42% (8/19), respectively, with the latter two having significantly higher positivity rates than hCGβ (p = 0.041). Both intact and total hCGs showed similar values. The median value of hCGβ, intact hCG, and total hCG before treatment was 0.1 ng/mL, 4.6 mIU/mL, and 4.5 mIU/mL, respectively. Conclusion Serum intact and total hCGs have higher detection rates than hCGβ for patients with germinoma using available commercial measurement tools.

Flexural or membrane-coupled or capillary gravity wave scattering by a submerged or a piercing vertical porous barrier is analytically studied based on a connection that involves the solution potentials and few auxiliary potentials. The problems for the auxiliary potentials are relatively easy to handle for their solutions. The original problem is decomposed into two scattering or radiation problems of this type. The solution wave potential is determined in terms of those resolved wave potentials. Numerical results for the explicitly obtained scattering quantities are also presented.

Objective: Evaluation of the implementation of a new guideline for diagnosis and treatment of women with pregnancy of unknown location (PUL) or ectopic pregnancy (EP). Design: Multicenter retrospective cohort study Setting: Six hospitals in the Northern part of the Netherlands Population and methods: Women above 18-years old with a final diagnosis of PUL or EP between January 2012 to April 2020. Main outcome measures: Diagnostic findings, type of treatment and outcomes, before and after implementation of the guideline. User interpretation of the guidelines. Results: 1306 women with PUL or EP were included. The amount of women diagnosed with PUL has significantly increased between the guideline cohorts (28.4%;174/693 versus 16.6%;115/613 P<0.001). A significantly lower percentage of women using the new guideline underwent surgical management versus treatment with MTX (odds ratio [OR] =0.516, 95% confidence interval [CI] 0.399 – 0.668 P<0.001). Among women treated with MTX, the overall success rate was significantly lower compared to surgery (80.5%;103/128 versus 95.2%; 943/991 P=0.007). There was no observed difference in adverse events or guideline adherence between the guidelines. Conclusion: The implementation of the new guideline contributes to an increase in women diagnosed with PUL and treated with MTX. Treatment with MTX caused more complications and a lower treatment success compared to women undergoing surgery. This did not lead to an increase in adverse events between the guidelines. The overall adherence to the guidelines was equal.

Since the discovery of pulmonary venous triggers,[1](#ref-0001) catheter ablation with pulmonary vein isolation (PVI) has matured as an important therapy for patients with atrial fibrillation (AF). However despite advances in ablation technology, for non-paroxysmal forms of AF, outcomes remain suboptimal with PVI alone.[](#ref-0002)2 ,3 Adjunctive strategies addressing the atrial substrate or targeting of non-pulmonary vein triggers have not shown consistent efficacy across studies and may carry additional complication risks or higher rates of recurrent organized atrial tachycardias. Recently, ethanol infusion into the vein of Marshall (VOM) has gained popularity with the publication of the VENUS randomized trial[4](#ref-0004) and the positive accumulating experience reported from a single center in Bordeaux.[](#ref-0005)5 ,6 However, adoption has been tempered due to the technical requirements of the procedure and unclear dominant mechanism of putative benefit. Thus, more widespread experience is needed to clarify the real-world impact on procedural success. This report aims to describe a single center experience with VOM ethanol infusion over three years, with description of technical approach, associated procedural success rates, and complications.

The clearing price in electricity spot market is an important reference that guides marker participants in making energy purchase. Current electricity price forecasting methods consider the numerical accuracy of the forecast result only, ignoring the need to optimize economic benefits, while higher numerical precision sometimes leads to lower electricity-purchase gain. This paper proposes a price forecasting method that considers both economic benefits and numerical accuracy. A function representing the relationship between the predicted electricity prices and the cost reference for making energy purchase decisions is calculated, and then introduced to the loss function of the prosumers' forecasting model as a revenue-optimizing term. A sequence comparison neural network structure is designed and added to consumers' forecasting model, so that the results of numerical prediction and comparison both contribute to predicting better prices. By co-optimizing numerical precision and electricity-purchase gain, the prediction is more conducive to reducing the cost of purchasing power. Actual electricity market price data are used to verify the feasibility of the proposed forecasting method in improving economic benefits.

A document by W John Martin. Click on the document to view its contents.

Fine target status can be represented by the extracted micro-Doppler (m-D) components from the radar echo. However, current methods do not consider the specialty of the m-D components and their performance to irregular components are poor. In this paper, neural network is applied to m-D signal extraction for the first time. Specifically, a novel and effective dual-branch network based m-D components extraction method is proposed. The dual-branch network consisting of a continuous m-D components extraction branch and a crossing point detection branch is designed to obtain components and cross points at the same time. To solve the error correlation problem of multi-component signals, the first-order parametric continuous condition and cubic spline interpolation are employed to obtain complete and smooth components curves. Simulation and measurement results show that this method of good robustness is a good candidate to separate the non-sinusoidal m-D components with intersections.

A document by Guangping Li. Click on the document to view its contents.

Due to surface defects on inner ring of Si 3N 4 ceramic bearing are tiny and difficult to defect, the defects accelerate the wear of ceramic parts and reduce the performance of ceramic parts. A surface defect detection method based on RetinaNet method and NAM attention mechanism is proposed. Besides, the performance of RetinaNet method and Faster RCNN method is compared. The platform for surface defects of Si 3N 4 ceramic bearing inner ring is built independently to collect images. The dataset is made up of collected images and expanded by online data augmentation. Resnet-50 is used as the feature extraction network. The NAM attention mechanism is added to the tail of Resnet-50 to form an attention module to improve the model accuracy. As the bounding box regression loss function, loss is used for learning bounding box regression and localization uncertainty. A multi-scale feature pyramid is constructed by a feature pyramid network to integrate multi-level feature information. And a small full convolutional network is used as a classification sub-network and a bounding box regression sub-network. The results show that the mAP of the method reaches 91.84%, which is 13.45% and 2.1% higher compared to Faster RCNN and RetinaNet, respectively. The method has good detection effect on the identification and classification of surface defect species.

Cold acclimation is a multigenic process by which many plant species of the temperate zone increase their freezing tolerance. Stabilization of photosynthesis and carbohydrate metabolism plays a crucial role in cold acclimation, and amounts of transient leaf starch, soluble carbohydrates and secondary metabolites, e.g., flavonoids, show significant cold-induced dynamics. To study regulation of primary and secondary metabolite accumulation during cold acclimation of Arabidopsis thaliana, metabolic mutants with deficiencies in either starch or flavonoid metabolism were exposed to 4°C over 14 days and sampled before as well as at early and late time points of cold acclimation. Photosynthetic activity was determined together with amounts of carbohydrates, anthocyanins, organic acids and maximum enzyme activities of the central carbohydrate metabolism. Starch deficiency was found to significantly delay soluble sugar accumulation during cold acclimation, while starch overaccumulation did not affect accumulation dynamics but resulted in lower total amounts of sucrose and glucose. Anthocyanin amounts were lowered in both starch deficient and overaccumulating mutants. Vice versa, however, flavonoid deficiency did not result in a changed starch amount which suggested a unidirectional signalling link between starch and flavonoid metabolism. Mathematical modelling of carbon metabolism indicated kinetics of sucrose metabolism and its export form source to sink tissue to be limiting for carbon partitioning in leaf tissue during cold exposure. Together with cold-induced dynamics of fumarate and malate amounts this provided evidence for a central role of sucrose phosphate synthase activity in carbon partitioning between biosynthetic and dissimilatory pathways which stabilizes photosynthesis and metabolism at low temperature.

N-terminal cysteine oxidases (NCOs) use molecular oxygen to oxidize the amino-terminal cysteine of specific proteins, thereby initiating the proteolytic N-degron pathway. To expand the characterization of the plant family of NCOs (PCOs), we performed a phylogenetic analysis across different taxa in terms of sequence similarity and transcriptional regulation. Based on this survey, we propose a distinction of PCOs into two main groups. A-type PCOs are conserved across all plant species and are generally unaffected at the mRNA level by oxygen availability. Instead, B-type PCOs differentiated in spermatophytes to acquire transcriptional regulation in response to hypoxia. The inactivation of two A-type PCOs in Arabidopsis thaliana, PCO4 and PCO5, is sufficient to activate the anaerobic response in young seedlings, whereas the additional removal of B-type PCOs leads to a stronger induction of anaerobic genes and impairs plant growth and development. Our results show that both PCO types are required to regulate the anaerobic response in angiosperms. Therefore, while it is possible to distinguish two clades within the PCO family, we conclude that they all contribute to restrain the anaerobic transcriptional program in normoxic conditions and together generate a molecular switch to toggle the hypoxic response.

1. The Millennium Ecosystem Assessment assessed ecosystem change, human well-being and scientific evidence for sustainable use of biological systems. Despite intergovernmental acknowledgement of the problem, global ecological decline has continued, including declines in insect biodiversity, which has received much media attention in recent years. 2. Several roadmaps to averting biological declines have failed, due to various economic and political factors, and so biodiversity loss continues, driven by several interacting human pressures. Humans are innately linked with nature but tend to take it for granted. The benefits we gain from the insect world are broad, yet aversion or phobias of invertebrates are common, and stand firmly in the path of their successful conservation. 3. Providing an integrated synthesis for policy teams, conservation NGOs, academic researchers and those interested in public engagement, this article considers: (1) the lack of progress to preserve and protect insects. (2) Examples relating to insect decline and contributions insects make to people worldwide, and consequently what we stand to lose. (3) How to engage the public, governmental organisations and researchers through “insect contributions to people” to better address insect declines. 4. International political will has consistently acknowledged the existence of biodiversity decline, but apart from a few narrow cases of charismatic megafauna, little meaningful change has been achieved. Public values are reflected in political willpower, the progress being made across the world changing views on insects in the public should initiate a much-needed political sea-change, but only if we as entomologists enormously expand our engagement efforts.

The present study reports production, partial purification, and media optimization for alkaline protease using Bacillus cereus PW3A. A profiling study for protease production indicates maximum enzyme activity (17.22 U/ml) was observed after 48 h of incubation. The studies also showed that the enzyme activity increased with the decrease in carbon content indicating the growth associated with nature protease production. Partial purification of protease was done using ammonium sulfate precipitation and dialysis. Further studies were conducted to assess significant media ingredients influencing protease production using the one-factor-at-a-time approach and Plackett-Burman design. Fructose and yeast extract were identified as the most significant variables. Response surface methodology was applied to optimize the factors for maximizing protease production. The results showed that the production increased from 17.22 U/ml to 47.43 U/ml indicating a threefold augment in enzyme activity. Characterization of protease showed that the highest enzyme activity was shown at pH 8.0 and temperature 50°C; however, significant enzyme activity was retained till pH 10 and temperature 60°C. Using casein as substrate, the enzyme showed maximum activity V max 39 U/ml and K m 18 μM. The activity was enhanced by MgCl 2 and CuSO 4 and inhibited by HgCl 2. Since the enzyme has both pH and temperature stability with greater substrate affinity, this protease finds many useful industrial applications.

Introduction Axial spondylarthritis (axSpA) is a chronic inflammatory disease and commonly results in pain and joint stiffness. Using remote technology, such as a computer vision-aided system, has the potential to monitor functional movement and posture. Methods The validity of the remote technology measurement of functional movement and posture were tested cross-sectionally and compared to a standard clinical measurement by a physiotherapist. The feasibility of remote implementation was tested in a home environment. In addition, a cost-benefit analysis was conducted. Results Thirty-one participants with axSpA (42% female, 54(SD 13) years old and 27.4(SD 5.3) kg/m2) and 31 participants without back pain (65% female, 36(SD 10) years old and 25.9(3.7) kg/m2). In the axSpA group, the validity of assessment on cervical rotation, lumbar flexion, lumbar side flexion, shoulder flexion, hip abduction, tragus-to-wall and thoracic kyphosis showed significant moderate to strong correlation; in the non-back pain group, the same measures showed significant correlation ranging from weak to strong. Conclusions Remote technology systems in rehabilitation have the potential to reduce health inequality and improve cost and time effectiveness for both patients and the health system. Additionally, results show that using this Computer Vision-aided system in a home environment is a safe method.

An improved predictive control strategy is proposed to regulate the speed for permanent magnet synchronous motor. Firstly, the motor model is discretized by Taylor series to obtain the expected voltage vector, and a novel cost function is reconstructed with only voltage variables for predictive control, which avoids weight-adjustment. Secondly, the angle of expected voltage vector is obtained by Clark transformation to select the sector, whose voltage vectors are the candidate voltage vectors to reduce calculations. Finally, the optimal voltage vector is determined to switch the inverter by the minimum of the cost function among the candidate voltage vectors. Superior control performance is verified in experiments compared to conventional predictive speed control.

A document by Robert Verkerk. Click on the document to view its contents.

Roflumilast is a phosphodiesterase 4 inhibitor developed for COPD treatment. Roflumilast N-oxide is the major metabolite with similar mechanism of action. The exposure difference between different races have been observed, but the need for dose adjustment have been controversial. The present study compared the pharmacokinetics of a single dose of the original oral roflumilast tablets (Daliresp®) 0.5 mg in healthy Chinese and Caucasian subjects under uniform conditions. The Chinese subjects were found to have longer t1/2, higher AUC0-t, AUCinf and Cmax than the Caucasian subjects. Compared to Caucasian subjects, the point estimate on geometric mean of AUC0-t and AUCinf in Chinese subjects was respectively 22% and 25% higher for roflumilast, and 46% and 48% higher for roflumilast N-oxide. The point estimate on geometric mean of Cmax 9% higher for roflumilast, and 24% higher for its N-oxide. After body weight normalization, the difference of pharmacokinetics (PK) exposure reduced but did not eliminate. Compared to the Caucasians, tPDE4i in Chinese subjects was 44% higher. After body- weight normalization, the difference reduced to 27%. Safety analysis showed signs indicating Chinese were less tolerant to roflumilast than Caucasians, or have different pharmacodynamic response. Our study suggests a dose of roflumilast lower than 0.5 mg daily for Chinese patients or future clinical trials. More dose exploration studies are needed to determine the optimal doses of roflumilast for Chinese COPD patients.

Aims: To evaluate the potential gastric pH-dependent drug-drug interaction (DDI), safety and tolerability of famitinib co-administered with omeprazole in healthy subjects. Methods: Twenty healthy subjects were enrolled in a single-center, single-arm, open-label, fixed-sequence study. Famitinib was administered as a single oral 25 mg under a fasting condition on day 1, omeprazole (40 mg once daily) was given on days 10–14, concomitantly with famitinib on day 15, and for the follow-up 7 additional days (days 16–22). Blood samples were collected at predetermined timepoints for the pharmacokinetic analysis of both famitinib and its metabolite SHR116637 following each famitinib dose. Safety and tolerability were assessed during the whole progress via clinical laboratory tests. Results: The least-squares geometric mean ratios (GMRs) (90% CI) of Cmax, AUC0-t and AUC0-∞ for famitinib combined with omeprazole to famitinib alone were 0.989 (0.953, 1.027), 0.956 (0.907, 1.007) and 0.953(0.905, 1.005) respectively. For the metabolite SHR116637, their GMRs (90% CI) of the above parameters were 0.851 (0.786, 0.920), 0.890 (0.838, 0.946）and 0.887 (0.835, 0.943), indicating the absence of significant differences in the parameters respectively. During the treatment period, 9(45%) subjects reported 16 treatment emergent adverse events (TEAE), among which 6 subjects (30%) reported 9 TEAEs and 1 subject (5%) reported 1 TEAE during famitinib or omeprazole administered alone respectively, 5 subjects (25.0 %) reported 6 TEAEs during in the combined administration phase. Conclusion: The PPI omeprazole did not have a significant influence on the pharmacokinetics (PK) of famitinib and SHR116637, and the safety profile was good upon co-administration.

Classic ecological theory has proven that temperature, precipitation, and productivity organize ecosystems at broad scales and are generalized drivers of biodiversity within different biomes. At local scales, the strength of these predictors is not reliable across different biomes. To better translate these theories to localized scales, it is essential to determine the links between drivers of biodiversity. Here we harmonize existing ecological theories to increase the predictive power for species richness and functional diversity. We test the relative importance of three-dimensional habitat structure as a link between local and broad scale patterns of avian richness and functional diversity. Our results indicate that habitat structure is stronger than precipitation, temperature, and elevation gradients for predicting avian species richness and functional diversity across different forest ecosystems in North America. We conclude that forest structure, driven by climatic drivers, is essential for predicting the response of biodiversity with future shifts in climatic regimes.

Ecosystem functions can be amplified or dampened by species responses to biotic and abiotic factors in the environment. In a group of marine primary producers, consisting of phytoplankton and kelp species, we tested for the features indicating Jensen's Inequality and synchronous or asynchronous dynamics that would indicate a Portfolio Effect. Nonlinearities that would drive an effect through Jensen's Inequality were weak and the relationship between environmental drivers and species fluctuations were often highly variable. Asynchrony dominated the multi-species assemblage, providing evidence of Portfolio Effects. The two canopy kelp species, however, showed temporal and spatial synchrony. Canopy kelp species had strong spatial autocorrelation up to 50 km. Spatial synchrony occurred over almost 300 km, with increased strength in spatial synchrony in two recent decades compared to the early 1990s. This potential Moran Effect, where an environmental variable generates large-scale biological synchrony, may increase the vulnerability of kelp populations into the future.

The study was carried out at the White Volta stretch in the Pwalugu area to assess the fish and fisheries of the River. The catch per unit effort (CPUE) was generally low over the entire period of study, as the highest and lowest CPUE were recorded in March, 2020 and May, 2020 respectively. The River stretch was found to be rich in fish fauna as 39 fish species belonging to 27 genera and 13 families were encountered during the period of study. Three species namely, Auchenoglanis occidentalis, Marcussenius senegalensis and Heterobranchus bidorsalis were identified as the major commercial fish species in the area. The widely used fishing gears in the area included gillnet, trap, cast net, hook-and-line and spear. Fishing activities on the river stretch were unreported and unregulated. It was recommended that the Fisheries Commission in the Upper East Region, Bolgatanga should be resourced with logistics and personnel to monitor and ensure compliance with fisheries regulations on the river.

Deep-frying is a popular food preparation method although oxidized oil may be a health hazard. Minor components in frying oil including antioxidants like tocopherols and tocotrienols, fatty acid composition, triacylglycerol (TAG), and vitamins serve to protect vegetable oil from thermal deterioration. The eating habits of three ethnicity in Malaysia due to influence from the West was briefly mentioned. The importance of fats and oils, as well as the characteristics of each plant oil, were also explained in this project paper. A total of 31 studies fulfilled our inclusion criteria. Studies with humans and animals were accepted and included in this Meta-analysis. The probability of occurrence of obesity, atherosclerosis, hypertension, Type 2 diabetes, and oxidative stress were checked. The overall weighted mean differences for palm oil (PO), canola oil (CNO), corn oil (CO), extra virgin olive oil (EVOO), sunflower oil (SFO), and soybean oil (SBO) were 0.18 [95% CI: 0.11, 0.25; P < 0.00001], 5.50 [95% CI: 4.12, 6.87; P < 0.00001], 0.62 [95% CI: -4.71, 5.95; P = 0.82], 1.13 [95% CI: 0.39, 1.87; P = 0.003], -3.79 [95% CI: -5.61, -1.97; P < 0.00001], 0.46 [95% CI:0.29, 0.64; P < 0.00001] respectively. In short, this study revealed that there was no strong relationship found between a heated and/or repeated heated vegetable oil with the adverse health complications included based on current meta-analysis.