Background: Preterm neonates with respiratory distress syndrome (RDS) who fail continuous positive airway pressure (CPAP) ventilation have higher risks for increased morbidity and mortality. Objective: To assess if machine learning, on multicenter data, may predict CPAP failure in preterm infants with RDS and allow proactive intervention to minimize CPAP failure burden and improve clinical outcomes. Methods: This study was conducted using the Oracle EHR Real-World Data (OERWD) database including preterm NICU admits between 2002-2023. CPAP failure was defined as the need for invasive mechanical ventilation within 72 hours of life. Demographics, admit vital signs, and laboratory values were retrieved to develop an explainable machine learning model using extreme gradient boosting (XGBoost). Results: 24,127 neonates from 27 NICUs qualified for the study with CPAP failure rate of 64.1%. FiO2 was the strongest predictor of CPAP failure followed by systolic blood pressure, temperature, birthweight, PaO2, oxygen saturation, heart rate, and gestational age followed in importance. Resulting XGBoost model attained an area under the receiver operator characteristic curve of 0.91 (95% CI: 0.90, 0.92) and an F-1 score of 0.87. Conclusions: CPAP failure can be predicted with high accuracy at admission to the NICU creating opportunities for early intervention and prevention of RDS related complications.

Introduction:Bowel perforation needs an urgent clinical intervention and it significantly increase the mortality in the patients. Bowel perforation is rarely seen in post-partum mother. (1) Bowel perforation after a normal vaginal delivery (NVD) is rarer than a Caesarean section (C-section). (1)Appendicitis can be operated during pregnancy but post-partum appendicitis is very rare. (2) In perforated appendicitis, “gas under diaphragm” in plain radiograph is also a very rare incident. (3). Post partum perforated appendicitis is also rarely reported. The most common differential diagnosis are peptic perforation and bowel perforation. Other differential diagnosis are Meckel’s diverticulitis, Ischemic colitis, bowel obstruction, cholecystitis, Fitz Hugh Curtis syndrome, round ligament syndrome, pelvis thrombophlebitis, torsion of adnexal structures etc.From early 1900, surgeon’s are publishing papers related to appendicitis during pregnancy, so currently surgeons are well aware of the diagnosis and management of the appendicitis during pregnancy. Babler had published a paper related to this in 1908. (4) Harris J Timerman had published a paper in 1942, presenting two cases of post-partum appendicitis. (5).So, here we are presenting a very rare case of post-partum perforated appendicitis, a diagnostic dilemma. The abdominal pain and tenderness can be misinterpreted as labour pain and the septic peritonitis can lead to a preterm labour and preterm delivery. (6)Highlights:Post-partum Bowel perforation and Post Partum appendicitis are rare“Gas under diaphragm” due to perforate appendix is also rarePerforated Appendicitis in post-partum period is also rare

Pylorospasm: A Less Common Functional Disorder Mimicking Hypertrophic Pyloric Stenosis, Leading to Persistent Vomiting in a Preterm Male Infant

Dear editor, I would like to cancel the pre printing service for the paper submitted to "Land Degradation&Development", as there are still many points in the paper that need to be revised based on the reviewer's comments. The paper title "Spatial heterogeneity characteristics and driving mechanisms of abandoned farmland at different scales and regions in China".  thank you! 

PIWI-interacting RNA (piRNA) is a subset of small noncoding RNA with approximately 26-30 nucleotides, and it plays a vital role in maintaining genome stability and modulating protein synthesis. Recently, emerging evidence suggested that piRNA are expressed in a tissue-specific manner across diverse human cancers, intricately modulating pivotal signaling pathways at the transcriptional or post transcriptional level. This review systematically underscores current investigations pertaining to piRNA in urologic carcinoma (UC), elucidating the proposed regulatory mechanisms encompassing N6- methyladenosine (m6A) modification and the silencing of transposable elements. Furthermore, we discussed the detection technology and the application of piRNA in the fields of clinical diagnosis.

In advanced processes, Single-Inductor Multiple-Output (SIMO) DC-DC converters with battery voltage as input face serious overvoltage problems due to low MOSFET withstand voltage. To meet the needs of SIMO converter design in advanced processes, this paper first proposes a SIMO converter with an adaptive power supply buffer (APSB) and voltage-limiting techniques in 22 nm CMOS. The proposed APSB technology ensures that the driving voltage of the power stage remains unchanged under the changing power supply, solving the breakdown problem caused by low MOSFET withstand voltage and simplifying the circuit design of the power stage. The proposed voltage-limiting techniques avoid the overvoltage of the internal circuit by special voltage-limiting design for the VX2 node and output voltage during startup and steady state. The proposed SIMO is designed and validated under a 22 nm CMOS process. The input power supply range is 2.8 V-5 V, and the three output voltages are 0.8 V, 1.1 V, and 1.8 V, respectively. The maximum load for each output voltage is 250 mA. The SIMO system achieves a peak efficiency of 92.2% over the full load range.

Post-translational modifications (PTMs) are of significant interest in molecular biomedicine due to their crucial role in signal transduction across various cellular and organismal processes. Characterizing PTMs, distinguishing between functional and inert modifications, quantifying their occupancies, and understanding PTM crosstalk are challenging tasks in any biosystem. Studying each PTM often requires a specific, labor-intensive experimental design. Here, we present a PTM-centric proteome informatic pipeline for predicting relevant PTMs in mass spectrometry-based proteomics data without prior information. Once predicted, these in silico identified PTMs can be incorporated into a refined database search and compared to measured data. As a practical application, we demonstrate how this pipeline can be used to study glycoproteomics in oral squamous cell carcinoma based on the proteome profile of primary tumors. Subsequently, we experimentally identified cellular proteins that are differentially expressed in cells treated with multikinase inhibitors dasatinib and staurosporine using mass spectrometry-based proteomics. Computational enrichment analysis was then employed to determine the potential PTMs of differentially expressed proteins induced by both drugs. Finally, we conducted an additional round of database search with the predicted PTMs. Our pipeline successfully analyzed the enriched PTMs and detected proteins not identified in the initial search. Our findings support the effectiveness of PTM-centric searching of MS data in proteomics based on computational enrichment analysis, and we propose integrating this approach into future proteomics search engines.

Objective Fungal infection of the external auditory canal, otomycosis, is generally a resistant mycotic infection. We designed a prospective, randomized, controlled cohort study to analyse the treatment effect of ear canal lavage on otomycosis. Methods The clinical patients were divided into two groups: an irrigation group and an irrigation + local drug treatment control group. Results From January 2022 to December 2023, a total of 102 patients treated for otomycosis were enrolled, and 98 of the patients were followed up for three months. Twenty-two of the 98 patients (22.45%) had no or minor symptoms. Other common symptoms such as pruritus, pain, hearing impairment, etc., presented solely or in combination (Table 1). Our fungal culture results revealed that, in 83 patients (84.69%) the otomycotic pathogen was Aspergillus. In the lavage group, 48 (48/52, 92.30%) patients were cured with initial treatment after three months of follow-up, two (2/52, 3.85%) patients were cured after one month but were lost to follow-up after three months, and two (2/52, 3.85%) patients failed after initial treatment, received topical miconazole ointment treatment and were eventually cured. In the irrigation + local drug control group, 48 (48/50, 96.00%) subjects responded to initial treatment without recurrent disease after three months; 2 (2/50, 4.00%) subjects were lost to follow-up. According to Fisher’s exact test, there was no significant difference between the two groups (Table 3, P = 0.258). Conclusion Both ear canal rinses and local antifungal creams are effective, and sequential treatment via both methods is reasonable.

The challenges that the world may face in the near future are the growing population, climate change, and water scarcity. Finding solutions to these challenges must be taken into account. Among these solutions, one is the optimization of resource use, such as energy and water, and the preservation of the soil quality. Now, one can ask how such challenges can be addressed, in which sustainable agriculture can be the answer. Agricultural activities are greatly enhanced through the use of IoT devices. The GreenPi, smart irrigation system proposed and designed in this paper will support sustainable agriculture with effective use of water. GreenPi employs real-time, distributed fog and edge computing and LoRa technology for the scheduling of irrigation based on information from the sensors and weather condition. GreenPi is a four-tier model with the following layers: 1) sensors and actuators to collect data from the field and send commands to actuator nodes like valves or water pumps; 2) the edge layer takes in sensors’ data and sends commands to actuators using ESP32 with LoRa; 3) a fog layer that exploits Docker containers for running applications to manage data processing, irrigation decisions, and communication with cloud and edge devices; and 4) a cloud layer to provide weather data and facilitate further data analysis. GreenPi is examined in real-time by continuously transmitting temperature, humidity, and soil moisture data to the fog. The proposed solution, with enhanced methodologies and reduced latency, achieves satisfactory outcomes for smart farming and automated irrigation. A small farm model is designed to showcase the GreenPi system’s effectiveness, which results in significant water savings, enhanced moisture level stability, and efficient energy saving that ensures sustainable operation of the system when compared to traditional irrigation methods, with the traditionally irrigated portion consuming 11.5 liters while the smartly irrigated portion consumed 10.6 liters. This system holds promise for sustainable water and energy management practices in agriculture.

To understand the phylogenetic relationships of Menyanthes and address the existing gap in the evolutionary study of embryological characteristics, we investigated and compared these characteristics with those of related taxa. Our objective was to deduce the evolutionary polarity of these characteristics. We analyzed the dicotyledonous type of anther wall, the development of an endothelium, and endosperm formation of the ab initio Cellular type. Our findings revealed that vascular bundles extending into the integument are an autapomorphy. When compared with the closely related taxon Nymphoides, Menyanthes share common embryological characteristics at the family level, except for three-celled pollen at shedding time. Primitive angiosperm Amborella exhibited tetra-sporangia, glandular tapetum, and other symplesiomorphic characters, while Menyanthes showed apomorphic characteristics such as simultaneous cytokinesis and endothelium development. Although previously classified as Campanulas, embryological characteristics of Menyanthaceae support its reclassification to Asterales in APG system IV. These findings indicate that Menyanthaceae is more primitive than Calyceraceae, Goodeniaceae, and Asteraceae within Asterales. Our study strongly supports the APG system IV classification based on both embryological and DNA data, providing new insights into the evolutionary history of Menyanthaceae

As launch and manufacturing costs have become affordable, the industrial and academic interest in Low-Earth Orbit (LEO) satellites has increased in recent years. With this interest, the concept of Low-Earth Orbit-based Positioning, Navigation and Timing (LEO-PNT) has also gained popularity as a complementary and/or standalone system in addition to the already existing Global Navigation Satellite Systems (GNSS). This article examines the LEO constellation optimization from the perspective of a LEO-PNT design, identifies and discusses the state-of-art of the LEO satellite constellation optimization approaches, introduces relevant performance and feasibility related metrics and parameters, and addresses key concepts and underlying trade-offs that must be considered for any LEO-PNT system design. In addition, a case study for a LEO-PNT constellation optimization is presented, where we showcase the discussed trade-offs. We present optimization results obtained with the adaptive weighting algorithm “ADaW” applied to the Pareto-optimization algorithm “NSGA-III”. A detailed performance analysis is done for six relevant scenarios with varying receiver location properties, namely by considering indoor/outdoor, rural/urban and line of sight/non-line of sight cases.

As autonomous driving technology rapidly advances, effective testing tools and methods become crucial. This paper comprehensively assesses the capabilities and limitations of publicly available autonomous driving datasets, simulators, and proving grounds, exploring their roles in testing autonomous vehicles. The aim of the paper is to analyze how these tools can assist in evaluating the capabilities of autonomous driving systems and their tasks in the actual verification process of autonomous driving technology. Furthermore, this paper discusses the challenges faced by autonomous driving datasets, simulators, and proving grounds, as well as future directions for development. It provides guidance for researchers and practitioners in the field of autonomous driving, helping them choose appropriate tools and methods based on specific testing needs.

The Major Histocompatibility Complex (MHC) is a central element in the vertebrate immune system. While MHC genes are a common target of conservation genomic studies, it has been challenging to reliably amplify locus-specific alleles, which is especially problematic when studying endangered lineages, like some Harbour porpoise (Phocoena phocoena) populations and subspecies. Here, we manually annotated all MHC II genes in the Harbour porpoise genome, and genotyped every exon 2 in 94 individuals spanning six geographical regions, including the endangered Black Sea porpoise subspecies (Phocoena phocoena relicta) and the endangered Proper Baltic Sea population of the North Atlantic subspecies (P. p. phocoena). We performed gene-wise analyses of diversity and selection, and put the results into perspective with 24 available Harbour porpoise genomes. Furthermore, we characterized all MHC II genes in 19 available long-read cetacean and terrestrial outgroups genomes to study the MHC II evolution across the cetacean diversification. From the 10 MHC II loci annotated in the Harbour porpoise genome, two (DRB1 and DQB) exhibited inflated allelic diversity and signatures of positive selection. Interestingly, DRB genes followed different evolutionary trajectories in mysticetes and odontocetes. Our results have significant conservation implications since we identified reduced MHC II diversity in the endangered Black Sea subspecies, and provide a case study for reliable MHC II genotyping in other species. Further, our study demonstrates the need for long-read genomes to understand the genomic architecture of MHC and to accurately assess its diversity and evolution.

Background: The diminished immune response observed in individuals with rheumatic diseases is a contributing factor to the occurrence of tuberculosis (TB) infection. The primary objectives of this investigation were to examine the risk factors associated with the advancement of rheumatic diseases in conjunction with latent tuberculosis infection (LTBI) leading to active tuberculosis (ATB). Methods: A retrospective study was conducted at the Xijing Hospital of the Fourth Military Medical University, utilizing the Laboratory Information System (LIS), to investigate rheumatic diseases diagnosed between January 2012 and October 2022. The collected data underwent statistical analysis using the Social Science Statistical Package (SPSS) version 26, with a significance level of p < 0.05 indicating statistical significance. Results: The research conducted involved a total of 33,020 individuals diagnosed with rheumatic conditions, of which only 18.16% underwent screening for latent tuberculosis infection (LTBI). Among the rheumatic patients, the incidence of LTBI was found to be 25.33%, with 14.57% of these cases progressing to active tuberculosis (ATB). Utilizing binary logistic regression analysis, it was determined that exposure to glucocorticoids (GCs) at a dosage of 20 mg/d or higher was an independent risk factor for the development of ATB [odds ratios (OR) = 3.59, 95% CI: 1.26-10.29, p = 0.017]. Conclusion: It is of the utmost importance to perform a screening for LTBI prior to commencing treatment in patients with rheumatic conditions, as they are at a significantly elevated risk of developing ATB due to their exposure to medium-high doses of glucocorticoids (GCs). Keywords: Latent tuberculosis infection; Active tuberculosis; Rheumatic diseases; Risk factors

ABSTRACTA 19-year-old phenotypically normal female from Kakamega, Kenya presented with primary amenorrhea. Physical examination revealed Tanner stage 3 breast development, Tanner stage 4 pubic hair, and normal external genitalia. Hormonal profile tests indicated hypergonadotropic hypogonadism with normal 17-hydroxyprogesterone and testosterone levels. Ultrasound scan showed a normal uterus without ovarian pathology, while MRI revealed a hypoplastic uterus and absent ovaries. Karyotyping confirmed a 46, XY genotype, leading to a diagnosis of 46, XY Complete Gonadal Dysgenesis (Swyer syndrome). Swyer syndrome is a rare disorder of sex development characterized by unambiguous female genitalia, bilateral streak gonads, and elevated gonadotropin levels in individuals with a 46, XY karyotype. The condition results from abnormal gonadal development due to mutations in testis-determining factors, most commonly the SRY gene. Patients typically present with primary amenorrhea and lack of secondary sexual characteristics. Management includes hormone replacement therapy and gonadectomy due to the increased risk of gonadal tumors. The patient was educated about her condition, initiated on combined contraceptive pills, and counseled on exploratory laparoscopic gonadectomy. This case highlights the importance of a comprehensive diagnostic approach in patients with primary amenorrhea, including physical examination, hormonal evaluation, imaging, and karyotyping, to accurately diagnose and manage disorders of sex development.

We report a unique case involving a male breast cancer complicated with leukemoid reaction caused by PEG-rhG-CSF after chemotherapy. A male patient with postoperative breast cancer developed leukemoid reaction induced by prophylactic use of PEG-rhG-CSF after AC-T regimen chemotherapy. Combined with the related literature, we analyzed and summarized the rare complications of clinical diagnosis, treatment, prevention of myelosuppression after chemotherapy and leukemoid reaction in male breast cancer.

Accurate staging of nodal involvement in pediatric sarcoma patients is important to determine correct systemic and local therapy, with the goal to reduce subsequent recurrences. However, differences in lymph node staging strategies, definitions, and treatment protocols between the Children’s Oncology Group (COG), European Pediatric Soft Tissue Sarcoma Study Group (EpSSG), and the Cooperative Weichteil Sarkom Studiengruppe (CWS), complicate comparisons. In this article we try to establish internationally recognized recommendations for lymph node assessment and treatment of children and adolescents diagnosed with RMS and NRSTS according to the Consensus Conference Standard Operating Procedure methodology.

Background: Musculoskeletal problems are reported in the literature as a common problem for people with cystic fibrosis, with a range of aetiologies including an inflammatory arthritis. However, accurate data on the presentations and prevalence are lacking. The aim of this cohort study was to describe the scale and impact of musculoskeletal symptoms in CF. Methods: A collaboratively designed questionnaire was administered to adults attending two large UK CF centres. Data collected evaluated scale and impact of musculoskeletal symptoms. Results: Results were obtained from 489 patients (response rate 59%). Of these, 49% reported that musculoskeletal symptoms impacted their activities of daily living in the previous year. Back pain was common, occurring in 44% of participants in the preceding week. The knee was the most commonly affected painful peripheral joint, with 26% of participants reporting knee pain within the last week rising to 50% within the last year. Early morning stiffness and joint swelling were markedly less common, suggesting that the majority of musculoskeletal pain in CF is not due to an inflammatory arthritis but is due to other factors. Conclusion: Musculoskeletal problems are common in CF and frequently affect activities of daily living. Symptoms of inflammatory arthritis occurred in only a small minority of individuals. A focused approach to characterising and clarifying the aetiology of musculoskeletal symptoms is needed to inform the management of these disabling symptoms.