Introduction Implantable permanent pacemaker function is supported by their energy sources by a mean period of 8,8 to 12,4 years. We previously published this case of a patient with a normally functioning VVI pacemaker, 31 years after implantation. Methods and Results In this report, we state that the device is still functioning normally 40 years after implantation. The most recent device interrogation revealed pacing threshold of 0.9 V/0.5 ms. Holter monitoring for 24 hours recorded a total of 98.707 beats with 97,78% paced beats, without any indication of pacemaker malfunction and with stable heart rate at 70-71 bpm. Conclusion Most patients with implantable devices have the appropriate follow-up and settings of low energy consumption. Manufacturing companies are mainly considered responsible for achieving prolonged device longevity, focusing on the goal of high energy capacity of future devices.

The nature of explanation is an important area of inquiry in philosophy of science. Consensus has been that explanation in the cognitive and brain sciences is typically a special case of causal explanation, specifically, mechanistic explanation (Craver 2007). But recently there has been increased attention to computational explanation in the brain sciences, and to whether that can be understood as a variety of mechanistic explanation. After laying out the stakes for a proper understanding of scientific explanation, we consider the status of computational explanation in the brain sciences by comparing the mechanistic proposal to computational accounts advanced by Piccinini (2015), Milkowski (2013)), Cao (2019), Chirimuuta (2014, 2018), and Ross (Ross 2015, 2023). We argue that many of these accounts of computational explanation in neuroscience can satisfy the same explanatory criteria as causal explanations, but not all. This has implications for interpretation of those computational explanations that satisfy different criteria.

This paper investigates the prescribed-time output consensus (PTOC) of heterogeneous multi-agent systems (MASs) based on sampled data. Firstly, a novel dynamic compensator is designed for each agent and its state is used to interact with its neighbors. Then, a hybrid sampling strategy (HSS), including a dynamic event-triggered sampling (ETS) and a time-triggered sampling (TTS), is developed to determine when to sample and broadcast the compensator state of agents. The execution of the HSS is divided into two steps, a dynamic ETS is presented before the first prescribed-time (PT) where the dynamic threshold decays to zero as time approaches the first PT. Subsequently, a TTS with a constant sampling period (CSP) is introduced after the first PT. With the proposed HSS, all compensators achieve the state consensus at the first PT while excluding the Zeno behavior. Based on the proposed dynamic compensators and the HSS, a fully distributed controller with high scalability and flexibility is developed. Through the Lyapunov stability theory, it is proved that the heterogeneous MASs with the proposed controller achieve the output consensus at the second PT (after the first PT). Finally, a simulation example on 8-wheeled mobile robots is performed to verify the validity of the theoretical results.

We present the development of a custom-built structured illumination microscope (SIM) featuring a specially designed transmission diffraction grating. Employing the analogue microfilming method, we fabricated transmission diffraction gratings suited to the specific requirements of our system. This robust and cost-effective method allows for the fabrication of diffraction gratings with customised constants, ensuring excellent transmission in both the visible and near-infrared spectra. Additionally, to assess the performance of our system, we measured the resolution in both epifluorescent and superresolution imaging modalities by applying two independent methods: the conventional resolution measurement using fluorescent beads and the knife-edge technique applied on the MoS 2 monolayer flakes. Both methods confirmed enhancement in the resolution of SIM over the epifluorescent imaging modality. Furthermore, we have successfully demonstrated the capabilities of our microscope by imaging fluorescently labelled astrocytes, specifically targeting the vimentin filament protein within these cells. The superresolution images reveal fine structures of the vimentin cytoskeleton that remain unresolved in the epifluorescent image.

Zirconia implants have emerged as a promising novel material in the field of dentistry due to their ability to overcome certain limitations associated with titanium implants. However, the appropriate sterilization protocols for zirconia implants have not yet been thoroughly investigated. To address this gap, this study conducted an assessment of the surface characteristics of fully sintered 3Y-TZP zirconia slices after being subjected to various sterilization methods, including ethylene oxide (EO), hydrogen peroxide plasma (HPP), electron beam (EB), and a combination of hydrogen peroxide plasma with either ethylene oxide (HPP+EO) or electron beam treatment (HPP+EB). Although the HPP treatment group did not demonstrate the highest level of hydrophilicity and contamination removal, it did exhibit notable hydrophilicity, effectively prevented hydrocarbon contamination, and maintained a substantial concentration of Zr. The surface of zirconia treated with HPP displayed significant enhancements in cell proliferation, cytoskeleton development, osteogenic differentiation, and adhesion capabilities for hBMSCs and HGFs, surpassing the performance of other groups. Based on these findings, the sterilization of zirconia implants using hydrogen peroxide plasma therapy appears to be a feasible technique.

Stem cells have differentiation and regulatory functions. Here, we discuss the effect of cell culture density on stem cell proliferate, adipogenesis and regulation ability. To investigate the effect of the initial culture density of human periodontal ligament stem cells (hPDLSC) on the adipogenic differentiation of autologous cells. We found that the proliferation rate of hPDLSC increased with the initial cell densities (0.5~8 × 10 4 cells/cm 2) increase. After adipogenic differentiation induced by different initial cell densities of hPDLSC, we found that the mean adipose concentration and the expression levels of lipoprotein lipase (LPL), CCAAT/enhancer binding protein α (CEBP-α) and peroxisome proliferator-activated receptor γ (PPAR-γ) genes all increased with increasing cell density. To investigate the regulatory role of hPDLSCs on the adipogenic differentiation of other cells, we used secreted exosomes derived from hPDLSCs cultured at different initial cell densities of 50 μg/mL to induce the adipogenic differentiation of human bone marrow stromal cells (hBMSC). We also found that the mean adipose concentration and the expression of LPL, CEBP-α and PPARγ genes increased with increasing cell density, the optimal culture density was 8 × 10 4 cells/cm 2. This provides a laboratory research basis for the application of adipogenic differentiation of stem cells.

Terrestrial water energy coupling (WEC), in the form of the non-linear relationship between Soil Moisture (SM) and evaporative fraction (EF, ratio of actual and potential evapotranspiration), controls critical ecohydrological processes. We investigate and parameterize the evolution of global SM–EF coupling from the field to remote-sensing (RS)-footprint. The field-scale EF and SM were obtained from 163 eddy covariance (EC) and SM sensors at various network (Texas Water Observatory and FLUXNET) sites around the globe. Remote-sensing (RS)-scale EF and SM estimates were obtained from Moderate-resolution Imaging Spectroradiometer (MODIS) and Soil Moisture Active Passive (SMAP) sensors, respectively. We estimate the effective thresholds of the WEC regimes from both EC and satellite datasets to highlight the influence of subgrid-scale heterogeneity, scaling, and observational constraints on the evolution of WEC regimes from field to RS-footprint scale. We compare the critical WEC thresholds of the water- and energy-limited regimes with an SM drydown-based approach and highlight the similarities between both methods in partitioning dominant WEC regimes. EF and SM are strongly coupled in dryland arid and semi-arid regions compared to humid climates. WEC regimes and thresholds have strong interseason variability due to dynamic interactions between soil, vegetation, and atmosphere at the RS-footprint scale. In contrast, field-scale SM-EF coupling is influenced predominantly by agricultural /land-use practices and soil conditions. Hence, future development of Earth-System/Land-Surface models must account for the inter-scale differences in the coupling between terrestrial water and energy fluxes representative of the “ effective” processes at large spatial scales.

The proliferation of Internet of Things (IoT) devices has introduced numerous security challenges in data exchange and authentication. This paper introduces an innovative multilayer authentication system for IoT devices integrated with a permissioned Blockchain framework. Our approach strategically employs signature-based authentication at the chaincode level, significantly enhancing the security and integrity of IoT data exchange. In the course of experimental implementation and evaluation, which includes rigorous real-world attack testing and an OpenVAS vulnerability assessment, we demonstrate the robustness of the proposed model in facilitating seamless data sharing and updates across the network, all while ensuring optimal response times. Key performance metrics, including latency and throughput, validate the efficiency of the system. The Authentication Success Rate evaluation affirms the accuracy and resilience of our authentication mechanism. This research not only underscores the feasibility of deploying our model in real-world scenarios but also emphasizes the critical considerations of network infrastructure and practical deployment. The study contributes significantly to advancing the field of secure and reliable IoT data exchange, laying the foundation for the development of more resilient and trusted IoT ecosystems.

Introduction While there is a growing volume of evidence suggesting that relatively prevalent functional polymorphisms present within apoptosis-related genes may influence human prostate cancer (PCa) susceptibility, the clinical relevance of these findings remains inconclusive. This meta-analysis was thus developed with the goal of generating more precise estimates of the relationships between polymorphisms in four apoptosis-associated genes (NKX3‑1, Caspase-3, Caspase-9, and BCL‑2) and the risk of PCa. Material and methods The PubMed, Web of Science, Google Scholar, Embase, Cochrane Library, and SinoMed (CNKI and Wanfang) databases were searched for relevant studies published through December 20, 2023 using the following keywords: ‘polymorphism’ or ‘variant’ and ‘carcinoma’ or ‘cancer’ or ‘tumor’ and ‘NKX3-1’, ‘CASP3’ or ‘Caspase-3’, ‘CASP9’ or ‘Caspase-9’, ‘BCL-2’ or ‘B-cell lymphoma’ and ‘prostate cancer’ or ‘PCa’ or ‘prostate adenocarcinoma’. Results This approach led to the identification of 22 case-control studies related to the association between apoptosis-related gene polymorphisms and PCa susceptibility enrolling 9,706 cases and 12,567 controls. Subsequent analyses revealed that the NKX3-1 rs2228013, CASP9 rs1052571, and CASP9 rs4645982 polymorphisms were associated with greater PCa risk, whereas the CASP3 rs4647603 polymorphism was associated with a risk reduction. Conclusions These findings provide strong evidence for the potential contributions of polymorphisms in the apoptosis-related caspase-3, caspase-9, and NKX3-1 genes in the onset and progression of PCa.

Background: Since the COVID-19 pandemic started in 2019, has resulted in various health conditions, including adverse effects on different systems. The female reproductive system (FRS) is known to be one of the organs affected by the virus or the vaccination due to its high expression of the ACE 2 receptor, which is one of the primary receptors of COVID-19 that facilitates its entry into the cells. This review assessed the impact of COVID-19 infection and vaccination on the female reproductive system and their relationship with endometrial, ovarian, cervical, and vulvar cancers. Recent findings: COVID-19 virus may elevate pro-inflammatory factors, such as TNF-α, IL-6, interleukin-1β (IL-1β), and interferon-gamma (IFN-γ), during both the acute and recovery phases of infection. COVID-19 infection can heighten the inflammatory response and cell susceptibility by downregulating the ACE-2 receptor. Additionally, COVID-19 influences the female reproductive system by altering the epithelial-mesenchymal tissue microenvironment and disrupting blood vessels and endothelial cells. However, studies fail to acknowledge the potential impact of vaccination on FRS. Conclusion: Given the pivotal roles of the TMPRSS2 enzyme and ACE2 receptor in the pathogenic mechanism of the coronavirus, it is suggested that cells expressing higher levels of these enzymes and receptors may be more prone to endometrial cancer development. Notably, the cytokine storm and ACE/ACE2 pathway imbalance increase the risk of ovarian cancer. Cervical cells have a low expression of the ACE2 receptor, reducing the likelihood of infection in intraepithelial cervical cells and cervical cancer. Although coronavirus infection and its immunization can lead to vulvar aphthous ulcers, limited research investigates the link between COVID-19 infection, immunization, and vulvar cancer.

Abstract: A Foliar anatomical study of five Kalanchoe species in Nigeria was carried out for taxonomic purposes. The study tends to provide anatomical information on Nigerian Kalanchoe species, for the purpose of documentation and delimiting the taxa studied. Matured fresh samples of the leaves of Kalanchoe crenata (Andr.) Haw, Kalanchoe gastonis-boonieri Raym.-Hamet & H.Perrier , Bryophyllum pinnatum (Lam.) Oken, Bryophyllum delagoense (Eckl. and Zeyh.) Schinz, Bryophyllum houghtonii (D.B Ward) P.I.Forst were used. Epidermal peels and transverse sections were carried out according to standard procedures. Unifying and diagnostic characters important for the taxonomy of the selected five species of the genus Kalanchoe were identified. Unifying characters include amphistomatic leaves, a non-pitted anticlinal wall, mesophyll not differentiated into palisades and a spongy layer. Diagnostic characters such as uniseriate to multiseriate epidermis in Bryophyllum houghtonii. The study provides concise information on the anatomical attributes of the epidermis and transverse section of the leaf of the Kalanchoe species studied

Plants share their habitats with a multitude of different microbes. This close vicinity promoted the evolution of inter-organismic interactions between plants and many different microorganisms that provide mutual growth benefits both to the plant and the microbial partner. The symbiosis of Arabidopsis thaliana with the beneficial root colonizing endophyte Serendipita indica represents a well-studied system. Co-colonization of Arabidopsis roots with S. indica significantly promotes plant growth. Due to the notable phenotypic alterations of fungus-infected root systems, the involvement of a reprogramming of plant hormone levels, especially that of indole-3-acetic acid, has been suggested earlier. However, until now, the molecular mechanism by which S. indica promotes plant growth remains largely unknown. This study used comprehensive transcriptomics, metabolomics, reverse genetics, and life cell imaging to reveal the intricacies of auxin-related processes that affect root growth in the symbiosis between A. thaliana and S. indica. Our experiments revealed the essential role of tightly controlled auxin conjugation in the plant–fungus interaction. It particularly highlighted the importance of two GRETCHEN HAGEN 3 ( GH3) genes, GH3.5 and GH3.17, for the fungus infection-triggered stimulation of biomass production, thus broadening our knowledge about the function of GH3s in plants. Furthermore, we provide evidence for the transcriptional alteration of the PIN2 auxin transporter gene in roots of Arabidopsis seedlings infected with S. indica and demonstrate that this transcriptional adjustment affects auxin signaling in roots, which results in increased plant growth.

Background For over 70 years the addition of fluoride to public water with intent to prevent dental caries continues to be controversial and risks are seldom included in monetary evaluations. Objectives To estimate an economic cost-benefit-risk of Community Water Fluoridation (CWF) using 2021 USA dollars Per Person Per Year (PPPY), with the inclusion of two risks: dental fluorosis and lower income resulting from developmental neurotoxicity as measured with lower IQ. Methods Published operational costs and benefits of CWF are used. Published and clinical experience treating dental fluorosis are utilized to estimate treatment costs of patient perceived dental fluorosis, and lost wages from lower IQ. Patients of record provided consent for photographs. Results: Published estimated caries averted, less operational costs, were calculated at $8 PPPY and estimates of compensation for functional and cosmetic dental fluorosis were $126 PPPY. Lower earnings from presumed harm of developmental neurotoxicity $438 PPPY. Net loss from CWF is estimated at $556 PPPY. Conclusions Previous economic evaluations of CWF have estimated caries averted and costs of operations. Few evaluations include the costs of treating harm. CWF is not cost effective if the cost of harm is included. Policy Implications Alternatives for the prevention of dental caries should be promoted and the cessation of CWF is indicated.

The present study investigates the feasibility and initial efficacy of the Unified Protocol (UP) for anxiety and depressive symptoms in Turkish university students with a pretest-posttest control group research design. Thirty-four undergraduate students with high levels of depressive and/or anxiety symptoms were randomly assigned to one of two study conditions: an intervention group based on the UP (n=17) or a waitlist control group (n=17). To determine the effectiveness of treatment, a 2 (intervention-control group) x 2 (pre-post test) mixed measures variance analysis was applied for the primary outcome measures: degree of anxiety and depressive symptoms as well as positive and negative affect and psychological well-being. The analyses revealed a significant difference between pre- and post-treatment scores on all outcome measures in the intervention group; these improvements were also significantly greater than those in the control group. In other words, participants receiving the Unified Protocol reported lower levels of anxiety and depressive symptoms, decreased negative affect, higher levels of positive affect, and improved psychological well-being compared to the control condition. The findings of this study provide preliminary support for the efficacy of the Unified Protocol in a Turkish sample. The study findings are evaluated in light of the relevant literature and within the scope of the study’s limitations, and suggestions for academic and clinical applications are presented.

Objective: To determine the optimal leading follicle size for triggering final oocyte maturation in POSEIDON groups 3 and 4 poor responders undergoing ART cycles. Design: Retrospective cohort study. Setting: University based Infertility Centre. Population: Data of 294 POSEIDON groups 3 and 4 poor responders aged between 20 and 42 years who underwent ICSI following a GnRH antagonist cycle between January 2015 and July 2021 were reviewed. Methods: Among the 342 patients eligible in our database, 294 fulfilling inclusion criteria were assessed for final analyses. Cycles were categorized into two groups according to occurrence of premature ovulation. Premature ovulation was defined as visualization of rupture of at least one of the leading follicles on the day of oocyte retrieval. In addition, number of oocytes retrieved, number of MII oocytes, MII/antral follicle count (AFC) ratio and follicle-oocyte index (FOI) were compared between different leading follicle sizes. Main Outcome Measures: Number of oocytes retrieved, number of MII oocytes, MII/antral follicle count (AFC) ratio and follicle-oocyte index (FOI). Results: Among all, 47 (16.2%) had premature ovulation between the trigger and oocyte pick-up days. The mean size of the leading follicle on the day of trigger was significantly higher in the premature ovulation group than the controls (19.8±2.4 mm vs.18.7±2 mm, respectively; P<0.001). Multivariate logistic regression analyses identified baseline LH (Odds ratio {OR} 1.144, 95% confidence interval {CI} 1.052-1.243; P=0.002), number of follicles >11 mm on the day of trigger (OR 0.580, 95% CI 0.438-0.767; P<0.001), and leading follicle size (OR 1.361, 95% CI 1.130-1.641; P=0.001) as independent predictors of premature ovulation. According to the one-way ANOVA test and non-linear curve estimation model the FOI and MII/AFC ratios peaked when the leading follicle size was between 16-17 mm, respectively. Conclusion: Individualized trigger based on leading follicle size can provide maximum efficiency in ovarian stimulation in POSEIDON expected poor responders. While late trigger may result in premature ovulation, early trigger may also result in less MII. Triggering when the leading follicle size is between 16.5 and 17 mm can help to prevent these negative outcomes and achieve optimal cycle outcome.

The paper addresses the problem of transforming observable, time-reversible and multi-input single-output discrete-time state equations into the extended observer form which comprises a linear observable component and a nonlinear injection term depending on the inputs, output, and a finite number of their past values. The intrinsic necessary and sufficient conditions for existence of the extended observer form are provided in terms of a certain vector field, defined by the system output and its past values. The algorithm is presented to find a parametrized state transformation that takes the state equations into the considered extended observer form. Two examples, one of them academic, illustrate the theory.

Introduction Chorioangioma is a benign vascular tumor of the placenta that occurs in approximately 1% of pregnancies1. The majority of cases are small and asymptomatic, with symptoms appearing in only 0.01%–0.03% of instances2. Giant chorioangiomas, defined as tumors larger than 4 cm, are remarkably rare, with a prevalence ranging from 1:9,000 to 1:50,000 3. While many chorioangiomas are detected during postnatal examination of placental histology, large chorioangiomas are associated with significant maternal and fetal complications. These include preterm labor, intrauterine growth restriction (IUGR), pre-eclampsia, polyhydramnios as well as hydrops fetalis, disseminated intravascular coagulation (DIC), and mortality 4–6.Despite significant advancements in therapeutic approaches, perinatal mortality rates remain high, estimated to be more than 30%7. Therefore, it is essential to highlight the importance of timely identification, comprehensive prenatal monitoring, and appropriate interventions to prevent fetal morbidity and mortality8. In this report, we present a case involving multiple giant chorioangiomas in a 23-year-old woman, which were associated with fetal complications and ultimately resulted in the neonate’s death due to hydrops fetalis. This case emphasizes the complexity of this condition and underscores the necessity for a multidisciplinary approach in evaluating and counseling patients with intricate fetal anomalies. This study has been reported in line with the CARE criteria9.

To deal with the issue of poor visibility caused by water turbidity during the operation of underwater robotics, we propose an attenuation prior formation model-guided enhancement algorithm for turbid underwater images. Specifically, we establish an imaging model suitable for turbid water by studying the influence of water turbidity on light attenuation and transmission. For this model, we first propose a scoring formula that takes into account multiple prior knowledge to estimate the global background light with the help of hierarchical searching technique. Then, we make full use of the advantages of different scale neighborhoods in image restoration, and propose an adaptive multi-scale weighted fusion transmission estimation method to balanc e brightness and contrast. In addition, to correct the color of the images with a natural appearance, a variation of white balance is introduced as post-processing. Extensive experiments on two image datasets show that our algorithm achieves better results than state-of-the-art methods.