Similar Time Research Articles

A New Strategy to Modify Hopfield by Using XOR Operation

تعد شبكة هوبفيلد واحدة من أسهل الأنواع الشبكات العصبية، تركيب الشبكة يكون كل خلية عصبية في الشبكة تتصل بالخلية الأخرى، وبالتالي تسمى الشبكة العصبية المتصلة بالكامل. بالإضافة إلى ذلك، يعتبر هذا النوع ذاكرة ارتباطية تلقائية، نظرًا لأن الشبكة تقوم بإرجاع النمط فور التعرف عليه، فإن هذه الشبكة بها العديد من القيود، بما في ذلك سعة الذاكرة، والتباين، والمتعامد بين الأنماط، والاوزان المتماثلة، والحد الأدنى. هذا البحث يقترح استراتيجية جديدة لتصميم شبكة الهوبفيلد باستخدام عملية XOR ؛ حيث تم اقتراح إستراتيجية جديدة لحل هذه القيود من خلال اقتراح خوارزمية جديدة، باستخدام هذه الاستراتيجية سيزيد من تحسين أداء شبكة الهوبفيلد من خلال تعديل بنية الشبكة، ومراحل التدريب والتقارب ، وان الاستراتيجية المقترحة تعتمد على حجم النمط. و تتجنب تعلم نمط مشابه عدة مرات، و تظهر قابليتها في التعرف على أنماط مشوهة بالضوضاء، وسعة تخزينها غير محدودة وحل مشكلة النمط المعكوس. أظهرت التجارب أن الطريقة المقترحة لها نتائج جيدة من خلال تجنب غالبية قيود شبكة هوبفيلد. بالإضافة إلى ذلك ، يتعلم التعرف على عدد لا حصر له من الأنماط بأحجام مختلفة مع الحفاظ على نسبة ضوضاء مناسبة.

An automated sample generation method by integrating phenology domain optical-SAR features in rice cropping pattern mapping

Accurate spatio-temporal information on rice cropping patterns is vital for predicting grain production, managing water resource and assessing greenhouse gas emissions. However, current automated mapping of rice cropping patterns at regional scale is heavily constrained by insufficient training samples and frequent cloudy weathers in major rice-producing areas. To tackle this challenge, we proposed a Phenology domain Optical-SAR feature inTegration method to Automatically generate single (SC-Rice) and double cropping Rice (DC-Rice) sample (POSTAR) for efficient and refined rice mapping. POSTAR includes three major steps: (1) generating a potential rice map using a phenology- and object-based classification method with optical data (Sentinel-2 MSI) to select candidate rice samples; (2) employing K-means to identify SC- and DC-Rice candidate samples according to unique SAR-based (Sentinel-1 SAR) phenological features; (3) implementing a two-step refinement strategy to filter high-confidence SC- and DC-Rice samples, maintaining a balance between intraclass phenological variance and sample purity. Test areas selected for validation include the Dongting Lake plain and Poyang Lake plain in South China, as well as Fujin county located in the Sanjiang plain of North China. POSTAR proved effective in producing reliable SC- and DC-Rice samples, achieving a high spectral correlation similarity (>0.85) and low dynamic time wrapping distance (<8.5) with field samples. Applying POSTAR-derived samples to random forest classifier yielded an overall accuracy of 89.6%, with F1 score of 0.899 for SC-Rice and 0.938 for DC-Rice in the Dongting Lake plain. Owing to the incorporation of knowledge-based optical and SAR phenological features, POSTAR exhibited strong spatial transferability, achieving an overall accuracy of 96.0% in the Poyang Lake plain and 97.8% in the Fujin county. These results demonstrated the effectiveness of the POSTAR method in accurately mapping rice cropping patterns without extensive field visits, providing valuable insights for crop monitoring in large, diverse, and cloudy regions through the integration of optical and SAR data.

Heterogeneity of morphometric similarity networks in health and schizophrenia.

Morphometric similarity is a recently developed neuroimaging phenotype of inter-regional connectivity by quantifying the similarity of a region to other regions based on multiple MRI parameters. Altered average morphometric similarity has been reported in psychotic disorders at the group level, with considerable heterogeneity across individuals. We used normative modeling to address cross-sectional and longitudinal inter-individual heterogeneity of morphometric similarity in health and schizophrenia. Morphometric similarity for 62 cortical regions was obtained from baseline and follow-up T1-weighted scans of healthy individuals and patients with chronic schizophrenia. Cortical regions were classified into seven predefined brain functional networks. Using Bayesian Linear Regression and taking into account age, sex, image quality and scanner, we trained and validated normative models in healthy controls from eleven datasets (n = 4310). Individual deviations from the norm (z-scores) in morphometric similarity were computed for each participant for each network and region at both timepoints. A z-score ≧ than 1.96 was considered supra-normal and a z-score ≦ -1.96 infra-normal. As a longitudinal metric, we calculated the change over time of the total number of infra- or supra-normal regions per participant. At baseline, patients with schizophrenia had decreased morphometric similarity of the default mode network and increased morphometric similarity of the somatomotor network when compared with healthy controls. The percentage of patients with infra- or supra-normal values for any region at baseline and follow-up was low (<6%) and did not differ from healthy controls. Mean intra-group changes over time in the total number of infra- or supra-normal regions were small in schizophrenia and healthy control groups (<1) and there were no significant between-group differences. In a case-control setting, a decrease of morphometric similarity within the default mode network may be a robust finding implicated in schizophrenia. However, normative modeling suggests that significant reductions and changes over time of regional morphometric similarity are evident only in a minority of patients.

Reversible assembly and disassembly of V-ATPase during the lysosome regeneration cycle.

Regulation of the luminal pH of late endocytic compartments in continuously fed mammalian cells is poorly understood. Using normal rat kidney fibroblasts, we investigated the reversible assembly/disassembly of the proton pumping V-ATPase when endolysosomes are formed by kissing and fusion of late endosomes with lysosomes and during the subsequent reformation of lysosomes. We took advantage of previous work showing that sucrosomes formed by the uptake of sucrose are swollen endolysosomes from which lysosomes are reformed after uptake of invertase. Using confocal microscopy and subcellular fractionation of NRK cells stably expressing fluorescently tagged proteins, we found net recruitment of the V1 subcomplex during sucrosome formation and loss during lysosome reformation, with a similar time course to RAB7a loss. Addition of invertase did not alter mTORC1 signalling, suggesting that the regulation of reversible V-ATPase assembly/disassembly in continuously fed cells differs from that in cells subject to amino acid depletion/refeeding. Using live cell microscopy, we demonstrated recruitment of a fluorescently tagged V1 subunit during endolysosome formation and a dynamic equilibrium and rapid exchange between the cytosolic and membrane bound pools of this subunit. We conclude that reversible V-ATPase assembly/disassembly plays a key role in regulating endolysosomal/lysosomal pH in continuously fed cells.

Optimizing Enhanced Extended Topological Active Nets Model Using Parallel Processing

In numerous clinical applications that support the diagnosis and treatment planning of a broad variety of disorders, medical image segmentation is essential. Medical picture segmentation using the Enhanced Extended Topological Active Net (EETAN) model has proven to be successful in correctly identifying structures. This study suggests a novel way to combine the best clustering techniques and parallel processing approaches to maximize the segmentation performance of the EETAN model. The Probabilistic Depth Search Optimization (PDSO) Algorithm, which makes the parallel searching technique to find the ideal contour set, is responsible for this. This work implements parallel processing and ideal clustering to improve the EETAN model's performance in medical image segmentation. Performance metrics like accuracy, precision, recall, dice similarity, and computational time are used for a comparison study. The results demonstrate the notable enhancements attained by employing parallel processing and effective clustering.

Energy‐aware power allocation using Ladybug Beetle Honey Badger Optimization in multiple‐input multiple‐output‐non‐orthogonal multiple access with multiple users

SummaryThe non‐orthogonal multiple access (NOMA) is highly capable of serving multiple users at similar times and frequencies. The power allocation (PA) is widely considered as a main factor in NOMA for efficient communication. Here, the application of multiple‐input multiple‐output (MIMO) is added to NOMA to fulfill demands of enriched spectral efficiencies and extra user data. In this research, the Ladybug Beetle Honey Badger Optimization (LBHBO) is proposed for efficient PA in MIMO‐NOMA. Initially, the received signals from the user are modulated for amplitude and frequency. Then, user grouping is conducted by fuzzy local information c‐means (FLICM) clustering followed by using PA done by proposed LBHBO. This power is then moved to the transmitter and then to the channel estimation process. Moreover, cyclic prefix (CP) removal is carried out that tends to discrete Fourier transform (DFT). Finally, quadrature amplitude modulation (QAM) demodulation is performed for reallocated output. Furthermore, LBHBO is formed by combining Ladybug Beetle Optimization (LBO) and Honey Badger Algorithm (HBA). The performance offered by the LBHBO‐PA with maximal values with energy efficiency (EE) of 25.38 Mbits/s, sum rate of 1.29 Mbits/s, and achievable rate of 100.47 Mbits/s.

Word-object and action-object learning in a unimodal context during early childhood

Abstract Word-object and action-object learning in children aged 30 to 48 months appears to develop at a similar time scale and adheres to similar attentional constraints. However, children below 36 months show different patterns of learning word-object and action-object associations when this information is presented in a bimodal context (Eiteljoerge et al., 2019b). Here, we investigated 12- and 24-month-olds’ word-object and action-object learning when this information is presented in a unimodal context. Forty 12- and 24-month-olds were presented with two novel objects that were either first associated with a novel label (word learning task) and then later with a novel action (action learning task) or vice versa. In subsequent yoked test phases, children either heard one of the novel labels or saw a hand performing one of the actions presented with the two objects on screen while we measured their target looking. Generalized linear mixed models indicate that 12-month-olds learned action-object associations but not word-object associations and 24-month-olds learned neither word- nor action-object associations. These results extend previous findings (Eiteljoerge et al., 2019b) and, together, suggest that children appear to learn action-object associations early in development while struggling with learning word-object associations in certain contexts until 2 years of age.

Understanding of ZnO‐Catalyzed Polyurethane Synthesis from Bisurea for Further Exploration of One‐Pot Synthesis and Property Evaluation Thereof

AbstractZnO is considered to be a good catalyst for the synthesis of polyurethanes (PUs) by alcoholysis of bisureas (BUs). ZnO tends to form Zn(NCO)2(NH3)2 in the presence of urea at high temperature, so does it in the alcoholysis of BUs. Here, attempt is made to understand the role Zn(NCO)2(NH3)2 plays in the alcoholysis of BUs. A loading of Zn(NCO)2(NH3)2 at 5 mol% is found to be sufficient to catalyze the polymerization and the reaction time is greatly cut from 40 h (catalyzed by ZnO) to 26 h, with similar chemical structures and properties. The tensile strength, elongation at break, and toughness for PU–Zn‐5 can reach 43.8 MPa, 330%, and 94.0 J cm−3, respectively. One‐pot synthetic strategy is then further introduced to improve the efficiency of the polymerization. Zn(NCO)2(NH3)2, BU, and PU can be synthesized in one‐pot, by adding ZnO, urea, diamine, LiBr, and diol sequentially. The feasibility of this one‐pot method is verified, indicated by the similar reaction time, chemical structures, molecular weight, thermal and mechanical properties. This one‐pot synthetic strategy offers an efficient way to synthesize PUs directly and simply from urea, diamines, and diols, which is beneficial for improving the molecular diversity of PUs.

Single and multi-dose pharmacology of recombinant and urinary human chorionic gonadotrophin in men.

Human choriogonadotrophin (hCG) treatment of gonadotrophin-deficient infertile men uses hCG of urinary (uhCG) or recombinant (rhCG) origin, but these treatments have not been compared nor are there studies defining rhCG dosing in men. hCG products were studied in randomized cross-over single-dose studies of standard (Study 1, 1500 IU and 62.5 µg, respectively) or high (Study 2, 5000 IU and 250 µg) dose and a multi-dose population pharmacology study of hCG use. Eight (Study 1) and seven (Study 2) volunteers in cross-over and 52 gonadotrophin-deficient men in the multi-dose study MEASUREMENTS: In cross-over studies, serum testosterone (T), dihydrotestosterone (DHT) and estradiol by liquid chromatography-mass spectrometry (LCMS) and serum hCG, LH, FSH, SHBG and T (observational study) by immunoassays. After standard and high-dose injection, serum hCG and testosterone responses had similar timing and peak concentrations except for a mildly lower early (<48 h) serum testosterone with uhCG. In the multi-dosing study, both hCGs had similar pharmacokinetics (pooled half-life 5.8 days, p < .001), while serum testosterone concentrations were stable after injection and did not differ between hCG products. Bench testing verified that 20% of pens from 4/10 individuals were used inappropriately. Although hCG pharmacokinetics are not formally bioequivalent, the similar pharmacodynamic effects on serum testosterone indicatethat at the doses tested both hCGs provide comparable clinical effects. The starting dose of rhCG for treating gonadotrophin-deficient men should be 62.5 µg (6 clicks) of the rhCG pen.

Thermal-Mechanical Analysis of a Power Module with Parametric Model Order Reduction

This paper presents parametric model order reduction (pMOR) by the Lagrange approach of matrix interpolation for the thermal-mechanical and reliability study of a power electronics module (PEM) with nonlinear behaviours. Most previous research in model order reduction (MOR) studies reports thermal-mechanical simulations using a sequentially coupled method. In this research, a direct-coupled thermal-mechanical analysis, which simultaneously solves the thermal and structural governing equations, has been used to obtain thermal and deformation results. Furthermore, for pMOR, the linear approach of matrix interpolation is limited to linear changes between sampled-parametric points. Hence, a new way of interpolating system matrices using the Lagrange interpolation method has been adopted to implement the matrix interpolation efficiently. The parametric reduced-order model (pROM) solution by the Lagrange approach of matrix interpolation agrees well with the full-order model (FOM) and takes similar computational time as the linear (bi-linear) approach of matrix interpolation. pROM simulations offer up to 85.5% reduction in computational time.

Diabetic Ketoacidosis at Onset of Type 1 Diabetes and Glycemic Outcomes with Closed-Loop Insulin Delivery.

The presence of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes (T1D) is associated with higher glycated hemoglobin levels over time. We evaluated whether hybrid-closed loop (HCL) therapy from onset of T1D could prevent the adverse impact of DKA at diagnosis on long-term glycemic outcomes. This was a posthoc analysis from 51 adolescents using HCL from diagnosis of T1D as part of the CLOuD trial (NCT02871089). We compared glycemic and insulin metrics between adolescents with (n = 17) and without (n = 34) DKA at diagnosis. Participants with and without DKA at diagnosis had similar time in target glucose range 3.9-10.0 mmol/L (70-180 mg/dL), time below range (<3.9 mmol/L, <70 mg/dL) and HbA1c at 6, 12, and 24 months. While insulin requirements at 6 months were higher in those with DKA at diagnosis, this was not statistically significant after adjusting for bodyweight. Residual C-peptide secretion was similar between groups. We conclude that HCL therapy may mitigate against the negative glycemic effects of DKA at T1D diagnosis.

Efficacy of Semaglutide in Overweight and Obese Patients with Type 1 Diabetes.

Introduction: More than two-thirds of patients with type 1 diabetes (T1D) are overweight (OW) and/or obese (OB) in the USA and Western Europe, resulting in insulin resistance as in type 2 diabetes. None of the currently available glucagon like polypeptide 1 (GLP-1) analogs are approved for patients with T1D. A higher dose of semaglutide has been approved by the Food and Drug Administration (FDA) for subjects with body mass index (BMI) >27 kg/m2. We evaluated the real-world use of semaglutide in patients with T1D. Methods: This was a retrospective chart review study of 50 OW or OB patients with T1D who were initiated on semaglutide and followed for 1 year. The control group comprised of 50 computer-matched patients (for sex, race, weight, BMI, and diabetes duration) during a similar time period and were not on any weight loss medications. Results: Most patients (92%) were non-Hispanic white in both arms. Mean ± standard deviation (SD) age and duration of diabetes were 42 ± 11 and 27 ± 12 years, respectively. The continuous glucose monitors (CGM), insulin pump use, baseline BMI and body weight were also similar in the two groups. Baseline glycosylated hemoglobin (HbA1c) was insignificantly lower in the semaglutide group (7.6% vs. 8.2%, respectively; P = non-significant [NS]). Total daily insulin dose (TDD) and insulin dose per kg body weight were higher in the semaglutide group at baseline with no difference in basal or prandial insulin dose. There were significantly greater declines in mean (±SD), BMI (7.9% ± 2.6%), body weight (15.9 lbs ± 5.4 lbs), HbA1c, CGM glucose SD and coefficient of variation (CV), and increase in CGM time in range (TIR) in the semaglutide group compared to the control group with no difference in insulin dose changes, time above range (TAR), or time below range (TBR). Conclusions: We conclude that use of semaglutide in patients who are OW and/or OB with T1D was effective in lowering body weight and BMI, and improving glycemic metrics in this pilot real-world study. We strongly recommend performing prospective, large-randomized clinical trials with newer GLP-1 analogs like semaglutide and tirzepatide (twin-cretin) for subjects with T1D associated with OW and/or OB.

Airway protection and outcomes after staged versus concurrent bilateral neck dissections with transoral base of tongue cancer resection.

To assess airway, safety, and resource utilization outcomes between transoral base of tongue (BOT) surgery with staged versus concurrent bilateral neck dissections (BND). A retrospective cohort study of patients with human papilloma virus (HPV)-related BOT cancer who underwent transoral surgery and BND from January 2015 through June 2022 was conducted. Free flap patients were excluded. Of 126 patients (46 [37%] staged and 80 [63%] concurrent BND), there were no significant differences in rates of postoperative intubation, tracheostomy, intensive care admission, operative takebacks, gastrostomy, and 30-day readmission. Total operative time (median difference 1.4 [95% CI 0.9-1.8] hours), length of stay (1.0 [1.0-1.0] day), and time between primary surgery and adjuvant therapy initiation (4.0 [0.0-8.0] days) were lower in the concurrent BND cohort. Concurrent BND alongside transoral BOT resection is safe with similar airway outcomes and lower total operative time, length of stay, and time to adjuvant therapy initiation compared to staged BND.

Comparative Efficacy of Madrid Plant Extracts in Controlling Red Flour Beetle Populations: A Laboratory Evaluation of Alcohol and Aqueous Solutions

The efficiency of the alcohol and aqueous excerpt from the Madrid plant in killing ratios of colour red cover beetle larvae and adults afterwards behaviours lasting 24, 48, and 72 hours was valued in laboratory research. Three dissimilar Madrid plant absorptions (1.50 per cent, 3.0%, and 4.59 per cent) were selected to stop the beetle's larvae and adults. The outcomes displayed that the Madrid plant excerpt formed notable degrees. Following 72 hours, the watery excerpt's adult expiry rate was 33.0%, while the alcohol excerpt was 60.0% at 3.0% absorption. After 72 hours, the alcohol excerpt is concentrated larval expiry rate was 71.0% at 3.0% absorption; whereas the watery excerpt's extreme rate was 66.0%. After it derives the phenomena of attraction and repulsion, the paper initiates that the Madrid excerpt in the watery form displayed the maximum level of pull, reaching 9.30% at the absorption of 3.0% after 72 hours, while the repulsion rate was 15.550% at the similar absorption and time. Following 48 hours, the alcohol excerpt of Madrid showed a pull rate of 12.550% at 1.50% concentration. Additionally, following 72 hours, a revulsion rate of 19.80% at 3.0% concentration was realized in adult beetles. The extreme pull rate of the watery excerpt for larvae was 0.00% at all absorptions, and after 72 hours, a comparable revulsion rate of 10.950% was realized at a 4.50% concentration. Also, after 72 hours, the alcohol excerpt displayed a revulsion rate of 19.150% at 3.0% absorption and a pull rate of 0.00% at all concentrations.

Optimal misoprostol dosing among patients with a body mass index greater than 30: a randomized controlled trial

Patients with obesity experience an increased duration of labor with an increased risk for perinatal morbidity. When compared with parturients without obesity, they also experience fewer uterine contractions after administration of misoprostol. It is unclear if the same dose of misoprostol should be used for induction of labor in patients with obesity compared to non-obese patients. Therefore, we sought to investigate if a higher dose of misoprostol for patients with obesity is more effective. This study aimed to determine if 50 μg compared with 25 μg of vaginal misoprostol reduced the time from induction start to delivery among patients with obesity. We performed a double-blinded, pragmatic randomized controlled trial, between June 1, 2022, and July 17, 2023. Patients with a body mass index ≥30 kg/m2 who underwent labor induction at ≥ 36 weeks' gestation, had a singleton gestation, and a cervical dilation ≤3 cm at admission were included. Patients were excluded if they had a contraindication to vaginal delivery or misoprostol administration. Patients were randomized to 25 or 50 μg of vaginal misoprostol, stratified by parity, body mass index <40 kg/m2 or ≥40 kg/m2, and provider intent to use mechanical dilation at the onset of labor induction. Usual labor management was followed at the discretion of the provider. The primary outcome was time from induction to delivery. A priori, we estimated that 90 subjects per group (N=180) were needed for an 85% power to detect a 3-hour difference between groups with a type I error of 5%. Analysis was by intention-to-treat. A 2-sample t test was used for the primary outcome, Cohen's d was used as a measure of effect, and P values were reported. Of the 180 patients randomized, 88 were assigned to the 25 μg group and 92 were assigned to the 50 μg group. Of those, 96.1% of patients received the designated intervention. The baseline characteristics were similar between groups. No difference was found in the primary outcome of time to delivery (21.6 hours vs 18.6 hours; d=.28; 95% confidence interval,-0.02 to 0.57). In a planned subgroup analysis, multiparous patients delivered faster in the 50 μg group (15.2 hours vs 12.0 hours; d=.51; 95% confidence interval, 0.04-0.97). The risk for tachysystole associated with fetal heart tracing changes was rare overall (2.2%) and not significantly different between groups. No differences in maternal or neonatal adverse effects were observed. Patients with obesity who underwent cervical ripening with 50 μg of vaginal misoprostol experienced a similar time to delivery when compared with those who received 25 μg of misoprostol. However, multiparous patients had a significantly reduced time to delivery when 50 μg was used. A higher dose of misoprostol may be a promising intervention for reducing time in labor, which warrants further study.

Soft H-L back transitions by applying resonant magnetic perturbations in the low q 95 EAST plasmas

Controlled ‘soft’ H-L transitions with a simultaneous ramp-down of plasma density and stored energy, generated by applying resonant magnetic perturbations (n = 2 RMPs), relevant to the control of ITER terminations, are achieved in the EAST tokamak. These H-mode plasmas are run at median electron densities and a low safety factor q 95 ( q95=3.5 –4.0) under neutral beam injection (NBI) dominant heating. During a slow ramp in the RMP current the internal transport barrier for the electron density collapses at the beginning and the edge transport barrier for the electron density collapses later. Before the controlled H-L back transitions, the plasma stored energy W MHD is linearly correlated with the core line-averaged density ⟨ne⟩ . These controlled H-L back transitions ensue from the collapse of the edge transport barrier and at a similar energy confinement time τeH-L∼48 ms. These H-L transitions are not sensitive to the NBI power but are very sensitive to the fueling rate and ramp-up rate of the RMP current.

In silico study of combination thrombolytic therapy with alteplase and mutant pro-urokinase for fibrinolysis in ischemic stroke

The synergistic advantage of combining tissue plasminogen activator (tPA) with pro-urokinase (proUK) for thrombolysis has been demonstrated in several in vitro experiments, and a single site proUK mutant (m-proUK) has been developed for better stability in plasma. Based on these studies, combination thrombolytic therapy with intravenous tPA and m-proUK has been suggested as a promising treatment for patients with ischemic stroke. This paper evaluates the efficacy and safety of the dual therapy by computational simulations of pharmacokinetics and pharmacodynamics coupled with a local fibrinolysis model. Seven dose regimens are simulated and compared with the standard intravenous tPA monotherapy. Our simulation results provide more insights into the complementary reaction mechanisms of tPA and m-proUK during clot lysis and demonstrate that the dual therapy can achieve a similar recanalization time (about 50 min) to tPA monotherapy, while keeping the circulating fibrinogen level within a normal range. Specifically, our results show that for all dual therapies with a 5 mg tPA bolus, the plasma concentration of fibrinogen remains stable at around 7.5 μM after a slow depletion over 50 min, whereas a rapid depletion of circulating fibrinogen (to 5 μM) is observed with the standard tPA therapy, indicating the potential advantage of dual therapy in reducing the risk of intracranial hemorrhage. Through simulations of varying dose combinations, it has been found that increasing tPA bolus can significantly affect fibrinogen level but only moderately improves recanalization time. Conversely, m-proUK doses and infusion duration exhibit a mild impact on fibrinogen level but significantly affect recanalization time. Therefore, future optimization of dose regimen should focus on limiting the tPA bolus while adjusting m-proUK dosage and infusion rate. Such adjustments could potentially maximize the therapeutic advantages of this combination therapy for ischemic stroke treatment.

Performance-Based Outcomes after Revision Ulnar Collateral Ligament Surgery in Professional Pitchers.

To compare performance in baseball pitchers before and after revision ulnar collateral ligament (UCL) surgery using performance metrics. Case series. Public online database. Players who underwent revision UCL surgery between 2015 and 2021 were identified. Players were included if they were Minor League (MiLB) or Major League (Major League baseball [MLB]) pitchers. Players were excluded if they were not pitchers, if they underwent their revision surgery as an amateur, or if there is no record of their primary reconstruction surgery. Revision UCL surgery (repair or reconstruction). Return to sport (RTS) rate, RTS time, pitch velocity, and pitch spin rate. Sixty-five pitchers underwent revision UCL surgery. MiLB pitchers had a shorter RTS time after their primary surgery (15.62 vs 20.77 months, P < 0.01) compared with MLB pitchers but similar RTS times after their revision reconstruction (19.64 vs 18.48 months, P = 0.44). There was also no difference in return to play (RTP) rate overall after primary versus revision reconstruction ( P = 1.00). Major League baseball pitchers also had decreased RTS time after primary compared with revision reconstruction (15.62 vs 19.64 months, P < 0.01) but similar RTP rates ( P = 0.28). Finally, MLB pitchers had similar pitch breakdowns, velocities, and spin rates before and after their primary and revision repair or reconstruction. Both revision UCL repair and reconstruction can return pitchers to preinjury performance levels. Pitchers and teams should be properly counseled on realistic RTP times and postsurgery performance when discussing revision UCL surgeries.

Prospective findings from the Dongfeng-Tongji cohort: Exposure to various metals, the expression of microRNA-4286, and the incidence of acute coronary syndrome

Mounting evidence suggests that metal/metalloid exposure is related to the adverse health effects. Our prior investigation revealed a positive relation between the plasma level of microRNA-4286 (miR-4286) and an increased risk of developing acute coronary syndrome (ACS). However, it is a lack of studies evaluating the connection between metal/metalloid exposure and miRNA expression on ACS. In the prospective Dongfeng-Tongji cohort, we performed a nested case-control study. A total of 480 ACS and 480 controls were carefully selected based on similar age, sex, and blood collection time. Using inductively coupled plasma mass spectrometry, we assessed the plasma concentrations of 24 different metals. Quantitative real-time polymerase chain reaction was used to analyze the plasma miR-4286. We examined the relations of plasma metals with miR-4286 levels, the incidence of ACS, and the potential interactions. Using the multivariate conditional logistic regression models, we observed that the adjusted odds ratios (95% confidence intervals [CI]) for incident ACS were 1.79 (1.03, 3.12; P-trend = 0.03), 0.60 (0.41, 0.87; P-trend = 0.008), and 0.66 (0.46, 0.93; P-trend = 0.02), when comparing the extreme tertiles of aluminum, rubidium, and selenium, respectively. There was a relation between the concentration of rubidium in plasma and a decrease in the level of plasma miR-4286 (percent difference [95% CI]: −13.36% [-22.74%, −2.83%]; P-trend = 0.01). Both multiplicative (P interaction = 0.009) and additive interactions (relative excess risk due to interaction [95% CI]: 0.82 [0.59, 1.06]) were noted in our observation regarding the relationship between plasma aluminum and miR-4286 in incident ACS. The findings indicated that plasma aluminum was positively while plasma rubidium and selenium were negatively linked to an increased risk of developing ACS. Plasma aluminum exposure and plasma miR-4286 expression might synergistically affect the incident ACS risk. Controlling aluminum exposure was important for ACS prevention, especially for individuals with high expression of plasma miR-4286.

Landscape-Scale Epidemiological Dynamics of SARS-CoV-2 in White-Tailed Deer

Understanding pathogen emergence in new host species is fundamental for developing prevention and response plans for human and animal health. We leveraged a large-scale surveillance dataset coordinated by United States Department of Agriculture, Animal and Plant Health Inspection Service and State Natural Resources Agencies to quantify the outbreak dynamics of SARS-CoV-2 in North American white-tailed deer (Odocoileus virginianus; WTD) throughout its range in the United States. Local epidemics in WTD were well approximated by a single-outbreak peak followed by fade out. Outbreaks peaked early in the northeast and mid-Atlantic. Local effective reproduction ratios of SARS-CoV-2 were between 1 and 2.5. Ten percent of variability in peak prevalence was explained by human infection pressure. This, together with the similar peak infection prevalence times across many counties and single-peak outbreak dynamics followed by fade out, suggest that widespread transmission via human-to-deer spillover may have been an important driver of the patterns and persistence. We provide a framework for inferring population-level epidemiological processes through joint analysis of many sparsely observed local outbreaks (landscape-scale surveillance data) and linking epidemiological parameters to ecological risk factors. The framework combines mechanistic and statistical models that can identify and track local outbreaks in long-term infection surveillance monitoring data.