Definition Of Threshold Research Articles

Multiscale phenology of seasonally dry tropical forests in an aridity gradient

The leaf phenology of seasonally dry tropical forests (SDTFs) is highly seasonal, marked by synchronized flushing of new leaves triggered by the first rains of the wet season. Such phenological transitions may not be accurately detected by remote sensing vegetation indices and derived transition dates (TDs) due to the coarse spatial and temporal resolutions of satellite data. The aim of this study was to compared TDs from PhenoCams and satellite remote sensing (RS) and used the TDs calculated from PhenoCams to select the best thresholds for RS time series and calculate TDs. For this purpose, we assembled cameras in seven sites along an aridity gradient in the Brazilian Caatinga, a region dominated by SDTFs. The leafing patterns were registered during one to three growing seasons from 2017 to 2020. We drew a region of interest (ROI) in the images to calculate the normalized green chromatic coordinate index. We compared the camera data with the NDVI time series (2000–2019) derived from near-infrared (NIR) and red bands from MODIS product data. Using calibrated PhenoCam thresholds reduced the mean absolute error by 5 days for SOS and 34 days for EOS, compared to common thresholds in land surface phenology studies. On average, growing season length (LOS) did not differ significantly among vegetation types, but the driest sites showed the highest interannual variation. This pattern was applied to leaf flushing (SOS) and leaf fall (EOS) as well. We found a positive relationship between the accumulated precipitation and the LOS and between the accumulated precipitation and maximum and minimum temperatures and the vegetation productivity (peak and accumulated NDVI). Our results demonstrated that (A) the fine temporal resolution of phenocamera phenology time series improved the definitions of TDs and thresholds for RS landscape phenology; (b) long-term RS greening responded to the variability in rainfall, adjusting their timing of green-up and green-down, and (C) the amount of rainfall, although not determinant for the length of the growing season, is related to the estimates of vegetation productivity.

Unitarity violation in field theories of Lee–Wick’s complex ghost

Abstract Theories with fourth-order derivatives, including the Lee–Wick finite QED model and quadratic gravity, have a better UV behavior, but the presence of negative metric ghost modes endangers unitarity. Noticing that the ghost acquires a complex mass by radiative corrections, Lee and Wick, in particular, claimed that such complex ghosts would never be created by collisions of physical particles because of energy conservation, so that the physical S-matrix unitarity must hold. We investigate the unitarity problem faithfully, working in the operator formalism of quantum field theory. When complex ghosts participate, a complex delta function (a generalization of the Dirac delta function) appears at each interaction vertex, which enforces a specific conservation law of complex energy. Its particular property implies that the naive Feynman rule is wrong if the four-momenta are assigned to the internal lines after taking account of the conservation law in advance. We show that complex ghosts are actually created and unitarity is violated in such fourth-order derivative theories. We also find a definite energy threshold below which ghosts cannot be created: The theories are unitary and renormalizable below the threshold.

A Threshold Design Method of Aircraft Sensor Fault Detection Monitor

A design method is proposed based on probability and statistics to solve the issue that the contradiction between false alarm rate and missed detection rate of sensor comparing monitor threshold definition. The sensor tracking error probability density function is deduced based on the probability, the false alarm rate and missed detection rate are calculated based on the different monitor threshold. Then a criterion is provided in according with sensor failure rate, aircraft dispatch reliability and monitor failure rate. In order to verify it, a quad redundant rate gyro used on aircraft is analysed and an advanced comparing monitor threshold is calculated. Comparing with the original threshold, the monitor coverage rate with the new threshold is increased 1.42 times than the original one. The actual flight date is researched to verify that the monitor failure rate reach to the minimum value 3.91*10-07/Fh which decrease one order of magnitude comparing with the original one 3.5*10-06/Fh. It could be verified that this method could achieve the balance between the safety and dispatch reliability requirement.

Incidence, Prevalence, and Disease Management Impactability of High Utilization in an Adult Sickle Cell Medical Home

Background: Utilization in adults with sickle cell disease (SCD) is driven by a biopsychosocial mix of predictors. Disease management intervenes on the biopsychosocial determinants of health, partly to drive down avoidable ED visits and hospitalizations. We previously reported the effect of disease management interventions on SCD utilization among adults enrolled in an Adult Sickle Cell Medical Home (Blood)[i]. To further understand the impact of these interventions, we evaluated the incidence, prevalence, and impactability of case management within our Medical Home. Method: The sample includes distinct individuals enrolled in the Adult SCD Medical Home (N=537 in 2017, N=621 in 2018, N=558 in 2019, N=677 in 2020, N=577 in 2021, and N=604 in 2022). We analyzed the “CoVID Years” (2020-2022) separately from the “Pre-CoVID” years (2017-2019). Interventions in the Adult SCD Medical Home included: medical care by MDs, NPs, and nurses; behavioral health counseling by a licensed clinical social worker; case management by Community Health Workers (Patient Navigators), and prior authorization management by a reimbursement specialist, a licensed pharmacy tech. To perform the analysis, we defined High utilizers (vs moderate or low utilizers) as those with >$200,000 in annual medical charges each year between the years 2017-2021. We used the definition threshold to calculate the annual incidence of high utilization: the percentage of moderate or low utilizers in an index year who became high utilizers in the subsequent year. Similarly, the annual prevalence of high utilization was the percentage of all patients who were high utilizers in an index year. And the impactability of high utilization was the percentage of high utilizers in an index year who became moderate or low utilizers in the subsequent year. We calculated the annual high-utilization incidence, prevalence, and impactability for 2018-2022. Results: The annual program high-utilizer incidence, prevalence, and impactability are shown in Table 1. Utilization was stable from year to year, except at the intersection of pre-COVID and COVID years. The impactability score was 0-3.5%. We could not find good literature showing comparative annual changes in rates of impactability in diabetes, congestive heart failure, or vulnerable Medicaid populations. The graphs show individual patients' index and multiple subsequent utilization costs for those remaining in the cohorts (Classes) starting from 2017-2022 (Class of 2018), 2018-2022 (Class of 2019), 2019-2022 (Class of 2020), and 2020-2022 (Class of 2021). No statistical analyses were performed, but the trends were numerically down for all periods. Conclusion: An intense disease management program, as part of an Adult Sickle Cell Medical Home was associated with stable year-over-year high-utilizer percentage. It was also associated with a stable, low annual incidence of ‘new’ high utilizers, and a stable, low impactability among current high utilizers. We could not determine how these program rates compare with analogous rates in other chronic diseases. [i] Intensive Case Management in an Adult Sickle Cell Medical Home: Annual Effects on Utilization Efficiency Using Community Health Workers; Shirley Johnson, BA, LSW1*, Daniel M Sop, BS, MS2, Yue May Zhang, MS3*,Benjamin Jaworowski, BS 1*and Wally R Smith, MD4

Balanced Definition of Thresholds for Mode Tracking in a Long-Term Seismic Monitoring System

The catastrophic events of recent years have strengthened the awareness of the fragility of the built heritage and the importance of careful and targeted maintenance. This, in combination with the development of modern techniques for the analysis of large datasets, has favoured the diffusion of long-term seismic monitoring systems for the protection of structures. In the field of structural health monitoring, data-driven techniques allow crucial information to be extracted from measurements without the need to model the physical phenomena involved, circumventing potential limitations that may arise. On the other hand, however, the results of data-driven approaches are based entirely on the measured structural response; this is why a high reliability of the procedure for extracting diagnostic parameters is essential. In this perspective, a Mode Tracking procedure is proposed to obtain coherent time histories of the modal frequencies of a structure as environmental conditions vary. The procedure is applied to the Sanctuary of Vicoforte, an important monumental structure located in Piedmont, known for its imposing oval dome and characterized by a permanent structural monitoring system. This study aims to disentangle the frequency time series and obtain a rigorous database on which to set up damage identification processes.

Effects of sediment transport on flood hazards: Lessons learned and remaining challenges

Sediment transport (bedload and suspension) plays a relevant role in the morphological response of river channels to large floods. Sediment load controls erosion and aggradation patterns during high flows, drives the migration of macroforms and contributes to the definition of thresholds for bank erosion and channel instability. Given this influence on channel morphology, it is clear that sediment transport influences both the channel geometry and water stage reached during floods and should therefore be considered in flood hazard analysis. So far, however, legislation on flood hazard and flood management plans still continues to typically disregard sediment transport. This is due mainly to the paucity of available data on sediment transport and the lack of standardized approaches for its integration into flood hazard analysis. The present work, which aims to provide some guidance on how to advance in this issue, has undertaken a bibliometric study and thorough review of the published scientific literature that had previously addressed the implications of sediment transport on flood hazards assessment. This review showed that: i) most studies on the influence of sediment transport on flood risk have focused on mountain streams, as they are highly sensitive systems to changes in sediment supply; ii) research has also focused on explaining historical changes in channel-conveyance capacity and flood frequency based on long-term trends in sediment supply; and iii) recent developments in hydrodynamic and morphodynamic numerical models provide opportunities to explicitly incorporate sediment transport in flood hazard analysis. However, despite the recent advances, we have identified important challenges and discussed needs to better consider sediment transport in flood hazards at different spatial and temporal scales.

Definition of a maximum threshold of direct solar radiation exposure for pedestrians of diverse walking abilities

Since pedestrians are impacted by solar radiation differently, urban designers must evaluate solar radiation exposure of pedestrian paths adopting an inclusive approach. This paper proposes a maximum threshold of direct solar radiation exposure for pedestrians based on activity, user profile and environmental conditions, defined as the difference between the energy consumption before feeling exhausted and the energy cost of walking. Two users of diverse walking abilities, a young adult and an elderly person with mobility impairment, were characterised by metabolic activity, walking speed and maximum energy capacity. Based on the theoretical framework, the energy budget of young adults to cope with thermal stress was set as three times higher than for the elderly. This framework was used to quantify the contribution of direct solar radiation to energy balance and then classify walkability during clear-sky summer hours; the term ‘walkable’ referred to environmental conditions allowing users to walk without feeling exhausted. The methodology was tested on an open area and an urban canyon in Milan; applicability by urban designers was key in developing a simplified way to evaluate shading needs. This approach could be applied to evaluate solar radiation exposure of pedestrian paths adopting diverse user experiences as an evaluation criterion.

Cropping System Stability Drives SOC Sequestration and Increases Saturation Deficit in Hot Arid Durum Wheat Cropping Systems

Stability analysis has been extensively employed in evaluating the genotype x environment interaction, but it can also be conveniently applied to cropping systems. This study applied stability analysis to a long-term experiment (1998–2016) conducted in an experimental farm in southern Italy. The experiment involved two standard semi-arid cropping systems (WW—durum wheat monocropping and WP—durum wheat–field pea rotation), with two nitrogen fertilization levels (60 kg ha−1—N60 and 120 kg ha−1—N120), along with an unfertilized control (N0). Soil organic carbon (SOC) was estimated in all treatments at the end of the experiment to investigate the potential for SOC sequestration and soil C saturation by analyzing the stability of all investigated cropping conditions in relation to SOC sequestration. The study also investigated the relationship between C input and SOC sequestration. SOC sequestration per year was higher in WW than in WP, confirming that including legumes in the rotation did not enhance the SOC content. Similarly, the positive impact of nitrogen application on biomass yield did not affect SOC accumulation. The stability analysis revealed that over the long term, WW exhibited greater stability than WP, suggesting that, in semi-arid environments, a more stable cropping system can enhance soil carbon sequestration, with nitrogen fertilization exerting a scarce influence. Segmented regression analysis identified two distinct patterns of SOC accumulation based on C input, separated by a definite threshold of C input (breakpoint) quantified at 14.7 Mg ha−1. It was found that the steady-state C level, achieved after the accumulation of this C input, was reached much faster in WW than in WP, in which it could only be inferred at 23 years. In conclusion, this study underscores the role of cropping system stability in driving SOC sequestration. Furthermore, it emphasizes the potential of stability analysis in assisting stakeholders in refining their strategies for different cropping conditions in dry and rainy environments.

Vaccine-induced SARS-CoV-2 antibody response: the comparability of S1-specific binding assays depends on epitope and isotype discrimination.

Quantification of the SARS-CoV-2-specific immune response by serological immunoassays is critical for the management of the COVID-19 pandemic. In particular, neutralizing antibody titers to the viral spike (S) protein have been proposed as a correlate of protection (CoP). The WHO established the First International Standard (WHO IS) for anti-SARS-CoV-2 immunoglobulin (Ig) (NIBSC 20/136) to harmonize binding assays with the same antigen specificity by assigning the same unitage in binding antibody units (BAU)/ml. In this study, we analyzed the S1-specific antibody response in a cohort of healthcare workers in Germany (n = 76) during a three-dose vaccination course over 8.5 months. Subjects received either heterologous or homologous prime-boost vaccination with ChAdOx1 nCoV-19 (AstraZeneca) and BNT162b2 (Pfizer-BioNTech) or three doses of BNT162b2. Antibodies were quantified using three anti-S1 binding assays (ELISA, ECLIA, and PETIA) harmonized to the WHO IS. Serum levels of neutralizing antibodies were determined using a surrogate virus neutralization test (sVNT). Binding assays were compared using Spearman's rank correlation and Passing-Bablok regression. All assays showed good correlation and similar antibody kinetics correlating with neutralizing potential. However, the assays show large proportional differences in BAU/ml. ECLIA and PETIA, which detect total antibodies against the receptor- binding domain (RBD) within the S1 subunit, interact similarly with the convalescent plasma-derived WHO IS but differently with vaccine serum, indicating a high sensitivity to the IgG/IgM/IgA ratio. All three binding assays allow monitoring of the antibody response in COVID-19-vaccinated individuals. However, the assay-specific differences hinder the definition of a common protective threshold in BAU/ml. Our results highlight the need for the thoughtful use of conversion factors and consideration of method-specific differences. To improve the management of future pandemics and harmonize total antibody assays, we should strive for reference material with a well-characterized Ig isotype composition.

Measuring the neglected anxiety disorder: validation of the social anxiety spectrum-short version (SHY-SV) questionnaire

BackgroundIn the recent years, a growing body of literature stressed the importance of a dimensional perspective on mental disorders. In particular, since its conceptualization, one of the main concerns in the field of Social Anxiety Disorder (SAD) has been the definition of a diagnostic threshold, leading to the suggestion that SAD may be more properly classified as a spectrum of severity rather than a discrete disorder based on subjectively determined threshold. The purpose of the current research is to evaluate the psychometric qualities of the Social Anxiety Spectrum - Short Version (SHY-SV), a novel questionnaire designed to measure the complete range of social anxiety symptoms, from overt manifestations to subthreshold ones.Methods42 subjects with a clinical diagnosis of social anxiety disorder (SAD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 43 subjects with a clinical diagnosis of Obsessive-Compulsive Disorder (OCD) and 60 individuals without current or lifetime mental disorders (HC) were recruited from the Psychiatric Clinic of the University of Pisa. Subjects were assessed with the SCID-5, Liebowitz Social Anxiety Scale (LSAS) and the SHY-SV.ResultsSHY-SV showed strong internal consistency, and both the total and domain scores had great test-retest reliability. The Pearson’s coefficients for the SHY-SV domain scores ranged from 0.391 to 0.933, and they were positively and significantly correlated with one another (p 0.001). All the SHY-SV domain scores were highly correlated with the SHY-SV total score. Results from of the correlation coefficients between SHY-SV and alternative measures of SAD were all significant and positive. Significant differences among diagnostic groups on both SAD-SV domains and total scores were found. SAD-SV total score increased significantly and progressively from HCs, to the OCD up to the SAD group which showed the highest values.ConclusionThe SHY-SV demonstrated significant convergent validity with other dimensional SAD measures, great internal consistency, and test-retest reliability. With an increasing score gradient from healthy controls to patients with OCD to those with SAD, the questionnaire performed differently in each of the three diagnostic categories.

A novel Vibrio alginolyticus phage and its therapy application in Portunus trituberculatus larvae

Ubiquitous pathogenic marine Vibrio alginolyticus is a very important pathogenic factor causing the outbreaks of sever vibriosis in marine-cultured animals broadly, an opportunistic pathogen for human, and a major pathogen associated with seafood. Antimicrobial drug resistances increased considerably, making the development of alternative therapeutics urgently needed. Isolation and characterization of V. alginolyticus phage vB_Va_Val-yong3 was performed. vB_Va_Val-yong3 contains an icosahedral head and a flexible tail. The diameter of the head is 62 ± 4 nm. The length and width of the tail is 110 ± 9.5 nm and 8 ± 1 nm, respectively. Its burst size is 87.5 PFU/cell. vB_Va_Val-yong3 is euryhaline, chloroform-tolerant, relatively UV-tolerant, stable at 4–50 °C and pH 5–12. Its genome size and GC content are 42,534 bp and 45.6%. It shared the highest nucleotide sequence similarity of 29.67% and the highest intergenomic similarity of 16.3% with all the other phages in PASC scanning and VIRIDIC scanning. Both the values were far below the threshold (> 70%) for genus definition, which illustrated that vB_Va_Val-yong3 revealed a novel phage genus. In the proteomic tree, vB_Va_Val-yong3 and three unclassified Vibrio phages (HY01, ST2-1pr and Seahorse) formed a clade, which clustered with two other clades representing the Mesyanzhionvvidriae family and the Casjensvidriae family respectively. VirClust analysis revealed that 27.7% of genes were shared between Vibrio phages vB_Va_Val-yong3, HY01 and ST2-1pr, which was higher than the family demarcation criteria (> 17%). Far <17% of genes shared between the three Vibrio phages and other viruses (including phage Seahorse and the phages of Mesyanzhionvvidriae and Casjensvidriae family). We advocate the establishment of a new phage family harboring Vibrio phages vB_Va_Val-yong3, HY01 and ST2-1pr. Phage therapy tests on swimming crab Portunus trituberculatus larvae were performed via immersion. vB_Va_Val-yong3 increased the survival rate of the larvae from 33.33% to 51.67% (p < 0.01). Very satisfactorily, the survivors of the infected larvae treated with vB_Va_Val-yong3 could molt and grow normally, while the survivors of the untreated larvae infected with V. alginolyticus all had the problems of molting and slow growth. This brings the very valuable results: all the survivors of the control groups were dwarf, while that of the experimental groups were normal. Food processing tests were also performed using vB_Va_Val-yong3 to eliminate V. alginolyticus in sashimi. The relative bacteriostatic rate of vB_Va_Val-yong3 in sashimi was 97.58% (p < 0.01). Results suggest that vB_Va_Val-yong3 has good potential to be developed as therapeutic agent against V. alginolyticus. This study enriches knowledge about Vibrio phages and lays a foundation for the application of the V. alginolyticus phage.

The added effects of cold spells on stroke admissions: Differential effects on ischemic and hemorrhagic stroke.

Epidemiological evidence suggests an association between low ambient temperature and stroke risk, but available data are limited particularly on associations with different stroke subtypes. The aim of this study is to estimate the relationship between cold spells and stroke admissions, including the effect of cold spells on different stroke subtypes (ischemic stroke and intracerebral hemorrhage (ICH)). A total of 144,405 stroke admissions from the Tianjin Centre for Health and Meteorology Multidisciplinary Innovation in China, covering the period from January 2016 to December 2020, were studied, as well as meteorological and air pollutant data. A generalized additive model with a distributed lag nonlinear model was employed to assess the relationship, considering 12 different definitions of a cold spell based on various temperature thresholds and durations. The analysis controlled for lagged and nonlinear effects of temperature. Analyses were performed on all strokes as well as ischemic stroke and ICH. There was a significant increase in stroke admissions during cold spells. Generally, the increased risk during cold spells increased as the temperature threshold decreased, but was not significantly affected by the duration. The optimal model was obtained using the cold-spell definition based on an average daily temperature below the 10th percentile (0.11°C) for 2 or more consecutive days. According to this model, the effect of cold spells on ischemic stroke admissions had a significant lag effect and was long-lasting, with a single-day effect occurring on lag 7d, peaking on lag 13d (relative risk (RR) = 1.05; 95% confidence interval (CI) = 1.02 to 1.09), and lasting until lag 20d. In contrast, the effect on ICH was immediate and short-lived, with the most significant single-day effect occurring on the current day (RR = 1.17; 95% CI = 1.06 to 1.29) and limited within 3 days. 14.15% of stroke cases could be attributed to cold spells, with ICH exhibiting a higher burden than ischemic stroke except for strict temperature threshold definitions. Cold spells are associated with an increased stroke risk. Different patterns of association were seen for different stroke subtypes. The effect on ischemic stroke had a lag effect and a longer duration, whereas the effect on ICH had an immediate effect and a shorter duration. These findings support the development and improvement of stroke cold-spell early warning systems and highlight the importance of public health interventions to mitigate the adverse health impacts of cold spells.

KLİNİK PRATİKTE ACR-TIRADS’IN UYGULANMASI

Objective&#x0D; To investigate the diagnostic accuracy of the Thyroid&#x0D; Imaging, Reporting and Data System of the American&#x0D; College of Radiology in thyroid nodules.&#x0D; Material and Method&#x0D; A total of 151 nodules were collected from 62 patients&#x0D; undergoing thyroid surgery in our center between&#x0D; August 2017 and September 2018. Ultrasonographic&#x0D; features of each nodule were recorded and classified&#x0D; according to the Thyroid, Imaging Reporting and Data&#x0D; System of the American College of Radiology by two&#x0D; radiologists and compared with a one-to-one basis on&#x0D; histopathology.&#x0D; Results&#x0D; The median size of 151 thyroid nodules measured on&#x0D; the ultrasound and in the pathology specimens were&#x0D; 19 (3-85) mm and 17 (0-97) mm, respectively. Papillary&#x0D; carcinoma was demonstrated in 28 patients (45%),&#x0D; papillary microcarcinoma in 14 patients (22.5%), and&#x0D; Hurthle cell carcinoma in 1 (1.6%) patient. Overall&#x0D; sensitivity, specificity, positive predictive value,&#x0D; and negative predictive value for this nodule risk&#x0D; stratification model were analyzed as 82.5%, 57%,&#x0D; 64.58%, and 77.67%, respectively.&#x0D; Conclusion&#x0D; Setting a definitive size threshold for fine needle&#x0D; aspiration might be misleading, instead signifying the&#x0D; malignant features on ultrasonography, and making a&#x0D; decision for surgery on an individual base should be&#x0D; recommended.

What is Polypharmacy in Patients with Chronic Kidney Disease? A Systematic Review

PurposePolypharmacy presents an increasing therapeutic challenge for physicians managing patients with chronic kidney disease (CKD). However, there is a lack of consensus regarding the specific medication count threshold that defines polypharmacy in this population. The objective of this review is to establish a unified definition of polypharmacy in the CKD population by examining the diverse definitions used in previously published studies. MethodsA comprehensive search was conducted in relevant databases (PubMed, SCOPUS, Cochrane, and disease-specific databases) from 2000 to May 2022 to identify studies with polypharmacy threshold definitions in patients with CKD. Studies meeting the inclusion criteria were included in this review, and their methodologic quality was assessed. FindingsFollowing the screening of the search results, duplicate records and studies that did not meet the inclusion criteria were removed, resulting in a total of 18 studies included in this review. Among these, 61.1% specified the polypharmacy definition to be a threshold of ≥5 medications. In addition, 22.2% specified a high polypharmacy definition at a threshold of ≥10 medications. However, none of the studies reported on the dichotomy between kidney-related and non-kidney-related polypharmacy. ImplicationsThis review indicates that a numerical threshold of ≥5 medications is commonly used to define polypharmacy in patients with CKD. Nevertheless, it remains uncertain whether a kidney-related polypharmacy definition or a high polypharmacy definition would better identify patients with CKD at risk for polypharmacy-related complications.

THE BOUNDARY OF LOVE: EXCESSIVE CARE MAY INCREASE CHILDREN'S HAPPINESS THRESHOLD

This study aims to deeply understand the effect of excessive care on childrens happiness threshold, by conducting an in-depth exploration and analysis. We systematically dissect how excessive care changes the happiness threshold of children and further elaborately explain how this impact diffuses into childrens psychological, emotional, social, and learning domains. In the introduction section, we provide a comprehensive and in-depth introduction to the research theme, explaining in detail the academic definition of the happiness threshold, and clarifying the core objectives and its importance of this research. According to the results of the study, we found that excessive care might increase the happiness threshold of children, making them have higher expectations for their parents love. This suggests that there is a significant causal relationship between excessive care and the happiness threshold. The impact of having a higher happiness threshold on children in psychological, emotional, social, and learning domains is multi-faceted and profound. However, we found that it is possible to find methods to balance care and the happiness threshold through implementing some effective strategies. In the conclusion section, we summarize the main findings of the research and also propose suggestions for future research directions and fields. We hope that this research can enhance the publics understanding of the issue of excessive care and the childrens happiness threshold, thus providing a reference for improving childrens happiness and quality of life. Besides, we also look forward to more researchers participating in the research in this field in the future to further deepen the understanding of this issue, promote the improvement of the related theoretical framework, and provide more effective strategies to solve the problem of excessive care and childrens happiness threshold. KEYWORDS: Etcexcessive care, Happiness threshold, Child psychology, Care balance strategies.

Factors associated with patent foramen ovale-related stroke: SAFAS study

BackgroundPersistent foramen ovale (PFO) contributes to cryptogenic stroke and is associated with stroke recurrence, although the exact mechanism of ischemic events is not fully understood. Several biomarkers have been developed for the prediction of atrial fibrillation after stroke, but there are currently only limited data on their potential value for the diagnosis of PFO-related stroke. MethodsThis study was a prospective single-center study that included all patients hospitalized between March 31, 2018, and January 18, 2020, in the stroke department of the Dijon University Hospital for ischemic stroke without obvious cause and without a history of atrial fibrillation. PFO was systematically screened by transthoracic echocardiography and images were reviewed by an independent cardiologist blinded from clinical data. PFO was defined according to the CLOSE trial criteria: PFO associated with interatrial septal aneurysm or significant interatrial shunt (> 30 microbubbles in the left atrium within three cardiac cycles after right atrial opacification). The potential association of PFO-related stroke with biomarkers of cardiac fibrosis and inflammation such as galectin-3, GDF-15, ST-2, osteoprotegerin and NT-proBNP was tested using multivariate backward stepwise logistic regression. ResultsOf the 240 patients included in the SAFAS study, 229 had complete echocardiographic data, and 23 (10%) had PFO-related stroke. Patients with PFO-related stroke were significantly younger (58±14 vs. 69±14, P<0.001), had less frequent previous arterial hypertension (30 vs. 60%, P=0.008), and more frequent cerebellar territory involvement (26 vs. 9%, P=0.014) compared to the other patients. In addition, they had less frequently left atrial dilatation (left atrial index volume>34mL/m2 [9 vs. 35%, P=0.009]). After ROC curve analysis for definition of thresholds, PFO-related stroke patients more often had galectin-3<9.5ng/mL (59 vs. 27%, P=0.002), ST2<13380pg/ml (23 vs. 50%, P=0.007), GDF-15<1200ng/mL (59 vs. 27%, P=0.002), osteoprotegerin<1133pg/mL (82 vs. 58%, P=0.033) and NT-proBNP<300pg/mL (88 vs. 55%, P=0.009). After multivariate analysis, only galectin-3<9.5ng/mL (OR [95% CI] 3.4 [1.18; 9.8], P=0.024) and osteoprotegerin<1133pg/L (OR [95% CI] 5.0 [1.1; 22.9], P=0.038) were independently associated with PFO-related stroke. ConclusionPatients in whom cryptogenic stroke is attributed to a significant PFO have a specific clinical and biological phenotype. Low levels of galectin-3 and osteoprotegerin may help identify patients with PFO-related strokes.

Technical–economic analysis to identify the acceptable maximum attenuation on PON FTTH lines for wholesale network operators

Telecommunications companies are constantly chasing continuous technological advances with their management methods of Operations & Maintenance (O&M) that still struggle to turn their eye toward innovation and simplification of processes. In a future that aims at fully fiber-optic networks, the objective of the research is to propose guidelines and provide data to support the Wholesale Operator for the definition of the acceptable attenuation threshold on the Passive Optical Network Fiber-To-The-Home (PON FTTH) infrastructure to determine the Service Level Agreements (SLA) to be contracted with Retail Operators. Following exceeding the threshold, the Retail Operator has the right to open a Trouble Ticket to request the resolution of the anomaly. Consequently, the definition of the attenuation threshold strongly affects the number of Trouble Tickets to be managed and the related costs the Wholesale Operator bears. This paper analyzes a specific case of the PON FTTH network of the Italian wholesale operator Open Fiber. The studied infrastructure, with a length of 11 km, allows a maximum attenuation of 37 dB without degrading the service. An economic model has been proposed to assess the cost impact of moving the attenuation threshold in the SLA.

An expert review of environmental heat exposure and stillbirth in the face of climate change: Clinical implications and priority issues.

Exposure to extreme heat in pregnancy increases the risk of stillbirth. Progress in reducing stillbirth rates has stalled, and populations are increasingly exposed to high temperatures and climate events that may further undermine health strategies. This narrative review summarises the current clinical and epidemiological evidence of the impact of maternal heat exposure on stillbirth risk. Out of 20 studies, 19 found an association between heat and stillbirth risk. Recent studies based in low- to middle-income countries and tropical settings add to the existing literature to demonstrate that all populations are at risk. Additionally, both short-term heat exposure and whole-pregnancy heat exposure increase the risk of stillbirth. A definitive threshold of effect has not been identified, as most studies define exposure as above the 90th centile of the usual temperature for that population. Therefore, the association between heat and stillbirth has been found with exposures from as low as >12.64°C up to >46.4°C. The pathophysiological pathways by which maternal heat exposure may lead to stillbirth, based on human and animal studies, include both placental and embryonic or fetal impacts. Although evidence gaps remain and further research is needed to characterise these mechanistic pathways in more detail, preliminary evidence suggests epigenetic changes, alteration in imprinted genes, congenital abnormalities, reduction in placental blood flow, size and function all play a part. Finally, we explore this topic from a public health perspective; we discuss and evaluate the current public health guidance on minimising the risk of extreme heat in the community. There is limited pregnancy-specific guidance within heatwave planning, and no evidence-based interventions have been established to prevent poor pregnancy outcomes. We highlight priority research questions to move forward in the field and specifically note the urgent need for evidence-based interventions that are sustainable.

A critical analysis of classical severity-based knock control strategies

A common variant of classical knock control strategies replaces fixed magnitude control moves with control actions that depend on the knock severity of the prior cycle. Though appealing to notions of proportional control, it is unclear whether such strategies offer benefit given the random nature of knock events. In this paper a new generalized event-based framework is developed and used to extend both time domain simulation and stochastic analysis methods for analyzing the closed loop behavior of such systems. These tools are then used to perform a rigorous analysis and comparison between standard advance-retard and severity-based control strategies. The analysis is also repeated using a lower knock threshold definition. The results show that the performance of severity-based knock control differs minimally from a similarly tuned standard advance-retard controller, and there is little benefit to recompense the additional complexity of severity-based control.

Comprehensive Grading System for Experimental Autoimmune Uveitis in Mice.

Experimental autoimmune uveitis (EAU) is the most commonly used animal model to study the progression of chronic uveitis and to test various therapies to treat the disease. However, to accurately evaluate the effectiveness of such treatments, a grading system that combines the latest imaging techniques with definitive quantitative grading thresholds is required. This study aimed to develop a comprehensive grading system that objectively evaluates EAU progression in C57BL/6J mice. EAU was induced following immunisation with interphotoreceptor retinoid-binding protein (IRBP) and pertussis toxin. Weekly fundus and optical coherence tomography (OCT) images were acquired over 12 weeks using a Micron IV imaging system. Each mouse was graded (between 0 to 4) based on changes seen on both the fundus (optic disc, retinal blood vessels and retinal tissue) and OCT (vitreous and retinal layers) images. A total EAU response (with a maximum score of 48) was calculated for each mouse based on the sum of the individual scores each week. Analysis of the clinical scores depicted a gradual increase in inflammatory signs including optic disc and vascular swelling, leukocyte infiltration in the vitreous, lesions in the retina and formation of granulomas and hyper-reflective foci in the retinal layers in EAU mice, with most signs reaching a plateau towards the end of the study period. Development of these signs into sight-threatening complications such as optic disc atrophy, structural damage to the retina and subretinal oedema were noted in 80-90% of mice suggesting consistent disease induction. Overall, a comprehensive and objective grading system encompassing all pathologies occurring in EAU mice was developed to enhance the preclinical evaluation of novel uveitis treatments.