Acute thrombus formation on the delivery sheath is rare condition during percutaneous left atrial appendage occlusion. We presented two cases that TEE showed a floating thrombus attached to the tip of delivery sheath during the procedure. Cerebral embolic protection devices were used to prevent neurological events after thrombus was detected. The

Background and Purpose: Our previous study reported that erythroferrone (ERFE), a newly identified hormone produced by erythroblasts, responded to recombinant human erythropoietin (rHuEPO) sensitively but its dynamics was complicated by double peaks and circadian rhythm. This study intends to elucidate the underlying mechanisms for the double peaks of ERFE dynamics, and further determine whether early ERFE measurements can predict hemoglobin (HGB) responses to rHuEPO. Experimental Approach: By expressing recombinant rat ERFE protein and investigating its deposition in rats, the production of ERFE was deconvoluted. To explore the role of iron in ERFE production, we monitored short-term changes of iron status after injection of rHuEPO or deferiprone (DFP). Pharmacokinetic/pharmacodynamic (PK/PD) modelling was used to confirm the mechanisms and examine the predictive ability of ERFE for long-term HGB responses. Key Results: The rRatERFE protein was successfully expressed and purified. The production of ERFE was deconvoluted and showed two independent peaks (2 h and 8 h). Transient iron decrease was observed at 4h after rHuEPO injection and DFP induced significant increases of ERFE. Based on this mechanism, the PK/PD model could characterize the complex dynamics of ERFE. In addition, the model predictions further revealed a stronger correlation between ERFE and HGB peak values than that for observed values. Conclusions and Implications: The complex dynamics of ERFE should be composited by an immediate release and transient iron deficiency-mediated secondary production of ERFE. The early peak values of ERFE, which occur within a few hours, can predict HGB responses several weeks after ESA treatment.

Accurate flow prediction is a primary goal of hydrological modeling studies, which can be affected by the use of varying rainfall datasets, autocalibration methods, and performance indices. The combined effect of three rainfall datasets — Fifth generation of European ReAnalysis (ERA-5), Gridded meteorological data (gridMET), Global Precipitation Measurement Integrated Multi-satellitE Retrievals (GPM IMERG) — and three autocalibration techniques — Dynamically Dimensioned Search (DDS), Generalized Likelihood Uncertainty Estimation (GLUE), Latin Hypercube Sampling (LHS) — on SWAT+ river flow prediction was measured using three evaluation metrics — Nash Sutcliffe Efficiency (NSE), Kling Gupta Efficiency (KGE) and coefficient of determination (R 2) — for two watersheds in North Carolina (Cape Fear, Tar Pamlico) using the Soil Water Assessment Tool Plus (SWAT+) model. Five parameters in the SWAT+ model, cn2, revap_co, flo_min, revap_min, and awc, were found to be significantly sensitive under all combinations for both watersheds. Simulated flow varied more with the change in rainfall than the calibration technique used. We discovered that GPM IMERG gave the best results of the rainfall datasets, followed by ERA-5 and gridMET. We observed that the NSE score is more sensitive to different combinations of rainfall datasets and calibration techniques than the KGE scores. SWAT+ underperformed in the prediction of base flow for the groundwater-driven watershed. Overall, we recommend using the GPM IMERG rainfall dataset with the GLUE optimization technique and KGE performance index for optimal flow simulations. The results from this study will help hydrological modelers choose an optimal combination of rainfall dataset, autocalibration technique, and performance index depending on watershed characteristics.

Reservoir is a vital tool for human utilization of water resources, and the deterioration of its water quality can seriously threaten the water cycle and sustainable urban development. However, there are relatively few studies in academia that analyze and evaluate the water quality of multiple reservoirs at the same time. To address this knowledge deficit, we collected 108 water samples from three different reservoirs in Chuzhou City for 36 months (from 2019 to 2021), explored the drivers of changes in water quality parameters over time and the extent of eutrophication. Our results indicated that the water quality of the reservoirs was deteriorating during the study period, among which Huanglishu Reservoir and Shahe Reservoir reached mild eutrophic status, and both had higher eutrophication levels than Chengxi Reservoir. Secchi Depth (SD), Total Nitrogen (TN), and Total Phosphorus (TP) were the principal factors inducing eutrophication. The biased utilization of reservoir functions was the major contributor to the discrepancy in the degree of eutrophication. Furthermore, Pearson Correlation Analysis revealed that there are significant correlations between many water quality parameters. Cluster Analysis (CA) grouped the 12 months of each year into three clusters (stable water level period, rainy season high flow period, and winter low flow period). Based on this, Analysis of Variance (ANOVA) showed that most water quality parameters varied considerably between the clusters. Collectively, this study identified the actual water quality conditions of three reservoirs in Chuzhou City and provided guidance for local water quality management and environmental protection.

The inherent limitation of threshold voltage drift in silicon carbide metal-oxide-semiconductor field-effect transistors has restricted their broader applicability. This paper proposes a driving method that introduces an additional gate drive level, effectively reducing the threshold voltage drift in silicon carbide metal-oxide-semiconductor field-effect transistors while preserving the advantages of a negative gate turn-off voltage. The practical effectiveness of this method is validated through experiments.

It is important to solve the problem of metal particle pollution inside the DC GIL. Using numerical simulation to calculate the trajectory of metal particles is an important method of designing particle traps and drive electrodes. In this paper, a 3D simulation method of dynamic particle motion randomly based on quadratic Rodrigues’ rotation is proposed to solve the trajectory of metal particles inside the DC GIL, considering the random reflection. Based on this model, the influence characteristics of random reflection angle, gravity inclination, particle size and other factors on particle motion are analyzed. From the results, the trapping efficiency of particle traps becomes weaker under the effect of gravity, and particles with larger sizes are more likely to escape. The drive electrodes set at the high voltage conductor can prevent particles from crossing the drive electrode. It can effectively improve the capture efficiency of the particle trap and increase the capture-escape ratio more than 45.9%.

Electricity network across the globe has witnessed an increase in penetration of distributed energy resources (DER) to the grid. A maiden attempt to integrate 50% loaded Combined Cycle Gas Turbine (CCGT) plant and doubly fed Induction Generator (DFIG) plant with DER is carried out for investigations to study frequency excursions in the hybrid system along with temperature excursions in the CCGT plant. A novel attempt is done to introduce modified beluga whale optimizer for tuning the controller gains and system parameters of the hybrid isolated system. This article emphasizes on the system behaviour of an isolated power system consisting of a CCGT plant and a DFIG plant integrated with distributed energy resources comprising of Diesel engine generator, wind turbine generator and battery energy storage system. Among the classical secondary controllers, comparison of system responses is carried out to select the best among proportional, proportional-integral, and proportional-integral-derivative controllers. A modified beluga whale optimization algorithm is utilized to tune the controllers. Various investigations conducted with different turbo generators confirm the control strategy to the frequency of excursions. The hybrid CCGT – DFIG - DER system is also evaluated under random load demand, change in generation rate constraints and DFIG power output.

The global signal (GS) in the brain potentially carries information that related with neural activities. However, the impacts of the GS on the interpretation of the consciousness-related measures during different types of anesthetics-induced unconsciousness remain unknown. Thirteen glioma patients underwent propofol and sevoflurane induced general anesthesia were enrolled for analysis. Blood oxygenation level dependent (BOLD) signals were recorded for all patients in awake state (i.e., baseline) and general anesthesia (i.e., unconscious state) by using functional magnetic resonance imaging (fMRI). Under the scenario of with GS and without GS, we examined the temporal variability and amplitude of low-frequency fluctuation (ALFF) to analyze the BLOD changes. The functional connectivity and brain networks were analyzed to investigate the alteration in different brain regions. In time domain and frequency domain analysis, both anesthetics significantly decreased in standard deviation (SD) (BF10 > 3) under both scenarios. While comparing baseline to the unconscious state, only propofol exhibited a significant normalized ALFF reduction under with GS scenario (BF10 > 3). In functional connectivity analysis, removing GS changed the significance of functional connectivity especially in Limbic network and Default network for propofol. For sevoflurane, most of functional connectivity (FC) significances were remarkably altered. In brain network analysis, removing GS changed the nodal indices, with different effects on different networks. In summary, for both anesthetics, the effects of GS had noticeable impacts on in functional connectivity and brain networks analysis-based measures. GS has a significant impact on explaining the changes of anesthetics induced functional connectivity and brain networks.

ADHD and anxiety frequently occur together; however, the cognitive outcomes of co-morbid anxiety and ADHD are not straightforward. A potential explanation for conflicting results in the literature may be that different core ADHD symptoms show different interactions with anxiety depending on the task processing demands. To address this question, we investigated whether different ADHD traits are related to different inhibitory outcomes, contingent upon the level of trait anxiety. The sample consists of 60 non-clinical university students (X ̅age= 20.5, 53% male). Conners’ Adult ADHD Rating Scale (CAARS-SL) and State Trait Anxiety Inventory (STAI) were used to measure ADHD-traits and anxiety, respectively. The participants completed a visual Go/NoGo task with and without distractor conditions while continuous EEG was recorded. Inhibitory control was operationalized as the frontocentral N2 maximum peak amplitude elicited in response inhibition (NoGo/No Distractor), cognitive inhibition (Go/Distractor), dual inhibition (NoGo/Distractor), and control (Go/No Distractor) conditions. We analyzed the moderating effect of trait anxiety on the prediction of inhibitory control by ADHD scores for each Go/NoGo condition with the varying inhibition demands. Results showed that trait anxiety moderated the effects of total ADHD and hyperactivity-impulsivity scores, but only in the response inhibition condition (NoGo/No Distractor). Additionally, inattentiveness was related to attenuated N2 amplitudes in the cognitive inhibition condition (Go/Distractor). These findings suggest that depending on the inhibitory demands of the task, unique cognitive outcomes may occur when different ADHD traits coexist with anxiety.

Multi module isolated converters (MMICs) find extensive application in various DC-DC applications due to their remarkable features of galvanic isolation, bi-directional power flow, high power density and enhanced efficiency. However, voltage and current sharing among the converter modules are the most significant issues in MMICs. This paper proposes Multi-port Integrated-Magnetics Transformers (MpIMTs) which address the input-output DC-link voltage imbalances within an ISOS converter. The proposed transformers ensure the input voltage sharing (IVS) and output voltage sharing (OVS) through balancing windings within their structures, thus substitutes the complicated active control scheme with the balancing winding. Besides, the input side and output side modules are decoupled from each other, thus the impact of parameters variation and inter-module energy transfer during a transient of one side does not reflect to the other side. These properties are achieved by proposing a custom-designed core and an off the shelf available U core assembled MpIMTs. The magnetic and electrical equivalent along with the design criteria of the balancing winding are also presented. Furthermore, the paper includes the comparative analysis of the proposed transformers which reveals that while the U-core MpIMT offers simplified construction, it comes at the expense of slightly reduced efficiency compared to the custom-designed MpIMT. Finally, the proposed U core MpIMT is validated through a laboratory prototype.

Aim The reference nutrient intake for vitamin D in people aged ≥4 years is 10 μg/day (400 IU/day) in the UK, but the recommended daily allowance is 15 μg/day (600 IU/day) for people aged 1-70 years in the US. Here, we aim to compare the 25-hydroxyvitamin D3 (25(OH)D3) serum concentration profiles between the two doses. Methods With adult trial data, we constructed a physiologically based pharmacokinetics (PBPK) model of serum concentrations of vitamin D3 and 25(OH)D3 using nonlinear mixed effects (NLME) modelling. We used this model to forecast the mean, 5% and 95% percentiles for serum 25(OH)D3 concentrations. Results Our final model uses bodyweight to adjust volume of each compartment and maximum clearance of 25(OH)D. No other covariate was identified. The model accurately predicted data from trials of a broad range of dose regimens. We simulated subjects of the average UK male and female weights with baseline 25(OH)D < 25 nmol/L. Simulation suggests circulating 25(OH)D concentrations in >5% of men and women taking 10 μg/day for a year might fail to reach 50 nmol/L, while those on 15 μg/day were predicted to attain this threshold. Conclusion The two doses generate significant difference in serum 25(OH)D3 concentrations. This needs to be considered for choosing the right dose for the public health guideline.

Wind turbines produce electricity with almost no emissions; nonetheless, there are environmental consequences associated with their life cycle stages. The present study focus on offshore wind farm in rural areas of Tamilnadu during their entire life cycle from Manufacturing, transportation, installation, operation and maintenance, finally decommissioning with cradle to grave system boundary. The process is modelled by Open LCA software following ISO 14044 standards. CML, TRACI, Ecoindicator, and ReCiPe were compared for environmental impacts and cumulative energy demand for embodies energy assessment respectively. Acidification, Eutrophication, Global warming, Ozone layer depletion, and human toxicity were some of the impacts. A Sensitivity analysis was performed with recycling scenarios for 50% and 80% showed 6 times and negligible reduction of global warming potential respectively. According to life cycle analysis, environmental consequences are concentrated in the manufacturing stage, which accounts for 78% of impacts. Assumptions in the LCA procedure were methodically addressed, with special emphasis on the O&M and transportation stages. Steel, iron, epoxy fibers in the manufacturing stage contributes 84%, 78%, and 86% of total CO2, SOx and CFC, concrete contributed 85% in the installation stage produces more emissions and energy intensive. Significant impact category among all is the human toxicity which contributed by styrene and glass fibres predominantly affects adults on dermal exposure. The energy pay back time 1.51 months for the embodied energy calculated was 539 MJeq. Higher percentage of recycling at the decommissioning stage reduces the kg CO2 emissions by 74 – 83% average.

Land use intensification favours particular trophic groups which can induce architectural changes in food-webs. These changes can deeply impact ecosystem functioning, stability and robustness to extinctions. However, the imprint of land management intensity on food-web architecture has rarely been characterised across large spatial extent and various land uses. We investigated the influence of land management intensity on six facets of food-web architecture for 67,051 European tetrapod communities, and its dependency on land use and climate. We found that intensification promoted lower proportions of both apex and basal species, with more connected and less compartmentalized food-webs, and unexpectedly, favoured longer trophic chains in cities and decreased omnivory in mediterranean climates. By favouring mesopredators and undermining basal tetrapods, intensification might lead to new forestry and agricultural pest outbreaks. Our results support mesopredator regulation and apex predator protection where possible, but urban and mediterranean contexts might need alternative strategies.

The National Confectionery Association (NCA) and the Chocolate Manufacturers Association (CMA) jointly developed a method for measuring the yield value and plastic viscosity of chocolates. The NCA/CMA method covers details including sample preparation, viscometer calibration, viscosity measurement, yield value and plastic viscosity calculation. The author recently had an opportunity to closely evaluate this method and has encountered a few issues in its application. After extensive research, the author concludes that the method has mistakenly introduced three parameters including a value, K value, and Xcorr factor. Those values are not only unnecessary but also may introduce artificial errors particularly in calculating the yield value of chocolate. This article shares those findings and intends to inspire more discussion to further improve the NCA/CMA method for viscosity.

While abiotic variation is undoubtedly important in shaping the composition of ecological communities, the extent to which environment predicts composition varies between communities and habitats. This raises the question of which features lead to robustness in the face of environmental change. We identify spatial structure as a major factor in dampening the effects of abiotic variation. Individual-based models predict that spatial structure leads to compositional convergence between environments that impose divergent selection pressures. We then test these predictions using microbial communities cultured on divergent carbon sources and which experience different degrees of spatial structure provided by glass beads. Again, more spatial structure results in increased community convergence across abiotic environments. Our work suggest that spatial structure can mitigate against the ecological consequences of environmental heterogeneity.

Plant genotype, drought stress, and their interaction are among the factors contributing to the susceptibility of the tall goldenrod, Solidago altissima, to herbivory by the chrysanthemum lace bug, Corythucha marmorata. The plant’s concentration of nitrogen, a critical and often limiting nutrient, differs with plant genotype and drought, but few studies have investigated the impact of the interaction of genotype and drought on herbivory and plant nitrogen. We established a common garden in Duluth, MN, of tall goldenrod collected from a local Minnesota site to analyze the effects of goldenrod genotype and drought on leaf nitrogen and lace bug preference and performance. Lace bugs had oviposition, nymph, and adult preferences among host plant genotypes, drought treatments, and among genotype and drought combinations. Nymph and adult survival and adult weight varied significantly due to plant genotype, drought treatment, the interaction of plant and drought treatment, and the interaction of treatment with lace bug density. Oviposition preference and offspring performance were significantly positively related. Leaf nitrogen increased with the increasing severity of the drought treatment in the absence of lace bugs. However, in the presence of lace bugs, there was no difference in nitrogen among drought treatments. We hypothesize that lace bugs feed on plants until nitrogen concentration reduces to a lower threshold and then move between plants until they have equalized the nitrogen concentration among all plants.

Animal tracking has undergone a technological revolution providing insight into biological details that were impossible to address until now. However, the increasing ease of access to tracking devices (biologgers) may lead to trivializing this technology. Consequently, many projects may not extract as much scientific knowledge as possible and neglect the ethical duties towards the tagged animals. Here we demonstrate this process of trivialization empirically on a local and global scale and propose some guidelines to avoid it.

One of the most dangerous substances, 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), has a devastating lethal effect on both animal and human tissues. It is representative of numerous environmental pollutants known as halogenated polycyclic hydrocarbons. As a result, significant efforts are being made to reduce the damaging effects of TCDD. Additionally, boron compounds are employed in a variety of sectors, from agriculture to the production of cosmetics and medicines. They have an impact on crucial cellular processes and enzymatic activities. Boric acid (BA) and other boron compounds, such as ulexite (UX) and borax (BX), which are widely used commercially, have little information on dosage-related effects. In the current investigation, PBMCs were treated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), which caused cytotoxicity and damaged membrane integrity. It led to a decrease in antioxidant status and an increase in MDA levels. The treatment with TCDD also promoted genomic damage by raising the levels of 8-OH-dG and CA frequency. Furthermore, boron compounds dramatically reduced the cytotoxicity, genotoxicity and oxidative damage induced by TCDD. Our findings imply that, at certain concentrations, boron compounds may function as a possible chemopreventive against dioxin-induced cytotoxicity and genotoxicity in PBMCs.

Subdural Empyema -A Rare Complication of Chronic Otitis Media: A Case ReportEmnet Tekeste1*+, Genet Tekeste2+, Nahom Daniel3, Samuel Tekle Mengistu41. General practitioner, Barentu Military Hospital, Barentu, Eritrea, Email: emenettekeste7@gmail.com, ORCID: https://orcid.org/0000-0002-8820-85642. Surgical resident, Orotta National Referral Hospital, Asmara, Eritrea, Email: ORCID:, 3. General practitioner, Mendefera Zonal Referral Hospital, Medefera, Eritrea, Email: millionweldu1241@yahoo.com4. Nakfa Hospital, Ministry of Health Northern Red Sea branch, Nakfa, Eritrea. Email: teklesam7@gmail.com ORCID: https://orcid.org/0000-0002-2817-1421*Correspondence: Emnet Tekeste MD, General practitioner, Barentu Military Hospital, Barentu, Eritrea. Tel +291-1-7205051, Email emnettekeste7@gmail.comIf any equal contribution of authors that you want to acknowledge+: These authors contributed equally to this work

IntroductionHowever, nasal reconstruction has always been challenging to the otolaryngologists, various nasal reconstruction methods have been introduced.These reconstruction techniques depend on various factors including defect etiology, size, location, and depth.1Recently, the forehead flap and the radial forearm free flap are recommended in nasal complex defects.2Our patient had a complex defect involving nasal tip, columella, septum, and a portion of upper lip after MOHS surgery for squamous cell carcinoma. Restoration of a nasal and lip function and contour are the main goals of reconstruction in this case.This report details a two stage approach to repairing such a defect using bilateral inferiorly based malar transposition flaps with auricular cartilage graft for more support and contour.

The luteal phase of the menstrual cycle is accompanied by diminished vagally mediated heart rate variability (vmHRV). VmHRV is consistently linked to anxiety, a commonly experienced symptom during the luteal phase. However, fear conditioning, a laboratory model of anxiety, has received limited attention in the context of menstrual cycle fluctuations. This study therefore aims to explore the influence of menstrual cycle phases on instructed fear conditioning and its interactions with vmHRV.In this study, 58 healthy individuals with regular menstrual cycles, currently in the luteal or follicular phase, participated in a fear conditioning paradigm. During this experiment, two geometric figures were either paired (CS+) or not paired (CS-) with an electric shock. Linear mixed models were used to analyze the modulatory effects of the menstrual cycle phase on the startle magnitude and skin conductance responses (SCRs) to these conditioned stimuli.Results revealed higher fear differentiation (CS+ vs. CS-) during the luteal phase in the startle magnitude, driven by a startle potentiation to the conditioned stimulus (CS+). In terms of SCR, interacting effects with vmHRV revealed that individuals with high vmHRV exhibited a similar increased fear differentiation during the luteal phase, while low vmHRV individuals showed less fear differentiation. These findings suggest that during the luteal phase, individuals exhibit stronger fear-related differentiation, a pattern that is partly modulated by vmHRV. These insights shed light on potential origins of varying symptom experiences like increased anxiety during the luteal phase. However, further research is required to investigate associations between these fluctuations and symptomatology. 

The Census of India 2021, similar to other national censuses, plays a crucial role in capturing accurate migration data. However, due to the unprecedented challenges posed by the COVID-19 pandemic, the census experienced significant delays, affecting its impact on migration patterns. This abstract explores the potential consequences of the delayed census on understanding and analysing migration trends in India. The nationwide lockdowns and restrictions imposed to curb the spread of the virus disrupted the regular timeline of conducting the census. The delayed census raises concerns regarding the accuracy and comprehensiveness of migration-related data. The pandemic-induced disruptions in internal and international migration further complicate the analysis of migration patterns. People's movement was restricted due to travel bans, economic uncertainty, and fear of infection. Consequently, the population shifts and migration trends during the pandemic might not be adequately captured due to the incomplete census data. The potential Impact on data sampling techniques used in the census also warrants attention. The accuracy of population estimates and statistical inferences related to migration may be affected by limited access to certain regions or groups of people during the pandemic. Adjustments and considerations will be essential to account for potential data biases stemming from these limitations.

Semaglutide is a Glucagon Like Peptide GLP agonist, Semaglutide has been shown to be effective in inducing weight loss in patients with obesity. Studies have shown that the infusion of GLP 1 results in reduced gastrointestinal emptying and an increased rate of fasting and postprandial gastric volumes, resulting in a decrease in hepatic glycemia. Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, Semaglutide affects the brain’s hunger control centers, causing a reduction in food intake and an increased feeling of fullness, that is helpful in people who are struggling to lose weight. Multiple trials have shown that introduction of Semaglutide in regime helps with weight loss in patients of PCOD and is also effective in management of insulin resistance and lowering high levels of VLDL, LDL and triglycerides. Possible introduction of Semaglutide in the treatment of PCOD and obesity should be considered.

TENOFOVIR INDUCED FANCONI SYNDROME IN A MIDDLE AGE AFRICAN FEMALE FROM KENYA, EAST AFRICA: CASE REPORT AND BRIEF LITERATURE REVIEW.