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Vanadium dioxide (VO2) nanoleafs were prepared by the thermal decomposition method. The synthesized vanadium dioxide (VO2) nanomaterials have been experimentally proven with well-known structural phase orientation properties. Besides, this VO2 nanoleaf-like material was scrutinized with a wide range of analyses with discussions also more desirable like XRD (X-ray diffraction analysis), FT-IR (Fourier transform infrared spectroscopy analysis), SEM (scanning electron microscope), and DRS UV–visible spectroscopy. VO2 nanoleaf materials V = O, V–O–V, and V–O stretching vibrations of the functional groups were signified in FT-IR examinations. The varagu tree leaf-like morphology structure was identified by the SEM equipment and observed to the remarkable diameter ranges. VO2 nanoleaf material has been acquired for low bandgap energy with a recorded value at 3.3 eV so it was nominated by dye degradation applications. Additionally, VO2 nanocatalysts will be reported, and predictable results were highly esteemed for the new research commitments and suggested for future research prospectus. This synthetic approach will focus on less time, low concentration, and good formation of the morphological growth identifications respectively. The VO2 nanoleaf materials have admirable efficiencies underneath visible light illumination during Brilliant Green (BG) dye and improved antibacterial activity performances. [ABSTRACT FROM AUTHOR]

Purpose: Approximately 20% of women worldwide have a retroverted uterus. A retroverted uterus is closer to the rectum and may cause toxicity during brachytherapy. Upon manipulation, a small percentage turn anteverted. Conventional brachytherapy applicators are designed for an anteverted uterus and can pose issues during insertion. Modified Fletcher suit and ring applicators have major differences in their geometry to achieve similar target coverage, and were analyzed in this study with respect to immediate adverse events and dosimetry. Material and methods: Three hundred seventy-four consecutive applications performed over a 20-month period were studied retrospectively to identify intra-cavitary applications (ICAs) in retroverted uteri. Cases were divided into 2 groups: modified Fletcher suit applicator with hemi-ovoids (group A) and ring applicator (group B). D2cc for bladder and rectum were noted, and acute adverse events were recorded. Results: Seventy-five applications were identified, out of which 47 cases used Fletcher suit applicator, and 28 cases used ring applicator. The median bladder D2cc for group A and B were 5.98 Gy and 6.3 Gy, respectively, and the median rectum D2cc was 5.27 Gy and 3.68 Gy, respectively; the median dose prescribed to point A was 6 Gy (range, 5.5-9.0 Gy). All patients had a point A coverage between 97% and 102%. Eighteen cases in both groups complained of pain requiring analgesics. Twenty-five cases (53.2%) and 20 cases (71.4%) in group A and B, respectively, required dose optimization, which was statistically insignificant (p > 0.11). A significant difference was identified (p < 0.00001) in rectal doses. A higher reported pain was noted in ring applicator group (p < 0.03). No patient experienced a profuse bleeding. Conclusions: In most parameters, the two applicators demonstrated comparable results. The control of rectal dosage is superior in the ring applicator at the cost of higher pain incidence. Patient's comfort and rectal dose in EBRT should be taken into consideration, with preference given to the ring applicator. [ABSTRACT FROM AUTHOR]

Epilepsy is one of the most common neurological disorders in the world. Common epileptic drugs generally affect ion channels or neurotransmitters and prevent the emergence of seizures. However, up to a third of the patients suffer from drug-resistant epilepsy, and there is an urgent need to develop new therapeutic strategies that go beyond acute antiepileptic (antiseizure) therapies towards therapeutics that also might have effects on chronic epilepsy comorbidities such as cognitive decline and depression. The mitochondrial calcium uniporter (MCU) mediates rapid mitochondrial Ca 2+ transport through the inner mitochondrial membrane. Ca 2+ influx is essential for mitochondrial functions, but longer elevations of intracellular Ca 2+ levels are closely associated with seizure-induced neuronal damage, which are underlying mechanisms of cognitive decline and depression. Using neuronal-specific MCU knockout mice (MCU -/-ΔN ), we demonstrate that neuronal MCU deficiency reduced hippocampal excitability in vivo. Furthermore, in vitro analyses of hippocampal glioneuronal cells reveal no change in total Ca 2+ levels but differences in intracellular Ca 2+ handling. MCU -/-ΔN reduces ROS production, declines metabolic fluxes, and consequently prevents glioneuronal cell death. This effect was also observed under pathological conditions, such as the low magnesium culture model of seizure-like activity or excitotoxic glutamate stimulation, whereby MCU -/-ΔN reduces ROS levels and suppresses Ca 2+ overload seen in WT cells. This study highlights the importance of MCU at the interface of Ca 2+ handling and metabolism as a mediator of stress-related mitochondrial dysfunction, which indicates the modulation of MCU as a potential target for future antiepileptogenic therapy., (© 2024. The Author(s).)

The COVID-19 pandemic has challenged the current paradigm of clinical and community-based disease detection. We present a multimodal wearable sensor system paired with a two-minute, movement-based activity sequence that successfully captures a snapshot of physiological data (including cardiac, respiratory, temperature, and percent oxygen saturation). We conducted a large, multi-site trial of this technology across India from June 2021 to April 2022 amidst the COVID-19 pandemic (Clinical trial registry name: International Validation of Wearable Sensor to Monitor COVID-19 Like Signs and Symptoms; NCT05334680; initial release: 04/15/2022). An Extreme Gradient Boosting algorithm was trained to discriminate between COVID-19 infected individuals (n = 295) and COVID-19 negative healthy controls (n = 172) and achieved an F1-Score of 0.80 (95% CI = [0.79, 0.81]). SHAP values were mapped to visualize feature importance and directionality, yielding engineered features from core temperature, cough, and lung sounds as highly important. The results demonstrated potential for data-driven wearable sensor technology for remote preliminary screening, highlighting a fundamental pivot from continuous to snapshot monitoring of cardiorespiratory illnesses., (© 2024. The Author(s).)

Small extracellular vesicles (sEV) are endogenous lipid-bound membrane vesicles secreted by both prokaryotic and eukaryotic cells into the extracellular environment, performs several biological functions such as cell-cell communication, transfer of proteins, mRNA, and ncRNA to target cells in distant sites. Due to their role in molecular pathogenesis and its potential to deliver biological cargo to target cells, it has become a prominent area of interest in recent research in the field of Neuroscience. However, their role in neurological disorders, like neurodegenerative diseases is more complex and still unaddressed. Thus, this review focuses on the role of sEV in neurodegenerative and neurodevelopmental diseases, including their biogenesis, classification, and pathogenesis, with translational advantages and limitations in the area of neurobiology., Competing Interests: Declaration of competing interest All authors declared no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

In this work, we propose a dual-port cell design to address the pass disturbance in vertical NAND storage, which can pass signals through a dedicated and string-compatible pass gate. We demonstrate that (i) the pass disturb-free feature originates from weakening of the depolarization field by the pass bias at the high- V TH (HVT) state and the screening of the applied field by the channel at the low- V TH (LVT) state; (ii) combined simulations and experimental demonstrations of dual-port design verify the disturb-free operation in a NAND string, overcoming a key challenge in single-port designs; (iii) the proposed design can be incorporated into a highly scaled vertical NAND FeFET string, and the pass gate can be incorporated into the existing three-dimensional (3D) NAND with the negligible overhead of the pass gate interconnection through a global bottom pass gate contact in the substrate.

Objective: This study aimed to assess the diagnostic accuracy of a novel marker, the combined lactate glucose ratio (CLGR), in identifying cerebrospinal fluid (CSF) bacterial infection (CBI) in neurosurgical patients. Additionally, it seeks to establish cutoff values for CLGR and evaluate the reliability of measurement using blood gas analyzer (BGA)., Methods: CSF samples were collected from 2 neurosurgical centers in Kuala Lumpur, Malaysia, between January 2022 and October 2023. Conventional markers and CLGR were quantified using standard laboratory methods, with BGA utilized for measurement when feasible. Samples were categorized into confirmed CBI-positive (CBI+) and CBI-negative (CBI-) groups. Marker performance was compared, and receiver operating characteristic analysis conducted. Pearson correlation assessed the agreement between BGA and laboratory measurements., Results: Among the 130 CSF samples, 11 were CBI+. Both cerebrospinal fluid lactate (cLac) and CLGR were significantly elevated in the CBI + group (P < 0.001). The area under the curve for cLac and CLGR was 0.990 and 0.994, respectively. Using a cutoff of 6.0 mmol/L, cLac demonstrated sensitivity of 100%, specificity of 93.3%, positive predictive value of 57.9%, negative predictive value of 100%, and diagnostic accuracy of 93.9%. CLGR ≥20.0 showed even higher accuracy: 100.0% sensitivity, 98.6% specificity, 84.6% positive predictive value, 100% negative predictive value, and overall accuracy of 98.5%. Both markers maintained excellent performance in blood-stained CSF. BGA measurements correlated well with laboratory results (r = 0.980 and 0.999, respectively, P < 0.001)., Conclusions: CLac levels ≥6.0 mmol/L and CLGR ≥20.0 accurately identified CBI in neurosurgical patients, with CLGR exhibiting superior efficacy. The potential for instant BGA measurement suggests promise for point-of-care testing., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Incorporating rare and threatened healing plants from Traditional Chinese Medicine (TCM) into modern medicine is a hopeful way to expand treatment choices and encourage the long-term use of plant resources. These plants have been used in Traditional Chinese Medicine for a long time. They have powerful healing properties, including the ability to reduce inflammation and fight cancer. They also protect nerves and the heart., Method: A thorough study of all the scientific studies, clinical trials, ethnobotanical surveys, and conservation reports that were found were all looked at in relation to rare and threatened medical plants used in TCM. We looked through databases like PubMed, Scopus, and Web of Science for relevant pieces. Studies published in peer-reviewed journals, reports from reputable conservation organisations, and written down traditional knowledge were all considered to be relevant., Results: Key results show that plants like Dendrobium, Panax notoginseng, Taxus chinensis, and Cistanche deserticola can be used as medicines and that there are good ways to protect them. Some of the conservation methods that have been named are agroforestry, community-based management, current breeding techniques, and sustainable gathering. Collaboration in research, clinical trials, personalised medicine, regulatory harmonisation, and public education programs are all part of the integration with modern medicine. These programs try to solve problems like scientific proof, protection, and cultural integration., Conclusion: When rare and threatened medical plants from Traditional Chinese Medicine (TCM) are used in modern medicine, it can improve health and help protect wildlife. Using both old information and new science discoveries together can lead to new treatments and long-term uses for these plant materials. Large-scale clinical studies, new ways of growing plants, and looking into how TCM herbs and regular drugs can work together should be the main topics of future study. For global healthcare to improve and for these important plant resources to be used in the long term, academics, healthcare workers, lawmakers, and local communities must work together.

Background: Viral mediated diseases are continuously posing potent threat to human health. Nutraceuticals are being employed as novel therapeutics during viral outbreaks. MAM granules consist of Curcuma longa, Withania somnifera, and Piper nigrum, is one such patented Siddha nutraceutical supplement that has been proposed to be a therapeutic agent against viral diseases., Objective: We characterised MAM for their phytochemical and physicochemical properties and evaluated its cytotoxicity via in vivo acute toxicity studies using Wistar rats and by cell-based MTT assays., Materials and Methods: The antiviral properties of the aqueous extract of MAM were investigated against SARS-CoV-2 and chikungunya virus (CHIKV). Further, using ABTS radical scavenging, SOD enzymatic assays and measurement of intracellular ROS, we investigated the antioxidant potential of MAM extract and its ingredients in RAW264.7 cells. Additionally, production of inflammatory mediators was evaluated via NO release, PGE2 production and release of pro-inflammatory cytokines (IL-1β and TNFα)., Results: The MAM granules and aqueous extracts demonstrated no significant toxicity and demonstrated potent antiviral activity during co-incubation assay with SARS-CoV-2 and CHIKV. Moreover, we observed potent antioxidant and anti-inflammatory activity of MAM extract in a dose dependent manner. Further investigations on the individual ingredients with respect to their antioxidant and anti-inflammatory activities showed that all ingredients contributed synergistically and Withania somnifera showed most potent anti-oxidant activity., Conclusion: The overall in vitro, and in vivo analysis demonstrated that MAM granules were non-toxic and possessed potent antiviral activity. Additionally, observed significant anti-oxidant and anti-inflammatory properties of MAM suggested the modulation of innate immune response in the host validating its use as an effective nutraceutical during viral outbreaks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Problems involving controlling the collective behavior of a population of structurally similar dynamical systems, the so-called ensemble control, arise in diverse emerging applications and pose a grand challenge in systems science and control engineering. Owing to the severely under-actuated nature and the difficulty of placing large-scale sensor networks, ensemble systems are limited to being actuated and monitored at the population level. Moreover, mathematical models describing the dynamics of ensemble systems are often elusive. Therefore, it is essential to design broadcast controls that excite the entire population in such a way that the heterogeneity in system dynamics is robustly compensated. In this article, we propose a reinforcement learning (RL)-based data-driven control framework incorporating population-level aggregated measurement data to learn a global control signal for steering a dynamic population in the desired manner. In particular, we introduce the notion of ensemble moments induced by aggregated measurements and derive the associated moment system to the original ensemble system. Then, using the moment system, we learn an approximation of optimal value functions and the associated policies in terms of ensemble moments through RL. We illustrate the feasibility and scalability of the proposed moment-based approach via numerical experiments using a population of linear, bilinear, and nonlinear dynamic ensemble systems. We report that the proposed method achieves the desired control objectives of various ensemble control tasks and obtains significantly better averaged-reward when compared with three existing methods.

Introduction: Dental extraction is a common oral surgery procedure, but it can lead to unpredictable changes in alveolar bone structure, which can complicate future rehabilitation with prostheses. Socket preservation aims to reduce bone and soft tissue loss after extraction and involves various techniques using different materials. Autogenous bone is considered the gold standard for grafts, while autologous platelet concentrates like platelet-rich fibrin (PRF) have been used for tissue healing. This study aims to radiographically assess the bone remodeling of freshly extracted socket filled with Activated Platelet Rich Fibrin (APRF) and PRF., Materials and Methods: A randomized controlled study was conducted on 60 patients undergoing tooth extraction as atraumatic as possible. Patients were divided into two groups: one receiving APRF with 10% Calcium Chloride as activating agent and the other PRF. Radiographic assessments were done using Kelley et al. scoring criteria at various time intervals, and statistical analyses were performed to evaluate the results., Results: In this study we found increased bone density in extracted socket filled with APRF at any given time interval compared to PRF which is statistically significant. The maxilla demonstrated better bone formation compared to the mandible. Gender, age, and site also influenced bone formation, with females showing differences in lamina dura and overall density., Discussion: PRF is rich in growth factors, promoting osteoblast formation and angiogenesis. Activation with calcium chloride accelerates clot formation and the release of growth factors. This study's radiographic data suggests that APRF may be more effective than PRF in promoting socket preservation and bone formation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The COVID-19 pandemic has posed unprecedented challenges with its impact on patient safety culture and staff well-being. This study was to identify potential changes in safety culture among health care workers from before to during the COVID-19 pandemic, and to determine the differences across occupational groups. The Safety Attitudes Questionnaire (SAQ) was administered electronically in both English and Malay languages using the Google Forms platform in 2018 and was repeated in 2021, during the COVID-19 pandemic. Comparisons were made between 2018 and 2021 to determine changes in patient safety culture for the overall staff population and by occupational groups. A total of 3175 health care workers completed the questionnaire in 2021. Overall, a comparable percentage agreement was found for all SAQ domains in 2018 and 2021 with visible improvements for doctors and support staff. Safety Attitudes Questionnaire domain scores differed in teamwork, safety climate, perception of hospital management, and working condition domains across occupational groups. Self-isolation and COVID-19 were associated with poorer SAQ domain scores, while redeployment was associated with improvements in SAQ domain scores. Interventions targeting areas of weakness as well as utilizing positive experiences such as redeployment should be explored to enhance patient safety in hospitals settings postpandemic., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The goal of this study was to assess the feasibility of using exome (ES) and genome sequencing (GS) in guiding preconception genetic screening (PCGS) for couples who are planning to conceive by creating a workflow for identifying risk alleles for autosomal recessive (AR) and X-linked (XL) disorders without the constraints of a predetermined, targeted gene panel. There were several limitations and challenges related to reporting and the technical aspects of ES and GS, which are listed in the discussion. We selected 150 couples from a cohort of families (trios) enrolled in a research protocol where the goal was to define the genetic etiology of disease in an affected child. Pre-existing, de-identified parental sequencing data were analyzed to define variants that would place the couple at risk of having a child affected by an AR or XL disorder. We identified 17 families who would be selected for counseling about risk alleles. We noted that only 3 of these at-risk couples would be identified if we limited ourselves to the current ACMG-recommended expanded carrier screening gene panel. ES and GS successfully identified couples who are at risk of having a child with a rare AR or XL disorder that would have been missed by the current recommended guidelines. Current limitations of this approach include ethical concerns, difficulties in reporting results including variant calling due to the rare nature of some of the variants, determining which disorders to report, as well as technical difficulties in detecting certain variants such as repeat expansions., (© 2024 The Author(s). Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors.)

We report three unrelated individuals with atypical clinical findings for cardio-facio-cutaneous (CFC) syndrome, all of whom have the same novel, heterozygous de novo p.H119Y (c.355 C>T) transition variant in MAP2K1, identified by exome sequencing. MAP2K1 encodes MEK1, dual specificity mitogen-activated protein kinase kinase 1, and is one of four genes in the canonical RAS/MAPK signal transduction pathway associated with CFC syndrome. The p.H119Y variant is a non-conservative amino acid substitution that is predicted to impact the tertiary protein structure, and it occurs at a position in the protein kinase domain of MAP2K1 that is highly conserved across species. The clinical findings in these three individuals include facial features that are nonclassical for CFC syndrome, extremely poor weight gain, absence of congenital cardiac defects or cardiomyopathy, normal cognition or only mild intellectual disabilities, normal hair, mild skin abnormalities, and consistent behavioral features of anxiety, photophobia, and sensory hypersensitivities. These individuals expand the phenotypic spectrum of MAP2K1-related RASopathy., (© 2024 Wiley Periodicals LLC.)

A 22-year-old male patient reported swelling in relation to the right eye and developed recurrent purulent discharge and epiphora following a reconstructive traumatic orbital floor fracture repair two years ago. Radiographic investigation and surgical exploration reveal obstruction of the lacrimal apparatus at the lacrimal sac level due to over-extension/migration of the orbital floor mesh. The migration of the mesh was probably due to the extension of the mesh medially into the paranasal region., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, M et al.)

The oral cavity surprises us with a humongous variety of lesions. Central giant cell granuloma (CGCG) is one such rare presentation. The etiology of CGCG is controversial, which ranges from initially being considered a reparative lesion to currently being hypothesized as a mesenchymal proliferative jaw lesion. Clinically, CGCG is not a typical presenting lesion. It may be asymptomatic or even manifest as a slow-growing swelling. This entity most commonly occurs in younger females, particularly situated in the mandible. Here is a case report of a 31-year-old female with CGCG., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sarangi et al.)

Physical activity is a modifiable lifestyle behavior known for reducing symptoms of and being a risk factor for depression and mental health disorders. However, emerging adults (ages 18-25) struggle to meet recommended amounts. In this study, we explore the association between physical activity, depressive symptoms, and health factors in 137 Hispanic emerging adults. Using a cross-sectional survey design, sociodemographic information, depressive symptoms (CES-D score), physical activity (IPAQ score), body composition, and blood pressure measures were obtained. Statistical analyses included correlation and regression analyses. More than half of the participants demonstrated depressive symptomology (59.1%) and body fat percentage greater than 25% (64.2%). Body fat percentage, lean body mass, stress, and heart rate demonstrated notable associations with depressive symptoms and physical activity. When measured continuously and categorically, IPAQ was not a significant predictor of depressive symptoms. When used as a binary variable with a cutoff of 600 MET min/week, IPAQ score revealed a negative relationship with CES-D score (β = -0.169, SE = 2.748, p = 0.034). Our results indicate that a threshold of physical activity, 600 MET min/week, may confer protective effects against depressive symptoms. Future research should investigate the context and quality of physical activity to address mental health disparities in this underrepresented population.

In this article, we address two key challenges in deep reinforcement learning (DRL) setting, sample inefficiency and slow learning, with a dual-neural network (NN)-driven learning approach. In the proposed approach, we use two deep NNs with independent initialization to robustly approximate the action-value function in the presence of image inputs. In particular, we develop a temporal difference (TD) error-driven learning (EDL) approach, where we introduce a set of linear transformations of the TD error to directly update the parameters of each layer in the deep NN. We demonstrate theoretically that the cost minimized by the EDL regime is an approximation of the empirical cost, and the approximation error reduces as learning progresses, irrespective of the size of the network. Using simulation analysis, we show that the proposed methods enable faster learning and convergence and require reduced buffer size (thereby increasing the sample efficiency).

Introduction: Pneumococcal diseases pose a significant public health concern in India, with substantial morbidity and mortality, with the elderly and those with coexisting medical conditions being most at risk. Pneumococcus was also seen to be one of the main reasons for co-infection, pneumonia and complications in COVID. Current guidelines recommend vaccination for specific adult populations, but there is a lack of uniformity and guidance on risk stratification, prioritisation and optimal timing., Methods: Nation Against Pneumococcal Infections - Expert Panel Opinion (NAP-EXPO) is a panel convened to review and update recommendations for adult pneumococcal vaccination in India. The panel of 23 experts from various medical specialties engaged in discussions and evidence-based reviews, discussed appropriate age for vaccination, risk stratification for COPD and asthma patients, vaccination strategies for post-COVID patients, smokers and diabetics, as well as methods to improve vaccine awareness and uptake., Outcome: The NAP-EXPO recommends the following for adults: All healthy individuals 60 years of age and above should receive the pneumococcal vaccine; all COPD patients, regardless of severity, high-risk asthma patients, post-COVID cases with lung fibrosis or significant lung damage, should be vaccinated with the pneumococcal vaccine; all current smokers and passive smokers should be educated and offered the pneumococcal vaccine, regardless of their age or health condition; all diabetic individuals should receive the pneumococcal vaccine, irrespective of their diabetes control. Strategies to improve vaccine awareness and uptake should involve general practitioners (GPs), primary health physicians (PHPs) and physicians treating patients at high risk of pneumococcal disease. Advocacy campaigns should involve media, including social media platforms., Conclusion: These recommendations aim to enhance pneumococcal vaccination coverage among high-risk populations in India in order to ensure a reduction in the burden of pneumococcal diseases, in the post-COVID era. There is a need to create more evidence and data to support the recommendations that the vaccine will be useful to a wider range of populations, as suggested in our consensus., (Copyright © 2024 Copyright: © 2024 Indian Chest Society.)

Objective: To evaluate oral rehydration therapy (ORT) compared with intravenous rehydration therapy (IVT) in the early inpatient management of hyperemesis gravidarum (HG)., Methods: A total of 124 women hospitalized for HG from February 10, 2021 till January 6, 2023 were randomized to ORT (n = 61) or IVT (n = 63) for an initial 12 h. Inclusion criteria includes women older than 18 years, with a viable intrauterine pregnancy less than 14 weeks at their first hospitalization for HG with ketonuria of at least 2+. Primary outcomes were (1) satisfaction score with allocated intervention, (2) weight change, and (3) ketonuria change at 12 h. Secondary outcomes included vomiting frequency, nausea score, serial vital signs, hematocrit and electrolyte levels at 12 h, deviation from treatment protocol (cross-over therapy), participant recommendation of allocated treatment to a friend, and length of hospital stay., Results: Primary outcomes of (1) participant satisfaction score (on a 0-10 visual numerical rating scale) was 7 (interquartile range [IQR] 5-8) versus 9 (IQR 8-10), P < 0.001; (2) weight gain was 293 ± 780 g versus 948 ± 758 g, P < 0.001; and (3) ketonuria improvement was 50/61 (82.0%) versus 49/63 (77.8%) (relative risk [RR] 1.05, 95% confidence interval [CI] 0.88-1.26, P = 0.561) for ORT versus IVT, respectively. For secondary outcomes, vomiting frequency was 2.6 ± 2.7 versus 1.1 ± 1.4 episodes (P < 0.001), participant cross-over rate to opposing treatment 20/61 (32.8%) versus 0/63 (0%) (P < 0.001) (in the 12-h study period) and participant recommendation of allocated treatment to a friend rate 24/61 (39.3%) versus 61/63 (96.8%) (RR 0.41, 95% CI 0.30-0.56, P < 0.001) for ORT versus IVT, respectively. By hospital discharge, 31/61 (50.8%) of women allocated to ORT had required IVT. Other secondary outcomes of serial assessments of nausea score and vital signs, hematocrit and electrolyte levels, and length of hospital stay were not different., Conclusions: ORT was inferior to IVT in two primary outcomes and three secondary outcomes. Cross-over rate to intravenous therapy from oral therapy was 50.8% by hospital discharge. Intravenous rehydration therapy should remain as first-line rehydration therapy in the early inpatient treatment of HG., Clinical Trial Registration: The present study was registered in ISRCTN registry on December 6, 2020 with trial identification number: ISRCTN 40152556 (https://doi.org/10.1186/ISRCTN40152556). The first participant was recruited on February 10, 2021., (© 2024 International Federation of Gynecology and Obstetrics.)

Advances in manufacturing technologies and materials are crucial to the commercial deployment of energy technologies. We present the case of concentrating solar power (CSP) with molten salt (MS) thermal storage, where low-cost, high-efficiency heat exchangers (HXs) are needed to achieve cost competitiveness. The materials required to tolerate the extreme operating conditions in CSP systems make it difficult or infeasible to produce them using conventional manufacturing processes. Although it is technically possible to produce HXs with adequate performance using additive manufacturing, specifically laser powder bed fusion (LPBF), here we assess whether doing so is cost-effective. We describe a process-based cost model (PBCM) to estimate the cost of fabricating a MS-to-supercritical carbon dioxide HX using LPBF. The PBCM is designed to identify modifications to designs, process choices, and manufacturing innovations that have the greatest effect on manufacturing cost. Our PBCM identified HX design and LPBF process modifications that reduced projected HX cost from $750 per kilo-Watt thermal (kW-th) ($8/cm 3 ) to $350/kW-th ($6/cm 3 ) using currently available LPBF technology, and down to $220/kW-th ($4/cm 3 ) with improvements in LPBF technology that are likely to be achieved in the near term. The PBCM also informed a redesign of the HX design that reduced projected costs to $140-160/kW-th ($3/cm 3 )., (Copyright 2023, Mary Ann Liebert, Inc., publishers.)

CSMD1 (Cub and Sushi Multiple Domains 1) is a well-recognized regulator of the complement cascade, an important component of the innate immune response. CSMD1 is highly expressed in the central nervous system (CNS) where emergent functions of the complement pathway modulate neural development and synaptic activity. While a genetic risk factor for neuropsychiatric disorders, the role of CSMD1 in neurodevelopmental disorders is unclear. Through international variant sharing, we identified inherited biallelic CSMD1 variants in eight individuals from six families of diverse ancestry who present with global developmental delay, intellectual disability, microcephaly, and polymicrogyria. We modeled CSMD1 loss-of-function (LOF) pathogenesis in early-stage forebrain organoids differentiated from CSMD1 knockout human embryonic stem cells (hESCs). We show that CSMD1 is necessary for neuroepithelial cytoarchitecture and synchronous differentiation. In summary, we identified a critical role for CSMD1 in brain development and biallelic CSMD1 variants as the molecular basis of a previously undefined neurodevelopmental disorder., (© 2024. The Author(s).)

Predicting anomalies in manufacturing assembly lines is crucial for reducing time and labor costs and improving processes. For instance, in rocket assembly, premature part failures can lead to significant financial losses and labor inefficiencies. With the abundance of sensor data in the Industry 4.0 era, machine learning (ML) offers potential for early anomaly detection. However, current ML methods for anomaly prediction have limitations, with F1 measure scores of only 50% and 66% for prediction and detection, respectively. This is due to challenges like the rarity of anomalous events, scarcity of high-fidelity simulation data (actual data are expensive), and the complex relationships between anomalies not easily captured using traditional ML approaches. Specifically, these challenges relate to two dimensions of anomaly prediction: predicting when anomalies will occur and understanding the dependencies between them. This paper introduces a new method called Robust and Interpretable 2D Anomaly Prediction (RI2AP) designed to address both dimensions effectively. RI2AP is demonstrated on a rocket assembly simulation, showing up to a 30-point improvement in F1 measure compared to current ML methods. This highlights its potential to enhance automated anomaly prediction in manufacturing. Additionally, RI2AP includes a novel interpretation mechanism inspired by a causal-influence framework, providing domain experts with valuable insights into sensor readings and their impact on predictions. Finally, the RI2AP model was deployed in a real manufacturing setting for assembling rocket parts. Results and insights from this deployment demonstrate the promise of RI2AP for anomaly prediction in manufacturing assembly pipelines.