A periodic split attractor reconstruction method facilitates cardiovascular signal diagnoses and obstructive sleep apnea syndrome monitoring.

Electrocardiogram (ECG) is a powerful tool to detect cardiovascular diseases (CVDs) and health conditions. We proposed a new method for evaluating ECG for efficient medical diagnosis in daily life. By splitting the signal according to the cardiac activity cycle, the periodic split attractor reconstruction (PSAR) method is proposed with time embedding, including three types of splitting methods to show its chaotic domain characteristics. We merged the CVDs dataset and the obstructive sleep apnea syndrome (OSAS) first-lead ECG signal dataset to validate the performance of PSAR for diagnosis and health monitoring using PSAR density maps as SE-ResNet input features. PSAR under 3 split methods showed different sensitivities for different CVDs. While in OSAS monitoring, PSAR showed good ability to recognize sleep abnormalities.

Life history strategies predict responses of lacustrine fish communities to eutrophication.

The demographic traits of an organism are key components of its fitness and life history theory aims at identifying the environmental drivers underlying the evolution of life history strategies. For fishes, the equilibrium species, those investing into larval survival (large eggs, parental care) rather than into absolute fecundity, are hypothesized to have evolved in stable and predictable environments with high biotic pressure. Human induced nutrient enrichment in many lakes around the world makes them increasingly subjected to perturbations such as anoxia and toxic algal blooms. We hypothesized that eutrophication results in lakes becoming more unstable, unpredictable and less resource-limited, in turn less favorable to equilibrium species. Another hypothesis states that lacustrine environment stability increases with ecosystem size. This study presents the first attempt to compare the two hypotheses in a group of 26 lakes. We found that the population abundance of equilibrium species was negatively related to increasing eutrophication. Long-lived and highly fecund periodic species responded more positively to eutrophication than short lived opportunistic species, with no parental care. This result could be demonstrated by seasonality in primary productivity which favors periodic species, disconnection from the river which prevents good colonist (i.e., opportunistic) species to (re)-establish after perturbation events, and predation by periodic species on opportunistic species. In contrast, we found no support for the ecosystem size hypothesis. Overall, we showed that human driven eutrophication affected species according to their life history strategies, reinforcing the usefulness of life history theory as a framework for assessing fish community response to a large array of human perturbations. More generally, our study emphasizes the importance of species traits to assess, explain, and predict community responses to human and natural perturbations.

A rare cutaneous infection with Mycobacterium chelonae in a pediatric patient treated with trametinib for KRAS-mutated diffuse glioma.

Mitogen-activated extracellular signal-regulated kinase inhibitors (MEKi) represent a promising new therapy for pediatric patients with low-grade gliomas, which frequently have abnormal signaling within the mitogen-activated protein kinase (MAP kinase) pathway. However, understanding of long-term efficacy and toxicity is limited in pediatric glioma patients. This article describes a rare presentation of a widespread cutaneous infection with Mycobacterium chelonae in a pediatric patient with a low-grade glioma treated with trametinib.

Age-related decline in goblet cell numbers and mucin content of the human colon: Implications for lower bowel functions in the elderly.

BACKGROUND & AIMS: Older people experience a greater incidence of lower bowel disorders, including constipation. Causes can include factors associated with growing older, such as use of medications or disease, but compounded by degenerative changes within the bowel wall. It has been suggested that the latter is exacerbated by loss of an effective mucosal barrier to luminal contents. In human colon, little is known about the impact of ageing on key components of this barrier, namely the goblet cells and mucin content. METHODS: Changes in the number of goblet cells and density of mucin content were investigated in macroscopically normal human ascending (AC; n = 13) and descending (DC; n = 14) colon from elderly (≥ 67 years) and younger adults (60 years and below). Samples were serially sectioned and stained for haematoxylin and eosin to assess tissue morphology, and alcian blue periodic acid Schiff (ABPAS) and MUC-2 antibody to identify goblet cells producing mucins. New procedures in visualization and identification of goblet cells and mucin contents were employed to ensure unbiased counting and densitometric analysis. RESULTS: Compared with the younger adults, the numbers of goblet cells per crypt were significantly lower in the elderly AC (72 ± 1.2 vs 51 ± 0.5) and DC (75 ± 2.6 vs. 54 ± 1.9), although this reduction did not reach statistical significance when assessed per mucosal area (AC: P = 0.068; DC: P = 0.096). In both regions from the elderly, numerous empty vesicles (normally containing mucins) were observed, and some areas of epithelium were devoid of goblet cells. Thus, the density of mucin content per unit mucosal area were significantly reduced with age. CONCLUSIONS: Ageing could result in a reduced number of goblet cells and development of degenerative changes in mucin production. Together, these have implications for the mucus barrier function in the colon of elderly individuals.

Interactions among lump optical solitons for coupled nonlinear Schrödinger equation with variable coefficient via bilinear method.

In this paper, a non-autonomous (3+1) dimensional coupled nonlinear Schrödinger equation (NLSE) with variable coefficients in optical fiber communication is analyzed. By means of bilinear technique and symbolic computations, new multi-soliton solutions of the coupled model in different trigonometric and lump functions are given. Then, in terms of perturbed waves, considering the steady state solution and the small perturbation on the three directions x, y, z and the time t, the soliton transmission are also considered. The behaviour of interaction among lump periodic soliton is studied and optical soliton solutions are reached. This study has certain significance for the analysis of other nonlinear dispersion systems and the application of optical physics. The results are presented through graphs generated by using Maple. The important feature of the proposed study is to show different behaviour of the soliton at each component. The behaviour of solitons, their interactions, and their transformations are all governed by the fundamental concept of energy conservation in all three examples. We demonstrate the efficiency of our suggested methodology for analyzing the NLSE equations using the numerical simulations and analytical tools, yielding fresh insights into their behaviour and solutions. Our findings help to develop mathematical tools for investigating nonlinear partial differential equation (NLPDEs) and provide new insights on the dynamics of NLSE equations, which have implications for many domains of physics and applied mathematics.

From Chronic Cannabis to Cyclic Chaos: A Glimpse Into Cannabinoid Hyperemesis Syndrome.

Cannabinoid hyperemesis syndrome (CHS) pathophysiology remains largely unknown, and it is often misdiagnosed. This paper identifies the clinical causes of CHS, outlines diagnostic and therapeutic approaches, and emphasizes early detection, comprehensive treatment, and timely intervention for improved patient outcomes. This case describes a 38-year-old male with a known history of cannabis use who experienced repeated episodes of intense vomiting, nausea, and abdominal pain consistent with symptoms of CHS. He was initially misdiagnosed with other gastrointestinal conditions despite the knowledge of marijuana ingestion. The diagnosis of CHS was initially missed; however, after further examination and consideration of his marijuana use, CHS was correctly identified. The patient's symptoms improved after the cessation of marijuana use. This case illustrates the diagnostic difficulties of cannabinoid hyperemesis syndrome (CHS) in cannabis users with significant gastrointestinal symptoms. The early detection and cessation of marijuana use are crucial for symptom management and resolution, emphasizing clinical awareness and personalized treatment.

Exploring Aeration Strategies for Enhanced Simultaneous Nitrification and Denitrification in Membrane Aerated Bioreactors: A Computational Approach.

In this study we employ computational methods to investigate the influence of aeration strategies on simultaneous nitrification-denitrification processes. Specifically, we explore the impact of periodic and intermittent aeration on denitrification rates, which typically lag behind nitrification rates under identical environmental conditions. A two-dimensional deterministic multi-scale model is employed to elucidate the fundamental processes governing the behavior of membrane aerated biofilm reactors (MABRs). We aim to identify key factors that promote denitrification under varying aeration strategies. Our findings indicate that the concentration of oxygen during the off phase and the duration of the off interval play crucial roles in controlling denitrification. Complete discontinuation of oxygen is not advisable, as it inhibits the formation of anaerobic heterotrophic bacteria, thereby impeding denitrification. Extending the length of the off interval, however, enhances denitrification. Furthermore, we demonstrate that the initial inoculation of the substratum (membrane in this study) influences substrate degradation under periodic aeration, with implications for both nitrification and denitrification. Comparison between continuous and periodic/intermittent aeration scenarios reveals that the latter can extend the operational cycle of MABRs. This extension is attributed to relatively low biofilm growth rates associated with non-continuous aeration strategies. Consequently, our study provides a comprehensive understanding of the intricate interplay between aeration strategies and simultaneous nitrification-denitrification in MABRs. The insights presented herein can contribute significantly to the optimization of MABR performance in wastewater treatment applications.

Periodic Single-Metal Site Catalysts: Creating Homogeneous and Ordered Atomic-Precision Structures.

Heterogeneous single-metal-site catalysts (SMSCs), often referred to as single-atom catalysts (SACs), demonstrate promising catalytic activity, selectivity, and stability across a wide spectrum of reactions due to their rationally designed microenvironments encompassing coordination geometry, binding ligands, and electronic configurations. However, the inherent disorderliness of SMSCs at both atomic scale and nanoscale poses challenges in deciphering working principles and establishing the correlations between microenvironments and the catalytic performances of SMSCs. The rearrangement of randomly dispersed single metals into homogeneous and atomic-precisely structured periodic single-metal site catalysts (PSMSCs) not only simplifies the chaos in SMSCs systems but also unveils new opportunities for manipulating catalytic performance and gaining profound insights into reaction mechanisms. Moreover, the synergistic effects of adjacent single metals and the integration effects of periodic single-metal arrangement further broaden the industrial application scope of SMSCs. This perspective offers a comprehensive overview of recent advancements and outlines prospective avenues for research in the design and characterizations of PSMSCs, while also acknowledging the formidable challenges encountered and the promising prospects that lie ahead.

The episodic ataxias.

The primary episodic ataxias (EAs) are a group of autosomal-dominant disorders characterized by transient recurrent incoordination and truncal instability, often triggered by physical exertion or emotional stress and variably associated with progressive baseline ataxia. There are now nine designated subtypes EA1-9 (OMIM) and late onset cerebellar ataxia with episodic features as newly designated SCA27B, based largely on genetic loci. Mutations have been identified in multiple individuals and families in 4 of the 9 EA subtypes, mostly with the onset before adulthood. This chapter focuses on the clinical assessment and management of EA, genetic diagnosis, and neurophysiologic consequences of the causative mutations in the best characterized EA syndromes: EA1 caused by mutations in KCNA1 encoding a neuronal voltage-gated potassium channel, EA2 caused by mutations in CACNA1A encoding a neuronal voltage-gated calcium channel, EA6 caused by mutations in SLC1A3 encoding a glutamate transporter that is also an anion channel, and SCA27B with late onset episodic ataxia caused by an intronic trinucleotide repeat in FGF14 encoding fibroblast growth factor 14 important in regulating the distribution of voltage-gated sodium channels in the cerebellar Purkinje and granule cells. The study of EA has illuminated previously unrecognized but important roles of ion channels and transporters in brain function with shared mechanisms underlying cerebellar ataxia, migraine, and epilepsy.

Pediatric neuromuscular channelopathies.

Pediatric skeletal muscle channelopathies include a spectrum of conditions including nondystrophic myotonias and periodic paralyses. They are rare inherited conditions that can cause significant morbidity. They are characterized by episodic stiffness and weakness. While there is significant phenotypic variability, there are distinct diagnostic features. The nondystrophic myotonias encompass myotonia congenita, paramyotonia congenita, and sodium channel myotonia caused by mutations in chloride and sodium channels. The clinical manifestations vary across age groups and a small subset with sodium channel mutations may have severe presentation with fetal akinesia, laryngospasm, or congenital myopathy. The periodic paralyses include hypokalemic periodic paralysis, hyperkalemic periodic paralysis, and Andersen-Tawil syndrome. The phenotypic differences between the groups can be helpful in diagnosis. It is important to review the cardiac phenotype in Andersen-Tawil syndrome due to a risk of life-threatening cardiac arrhythmias. Early and accurate diagnosis utilizing clinical features aided by investigations is important across all the pediatric channelopathies, as effective symptomatic treatment is available and can substantially improve quality of life.

Andersen-Tawil syndrome.

Andersen-Tawil syndrome (ATS) is one of the periodic paralyses, a set of skeletal muscle disorders that cause transient weakness of the arms and legs lasting minutes to many hours. Distinguishing features of ATS include facial and limb dysmorphisms, cardiac arrhythmia, difficulties with executive function, and association with dominant mutations in the potassium channel, KCNJ2. In this review, we discuss the key features of ATS, diagnostic testing, pathophysiology and treatment of ATS, and compare them with other periodic paralyses.

Sex-based disparities in dopamine agonist response in patients with restless legs syndrome.

This study aimed to investigate sex-related differences in the response to ropinirole and pramipexole in patients with restless legs syndrome (RLS). By analysing clinical parameters and polysomnographic (PSG) findings, we sought to elucidate the potential factors related to sex disparities modulating treatment responses and sleep quality in RLS. A total of 41 drug-free patients with RLS, aged ≥18 years, underwent two consecutive nocturnal PSG recordings, without medication at baseline; before the second night, 26 patients received an oral dose of 0.25 mg pramipexole whereas 15 received 0.5 mg ropinirole. After each PSG recording, patients self-evaluated the severity of their previous night symptoms by means of an ad hoc visual analogue scale (VAS). At baseline, sleep efficiency and percentage of Stage N2 tended to be higher in females while wakefulness after sleep onset was significantly higher in males. After treatment, total leg movements during sleep (LMS), periodic LMS (PLMS), and periodicity indexes were significantly lower in females than in males. The VAS score was lower after treatment in all patients, without differences between the two sexes. This study demonstrates a higher acute responsiveness of PLMS to dopamine agonists (pramipexole and ropinirole) in females than in males with RLS. These findings might be explained by differential sex-related expression of dopamine receptors, especially D3, within the central nervous system. In addition, our findings provide translational hints toward a better tailored and sex-specific approach to the treatment of RLS associated with PLMS, with dopamine agonist possibly associated with a better outcome in females than in males.

Self-folding RCA product into a parallel monolayer DNA nanoribbon and woven into a nano-fence structure by a short bridge strand.

The universal programmed construction of patterned periodic self-assembled nanostructures is a technical challenge in DNA origami nanotechnology but has numerous potential applications in biotechnology and biomedicine. In order to circumvent the dilemma that traditional DNA origami requires a long unusual single-stranded virus DNA as the scaffold and hundreds or even thousands of short strands as staples, we report a method for constructing periodically-self-folded rolling circle amplification products (RPs). The repeating unit is designed to have 3 intra-unit duplexes (inDP1,2,3) and 2 between-unit duplexes (buDP1,2). Based on the complementary pairing of bases, RPs each can self-fold into a periodic grid-patterned ribbon (GR) without the help of any auxiliary oligonucleotide staple. Moreover, by using only an oligonucleotide bridge strand, the GRs are connected together into the larger and denser planar nano-fence-shaped product (FP), which substantially reduces the number of DNA components compared with DNA origami and eliminates the obstacles in the practical application of DNA nanostructures. More interestingly, the FP-based DNA framework can be easily functionalized to offer spatial addressability for the precise positioning of nanoparticles and guest proteins with high spatial resolution, providing a new avenue for the future application of DNA assembled framework nanostructures in biology, material science, nanomedicine and computer science that often requires the ordered organization of functional moieties with nanometer-level and even molecular-level precision.

Two-Dimensional Exciton Oriented Diffusion via Periodic Potentials.

Excitonic devices operate based on excitons, which can be excited by photons as well as emitting photons and serve as a medium for photon-carrier conversion. Excitonic devices are expected to combine the advantages of both the high response rate of photonic devices and the high integration of electronic devices simultaneously. However, because of the neutral feature, exciton transport is generally achieved via diffusion rather than using electric fields, and the efficient control of exciton flux directionality has always been difficult. In this work, a precisely designed one-dimensional periodic nanostructure (1DPS) is used to introduce periodic strain field along with resonant mode to the WS2 monolayer, achieving exciton oriented diffusion with a 7.6-fold exciton diffusion coefficient enhancement relative to that of intrinsic, while enhancing the excitonic emission intensity by a factor of 10 and reducing exciton saturation threshold power by 2 orders of magnitude. Based on the analysis of the density functional theory (DFT) and the finite-element method (FEM), we attribute the anisotropy of exciton diffusion to exciton funneling induced by periodic potentials, which do not require excessive potential height difference for an efficient oriented diffusion. As a result of resonant emission, the exciton diffusion is dragged into the nonlinear regime owing to the high exciton density close to saturation, which improves the exciton diffusion coefficient and diffusion anisotropy more appreciably.

Automated Quantification of Periodic Discharges in Human Electroencephalogram.

Periodic discharges (PDs) are pathologic patterns of epileptiform discharges repeating at regular intervals, commonly detected in the human electroencephalogram (EEG) signals in patients who are critically ill. The frequency and spatial extent of PDs are associated with the tendency of PDs to cause brain injury, existing automated algorithms do not quantify the frequency and spatial extent of PDs. The present study presents an algorithm for quantifying frequency and spatial extent of PDs. The algorithm quantifies the evolution of these parameters within a short (10-14 second) window, with a focus on lateralized and generalized periodic discharges. We test our algorithm on 300 ``easy'', 300 ``medium'', and 240 ``hard'' examples (840 total epochs) of periodic discharges as quantified by interrater consensus from human experts when analyzing the given EEG epochs. We observe $95.0\%$ agreement with a 95\% confidence interval (CI) of $[94.9\%, 95.1\%]$ between algorithm outputs with reviewer clincal judgement for easy examples, $92.0\%$ agreement (95\% CI $[91.9\%, 92.2\%]$) for medium examples, and $90.4\%$ agreement (95\% CI $[90.3\%, 90.6\%]$) for hard examples. The algorithm is also computationally efficient and is able to run in $0.385 \pm 0.038$ seconds for a single epoch using our provided implementation of the algorithm. The results demonstrate the algorithm's effectiveness in quantifying these discharges and provide a standardized and efficient approach for PD quantification as compared to existing manual approaches.

The development of aperiodic and periodic resting-state power between early childhood and adulthood: New insights from optically pumped magnetometers.

Neurophysiological signals, comprised of both periodic (e.g., oscillatory) and aperiodic (e.g., non-oscillatory) activity, undergo complex developmental changes between childhood and adulthood. With much of the existing literature primarily focused on the periodic features of brain function, our understanding of aperiodic signals is still in its infancy. Here, we are the first to examine age-related changes in periodic (peak frequency and power) and aperiodic (slope and offset) activity using optically pumped magnetometers (OPMs), a new, wearable magnetoencephalography (MEG) technology that is particularly well-suited for studying development. We examined age-related changes in these spectral features in a sample (N=65) of toddlers (1-3 years), children (4-5 years), young adults (20-26 years), and adults (27-38 years). Consistent with the extant literature, we found significant age-related decreases in the aperiodic slope and offset, and changes in peak frequency and power that were frequency-specific; we are the first to show that the effect sizes of these changes also varied across brain regions. This work not only adds to the growing body of work highlighting the advantages of using OPMs, especially for studying development, but also contributes novel information regarding the variation of neurophysiological changes with age across the brain.

A Novel Friction Compensation Method for Machine Tool Drive Systems in Insufficient Lubrication.

Friction is the dominant factor restricting tracking accuracy and machining surface quality in mechanical systems such as machine tool feed-drive. Hence, friction modeling and compensation is an important method in accurate tracking control of CNC machine tools used for welding, 3D printing, and milling, etc. Many static and dynamic friction models have been proposed to compensate for frictional effects to reduce the tracking error in the desired trajectory and to improve the surface quality. However, most of them focus on the friction characteristics of the pre-sliding zone and low-speed sliding regions. These models do not fully describe friction in the case of insufficient lubrication or high acceleration and deceleration in machine tool systems. This paper presents a new nonlinear friction model that includes the typical Coulomb-Viscous friction, a nonlinear periodic harmonic friction term for describing the lead screw property in insufficient lubrication, and a functional component of acceleration for describing the friction lag caused by the acceleration and deceleration of the system. Experiments were conducted to compare the friction compensation performance between the proposed and the conventional friction models. Experimental results indicate that the root mean square and maximum absolute tracking error can be significantly reduced after applying the proposed friction model.

Solving a diagnostic dilemma in a patient with periodic fever-When the pieces of the puzzle finally fit.

The lack of pediatric subspecialists locally prior to 5 years ago, meant that some of our patients with rare, relapsing conditions were left behind. Familial Mediterranean fever can be diagnosed clinically and supported via genetic panel studies. Although neurological symptoms can be non-specific, this system symptomatology may lead patients and carers to seek medical attention. When neurological symptoms progress, seemingly refractory to first-line treatment, or suggestive of colchicine resistance, CNS demyelination should be considered by the neurologist. Abstract: Familial Mediterranean fever (FMF) is an inherited disorder with episodic fevers accompanied by pain in the abdomen, joints, or chest. It is a clinical entity that can be confirmed with a specific genetic mutation. Neurological symptoms have not been a focal point in clinical case descriptions. We aim to present the long road to diagnosing our patient, where the diagnostic clues centered around her neurological symptoms.

Subacute encephalopathy with seizures in alcoholics (SESA) syndrome: Relevant questions.

OBJECTIVE: The aim of this article is to answer three relevant issues: i/What epileptic condition is referred to as subacute encephalopathy with seizures in alcoholics (SESA) syndrome; ii/ Why it can be important to distinguish SESA syndrome in clinical practice and iii/ What do we know about its pathophysiology. METHODS: We reviewed all cases published in the English language from the initial description of the syndrome to the present. All met the previously established criteria for SESA syndrome were included in our analysis. RESULTS: We found 34 patients diagnosed with SESA syndrome Fourteen (41.1%) out of 34 patients were over 60 years of age. In 12 (35.2 %), abstinence, and in 4 (11.7 %) excessive consumption of alcohol, were considered precipitating factors, respectively. Triggering causes were unknown in 18 cases (53.0 %). All cases (100 %) presented with altered mental status. Fourteen (41.1 %) subjects had a history of epileptic seizures in the context of alcohol withdrawal syndrome (AWS). Twenty (58.8 %) patients had focal motor seizures (FMSs), 24 (70.5 %) bilateral tonic-clonic seizures (BTCSs), and 15 (44.1 %) focal impaired awareness seizures (FIASs). In 8 (23.5 %), criteria for focal nonconvulsive status epilepticus (NCSE) were met. Twenty-eight (82.3 %) subjects had transient neurological deficits. In 29 (85.2 %) subjects, lateralized periodic discharges (LPDs) were observed on the EEG. Areas of signal hyperintensities and restricted diffusion in neuroimaging were mentioned in 22 subjects (64.7 %). Transfer to the intensive care unit was necessary in 8 (23.5 %) subjects. Thirteen (38.2 %) had recurrent episodes. Enduring brain damage was mentioned in 9 (26.4 %) cases. The most used anti-seizure medication (ASM) was levetiracetam, followed by phenytoin and lacosamide. CONCLUSIONS: SESA syndrome represents a well-defined subtype of focal NCSE in patients with chronic alcoholism. Its prompt recognition can facilitate the initiation of early ASM therapy and help design appropriate video-EEG evaluation and a treatment strategy.

First Principles Simulations of Optical Rotation of Chiral Molecular Crystals.

In this work, we present simulations of the optical rotation (OR) for five molecular crystals at density functional theory level with periodic boundary conditions (DFT-PBC). Calculations are compared with experimental measurements and show semi-quantitative agreement with experimental data for three of the crystals: tartatic acid, benzil, and pentaerythritol. For the other two crystals, aspartic acid and glutamic acid, the calculated data are in qualitative agreement with, but two orders of magnitude smaller than, the experimental data. We provide some arguments that support the theoretical predictions and suggest that the experiments should be revisited. We also find that the position of H centers provided in experimental X-ray data is not sufficiently reliable for simulating OR, and better results are obtained when H atoms are allowed to relax while keeping heavier elements fixed at the experimental positions. Comparison with molecular cluster calculations with a better functional and a larger basis set indicate that the role of intermolecular interactions (reproduced with the PBC technique) is as or more important than the choice of model chemistry. Despite the current limitations in the level of theory that can be employed, these simulations provide a promising avenue to investigate the effect of intermolecular interactions on this sensitive electronic property of molecules and materials.