Comparison of Different Treatments of Persistent Pulmonary Hypertension of the Newborn: A Systematic Review and Network Meta-Analysis.

OBJECTIVES: Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening disease. Despite being considered the gold standard treatment scheme, inhaled nitric oxide (iNO) is not readily available in settings with limited resources. Therefore, in recent years, research on related drugs is being actively pursued. Herein, we aimed to use random-effects network meta-analysis to evaluate the efficacy and associated mortality of different PPHN therapies. DATA SOURCES: We electronically searched the PubMed, Embase, and Cochrane Library for data up to January 27, 2023. STUDY SELECTION: Randomized controlled trials involving neonates with PPHN assessing efficacy and mortality of various treatments. DATA EXTRACTION: Details of study population, treatments, and outcomes were extracted. DATA SYNTHESIS: Direct pairwise comparisons and a network meta-analysis was performed under random effects. The ranking probability was further assessed based on the surface under the cumulative ranking curve (SUCRA). We analyzed 23 randomized clinical trials involving 902 newborns with PPHN. Sixteen different treatment strategies were compared with each other and conventional therapy (CON). A median concentration of 10-20 parts per million (ppm) iNO (MNO) coupled with sildenafil orally administered at a dose of 1-3 mg/kg/dose every 6-8 hours (OSID) demonstrated the best efficacy (MNO + OSID vs. CON: odds ratio [OR] = 27.53, 95% CI, 2.36-321.75; SUCRA = 0.818, ranking first; moderate quality). OSID combined with milrinone administered IV also performed well in terms of efficacy (OSID + milrinone vs. CON: OR = 25.13, 95% CI = 1.67-377.78; SUCRA = 0.811, ranking second; low quality) and mortality reduction (CON vs. OSID + milrinone: OR = 25.13, 95% CI = 1.67-377.78; SUCRA = 0.786, ranking last; low quality). CONCLUSIONS: MNO + OSID is the most effective PPHN treatment. If iNO is not available, OSID + milrinone is preferred.

Research on Traffic Flow Prediction at Intersections Based on DT-TCN-Attention.

Traditional nonintelligent signal control systems are typically used in road traffic signal systems, which cannot provide optimal guidance and have low traffic efficiency during rush hour. This study proposes a traffic signal phase dynamic timing optimization strategy based on a time convolution network and attention mechanism to improve traffic efficiency at intersections. The corresponding optimization was performed after predicting traffic conditions with different impacts using the digital twinning technique. This method uses a time-convolution network to extract the cross-time nonlinear characteristics of traffic data at road intersections. An attention mechanism was introduced to capture the relationship between the importance distribution and duration of the historical time series to predict the traffic flow at an intersection. The interpretability and prediction accuracy of the model was effectively improved. The model was tested using traffic flow data from a signalized intersection in Shangrao, Jiangxi Province, China. The experimental results indicate that the model generated by training has a strong learning ability for the temporal characteristics of traffic flow. The model has high prediction accuracy, good optimization results, and wide application prospects in different scenarios.

The clinical application of flexible bronchoscopy in a neonatal intensive care unit.

Objective: Flexible bronchoscopy is widely used in infants and it plays a crucial role. The aim of this study was to investigate the value and clinical safety of flexible bronchoscopy in a neonatal intensive care unit. Methods: A retrospective analysis was performed on the clinical data of 116 neonates who underwent flexible bronchoscopy and the outcomes of 147 procedures. A correlation analysis was performed on the relationship between flexible bronchoscopy findings, microscopic indications, and clinical disease. Results: The 147 procedures performed were due to the following reasons: problems related to artificial airways, 58 cases (39.45%); upper respiratory problems, 60 cases (40.81%) (recurrent dyspnea, 23 cases; upper airway obstruction, 17 cases; recurrent stridor, 14 cases; and hoarseness, six cases), lower respiratory problems, 51 cases (34.69%) (persistent pneumonia, 21 cases; suspicious airway anatomical disease, 21 cases; recurrent atelectasis, eight cases; and pneumorrhagia, one case), feeding difficulty three cases (2.04%). The 147 endoscopic examinations were performed for the following reasons: pathological changes, 141 cases (95.92%); laryngomalacia, 78 cases (53.06%); mucosal inflammation/secretions, 64 cases (43.54%); vocal cord paralysis, 29 cases (19.72%); trachea/bronchus stenosis, 17 cases (11.56%) [five cases of congenital annular constriction of the trachea, seven cases of left main tracheal stenosis, one case of the right middle bronchial stenosis, two cases of tracheal compression, and two cases of congenital tracheal stenosis]; subglottic lesions, 15 cases (10.20%) [eight cases of subglottic granulation tissue, six cases of subglottic stenosis, one cases of subglottic hemangioma]; tracheomalacia, 14 cases (9.52%); laryngeal edema, five cases (3.40%); tracheoesophageal fistula, four cases (2.72%); rhinostenosis, three cases (2.04%); tracheal bronchus, three cases (2.04%); glossoptosis, two cases (1.36%); laryngeal cyst, two cases (1.36%); laryngeal cleft, two cases (1.36%); tongue base cysts, one case (0.68%); and pneumorrhagia, one case (0.68%). Complications were rare and mild. Conclusion: Flexible bronchoscopy is safe and effective for diagnosing and differentiating neonatal respiratory disorders in neonatal intensive care units.

Validation and Improvement of COCTS/HY-1C Sea Surface Temperature Products.

In oceanographic study, satellite-based sea surface temperature (SST) retrieval has always been the focus of researchers. This paper investigates several multi-channel SST retrieval algorithms for the thermal infrared band, and evaluates the accuracy of the COCTS/HY-1C SST products. NEAR-GOOS in situ SST data are utilized for validation and improvement, and a three-step matching procedure including geographic location screening, cloud masking, and homogeneity check is conducted to match in situ SST data with satellite SST data. Two improvement schemes, including nonlinear regression and regularization iteration, are proposed to improve the accuracy of the COCTS/HY-1C SST products and the typical application scenarios and the algorithm characteristics of these two schemes are discussed. The standard deviation of residual between retrieved SST and measured SST for these two data improvement algorithms, which are considered as the main indexes for assessment, result in an improvement of 13.245% and 14.096%, respectively. In addition, the generalization ability of the SST models under two data improvement methods is quantitatively compared, and the factors affecting the model accuracy are also carefully evaluated, including the in situ data acquisition method and measurement time (day/night). Finally, future works about SST retrieval with COCTS/HY-1C satellite data are summarized.

Clinical Features in Patients with Xq23 Microdeletion: A Case Report and Literature Review

Xq22.3-q23 microdeletion is a rare genomic disorder. The purpose of this study was to emphasize the correlation between clinical phenotype and genotype of proximal deletion on chromosome Xq22.3-q23. A 5 years old boy had a 671 KB microdeletion on Xq23 by chromosomal microarray analysis, including AMMECR1 and CHRDL1 genes. He presented with microsomia, midface hypoplasia, right kidney dysplasia and mildly motor retardation, which have not previously been reported in relation to Xq23 deletion. To the best of our knowledge, this is the first case with Xq23 microdeletion. A total of nine cases with microdeletion at Xq22.3-q23 affecting AMMECR1 and two cases with CHRDL1 mutation were reviewed. This review showed that Xq23 microdeletion with microsomia, midface hypoplasia, kidney dysplasia, and mild motor retardation was rare. The previous literature showed two novel point mutations in AMMECR1 and CHRDL1 with some phenotype difference from the presented case. Xq23 microdeletion should be considered for patients with microsomia, midface hypoplasia, kidney dysplasia and growth retardation.

Pulmonary Nocardia infection in a child with idiopathic pulmonary hemosiderosis.

BACKGROUND: Idiopathic pulmonary hemosiderosis (IPH) encompasses a rare and agnogenic group of diffuse alveolar capillary hemorrhagic diseases. Corticosteroid treatment is the globally preferred therapeutic strategy for IPH; however, it can cause immunodeficiency. Nocardia infection often occurs in immunocompromised patients and primarily involves the pleura and lungs. Herein, we describe a case of pediatric pulmonary Nocardia infection after the corticosteroid treatment of IPH. CASE PRESENTATION: A 7-year-old girl presented with chief complaints of pale complexion persisting for 1 year and a cough for 20 days. Abundant hemosiderin-laden macrophages were detected in the gastric juice, which supported the diagnosis of IPH. Uninterrupted doses of corticosteroids were administered during the last hospitalization. After nearly 2 months of corticosteroids therapy, the patient began to cough and produce a purulent sputum. Next-generation sequencing of the bronchoalveolar lavage fluid revealed Nocardia abscessus (N. abscessus) DNA. Linezolid was administered with good response, and the patient was discharged after 18 days of hospitalization. Her symptoms and pulmonary lesions had recovered, and the IPH appeared to be well-controlled with low dose of corticosteroids in follow-up. CONCLUSIONS: Nocardia infection should be considered in the differential diagnoses for IPH patients receiving corticosteroid therapy, especially in patients with poor response to conventional empirical antibiotic therapy. Next-generation sequencing of bronchoalveolar lavage fluid may be used to quickly identify the Nocardia. Sulfonamides or linezolid are effective for pediatric pulmonary Nocardia infection.

Clinical Features of Hypersensitivity Pneumonitis in Children: A Single Center Study.

BACKGROUND: Hypersensitivity pneumonia (HP) is an interstitial lung disease (ILD) mainly involving small airways and lung parenchyma that is caused by the inhalation of antigens in susceptible people to stimulate the body's immune response. METHODS: A total of 6 Chinese children with HP treated in our center from July 2017 to July 2021 were included in our study. RESULTS: Among the children, there were 4 males and 2 females, ranging in age from 4 to 14 years. Three cases had chest tightness and shortness of breath, 2 cases had cough, 1 case had chest pain, and 1 case had fever. Two cases of children had a history of close contact with pet dogs, 1 case had a history of contact with pigeons, 2 cases lived in a moldy house recently, and 1 case recently played a saxophone that had been idle for more than 2 years. The parents of two cases also had similar symptoms recently. The specific signs of chest HRCT of 6 cases all were in line with the characteristics of HP. After avoiding the sensitization environment, 2 children quickly recovered, 4 patients received low-dose glucocorticoid oral treatment, and after symptom control the dose was gradually reduced. The course of treatment was about 3-6 months. CONCLUSIONS: Exposure to a potential antigen has been found in all 6 HP children. The clinical manifestations are heterogeneous and easy to confuse with other diseases. A clear history of exposure to the antigens, respiratory symptoms associated with HP, signs of HP on HRCT, and improvement after removal from the antigenic environment constitute the cornerstone of the diagnosis of HP children in our unit. Avoiding exposure to antigenic environment is the first step in treatment, and glucocorticoid use is necessary in children with persistent symptoms.

Cyclin-Dependent Kinase 9 (CDK9) Inhibitor Atuveciclib Suppresses Intervertebral Disk Degeneration via the Inhibition of the NF-κB Signaling Pathway.

Intervertebral disk degeneration (IVDD) is a spinal disk condition caused by an inflammatory response induced by various proinflammatory cytokines, such as interleukin (IL)-1ß and tumor necrosis factor (TNF)-α. cyclin-dependent kinase 9 (CDK9) is a transcriptional regulator and potential therapeutic target for many diseases, especially in regulating the activation of primary inflammatory response genes. Our study investigated a highly selective CDK9 inhibitor, atuveciclib, which protects nucleus pulposus (NP) cells from proinflammatory stimuli-induced catabolism. The effects of CDK9 inhibition were determined in human and rat NP cells treated with IL-1ß in the presence or absence of atuveciclib or small interfering RNA target CDK9. Inhibition of CDK9 led to the attenuation of inflammatory response. In addition, rat intervertebral disk (IVD) explants were used to determine the role of CDK9 inhibition in extracellular matrix degradation. The rat IVDD model also proved that CDK9 inhibition attenuated IVDD, as validated using magnetic resonance imaging and immunohistochemistry. Taken together, CDK9 is a potential therapeutic target to prevent IVDD.

[Spectral Uncertainty of Terrestrial Objects and the Applicability of Spectral Angle Mapper Algorithm].

The spectral uncertainty of terrestrial objects causes a certain degree of spectral differences among feature spectra, which affects the accuracy of object recognition and also impacts the object recognition of spectral angle mapper algorithm (SAM). The spectral angle mapper algorithm is based on the overall similarity of the spectral curves, which was widely used in the classification of hyperspectral remotely sensed information. The spectral angle mapper algorithm does not take the spectral uncertainty of terrestrial objects into account while calculating the spectral angle between the spectral curves, and therefore does not tend to correctly identify the target objects. The applicability of the spectral angle mapper algorithm is studied for the spectral uncertainty of terrestrial objects and a modified SAM is proposed in this paper. In order to overcome the influence of the spectral uncertainty, the basic idea is to set a spectral difference value for the test spectra and the reference spectra and to calculate the spectral difference value based on derivation method according to the principle of minimum angle between the test spectra and the reference spectra. By considering the impact of the spectral uncertainty of terrestrial objects, this paper uses five kaolinite mineral spectra of USGS to calculate the spectral angle between the five kalinite mineral spectra by using local band combination and all bands to verify the improved algorithm. The calculation results and the applicability of the spectral angle mapper algorithm were analyzed. The results obtained from the experiments based on USGS mineral spectral data indicate that the modified SAM is not only helpful in characterizing and overcoming the impact of the spectral uncertainty but it can also improve the accuracy of object recognition to certain extent especially for selecting local band combination and has better applicability for the spectral uncertainty of terrestrial objects.

Laboratory calibration of a field imaging spectrometer system.

A new Field Imaging Spectrometer System (FISS) based on a cooling area CCD was developed. This paper describes the imaging principle, structural design, and main parameters of the FISS sensor. The FISS was spectrally calibrated with a double grating monochromator to determine the center wavelength and FWHM of each band. Calibration results showed that the spectral range of the FISS system is 437-902 nm, the number of channels is 344 and the spectral resolution of each channel is better than 5 nm. An integrating sphere was used to achieve absolute radiometric calibration of the FISS with less than 5% calibration error for each band. There are 215 channels with signal to noise ratios (SNRs) greater than 500 (62.5% of the bands). The results demonstrated that the FISS has achieved high performance that assures the feasibility of its practical use in various fields.

[Quantitative estimation of CaO content in surface rocks using hyperspectral thermal infrared emissivity].

The objective of the present paper is to study the quantitative relationship between the CaO content and the thermal infrared emissivity spectra. The surface spectral emissivity of 23 solid rocks samples were measured in the field and the first derivative of the spectral emissivity was also calculated. Multiple linear regression (MLR), principal component analysis (PCR) and partial least squares regression (PLSR) were modeled and the regression results were compared. The results show that there is a good relationship between CaO content and thermal emissivity spectra features; emissivities become lower when CaO content increases in the 10.3-13 mm region; the first derivative spectra have a better predictive ability compared to the original emissivity spectra.