Hasil untuk "Internal medicine"

Youichi Yanagawa, Raiki Tokutsu, Satoshi Takagi et al.

Dariush Salami, Nima Bahmani, Hüseyin Yiğitler et al.

We present a novel internal calibration framework for Millimeter- Wave (mmWave) Frequency-Modulated Continuous-Wave (FMCW) radars to ensure robust performance under internal temperature variations, tailored for deployment in dense wireless networks. Our approach mitigates the impact of temperature-induced drifts in radar hardware, enhancing reliability. We propose a temperature compensation model that leverages internal sensor data and signal processing techniques to maintain measurement accuracy. Experimental results demonstrate improved robustness across a range of internal temperature conditions, with minimal computational overhead, ensuring scalability in dense network environments. The framework also incorporates ethical design principles, avoiding reliance on sensitive external data. The proposed scheme reduces the Pearson correlation between the amplitude of the Intermediate Frequency (IF) signal and internal temperature drift up to 84%, significantly mitigating the temperature drift.

Talia Azad, Muhammad Umair, Shaheer Alam et al.

Abstract Introduction Liver cirrhosis (LC) is a serious condition occurring as a result of chronic liver disease. Amongst its various complications, acute variceal bleeding is the most feared, which presents as esophageal, gastroesophageal, and isolated gastric varices (IGV). The existing literature on the epidemiology of Gastric Varices in cirrhotic patients is very deficient. Hence, we aim to find the prevalence of gastric varices in liver cirrhotic patients undergoing OGD with complaints of upper GI Bleed at Shifa International Hospital, Islamabad (SIH). Methods We conducted an analytical cross-sectional study at the Department of Gastroenterology, Shifa international hospital, Islamabad. Our study spanned a period of six months after approval of the synopsis from 01-Feb till 01-Aug-22. Quantitative and qualitative data were collected, presented, and analyzed. We then applied the Post-stratification chi-square test, taking a p-value of ≤ 0.05 as significant. Results A total of 186 patients were included in this study. Mean age and duration of liver cirrhosis were 58.69 ± 8.39 years and 4.72 ± 2.24 years, respectively. 91 (48.9%) were males and 95 (51.1%) were females. 34 (18.3%) had and 152 (81.7%) did not have gastric varices. The stratification of various factors showed no significance concerning GV except for educational status, which was significant with a p-value of 0.01. Conclusion Gastric varices are among the rare but serious complications of portal hypertension due to LC. A total of 186 patients were included in our study out of which 34 (18.3%) had gastric varices. The existing predictive markers, like age and Child Pugh Score, etc., showed no significant association, which shows that existing literature is very deficient and new protocols need to be included for better patient care. Our study has certain limitations, such as a lack of pediatric population data, a limited sample size, selection bias, lack of multi variate analysis and a single-center study.

G. Buldgen, L. Fellay, J. Bétrisey et al.

The measurement of the internal rotation of post-main sequence stars using data from space-based photometry missions has demonstrated the need for an efficient angular momentum transport in stellar interiors. So far, no clear solution has emerged and explaining the observed trends remain a challenge for stellar modellers. We aim at constraining both the shape of the internal rotation profile of six Kepler subgiants studied in details in 2014 and the properties of the missing angular momentum transport process acting in stellar interiors from MCMC inversions of the internal rotation. We apply a new MCMC inversion technique to existing Kepler subgiant targets and test various shapes of the internal rotation profile of all six original subgiants observed in 2014. We also constrain the limitations on the number of free parameters that can be used in the MCMC inversion, showing the limitations in the amount of information in the seismic data. First, we show that large-scale fossil magnetic fields are not able to explain the internal rotation of subgiants, similarly to what was determined from detailed studies of Kepler red giants. We are also able to constrain the location of the transition in the internal rotation profile for the most evolved stars in the available set of subgiants. We find that some of them exhibit a transition located close to the border of the helium core while one clearly does not. We conclude that it might be possible that various processes might be at play to explain our observations, but that revealing the physical nature of the angular momentum process will require a consistent detailed modelling of all subgiants available, particularly the least evolved. In addition, increasing the number of stars for which such inferences are possible (e.g. with the future PLATO mission) is paramount given the key role they play in validating transport process candidates.

Song Yu, Xiaofei Xu, Fangfei Xu et al.

Although large language models perform well in understanding and responding to user intent, their performance in specialized domains such as Traditional Chinese Medicine (TCM) remains limited due to lack of expertise. In addition, high-quality data related to TCM is scarce and difficult to obtain, making large language models ineffective in handling TCM tasks. In this work, we propose a framework to improve the performance of large language models for TCM tasks using only a small amount of data. First, we use medical case data for supervised fine-tuning of the large model, making it initially capable of performing TCM tasks. Subsequently, we further optimize the model's performance using reinforcement learning from AI feedback (RLAIF) to align it with the preference data. The ablation study also demonstrated the performance gain is attributed to both supervised fine-tuning and the direct policy optimization. The experimental results show that the model trained with a small amount of data achieves a significant performance improvement on a representative TCM task.

Li-Ping Deng, Hongyu Liu, Zhi-Qiang Miao et al.

The paper investigates an inverse problem of recovering the internal source from external temperature measurements in photo-thermal effect. The photo-thermal effect actually involves two physical processes: electromagnetic scattering and heat transfer, described by a nonlinear coupled system of Maxwell's equation and the heat transfer equation. The nonlinear coupling term in the system is represented by the square of the modulus of the electromagnetic (missing the phase information of the electromagnetic field), and the absence of this phase information poses a significant challenge to the reconstruction of the internal source. In addition, the interaction and mutual influence of multiple physical fields, including electric field, magnetic field and temperature field, add to the complexity involved in the inversion of the internal source. Based on the potential theory and asymptotic analysis, we prove that the internal source can be uniquely determined up to sign by the external temperature field. This provides a solid theoretical basis for designing the internal source inversion algorithm and further exploring the theoretical aspects of photo-thermal effect.

Irvane E. Nelson, Kobi A. Baker, Ary Faraji et al.

Abstract Background Sugar alcohols, such as erythritol, are low-impact candidates for attractive toxic sugar baits (ATSB) to kill mosquitoes. To determine whether erythritol has a viable future in ATSB formulations, a suite of assays was conducted to diagnose toxicity mechanisms and starvation effects on mortality in Aedes aegypti (L.) as a model system. Methods We measured general carbohydrate load, glucosidase levels, and free glucose in intoxicated adult mosquitoes to observe whether sugar digestion was impaired. We assayed the effects of sugar combinations with erythritol on larvae and adults. To measure erythritol effects when mosquitoes were not resource-deprived, additional assays manipulated the prior starvation status. Results Up to 50,000 ppm of erythritol in water had no effect on larvae within 72 h, but an ammonia spike indicated diuresis in larvae as early as 4 h (F 8,44 = 22.50, P < 0.0001) after sucrose/erythritol combinations were added. Adult consumption of erythritol was diuretic regardless of the sugar pairing, while sucrose and erythritol together generated above 80% mortality (F 2,273 = 33.30, P < 0.0001) alongside triple the normal excretion (F 5,78 = 26.80, P < 0.0004). Glucose and fructose paired individually with erythritol had less mortality, but still double the fecal excretion. When ingesting erythritol-laced meals, less sugar was detected in mosquitoes as compared to after sucrose meals (χ 2 = 12.54, df = 1, P = 0.0004). Conclusions Data showed that erythritol is a linear competitive inhibitor of α-glucosidase, marking it as a novel class of insecticide in the current research climate. However, the efficacy on larvae was null and not persistent in adult mosquitoes when compared across various starvation levels. Despite significant diuresis, the combined effects from erythritol are not acute enough for vector control programs considering ATSB against mosquitoes. Graphical Abstract

Satoshi Higa

Enrico La Spina, Sebastiano Giallongo, Cesarina Giallongo et al.

Chronic myeloproliferative neoplasms encompass the BCR-ABL1-negative neoplasms polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). These are characterized by calreticulin (CALR), myeloproliferative leukemia virus proto-oncogene (MPL) and the tyrosine kinase Janus kinase 2 (JAK2) mutations, eventually establishing a hyperinflammatory tumor microenvironment (TME). Several reports have come to describe how constitutive activation of JAK-STAT and NFκB signaling pathways lead to uncontrolled myeloproliferation and pro-inflammatory cytokines secretion. In such a highly oxidative TME, the balance between Hematopoietic Stem Cells (HSCs) and Mesenchymal Stromal Cells (MSCs) has a crucial role in MPN development. For this reason, we sought to review the current literature concerning the interplay between HSCs and MSCs. The latter have been reported to play an outstanding role in establishing of the typical bone marrow (BM) fibrotic TME as a consequence of the upregulation of different fibrosis-associated genes including PDGF- β upon their exposure to the hyperoxidative TME characterizing MPNs. Therefore, MSCs might turn to be valuable candidates for niche-targeted targeting the synthesis of cytokines and oxidative stress in association with drugs eradicating the hematopoietic clone.

David Collister, Mark Farrar, Lesha Farrar et al.

Rationale &amp; Objective: We sought to elicit patient preferences regarding the use of plasma exchange in antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and its tradeoffs of risk of kidney failure and risk of serious infection. Study Design: Patient survey. Setting &amp; Participants: The online survey was circulated to adults with AAV via kidney and vasculitis networks in Canada, the United Kingdom, and the United States. Outcomes: Respondents reviewed the estimated 1-year risks of kidney failure and serious infection in AAV with and without plasma exchange across 5 serum creatinine categories (150, 250, 350, 450, and 600 μmol/L). For each scenario, participants indicated whether or not they would choose plasma exchange. Analytical Approach: Responses were assessed with multilevel multivariable logistic regression models to identify predictors of respondent choice regarding treatment with plasma exchange. Results: The 470 respondents from the 13 countries (United States 61.7%, United Kingdom 20.0%, Canada 13.8%, and other countries 4.5%) had a mean age of 58.6 (SD 14.3) years, 70.2% women. Respondents were more likely to choose plasma exchange in scenarios at high risk of kidney failure and serious infection (creatinine level of 350 or 450 μmol/L) compared with lower risk scenarios or the highest risk scenario. However, 145 (30.9%) chose plasma exchange across all scenarios, whereas 80 (17.0%) declined plasma exchange across all scenarios. Respondents from the United Kingdom (OR, 2.61; 95% CI, 1.09-6.22) who received previous dialysis (OR, 2.70; 95% CI, 1.12-6.52) or received previous plasma exchange (OR, 5.62; 95% CI, 2.72-11.61) were more likely to choose plasma exchange, whereas older respondents (OR, 0.98; 95% CI, 0.96-0.99 per 1 year increase) were less likely. Limitations: Unclear generalizability to non–English-speaking, older, and less health literate adults, possible responder bias, survivor bias, lack of individualized risk assessments for kidney failure, and serious infection. Conclusions: Patients with AAV do not express a consistent choice for plasma exchange, which highlights the need for shared decision making.

Evgenii Filippov, Sanchit Duhan, Laura Lehman et al.

A 33-year-old man in Baltimore, Maryland, USA, with untreated HIV infection had a 74-day course of mpox with multiorgan system involvement and unique clinical findings. In this clinical experience combining 3 novel therapeutic regimens, this patient died from severe mpox in the context of untreated HIV and advanced immunodeficiency.

Ali Yurtseven, Caner Turan, Gizem Güner Özenen et al.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) that causes a respiratory illness, continues to be a global pandemic. In this study, we purpose to identify the features of children with COVID-19 and the factors affecting disease severity. METHODS: This is a retrospective, observational study was conducted on patients who presented with suspicion of COVID-19 from April 1, 2020, to March 31, 2021, at a tertiary care medical center in Turkey. The characteristics of 640 children who were confirmed to have COVID-19 by real-time reverse transcription-polymerase chain reaction were retrieved from medical records. RESULTS: The mean age of the cases was 10 ± 6 years, and 56% of them were male. Seasonal difference did not affect the number of cases. The majority of the cases (n = 501, 78%) were infected by family members. Fever (67%) and cough (38%) were common complaints. The mean duration of fever was 1.9 ± 1.1 days. One-fourth of the cases were asymptomatic, 462 (72%) had mild upper respiratory tract infections, and 18 (3%) had pneumonia. Patients with pneumonia were more likely to have comorbidities and had a longer fever duration (both P < 0.001). Fever, cough, and respiratory distress were more common in patients with pneumonia (P = 0.010, P = 0.023, and P < 0.001, respectively). The mean C-reactive protein (CRP) value of the patients with pneumonia was significantly higher than that of the others (P < 0.001). A total of 70 (11%) complicated patients were hospitalized, 5 of them requiring intensive care admission. All hospitalized patients were discharged with recovery. CONCLUSIONS: Although pediatric COVID-19 patients tended to have a mild disease, some children with comorbidities can still develop a severe illness. CRP value is a useful indicator in the diagnosis of COVID-19 pneumonia. Furthermore, the prevalence rate of COVID-19 did not decrease with hot seasons.

Naruhiro Kimura, Toru Setsu, Yoshihisa Arao et al.

Abstract Background and Aim Symptoms of primary biliary cholangitis (PBC) frequently impair one's quality of life (QOL). Nonetheless, with improved treatment, the prognosis of PBC also improves. QOL plays an important role in patients with PBC. In this study, we aimed to reevaluate the transition of new symptom development in PBC and its predictive factors. Methods This retrospective multicenter study enrolled 382 patients with PBC for symptom analysis. The impact of a newly developed symptom on PBC prognosis was investigated by Kaplan–Meier analysis with propensity score matching and logistic progression analysis. Results The cumulative risk of developing a new symptom after 10 and 20 years of follow‐up was 7.6 and 28.2%, and specifically that of pruritus, which was the most common symptom, was 6.7 and 23.3%, respectively. In Cox hazard risk analysis, serum Alb level (hazard ratio [HR], 1.097; 95% confidence interval [CI], 1.033–1.165; P = 0.002), the serum D‐Bil level (HR, 6.262; 95% CI, 2.522–15.553, P < 0.001), and Paris II criteria (HR, 0.435; 95% CI, 0.183–1.036; P = 0.037) were significant independent predictors of a new symptom. Kaplan–Meier analysis showed that the overall survival and liver‐related death were not significant between patients with and without a new symptom. Conclusion The cumulative risk of new symptom development is roughly 30% 20 years after diagnosis and could be predicted by factors including serum albumin levels, serum D‐Bil level, and Paris II criteria.

B. Alansari, T. Alali

Introduction The BFI-2-S assesses the domain level of the Big Five with three prototypical facets of each domain capturing approximately 91% of the total variance in the full BFI-2 domain scales and approximately 89% of the predictive power of the BFI-2 facets in German adaptations and their original American versions. Objectives The study aims to investigate the psychometric properties of the Arabic adaptation of the BFI-2 short form. Methods The Arabic version of the BFI-2-S a 30-item with 15 and NEO Five-Factor Inventory (NEO–PI-R) were administered to 1560 (576 males, 984 females) Kuwait University undergraduates with a mean age = 22.75 ± 3.81. The internal consistency reliability, factor structure, and convergent validity of the BFI-2-S with NEO–PI-R were assessed. Results Cronbach’s alpha was satisfactory for N (0.79), E (0.73), O (0.73), A (0.76) and C (0.77). Results revealed significant gender differences in O, C & E with a favor for males and in N a favor with females. PCA showed that BFI-2-S five factors explains 64.38% of the total variance. However, the high mean correlations between the BFI-2-S and NEO–PI-R scales, with coefficients of (0.67) for the N, (0.66) for the E, (0.56) for the C, (0.61) for the A, and (0.58) for the C. The convergence between each BFI-2-S domain correlated substantially with the relevant NEO-PI-R domain scales, with the average correlation being .62. Conclusions The findings support the psychometric properties of the Arabic adaptations of the BFI-2-S as useful instruments for assessing the Big Five. Disclosure No significant relationships.

Cansu Önlen Güneri, Hamza Malik Okuyan, Gülay Gülbol Duran et al.

<b>Aim: </b>Patients infected with the hepatitis B virus (HBV) are at a higher risk of cirrhosis and hepatocellular carcinoma. Despite the recent advancement of antiviral therapy, many patients still cannot respond to existing therapies. Hence, to detect the changes in liver function earlier, non-invasive methods are needed. Long non-coding RNAs (lncRNAs) play important roles in essential biological process as well as human cancer. LncRNAs may be used as biomarkers in human diseases. Thus, in this study, we purposed to analyze the expression levels of lncRNAs (HOX transcript antisense RNA (HOTAIR), maternally expressed 3 (MEG-3), highly upregulated in liver cancer&nbsp;(HULC)) in patients with hepatitis B virus and healthy volunteers.<br /> <b>Methods: </b>We selected three lncRNAs as candidate lncRNAs based on their association with liver disease.&nbsp;Whole blood samples were collected from 40 patients with HBV and 48 healthy volunteers. The expression levels of all the samples were evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). Statistical analysis was implemented using GraphPad Prism software. A p-value lower than 0.05 was statistically meaningful.<br /> <b>Results: </b>The expression levels of HOTAIR and HULC were remarkably upregulated in the plasma of the patients with HBV compared with healthy control (p&lt;0.05). In contrast, no significant difference in MEG-3 expression levels was observed between groups.<br /> <b>Conclusion: </b>Our findings showed that the expression of HOTAIR and HULC in plasma might be new promising&nbsp;diagnostic and/or prognostic biomarkers for HBV.

Jinlyu Cao, H. A. Fertig, Luis Brey

Plasmons are usually described in terms of macroscopic quantities such as electric fields and currents. However as fundamental excitations of metals they are also quantum objects with internal structure. We demonstrate that this can induce an intrinsic dipole moment which is tied to the quantum geometry of the Hilbert space of plasmon states. This {\it quantum geometric dipole} offers a unique handle for manipulation of plasmon dynamics, via density modulations and electric fields. As a concrete example we demonstrate that scattering of plasmons with non-vanishing quantum geometric dipole from impurities is non-reciprocal, skewing in different directions in a valley-dependent fashion. This internal structure can be used to control plasmon trajectories in two dimensional materials.

Konrad Gizynski, Karol Makuch, Jan Paczesny et al.

We analyse a compressible Poiseuille flow of ideal gas in a plane channel. We provide the form of internal energy U for a non-equilibrium stationary state (NESS) that includes viscous dissipation and pressure work. We demonstrate that U depends strongly on the ratio Δp/p_0, where Δp is the pressure difference between inlet and outlet and p_0 is the outlet's pressure. In addition, U depends on two other variables: the channel aspect ratio and the parameter equivalent to Reynolds number. The stored internal energy, ΔU=U-U0, is small compared to the internal energy U0 of the equilibrium state (ES) for a moderate range of values of Δp/p_0. However, ΔU can become large for big Δp or close to vacuum conditions at the outlet (p_0~0 Pa).

R. Kailasham, Rajarshi Chakrabarti, J. Ravi Prakash

A coarse-grained bead-spring-dashpot chain model with the dashpots representing the presence of internal friction, is solved exactly numerically, for the case of chains with more than two beads. Using a decoupling procedure to remove the explicit coupling of a bead's velocity with that of its nearest neighbors, the governing set of stochastic differential equations are solved with Brownian dynamics simulations to obtain material functions in oscillatory and steady simple shear flow. Simulation results for the real and imaginary components of the complex viscosity have been compared with the results of previously derived semi-analytical approximations, and the difference in the predictions are seen to diminish with an increase in the number of beads in the chain. The inclusion of internal friction results in a non-monotonous variation of the viscosity with shear rate, with the occurrence of continuous shear-thickening following an initial shear-thinning regime. The onset of shear-thickening in the first normal stress coefficient is pushed to lower shear rates with an increase in the internal friction parameter.

Terezka S. Mollee, Pieter U. Dijkstra, Rienk Dekker et al.

Abstract Background Obesity is common in persons with a lower limb amputation, an amputation can also lead to further weight gain. Data regarding the prevalence of obesity in the Dutch population with a lower limb amputation are lacking. Furthermore, the impact of obesity on skin problems of the residual limb and the need of prosthetic repairs is unknown. The aim of this study was to determine the prevalence of obesity in Dutch persons with a lower limb amputation and to investigate the relationship between body weight, body mass index and skin problems of the residual limb and the frequency of prosthetic repairs. Methods A survey was performed among adults with a unilateral lower limb amputation due to any cause, and who are user of a prosthesis. The survey consisted of measurement of the subjects’ body height and weight, a questionnaire which assessed self-reported skin problems in the previous month and factors potentially associated with these skin problems, and assessment of the frequency of visits to the orthopedic workshop. Results In total, 413 persons were enrolled. Of them, 39% (95 % confidence interval 35;44) were overweight and 28% (95% confidence interval 24;33) were obese. A total of 77% (95% confidence interval 73;81) reported one or more skin problems in the past month. Body weight and body mass index were neither associated with the presence of skin problems in general nor with the number of prosthetic repairs. Persons with severe skin problems had a slightly lower body mass index (26.6 kg/m2 vs. 28.0 kg/m2, p = 0.012). Persons with skin problems were younger than those without (difference in means 6.0 years (95% confidence interval 3.0;8.9)). Conclusions Our findings show that obesity is common in the Dutch ambulant population with a lower limb amputation, with a prevalence being higher than in the general Dutch adult population. However, its negative impact on the presence of skin problems and the frequency of prosthetic repairs may be limited.

Christopher J. Howland, John R. Taylor, C. P. Caulfield

Motivated by observations of turbulence in the strongly stratified ocean thermocline, we use direct numerical simulations to investigate the interaction of a sinusoidal shear flow and a large-amplitude internal gravity wave. Despite strong nonlinearities in the flow and a lack of scale separation, we find that linear ray tracing theory is qualitatively useful in describing the early development of the flow as the wave is refracted by the shear. Consistent with the linear theory, the energy of the wave accumulates in regions of negative mean shear where we observe evidence of convective and shear instabilities. Streamwise-aligned convective rolls emerge the fastest, but their contribution to irreversible mixing is dwarfed by shear-driven billow structures that develop later. Although the wave strongly distorts the buoyancy field on which these billows develop, the mixing efficiency of the subsequent turbulence is similar to that arising from Kelvin-Helmholtz instability in a stratified shear layer. We run simulations at Reynolds numbers of 5000 and 8000, and vary the initial amplitude of the internal gravity wave. For high values of initial wave amplitude, the results are qualitatively independent of $Re$. Smaller initial wave amplitudes delay the onset of the instabilities, and allow for significant laminar diffusion of the internal wave, leading to reduced turbulent activity. We discuss the complex interaction between the mean flow, internal gravity wave and turbulence, and its implications for internal wave-driven mixing in the ocean.