This randomized control trial aims to test the hypothesis that twice-daily nurse-administered saline enema(SE) is comparable to physician-administrated SE in very low birth weight infants (VLBW) with meconium obstruction of prematurity (MOP). MOP is defined as no bowel opening for 48 h, and treatment failure is defined as the need for additional intervention and safety. Twice-daily SE was administered by accredited nurses, surgeons/neonatologists using standardized protocols. The outcomes were comparability of nurse to physician-administered SE in terms of frequency of administration, catheter insertion length and volume of enema, daily maximum meconium output, and treatment failure, defined as the need for additional intervention. Safety outcomes were evaluated. Twenty-eight infants were managed with SE. 389 SE were administered, 96 and 293 in 750-999g and 1000-1500g birth weight groups, respectively. Nurses administered 72.9% and 81.5% of SE in 750-999g and 1000-1500g birth weight groups, respectively. Physicians performed the rest of the SE. Daily meconium output was comparable in nurse and physician-administered SE in both groups. There were no treatment failures or adverse events in both SE group. SE administered by nurses was found to be comparable in terms of safety, efficacy, and frequency of administration to that of physician-administered SE.

Introduction The increase in survival of extremely preterm infants has led to increased rates of bronchopulmonary dysplasia (BPD). Therefore, a potential role of human milk feeding in protecting against this condition has been suggested. Material and methods Retrospective descriptive study based on data about morbidity in the population of infants born from 22+0 to 26+6 weeks of gestation, included in the Spanish network SEN1500 during the period 2004-2019 and who were alive at discharge. The primary outcome was moderate-severe BPD. In addition, associated conditions were studied, including breastfeeding at discharge. The temporal trends of BPD and breastfeeding rates at discharge were also studied. Results In the study population of 4341 infants who survived to discharge, the rate of moderate-severe BPD was 43,7% and increased over the period to a rate >50% in the last three years. The factors significantly associated with a higher risk of moderate-severe BPD were male sex, high-frequency oscillatory ventilation, inhaled nitric oxide, patent ductus arteriosus, and late-onset sepsis. Exclusive human milk feeding at discharge and any amount of human milk at discharge were associated with a lower incidence of moderate-severe BPD (OR 0.752, 95% CI 0.629-0.901, and OR 0.714, 95% CI 0.602-0.847, respectively). The rates of human milk at discharge in infants with moderate-severe BPD increased over the period. In the last years, more than one-third of extremely preterm infants were discharged on exclusive human milk feeds, and about two-thirds of them on any amount of human milk feeding. Conclusions
The results of the present study strongly support the role of any amount of human milk in preventing BDP in extremely preterm infants.

(1) Background: This study aimed to evaluate whether the implementation of a modified blood sampling protocol, which focused on need-based laboratory testing and minimized venous sampling by replacing it with point-of-care testing (POCT) via capillary puncture, successfully reduced iatrogenic blood loss, incidence of anemia, and frequency of blood transfusion in extremely low birth weight infants (ELBWIs) without negatively affecting neonatal outcomes. (2) Methods: A retrospective analysis was conducted on 313 ELBWIs of gestational age (GA) between 23 and 28 weeks, born between 2013 and 2019. The infants were divided into two groups: before (period I) and after (period II) the implementation of the modified blood sampling protocol in January 2016. Propensity score matching was conducted to minimize selection bias. Clinical data, including the frequency and amount of blood sampling, frequency and volume of blood transfusion, and clinical characteristics, such as gestational age, birth weight, and neonatal outcome data, were collected and compared between the two groups. (3) Results: No significant differences in the GA or birth weight between the two periods were observed. The total sampling volume during a month after birth (16.7 ± 4.1 mL vs. 15.6 ± 4.4 mL, P=0.03) and total sampling volume during hospital days (51.4 ± 29.7 mL vs. 44.3 ± 27.5 mL, P=0.04) in period II were significantly lower than that in period I. There were no differences in the mortality or morbidity between the two periods. Although the transfusion frequency and amount did not have significant differences between the periods, we observed a positive correlation between the transfusion frequency and sampling volume (coefficient: 0.09, 95% CI: 0.08–0.11). (4) Conclusions: The modified blood sampling protocol effectively reduced the iatrogenic blood loss without negatively affecting the neonatal outcomes.

Background: Survival and outcome of extremely preterm (EP) infants have improved due to changes in the management of stabilization at birth and respiratory distress syndrome. Methods: In a retrospective study conducted at an academic perinatal level III center in Romania, we compared the effects of different protocols on the early outcomes of EP infants of two different periods (2008-2012 vs. 2018 vs. 2022). Two subgroups were studied in each period, based on gestational age (GA), 22-25 weeks, and 26-28 weeks, excluding those with significant congenital anomalies or missing data. Results: 270 EP infants were included in the study (121/149), with a mean GA 26.1±1.6/26.7±1.1 weeks. Significant improvements were found during period II regarding initial FiO2 (40% vs. 100%; <0.001), nCPAP (55.7% vs. 19.0%; p<0.001) at birth, early rescue surfactant administration (65.8% vs. 34.7%; p<0.001), need of mechanical ventilation (58.4% vs. 98.3%; p<0.001). Survival rates of EP infants significantly improved from 41.3% to 72.5%, particularly in the 26-28 weeks subgroup (63.8% to 83%). The frequency of severe IVH decreased in period II from 30.6% to 14.1%, while the rates of BPD were lower in period II (23.4% vs. 36.6%; p=0.045), in the 26-28 weeks subgroup. We found improvements but no significant differences in NEC, sepsis, PVL, ROP, or PDA frequencies. Conclusions: Using updated guidelines and protocols is crucial for improving outcomes.

Pinus squamata is one of the most threatened conifer endemic to northeastern Yunnan Province, China, and it is prioritized as one of the Plant Species with Extremely Small Populations (PSESP) for urgent protection in China. However, we lack a comprehensive consideration of the protection effect and the endangered mechanism, especially based on the underground growth status of endangered plants. The integrated study of soil properties and rhizosphere bacteria can assist conservation to understand therequired conditions for the protection and survival of rare and endangered species. In our study, bacterial communities in wild, ex-situ, and reintroduced P. squamata rhizosphere were compared using Illumina sequencing of the V3-V4 region of the 16S rRNA genes. We determined the soil physicochemical properties, analyzed the relationships between the bacterial communities and soil physicochemical factors, and predicted the potential bacterial ecological functions. The reintroduced site Qiaojia (RQ) had the highest richness and diversity. Samples were scattered (R = 0.93, P = 0.001), indicating significant difference between the different conservation sites. Soil total potassium (TK) and available nitrogen (AN) were the main factors driving bacterial community (0.01 < P ≤ 0.05). The low abundance of Plant growth-promoting rhizobacteria (PGPR) may be a biotic factor contributing to the endangerment of P. squamata. This study provides a foundation to assess the effect of conservation based on bacterial diversity and plant growth-promoting rhizobacteria (PGPR) to guide future research into the conservation of P. squamata.

Based on 541 Landsat images between 1988 and 2016, the normalized difference vegetation indices (NDVIs) of the wetland vegetation at Xitugou (XTG) and Wowachi (WWC) inside the Dunhuang Yangguan National Nature Reserve (YNNR) in northwest China were calculated for assessing impacts of climate change on wetland vegetation in the YNNR. It was found that the wetland vegetation at the XTG and WWC both had shown a significant increasing trend in the past 30 years, and the increase in both annual mean temperature and peak snow depth over the Altun Mountains led to the increase of wetland vegetation. The influence of local precipitation on the XTG wetland vegetation was greater than on the WWC wetland vegetation, which demonstrates that in extremely arid regions, the major constrain to the wetland vegetation is water availability in soils which is greatly related to the surface water detention and discharge of groundwater. At both XTG and WWC, snowmelt from the Altun Mountains is the main contributor to the groundwater discharge, while local precipitation plays a less role in influencing the wetland vegetation at the WWC than at the XTG, because the wetland vegetation grows on a relatively flat terrain at the WWC, while in a stream channel at the XTG.

The results shown in this paper extend our research group's previous work, which presents the theoretically achievable hydrogen engine-out NOx (H2-NOx) Pareto front of a hydrogen hybrid electric vehicle (H2-HEV). While the Pareto front is calculated offline, which requires significant computing power and time, this work presents an online-capable algorithm to tackle the energy management of a H2-HEV with explicit consideration of the H2-NOx trade-off. Through the inclusion of realistic predictive data on the upcoming driving mission, a model predictive control algorithm (MPC) is utilized to effectively tackle the conflicting goal of achieving low hydrogen consumption while simultaneously minimizing the NOx. In a case study it is shown that the MPC is able to satisfy user-defined NOx limits over the course of various driving missions. Moreover, a comparison to the optimal Pareto front highlights the MPC's ability to achieve close-to-optimal fuel-performance for any desired cumulated NOx target on four realistic routes for passenger cars.

In the steeply inclined and extremely thick coal seams (SIETCS) mined using the horizontal sublevel top-coal caving (HSTCC) method, the uncertainty of gas emission is a safety threat to the mining operations. In order to reduce the occurrence of accidents, the determination of gas emission is crucial. In this paper, we first proposed a prediction model for workers at the floor coalbed to calculate gas emission on site. We then put forward a finite element numerical simulation for researchers to predict gas emission from the floor coalbed. At last, we measured gas emitted from the floor coalbed of SIETCS in Wudong Coal Mine in a specific mining period and used the data to verify the applicability and accuracy of these two gas-emission prediction methods. The results showed that the gas emission from Wudong Coal Mine was 1.08 m³/min calculated based on the prediction model and 1.07 m³/min obtained using the user-defined integration method. Both methods have their own advantages, disadvantages and applicable objects, and are important in predicting gas emission from SIETCS mined using HSTCC method.

A significant challenge encountered in mmWave and Sub-terahertz systems used in 5G and 1 the upcoming 6G networks is the rapid fluctuation in signal quality across various beam directions. Extremely high-frequency waves are highly vulnerable to obstruction, making even slight adjustments in device orientation or the presence of blockers capable of causing substantial fluctuations in link quality along a designated path. This issue poses a major obstacle because numerous applications with low-latency requirements necessitate precise forecasting of network quality from many directions and cells. The method that is proposed in this research demonstrates an avant-garde approach for assessing the quality of multi-directional connections in mmWave systems by utilizing the Liquid Time Constant network (LTC) instead of the conventionally used Long Short-Term Memory (LSTM) technique. The method’s validity was tested through an optimistic simulation involving the monitoring of multi-cell connections at 28 GHz in a scenario where humans and various obstructions were moving arbitrarily. The results with LTC are significantly better than those obtained by conventional approaches such as LSTM. The latter resulted in a test Root Mean Squared Error (RMSE) of 3.44 dB, while the former, 0.25 dB, demonstrating a 13-fold improvement. For better interpretability and to illustrate the complexity of prediction, an approximate mathematical expression is also fitted to the simulated signal data using Symbolic Regression.

This paper is a mini literature review about electromagnetic field’s effects on cells, tissues and new treatment modalities. We have reviewed a papers which have been published in high quality journals in the last 5 years as two authors. This review’s aim is to be a resource for experimental studies about electricity’s effects on cell biology and pathophysiology. As a result of this literature review, we found that especially extremely low electric frequency and intermediate frequency fields have very important pathophysiological effects. We have mentioned four important expressions on this subject; electroporation, electrofusion, electrochemotherapy, gene electrotransference. Two different new treatment approaches have been developed by use of these two important electrical waves. First is tumor treating fields and the other is pulsed electric fields. Most studies in literature have been done with extremely low frequency and pulsed electric fields. In terms of diseases, most studies are about glioblastoma multiforme and malign melanoma.Most studies in literature have been done with extremely low frequency and pulsed electric fields. In terms of diseases, most studies are about glioblastoma and melanoma.

Background Although high-density lipoprotein has cardioprotective effects, the association between serum high-density lipoprotein cholesterol (HDL-C) and hypertension is poorly understood. Objective We investigated whether low and high concentrations of HDL-C are associated with hypertension using a large healthcare dataset. Methods In a community-based cross-sectional study of 1,493,152 Japanese people aged 40–74 years who underwent a health checkup, blood pressures and clinical parameters, including nine HDL-C concentrations (20–110 mg/dL or over) were investigated. Results A crude U-shaped relationship was observed between the nine HDL-C concentrations and blood pressure in males (n = 830,669), while a left-to-right inverted J-shaped relationship was observed in females(n = 662,483). An age-adjusted logistic regression analysis showed J-shaped relationships (left-to-right inversion in females) between HDL-C and odds ratios for hypertension (≥140/90 mmHg), with lower limits of 60–79 mg/dL in males and 90–99 mg/dL in females, which were unchanged after adjusting for smoking, habitual exercise, alcohol consumption, and pharmacotherapy for hypertension, dyslipidemia, and diabetes. However, further adjustment for body mass index and serum triglyceride concentration revealed latent positive linear associations between HDL-C and hypertension, although the association between extremely high HDL-C (≥100 mg/dL) and hypertension was attenuated in non-alcohol drinkers. Conclusion Both low and extremely high HDL-C concentrations are associated with hypertension. The former association may be dependent on excess fat mass, which is often concomitant with low HDL-C, whereas the latter association may be dependent on frequent alcohol consumption.