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Liping Feng,1,* Wencong He,2,* Zexuan Song,3,* Bing Zhao,3 Chong Teng,3 Eryong Liu,3 Hanfang Zhu,1 Shaojun Pei,4 Lina Liu,5 Yuanyuan Song,3 Yang Zheng,3 Xiangyi Liu,2 Yanlin Zhao,3 Xichao Ou3 1Department of Microbiology, Hinggan League Center for Disease Control and Prevention, Ulanhot, 137499, People’s Republic of China; 2Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, People’s Republic of China; 3National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for Tuberculosis Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, 102206, People’s Republic of China; 4School of Public Health, Peking University, Beijing, 100191, People’s Republic of China; 5Blood Transfusion Department, Hinggan League People’s Hospital, Ulanhot, 137400, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xichao Ou; Yanlin Zhao, Email ouxc@chinacdc.cn; zhaoyl@chinacdc.cnBackground: Tuberculosis remains a major public health concern in China, with varying prevalence and drug resistance profiles across regions. This study explores the genetic diversity and drug-resistant profiles of MTB strains in Hinggan League, a high TB burden in Inner Mongolia, China.Methods: This population-based retrospective study, encompassing all culture-positive TB cases from Jun. 2021 to Jun. 2023 in Hinggan League. Drug resistant profiles and genetic diversity of MTB strains were assessed using phenotypic drug susceptibility testing and whole-genome sequencing. Risk factors associated with drug resistance were analyzed using univariate and multivariate logistic regression models.Results: A total of 211 MTB strains were recovered successfully and included into final analysis. Lineage 2.2.1 (88.6%, 187/211) was the dominant sub-lineage, followed by lineage 4.5 (7.1%, 15/211) and lineage 4.4 (4.3%, 9/211). MTB strains exhibited the highest resistance rates to isoniazid (16.1%, 34/211), followed by rifampicin (10.0, 21/211). In addition, the MTB strains also showed relatively high rates of resistance against new and repurposed anti-TB drugs, with resistant rates of 2.4% (5/211) to delamanid and 1.9% (4/211) to bedaquiline. Overall, 25.6% (54/211) of MTB strains were DR-TB, and 14 MTB strains met the definition of MDR-TB, including 7 strains of simple-MDR-TB, 5 of pre-XDR-TB, and 2 of XDR-TB. Genetic analysis revealed that the dominant mutations of isoniazid-, rifampin-, ethambutol-, levofloxacin-/moxifloxacin-, and ethionamide- resistance were katG_Ser315Thr(46.4%), rpoB_Ser450Leu (47.4%), embB_Met306Val (25.0%), gyrA_Asp94Ala (40.0%), and fabG1_c15t (42.9%), respectively. Previously treated patients (AOR = 2.015, 95% CI: 1.052– 4.210) and male patients (AOR = 3.858, 95% CI: 1.416– 10.511) were identified as independent risk factors associated with DR-TB.Conclusion: Our study offers crucial insights into the genetic diversity and drug-resistant profiles of TB strains circulating in Hinggan League. These findings are valuable for DR-TB surveillance and for guiding treatment regimens and public health interventions in the region.Keywords: Mycobacterium tuberculosis, drug resistance, genetic diversity, whole-genome sequencing

Sangsang Xiong,1,* Mingqi Tu,1,* Xiaoting Wu,1 Siying Qu,1 Nisang Chen,1 Junyan Jin,1 Haiqin Rong,1 Shuangyi Pei,2 Jianqiao Fang,1 Xiaomei Shao1 1Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China; 2The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaomei Shao; Jianqiao Fang, Zhejiang Chinese Medical University, No. 548, Binwen Road, Binjiang District, Hangzhou City, Zhejiang Province, People’s Republic of China, Tel +86 189 5713 0287, Email shaoxiaomei@zcmu.edu.cn; fangjianqiao7532@163.comBackground: Major depressive disorder (MDD) is highly prevalent, affecting more than 300 million individuals worldwide, and its occurrence may be related to the abnormality of the prefrontal cortex and bilateral temporal cortex. Acupuncture, rooted in the theories of acupoints and meridians, has demonstrated its efficacy in regulating cortical blood flow (CBF) in the brains of MDD patients. As one form of acupuncture, intradermal acupuncture (IA) can alleviate clinical symptoms such as depressive mood and insomnia in MDD patients. However, it remains unknown whether IA will have a specific effect on the prefrontal cortex and bilateral temporal cortex in MDD patients.Methods: In total, 60 participants will be recruited: 20 healthy control participants and 40 MDD patients. All healthy control participants will be allocated to the control group, whereas the 40 MDD patients will be randomly divided into two groups: the gallbladder meridian acupoint (GBA) group and the non-acupoint (NA) group, at a 1:1 allocation ratio. All groups will undergo a one-time IA intervention while their cortical activity is monitored using functional near-infrared spectroscopy (fNIRS). Total hemoglobin, oxygenated hemoglobin, and deoxygenated hemoglobin of the prefrontal and bilateral temporal cortices will be measured by fNIRS during the test procedure.Discussion: This trial aims to use fNIRS to compare real-time hemodynamic changes in the prefrontal and bilateral temporal cortices of healthy individuals and MDD patients during IA. The primary objective is to investigate whether MDD patients exhibit specific real-time responses to IA stimulation in these brain regions. The findings from this study will provide clinical data and a possible theoretical basis for the assumption that stimulation of IA may treat MDD by modulating the relevant brain regions.Trial Registration: The study protocol has been registered in the clinicaltrials.gov with the code NCT05707299.Keywords: major depressive disorder, intradermal acupuncture, functional near-infrared spectroscopy, prefrontal cortex, temporal cortex

Ruifeng Bai,1 Jianqiu Pei,1 Shengqiang Pei,1 Xiangfeng Cong,1 Jerold Chun,2 Fang Wang,1,3,4 Xi Chen1,3 1State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 2Neuroscience Drug Discovery, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA; 3Diagnostic Laboratory Service, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 4Department of Clinical Laboratory, Fuwai Yunnan Cardiovascular Hospital, Kunming, People’s Republic of ChinaCorrespondence: Xi Chen; Fang Wang, Email chenxifw@pumc.edu.cn; fray.163@163.comBackground: Increased endothelial permeability of pulmonary vessels is a primary pathological characteristic of septic acute lung injury (ALI). Previously, elevated lysophosphatidic acid (LPA) levels and LPA2 (an LPA receptor) expression have been found in the peripheral blood and lungs of septic mice, respectively. However, the specific role of LPA2 in septic ALI remains unclear.Methods: A lipopolysaccharide (LPS)-induced model of sepsis was established in wild-type (WT) and global LPA2 knockout (Lpar2−/−) mice. We examined mortality, lung injury, assessed endothelial permeability through Evans blue dye (EBD) assay in vivo, and transendothelial electrical resistance (TEER) of mouse lung microvascular endothelial cells (MLMECs) in vitro. Enzyme-linked immunosorbent assay (ELISA), histopathological, immunofluorescence, immunohistochemistry, and Western blot were employed to investigate the role of LPA2 in septic ALI.Results: Lpar2 deficiency increased vascular endothelial permeability, impaired lung injury, and increased mortality. Histological examination revealed aggravated inflammation, edema, hemorrhage and alveolar septal thickening in the lungs of septic Lpar2−/− mice. In vitro, loss of Lpar2 resulted in increased permeability of MLMECs. Pharmacological activation of LPA2 by the agonist DBIBB led to significantly reduced inflammation, edema and hemorrhage, as well as increased expression of the vascular endothelial tight junction (TJ) protein zonula occludens-1 (ZO-1) and claudin-5, as well as the adheren junction (AJ) protein VE-cadherin. Moreover, DBIBB treatment was found to alleviate mortality by protecting against vascular endothelial permeability. Mechanistically, we demonstrated that vascular endothelial permeability was alleviated through LPA-LPA2 signaling via the PLC-PKC-FAK pathway.Conclusion: These data provide a novel mechanism of endothelial barrier protection via PLC-PKC-FAK pathway and suggest that LPA2 may contribute to the therapeutic effects of septic ALI.Keywords: septic ALI, LPA, vascular endothelial permeability, LPA2, lung microvascular endothelial cells

Nisang Chen,1,* Xiaoting Wu,1,* Mingqi Tu,1 Sangsang Xiong,1 Junyan Jin,1 Siying Qu,1 Shuangyi Pei,1,2 Jianqiao Fang,1,2 Xiaomei Shao1,2 1Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China; 2Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaomei Shao; Jianqiao Fang, Zhejiang Chinese Medical University, No. 548, Binwen Road, Binjiang District, Hangzhou City, Zhejiang Province, People’s Republic of China, Email 13185097375@163.com; shaoxiaomei@zcmu.edu.cn; fangjianqiao7532@163.comBackground: Major depressive disorder (MDD) exhibits a pronounced occurrence among adolescents, aligning closely with the lifetime prevalence rate of 16.6% observed in adults. It is difficult to treat and prone to recurrence. Acupuncture has shown potential in enhancing treatment effectiveness. Nonetheless, there is a lack of research on the use of intradermal acupuncture (IA) in treating adolescent MDD.Methods: This study is a double-blind, randomized controlled trial. A cohort of 120 participants will be assigned randomly to three distinct groups, namely a Selective Serotonin Reuptake Inhibitors (SSRIs)-only group, a sham intradermal acupuncture combined with SSRIs (SIA) group, and an active intradermal acupuncture combined with SSRIs (AIA) group. Hamilton Depression Rating Scale will serve as the primary outcome, while Patient Health Questionnaire-9, Self-Rating Depression Scale, Pittsburgh Sleep Quality Index, and Short Form 36 Questionnaire will serve as secondary outcomes in assessing the amelioration of depressive symptoms in patients. These data will be analyzed using SPSS26.0 software.Results: We will assess the efficacy and safety of IA for MDD using commonly employed clinical psychiatric scales.Conclusion: The efficacy of IA in treating adolescent MDD may be demonstrated in this study, suggesting its potential for optimizing MDD treatment schemes.Trial Registration: ClinicalTrials.gov Identifier: NCT 05832619 (April 27, 2023).Keywords: major depressive disorder, intradermal acupuncture, selective serotonin reuptake inhibitors, adolescent, randomized controlled trial, protocol

Yuanxiao Li,1,* Ying Tian,2,* Shufen Pei,3 Baoyuan Xie,2 Xiaonan Xu,1 Bin Wang4 1Department of Pediatric Gastroenterology, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China; 2Department of Clinical Medicine, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China; 3Department of Clinical Medicine, North Sichuan Medical College, Nanchong, People’s Republic of China; 4Department of Infectious Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bin Wang, 88 Jie Fang Lu, Shangcheng District, Hangzhou, Zhejiang, 310009, People’s Republic of China, Email wangbin2022@zju.edu.cnObjective: The purpose of this study was to characterize real-world studies (RWSs) registered at ClinicalTrials.gov to help investigators better conduct relevant research in clinical practice.Methods: A retrospective analysis of 944 studies was performed on February 28, 2023.Results: A total of 944 studies were included. The included studies involved a total of 48 countries. China was the leading country in terms of the total number of registered studies (37.9%, 358), followed by the United States (19.7%, 186). Regarding intervention type, 42.4% (400) of the studies involved drugs, and only 9.1% (86) of the studies involved devices. Only 8.5% (80) of the studies mentioned both the detailed study design type and data source in the “Brief Summary”. A total of 49.4% (466) of studies had a sample size of 500 participants and above. Overall, 63% (595) of the studies were single-center studies. A total of 213 conditions were covered in the included studies. One-third of the studies (32.7%, 309) involved neoplasms (or tumors). China and the United States were very different regarding the study of different conditions.Conclusion: Although the pandemic has provided new opportunities for RWSs, the rigor of scientific research still needs to be emphasized. Special attention needs to be given to the correct and comprehensive description of the study design in the Brief Summary of registered studies, thereby promoting communication and understanding. In addition, deficiencies in ClinicalTrials.gov registration data remain prominent.Keywords: real-world data, real-world evidence, real-world study, study design, ClinicalTrials.gov

Jin Zhao,1,* Zhong Guo,1,* Qiang Wang,2 Tianbin Si,3 Shuyan Pei,1 Hongmei Qu,1 Lina Shang,1 Yuqing Yang,1 Lili Wang11Department of Medical Function, Medical College of Northwest Minzu University, Lanzhou 730030, People’s Republic of China; 2Department of Pathology, No. 1 Hospital of Longnan City, Longnan 746000, People’s Republic of China; 3Department of Gynecology and Oncology, Gansu Provincial Cancer Hospital, Lanzhou 730050, People’s Republic of China*These authors contributed equally to this workObjectives: This study was to assess whether human papillomavirus (HPV) resulting in genetic instability is one reason for the high incidence and mortality of cervical cancer in Longnan.Methods: Between 2012 and 2016, a total of 346 samples from Longnan were collected and divided into four groups: cervicitis group (n=57), cervical intraepithelial neoplasia I group (CIN I, n=63), CIN II/III group (n=79) and invasive squamous cell carcinoma group (SCC, n=147). HPV E6/E7 mRNA was detected by Quantivirus® HPV E6/E7 RNA 3.0 assay (bDNA). The markers of DNA damage response (DDR) – ataxia telangiectasia mutated (ATM) pSer1981, H2AX pSer139 (γH2AX), Chk2 pThr68 and P53 – were analyzed by immunohistochemistry.Results: The activation of ATM, γH2AX, Chk2 and P53 was increased with increasing severity of cervical lesion. A significant difference of ATM expression in simple infection was also shown accompanied by the cervical lesion. The expression of γH2AX between HPV16+ and HPV16- specimens, γH2AX and P53 between HPV58+ and HPV58- groups had statistical significance. The expression and copy number of HPV E6/7 mRNA increases with the cervical lesion severity. A significant difference was shown for P53 expression between HPV E6/7 mRNA+ and mRNA- specimens. A close correlation with CHK2 expression for HPV E6/7 mRNA+ and HPV16 E6/7 mRNA+ specimens and γH2AX and CHK2 expression for SCC specimens was shown between low and high viral load groups.Conclusions: DDR, HPV genotypes and HPV E6/E7 oncogene expression correlated with the level of dysplasia of cervical lesions. HPV infection resulted in genetic instability may be one reason for the high incidence and mortality in Longnan.Keywords: human papillomaviruses, E6/E7 oncogenes, DNA damage response, cervical cancer

Summary: Microendoscopic calcium imaging with one-photon miniature microscopes enables unprecedented readout of neural circuit dynamics during active behavior in rodents. In this study, we describe successful application of this technology in the rhesus macaque, demonstrating plug-and-play, head-mounted recordings of cellular-resolution calcium dynamics from large populations of neurons simultaneously in bilateral dorsal premotor cortices during performance of a naturalistic motor reach task. Imaging is stable over several months, allowing us to longitudinally track individual neurons and monitor their relationship to motor behavior over time. We observe neuronal calcium dynamics selective for reach direction, which we could use to decode the animal’s trial-by-trial motor behavior. This work establishes head-mounted microendoscopic calcium imaging in macaques as a powerful approach for studying the neural circuit mechanisms underlying complex and clinically relevant behaviors, and it promises to greatly advance our understanding of human brain function, as well as its dysfunction in neurological disease.

Shenglin Pei,1,* Chengmao Zhou,2,* Yu Zhu,2 Bing Huang 1 1Department of Anesthesiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 2Zhaoqing Medical College, Zhaoqing, People’s Republic of China *These authors contributed equally to this work Aim: This review was performed to investigate the effect of ondansetron on the prevention of propofol injection pain. Methods: PubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched for randomized controlled trials (RCTs) of ondansetron in preventing the pain on injection of propofol. Then, RevMan 5.2 was adopted to conduct a meta-analysis on propofol injection pain. Results: Ten RCTs, totaling 782 patients, were included in this analysis. The meta-analysis showed that: 1) compared with the control group, the ondansetron group was related to a decreasing incidence of propofol injection pain, and it was statistically significant (risk ratio [RR] = 0.41, 95% confidence interval [CI, 0.34, 0.49], P < 0.00001); 2) compared with the incidence of propofol injection pain in the lidocaine group, there was no difference and no statistical significance (RR = 1.28, 95% CI [0.85, 1.93], P = 0.25); 3) no statistically significant differences were found between the ondansetron and magnesium sulfate groups in the incidence of propofol injection pain (RR = 1.20, 95% CI [0.87, 1.66], P = 0.27); and 4) the incidence of ondansetron group igniting moderate pain (RR = 0.37, 95% CI [0.26, 0.52], P < 0.00001) and severe pain (RR = 0.27, 95% CI [0.17, 0.43] P < 0.00001) was less likely to occur during the injection of propofol compared with the control group, but there was no difference between the ondansetron and control groups in the incidence of mild propofol injection pain (RR = 0.83, 95% CI [0.63, 1.10], P = 0.20). Conclusion: Ondansetron can effectively prevent propofol injection pain, and the effect is similar to that of magnesium sulfate and lidocaine. Keywords: ondansetron, propofol injection pain, meta-analysis

Microendoscopic calcium imaging with one-photon miniature microscopes enables unprecedented readout of neural circuit dynamics during active behavior in rodents. In this study, we describe successful application of this technology in the rhesus macaque, demonstrating plug-and-play, head-mounted recordings of cellular-resolution calcium dynamics from large populations of neurons simultaneously in bilateral dorsal premotor cortices during performance of a naturalistic motor reach task. Imaging is stable over several months, allowing us to longitudinally track individual neurons and monitor their relationship to motor behavior over time. We observe neuronal calcium dynamics selective for reach direction, which we could use to decode the animal's trial-by-trial motor behavior. This work establishes head-mounted microendoscopic calcium imaging in macaques as a powerful approach for studying the neural circuit mechanisms underlying complex and clinically relevant behaviors, and it promises to greatly advance our understanding of human brain function, as well as its dysfunction in neurological disease.

Parkinson disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms and signs. Many reports suggest that diminished heart rate variability occurs early, even prior to the cardinal signs of PD. In a longitudinal study of PD, we evaluated whether heart rate variability (HRV) obtained using a 10-second ECG tracing, and the electrocardiographic QT-interval would be associated with PD severity and progression. Subjects were derived from a longitudinal study of 1741 individuals with early, stable PD. The severity of PD was measured using the global statistical test (GST). In a subset, the heart rate corrected QT-interval (QTcB) was calculated for each electrocardiogram (ECG). The HRV was measured for each ECG and then transformed to fit a normal distribution. The baseline analysis included 653 subjects, with 256 completing the 5-year follow up study. There was an association (P

The structural parameter, elastic anisotropy, and thermal properties of cubic MgIn2S4 under pressures is examined using first principles techniques. The determined lattice constant exhibits a high level of concurrence with the values reported in existing literature. Based on the mechanical characteristics, there is an observed enhancement in both ductility and anisotropy of MgIn2S4 under increased pressure. The investigation focuses on the thermal characteristics, encompassing the impact of temperature and pressure on key parameters such as Debye temperature, Grüneisen constant et al. [ABSTRACT FROM AUTHOR]

Recently, there has been a suggestion that Cu2BaSnS4 could be a promising candidate for a photovoltaic absorber with a wide band gap. The study primarily examined the structural, along with the mechanical and thermodynamic characteristics of Cu2BaSnS4. In addition, a study was performed to examine the presentation and representation of three-dimensional (3D) characteristics related to linear compressibility, shear modulus, and Young's modulus. The investigation into thermodynamic characteristics was calculated and analyzed. [ABSTRACT FROM AUTHOR]

In Zombie Vortex Instability (ZVI), perturbations excite critical layers in stratified, rotating shear flow (as in protoplanetary disks (PPDs)), causing them to generate vortex layers, which roll up into anticyclonic zombie vortices and cyclonic vortex sheets. The process is self-sustaining as zombie vortices perturb new critical layers, spawning a next generation of zombie vortices. Here, we focus on two issues: the minimum threshold of perturbations that trigger self-sustaining vortex generation, and the properties of the late-time zombie turbulence on large and small scales. The critical parameter that determines whether ZVI is triggered is the magnitude of the vorticity on the small scales (and not velocity); the minimum Rossby number needed for instability is Rocrit ∼ 0.2 for β ≡ N/Ω = 2, where N is the Brunt-Väisälä frequency. While the threshold is set by vorticity, it is useful to infer a criterion on the Mach number; for Kolmogorov noise, the critical Mach number scales with Reynolds number: Macrit ∼ RocritRe-1/2. In PPDs, this is Macrit∼ 10-6. On large scales, zombie turbulence is characterized by anticyclones and cyclonic sheets with typical Rossby number ∼0.3. The spacing of the cyclonic sheets and anticyclones appears to have a "memory" of the spacing of the critical layers. On small scales, zombie turbulence has no memory of the initial conditions and has a Kolmogorov-like energy spectrum. While our earlier work was in the limit of uniform stratification, we have demonstrated that ZVI works for non-uniform Brunt-Väisälä frequency profiles that may be found in PPDs.

Despite the implementation of various initiatives, dengue remains a significant public health concern in Malaysia. Given that dengue has no specific treatment, dengue prediction remains a useful early warning mechanism for timely and effective deployment of public health preventative measures. This study aims to develop a comprehensive approach for forecasting dengue cases in Selangor, Malaysia by incorporating climate variables. An ensemble of Multiple Linear Regression (MLR) model, Long Short-Term Memory (LSTM), and Susceptible-Infected mosquito vectors, Susceptible-Infected-Recovered human hosts (SI-SIR) model were used to establish a relation between climate variables (temperature, humidity, precipitation) and mosquito biting rate. Dengue incidence subject to climate variability can then be projected by SI-SIR model using the forecasted mosquito biting rate. The proposed approach outperformed three alternative approaches and expanded the temporal horizon of dengue prediction for Selangor with the ability to forecast approximately 60 weeks ahead with a Mean Absolute Percentage Error (MAPE) of 13.97 for the chosen prediction window before the implementation of the Movement Control Order (MCO) in Malaysia. Extended validation across subsequent periods also indicates relatively satisfactory forecasting performance (with MAPE ranging from 13.12 to 17.09). This research contributed to the field by introducing a novel framework for the prediction of dengue cases over an extended temporal range.

Introduction: The rising rate of adolescent suicide, and the burden of self-harm and mental health disorders, pose significant threats to Singapore’s future health outcomes and human potential. This study sought to examine the risk profile and healthcare utilisation patterns of Singaporean adolescents who presented to the emergency department (ED) for suicidal or self-harm behaviour. Method: A retrospective review of medical records for patients aged 10 to 19 years who visited Singapore’s KK Women’s and Children’s Hospital ED for suicidal or self-harm attempts from January to December 2021 was conducted. Results: A total of 221 patients were identified, with a predominance of female patients (85.5%) over males (14.5%). The mean age was 14.2 ± 1.4 years. Intentional drug overdose (52.0%) was the most commonly used method. Significantly more females presented for intentional paracetamol overdose (46.6% versus [vs] 28.1%, P=0.049), whereas jumping from a height was more common among males (18.8% vs 5.8%, P=0.022). The most frequently observed mental health challenges were stress-related and emotional coping difficulties (50.7%), followed by mood and anxiety symptoms (53.4%). A history of self-harm and suicidal behaviours were the most common psychosocial risk factors. Within the year prior to their ED presentation, 15.4% had accessed healthcare services for mild medical ailments, 19.5% for medically unexplained symptoms, and 17.2% for previous self-harm or suicide attempts. Conclusion: Most cases involved psychosocial and emotional regulation difficulties, some of which displayed sex-specific patterns, rather than complex psychiatric disorders. The identified predictive factors can help inform Singapore’s National Mental Health and Well-being Strategy, to guide targeted and transdiagnostic interventions in schools and community settings.

The application of silicon carbide (SiC) MOSFETs in the field of high voltage and high frequency brings the major challenge of high switching loss. To give full advantage of its performance in high-frequency applications and provide a simulation analysis method for the analysis and design of power electronic systems, it is essential to establish simulation models of the SiC power MOSFET switching behavior suitable for different ambient temperatures. A temperature-dependent compact SPICE model considering parasitic parameters is proposed in this article, which uses only the parameters in the datasheet or provided by manufacturers. The main technology-dependent parameters are analyzed and discussed in detail, including the nonlinear parasitic capacitance, parasitic parameters of the power module, and static characteristic parameters. In static characteristics, a simple and continuous equation is used to describe the drain-source current of the SiC power MOSFET. The static characteristic parameters of the SPICE model were compared with the 1.2-kV SiC power MOSFET, manufactured by ROHM, Inc., (SCT3030KLHR). Subsequently, the dynamic characteristic is verified by comparing the simulation results with experimental results in a double pulse circuit employing the half-bridge module under different temperatures. Comparisons between the datasheet and experiments demonstrate the precision of the modeling methodology and the consistency of the results.

Many different malignancies occur in children, but overall, cancer in childhood is rare. Survival rates have improved appreciably and are higher compared with most adult tumour types. Treatment schedules evolve as a result of clinical trials and are typically complex and multi-modality, with radiotherapy an integral component of many. Risk stratification in paediatric oncology is increasingly refined, resulting in a more personalized use of radiation. Every available modality of radiation delivery: simple and advanced photon techniques, proton beam therapy, molecular radiotherapy, and brachytherapy, have their place in the treatment of children's cancers. Radiotherapy is rarely the sole treatment. As local therapy, it is often given before or after surgery, so the involvement of the surgeon is critically important, particularly when brachytherapy is used. Systemic treatment is the standard of care for most paediatric tumour types, concomitant administration of chemotherapy is typical, and immunotherapy has an increasing role. Delivery of radiotherapy is not done by clinical or radiation oncologists alone; play specialists and anaesthetists are required, together with mould room staff, to ensure compliance and immobilization. The support of clinical radiologists is needed to ensure the correct interpretation of imaging for target volume delineation. Physicists and dosimetrists ensure the optimal dose distribution, minimizing exposure of organs at risk. Paediatric oncology doctors, nurses, and a range of allied health professionals are needed for the holistic wrap-around care of the child and family. Radiographers are essential at every step of the way. With increasing complexity comes a need for greater centralization of services. [ABSTRACT FROM AUTHOR]