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Objective: To investigate the pathogenesis of Primary Angle-Closure Glaucoma (PACG) and its relationship with the anatomical structure of the anterior segment by obtaining biometric parameters using the IOL-Master 700. Methods: A retrospective case-control study was conducted. Clinical data from 39 PACG patients and 40 normal controls treated at the Aier Eye Hospital affiliated with Wuhan University from January to December 2022 were collected. Anterior chamber depth (AC), white-to-white (WTW), lens thickness (LT), central corneal thickness (CCT), axial length (AL), corneal curvature (K1), corneal curvature (K2), and lens position (LP) were measured using the IOL-Master 700 to analyze the characteristics and differences in the anterior segment structure of both groups. Statistical methods included independent sample t-tests and logistic regression analysis. Results: Significant differences were found in the anterior segment biometric parameters between PACG patients and normal controls (p < 0.05). Anterior chamber depth, white-to-white, lens thickness, central corneal thickness, axial length, and K2 were all related to the occurrence of PACG (p < 0.05). The occurrence of PACG was negatively correlated with ACD, CCT, and AL (OR = 0.12-0.64, p < 0.05), and positively correlated with LT. Conclusion: Compared to the normal control group, PACG patients in the Hubei region have a smaller anterior segment space, narrower angles, thicker lens, thinner cornea, shorter axial length, flatter cornea, and more anteriorly positioned lens.

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Background: This study aims to compare the refractive outcomes of cataract surgery using two different biometry devices, the IOL Master 500 and IOL Master 700, and to investigate the influence of patient-related factors on these outcomes. Methods: In this retrospective study, we analyzed data from 2994 eyes that underwent cataract surgery. Multiple linear regression analyses were performed to examine the impact of the biometry device (IOL Master 500 or IOL Master 700), patient age, time elapsed between biometry and surgery, gender, and insurance status, as well as biometric parameters (anterior chamber depth, axial length, and corneal curvature), on postoperative refractive outcomes, specifically the deviation from target refraction. Results: The choice of the IOL Master device did not result in a statistically significant difference between the two devices (p = 0.205). Age (p = 0.006) and gender (p = 0.001) were identified as significant predictors of refractive outcomes, with older patients and males experiencing slightly more hyperopic outcomes compared to younger patients and females, respectively. The time elapsed between biometry and surgery and insurance status did not significantly influence the refractive outcomes. Conclusions: Our study, supported by a large cohort and a diverse group of patients representing typical anatomical variants seen in cataract surgery, supports the thesis that the IOL Master 500 and IOL Master 700 can be regarded as equivalent and effective for biometry in cataract surgery. The differences between the devices were negligible. Therefore, switching between the devices is safe for bilateral patients.

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PURPOSE: This study aimed to compare the differences between the Zeiss IOL Master and Oculus Pentacam in keratometry and central anterior chamber depth (ACD) measurements in patients with high myopia and cataracts. METHODS: Between January 2019 and December 2020, 89 patients (103 eyes) with cataracts and high myopia who underwent preoperative cataract evaluation at Nanchang First Hospital were selected for retrospective analysis. Keratometry (K1, K2) and ACD were measured with the IOL Master and Pentacam. Paired t-tests were performed to compare the differences, while the Bland-Altman method was used to evaluate the agreement. RESULTS: The K1 value was (43.15±2.44) D for the IOL Master and (42.98±2.47) D for the Pentacam, and the difference between the two instruments was statistically significant (P<0.01). The K2 value was (44.55±2.63) D for the IOL Master and (44.32±2.55) D for the Pentacam. The ACD was (3.44±0.33)mm for the IOL Master and (3.39±0.36)mm for the Pentacam. There were statistically significant differences between the two instruments in both keratometry and ACD (P<0.01). The absolute values of the maximum difference between the two instruments for K1 and K2 were 1.1 and 1.07; thus, the consistency of the two instruments with respect to this measurement was poor. However, the absolute value of the maximum difference between the two instruments for ACD was 0.34, so the consistency of the two instruments in relation to this measurement was good. CONCLUSIONS: Both the IOL Master and the Pentacam can be used in the measurement of keratometry and ACD in patients with high myopia and cataracts, but the keratometry measurements should be compared in clinical application.

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Аims: This research aimed to study the features of gene regulation of the inflammatory response in cells carrying mitochondrial mutations associated with atherosclerosis. BACKGROUND: Inflammation plays an important, if not decisive, role in the occurrence of atherosclerotic lesions and then accompanies it throughout its further development. Thus, atherogenesis is a chronic inflammatory process. Chronification of inflammation is a consequence of disruption of the normal inflammatory response at the cell level of the vascular wall. OBJECTIVES: In this study, we used cytoplasmic hybrids or cybrids carrying atherosclerosis-associated mitochondrial mutations to study gene regulation of inflammatory response. The main goal of the study was to identify the key genes responsible for the impaired inflammatory response revealed for some cybrids. METHODS: Inflammatory stimulation of cybrids was induced with bacterial lipopolysaccharide, and assessed through secretion of pro-inflammatory cytokines CCL2, IL8, IL6, IL1b. A transcriptome analysis was performed to identify the key genes (master regulators) in the normal (tolerant) and intolerant response of cybrid cells. RESULTS: Normal inflammatory response after re-stimulation elicited a much smaller secretion of pro-inflammatory cytokines. In an intolerant response, the level of secretion upon re-stimulation was the same or even higher than after the first stimulation. Normal and intolerant responses differed significantly both in terms of the number of signaling pathways involved and qualitatively, since the signaling pathways for normal and intolerant responses are completely different. Master regulators controlling normal and intolerant inflammatory response were identified. For a normal response to the first inflammatory stimulation, no common master up-regulators and 3 master down-regulators were identified. The reverse situation was observed with the intolerant inflammatory response: 6 master up-regulators, and no master down regulators were identified. After the second inflammatory stimulation, no master regulator common to all studied cytokines was found. Thus, key genes involved in the development of intolerant inflammatory response have been identified. In addition, other key genes were identified that were initially associated with an intolerant inflammatory response and thus determine disorders of the inflammatory reaction leading to chronification of inflammation. CONCLUSION: We identified disturbances in gene associated with the development of intolerant immune response that may be relevant to atherosclerosis. Key genes responsible for the chronification of inflammation were discovered.

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Distributed control is an effective method to coordinate the microgrid with various components, and also in a smart microgrid, communication graph layouts are essential since changing the topology unexpectedly could disrupt the operation of the distributed controllers, and also an imbalance may occur between the production and load. Hence, reducing the exchanged data between units and system operator is essential in order to reduce the transmitted data volume and computational burden. For this purpose, an islanded microgrid with multiple agents which is using cloud-fog computing is proposed here, in order to reduce the computing burden on the central control unit as well as reducing data exchange among units. To balance the production power and loads in a smart island with a stable voltage/frequency, a hybrid backstepping sliding mode controller (BSMC) with disturbance observer (DO) is suggested to control voltage/frequency and current in the MG-based master-slave organization. Therefore, this paper proposes a DO-driven BSMC for controlling voltage/frequency, and power of energy sources within a Master-Slave organization; in addition, the study proposes a clod-fog computing for enhancing performance, reducing transferred data volume, and processing information on time. In the extensive simulations, the suggested controller shows a reduction in steady-state error, a fast response, and a lower total harmonic distortion (THD) for nonlinear and linear loads less than 0.33 %. The fog layer serves as a local processing level, so it reduces the exchanged data between cloud and fog nodes.

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Cataract surgery is one of the most successful surgical procedures, mainly due to the recent developments in surgical instruments and intraocular lens (IOL) measurements. Understanding the nature of axial length (AL) and keratometry readings (K) in patients with cataracts has significant implications for accurate postoperative IOL size selection. This study aimed to measure AL and K in patients undergoing cataract surgery in Saudi Arabia. This retrospective study included patients who underwent cataract surgery in Madinah, Saudi Arabia. The medical records of adult patients between May 2022 and May 2023 were reviewed, and those with a history of retinal detachment, refractive surgery, or trauma were excluded. The AL and K readings were obtained from the patient's IOL master results. A total of 691 eyes from 451 patients were included in the analysis. The mean age was 64.54 years old. Most of the patients were women (55%). The mean AL, K1, and K2 values were 23.27, 43.42, and 44.69, respectively. Linear regression analysis was used to measure the relationship between AL and K, revealing an inverse relationship in our findings. As AL increased by one unit, the mean K was estimated to decrease by 0.548, with a 95% confidence interval. Our results demonstrated an inverse relationship between AL and K, implying that when AL increases, K decreases, or the corneal curvature becomes flat. Further studies are needed to investigate the biomechanical mechanisms underlying this relationship.

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The mandibular first premolar, which is the anteriormost tooth in the mandibular arch, differs from other teeth in that it typically has two roots and two to four canals. The current case involves treating a mandibular first premolar with two canals through endodontic therapy. The 42-year-old male patient's left mandibular first premolar was diagnosed with irreversible pulpitis. The lateral view X-ray depicted two canals. In the dental procedure, endodontic treatment involves working under an operating microscope and using magnification to treat the affected tooth. After canal shaping the tooth was treated with the crown after it had been cleaned and then adjusted for the bite. As aforementioned, no signs of periapical disease were observed when the tooth was rediscovered a year later. However, this case study indicates that any shift in the anatomy of the canal in premolars should be well monitored and controlled to improve endodontic treatment outcomes of such teeth as the mandibular first premolars.

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BACKGROUND: During a robot-assisted minimally invasive surgery, hand tremors in a surgeon's manipulation of the master manipulator can cause vibrations of the slave surgical instruments. METHODS: This letter addresses this problem by proposing an improved Enhanced Band-Limited Multiple Linear Fourier Combiner (E-BMFLC) algorithm for filtering the physiological tremor signals of a surgeon's hand. The proposed method uses the amplitude of the input signal to adapt the learning rate and a dense division of the combiner bands for the higher amplitude bands of the tremor signals. RESULTS: By using the proposed improved E-BMFLC algorithm, the compensation accuracy can be improved by 4.5%-8.9%, as well as a spatial position error of less than 1 mm. CONCLUSION: The results show that among all filtering methods, the improved E-BMFLC filtering method has the highest number of successful experiments and the lowest experimental time.

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BACKGROUND: Master-slave remote control technology allows patients to be treated promptly during transport and also reduces the risk of contagious infections. Endotracheal intubation, guided by endoscopy and a master-slave system, enables doctors to perform the procedure efficiently and accurately. METHODS: In this paper, we present the development of a master-slave controlled endotracheal intubation robot (EIR). It is based on operation incremental mapping, a weighted recursive average filtering method to reduce vibration, and a virtual fixture designed to reduce mishandling in minimally invasive surgery. RESULTS: Simulation analysis of the master-slave control demonstrates that the weighted recursive average filtering method effectively reduces vibration, while the virtual fixture assists in confining the operator's movement within a delimited area. Experimental validation confirms the validity of the robot's structural design and control method. CONCLUSIONS: The developed robot successfully achieves the necessary motion for endotracheal intubation surgery through master-slave control.

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BACKGROUND: Well-trained public health professionals are key to addressing both global and local public health challenges of the twenty-first century. Though availability of programs has increased, the population health science (PHS) and public health (PH) higher education landscape in Germany remains scattered. To date, no comprehensive overview of programs exists. OBJECTIVES: This study aimed to map PHS and PH master's and structured doctoral programs in Germany, including selected program characteristics, curricula and target competencies. METHODS: We conducted a systematic mapping of PHS and PH programs in Germany following a prospectively registered protocol ( https://doi.org/10.17605/OSF.IO/KTCBA ). Relevant master's and doctoral programs were identified by two study authors independently searching a comprehensive higher education database, which was, for doctoral programs, supplemented with a google search. For PHS programs, general characteristics were mapped and for the subset of PH programs, in-depth characteristics were extracted. RESULTS: Overall, 75 master's and 18 structured doctoral PHS programs were included. Of these, 23 master's and 8 doctoral programs focused specifically on PH. The majority of PHS master's programs awarded a Master of Science degree (55 out of 75 programs). The PH master's program curricula offered various courses, allowing for different specializations. Courses on topics like public health, epidemiology, health systems (research) and research methods were common for the majority of the master's programs, while courses on physical activity, behavioral science, nutrition, and mental health were offered less frequently. Structured PH doctoral programs were mainly offered by medical faculties (6 out of 8 programs) and awarded a doctorate of philosophy (Ph.D.) (6 out of 8 programs). PH doctoral programs were very heterogeneous regarding curricula, entry, and publication requirements. There was a broad geographical distribution of programs across Germany, with educational clusters in Munich, Berlin, Bielefeld and Düsseldorf. CONCLUSION: Germany offers a diverse landscape of PHS and PH master's programs, but only few structured doctoral programs. The variety of mandatory courses and competencies in these programs reflect Germany's higher education system's answer to the evolving demands of the PH sector. This review may aid in advancing PH education both in Germany and globally.

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Background: Currently in Canada there are limited opportunities for advanced clinical pharmacy training after a year 1 residency. Advanced training programs currently in existence are year 2 residencies, clinical Master's degrees, and Fellowships. Objectives: To characterize the perceived need for advanced clinical pharmacy training in British Columbia and to determine the desired educational competencies to be gained through advanced training. Methods: Current pharmacy residents (academic year 2021/22) and residency graduates of the past 5 years (2017-2021), together referred to as early career pharmacists or ECPs, were surveyed. Provincial health authority pharmacy leaders who hire clinical pharmacists were also surveyed and invited to participate in key informant interviews. Results: Eighty-four ECPs and 22 pharmacy leaders participated in the surveys (estimated response rates 26% and 35%, respectively). Eleven (13%) of the ECPs had already completed advanced clinical training, and an additional 24 (29%) planned to pursue such training within 5 years. Sixteen (73%) of the pharmacy leaders had experienced difficulties in filling advanced practice positions over the previous 3 years due to a lack of qualified applicants, and 21 (95%) believed that more advanced training positions should be offered. The majority of ECPs interested in advanced training (39/60, 65%) chose year 2 residency as their preferred program, and 20 (91%) of the pharmacy leaders agreed that British Columbia should offer year 2 residencies. Both ECPs and leaders rated clinical skills and knowledge as the most important educational competencies. Conclusions: Pharmacy leaders expressed a need for more pharmacists with advanced clinical pharmacy training, and many ECPs were interested in pursuing such advanced training. Most respondents preferred the year 2 residency, with the most common goal being to improve clinical competencies.

Contexte: Actuellement au Canada, les possibilités de formation avancée en pharmacie clinique après une première année de résidence sont limitées. Les programmes de formation avancée qui existent actuellement sont les résidences de deuxième année, les maîtrises cliniques et les programmes de bourses. Objectifs: Caractériser le besoin perçu de formation avancée en pharmacie clinique en Colombie-Britannique et déterminer les compétences pédagogiques souhaitées qui doivent être acquises grâce à la formation avancée. Méthodologie: Les résidents actuels en pharmacie (année universitaire 2021­2022) et les diplômés en résidence des 5 dernières années (2017­2021), appelés ensemble « pharmaciens en début de carrière ¼ (« PDC ¼), ont été interrogés. Les responsables de pharmacie des autorités sanitaires provinciales qui embauchent des pharmaciens cliniciens ont également été interrogés et invités à participer à des entrevues à titre d'informateurs clés. Résultats: Quatre-vingt-quatre PDC et 22 responsables de pharmacie ont participé aux sondages (taux de réponse estimés à 26 % et 35 %, respectivement). Onze PDC (13 %) avaient déjà suivi une formation clinique avancée et 24 autres (29 %) prévoyaient de le faire dans les cinq ans. Seize responsables de pharmacie (73 %) ont éprouvé des difficultés à pourvoir des postes de pratique avancée au cours des trois années précédentes en raison d'un manque de candidats qualifiés, et 21 (95 %) d'entre eux étaient d'avis que des postes de formation plus avancée devraient être offerts. La majorité des PDC intéressés par une formation avancée (39/60, 65 %) ont choisi la résidence de deuxième année comme programme de premier choix, et 20 responsables de pharmacie (91 %) convenaient que la Colombie-Britannique devrait offrir des résidences de deuxième année. Les PDC et les responsables ont évalué les compétences et les connaissances cliniques comme étant les compétences théoriques les plus importantes. Conclusions: Les chefs de file des pharmacies ont exprimé le besoin de disposer d'un plus grand nombre de pharmaciens ayant une formation avancée en pharmacie clinique, et de nombreux PDC souhaitaient poursuivre une telle formation. La plupart des répondants préféraient la résidence de deuxième année, l'objectif le plus couramment cité étant l'amélioration des compétences cliniques.

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The increasing percentage of elderly in our society is challenging the health care system. To meet the challenge, we have implemented an experience-based master's programme in digital health care. The 3-yrs 90 ECTS programme consists of physical sessions of three days duration and weekly 2-3-hour digital lectures and bi-weekly supervisions. A main goal of the program has been to involve the students in relevant local and regional health problems as well as inviting health care personnel to participate in the planning of the study program, present relevant health problems and challenges and follow our open digital health workshops. In this way we have managed to create a stimulating learning environment for both students on further education and local and regional health care personnel.

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Background: Master of Nursing (MN) programs serve as an important structured pathway to prepare the nursing workforce to develop advanced capabilities. Little research has been done to examine the key characteristics of MN programs in Australia and their responsiveness to meeting the health needs of the community. Aim: The aim of this desktop analysis is to provide a detailed overview of the key characteristics of MN programs in Australia. Method: A desktop analysis of MN programs in Australia utilising content analysis of publicly available information gathered from program websites of Australian Universities. Results: A total of 70 MN programs were analysed from the 28 that offered these programs. Nine categories were developed that describe the key characteristics of these programs: nomenclature and program focus, program outcomes, regulation and professional recognition, structure, work integrated learning, delivery mode, admission, and tuition fees. Inconsistencies were identified across all categories. Discussion: While Australian universities offer a diverse range of MN programs, inconsistencies across the programs can impact quality and intent and have implications for students, employees, and universities. Conclusion: There is a pressing need to ensure the quality of MN education is maintained and adequate to meet healthcare needs. The benefits and risks of professional regulation of all MN programs should be considered as a mechanism for enhancing the quality of nursing education.

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Optimizing the operation of photovoltaic (PV) storage systems is crucial for meeting the load demands of parks while minimizing curtailment and enhancing economic efficiency. This paper proposes a multi-scenario collaborative optimization strategy for PV storage systems based on a master-slave game model. Three types of energy storage system (ESS) application scenarios are designed to comprehensively stabilize PV fluctuations, compensate for load transfers, and participate in the frequency regulation (FR) market, thereby optimizing the overall operational strategy of PV storage systems in parks. The upper-level objective is to maximize the park operators' profit, while the lower-level objective is to minimize the user's power supply costs. Case studies demonstrate that this strategy can significantly increase the economic benefits for park operators by 25.8%, reduce user electricity expenditures by 5.27%, and lower curtailment through a load response mechanism, thereby promoting the development and construction of PV storage parks.

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BACKGROUND: Patient safety (PS) is a core competency for registered nurses. However, there is a gap between the PS competence of nursing students and their clinical experience in PS. This study explored the effect of PS competence levels on the occurrence of adverse events (AEs) among nursing master's students in China. METHODS: A sequential mixed methods design was used, with a purposive sample across seven colleges. A total of 327 graduate nursing students, aged 22 to 38, participated in the survey, and 15 participated in qualitative interviews. The Health Professional Education in Patient Safety Survey (H-PEPSS) assessed the students' competence levels in PS. The respondents also reported any AEs that they had been involved in over the past year. RESULTS: A total of 78 AEs occurred in the past year, with 17.7% of the participants involved 1 to 3 AEs. The most common AEs were medication administration errors (30.77%) and improper use of medical equipment/supplies (28.20%). Students acquired more competencies from the clinical setting than from the classroom setting. Three competencies learned from classroom settings were associated with clinical AEs: low clinical safety skills [OR = 0.61], inappropriate identify, response to and disclosing AE and close calls [OR = 0.454], and low confidence in working in teams with other health professionals [OR = 2.168]. Qualitative data analysis revealed five themes: recognizing AEs, reducing harm by addressing immediate risks to patients and others involved, promoting safe medication and clinical practice, managing members' authority and team dynamics, and dealing with inter-professional conflict. CONCLUSIONS: The quantitative and qualitative data align, supporting the enhancement of students' PS competence.

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Epidemic models study the spread of undesired agents through populations, be it infectious diseases through a country, misinformation in social media or pests infesting a region. In combating these epidemics, we rely neither on global top-down interventions, nor solely on individual adaptations. Instead, interventions commonly come from local institutions such as public health departments, moderation teams on social media platforms or other forms of group governance. Classic models, which are often individual or agent-based, are ill-suited to capture local adaptations. We leverage developments of institutional dynamics based on cultural group selection to study how groups attempt local control of an epidemic by taking inspiration from the successes and failures of other groups. Incorporating institutional changes into epidemic dynamics reveals paradoxes: a higher transmission rate can result in smaller outbreaks as does decreasing the speed of institutional adaptation. When groups perceive a contagion as more worrisome, they can invest in improved policies and, if they maintain these policies long enough to have impact, lead to a reduction in endemicity. By looking at the interplay between the speed of institutions and the transmission rate of the contagions, we find rich coevolutionary dynamics that reflect the complexity of known biological and social contagions.

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The development of electric vehicles (EVs) has been incremental because EVs satisfy a significant demand for energy sources. Electronic control unit (ECU) is an important component that processes the electric signals received from various sensors for generating the control signals for the actuators. Automotive control systems were initially operated manually throughout the automotive revolution based on the responses of input signals received from ECUs and drivers. Most of the functions in EV are controlled by the ECU and every ECU consumes power at all times even if it is not in use. The larger power consumption of passive ECUs like adaptive lighting systems (ALS), automatic wiper systems (AWS) brake light systems (BLS), etc., affect the life of ECUs and the range of EVs. This article is primarily concerned with limiting power consumption by switching the power supply to the passive ECUs based on their requirements. Hence, to achieve the objective, the intelligent zone (i-zone) based master ECU is triggered to activate the slave ECUs. Designing suites including Proteus and KiCAD were used for designing the circuits including master as well as slave ECU. This prototype is built using three secondary ECUs such as ALS & AWS and BLS which are controlled using i-zone-based master ECU. The performance of this implemented design is evaluated, and it is discovered that almost 40% of the battery consumption is reduced. This i-zone-based master ECU and all its slave ECUs manage power while ensuring the safety and reliability of EVs.

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Drug development has historically relied on phase I-III clinical trials including participants sharing the same disease. However, drug development has evolved as the discovery of mechanistic drivers of disease demonstrated that the same therapeutic target may provide benefits across different diseases. A basket trial condenses evaluation of one therapy among multiple related diseases into a single trial and presents an opportunity to borrow information across them rather than viewing each in isolation. Borrowing is a statistical tool but requires a foundation of clinical and therapeutic mechanistic justification. We review the Bayesian borrowing approach, including its assumptions, and provide a framework for how this approach can be evaluated for successful use in a basket trial for drug development.

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The tendency for cell fate to be robust to most perturbations, yet sensitive to certain perturbations raises intriguing questions about the existence of a key path within the underlying molecular network that critically determines distinct cell fates. Reprogramming and trans-differentiation clearly show examples of cell fate change by regulating only a few or even a single molecular switch. However, it is still unknown how to identify such a switch, called a master regulator, and how cell fate is determined by its regulation. Here, we present CAESAR, a computational framework that can systematically identify master regulators and unravel the resulting canalizing kernel, a key substructure of interconnected feedbacks that is critical for cell fate determination. We demonstrate that CAESAR can successfully predict reprogramming factors for de-differentiation into mouse embryonic stem cells and trans-differentiation of hematopoietic stem cells, while unveiling the underlying essential mechanism through the canalizing kernel. CAESAR provides a system-level understanding of how complex molecular networks determine cell fates.

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