Cefepime Neurotoxicity in Patients With Normal Renal Function: An Overlooked Cause of Encephalopathy in the Intensive Care Unit.

Cefepime is a fourth-generation cephalosporin with extended antimicrobial coverage. Concerns have been raised about the side effects of cefepime including myoclonus, encephalopathy, and seizures, especially when renal impairment is present. There have been reports of cases of adverse neurological consequences despite appropriate renal adjustment. Here, we present a case of a 69-year-old patient initially diagnosed with pneumonia and treated with cefepime. The patient later developed altered mental status, leading to differential diagnoses including stroke, drug overdose, or non-convulsive seizures. Following a comprehensive workup, it was determined that she had cefepime-induced encephalopathy, despite having normal kidney function, which resolved completely after discontinuing the medication. In addition, we include similar cases retrieved from PubMed up to the present date, to the best of our knowledge.

Elastic metasurfaces for Scholte-Stoneley wave control.

In this work, we investigate the dynamics of Scholte-Stoneley waves (SSWs) travelling along elastic metasurfaces, e.g. thin resonant structures embedding mechanical oscillators, placed at the interface between solid and fluid. To this purpose, an analytical dispersion law, valid in the long-wavelength regime, is derived and used to reveal the hybridization of SSWs with the collective resonance of the mechanical oscillators and the conversion of SSWs into leaky modes within the fluid. The analytical predictions are validated through numerical simulations that include both dispersive and harmonic analysis. Our findings disclose the capabilities of elastic metasurfaces in filtering, trapping and converting SSWs along fluid-solid interfaces, thus supporting the design of novel devices for solid-fluid interaction across various engineering applications, including microfluidics. This article is part of the theme issue 'Current developments in elastic and acoustic metamaterials science (Part 1)'.

Broadband surface wave manipulation by periodic barriers in unsaturated soil.

Periodic wave barriers have been widely used to manipulate elastic waves propagating in saturated and single-phase soil due to their attenuation zone properties. However, it is difficult to promote application of periodic barriers in unsaturated soils due to their complex constitutive relationship. In this study, manipulation of surface waves by periodic in-filled trench barriers in unsaturated soil has been studied based on the periodic theory. The dispersion relations of a periodic structure for surface waves in unsaturated soil are determined. The attenuation mechanism of evanescent surface waves is revealed. Next, the effects of several key parameters of unsaturated soil on the attenuation zones of the periodic in-filled trench barriers are comprehensively discussed. It is found that in a particular range for material parameter, the surface waves are attenuated over the entire frequency range due to the viscosity of fluid. Finally, a periodic in-filled trench barrier is designed according to a field test of ground vibration induced by a train, and its performances in mitigating surface waves propagating in unsaturated and saturated soils are conducted and compared by conducting analysis in time domain. This investigation provides a new insight for manipulating surface waves by periodic barriers. This article is part of the theme issue 'Current developments in elastic and acoustic metamaterials science (Part 1)'.

Surface wave mitigation by periodic wave barriers under a moving load: theoretical analysis, numerical simulation and experimental validation.

Periodic wave barriers (PWB) open a new window for vibration mitigation. However, the Doppler effect is rarely considered in most of the previous investigations on the control of ambient vibration induced by moving loads. This article reveals the significance of the speed and frequency of moving loads on surface waves, and improves the design method of PWB for ambient vibration reduction and isolation. First, the theoretical expression of the main frequency band of surface waves propagating in an elastic half-space caused by a moving load was obtained. Comparisons with the numerical results under three different types of traffic loads were also conducted and good agreement was found. Second, the theoretical expression and numerical results were verified by experimental studies. Some inherent properties of wave propagation caused by a moving load in an elastic half-space were also revealed. Third, two kinds of PWBs, i.e. periodic empty trench barrier and periodic pile barrier, were introduced to mitigate wave propagation. It has been confirmed that if the attenuation zones of PWB match the target frequency bands given by the theoretical expression, good vibration mitigation can be achieved. This article is part of the theme issue 'Current developments in elastic and acoustic metamaterials science (Part 1)'.

The Persistent Paradox of Rapid Eye Movement Sleep (REMS): Brain Waves and Dreaming.

The original conceptualization of REM sleep as paradoxical sleep was based on its EEG resembling wakefulness and its association with dreaming. Over time, the concept of paradox was expanded to include various associations with REM sleep, such as dream exclusivity, high recall, and pathophysiology. However, none of these associations are unique to REM sleep; they can also occur in other sleep states. Today, after more than fifty years of focused research, two aspects of REMS clearly retain paradoxical exclusivity. Despite the persistent contention that the EEG of human REMS consists of wake-like, low-voltage, non-synchronous electrical discharges, REMS is based on and defined by the intracranial electrical presence of 5-8 Hz. theta, which has always been the marker of REMS in other animals. The wake-like EEG used to define REMS on human polysomnography is secondary to a generalized absence of electrophysiological waveforms because the strong waves of intracranial theta do not propagate to scalp electrodes placed outside the skull. It is a persistent paradox that the theta frequency is restricted to a cyclical intracranial dynamic that does not extend beyond the lining of the brain. REMS has a persistent association with narratively long and salient dream reports. However, the extension of this finding to equate REMS with dreaming led to a foundational error in neuroscientific logic. Major theories and clinical approaches were built upon this belief despite clear evidence that dreaming is reported throughout sleep in definingly different physiologic and phenomenological forms. Few studies have addressed the differences between the dreams reported from the different stages of sleep so that today, the most paradoxical aspect of REMS dreaming may be how little the state has actually been studied. An assessment of the differences in dreaming between sleep stages could provide valuable insights into how dreaming relates to the underlying brain activity and physiological processes occurring during each stage. The brain waves and dreams of REMS persist as being paradoxically unique and different from waking and the other states of sleep consciousness.

Digital Image Correlation and Ultrasonic Lamb Waves for the Detection and Prediction of Crack-Type Damage in Fiber-Reinforced Polymer Composite Laminates.

The possibility of using the Digital Image Correlation (DIC) technique, along with Lamb wave analysis, was investigated in this study for damage detection and characterization of polymer carbon fiber (CFRP) composites with the help of numerical modeling. The finite element model (FEM) of the composite specimen with artificial damage was developed in ANSYS and validated by the results of full-field DIC strain measurements. A quantitative analysis of the damage detection capabilities of DIC structure surface strain measurements in the context of different defect sizes, depths, and orientation angles relative to the loading direction was conducted. For Lamb wave analysis, a 2D spatial-temporal spectrum analysis and FEM using ABAQUS software were conducted to investigate the interaction of Lamb waves with the different defects. It was demonstrated that the FEM updating procedure could be used to characterize damage shape and size from the composite structure surface strain field from DIC. DIC defect detection capabilities for different loadings are demonstrated for the CFRP composite. For the identification of any composite defect, its characterization, and possible further monitoring, a methodology based on initial Lamb wave analysis followed by DIC testing is proposed.

Circular SAW Resonators: Influence of Sensitive Element Dimensions on Strength Characteristics and First Experimental Samples.

In preceding research endeavors, the frequency characteristics of a ring resonator on surface acoustic waves made of various materials were studied. Investigations encompassed fixation techniques within the housing, the impact of external variables on these components, and the most efficient configuration of the interdigital transducer within the ring resonator to curtail bandwidth. This current study is dedicated to investigating the correlation between sensitivity and the highest measurable acceleration concerning the dimensions of these sensitive elements. Furthermore, it involves assessing the attributes of produced experimental samples to verify the simulation results. The results obtained represent the possibility of creating a micromechanical accelerometer that can be used in the automotive industry as a g-sensor shock, as well as in industries where the numerical value of high overloads is required.

Delineation of 12-Lead ECG Representative Beats Using Convolutional Encoder-Decoders with Residual and Recurrent Connections.

The aim of this study is to address the challenge of 12-lead ECG delineation by different encoder-decoder architectures of deep neural networks (DNNs). This study compares four concepts for encoder-decoders based on a fully convolutional architecture (CED-Net) and its modifications with a recurrent layer (CED-LSTM-Net), residual connections between symmetrical encoder and decoder feature maps (CED-U-Net), and sequential residual blocks (CED-Res-Net). All DNNs transform 12-lead representative beats to three diagnostic ECG intervals (P-wave, QRS-complex, QT-interval) used for the global delineation of the representative beat (P-onset, P-offset, QRS-onset, QRS-offset, T-offset). All DNNs were trained and optimized using the large PhysioNet ECG database (PTB-XL) under identical conditions, applying an advanced approach for machine-based supervised learning with a reference algorithm for ECG delineation (ETM, Schiller AG, Baar, Switzerland). The test results indicate that all DNN architectures are equally capable of reproducing the reference delineation algorithm's measurements in the diagnostic PTB database with an average P-wave detection accuracy (96.6%) and time and duration errors: mean values (-2.6 to 2.4 ms) and standard deviations (2.9 to 11.4 ms). The validation according to the standard-based evaluation practices of diagnostic electrocardiographs with the CSE database outlines a CED-Net model, which measures P-duration (2.6 ± 11.0 ms), PQ-interval (0.9 ± 5.8 ms), QRS-duration (-2.4 ± 5.4 ms), and QT-interval (-0.7 ± 10.3 ms), which meet all standard tolerances. Noise tests with high-frequency, low-frequency, and power-line frequency noise (50/60 Hz) confirm that CED-Net, CED-Res-Net, and CED-LSTM-Net are robust to all types of noise, mostly presenting a mean duration error < 2.5 ms when compared to measurements without noise. Reduced noise immunity is observed for the U-net architecture. Comparative analysis with other published studies scores this research within the lower range of time errors, highlighting its competitive performance.

Competition and synergy of Arp2/3 and formins in nucleating actin waves.

Actin assembly and dynamics are crucial for maintaining cell structure and changing physiological states. The broad impact of actin on various cellular processes makes it challenging to dissect the specific role of actin regulatory proteins. Using actin waves that propagate on the cortex of mast cells as a model, we discovered that formins (FMNL1 and mDia3) are recruited before the Arp2/3 complex in actin waves. GTPase Cdc42 interactions drive FMNL1 oscillations, with active Cdc42 and the constitutively active mutant of FMNL1 capable of forming waves on the plasma membrane independently of actin waves. Additionally, the delayed recruitment of Arp2/3 antagonizes FMNL1 and active Cdc42. This antagonism is not due to competition for monomeric actin but rather for their common upstream regulator, active Cdc42, whose levels are negatively regulated by Arp2/3 via SHIP1 recruitment. Collectively, our study highlights the complex feedback loops in the dynamic control of the actin cytoskeletal network.

BDNF-TrkB signaling orchestrates the buildup process of local sleep.

Sleep debt accumulates during wakefulness, leading to increased slow wave activity (SWA) during sleep, an encephalographic marker for sleep need. The use-dependent demands of prior wakefulness increase sleep SWA locally. However, the circuitry and molecular identity of this "local sleep" remain unclear. Using pharmacology and optogenetic perturbations together with transcriptomics, we find that cortical brain-derived neurotrophic factor (BDNF) regulates SWA via the activation of tyrosine kinase B (TrkB) receptor and cAMP-response element-binding protein (CREB). We map BDNF/TrkB-induced sleep SWA to layer 5 (L5) pyramidal neurons of the cortex, independent of neuronal firing per se. Using mathematical modeling, we here propose a model of how BDNF's effects on synaptic strength can increase SWA in ways not achieved through increased firing alone. Proteomic analysis further reveals that TrkB activation enriches ubiquitin and proteasome subunits. Together, our study reveals that local SWA control is mediated by BDNF-TrkB-CREB signaling in L5 excitatory cortical neurons.

Analyzing the Micro-topography Guidance of Dictyostelium Cells Using Microfabricated Structures.

Over the last decade, the use of microfabricated substrates has proven pivotal for studying the effect of substrate topography on cell deformation and migration. Microfabrication techniques allow one to construct a transparent substrate with topographic features with high designability and reproducibility and thus well suited to experiments that microscopically address how spatial and directional bias are brought about in the cytoskeletal machineries and hence cell motility. While much of the progress in this avenue of study has so far been made in adhesive cells of epithelial and mesenchymal nature, whether related phenomena exist in less adhesive fast migrating cells is relatively unknown. In this chapter, we describe a method that makes use of micrometer-scale ridges to study fast-migrating Dictyostelium cells where it was recently shown that membrane evagination associated with macropinocytic cup formation plays a pivotal role in the topography sensing. The method requires only basic photolithography, and thus the step-by-step protocol should be a good entry point for cell biologists looking to incorporate similar microfabrication approaches.

Effects of non-rapid eye movement sleep on the cortical synaptic expression of GluA1-containing AMPA receptors.

Converging electrophysiological, molecular and ultrastructural evidence supports the hypothesis that sleep promotes a net decrease in excitatory synaptic strength, counteracting the net synaptic potentiation caused by ongoing learning during waking. However, several outstanding questions about sleep-dependent synaptic weakening remain. Here, we address some of these questions by using two established molecular markers of synaptic strength, the levels of the AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid) receptors containing the GluA1 subunit and the phosphorylation of GluA1 at serine 845 (p-GluA1(845)). We previously found that, in the rat cortex and hippocampus, these markers are lower after 6-8 h of sleep than after the same time spent awake. Here, we measure GluA1 and p-GluA1(845) levels in synaptosomes of mouse cortex after 5 h of either sleep, sleep deprivation, recovery sleep after sleep deprivation or selective REM sleep deprivation (32 C57BL/B6 adult mice, 16 females). We find that relative to after sleep deprivation, these synaptic markers are lower after sleep independent of whether the mice were allowed to enter REM sleep. Moreover, 5 h of recovery sleep following acute sleep deprivation is enough to renormalize their expression. Thus, the renormalization of GluA1 and p-GluA1(845) expression crucially relies on NREM sleep and can occur in a few hours of sleep after acute sleep deprivation.

Evolving Arctic maritime hazards: Declining sea ice and rising waves in the Northwest Passage.

The ongoing and projected retreat of Arctic sea ice has garnered international interest toward the utilization of Arctic maritime corridors for shipping, tourism, and development. Yet, with potential for increasing traffic in Arctic regions, it's important to consider additional environmental variables affected by climate change which may threaten maritime operations. Here, we use four climate model projections to produce ocean wave simulations and investigate the future magnitude and seasonality of sea ice risk coupled with wave hazards. Analyzing the potential 5 mo shipping season spanning July to November along the Northwest Passage maritime route between 2020 and 2070, our results show a substantial decline in sea ice risk over the analysis time period, resulting in near open-water conditions along the route for a 5 mo period by 2070. However, as seasonal ice coverage retreats, there is a significant upward trend in wave heights along the route during July and November, with the timing of the greatest wave height shifting away from September toward later in the season. This result is pertinent as the possibility of seasonally unprecedented extreme waves coupled with subfreezing late fall temperatures makes for an especially hazardous environment, thus emphasizing the importance of considering the interaction between evolving sea ice and interdependent hazards when predicting the risks and challenges faced by Arctic maritime operations.

A Compact Linear Microstrip Patch Beamformer Antenna Array for Millimeter-Wave Future Communication.

5/6G is anticipated to address challenges such as low data speed and high latency in current cellular networks, particularly as the number of users overwhelms 4G and LTE capabilities. This paper proposes a microstrip patch antenna array comprising six radiating patches and utilizing a microstrip line feeding technique to facilitate the compact design crucial for 5G implementation. ROGER 3003, chosen for its advanced and environmentally friendly features, serves as the dielectric material, ensuring suitability for 5G and B5G applications. The designed antenna, evaluated at a resonating frequency of 28.8 GHz with a -10 dB impedance bandwidth of 1 GHz, offers a high gain of 9.19 dBi. Its compact array, cost-effectiveness, and broad impedance and radiation coverage position it as a viable candidate for 5G and future communication applications.

Stress Wave Propagation in a Rayleigh-Love Rod with Sudden Cross-Sectional Area Variations Impacted by a Striker Rod.

This paper presents an in-depth study of the stress wave behavior propagating in a Rayleigh-Love rod with sudden cross-sectional area variations. The analytical solutions of stress waves are derived for the reflection and transmission propagation behavior at the interface of the cross-sectional area change in the rod, considering inertia and Poisson's effects on the rod material. Examples solved using the finite element method are provided to verify the correctness of the analytical results. Based on the forward analysis of Rayleigh-Love wave propagation in a rod impacted by a striker rod, an impact-echo-type nondestructive testing (NDT) method is proposed to conduct defect assessment in rod-type structural components with sudden cross-sectional area changes within a cover medium. This proposed NDT method can identify the location, extension, and cross-sectional area drop ratios of an irregular zone in the rod to be inspected.

Long Short-Term Memory Networks' Application on Typhoon Wave Prediction for the Western Coast of Taiwan.

Huge waves caused by typhoons often induce severe disasters along coastal areas, making the effective prediction of typhoon-induced waves a crucial research issue for researchers. In recent years, the development of the Internet of Underwater Things (IoUT) has rapidly increased the prediction of oceanic environmental disasters. Past studies have utilized meteorological data and feedforward neural networks (e.g., BPNN) with static network structures to establish short lead time (e.g., 1 h) typhoon wave prediction models for the coast of Taiwan. However, sufficient lead time for prediction remains essential for preparedness, early warning, and response to minimize the loss of lives and properties during typhoons. The aim of this research is to construct a novel long lead time typhoon-induced wave prediction model using Long Short-Term Memory (LSTM), which incorporates a dynamic network structure. LSTM can capture long-term information through its recurrent structure and selectively retain necessary signals using memory gates. Compared to earlier studies, this method extends the prediction lead time and significantly improves the learning and generalization capability, thereby enhancing prediction accuracy markedly.

A new stress measurement strategy based on time-frequency characteristics of Lamb waves.

Existing stress evaluation methods based on the Lamb waves mainly use the time of flight (TOF) or velocity as the means of stress measurement. However, these two features used for stress measurement are sometimes insensitive to stress changes. Therefore, it is essential to explore other features that are potentially more sensitive to stress changes. The time-frequency spectrums of signals containing stress information have not yet been fully studied for stress evaluation. This paper proposes a uniaxial stress measurement method based on two time-frequency characteristics of Lamb waves, i.e., the slope of time-frequency spectrum distribution (TFSD) and pulse width impact factor. Theoretical expressions of the slope of TFSD are derived. The impacts of excitation signal parameters (i.e., bandwidth and center frequency) and noise on two time-frequency characteristics were discussed. Then, the fitting results of the finite element simulation are consistent with the results predicted by theory. To experimentally validate the proposed theory, aluminum plate specimens with two different types of adhesives were used for the experiment. According to the experimental stress measurement expression, three uniaxial tensile tests in the range of 35-95 MPa were conducted on the identical batch of specimens. The maximum standard deviation of multiple measured stress based on pulse width impact factor is 3.76433 MPa, demonstrating excellent measurement stability. The maximum standard deviation of multiple measured stress based on the slope of TFSD is 9.12492 MPa. It shows that the proposed methodology is a promising alternative for stress measurement.

Mode conversion of fundamental guided ultrasonic wave modes at part-thickness crack-like defects.

Guided ultrasonic waves can be employed for efficient structural health monitoring (SHM) and non-destructive evaluation (NDE), as they can propagate long distances along thin structures. The scattering (S0 mode) and mode conversion of low frequency guided waves (S0 to A0 and SH0 wave modes) at part-thickness crack-like defects was studied to quantify the defect detection sensitivity. Three-dimensional (3D) Finite Element (FE) modelling was used to predict the mode conversion and scattering of the fundamental guided wave modes. Experimentally, the S0 mode was excited by a piezoelectric (PZT) transducer in an aluminum plate. A laser vibrometer was used to measure the out-of-plane displacement to characterize the mode-converted A0 mode, employing baseline subtraction to achieve mode and pulse separation. Good agreement between FE model predictions and experimental results was obtained for perpendicular incidence of the S0 mode. The influence of defect depth and length on the scattering and mode conversion was studied and the sensitivity for part-thickness defects was quantified. The maximum mode conversion (S0-A0 mode) occurred for ¾ defect depth and the amplitude of the mode-converted A0 and scattered S0 modes mostly increased linearly as the defect length increased with an almost constant A0/S0 mode scattered amplitude ratio. Similar forward and backward scattering amplitude was found for the mode converted A0 mode. The mode conversion of the S0 to SH0 mode has the highest sensitivity for short defects, but the SH0 mode amplitude only increased slightly for longer defects. Employing the information contained in the mode-converted, scattered guided ultrasonic wave modes could improve the detection sensitivity and localization accuracy of SHM algorithms.

Present and future of CosmoLattice.

We discuss the present state and planned updates of CosmoLattice, a cutting-edge code for lattice simulations of non-linear dynamics of scalar-gauge field theories in an expanding background. We first review current capabilities of the code, including the simulation of interacting singlet scalars and of Abelian and non-Abelian scalar-gauge theories. We also comment on new features recently implemented, such as the simulation of gravitational waves from scalar and gauge fields. Secondly, we discuss new extensions of CosmoLattice that we plan to release publicly. On the one hand, we comment on new physics modules, which include axion-gauge interactions φFF̃, non-minimal gravitational couplings φ^2R, creation and evolution of cosmic defect networks, and magneto-hydro-dynamics (MHD). On the other hand, we discuss new technical features, including evolvers for non-canonical interactions, arbitrary initial conditions, simulations in 2+1 dimensions, and higher accuracy spatial derivatives. .

Effectiveness of brainwave entrainment on pre-operative fear and anxiety in pediatric dental patients: a randomized controlled trial.

PURPOSE: The study aims to evaluate the effectiveness of brainwave entrainment on pre-operative fear and anxiety in pediatric dental patients. METHODS: The study protocol received approval from the Institutional Ethical Committee under reference number 3010/IEC/2021. Pediatric patients (252) aged from 7 to 12 years, who reported to the dental department were randomized pre-operatively and presented either with brainwave entrainment (experimental), delivered using a "David delight plus device" or a standard behavior management protocol (control). Baseline and post-assessment of anxiety and fear levels were done using the Visual Facial Anxiety Scale and Frankl's behavior rating scale with Wright's modification. Vitals such as blood pressure and pulse rate were also measured. RESULTS: The study sample (n = 252) comprised 118 females and 134 males. The non-significant differences for values of (VFAS1, FRS1, HR1, and BP1) indicated similar baseline characteristics. In the brainwave entrainment group, the p values of the Mann-Whitney U test and Wilcoxon Signed Ranks test (p < 0.01) between the two-timepoints indicated a statistical difference for the values of (VFAS1, FBRS1, HR1, BP1) and (VFAS2, FBRS2, HR2, BP2). CONCLUSIONS: Brainwave entrainment effectively reduces pre-operative fear and anxiety in pediatric dental patients. Therefore, they can be a non-pharmacological and non-invasive behavior management aid. TRIAL REGISTRATION: Clinical Trial Registry of India database CTRI/2023/03/051066.