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Nick K. Jones1,2*, Lucy Rivett1,2*, Chris Workman3, Mark Ferris3, Ashley Shaw1, Cambridge COVID-19 Collaboration1,4, Paul J. Lehner1,4, Rob Howes5, Giles Wright3, Nicholas J. Matheson1,4,6¶, Michael P. Weekes1,7¶1 Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK2 Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK3 Occupational Health and Wellbeing, Cambridge Biomedical Campus, Cambridge, UK4 Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK5 Cambridge COVID-19 Testing Centre and AstraZeneca, Anne Mclaren Building, Cambridge, UK6 NHS Blood and Transplant, Cambridge, UK7 Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK*Joint first authorship¶Joint last authorshipCorrespondence: mpw1001@cam.ac.ukThe UK has initiated mass COVID-19 immunisation, with healthcare workers (HCWs) given early priority because of the potential for workplace exposure and risk of onward transmission to patients. The UK’s Joint Committee on Vaccination and Immunisation has recommended maximising the number of people vaccinated with first doses at the expense of early booster vaccinations, based on single dose efficacy against symptomatic COVID-19 disease.1-3At the time of writing, three COVID-19 vaccines have been granted emergency use authorisation in the UK, including the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). A vital outstanding question is whether this vaccine prevents or promotes asymptomatic SARS-CoV-2 infection, rather than symptomatic COVID-19 disease, because sub-clinical infection following vaccination could continue to drive transmission. This is especially important because many UK HCWs have received this vaccine, and nosocomial COVID-19 infection has been a persistent problem.Through the implementation of a 24 h-turnaround PCR-based comprehensive HCW screening programme at Cambridge University Hospitals NHS Foundation Trust (CUHNFT), we previously demonstrated the frequent presence of pauci- and asymptomatic infection amongst HCWs during the UK’s first wave of the COVID-19 pandemic.4 Here, we evaluate the effect of first-dose BNT162b2 vaccination on test positivity rates and cycle threshold (Ct) values in the asymptomatic arm of our programme, which now offers weekly screening to all staff.Vaccination of HCWs at CUHNFT began on 8th December 2020, with mass vaccination from 8th January 2021. Here, we analyse data from the two weeks spanning 18thto 31st January 2021, during which: (a) the prevalence of COVID-19 amongst HCWs remained approximately constant; and (b) we screened comparable numbers of vaccinated and unvaccinated HCWs. Over this period, 4,408 (week 1) and 4,411 (week 2) PCR tests were performed from individuals reporting well to work. We stratified HCWs <12 days or > 12 days post-vaccination because this was the point at which protection against symptomatic infection began to appear in phase III clinical trial.226/3,252 (0·80%) tests from unvaccinated HCWs were positive (Ct<36), compared to 13/3,535 (0·37%) from HCWs <12 days post-vaccination and 4/1,989 (0·20%) tests from HCWs ≥12 days post-vaccination (p=0·023 and p=0·004, respectively; Fisher’s exact test, Figure). This suggests a four-fold decrease in the risk of asymptomatic SARS-CoV-2 infection amongst HCWs ≥12 days post-vaccination, compared to unvaccinated HCWs, with an intermediate effect amongst HCWs <12 days post-vaccination.A marked reduction in infections was also seen when analyses were repeated with: (a) inclusion of HCWs testing positive through both the symptomatic and asymptomatic arms of the programme (56/3,282 (1·71%) unvaccinated vs 8/1,997 (0·40%) ≥12 days post-vaccination, 4·3-fold reduction, p=0·00001); (b) inclusion of PCR tests which were positive at the limit of detection (Ct>36, 42/3,268 (1·29%) vs 15/2,000 (0·75%), 1·7-fold reduction, p=0·075); and (c) extension of the period of analysis to include six weeks from December 28th to February 7th 2021 (113/14,083 (0·80%) vs 5/4,872 (0·10%), 7·8-fold reduction, p=1x10-9). In addition, the median Ct value of positive tests showed a non-significant trend towards increase between unvaccinated HCWs and HCWs > 12 days post-vaccination (23·3 to 30·3, Figure), suggesting that samples from vaccinated individuals had lower viral loads.We therefore provide real-world evidence for a high level of protection against asymptomatic SARS-CoV-2 infection after a single dose of BNT162b2 vaccine, at a time of predominant transmission of the UK COVID-19 variant of concern 202012/01 (lineage B.1.1.7), and amongst a population with a relatively low frequency of prior infection (7.2% antibody positive).5This work was funded by a Wellcome Senior Clinical Research Fellowship to MPW (108070/Z/15/Z), a Wellcome Principal Research Fellowship to PJL (210688/Z/18/Z), and an MRC Clinician Scientist Fellowship (MR/P008801/1) and NHSBT workpackage (WPA15-02) to NJM. Funding was also received from Addenbrooke’s Charitable Trust and the Cambridge Biomedical Research Centre. We also acknowledge contributions from all staff at CUHNFT Occupational Health and Wellbeing and the Cambridge COVID-19 Testing Centre.

Scene flow tracks the three-dimensional (3D) motion of each point in adjacent point clouds. It provides fundamental 3D motion perception for autonomous driving and server robot. Although the Red Green Blue Depth (RGBD) camera or Light Detection and Ranging (LiDAR) capture discrete 3D points in space, the objects and motions usually are continuous in the macro world. That is, the objects keep themselves consistent as they flow from the current frame to the next frame. Based on this insight, the Generative Adversarial Networks (GAN) is utilized to self-learn 3D scene flow with no need for ground truth. The fake point cloud of the second frame is synthesized from the predicted scene flow and the point cloud of the first frame. The adversarial training of the generator and discriminator is realized through synthesizing indistinguishable fake point cloud and discriminating the real point cloud and the synthesized fake point cloud. The experiments on Karlsruhe Institute of Technology and Toyota Technological Institute (KITTI) scene flow dataset show that our method realizes promising results without ground truth. Just as human, the proposed method can identify the similar local structures of two adjacent frames even without knowing the ground truth scene flow. Then, the local correspondence can be correctly estimated, and further the scene flow is correctly estimated.   Corresponding author(s) Email: wanghesheng@sjtu.edu.cn

Leukocyte differential test is a widely performed clinical procedure for screening infectious diseases. Existing hematology analyzers require labor-intensive work and a panel of expensive reagents. Here we report an artificial-intelligence enabled reagent-free imaging hematology analyzer (AIRFIHA) modality that can accurately classify subpopulations of leukocytes with minimal sample preparation. AIRFIHA is realized through training a two-step residual neural network using label-free images of isolated leukocytes acquired from a custom-built quantitative phase microscope. By leveraging the rich information contained in quantitative phase images, we not only achieved high accuracy in differentiating B and T lymphocytes, but also classified CD4 and CD8 cells, therefore outperforming the classification accuracy of most current hematology analyzers. We validated the performance of AIRFIHA in a randomly selected test set and cross-validated it across all blood donors. Owing to its easy operation, low cost, and accurate discerning capability of complex leukocyte subpopulations, we envision AIRFIHA is clinically translatable and can also be deployed in resource-limited settings, e.g., during pandemic situations for the rapid screening of infectious diseases.  Corresponding author(s) Email:    rjzhou@cuhk.edu.hk,  rishikesh.pandey@uconn.edu

Tam Hunt [1], Jonathan SchoolerUniversity of California Santa Barbara Synchronization, harmonization, vibrations, or simply resonance in its most general sense seems to have an integral relationship with consciousness itself. One of the possible “neural correlates of consciousness” in mammalian brains is a combination of gamma, beta and theta synchrony. More broadly, we see similar kinds of resonance patterns in living and non-living structures of many types. What clues can resonance provide about the nature of consciousness more generally? This paper provides an overview of resonating structures in the fields of neuroscience, biology and physics and attempts to coalesce these data into a solution to what we see as the “easy part” of the Hard Problem, which is generally known as the “combination problem” or the “binding problem.” The combination problem asks: how do micro-conscious entities combine into a higher-level macro-consciousness? The proposed solution in the context of mammalian consciousness suggests that a shared resonance is what allows different parts of the brain to achieve a phase transition in the speed and bandwidth of information flows between the constituent parts. This phase transition allows for richer varieties of consciousness to arise, with the character and content of that consciousness in each moment determined by the particular set of constituent neurons. We also offer more general insights into the ontology of consciousness and suggest that consciousness manifests as a relatively smooth continuum of increasing richness in all physical processes, distinguishing our view from emergentist materialism. We refer to this approach as a (general) resonance theory of consciousness and offer some responses to Chalmers’ questions about the different kinds of “combination problem.”  At the heart of the universe is a steady, insistent beat: the sound of cycles in sync…. [T]hese feats of synchrony occur spontaneously, almost as if nature has an eerie yearning for order. Steven Strogatz, Sync: How Order Emerges From Chaos in the Universe, Nature and Daily Life (2003) If you want to find the secrets of the universe, think in terms of energy, frequency and vibration.Nikola Tesla (1942) I.               Introduction Is there an “easy part” and a “hard part” to the Hard Problem of consciousness? In this paper, we suggest that there is. The harder part is arriving at a philosophical position with respect to the relationship of matter and mind. This paper is about the “easy part” of the Hard Problem but we address the “hard part” briefly in this introduction.  We have both arrived, after much deliberation, at the position of panpsychism or panexperientialism (all matter has at least some associated mind/experience and vice versa). This is the view that all things and processes have both mental and physical aspects. Matter and mind are two sides of the same coin.  Panpsychism is one of many possible approaches that addresses the “hard part” of the Hard Problem. We adopt this position for all the reasons various authors have listed (Chalmers 1996, Griffin 1997, Hunt 2011, Goff 2017). This first step is particularly powerful if we adopt the Whiteheadian version of panpsychism (Whitehead 1929).  Reaching a position on this fundamental question of how mind relates to matter must be based on a “weight of plausibility” approach, rather than on definitive evidence, because establishing definitive evidence with respect to the presence of mind/experience is difficult. We must generally rely on examining various “behavioral correlates of consciousness” in judging whether entities other than ourselves are conscious – even with respect to other humans—since the only consciousness we can know with certainty is our own. Positing that matter and mind are two sides of the same coin explains the problem of consciousness insofar as it avoids the problems of emergence because under this approach consciousness doesn’t emerge. Consciousness is, rather, always present, at some level, even in the simplest of processes, but it “complexifies” as matter complexifies, and vice versa. Consciousness starts very simple and becomes more complex and rich under the right conditions, which in our proposed framework rely on resonance mechanisms. Matter and mind are two sides of the coin. Neither is primary; they are coequal.  We acknowledge the challenges of adopting this perspective, but encourage readers to consider the many compelling reasons to consider it that are reviewed elsewhere (Chalmers 1996, Griffin 1998, Hunt 2011, Goff 2017, Schooler, Schooler, & Hunt, 2011; Schooler, 2015).  Taking a position on the overarching ontology is the first step in addressing the Hard Problem. But this leads to the related questions: at what level of organization does consciousness reside in any particular process? Is a rock conscious? A chair? An ant? A bacterium? Or are only the smaller constituents, such as atoms or molecules, of these entities conscious? And if there is some degree of consciousness even in atoms and molecules, as panpsychism suggests (albeit of a very rudimentary nature, an important point to remember), how do these micro-conscious entities combine into the higher-level and obvious consciousness we witness in entities like humans and other mammals?  This set of questions is known as the “combination problem,” another now-classic problem in the philosophy of mind, and is what we describe here as the “easy part” of the Hard Problem. Our characterization of this part of the problem as “easy”[2] is, of course, more than a little tongue in cheek. The authors have discussed frequently with each other what part of the Hard Problem should be labeled the easier part and which the harder part. Regardless of the labels we choose, however, this paper focuses on our suggested solution to the combination problem.  Various solutions to the combination problem have been proposed but none have gained widespread acceptance. This paper further elaborates a proposed solution to the combination problem that we first described in Hunt 2011 and Schooler, Hunt, and Schooler 2011. The proposed solution rests on the idea of resonance, a shared vibratory frequency, which can also be called synchrony or field coherence. We will generally use resonance and “sync,” short for synchrony, interchangeably in this paper. We describe the approach as a general resonance theory of consciousness or just “general resonance theory” (GRT). GRT is a field theory of consciousness wherein the various specific fields associated with matter and energy are the seat of conscious awareness.  A summary of our approach appears in Appendix 1.  All things in our universe are constantly in motion, in process. Even objects that appear to be stationary are in fact vibrating, oscillating, resonating, at specific frequencies. So all things are actually processes. Resonance is a specific type of motion, characterized by synchronized oscillation between two states.  An interesting phenomenon occurs when different vibrating processes come into proximity: they will often start vibrating together at the same frequency. They “sync up,” sometimes in ways that can seem mysterious, and allow for richer and faster information and energy flows (Figure 1 offers a schematic). Examining this phenomenon leads to potentially deep insights about the nature of consciousness in both the human/mammalian context but also at a deeper ontological level.

Cannabis sativa is an extraordinarily versatile species. Hemp and its cousin marijuana, both C. sativa, have been used for millennia as a source of fibre, oil and for medicinal, spiritual and recreational purposes. Because the consumption of Cannabis can have psychoactive effects, the plant has been widely banned throughout the last century. In the past decade, evidence of its medicinal properties did lead to the relaxation of legislation in many countries around the world. Consequently, the genetics and development of Cannabis as well as Cannabis-derived products are the subject of renewed attention.Here, we review the biology of C. sativa, including recent insights from taxonomy, morphology and genomics, with an emphasis on the genetics of cannabinoid synthesis. Because the female Cannabis flower is of special interest as the site of cannabinoid synthesis, we explore flower development, flowering time well as the species’ unique sex determination system in detail. Furthermore, we outline the tremendous medicinal, engineering, and environmental opportunities that Cannabis bears. Together, the picture emerges that our understanding of Cannabis biology currently progresses at an unusual speed. A future challenge will be to preserve the multi-purpose nature of Cannabis, and to harness its medicinal properties and sustainability advantages simultaneously.

Quantum chemistry must evolve if it wants to fully leverage the benefits of the internet age, where the world wide web offers a vast tapestry of tools that enable users to communicate and interact with complex data at the speed and convenience of a button press. The Open Chemistry project has developed an open source framework that offers an end-to-end solution for producing, sharing, and visualizing quantum chemical data interactively on the web using an array of modern tools and approaches. These tools build on some of the best open source community projects such as Jupyter for interactive online notebooks, coupled with 3D accelerated visualization, state-of-the-art computational chemistry codes including NWChem and Psi4 and emerging machine learning and data mining tools such as ChemML and ANI. They offer flexible formats to import and export data, along with approaches to compare computational and experimental data.

This paper responds to one by Graham Martin and colleagues, who offered a critique of my previous publications on masks for the lay public in the Covid-19 pandemic. I address their charges that my co-authors and I had misapplied the precautionary principle; drawn conclusions that were not supported by empirical research; and failed to take account of potential harms. But before that, I remind Martin et al that the evidence on mask wearing goes beyond the contested trials and observational studies they place centre stage. I set out some key findings from basic science, epidemiology, mathematical modelling, case studies and natural experiments, and use this rich and diverse body of evidence as the backdrop for my rebuttal of their narrowly-framed objections. I challenge my critics’ apparent assumption that a particular kind of systematic review should be valorised over narrative and real-world evidence, since stories are crucial to both our scientific understanding and our moral imagination. I conclude by thanking my academic adversaries for the intellectual sparring match, but exhort them to remember our professional accountability to a society in crisis. It is time to lay straw men to rest and engage, scientifically and morally, with the dreadful tragedy that is unfolding across the world.

This Supporting information includes interactive plots, videos, and data captured while performing evaluation and validation experiments for our paper. 

The construct of wellbeing has been criticised as a neoliberal construction of western individualism that ignores wider systemic issues including increasing burden of chronic disease, widening inequality, concerns over environmental degradation and anthropogenic climate change. While these criticisms overlook recent developments, there remains a need for biopsychosocial models that extend theoretical grounding beyond individual wellbeing, incorporating overlapping contextual issues relating to community and environment. Our first GENIAL model \cite{Kemp_2017} provided a more expansive view of pathways to longevity in the context of individual health and wellbeing, emphasising bidirectional links to positive social ties and the impact of sociocultural factors. In this paper, we build on these ideas and propose GENIAL 2.0, focusing on intersecting individual-community-environmental contributions to health and wellbeing, and laying an evidence-based, theoretical framework on which future research and innovative therapeutic innovations could be based. We suggest that our transdisciplinary model of wellbeing - focusing on individual, community and environmental contributions to personal wellbeing - will help to move the research field forward. In reconceptualising wellbeing, GENIAL 2.0 bridges the gap between psychological science and population health health systems, and presents opportunities for enhancing the health and wellbeing of people living with chronic conditions. Implications for future generations including the very survival of our species are discussed.  

Floral plantings are promoted to foster ecological intensification of agriculture through provisioning of ecosystem services. However, a comprehensive assessment of the effectiveness of different floral plantings, their characteristics and consequences for crop yield across global regions is lacking. Here we quantified the impacts of flower strips and hedgerows on pest control and pollination services in adjacent crops using a global dataset of 529 sites. Flower strips, but not hedgerows, enhanced pest control services in adjacent fields by 16% on average. However, effects on crop pollination and yield were more variable. Our synthesis identifies several important drivers of variability in effectiveness of plantings: pollination services declined exponentially with distance from plantings, and perennial and older flower strips with higher flowering plant diversity enhanced pollination more effectively. These findings provide promising pathways to optimize floral plantings to more effectively contribute to ecosystem service delivery and ecological intensification of agriculture in the future.

Researchers' ability to accurately screen fossil and subfossil specimens for preservation of DNA and protein sequences remains limited. Thermal exposure and geologic age are usable proxies for sequence preservation on a broad scale but are of nominal use for specimens of similar depositional environments. Cell and tissue biomolecular histology is thus proposed as a novel proxy for determining sequence preservation potential of ancient specimens with improved accuracy. Biomolecular histology as a proxy is hypothesized to elucidate why fossils/subfossils of some depositional environments preserve sequences while others do not and to facilitate selection of ancient specimens for use in molecular studies.

IntroductionConsistent with World Health Organization (WHO) advice [1], UK Infection Protection Control guidance recommends that healthcare workers (HCWs) caring for patients with coronavirus disease 2019 (COVID-19) should use fluid resistant surgical masks type IIR (FRSMs) as respiratory protective equipment (RPE), unless aerosol generating procedures (AGPs) are being undertaken or are likely, when a filtering face piece 3 (FFP3) respirator should be used [2]. In a recent update, an FFP3 respirator is recommended if “an unacceptable risk of transmission remains following rigorous application of the hierarchy of control” [3]. Conversely, guidance from the Centers for Disease Control and Prevention (CDC) recommends that HCWs caring for patients with COVID-19 should use an N95 or higher level respirator [4]. WHO guidance suggests that a respirator, such as FFP3, may be used for HCWs in the absence of AGPs if availability or cost is not an issue [1].A recent systematic review undertaken for PHE concluded that: “patients with SARS-CoV-2 infection who are breathing, talking or coughing generate both respiratory droplets and aerosols, but FRSM (and where required, eye protection) are considered to provide adequate staff protection” [5]. Nevertheless, FFP3 respirators are more effective in preventing aerosol transmission than FRSMs, and observational data suggests that they may improve protection for HCWs [6]. It has therefore been suggested that respirators should be considered as a means of affording the best available protection [7], and some organisations have decided to provide FFP3 (or equivalent) respirators to HCWs caring for COVID-19 patients, despite a lack of mandate from local or national guidelines [8].Data from the HCW testing programme at Cambridge University Hospitals NHS Foundation Trust (CUHNFT) during the first wave of the UK severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic indicated a higher incidence of infection amongst HCWs caring for patients with COVID-19, compared with those who did not [9]. Subsequent studies have confirmed this observation [10, 11]. This disparity persisted at CUHNFT in December 2020, despite control measures consistent with PHE guidance and audits indicating good compliance. The CUHNFT infection control committee therefore implemented a change of RPE for staff on “red” (COVID-19) wards from FRSMs to FFP3 respirators. In this study, we analyse the incidence of SARS-CoV-2 infection in HCWs before and after this transition.

A thrombosed LV aneurysm simulating an Intra-myocardial dissection hematoma (IDH) is a rarely reported condition. We describe a rare case of a 52-year-old man suffering from a thrombosed LV aneurysm, who was initially diagnosed as an IDH by conventional echocardiography. Finally, the patient was diagnosed with thrombosed LV aneurysm through multimodal imaging. We discuss the diagnostic process and surgery of the thrombosed LV aneurysm.

We report the first case of egg burying behaviour in a neotropical direct-developing frog. An amplectant pair of Pristimantis chocoensis was found and we recorded oviposition and the subsequent burying of the clutch by the female. Both parents remained near the nest during the following day. This rare observation sheds light over the intricate reproductive behaviours of terrestrial amphibians and suggests that the evolution of direct development has selected for highly specialized forms of parenting.

Background: The prevalence of infertility has rarely been synthesized at the global level. Objective: To conduct a systematic review and meta-analysis to assess the community-based global prevalence of infertility. Search Strategy: PubMed, MEDLINE, Web of Science, and Science Direct were searched from inception until October 2022. Selection Criteria: Studies were included if they were published in English, had quantitative data, and reported the community-based prevalence of infertility. Data Collection and Analysis: Two authors independently extracted data. Random-effects meta-analysis was used to derive the pooled prevalence of infertility. Variations in the prevalence estimates in different subgroups. Univariate meta-regression was used to explore possible sources of heterogeneity. Main Results: The findings indicated the pooled prevalence of infertility was 12.87% (95% CI,12.41%-13.33%). The prevalences of primary infertility and secondary infertility were 7.34% and 6.01%, respectively. The overall prevalence of infertility among people was the highest in Africa (16.73%) and lowest in the North America (8.84%). Lower prevalence in cohort or prospective follow-up studies (9.75%) than in cross-sectional studies (12.93%). Women aged 35 and above had a higher prevalence of infertility (11.68%) compared to women below 35 years old (5.92%). The prevalence of infertility increased with the number of years, and increased with the degree of literature bias from low to high. Conclusions: This community-based study estimated the global prevalence of infertility to be 12.87% and suggested that an upward trend of the prevalence of infertility may persist in the future.

Skin lesion detection has gained a lot of attention in the last couple of years due to the spread of skin cancer around the world. System-assisted design requires training and classification structure that can only be precise if features are selected appropriately along with improved segmentation of the lesion. This paper introduces a hybrid classification and training algorithm architecture that uses machine learning in all aspects of training and feature selection. The algorithm has been improved by adding novel behavior of Particles and Moth flames to be precise on nature. The proposed algorithm uses a multilayer propagation network for training and classification. The proposed work has been compared with other state-of-the-art algorithms based on quantitative parameters. The proposed work shows a significant improvement in all parameters and aspects.

To ensure the engineering quality and durability of reinforced concrete, vibrating is necessary during the pouring process. Currently, the vibration process during the construction of high-rise buildings is mainly done manually using handheld vibrating rods. However, manual vibration relies heavily on human experience and often results in issues such as over-vibration or insufficient vibration. Once the concrete solidifies, these problems can lead to irreversible consequences. This paper proposes a vibration robot that replaces manual vibrating with a strictly programmed process, improving construction efficiency and project quality. The vibration robot is based on the YOLOv5s algorithm and incorporates Deformable Convolutional Networks (DCN) and Coordinate Attention (CA) mechanisms into the backbone network to enhance target recognition performance. Through image recognition, the vibration robot obtains the coordinates of the vibration center point for controlling the vibration operation. Experimental results show that this method achieves a target recognition rate of 95.24% and a frame transfer rate of 16.94 frames per second. Therefore, using a vibration robot for concrete vibration during pouring holds significant practical value.

Arthropod-eating birds comprise a diverse group with varying degrees of sensitivity to environmental changes and distinct responses to habitat degradation. In our study, we investigated the impact of landscape and habitat characteristics on the functional diversity of insectivorous birds in the Brazilian Atlantic Forest. Our hypotheses are focused on (I) how species composition and functional diversity respond to habitat turnover and nestedness and (II) whether an increase in native forest cover positively influences bird species richness and functional diversity. Our research encompasses 22 different landscapes within the Cantareira-Mantiqueira region, southeastern Brazil, including native forests, pastures, and marshes, within 1 km radius buffers. To assess functional diversity, we employed beta pair and beta multi-function indices for each environment type. Generalized mixed linear models were calculated to examine the effects of the native forest cover gradient and environment type on functional diversity. Our findings indicated negative effects of increased native forest cover on functional diversity indices. Bird communities were susceptibility to turnover in pasturelands, to nestedness in marshes, and both species nestedness and turnover in native forests. These results may be partially due to the predominantly second-growth, small-sized, and early successional stages of the native forest fragments in the region. These findings underscore the intricate interplay between landscape characteristics, habitat types, and bird functional diversity within the Brazilian Atlantic Forest. They also highlight the significance of considering habitat quality and succession stages in conservation efforts in this region.

Multi-shaft stirred reactors significantly impact the mixing efficiency and eliminate isolated mixed regions. Herein, the chaotic characteristics and spatiotemporal instability of flow fields were investigated in three different stirred reactor, and a novel flow field visualization technique was proposed to address limitations with low-viscosity fluids. Results demonstrated the chaotic behavior and energy transfer are inconsistent at various axial positions in the S-T-STR, D-T-STR, and T-T-STR flow fields, which are supported by pressure pulsation attractors, fractal dimension, largest Lyapunov exponents, multiscale entropy, and Kolmogorov entropy analysis. Torque signal attractor images confirmed stable periodic energy input to the flow field through the impeller. Hilbert spectrum analysis revealed time instability and periodic energy features after flow field stabilization. T-T-STR exhibited reduced spatial and temporal instability, denser periodic cycles, accelerated flow field structure evolution and energy transfer rate. These distinctions result from the distinctive flow field structure within each reactor configuration.

Background: In this study, the clinical and laboratory findings, complications, and responses to regular intravenous immunoglobulin (IVIG) treatment of 34 patients diagnosed with primary immunodeficiency (PID) carrying transmembrane activator and CAML interactor (TACI) protein mutations were retrospectively evaluated. Material and Method: Clinical characteristics of patients, complete blood counts, serum immunoglobulin and compleman levels, lymphocyte subgroups, and mutation types of the patients followed up in our clinic for PID and diagnosed with TACI Mutation with Next Generation Sequencing (NGS) Method were examined. Results: A total of 20 (59%) of the patients were male, 14 (41%) were female, 18 were children (<18 years old) who had a median age of genetic diagnosis of 6.2 years and 16 were adults (>18 years) with a median age of genetic diagnosis of 34 years. The most common complaint was recurrent respiratory tract infection (68%). According to the Euro Class Classification (ECC), 14 patients who met the diagnostic criteria of Common Variable Immunodeficiency (CVID) had significantly lower lymphocyte, naïve (CD19+IgD+27-), non-switched (CD19+IgD-27+) number and percentage of B cells than the 20 patients who did not match (p<0.05). A total of 24 of the 34 patients, 13 of whom were children and 11 of whom were adults, received regular IVIG treatment because they met the criteria for ECS and/or had comorbidities. Conclusion: In our study, the fact that bronchiectasis and recurrent pneumonia and the need for hospitalized treatment were less common than in the literature was thought to be related to early IVIG treatment.

Objective: To explore the scope of antimicrobial stewardship activities based on the point prevalence study of antimicrobials among hospitalized patients in a tertiary-level care hospital in the UAE. Methods: A single-center cross-sectional prevalence study was conducted among inpatients admitted to a tertiary care hospital using the European Surveillance of Antimicrobial Consumption tool in February 2023. Antimicrobials used against bacteria only were surveyed. All patients admitted to the selected departments at 8 AM on the day of the survey were included. Data were described in numbers and percentages. Results: Among 136 patients admitted at the time of the study, 87 received antimicrobials, representing a prevalence of 64%. A total of 144 antimicrobial prescriptions were prescribed in 87 patients. The majority of the antimicrobials were administered parenterally (n=122, 84.7%), and over 60% (n=53) of the patients on antimicrobials received two antimicrobials. The majority of antimicrobials used for therapy were empiric in nature (n=68, 89.5%). Over half of the patients receiving antimicrobials for surgical prophylaxis were prescribed antimicrobials for two or more days. More than 60% of the antimicrobial orders were adherent to the hospital guidelines. Conclusion: The point prevalence of the use of antimicrobials is high, which highlights the need for more efficient and targeted stewardship efforts in improving adherence with the hospital guidelines. Wide usage of broadspectrum antimicrobials is observed.

Background: Intracardiac echocardiography (ICE) is increasingly used during left atrial appendage occlusion (LAAO) as an alternative to transesophageal echocardiography (TEE) Aim: To evaluate the impact of ICE vs. TEE guidance during LAAO on procedural characteristics and acute outcomes, as well the presence of peri-device leaks and residual septal defects during follow-up. Methods: All studies comparing ICE-guided vs. TEE-guided LAAO were identified. The primary outcomes were procedural efficacy and occurrence of procedure-related complications. Secondary outcomes included lab efficiency (defined as a reduction in in-room time), procedural time, fluoroscopy time, and presence of peri-device leaks and residual interatrial septal defects (IASD) during follow-up. Results: Twelve studies (n=5637) were included. There were no differences in procedural success group (98.3% vs. 97.8%; OR 0.73, 95% CI 0.42-1.27, p=0.27; I2=0%) or adverse events (4.5% vs. 4.4%; OR 0.81 95% CI 0.56-1.16, p=0.25; I2=0%) between the ICE-guided and TEE-guided groups. ICE guidance reduced in in-room time (mean-weighted 28.6-minute reduction in in-room time) without differences in procedural time or fluoroscopy time. There were no differences in peri-device leak (OR 0.93, 95% CI 0.68-1.27, p=0.64); however, an increased prevalence of residual IASD was observed with ICE-guided vs. TEE-guided LAAO (46.3% vs. 34.2%; OR 2.23, 95% CI 1.05-4.75, p=0.04). Conclusion: ICE guidance is associated with similar procedural efficacy and safety, but could result in improved lab efficiency (as established by a significant reduction in in-room time). No differences in the rate of periprocedural leaks were found. A higher prevalence of residual interatrial septal defects was observed with ICE guidance.

This study focuses on the evolution of the fatigue strength of L-PBF produced Ti-6Al-4V as a function of the chemical etching finishing process. The aim is to identify the critical fatigue crack initiation mechanisms and the transitions between them in terms of the evolution of the surface micro-geometry caused by the finishing process. This has been done using three different geometries and six different surface states, including the machined reference surface state. The evolution of the crack initiation mechanisms, identified via SEM observations of the fatigue failure surfaces, is then used to explain the evolutions of the fatigue strength and the fatigue scatter, in both the finite and the high cycle fatigue-life domains. As expected, chemical etching effects the fatigue life via a polishing effect on the micro-geometry, which directly influences both the finite and the high cycle fatigue domains. It is shown that chemical etching makes it possible to obtain fatigue strengths that are almost similar to those of the machined surface, despite the fact that the roughness is higher, even after an optimal etching time. However, it is also observed that etching cannot fully counter the effects of large surface connected porosities (typically lack-of-fusion) that lead to large surface cavities. Some minor scale or size effects can also be noted between the different coupon geometries. This does not modify the conclusions concerning the initiation mechanisms and their effect on the fatigue life.

Aims: Although alcohol consumption is proposed to trigger electrographic abnormalities, acute changes in arrythmias and conductance disturbances have not been systematically studied in young adults who are the age group most likely to binge drink. The aim of this study was to determine if changes in breath alcohol content (BrAC) during an acute binging episode influence electrographic abnormalities in young adults. Methods: Fifty-five university students (20.6±2.1 years of age), who were not regular users of alcohol, consumed 60% mixer and 40% vodka until 0.08% BrAC was reached (6.4±1.9 standard drinks). Five-lead Holter recordings were analysed by a blinded cardiac technician. Electrographic abnormalities were identified and classified according to location (supraventricular or ventricular) and type (arrhythmia or conduction disturbance). Results: Although heart rate was elevated with BrAC beyond 0.05% compared to 0.00%, no differences existed in the relative incidence of electrographic abnormalities by location or type. Logistic regression revealed that baseline electrographic abnormality significantly contributed to predicting electrographic abnormality in 0.00% to 0.05% (p=0.02) and 0.05% to 0.08% BrAC phases (p=0.01). Conclusions: Alcohol consumption, resulting in BrAC of 0.08%, increased heart rate after BrAC reached 0.05% but did not acutely influence the relative incidence of electrographic abnormality by location or type in apparently healthy young people. These results do not support the hypothesis that a binge drinking episode causes electrographic abnormalities in young adults.