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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.

Two cases of severe mitral regurgitation and pulmonary hypertension immediately after birth are presented. Initial echocardiographic findings showed a thick atrial septum rather than a normal flap septum. The patients were tentatively diagnosed with premature restriction of the foramen ovale and congenital mitral regurgitation. Subsequently, the mitral regurgitation resolved over time with improvement of pulmonary hypertension. The postnatal ductus arteriosus closure process was considered to be the cause of the mitral regurgitation and pulmonary hypertension.

As one of the primary medicinal species of Glycyrrhiza under state key protection, Glycyrrhiza iflata has the characteristics of light-loving, drought-tolerant, heat-resistant, and salt-tolerant, and belongs to the dominant species in Xinjiang extreme desert ecosystem. Based on 130 effective distribution records and 8 environmental factors in China, the Maxent model was used to construct the potential geographical distribution pattern of Glycyrrhiza iflata in the last glacial maximum, middle Holocene, modern and future (2050). Essence Results show that: (1) The key climate restrictions that affect the geographical distribution of Glycyrrhiza iflata is the average annual precipitation. (2) The modern area of Glycyrrhiza iflata is 18.3 × 105km2. (3) Under the low emission scenario from the last interglacial maximum to 2050, the potential habitable area is 18.1×105km2, and the reduced area is 4.2×105km2, with a reduction rate of 19.0%. The highly suitable area was 2.5×105km2, and the reduced area was 2.8×105km2, with a reduction rate of 52.6%. (4) From the last glaciation maximum to the middle Holocene, the geographical distribution center shifted to the southwest margin of the Kumtag Desert, Xinjiang. Since then, the geographical distribution center of Glycyrrhiza iflata will continue to migrate to the southwest, but it’s going to stabilize in the future (2050). These results provided theoretical basis for the protection, utilization, origin, and evolution of Glycyrrhiza iflata.

OBJECTIVES: There is a need for early identification and intervention of Adverse Drug Reaction (ADR) to alleviate unacceptably growing burden, morbidity and mortality associated in People With Epilepsy (PWE). This study is aimed at identifying factors associated with ADR and medication adherence among patients in PWE. METHODS: It is a cross-sectional questionnaire-based study consisting of 940 consenting participants aged 16 years and above attending epilepsy clinics for period of 5years with diagnosis confirmed by International League against Epilepsy (ILAE) criteria and supported by Electroencephalography (EEG). 21-item Liverpool Adverse Effect Profile (LEAP) and 8-item. Morinsky Medication Adherence Scale (MMAS) were used to assess ADR and adherence respectively. RESULTS: The highest reported ADR in PWE were nervousness (34.3%), aggression (33.6%) and weight gain (32.3%). Specifically, (20.1%) of the participant complained of memory problem, while the lowest were hair loss (7.2%), trouble with mouth (8.9%) and problem with skin (9.3%). Using the MMAS, 545(90.2%), 28(4.6%) and 31(5.1%) of PWE in this study were classified as having high, medium, and low adherence, respectively. Duration of AEDs use and duration of epilepsy were the major determinant of ADR in PWE on regression model. CONCLUSION: Duration of AEDs use and duration of epilepsy are the major determinant of ADR in PWE. Effective strategies to identify and reduce ADR should be incorporated to management of PWE by Health Care Providers to improve their quality of life. Furthermore, physician should aim towards reducing the duration of AED use and the epilepsy.

A document by Nagaveni Somayaji. Click on the document to view its contents.

Root exudates serve as crucial mediators for the information exchange between plants and soil, which is an important evolutionary mechanism for plants to adapt to environmental changes. In this study, 15 different abiotic stress models were established using various stress factors, including drought (D), high temperature (T), nitrogen deficiency (N), and phosphorus deficiency (P) and their combinations. We investigated their effects on the seedling growth of Salvia miltiorrhiza Bunge and the activities of

1. After the Fukushima Daiichi Nuclear Power Plant accident in 2011, radionuclides have been detected in the tissues of wild animals. It was found that some individuals had higher radiocesium activity concentrations than others, despite being captured in the same area. One of the reasons for this disparity was attributed to migration from areas where radiocesium contamination level was different. 2. We identified the genetic population of Asian black bears using two genetic markers, such as mtDNA D-loop haplotype and SNPs by MIG-seq analysis. Then, we assessed migration between populations and variation in the radiocesium activity concentrations in the muscle tissue of distinct populations. 3. The SNPs analysis identified clearer two populations (SP1 and SP2) than the mtDNA analysis. Population distribution inferred based on SNPs was affected by geographic features and land use. 4. The radiocesium activity concentrations in muscle tissues in SP2 were higher than those in SP1. The radiocesium activity concentrations in muscle tissue were positively correlated with radiocesium contamination levels at the capture site. Since the radiocesium contamination levels at the capture sites of SP2 were higher than those of SP1, it was inferred that the levels of radiocesium contamination in each population would show a similar pattern. 5. Migration occurred between the genetic populations and migration rate differed between the genetic populations, with the rate of individuals migrating from SP2 to SP1 being smaller than that from SP1 to SP2. Therefore, it was suggested migration was responsible for some individuals having relatively higher radiocesium activity concentrations in muscle tissue, despite being captured in the same area. 6. This study is the first report that showed the genetic structure of Asian black bear in Fukushima Prefecture in fine scale, the migration rate between the populations, and the effect of migration on the variation of radiocesium activity concentration.

Introduction:Snapping at the lateral knee can be caused by a variety of pathologies involving surrounding soft tissue structures such as the popliteus, semitendinosus and/or gracilis tendons, IT Band syndrome, lateral meniscus tears, or rheumatoid nodules.1-4snapping In rare instances, lateral knee pain may also be caused by the distal tendon of the biceps femoris long head shifting over the fibular head.5-6 Regardless, the various differential diagnoses should be properly ruled out by a careful history, a detailed physical exam, and advanced imaging.Few cases of snapping biceps femoris tendons have been recorded in the literature across various case reports. Causes of the snapping biceps femoris tendon have been attributed to anomalous insertions (most prevalent), 7-16 tendon subluxation,17-18 abnormalities of the fibular head,19-23 or secondary to trauma. 6, 24 Conservative treatment is usually attempted first and consists of physical therapy and anti-inflammatory medications as needed. Surgery, which is usually the last resort and the most effective, consists of resecting the anomalous tendon insertion or correcting any fibular deformities.In this report, we present a patient with lateral knee pain from an accessory insertion of the snapping biceps femoris tendon and discuss surgical exploration and repair. The patient was informed that his case would be submitted for publication and he provided consent.

Halophilic microorganisms play a crucial role in plant health and growth in salinity affected lands. The objective of this study was to evaluate the haloarchaeal diversity from the rhizosphere of halophytes and plant growth promoting abilities of these strains. The whole genome sequences of two haloarchaeal strains, Halorubrum lacusprofundi HL1RP11 and Halobacterium noricense NRS2HaP9, were analyzed, and genes related to plant growth promoting traits were identified. Phylogenetic analysis showed that archaeal strains of Halococcus, Halorubrum, Halobacterium and Natrinema were dominant in the rhizosphere of halophytes. More than 60% of the strains were positive for phosphate solubilization and IAA production. About 50% of strains were positive for nitrogen fixation, while 33% were siderophore producers. More than 40% of haloarchaeal strains showed the heavy metal resistance for Nickel, Cadmium, Chromium and Zinc at a concentration of 5 mM. Genes involved in plant growth promotion were identified through annotation. Gene clusters related to secondary metabolites including phenazine, siderophore production and terpene were also identified in this study. Our results suggested that these haloarchaeal strains can be used as an eco-friendly biofertilizer to improve growth and productivity in hypersaline environment.

A 46-year-old woman underwent pericardiocentesis and pericardial window for recurrent pericardial effusion. She presented 17 months later with signs and symptoms consistent with constrictive pericarditis. Cardiac magnetic resonance imaging revealed an infiltrative mass surrounding the pericardium. A transcutaneous core needle biopsy of the pericardium confirmed the diagnosis of pericardial mesothelioma.

To improve the detection rate of pulmonary nodules in early lung cancer screening, a low-dose CT pulmonary nodule detection algorithm based on 3D CNN-CapsNet (3D convolution neural network and capsule network) was presented. However, the convolution kernel size of the traditional CNN is relatively simple at each layer, and it is difficult to obtain more abundant features, which is not effective for medical images with a hierarchical structure and does not fully consider the spatial information of medical sequence data. CapsNet is a new network architecture that can be used to classify, using a group of neurons as a capsule to replace the traditional neural networks, it may be made to the attribute information and spatial feature extraction. The network structure we designed includes FCN and CapsNet. First, the convolution kernels of different sizes are used to extract features at different scales. Then enter the initial feature map to obtain the first part into the designed CapsNet to get the final classification result. Through the experimental verification of the ELCAP database, the nodule detection rate is 95.19%, the sensitivity is 92.31%, the specificity is 98.08% and the F1-score is 0.95 which are much better than other baseline methods.

Rationale: The United States has one of the highest healthcare expenditures among developed nations despite performing poorly on health metrics and access to care. Wasteful healthcare expenditures in the US not only affect patients but also have broader implications for public health. Aims and objectives: To identify major sources that contribute to wasteful spending in the US healthcare system. Method: A comprehensive literature search was conducted to identify relevant studies on wasteful expenditures burdening the US healthcare system. Search terms such as “wasteful expenditures,” “healthcare costs,” and “inefficiencies in US healthcare” were used in PubMed and Google Scholar databases. Full-text peer-reviewed articles, reports, internet articles, and policy documents were included in the study. Studies published in languages other than English were excluded. No ethical approval was required for this review as the analysis was conducted on previously published literature. Results: Approximately a third of US healthcare spending is considered wasteful. According to the Institute of Medicine, excess costs have been associated with unnecessary services, inefficient delivery of services, high service prices, excessive administrative costs, low emphasis on prevention, and fraud. Other factors that were identified to affect the healthcare experience for patients included insurance payment denials, high out-of-pocket expenses, and administrative complexities. Overcoming these aspects might result in annual savings that can range up to $282 billion. Additionally, the US has greater preventable and treatable mortality rates than other nations due to increasing chronic diseases, emphasizing the need for greater utility of preventive and primary care services. Despite the ACA’s intention to include preventive services in health plans, obstacles persist in their consistent integration across states. Conclusion: In summary, improving access to care by increasing affordability and prioritizing preventive care services can substantially reduce unnecessary costs to the US healthcare system.

After using epidural electrical stimulation to reduce spastic pains in spinal cord injury sufferers from long ago, more recently the possibility of its usage in improving motor abilities has been proposed and shown in some human clinical trials. This systematic review searches 4 important databases including PubMed, Embase, Scopus and web of science in compliance with the PRISMA guidelines to find relevant human clinical trials and extract their data to get the most accurate conclusion and possibly consider the use of epidural electrical stimulation more seriously and extensively to help spinal cord injury patients struggling for their most basic skills. We concluded that epidural electrical stimulation has had notable effect on regain of walking even in those with chronic complete paralysis.