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Michael Weekes

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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: [email protected] 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.

Guangming Wang

and 4 more

Tam Hunt

and 1 more

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.

Susanne Schilling*^

and 9 more

Jessica mead

and 6 more

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.  

Mark Ferris

and 14 more

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.

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Nikolaos Neokleous

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Introduction: Hospitals as well as other Health Organizations are stressful work environments with a heavy workload. This is the main reason why conflicts between the workers come to fruition in this environment. Employees express their dissatisfaction with the confrontational environment, their harmonious cooperation is disturbed, which ultimately has a negative impact on the provision and degree of quality of health care. Purpose: The purpose of this study is to investigate the management of conflicts between medical staff in state hospitals. It was examined which individuals’ doctors usually argue with, how and why do they react to the conflict, what are the main causes of conflicts and how they are resolved. It will be examined also whether or not there are any differences between hospitals or between medical specialties or between professional levels. Methodology: A cross-sectional study was carried out at February 2023 among the members of State Health Services Organization and Pancyprian Union of Government Physicians. A single two-part questionnaire was used for sampling. The first part consists of demographic and professional characteristics of the participants medical workers and the second part deals with the management of conflicts. The analysis of the data was done using the statistical package IBM SPSS Statistics version 29.0.0.0 (241). Statistical significance was defined as p<0.05. Results: The survey involved 103 people, the majority were men (53.4%), with more than 15 years of work experience (43.7%) and with open-ended job position (55.3%). 79.6% of the sample was found to be likely to collide with a colleague, 52.3% with a doctor of the same specialty and 23.3% with the same and another specialty, of the same and another hospital. As a way to react to the conflict, 31.1% chose to collaborate and only 4 people to use mediator, of which 75% said that for mediation they would choose their supervisor. Conclusions: The development of an environment of justice and cooperation in the health areas is necessary and presupposes the optimal settlement of conflicts. In a working environment such as that of hospitals, it is necessary to transmit the culture of team spirit and cooperation. Thus, managers play a primary role through their attitude and their actions. Educational actions should therefore be organised regarding the improvement of communication, the expansion of emotional intelligence and conflict management techniques.

Hao guoxiong

and 6 more

Purpose:The primary objective of this study was to comprehensively evaluate and compare the therapeutic efficacy of trastuzumab in combination with capecitabine plus cisplatin versus capecitabine plus cisplatin in the management of patients diagnosed with advanced human epidermal growth factor receptor 2 (HER2)-positive gastric cancer. Aiming to facilitate clinical decision-making and ultimately improving treatment outcomes for this specific patient population. Methods:A comprehensive computerized search was conducted across multiple databases, including Cochrane Library, Web of Science, PubMed, Embase, CNKI, CBM, VIP, and Wanfang to identify domestic and foreign clinical randomized controlled trials (RCTs), investigating the efficacy of trastuzumab in combination with capecitabine plus cisplatin for the treatment of patients with advanced HER2-positive gastric cancer. The search encompassed articles published from the inception of the databases until July 1, 2022. Results:This meta-analysis comprised 12 studies involving a total of 1199 patients diagnosed with advanced HER2-positive gastric cancer. The results revealed that the experimental group exhibited significantly higher rates of total effectiveness and control compared to the control group. Moreover, the experimental group showed a significant increase in median survival time compared to the control group. Additionally, the experimental group exhibited a significantly higher quality of life score and demonstrated improved prognosis in terms of carbohydrate antigen 19-9 (CA19-9) levels, with a lower recurrence rate. The experimental group showed a decrease in the stage of gastric cancer based on carbohydrate antigen 72-4 (CA72-4) levels and (CEA) levels compared to the control group.. Furthermore, the experimental group exhibited a notable enhancement in the therapeutic efficacy of vascular endothelial growth factor (VEGF) and a superior prognosis compared to the control group. Conclusion:Trastuzumab in combination with capecitabine plus cisplatin can be a preferred first-line treatment option for advanced HER2-positive gastric cancer, accompanying by a promising therapeutic efficacy.

Feng Chun Yang

and 8 more

Yuanjiang dry-hot valley is a poorly vegetated area and a fragile arid ecosystem. Although, in the past the valley was lushly forested, it has become a tropical montane savannah in recent decades. Nonetheless, it is unclear what controls plant species distribution in these kinds of dry-hot valleys. Clarifying this will be beneficial to sustainable ecosystem management in dry-hot valleys. This study explored the relationship between plant species and their living environments in the low land of this dry-hot valley. To achieve this, transects and plots were arranged along the river channel while alpha and beta indices were employed to observe the biodiversity change between species and environments. Estimated species, rarity, and abundance indices were also subscribed to examine the correlation among species, population size, and their living circumstances in terms of Species_estimated, Singletons, Uniques, ACE, ICE, and Chao2. Fifty years of meteorological records including temperature and precipitation were collected for environmental reference . The results indicated that: (1) alpha diversity is higher when located closer to the river channel than from afar whereas beta diversity increases from the upper stream to the lower stream with Bray-Curtis < 0.500, but this condition is reversed in the transect perpendicular to the river; (2) total phosphorous (TP) and total potassium (TK) are increased when slope is declined, tending to be in the same direction as the total increase of nitrogen (TN) and organic matters (OM); (3) all measured nutrients are aggregated to the lower stream along with river flows, corresponding to an increased number of species; (4) water supply is the determinant factor for plant distribution while soil condition is the key decisive factor for water retention; (5) estimated species, rarity and abundance indices are significant on the sites that are closer to the river, thus strongly indicating heterogeneous of habitats and soil condition. (6) Fern species is screened as an indicator, thus representing the xeric environment in Yuanjiang dry-hot valley. Conclusively, plants are not flourished at low altitudes which are ascribed to high temperatures and low water supply. Therefore, attention and policy on microhabitat protection and environment management should be drawn and enforced exclusively for this valley.

Mehdi Azad

and 2 more

Marie-Douce Primeau

and 4 more

Background. Patient engagement is seen as a fundamental strategy for achieving quality patient-centred care, especially in community-based primary healthcare (OMS2023, Haesebaert et al. 2018). Despite growing interest in patient engagement in Sub-Saharan Africa, few patient engagement initiatives have been identified, and those often are limited to lower-levels of engagement, in participation in health research or in health system improvement (Gogovor et al. 2023). With the aim of giving a voice to under-represented community groups in healthcare governance, the ASSK project supported the implementation of primary health services user committees in the Democratic Republic of the Congo (DRC), designed to enable the representation of two user groups with specific unmet sexual and reproductive health (SRH) needs: women and adolescents. Aims and Methods. Using a mixed-method case study design combining quantitative secondary data (DHIS2) and qualitative data from two research World Cafés (WC1:Women user committees (WUC) n=55; WC2: Adolescents user committee (AUC) n=63)(Schield et al. 2022), this paper looks at the implementation facilitators and barriers, and at the results of this initiative. Results. Women and adolescent members of the user committees highlighted that their participation resulted in increased knowledge of SRH and their related rights, as well as in their “soft skills” such as communication and leadership. In addition, participants reported greater transparency and accountability on the part of the community primary health centers (e.g. by displaying fees for procedures to counter over-billing). Ultimately, WUC and AUC were associated with improved health practices in the community such as increased use of sexual and reproductive health services, including adolescent family planning and assisted childbirth (15-49 years old). Conclusions. Patient user committees for specific marginalized or under-represented groups appear to be an effective way of improving the quality of primary health care services. Further research is needed to better understand how to maximize its potential.
The integration of precise landing capabilities into UAVs is crucial for enabling autonomous operations, particularly in challenging environments such as the offshore scenarios. This work proposes a heterogeneous perception system that incorporates a multimodal fiducial marker, designed to improve the accuracy and robustness of autonomous landing of UAVs in both daytime and nighttime operations. This work presents ViTAL-TAPE, a visual transformer-based model, that enhance the detection reliability of the landing target and overcomes the changes in the illumination conditions and viewpoint positions, where traditional methods fail. VITAL-TAPE is an end-to-end model that combines multimodal perceptual information, including photometric and radiometric data, to detect landing targets defined by a fiducial marker with 6 degrees-of-freedom. Extensive experiments have proved the ability of VITAL-TAPE to detect fiducial markers with an error of 0.01 m. Moreover, experiments using the RAVEN UAV, designed to endure the challenging weather conditions of offshore scenarios, demonstrated that the autonomous landing technology proposed in this work achieved an accuracy up to 0.1 m. This research also presents the first successful autonomous operation of a UAV in a commercial offshore wind farm with floating foundations installed in the Atlantic Ocean. These experiments showcased the system's accuracy, resilience and robustness, resulting in a precise landing technology that extends mission capabilities of UAVs, enabling autonomous and Beyond Visual Line of Sight offshore operations.

Andrew Fleming

and 14 more

Background: Concomitant Wilms tumor (WT) and autosomal dominant polycystic kidney disease (ADPKD) is exceedingly rare, presenting a diagnostic and technical challenge to pediatric surgical oncologists. The simultaneous workup and management of these disease processes is incompletely described. Procedure: We performed a retrospective analysis of patients treated at our institution with concomitant diagnoses of WT and ADPKD. We also review the literature on the underlying biology and management principles of these conditions. Results: We present three diverse cases of concomitant unilateral WT and ADPKD who underwent nephrectomy. One patient had preoperative imaging consistent with ADPKD with confirmatory testing postoperatively, one was found to have contralateral renal cysts intraoperatively with confirmatory imaging post-nephrectomy, and one was diagnosed in childhood post-nephrectomy. All patients are alive at last follow-up, and the patient with longest follow-up has progressed to end-stage kidney failure requiring transplantation and dialysis in adulthood. All patients underwent germline testing and were found to have no cancer predisposition syndrome or pathogenic or likely-pathogenic variants for WT. Conclusion: Concomitant inheritance of ADPKD and development of WT is extremely rare, and manifestations of ADPKD may not present until late childhood or adulthood. ADPKD is not a known predisposing condition for WT. When ADPKD diagnosis is made by family history, imaging, and/or genetic testing before WT diagnosis and treatment, the need for extensive preoperative characterization of cystic kidney lesions in children and increased risk of post-nephrectomy kidney failure warrant further discussion of surgical approach and peri-operative management strategies.

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Urbanization modifies ecosystem conditions and evolutionary processes. This includes air pollution, mostly as tropospheric ozone (O3), which contributes to the decline of urban and peri-urban forests. A notable case are fir(Abies religiosa) forests in the peripheral mountains southwest of Mexico City, which have been severely affected by O3 pollution since the 1970s. Interestingly, some young individuals exhibiting minimal O3—related damage have been observed within a zone of significant O3 exposure. Using this setting as a natural experiment, we compared asymptomatic and symptomatic individuals of similar age (≤15 years old; n = 10) using histological, metabolomic and transcriptomic approaches. Plants were sampled during days of high (170 ppb) and moderate (87 ppb) O3 concentration. Given that there have been reforestation efforts in the region, with plants from different source populations, we first confirmed that all analysed individuals clustered within the local genetic group when compared to a species-wide panel (Admixture analysis with ~1.5K SNPs). We observed thicker epidermis and more collapsed cells in the palisade parenchyma of needles from symptomatic individuals than from their asymptomatic counterparts, with differences increasing with needle age. Furthermore, symptomatic individuals exhibited lower concentrations of various terpenes (ß-pinene, ß-caryophylene oxide, α-caryophylene and ß-α-cubebene) than asymptomatic trees, as evidenced through GC-MS. Finally, transcriptomic analyses revealed differential expression for thirteen genes related to carbohydrate metabolism, plant defense, and gene regulation. Our results indicate a rapid and contrasting phenotypic response among trees, likely influenced by standing genetic variation and/or plastic mechanisms. They open the door to future evolutionary studies for understanding how O3 tolerance develops in urban environments, and how this knowledge could contribute to forest restoration.

Mohammad Rowshan

and 4 more

Channel coding plays a pivotal role in ensuring reliable communication over wireless channels. With the growing need for ultra-reliable communication in emerging wireless use cases, the significance of channel coding has amplified. Furthermore, minimizing decoding latency is crucial for critical-mission applications, while optimizing energy efficiency is paramount for mobile and the Internet of Things (IoT) communications. As the fifth generation (5G) of mobile communications is currently in operation and 5G-advanced is on the horizon, the objective of this paper is to assess prominent channel coding schemes in the context of recent advancements and the anticipated requirements for the sixth generation (6G). In this paper, after considering the potential impact of channel coding on key performance indicators (KPIs) of wireless networks, we review the evolution of mobile communication standards and the organizations involved in the standardization, from the first generation (1G) to the current 5G, highlighting the technologies integral to achieving targeted KPIs such as reliability, data rate, latency, energy efficiency, spectral efficiency, connection density, and traffic capacity. Following this, we delve into the anticipated requirements for potential use cases in 6G. The subsequent sections of the paper focus on a comprehensive review of three primary coding schemes utilized in past generations and their recent advancements: lowdensity parity-check (LDPC) codes, turbo codes (including convolutional codes), and polar codes (alongside Reed-Muller codes). Additionally, we examine alternative coding schemes like Fountain codes (also known as rate-less codes), sparse regression codes, among others. Our evaluation includes a comparative analysis of error correction performance and the performance of hardware implementation for these coding schemes, providing insights into their potential and suitability for the upcoming 6G era. Lastly, we will briefly explore considerations such as higher-order modulations and waveform design, examining their contributions to enhancing key performance indicators in conjunction with channel coding schemes.
The involvement of users in the product development process can significantly enhance product quality. The relationship between user experience and knowledge in product design contributes to product efficiency during the development phase. Users often struggle to align their perceptions, leading to extended product usage times and an inability to react to potential performance variations. Product manufacturers also face challenges in identifying suitable features that can positively impact product success and marketability. User experience in product interactions, encompassing both aesthetic and functional aspects, plays a pivotal role in influencing user evaluations and distinguishing characteristics crucial for achieving product success. Determining user knowledge’s influence on product success characteristics can provide valuable insights for the new product development process. This study conducted a survey to gather user experiences and knowledge, aiming to enhance the understanding of how users perceive products. This understanding is crucial for identifying product success characteristics, encompassing aspects such as specifications, sustainability, and recognition, which are instrumental in achieving overall product success. The results of the survey indicate that user knowledge, emotional experiences, and product attribute knowledge can assist product designers and manufacturers in identifying key characteristics for success during the early stages of the new product development process.

Christian Mazimpaka

and 14 more

Background: In Rwanda, Community Health Workers (CHWs) serve a crucial function in providing community-based maternal and neonatal health (CBMNH) services. However, limited access to refresher training contributes to knowledge gaps among CHWs, affecting their confidence and ability to execute their roles effectively. This study aimed to evaluate the impact of eLearning on enhancing and maintaining CHWs’ knowledge of CBMNH. Methods: This prospective cohort study, conducted from April-October 2021 in two Rwandan districts, evaluated knowledge acquisition and retention among 36 Community Health Workers (CHWs) participating in an eLearning course. Knowledge scores were measured using a structured questionnaire administered pre-training, post-training, and at a six-month follow-up. Descriptive analysis and paired t-tests were used to assess mean score differences, exploring the effectiveness of this eLearning approach. Results: This study demonstrated an improvement in Community Health Workers’ (CHWs) performance scores following eLearning training, with an average rise from 86.5% to 98.2%. The improvement was sustained at a six-month follow-up. Statistical significance was found between age category and CHWs’ pre and post-test performance (p=0.01, p=0.04 respectively), and between years of experience and pre-test scores (p=0.02), highlighting demographic influences on training outcomes. Conclusions: The results of this study suggest that eLearning is an effective method for enhancing and retaining CHWs’ knowledge of CBMNH. The findings support the use of eLearning as a valuable strategy for strengthening the capacity of CHWs in Rwanda and other countries with similar contexts.

Dan Bayley

and 4 more

The threat from novel marine species introductions is a global issue. When Non-native marine species are introduced to novel environments and become invasive, they can affect biodiversity, industry, ecosystem function, and both human and wildlife health. Isolated areas with sensitive or highly specialised endemic species can be particularly impacted. The global increase in the scope of tourism activities together with a rapidly changing climate, now put these remote ecosystems under threat. In this context, we analyse invasion pathways into South Georgia & the South Sandwich Islands (SGSSI) for marine non-native species via vessel biofouling. The SGSSI archipelago has high biodiversity and endemism, and has historically been highly isolated from the South American mainland. The islands sit just below the Polar Front temperature boundary, affording some protection against introductions. However, the region is now warming and SGSSI increasingly acts as a gateway port for vessel traffic into the wider Antarctic, amplifying invasion likelihood. We use remote AIS vessel-tracking data over a two-year period to map vessel movement and behaviour around South Georgia, and across the ‘Scotia Sea’, ‘Magellanic’, and northern ‘Continental High Antarctic’ ecoregions. We find multiple vessel types from locations across the globe frequently now enter shallow inshore waters and stop for prolonged periods (weeks/months) at anchor. Vessels are active throughout the year and stop at multiple port hubs, frequently crossing international waters and ecoregions. Management recommendations to reduce marine invasion likelihood within SGSSI include initiating benthic and hull monitoring at the identified activity/dispersion hubs of King Edward Point, Bay of Isles, Gold Harbour, St Andrews Bay and Stromness Bay. More broadly, regional collaboration and coordination is necessary at neighbouring international ports. Here vessels need increased pre- and post-arrival biosecurity assessment following set protocols, and improved monitoring of hulls for biofouling to pre-emptively mitigate this threat.

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