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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.

In this paper, Hopf and zero-Hopf bifurcations are investigated for a class of three-dimensional cubic Kolmogorov systems with one positive equilibrium. Firstly, by computing the singular point quantities and figuring out center conditions, we determined that the highest order of the positive equilibrium is eight as a fine focus, which yields that there exist at most seven small amplitude limit cycles restricted to one center manifold and Hopf cyclicity 8 at the positive equilibrium. Secondly, by using the normal form algorithm, we discuss the existence of stable periodic solution via zero-Hopf bifurcation around the positive equilibrium. At the same time, the relevance between zero-Hopf bifurcation and Hopf bifurcation is analyzed via its special case, which is rarely considered. Finally, some related illustrations are given by means of numerical simulation.

Introduction: National lockdown was implemented to slow down the COVID-19 outbreak. This paper aims to compare the epidemiology of paediatric orthopaedic trauma presentation, management and outcomes during the lockdown period with the matched pre-pandemic period in 2019. Methods: This was a retrospective cohort study. All patients aged 0 - 18 years who required trauma unit management during the school closure period (18 March – 25 May 2020) were included. Cases for the matched period in 2019 were analysed for comparison. Patient demographics, mechanism and anatomic location of injury, management, and follow-up were assessed. Results: 286 and 575 injuries were observed in 2020 and 2019, respectively. In 2020, we observed a 50.3% fall in paediatric trauma presentation. There was a significant reduction in the average age at presentation by more than one year (p < 0.001). Sports-related injuries decreased significantly (n=16 5.6% vs n=127 22.1%; p<0.001). Proportion of ride on injuries increased significantly (n=63 22% vs n=61 10.6%; p<0.0001). Non-accidental injury concerns rose significantly (n=9 3.1% vs n=4 0.7%; p=0.01). There was a proportional increase in upper limb injuries (64.3% vs 58.4%) and proportional reduction in lower limb injuries (32.1% vs 35.5%). Use of conservative management increased. Telephone follow-up rose significantly (23% vs 6%; p < 0.001). Re-presentation rate increased significantly (1.4% vs 0.2%; p = 0.04). Conclusion: There was a reduction in paediatric trauma presentation and the average age at presentation during lockdown. This change was accompanied by a shift in mechanism and anatomic location of injury, management, and follow-up.

The use of artificial intelligence (AI) techniques in agriculture has reached a critical point, and classification studies utilizing machine learning (ML) methods for agricultural products are being conducted intensively. However, these studies face challenges in creating balanced datasets, which can significantly impact the performance of proposed methods and lead to confusing results. In this study, we address this challenge by creating a dataset comprising data from 7 species of date palm (Phoenix dactylifera L.) and 2 species of pistachio fruit (Pistacia vera L). Our objective is to evaluate the performance of ML methods on this dataset and explore the effectiveness of the Synthetic Minority Over-Sampling Technique (SMOTE) for improving classification accuracy. Initially, we performed classification on the original dataset using popular ML methods. Among these methods, the POLY-SVM model exhibited the best performance with an accuracy ratio of 92.95%. However, we observed limitations in the classification results due to the unbalanced distribution of data among different classes. To address this issue, we applied the SMOTE technique for over-sampling, which effectively balanced the data distribution. The POLY-SVM model, when trained on the dataset after SMOTE over-sampling, achieved a significantly improved classification accuracy of 98.64%. Furthermore, our proposed model demonstrated enhanced sub-classification performance, particularly for fruit species. In conclusion, this study highlights the challenges posed by unbalanced data distribution in agricultural product classification studies using ML methods. By utilizing the SMOTE technique for data over-sampling, we successfully addressed this challenge and improved classification accuracy.

Aims: Conduct a systematic review of case reports and case series regarding the development of acute abdomen following vaccination with COVID-19, to describe in detail the possible association, the clinical and demographic characteristics. Methods: Case report studies and case series regarding the development of acute abdomen following COVID-19 vaccination were included. Systematic review studies, literature, letters to the editor, brief comments, etc. were excluded. PubMed, Scopus, EMBASE, and Web of Science databases were searched until June 15, 2023. The Joanna Brigs Institute tool was used to assess risk of bias and study quality. Descriptive data were expressed as frequency, median, mean, and standard deviation. Results: Seventeen clinical case studies were identified and 17 patients with acute abdomen associated with COVID-19 vaccination were evaluated, including: acute appendicitis (n=3), acute pancreatitis (n=9), diverticulitis (n=1), cholecystitis (n=2) and colitis (n=2). The most associated COVID-19 vaccine was Pfizer-BioNTech (mRNA) with 64.71 %. The majority of cases acute abdomen was after the first dose (52.94 %). All patients responded objectively to medical (88.34 %) and surgical (11.76 %) treatment and were discharged within a few weeks. There were no cases of death. Conclusions: Acute abdomen is a rare complication of great interest in the medical and surgical practice of COVID-19 vaccination, our study reviewed based on a small sample of patients, therefore it is recommended to conduct future observational studies and fully elucidate the mechanisms by which this association occurs.

Glioma refers to a highly prevalent type of brain tumor that is strongly associated with a high mortality rate. During the treatment process of the disease, it is particularly important to accurately perform segmentation of the glioma from Magnetic Resonance Imaging (MRI). However, existing methods used for glioma segmentation usually rely solely on either local or global features and perform poorly in terms of capturing and exploiting critical information from tumor volume features. Herein, we propose a local and global dual transformer with an attentional supervision U-shape network called DTASUnet, which is purposed for glioma segmentation. First, we built a pyramid hierarchical encoder based on 3D shift local and global transformers to effectively extract the features and relationships of different tumor regions. We also designed a 3D channel and spatial attention supervision module to guide the network, allowing it to capture key information in volumetric features more accurately during the training process. The experimental results show that DTASUnet exhibited superior or competitive performance compared to other state-of-the-art algorithms. In the BraTS 2018 validation set, the average Dice scores of DTASUnet for the tumor core (TC), whole tumor (WT), and enhancing tumor (ET) regions were 0.845, 0.905, and 0.808, respectively. For the BraTS 2020 validation set, the average Dice scores of TC, WT, and ET were 0.844, 0.906, and 0.790, respectively. These results demonstrate that DTASUnet has utility in assisting clinicians with determining the location of gliomas to facilitate more efficient and accurate brain surgery and diagnosis.

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The objective of this study is to evaluate the effect of photobiomodulation (PBM) on pain control during pterygomandibular puncture. A patient received anesthesia on both sides of the mouth in a randomized manner. On the right side, an 808nm infrared low-level laser was applied before local anesthesia. On the left side, a sham laser was applied using the same technique. There was a 50% reduction in pain levels on the PBM-treated side compared to the sham PBM side, as measured by the visual analog scale. Sensitivity tests revealed that anesthesia was more effective on the PBM side. There was no significant difference in blood pressure before and after anesthesia on either side. While these findings are based on a single case report, they suggest that photobiomodulation before anesthesia may alleviate puncture pain associated with anesthesia. Nevertheless, further well-designed clinical trials are necessary to confirm the effectiveness of this complementary therapy.

Infective endocarditis associated with atopic dermatitisYamato Tamura, MD*, and Takehisa Abe, MDDepartment of Cardiovascular Surgery, Nara Prefectural Seiwa Medical Center, 1-14-16 Mimuro, Sango-cho, Ikoma-gun, Nara, 636-0802, Japan*Corresponding author: Yamato Tamura, MDDepartment of Cardiovascular Surgery, Nara Prefectural Seiwa Medical Center1-14-16 Mimuro, Sango-cho, Ikoma-gun, Nara 636-0802, JapanTel: +81-745-32-0505Fax: +81-745-32-0517E-mail: ytamura.cvs@gmail.com

IntroductionConsciousness refers to the state in which a person is awake and aware. The depth of wakefulness can be measured by Glasgow coma scale (GCS). Awareness is ability of responding appropriately to internal and external stimuli (1, 2). Consciousness state divides into coma (a pathologic state without wakefulness or awareness), vegetative state (unresponsive wakefulness syndrome), and minimally conscious state (1, 3).There is a broad spectrum of disorders that can cause stupor and coma. They are divided to two main groups: structural and functional pathologies. Structural etiologies include trauma and cerebrovascular disease. Nonstructural etiologies are intoxications, infections, seizures and metabolic derangements (4). Some of these differential diagnoses are emergencies such as acute stroke, expanding mass lesion, and herniation syndrome especially when there is papilledema or focal neurologic deficits in physical examinations and we can exclude them by head CT scan. Another emergency condition is bacterial meningitis and viral encephalitis presenting with fever. Thus, febrile unconsciousness suggest LP and further CSF evaluation (5). As mentioned above, metabolic derangements (such as hypoxia, hypoglycemia, hypernatremia, diabetic ketoacidosis, uremia, and hypothyroidism), toxins (including lead, cyanide, methanol, and carbon monoxide) and drugs (such as sedatives, barbiturates, opiates, alcohol, anticholinergics, H1-antihitamines, and amphetamines) could also result in decreased level of consciousness (6, 7).An important cause of decreased level of consciousness is drug intoxication, unintentional or deliberate poisoning. Deliberate self-poisoning is the most common way of suicide that leads to death or some substantial consequences like cardiac, brain, pulmonary, renal injury and other organ dysfunctions (8-10).Herein, we report a 25-year-old woman presented with steady unconsciousness (GCS=7) for 10 days.

The study of microbiomes across organisms and environments has become a prominent focus in molecular ecology. This perspective article explores methodological advancements, common challenges and future directions in the field. Key research areas include understanding the drivers of microbiome community assembly, linking microbiome composition to host genetics, exploring microbial functions, transience, and spatial partitioning, and disentangling non-bacterial components of the microbiome. Methodological advancements, such as quantifying absolute abundances, sequencing complete genomes, and utilizing novel statistical approaches, are also useful tools for understanding complex microbial diversity patterns. Our aims are to encourage robust practices in microbiome studies and inspire researchers to explore the next frontier of this rapidly changing field.

The plant cell wall is a plastic structure of variable composition that constitutes the first line of defense against environmental challenges. Lodging and drought are two stressful conditions that severely impact on maize yield. In a previous work, we characterized the cell walls of two maize inbreds susceptible (EA2024) or resistant (B73) to stalk-lodging. Here, we show that drought induces phenotypical, physiological, cell wall, and transcriptional changes with distinct dynamics in the two inbreds, and that B73 is less tolerant than EA2024 to this stress. While in control conditions, stalk of EA2024 had higher levels of cellulose, uronic acids and p-coumarate than B73, upon drought these displayed increased levels of arabinose-enriched polymers, such as pectin-arabinans and arabinogalactan proteins, and a decreased lignin content. By contrast, a deeper rearrangement of cell walls including the modification of lignin composition and an increase of uronic acids was observed in B73. Drought induced higher changes in gene expression in B73 compared to EA2024, particularly in cell wall-related genes, that were altered in an inbred-specific manner. Transcription factor enrichment assays unveiled inbred-specific regulatory networks coordinating cell wall genes expression. Altogether, these findings reveal that B73 and EA2024 inbreds, with opposite stalk-lodging phenotypes, undertake different cell wall modification strategies in response to drought. We propose that the specific cell wall composition that confers lodging resistance to B73 compromises its cell wall plasticity and renders this inbred more susceptible to drought.

This research delves into the critical domain of high-temperature pressure vessel design, focusing on SA 387 Grade 11 Class 2 steel—an exceptional material known for its resistance to both corrosion and high temperatures. The study combines experimental investigations and numerical simulations to explore the intricate temperature distributions within this material during the Submerged Arc Welding (SAW) process. Experimental endeavors entailed welding SA387 steel plates under controlled conditions, precisely measuring temperatures at key locations. Concurrently, a numerical finite element analysis (FEA) model was developed, incorporating a 3D Goldak’s double ellipsoidal heat source model within ANSYS software. The research seamlessly integrates these two approaches, allowing for a comprehensive comparison of experimental and numerical temperature data. The results highlight the capacity of the FEA model to predict temperature profiles during SAW accurately, presenting a potent tool for optimizing welding parameters without extensive trial and error. Furthermore, this study advances our comprehension of welding processes involving high-temperature-resistant materials, offering valuable insights for industries requiring operations at elevated temperatures.