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Michael Weekes

and 11 more

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: 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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Sagun Ghimire

and 3 more

ALSTROM HALLGREN SYNDROME WITH CLASSICAL FINDINGS: A RARE CASE REPORT OF MONOGENIC CILIOPATHY CO-OCCURRENCE IN TWINS.Clinical Message: With the prevalence of 1 in million cases Alstorm Hallgren syndrome is one of the rare genetic disorder with poor prognosis. In our case we present classical findings in twins who were diagnosed as Alstrom syndrome concurrently and further diseases progressed simultaneously .Keywords: Alstrom Hallgren syndrome, monogenic ciliopathy, twinsCorresponding Author :1Sagun ghimire,KIST medical college and Teaching Hospital, Gwarko, Lalitpur, NepalSagunghimire01@gmail.comCo-authors:2Suman simkhada, KIST medical college and teaching hospital,gwarko, lalitpur, Nepalsimkhadasuman@gmail.com3Samir Thapa, KIST medical college and teaching hospital, gwarko,lalitpur, NepalThapasamir32@gmail.com4Kiran Ghising, KIST medical college and teaching hospital, gwarko,lalitpur, NepalKiran.ghising98@gmail.com1 . INTRODUCTION:Alström syndrome is a rare autosomal recessive genetic disorder,thought to have a prevalence of less than one per million in the general population. It is characterized by the progressive development of multi-organpathology [1]. It is caused by recessive mutations in ALMS1 (Chr 2q13). Although its function is not completely understood, evidence to date suggests that ALMS1 plays roles in ciliary function, cell cycle regulation, endosomal trafficking, cell migration, and extracellular matrix production [2]. Diagnosis of Alström Syndrome can be difficult because some features begin at birth and others emerge as the child develops. There is considerable variation both within and among families. The major phenotypes usually observed in children with Alström Syndrome include cone–rod retinal dystrophy beginning in infancy and leading to eventual juvenile blindness, sensorineural hearing impairment, insulin resistance, and obesity. In some cases, infants present with congestive heart failure (CHF) due to dilated cardiomyopathy (DCM). As patients reach adolescence, more of the major phenotypes develop, including type 2 diabetes mellitus (T2DM), hypertriglyceridemia, and adolescent-onset DCM. Short stature, scoliosis, alopecia, and male hypogonadism and hyperandrogenism in female patients may be present when patients reach adulthood. Pulmonary, hepatic, and renal phenotypes are progressive. Fibrosis in multiple organs has been described [3]. Currently there are no specific treatments for Alström syndrome that can cure the disease, prevent the complications, or reverse the complications. A multidisciplinary approach is currently preferred to detect, predict, and treat the complications of Alström syndrome[4]. The article is presented in accordance with CARE guidelines for case reports[5]. Here, we present a case of twin siblings with signs and symptoms consistent with AS and associated with two AMLS1 variants.2. CASE SUMMARYPatients Demography :In this report we describe monochorionic, diamniotic twin boys who were born pre term at 36 weeks to a healthy 28 year old mother and healthy 32 year old father, with natal history of low birth weight of in one twin and in another twin with APGAR score of 6\10 and 7\10 and post natal history of raised total serum bilirubin for which both twins were kept under phototherapy. There is no history of delay in attainment of age related milestones . Parents are of Asian heritage who deny consanguinity, both alive and well as well as two twins siblings currently aged 16 years . The family structure is outlined in( Figure 1). Family history was not significant for any genetic disease on the paternal and maternal side.Clinical Evaluation :On physical examination, there was evidence of central obesity in both twins with the body mass index ( in both) being 34.9 kg/m2. Their blood pressure was within normal percentile with a regular pulse of 80 beats per minute. Behaviorally, they do not demonstrates several features concerning for autism spectrum disorder, including poor eye contact, lack of a social smile, and disinterest in social interaction. Their weight since birth has been seen to in increasing trend, and height within mid parental range. There was no evidence of poly- or syndactyly or any other features suggestive of Bardet-Biedl syndrome. Features of hirsutism was also absent on the face, abdomen, and arms. There was significant history of decreased vision in both eyes since neonatal period .Both the twins presented at four years of age with visual symptoms suggestive of photosensitivity. There was features suggestive of rotatory nystagmus . Amsler grid and color vision tests were normal. Visual field revealed concentric contraction in both eyes. The fundoscopy showed pale optic discs, atrophic maculopathy, golden appearance of peripheral and midperipheral fundus, coarser pigmentary changes with a ”bone-spicule” configuration and arteriolar narrowing. The red free pictures demonstrated the atrophy of internal retinal layers and the infrared pictures revealed the atrophy of the external layers of the retina in posterior pole of the fundus. The flash ERG showed reduced amplitude of photopic and scotopic b-wave. The multifocal ERG demonstrated the normal function of the central retina. revealed decreased Arden ratio in both eyes. The pattern VEP revealed the P100 amplitude reduction by 80% and elongation of latency by 120% in the right eye and normal in the left eye. Subsequent ophthalmologic exam showed visual acuity of counting finger from 2 and half meter binocularly only due to high hyperopia with amblyopia. The findings were consistent with cone-rod dystrophy through electroretinography (ERG). Subsequently there was progressive visual loss and legal blindness was declared to both of the twins at the age of 11 years. The cardiovascular examination was unremarkable with no any significant Echocardiography and electrocardiography findings . There was not any features suggestive of congestive heart failure, myocarditis, dilated cardiomyopathy. Cardiac catheterization and Endomyocardial biopsy were not done . A comprehensive systemic panel did not identify any disease causing mutations and screening for evidence of metabolic and mitochondrial diseases was negative. The patient also showed features such as weight loss, polyuria, polydipsia, predilection to sweet foods.

Sushmita Ghimire

and 1 more

INTRODUCTION Type 1 diabetes mellitus (T1DM) is an autoimmune disorder leading to the destruction of insulin producing pancreatic beta cells, resulting in elevated blood sugar levels 1. Polyuria, polydipsia and weight loss are the key presenting symptoms 2. A systematic review and meta-analysis reported the global T1DM prevalence of 9.5%, with an incidence of 15 per 100,000 people3. Diabetic ketoacidosis (DKA) is a grievous complication of diabetes mellitus caused by insufficient insulin, resulting in elevated blood glucose, ketonemia and acidosis. The overall DKA prevalence across 13 countries over 13 years was 29.9%, with a 3.5% prevalence in Nepal. 4,5.The most common risk factors leading to DKA include missed insulin doses and infections, while other factors like stress-inducing events or the initial onset of diabetes can also trigger DKA. The clinical manifestations of DKA encompass a range of symptoms, including nausea, severe vomiting, dehydration, polyuria, polydipsia, abdominal pain or discomfort, presence of acetone breath odor, Kussmaul breathing, overall profound fatigue with altered consciousness, disorientation, confusion or occasionally coma when the condition is severe 6. Typical diagnosing criteria for DKA include blood glucose greater than 250 mg/dl, arterial pH less than 7.3, serum bicarbonate less than 15 mEq/l, and the presence of ketonemia or ketonuria 7.Immediate intervention is crucial that includes restoring the circulatory volume, correcting electrolyte abnormalities, insulin therapy and addressing the underlying cause 8. Failure to promptly treat DKA can result in the breakdown of compensatory mechanisms and cause electrolyte abnormalities like hyponatremia, hyperkalemia and ultimately lead to life threatening complications including cerebral edema, acute respiratory distress syndrome, and sepsis.  Nursing management for a patient with Diabetic Ketoacidosis (DKA) involves a comprehensive approach that involves monitoring vital signs, blood sugar levels, and electrolytes, administering fluids, assessing renal function and mental status, monitoring intake output, checking for signs of infection, assessing lung sound; educating the patient on insulin injection techniques, medication compliance, promoting lifestyle changes like smoking cessation and diabetic diet9.In DKA, dilutional hyponatremia is common due to rising glucose level that creates osmolar gradient causing water to shift from cells into the intravascular space. However, on rare occasion, hypernatremia is found that happens when there’s a deficit of water intake and excessive loss of free water, which outweighs electrolyte loss through various factors10. This report emphasizes the significance of a fluid management strategy for DKA patients, even when encountering the unusual occurrence of hypernatremia.

Emine Müge Ozkan

and 5 more

Maria T. Papadopoulou

and 13 more

Introduction: Acute lymphoblastic leukemia (ALL) represents the most prevalent childhood malignancy. Despite high cure rates, several questions regarding predisposition, response to treatment, and prognosis of the disease remain. The role of intermediary metabolism in the individualized mechanistic pathways of the disease is unclear. We have hypothesized that children with any (sub)type of ALL present a distinct metabolomic fingerprint at diagnosis when compared: i) to a control group; ii) to children with a different (sub)type of ALL; iii) to the end of the induction treatment. Methods: This prospective case-control study (NCT03035344) analyzed plasma and urinary metabolites in 34 children with ALL before the beginning (D0) and at the end of the induction treatment (D33). Their metabolic fingerprint was defined by targeted analysis of 106 metabolites and compared to that of an equal number of matched controls. Multivariate and univariate statistical analysis was conducted by SIMCAP and scripts under R programming language. Results: Metabolome analysis showed distinct changes in patients with ALL compared to controls on both D0 and D33. The metabolomic fingerprint within the group of patients differed significantly between common B and pre-B ALL, and between D0 and D33, reflecting the effect of treatment. We have further identified the main components of this metabolic dysregulation that indicate shifts in fatty acid synthesis, transfer and oxidation, in amino acid and glycerophospholipids metabolism and in glutaminolysis/TCA cycle. Conclusions: The notable type and disease time point specific metabolic alterations observed in pediatric ALL may offer the potential for the discovery of new prognostic biomarkers and therapeutic targets.

Sandra Bucci

and 9 more

Changes in water and nitrogen availability can affect the structure and function of arid ecosystems. How these resources affect aboveground primary productivity (ANPP) remains far from clear. We examined the N and water limitation of ANPP from the species to the community level and the response of ANPP to annual precipitation in a Patagonian steppe. We conducted a 7-year field experiment with water addition (+W), nitrogen addition (+N), and +NW. Destructive methods for grasses and allometric relationships for shrubs were used to assess ANPP and vegetation indices (NDVI and MSAVI2) to estimate community ANPP. An increase in ANPP of one grass species ( Papposstipa humilis) and a decrease of the grass Poa ligularis under +N were observed. Some shrubs species exhibited mortality under nitrogen addition. Nitrogen exerted a positive effect on grass ANPP and amplified the sensitivity of grass ANPP to annual precipitation. However, +N had not effects on the shrub ANPP and shrub ANPP-precipitation relationship. Water addition by itself had no effect on ANPP for either shrubs or grasses. However, shrubs responded positively to an unusually wet year regardless of treatment and were also more sensitive to changes in annual precipitation than grasses. Total ANPP increased significantly in +N relative to the C and +W, but without changes in the sensitivity to annual precipitation. The results suggest that the responses of grasses and shrubs to water inputs is driven by soil moisture redistribution and rooting depth and that grass and community ANPP is more limited by N than by water.
Abstract As part of this study, a unique method for automatic real-time analysis of sentiment in product reviews for online shopping applications is provided. The main goal is to create a model that has a high level of accuracy and is able to categorize product reviews with either a positive, negative, or neutral sentiment. To achieve this goal, a combination of natural language processing (NLP) strategies and machine learning algorithms is employed. The first step in the process, known as pre-processing, cleans up the text data by removing any noise and then applies tokenization and stemming techniques to it so that significant features can be extracted. A variety of machine learning models, such as B. Support Vector Machines (SVM), Naive Bayes and Random Forest, are trained and evaluated using an extensive data set of labeled customer reviews of various products. The development of a web application was chosen as the implementation method for the system in order to enable easy integration with the online trading platform. This solution ensures that processing occurs in real-time, allowing for effective analysis and quick response to users. Users can better understand product reviews and make more informed purchasing decisions when sentiment analysis is integrated into the online shopping experience. The proposed approach is a major advance in the development of sentiment analysis for online trading related applications. His ability to conduct real-time sentiment analysis allows him to uncover key insights into customers’ thoughts and preferences. The method provides a viable way for companies to assess consumer satisfaction and sentiment trends by properly classifying product reviews. As a result, companies can ultimately improve the quality of the products and services they provide. Keyword: Online shopping applications, Sentiment analysis, Product reviews, Natural language processing (NLP), support vector machines (SVM), Naive Bayes, Random forest.

Kalpana Murugan

and 1 more

The development of the Internet of Things (IoT), which enables communication between people, things, data, and virtual platforms in the environment, is a result of the exponential rise of information technology (IT). Recently, numerous decision support systems in the medical industry have been offered via IoT and cloud-based e-health services. Owing to the developments in IoT-enabled medical gadgets and sensing devices. Chronic diseases are often considered as a major source of concern and a threat to public health on a global scale. The kidneys are one of the body’s most complicated organs and perform several tasks. The elimination of waste materials by the kidneys during the formation of urine helps to cleanse the blood. When the kidneys begin to lose function, Chronic Kidney Disease (CKD) occurs. The accurate diagnosis of CKD is an important and crucial step in medical informatics. An earlier diagnosis can save more human lives. But, it is complicated task due to similar symptoms, inaccurate data and information, lack of knowledge, etc. It is also seen that the presence of missing values and outliers can also complicate the prediction task and, in turn, produce less accurate results. The primary objective of this research work is to develop an IoT framework for collecting the real time CKD dataset and also to handle the two well-known issues of medical data, i.e. outlier detection and CKD prediction. This work proposes the Chicken Swarm Optimization (CSO) algorithm to enhance the raw data and diagnose CKD diseases using k-NN.

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Abstract: This study delves into an often overlooked facet of animal relationships, shedding light on the intricacies that render these bonds distinct. The research centers on the mechanisms through which animals cultivate friendships, the benefits they derive from such connections, and the myriad manifestations of these relationships across three distinct regions in Bangladesh. Notably, this investigation extends beyond intraspecies interactions to encompass interspecies bonds, including those between humans and feline and ovine companions, the companionship shared between a young feline and a human, human-canine affiliations, and the human-goat relationships. By examining these varied connections, this research seeks to unveil the profound emotional ties that transcend species boundaries and underscore the transformative influence they exert on the well-being of animals.Keywords: Ethology, Zoology, Animal Behavior, Behavioral Diversity, Domestic AnimalsIntroduction: Animals are fascinating creatures that never cease to amaze us with their unique abilities and behaviors. One aspect of their lives that has been gaining attention in recent years is their ability to form deep and lasting friendships with members of their own species and even with members of other species. From unlikely pairings, such as a cat and a man, to more common partnerships, like a dog and a human, these bonds can be heartwarming and fascinating to observe. On the basis of three different regions of Bangladesh, I attempted to investigate some of the most fascinating instances of animal friendship, exploring the scientific underpinnings of these bonds and the priceless lessons they can impart about the relationships we develop with others. In the vast and diverse animal kingdom, friendships transcend species boundaries, defying conventional expectations and captivating the hearts of enthusiasts. It can be a source of protection, with individuals banding together to avoid potential threats. It can also serve as a means of survival, with different species depending on each other for food, shelter, or mutual defense. Perhaps the most significant aspect of animal friendship is the emotional bond that can develop between individuals, transcending the boundaries of instinct and biological necessity. Dolphins are known for forming complex social networks, with individuals often developing strong bonds that can endure throughout their lifetime. Elephants display remarkable empathy and solidarity, offering comfort and support to their fellow herd members in times of distress. Even seemingly solitary big cats have been observed to form social bonds, displaying moments of affection and dependence on one another. While friendships in some animals may have clear evolutionary advantages, others seem to defy any logical explanation. Consider the well-known story of Owen and Mazie, a young hippopotamus and an older turtle who became inseparable friends after meeting in a Kenyan wildlife sanctuary (Hatkoff 2006). Despite their stark differences in size, species, and behavior, their friendship blossomed, captivating the world and reminding us of the unexpected connections that arise in nature. In light of the fact that there had not been any research on this subject from a Bangladeshi perspective, I thought about conducting a study and gathering information to share with everyone, whether they love animals or not.

Gizem Koken

and 8 more

Background: Food-induced immediate response of the esophagus (FIRE) is a new phenomenon that has been described in eosinophilic esophagitis (EoE) patients. It is suspected when unpleasant symptoms occur suddenly on contact of the triggering food with the esophageal surface and recur with repeated exposures. It can often be mistaken for pollen-food allergy syndrome (PFAS) and solid food dysphagia. Data on FIRE is limited to one survey study and case reports, and there are no screening studies conducted on either adults or children with EoE. In this study, we aimed to screen children aged ≥7 years old with EoE for FIRE. Methods: Demographic data were collected from medical records. A questionnaire about FIRE was applied to all participants. Skin prick tests (SPTs) were done on suspected patients to identify the triggering foods. FIRE is defined as suitable clinical symptoms with suspected food allergen exposure. Results: Seventy-eight patients (74.4% male, median age: 13.5 years) were included. Unpleasant and recurrent symptoms distinct from dysphagia with specific foods were reported in %16.7 of the patients, all of whom had concomitant allergic rhinitis (AR). The symptoms described by almost all patients were oropharyngeal itching and tingling (PFAS: 15.3%) excluding only one patient reporting retrosternal narrowing and pressure after specific food consumption (FIRE: 1.2%). Conclusions: Although definitive conclusions regarding the true prevalence of FIRE cannot be made, it does not seem to be common as PFAS. However, it deserves questioning particularly in the presence of concurrent AR and/or PFAS in children with EoE.

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