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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.

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: [email protected]

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:    [email protected],  [email protected]

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.

1. Activities of wood decomposer fungi alter abiotic and biotic properties of deadwood, which are important for tree seedling regeneration on nurse logs. However, the effects were seldom evaluated experimentally. 2. In this study, we examined germination, growth, and survival of six arbuscular mycorrhizal and six ectomycorrhizal tree species on three substrates (brown rot logs, white rot logs, and soil) by seed sowing experiments in a mixed forest dominated by Pinus densiflora and Quercus serrata. We also analyzed fungal communities in these substrates by rDNA ITS1 sequencing. 3. Some significant substrate effects were found on seedling performance when comparing wood decay types, but these were not clearly consistent across mycorrhizal status of the seedlings. Nevertheless, seedlings of arbuscular mycorrhizal trees tended to show better growth on brown rot logs than on white rot logs, whereas ectomycorrhizal tree seedlings tended to survive better on white rot logs and soil compared to brown rot logs. 4. The fungal community was significantly different across three substrates. Richness of Operational Taxonomic Units (OTUs) of arbuscular mycorrhizal fungi was largest in brown rot logs, whereas OTU richness of ectomycorrhizal fungi was largest in soil. 5. Synthesis: The effects of fungal wood decay type on nurse log regeneration of tree seedlings might be partly attributable to water content and fungal communities in the logs. Particularly, rich communities of arbuscular mycorrhizal fungi in brown rot logs could assist in the growth of arbuscular mycorrhizal tree seedlings.

Background: The Patient Voice Program and Citizen Voice and Action models use scorecard meetings for community-provider-government dialogue to improve health services. This study evaluates the responsiveness of leaders and providers to concerns voiced by citizens through these scorecard meetings at the health center and district office levels in Rwanda. Methods: We conducted a cross-sectional study from July to September 2022 in 325 Rwandan health centers across 20 districts. Responsiveness was measured by comparing resolved issues to raised issues. Logistic regression identified predictors of issue resolution, with a p-value less than 0.05 considered significant. Median responsiveness turnaround time was also analyzed. Results: In total, 59.4% (1,163) of the identified gaps were resolved. Facility-level issues experienced a higher resolution rate (65.9%) than district-level issues (35.4%). Gaps at the facility level were 3.24 times more likely to be resolved than those at the district level (OR: 3.24, p<0.001, 95% CI: [2.48,4.25]). Integrated gaps had 1.46 times higher odds of resolution compared to issues stemming from reproductive, maternal, newborn, and child health services (OR: 1.46, p<0.05, 95% CI: [1.13,1.88]). The median responsiveness turnaround time for resolving a gap was approximately 15.4 months (IQR: 6.7-25.8). Conclusions: The study shows that Patient Voice Program and Citizen Voice and Action models are effective in addressing healthcare service gaps. By promoting collaboration among communities, healthcare providers, and governments, these models facilitate targeted, locally-supported solutions that significantly improve the resolution of health service delivery issues.

A document by Ali Chamani. Click on the document to view its contents.

Converging electrophysiological, molecular, and ultrastructural evidence supports the hypothesis that sleep promotes a net decrease in excitatory synaptic strength, counteracting the net synaptic potentiation caused by ongoing learning during waking. However, several outstanding questions about sleep-dependent synaptic weakening remain. Here, we address some of these questions by using two established molecular markers of synaptic strength, the levels of the calcium-permeable AMPA (Alpha-Amino-3-Hydroxy-5-Methyl-4-Isoxazole Propionic Acid) receptors containing the GluA1 subunit, and the phosphorylation of GluA1 at serine 845. We previously found that, in the rat cortex and hippocampus, these markers are lower after 6-8 hours of sleep than after the same time spent awake. Here, we measure GluA1 expression in mouse cortex after 5 hours of either sleep, sleep deprivation, recovery sleep after sleep deprivation, or selective REM sleep deprivation (32 C57BL/B6 adult mice, 16 females). We find that relative to after sleep deprivation, synaptic GluA1 expression is lower after sleep independent of whether the mice were allowed to enter REM sleep. Moreover, 5 hours of recovery sleep following acute sleep deprivation are enough to renormalize GluA1 expression. In a pilot study in old mice (12 C57BL/B6 male mice, 20-month-old) we also find that GluA1 expression is high after sleep deprivation and low after sleep and recovery sleep. Thus, the renormalization of GluA1 expression crucially relies on NREM sleep and can occur in a few hours of sleep after acute sleep deprivation. Moreover, as measured by GluA1 expression, it appears that sleep-dependent synaptic weakening is unaffected by aging.

Ellis-van Creveld syndrome presenting with ruptured hemorrhagic cyst of right ovary: A rare clinical entity Authors : Bhatta Sunil1, Awasthi Pusp Raj2, Pandit Sukriti2, Paudel Pratigya2, Bist Omkar3.1-Department of Anesthesia and Critical Care, Nisarga Hospital and Research Center Pvt. Ltd.Email:[email protected](Corresponding author)2-Department of Pediatrics and adolescent medicine, Nisarga Hospital and Research Center Pvt. Ltd.3-Department of Orthopedic surgery, Nisarga Hospital and Research Center Pvt. Ltd.Data availability statement : Data described to support the findings is openly accessible in the article.

Oral Erythema Multiforme attributed to Herpes Simplex Virus: A less recognized variantSantosh Dharel1, Bandana Koirala1, Mamta Dali11Department of Pedodontics and Preventive Dentistry, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Koshi Province, Nepal.Correspondence: Santosh Dharel, Department of Pedodontics and Preventive Dentistry, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Koshi Province, Nepal.E-mail: [email protected]

A document by Muhammad Hanif. Click on the document to view its contents.

In this paper, based on the electric field data (EFD) of the China Seismo-Electromagnetic Satellite (CSES), which is divided into 4 frequency bands (ULF, ELF, VLF, HF) from DC to 3.5 MHz, we study the impact characteristics of the 4 November 2021 magnetic storm activity in different frequency bands. It was found that the electric field anomalies caused by magnetic storms were mainly concentrated below 18 kHz, and above 18 kHz the effects were weak and gradually diminished to negligible. In the ULF band, excluding the influence of Schumann waves, the electric field anomalies caused by magnetic storms are mainly below 5 Hz, with the most influential frequency point being 3.4 Hz. In the ELF band, the more obvious anomalies appear at 300 Hz – 900 Hz and above 1.8 kHz, with the most significant anomalies in the 300 Hz – 900 Hz band around 780 Hz. In the VLF band, electric field anomalies are concentrated in 2.5 - 10 kHz. Magnetic storms had essentially no effect on the HF band. Magnetic storms at low and middle latitudes have a weak effect on the ELF and VLF bands and are more pronounced in the ULF band. During the main phase of the magnetic storm, the absolute magnitude of variance change in the ELF and VLF bands is greater than that in the ULF band as a whole, but the relative magnitude of variance change in the ULF band is 10% greater than that in the ELF and VLF bands.

Predicting software defects can improve software assurance reliability and reduce development costs. Traditional predictions usually lack precision. The early detection of fault-prone modules helps software project managers allocate developers' limited time for testing the defect-prone modules more intensively. Traditional methods for predicting software defects often lack precision, highlighting the need for enhanced techniques. The proposed solution introduces an ensemble learning algorithm based on clustering for software defect prediction, aiming to handle imbalanced datasets and manage redundant features. The method incorporates clustering and oversampling for data preparation, followed by cost-sensitive feature selection and ensemble learning for improved classification. By employing clustering to group similar data and addressing imbalanced datasets through K-member fuzzy clustering algorithms, the strategy enhances the accuracy of defect prediction. The optimization stage involves selecting the best classifier, features for each cluster, and their hyper-parameters using the NSGA-II algorithm. Experiments conducted on real-world datasets demonstrate better performance of the suggested approach in contrast to other established approaches in the software defect detection literature.

With the growing recognition of the unique advantages of reinforcement learning and genetic algorithms in addressing combinatorial optimization problems, this study aims to integrate these two methods to collectively tackle the classic combinatorial optimization challenge of the Traveling Salesman Problem (TSP). The Traveling Salesman Problem (TSP) stands as a quintessential combinatorial optimization challenge, tasked with determining the shortest path among designated cities. This paper introduces an innovative approach by amalgamating reinforcement learning’s path selection prowess with genetic algorithms’ global search strategy, aiming to uncover superior solutions in TSP. Specifically, the experiment employs a dual Q-learning algorithm within reinforcement learning to identify multiple optimal paths, serving as progenitors for the genetic algorithm to further enhance performance. The paper meticulously outlines the problem modeling process, elucidating TSP instance definitions, descriptions, and precise objective function definitions. Experimental findings underscore the substantial enhancements achievable in TSP optimization through this comprehensive approach, offering a fresh perspective and methodology for tackling combinatorial optimization challenges.

Aims: The purpose of this study is to establish a novel diagnosis system in early acute coronary syndrome (ACS) using Probe Electrospray Ionization-Mass Spectrometry (PESI-MS) and machine learning (ML) and to validate the diagnostic accuracy. Methods: Total 32 serum samples derived of 16 ACS patients and 16 control patients were analyzed by PESI-MS. The acquired mass spectrum dataset was subsequently analyzed by partial least squares (PLS) regression to find the relationship between two groups. Support vector machine (SVM), a method of machine learning, was applied on the dataset to construct the diagnostic algorithm. Results: Control and ACS groups were separated into the two clusters in PLS plot, indicating ACS patients differed from the control in the profile of serum composition obtained by PESI-MS. The sensitivity, specificity and accuracy of our diagnostic system were all 93.8%, and the area under the receiver operating characteristic curve showed 0.965 (95%CI: 0.84-1). Conclusion: The PESI-MS and ML-based diagnosis system is likely an optimal solution to assist physicians in ACS diagnosis with its remarkably predictive accuracy.

Background: Multiple myeloma (MM) has different complications, including renal failure, anemia, infections, metabolic complications, and skeletal problems. Hypercalcemia is the most common metabolic complication, and the presence of hypercalcemia indicates worse outcomes. Aims: The study aims to examine outcomes such as hospitalization costs, length of stay, survival rates, and the incidence of complications of hypercalcemia in multiple myeloma patients admitted in the United States from 2017 to 2020. Methods: We performed a retrospective analysis using the National Inpatient Sample database to determine the incidence of hypercalcemia in patients admitted to United States hospitals from 2017 to 2020. Univariate and multivariate logistic regression were used to calculate the odds ratio. We used STATA software 17 to perform the analysis. Results: We found that the total number of patients with MM was 437799, out of which 8.6% had hypercalcemia. The mean age of the patients was 69 years, and hypercalcemia was found to be more common in males (55%) than females (45%). The presence of hypercalcemia was also associated with increased mortality (adjusted odds ratio 1.3, p-value 0.00). It was also seen that MM patients who had hypercalcemia had a higher risk of complications, including acute kidney injury (OR 3, p<0.05), hyperkalemia (OR 1.8, p-value <0.05), metabolic acidosis (1.4, p-value <0.05), spinal cord compression (OR 0.9, p-value >0.05), increased length of stay (OR 3, p-value <0.05), and higher cost of hospitalizations (p-value <0.05). Conclusion: The data is also limited to the demographic characteristics, impact, and outcomes of hypercalcemia on patients with MM. This study contributes valuable insights into the clinical implications of hypercalcemia in patients with multiple myeloma (MM). It fills existing gaps in the literature by utilizing a large population-based dataset.