With the increasing automation and digitization of manufacturing equipment, many hidden problems in industrial equipment cannot be determined by decision-makers, often causing unexpected equipment downtime or product quality degradation. Traditional maintenance methods have difficulty ensuring the stability of equipment and products. Consequently, predictive maintenance (PdM), an emerging maintenance approach, has become an active research topic in this industry. PdM can predict future trends and possible component failure modes based on data-driven and mechanistic analysis, thus, providing maintenance decisions in advance. In this study, we assessed industrial robots, essentials in automotive manufacturing, as the research object, and provided a comprehensive overview of industrial robot PdM. We then discussed the status of industrial robot failure prediction model research, analyzed the problems of various types of PdM research, proposed constructive improvement solutions, and provided an outlook on the future research trends of PdM.

PREMISE OF THE STUDY Plant reproductive failure is a critical concern for conserving rare and endangered species that typically have low-density and sparse populations. One important factor contributing to reproductive failure is the spatial arrangement of plants within a population, which can lead to isolation and negatively affect seed output, particularly in obligate outcrossers. Additionally, this effect can be compounded by plant size. Here, we investigate how plants’ spatial distribution and size influence the reproductive success of Carica chilensis, a threatened papaya species. METHODS Using flower exclusion, we first examined whether C. chilensis can produce seeds via apomixis. We then used Spatial Point Pattern Analysis (SPPA) in three populations to examine the spatial arrangement of plants and, finally, we assess whether plant size and mate distance influence the reproductive success of this plant species. KEY RESULTS C. chilensis is a dioecious shrub unable to produce fruits through apomixis. The SPPA revealed significant clustering of female and male plants at different spatial scales, indicating a non-random distribution. Moreover, a significant attraction between the sexes suggested a preference for proximity. In two populations, closer proximity to male plants was linked to higher seed production. CONCLUSIONS Our study revealed that the absence of apomixis in C. chilensis makes it prone to experiencing distance-dependent reproductive failure. In particular, the seed set was compromised in female plants isolated from male neighbors. This link between isolation and seed production was especially significant in the driest site, and we discuss how environmental factors can exacerbate this effect.

Pseudocyesis is rare but it is a concern in remote areas based on sociocultural factors:

INTRODUCTIONEpilepsy is a common neurological disorder affecting more than 70 million people around the world. It is the most common neurological disorder in the pediatric population, affecting 1% to 3% of children, and is defined as any disorder in which spontaneous recurrence of unprovoked seizures is the main symptom. A seizure is usually defined as a sudden alteration of behavior due to a temporary change in the electrical functioning of the brain, that continuously generates tiny electrical impulses in an orderly pattern. The etiology of epilepsy can be different, including structural, genetic, infectious, metabolic, and immune causes, but most often the cause is unknown, that is when it refers to the so-called idiopathic epilepsy, which occurs in 40% of people with epilepsy. Despite the recent introduction of new antiepileptic drugs (AEDs), about one-third of epilepsy patients have drug-resistant (refractory) epilepsy, affecting about 30% of children with epilepsy.Refractory epilepsy, which is the most severe form of epilepsy, according to the International league against epilepsy (ILAE), is defined as failure to control seizures when using two or more appropriately chosen and tolerated antiepileptic drugs (as monotherapy or in combination) during an appropriate period. Severe and refractory epilepsies in children affect their cognitive function, leading to worsening of the prognosis, serious psychosocial consequences, difficulties in care and quality of life, anxiety in the family, as well as an increase in the risk of death, including unexpected death in epilepsy (SUDEP).The expansion of genetic research and technologies in recent years and the advances in next-generation sequencing (NGS) have shown that a large proportion of unexplained epilepsies, especially idiopathic ones, have a genetic basis. Numerous epilepsy genes helped the understanding of mechanisms underlying epileptogenesis and guided the development of treatments.ANKRD11 gene functions as a co-regulator in the developing brain. The role of the ANKRD11 gene in neurodevelopment was suggested by subsequent reports of individuals with intellectual disability, facial dysmorphism, and ASD. In 1975, Herrman et al., first described the KBG syndrome, a neurodevelopmental autosomal dominant disorder, caused by the haploinsufficiency of the ANKRD11 at 16q24.3 locus due to heterozygous pathogenic variants or chromosomal imbalances/rearrangement such as point mutations, duplications or microdeletions involving this gene.KBGS is characterized by global developmental delay (DD), intellectual disability (ID), learning difficulties, neurobehavioral problems, short stature, macrodontia, facial dysmorphism, skeletal anomalies, and multiple congenital anomalies, sometimes associated with seizures, delayed closing of fontanels and electroencephalographic (EEG) abnormalities. So far, there have been reported more than 200 cases of KBG syndrome.The diagnosis of KBG syndrome is established, by the most commonly used criteria of Skjei et al. and Low et al . A diagnosis of epilepsy, a major criterion, according to Skjei et al ., and a minor criterion according to Low et al . has been reported in approximately 30% of patients in a systematic review of 140 patients with KBG syndrome. The onset of epilepsy is predominantly between infancy and mid-teens and seizure remission occurred in the majority after adolescence with good response to AEDs. Heterogeneous seizure types have been reported, with tonic–clonic seizures, absences, myoclonic seizures, and unclassified sleep-related seizures with motor symptoms being most common, but no specific epilepsy syndrome has been identified.Detailed classification of the seizures, epilepsy type, or syndrome was only made in 26 patients from 12 studies. Only two patients had an epilepsy syndrome classification. No genotype–phenotype correlation studies have been performed for the presence and type of epilepsy in patients with KBG syndrome. Generalized epilepsy with febrile seizures plus (GEFS+) is reported in a de novo mutation of the ANKRD11gene, with a clinical phenotype compatible with KBG syndrome.A systemic review of epilepsy and EEG anomalies in subjects with KBG syndrome is deficient. Samanta first described in a patient an intermittent bisynchronous temporo-occipital rhythmic delta activity and episodes of staring spells with no EEG changes suggesting that these findings may be specific to KBG syndrome. Here, we report a patient with a severe neurological phenotype of KBG syndrome associated with a novel heterozygous frame-shift de novo variant in the ANKRD11 gene, to contribute to identifying a specific electroclinical pattern of KBG syndrome.

The mechanical properties of hard thin films need meticulous and precise inspection for their efficient applicability. SiCN hard coatings deposited on silicon substrates underwent Vickers indentation and fracture analysis was performed with the help of images of fractured regions under the microscope. The fractured regions were matched with geometrical patterns and the mechanism of the occurrence of delaminated and regions subject to brille failure was studied. Finite Element Analysis (FEA) were carried out to study the elastic-plastic as well as ductile to brittle transition in the indentation process. The novel features in the fracture process identified will add to the knowledge in the field of fractographic studies of hard coatings. The findings shall be helpful in fracture analysis of components subject to loading used in heavy-duty equipment as well as MEMS.

Comment on Shao et al.’s “risk factors associated with COVID‐19 pneumonia in Chinese patients with pre‐existing interstitial lung disease during the SARS‐CoV‐2 pandemic”Hsiu-Ming Lee 1, Po-Cheng Shih 2,3, James Cheng-Chung Wei, MD, PhD 2,4,51 School of Medicine, China Medical University, Taichung, Taiwan2 Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan3 Department of Allergy, Immunology & Rheumatology, Changhua Christian Hospital, Changhua, Taiwan4 Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan5 Graduate Institute of Integrated Medicine, China Medical University, Taichung, TaiwanHsiu-Ming Lee and Po-Cheng Shih contribute equally.Correspondence： James Cheng-Chung Wei, MD, PhD.Address : No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan.TEL : ＋886 4 24739595 #34718. (FAX) +886 4 24637389E-mail : jccwei@gmail.comORCID 0000-0002-1235-0679Word counts: 498Table counts: 0Figure counts: 0Funding Sources : noneConflicts of Interest : The authors declare no conflicts of interest.Dear Editor,We read the article with great interest by Shao et al, where a retrospective study analyzed the risk factors for pneumonia related to the 2019 coronavirus disease (COVID-19) in patients with various types of interstitial lung disease (ILD) caused by SARS-CoV-2 infection. According to Cox’s multivariate analysis, only male gender and the use of corticosteroids emerged as risk factors for developing new coronavirus pneumonia following illness. On the other hand, receiving two to three doses of vaccination proved protective for individuals with preexisting ILD who contracted COVID-19 pneumonia.[1] As a result, it is recommended that patients with preexisting ILD, especially those who are male and using corticosteroids, receive more than two doses of the vaccine for enhanced protection. Since 2019, WHO has reported 770 million confirmed COVID-19 cases and 6.9 million deaths globally.[2] Studies have linked interstitial lung disease to worse COVID-19 outcomes, showing a four-fold mortality increase.[3] Interstitial lung disease includes inflammatory and fibrotic conditions, with incidence rates of 7 to 1,650 per 100,000.[4, 5] In contrast, COVID-19 can also trigger interstitial lung disease.[6] As COVID-19 spreads, global lung disease rates will increase. Identifying risk factors for interstitial lung disease after a COVID-19 diagnosis is crucial for early prevention, resource allocation, and effective management. However, some details in the article still need to be further clarified.First, this paper analyzed several variables in developing pneumonia during COVID-19 infection, including age, sex, vaccination history, common immunosuppressants, antifibrotic agents, and corticosteroids. However, it should be noted that certain risk factors, such as smoking, diabetes mellitus, autoimmune diseases, and recurrent COVID-19 infections, still exhibit a high association with pneumonia and were not included in the analysis.[7-9] Therefore, we recommend that the authors consider incorporating these factors into future similar studies. The paper analyzed corticosteroid use as a potential risk factor but without mentioning the timing of administration. The Centers for Disease Control and Prevention (CDC) recommends steroids for COVID-19 cases beyond a sure severity threshold. Failing to differentiate when they were given may overestimate the proportion of pneumonia cases using steroids, affecting p-values. Some ILD patients use multiple immunosuppressants, impacting immune function and COVID-19 pneumonia risk. While the article lists common medications, it doesn’t analyze the number of patients receiving combined therapy. Therefore, we recommend that future studies assess the risk associated with concurrently using immunosuppressants to understand the implications of combination therapy better.Second, this paper reveals an intriguing shift, as sarcoidosis appears to become a protective factor against pneumonia following a COVID-19 diagnosis. It could be a groundbreaking revelation since the articles consistently state that sarcoidosis is an excessively high-risk factor for severe COVID-19 pneumonia.[10] No literature has delved into this phenomenon, its mechanisms, or potential implications. Given the substantial representation of sarcoidosis patients in this study, we recommended that authors separately analyze its subgroup, examining their disease site, activity, severity, and medication use differences. Furthermore, future research should focus on investigating the interaction mechanisms and conducting comprehensive comparative studies to unlock the full potential of this discovery.References:1. Shao, C., et al., Risk factors associated with COVID-19 pneumonia in Chinese patients with pre-existing interstitial lung disease during the SARS-CoV-2 pandemic. J Med Virol, 2023.95 (9): p. e29098.2. WHO Coronavirus (COVID-19) Dashboard . 2023 [cited 2023 Oct 10, 2023]; Available from:https://covid19.who.int/.3. Valenzuela, C., G. Waterer, and G. Raghu, Interstitial lung disease before and after COVID-19: a double threat? Eur Respir J, 2021.58 (6).4. Shah Gupta, R., et al., Incidence and prevalence of interstitial lung diseases worldwide: a systematic literature review.BMJ Open Respir Res, 2023. 10 (1).5. Lee, C.Y., Interstitial lung disease-From pulmonary perspective to pathogenesis, multidisciplinary approach and treatment. Int J Rheum Dis, 2023. 26 (5): p. 823-824.6. Myall, K.J., et al., Persistent Post-COVID-19 Interstitial Lung Disease. An Observational Study of Corticosteroid Treatment. Ann Am Thorac Soc, 2021. 18 (5): p. 799-806.7. Strzelak, A., et al., Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review. Int J Environ Res Public Health, 2018. 15 (5).8. Wang, W., et al., Clinical characteristics of moderate or severe COVID-19 infection in patients with rheumatic diseases and analysis of risk factors leading to severe disease. Int J Rheum Dis, 2023. 26 (10): p. 1951-1959.9. Batu, E.D. and A. Erden, The outcome of COVID-19 in patients with autoimmune rheumatic diseases: Comparable to the general population or worse? Int J Rheum Dis, 2023. 26 (8): p. 1435-1439.10. Tana, C., et al., Sarcoidosis and COVID-19: At the Cross-Road between Immunopathology and Clinical Manifestation. Biomedicines, 2022.10 (10).

1. Graphs in research articles can increase the comprehension of statistical data but may mislead readers if poorly designed. Previous literature has found that the two most frequently used plot types - bar charts and dot and whisker plots - are a poor way to represent data because they only show the summary statistics of data, not their distribution, potentially hiding important information. 2. Calls have been made encouraging abandonment of bar charts and the use of more informative plot types, such as boxplots, violin plots, univariate scatter plots, and dot plots. We compare these plot types to assess their relative strengths and weaknesses to represent four different distributions of the data commonly observed in biological studies, finding that all the assessed plot types are either difficult to read at large sample sizes or misrepresent certain distributions of data. 3. We present an analysis of the plot types used in four ecology and conservation journals covering multiple areas of these research fields, finding widespread use of uninformative bar charts and dot and whisker plots (60 % of all plots showing one-dimensional data from multiple groups for the purpose of comparison). Some articles presented more informative figures by combining plot types, generally boxplots and a second layer such as a flat violin plot, to better display the data. This shows an appetite for more effective plot types within conservation and ecology, which may further increase if an accurate and user-friendly plot types were made available. 4. In response to this, we propose sea stack plots, which combine vertical histograms and summary statistics, and allow for an accurate representation of different data distributions, thereby largely overcoming the weaknesses associated with other alternatives to uninformative plots. We provide a tool to create sea stack plots with our R package ‘seastackplot’, available through GitHub.

Climate change affects biodiversity in diverse ways, necessitating the exploration of multiple climate dimensions using standardized metrics. However, existing methods for quantifying these metrics are scattered and tools for comparing alternative climate change metrics on the same footing are lacking. To address this gap, we developed “climetrics” which is an extensible and reproducible R package to spatially quantify and explore multiple dimensions of climate change through a unified procedure. Six widely used climate change metrics are currently implemented, including 1) Standardized Local Anomalies; 2) Changes in Probabilities of Local Climate Extremes; 3) Changes in Areas of Analogous Climates; 4) Novel Climates; 5) Changes in Distances to Analogous Climates; and 6) Climate Change Velocity. For climate change velocity, three different algorithms are implemented and available within the package including; a) Distanced-based Velocity (“dVe”); b) Threshold-based Velocity (“ve”); and c) Gradient-based Velocity (“gVe”). The package also provides additional tools to calculate the monthly mean of climate variables over multiple years, to quantify and map the temporal trend (slope) of a given climate variable at the pixel level, and to classify and map Köppen-Geiger (KG) climate zones. The climetrics R package is seamlessly integrated with the rts package for efficient handling of raster time-series data. The functions in climetrics are designed to be user-friendly, making them suitable for less-experienced R users. Detailed comments and descriptions in their help pages and vignettes of the package facilitate further customization by advanced users. In summary, the climetrics R package offers a unified framework for quantifying various climate change metrics, making it a useful tool for characterizing multiple dimensions of climate change and exploring their spatiotemporal patterns.

Background: Occupational crystalline silica (CS) particle exposure leads to silicosis. The burden of CS-associated disease remains high, and treatment options are limited due to vague mechanisms. CD4 + tissue-resident memory T cells (T RM) accumulate in the lung responded to CS particles, mediating the pathogenesis of silicosis. Methods: Based on silicosis murine model by single intratracheal instillation of CS suspension, we further employ adoptive transfer, FTY720 treatment, and parabiosis murine model to explore their source. After defining T RM cell subsets by CD103 and CD69, we intervene CD103 +subset and block IL-7 signaling to alleviate silicosis. Results: The CD4 + T RM cells are derived from peripheral lymphocyte recruitment and in situ expansion. Specifically, T RM-Treg cells depend more on circulating T cell replenishment. The cell retention markers CD103 and CD69 can divide the T RM cells into effector and regulatory subsets. However, targeting CD103 + T RM-Treg cells do not mitigate disease phenotype since the T RM subsets exerted immunosuppressive but not pro-fibrotic roles. We further dissect that IL-7 signaling promotes the progression of silicosis by tuning the maintenance of T RM-effector T cells. Conclusion: Our findings highlight the distinct role of CD4 + T RM cells in mediating CS-induced fibrosis and provide potential therapeutic strategies for silicosis.

Revolutionizing wireless traffic forecasting empowers proactive resource allocation, optimizing network performance and ensuring efficient utilization of resources in dynamic wireless environments. real-time traffic data from a business network with There are 470 APs.), this research provides a thorough examination of the temporal and geographical dynamics of network traffic. Time series data forecasting is given a new spin with the help of machine learning models built on the Transformer framework. This approach uses the brain’s attentional processes to analyze time series data for hidden dynamics and complex patterns. Notably, the analysis identifies high-traffic-utilization AP groups exhibiting robust seasonality patterns, alongside those devoid of such patterns. Several different types of forecasting methods are used and evaluated in this research, among them the Holt-Winters technique, a SARIMA model, a GRU model, a CNN model, and a model based on convolutional neural networks. In conclusion, the research sheds light on the complex patterns underlying network traffic and presents an innovative forecasting approach, bolstering the potential for improved wireless network resource management.

Background In 2019, the Chinese government launched the national volume-based procurement (NVBP). 7 antihypertensive drugs were selected in the first round of NVBP. This study aimed to evaluate the impact of NVBP on the expenditure of patients with hypertension. Methods The Guangzhou claims data of patients diagnosed with hypertension was extracted from the China Health Insurance Research Association (CHIRA) database, covering 36 months from January 2017 to December 2019. Adopting the interrupted time series (ITS) and difference-in-difference (DID) approach, we evaluated the impacts of the NVBP policy on total healthcare expenditure, health insurance expenditure, and patients’ financial burden at both the collective level and individual level. We also examined how patients and health facilities’ characteristics affected the association. Results At the collective level, we found that the introduction of the NVBP policy reduced total healthcare expenditures and health insurance expenditures for outpatient services by 11.40% and 15.63%, respectively (all p<0.01), while it appeared to have no impact on inpatient services. At the individual level, the DID analysis showed that the total healthcare expenditures per visit decreased by 35.40% (p<0.01), among which healthcare insurance expenditures decreased by 36.81% and out-of-pocket expenditures decreased by 24.65% for outpatients treated with NVBP-list drugs. However, we did not detect any changes in healthcare expenditures per admission. In subgroup analysis, we found a greater decrease in healthcare expenditure per visit for secondary and tertiary hospitals, as well as patients with Urban and Rural Residents Medical Insurance (URRMI). Conclusion This study provides additional evidence that the NVBP policy was associated with achieving cost-containment, alleviating patients’ burdens, and relieving pressure on health insurance funds, which provides important lessons for other countries that are seeking to improve their drug procurement processes. However, the impact of NVBP policy is likely to differ across facilities level and health insurance schemes.

Small-molecule dyes for fluorescence imaging in the second near-infrared region (NIR-II, 900‒1880 nm) hold great promise in clinical applications. Constructing donor-acceptor-donor (D-A-D) architecture has been recognized to be a feasible strategy to achieve the NIR-II fluorescence. However, the development of NIR-II dyes via such a scheme is hampered by the lack of high-performance electron-acceptors and donors. Diketopyrrolopyrrole (DPP), as a classic organic optoelectronic material, enjoys strong light absorption, high fluorescence quantum yield (QY), and facile derivatization. Nevertheless, its application in the NIR-II imaging field has been hindered by its limited electron-withdrawing ability and the aggregation-caused quenching (ACQ) effect resulted from the planar structure of DPP. Herein, with DPP as an electron-acceptor and through the donor engineering, we have successfully designed and synthesized a DPP-based dye named as T-27, in which the strong D-A interaction confers excellent NIR absorption and high-brightness NIR-II fluorescence tail emission. By strategically introducing long alkyl chains on the donor unit to increase intermolecular spacing and reduce the influence of solvent molecules, T-27 exhibits an improved anti-ACQ effect in the aqueous solutions. After being encapsulated into DSPE-PEG2000, T-27 nanoparticles (NPs) show a relative NIR-II fluorescence QY of 3.4% in water, representing the highest value among the DPP-based NIR-II dyes reported to date. The outstanding photophysical properties of T-27 NPs enable the multi-mode NIR-IIa bioimaging under the 808 nm-excitation. As such, the T-27 NPs can distinguish mouse femoral vein and artery, and achieve cerebral vascular microscopic imaging with a penetrating depth of 800 μm, demonstrating the capability for high-resolution deep-tissue imaging.

A document by Manh Tuan Hoang. Click on the document to view its contents.

This paper investigates an optimal investment-reinsurance problem for an insurer who possesses extra information regarding the future realizations of the claim process and risky asset process. The insurer sells insurance contracts, has access to proportional reinsurance business, and invests in a financial market consisting of three assets: one risk-free asset, one bond and one stock. Here, the nominal interest rate is characterized by the Vasicek model; and the stock price is driven by the Heston’s stochastic volatility model. Applying the enlargement of filtration techniques, we establish the optimal control problem in which an insurer maximizes the expected power utility of the terminal wealth. By using the dynamic programming principle, the problem can be changed to four-dimensional Hamilton-Jacobi-Bellman equation. In addition, we adopt a deep neural network method by which the partial differential equation is converted to two backward stochastic differential equations and solved by a stochastic gradient descent-type optimization procedure. Numerical results obtained using TensorFlow in Python and the economic behavior of the approximate optimal strategy and the approximate optimal utility of the insurer are analyzed.

Abstract: Antimicrobial resistance (AMR), also known as drug resistance, occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve in ways that render the medications used to cure the infections they cause ineffective [1]. When the microorganisms become resistant to most antimicrobials, they are often referred to as “superbugs” [1]. AMR is a major public health concern because a resistant infection may kill, can spread to others, and imposes a huge cost on individuals and society [1]. Therefore, this policy brief presents a situational analysis of AMR and advocates for a multi-disciplinary approach to control AMR in India. The most recent and relevant publications on AMR in India were reviewed and analyzed to recommend a comprehensive health policy framework. The study recommends an innovative health policy framework for avoiding emergence, supporting research and development (R&D) for new drugs, and encouraging multi-sectoral coordination. Further amendments to the existing health policy with a targeted approach to prevent the growing epidemic of AMR are required. Failure to do so may cause irreversible damage with high morbidity, mortality, and disability in India.IntroductionThe antibiotics have represented a great revolution for humankind, the development after the World War II of a magic bullet (the antibiotic molecule), as imagined by Paul Erlich, the pioneer of chemotherapy, with the property to kill or inhibit the growth of microorganisms by hitting the microbial structures with low toxicity for host cells and tissues, has determined a new era in the treatment and prophylaxis of infectious disease and in the quality of human life [2].The antibiotic era revolutionized the treatment of infectious diseases worldwide [3]. Antimicrobial usage has brought remarkable improvements in human life. Administering antimicrobial right from birth (especially for pre-term and low birth weight neonates) has increased life expectancy at birth, it has greatly reduced death rates due to communicable diseases [3], injuries and most importantly reduced incidences of fatal diseases like cholera, diphtheria, pneumonia, typhoid fever, plaque, tuberculosis, typhus, syphilis, etc. to an extent of complete eradication [3], [4]. However irrational use of antimicrobial has introduced new forms of public health challenges [1], [5] – resistance to ages long invented antimicrobial by evolving microbes; where microbes do not respond to antibiotic dosage and continues to threaten human life [1], [5]. Practices like over prescription of Antimicrobial, lack of counselling before prescribing them, and improper dosage taken by patients thanks to temporary relief are making situation worse than before [6]. Besides, fear of frequent epidemics of veterinary diseases like bird flu; as a result, on large scale Antimicrobial are administered to chickens in large poultry houses [7]. Similar situation does exist in pig farms, where irrational use of Antimicrobial indirectly releases resistant microbes into food chain [7], [8]. There is need to regulate – private partners, drug distribution systems of chemists, and provide capacity building to employees in poultry and pig farms to use Antimicrobial as per need and that only if prescribed by veterinary doctor. Antimicrobial Resistance is a Global ThreatAdvancement in contemporary medicine and surgery could not be possible without use of anti-microbial drugs [5]. They have remarkably reduced the number of cases with infections and have made it possible to introduction of complex medical interventions [9]. Replacing damaged body parts or organs, advanced surgery and care of premature or low birth weights children are some of the procedures endangered by increasing spread of resistant organisms [9]. Antimicrobial resistance (AMR) is a natural phenomenon, which due to irrational use has been accelerated in last few decades [10]. Figure 1 presents the key facts about anti-microbial resistance. Irrational use includes unnecessarily prescribing antimicrobials in low dosage than required, it also includes use of antimicrobials in unhygienic hospital settings [11]–[13]. High use of antimicrobial in the animals used for food consumption such as in poultry and pig farms is supportive for growing AMR, as it has been a global practice to introduce antimicrobials on large scale to livestock [12]. By 2030, world-wide it is estimated that the consumption of antimicrobials in the livestock sector is increase by 66.7 per cent [14]. International transportation and trading have accelerated the spread of resistant micro-organisms [11], [13], [15]. Besides, research and development of new generations of antimicrobial drugs has almost stopped [5], [16]–[18].Health and Economic BurdenAntimicrobial resistance (AMR) augment the health problems as well as brings huge economic loss in the form of significant reduction in productive days of work by employee who are severely ill [5]. The most common resistant microbes found across India are presented in Table 1. These microbes with higher resistance rate are responsible for high morbidity and mortality due to severe infections. Further, patients infected with resistant microbes are more likely to receive therapies that are inadequate or receive the appropriate therapies in low dosages than recommended [10]. With this risk of spreading that infection increases to other organs and to entire body as well [10]. Patients infected with resistant microbes are more likely to die than those who are infected with regular microbes. Patients infected with resistant microbes. World-wide, Antimicrobial resistance (AMR) causes around 700,000 deaths annually [5], [9], [10], [19], [20]. If such pace remains there, then resistance rates increase by 40% as a result 9.5 million deaths will be there annually [19], [20].AMR increases the cost of healthcare. Patients infected by resistant microbes needs advanced and costly care and are more probably to get admitted to a for serious health consequences [19], [20]. Aggressive antimicrobial therapies and additional laboratory tests adds extra expenditure is due excessive cost on nursing and medical care cost, as well as many other things [15], [20]. As first line drugs do not work even for common ailment, physicians need to prescribe costly second or third-line of antimicrobial drugs [10]. The situation will become worse if current picture of increase in antimicrobial resistance (AMR) remains same.Antimicrobial resistance (AMR) cost more to society. as with more drugs are required to administer with higher cost than usual first line drugs, this will collectively increase the cost of entire healthcare [20]. Increase in cost is directly associated to treatment failure, ill-health and also it results in loss of income due to death and disability [20]–[22]. Indirect cost on seeking health care adds more to the loss in productivity as patient may remain in hospital for longer period which keep him or her away from work [23]. If no effective strategies are put in place, it may result in deaths and disability among citizens in productive age group. This will adversely affect the total GDP.Responding to the Rise of AMRAntimicrobial resistance (AMR) is a major public health concern for India where the burden of infectious diseases is high and consumption of antibiotics is huge and un-regulated [24]. In this regard there is need to devise interventions focused to tackle excessive or irrational use of antimicrobials and limits transmission of resistant microbes into humans, as well as R & D, are needed to control the health as well as economic burden caused by Antimicrobial resistance (AMR). This policy brief recommends the following strategies to prevent consequences of AMR in India:Avoiding emergenceAvoiding spreadEncouraging R & DInnovative policieMulti-disciplinary approachRestricting OTC

Independent living is becoming more and more important in today’s society, where persons with visual impairments struggle with a lot of limitations. Visually impaired people are at a disadvantage since they need manual help to compel information about their surroundings. Since many tasks require visual information, persons who are visually impaired find it difficult to complete many of life’s essential chores, such as going for a stroll, eating, and conversing with a group of people. The development of technology has made it feasible to assist the blind. With the advent of recent advances in Artificial Intelligence Techniques and Deep Learning models, this project proposes a sophisticated system to help visually challenged people. The system uses Deep Learning Faster R-CNN ResNet-50 FPN for object detection, CNN ResNet-50 for Face recognition, and CNN ResNet-50 and LSTM for Image Captioning. Then a voice message is generated to assist the Visually Impaired person.

Background: New-onset atrial fibrillation (NOAF) in COVID-19 raises significant clinical and public health issues. This systematic review and meta-analysis aims to compile and analyze the current literature on NOAF in COVID-19 and give a more comprehensive understanding of the prevalence and outcomes of NOAF in COVID-19. Methods: A comprehensive literature search was carried out using several databases. The random effect model using inverse variance method and DerSimonian and Laird estimator of Tua2 was used to calculate the pooled prevalence and associated 95% confidence interval (CI). Results for outcome analysis were presented as odds ratios (ORs) with 95% CI and pooled using the Mantel-Haenszel random-effects model. Results: The pooled prevalence of NOAF in COVID-19 was 7.8% (95% CI, 6.54% to 9.32%), pooled estimate from 30 articles (81,929 COVID-19 patients). Furthermore, our analysis reported that COVID-19 patients with NOAF had a higher risk of developing severe disease compared with COVID–19 patients without a history of atrial fibrillation (OR= 4.78, 95% CI 3.75 to 6.09) and COVID-19 patients with a history of pre-existing atrial fibrillation (OR= 2.75, 95% CI 2.10 to 3.59) . Similarly, our analysis also indicated that COVID–19 patients with NOAF had a higher risk of all-cause mortality compared with, COVID–19 patients without a history of atrial fibrillation (OOR= 3.83, 95% CI 2.99 to 4.92) and COVID-19 patients with a history of pre-existing atrial fibrillation (OR= 2.32, 95% CI 1.35 to 3.96). The meta-analysis did not reveal any significant publication bias. Conclusion: The results of the current meta-analysis a high prevalence rate of NOAF among COVID-19 patients. Further the study reported higher disease severity with NOAF compared with COVID-19 patients without a history of atrial fibrillation and with a history of atrial fibrillation.

Objective: Few studies have examined whether number of births is associated with women’s aging. This study aims to evaluate the association of number of births with women’s biological aging, premature mortality and life expectancy. Methods: A total of 272,494 participants from UK biobank who completed the questionnaire on number of live births were enrolled at baseline. The number of births was categorized into 6 groups, and participants with one live birth was the reference group. General linear regression model and cox proportional hazards model were performed to evaluate the association of number of births with women’s biological aging and premature mortality. Restricted cubic spline (RCS) was used to visualize dose-response relationship. Moreover, the latest Office for National Statistics life tables rom was used to calculate the life expectancy. Results: During a median follow-up of 11.9 years, a total of 10,992 cases of all-cause premature death were documented. After adjustment for potential confounders, compared to women had one birth, childless women had greater premature death (hazard ratio, HR=1.17, 95%CI: 1.09-1.25), whereas women with two or three children had lower risk of premature death (HR=0.87, 95%CI:0.82-0.93, HR=0.90, 95%CI: 0.82-0.99), which showed a U-shaped relationship visualized by RCS (P<0.05 for non-linearity). Further, at age 40, childless women had 1.41 years lower life expectancy, and women with two children was related to 1.10 years higher life expectancy. Moreover, compared to women had one birth, the women with two or three children had lower corrected estimated values of FI, ΔKDM-biological age and HD, and the women with five or more children had higher corrected estimated values of FI, ΔKDM-biological age, and HD (all the P<0.05). Conclusions: The association of number of live births with women’s biological aging, premature mortality and life expectancy had a U-shape relation. The childless or five more child women were more likely to be aging with increased risk of premature death and decreased life expectancy years. The double-child women decreased aging process with lower risk of premature death and high life expectancy.

Raman spectroscopy, as a label-free sensor, is commonly used for real-time monitoring of key parameters in the cultivation of recombinant protein. However, ensuring accurate parameter values necessitates a large quantity of offline measurement data, which is time-consuming and labor-intensive. In order to address the limitations of conventional complex data preprocessing, this study considers a genetic algorithm-based semi-supervised convolutional neural network (GA-SCNN). The GA-SCNN facilitates feature extraction and unsupervised sequence labeling, and has been applied to the model system of E. coli expressing recombinant ProA5M protein. By applying model prediction and sequence interpolation techniques, the GA-SCNN significantly expanded the database for glucose, lactate, ammonium ions, and OD600 from 52 to 1302 samples. A comparative analysis using standard regression algorithms has demonstrated the superior predictive performance of the GA-SCNN framework when dealing with a large volume of spectral data without the requirement for preprocessing. Model cross-validation has confirmed high accuracy and robustness in determining coefficients. In addition, a transfer learning strategy has been employed using the OD600 data and limited recombinant protein expression data to develop a prediction model for the target protein. Validation experiments demonstrate good agreement between model predictions and offline results.

A 70-year-old male patient presented to the Emergency Department with a history of dyspnea, anorexia, and fever. While waiting for observation, the patient had a syncope with loss of sphincter control. He was hypotensive, and tachycardic, had signs of poor peripheral perfusion and abdominal distension. Laboratory findings showed elevated inflammatory parameters, acute kidney injury, and metabolic acidemia.The patient underwent an abdominal and pelvic computed tomography (CT) study (Figure 1), which revealed exuberant gastric distention and wall thickening of the pylorusA nasogastric tube was placed, draining 1 liter of gastric content. On endoscopy the stomach was found to remain filled with abundant content and the scope could not be passed through the pylorus due to non-distensibility of its wall.A thorough review of the CT study revealed the existence of pneumobilia, which raised the suspicion of a colecystoenteric fistula. A subtle dense image was seen inside the pylorus.The CT study was repeated with oral contrast material (Figure 2), which confirmed the presence of a gallstone lodged in the pylorus surrounded by oral contrast material.The patient showed a good clinical evolution after conservative treatment and was discharged with a referral to a gastroenterologist appointment for follow-up.Gastric outlet obstruction caused by gallstone impaction in the distal stomach or proximal duodenum is designated Bouveret syndrome. It occurs most frequently in elderly women. Probably due to the patient’s advanced age and comorbidities, mortality is still high. Clinical presentation and laboratory findings are nonspecific. Symptoms may include nausea, vomits, and epigastric pain. 1The presence of the Rigler triad (bowel obstruction, pneumobilia, and an ectopic gallstone) on the abdominal radiography can be the clue to the diagnosis. Ultrasound may also suggest the diagnosis, although findings can be difficult to interpret. CT can demonstrate the Rigler triad and also the fistula, if it is filled with oral contrast material or air. The identification of the gallstone may be challenging if it is radiolucent. As in our case, oral contrast material can be very helpful because a gallstone surrounded by oral contrast material will be more easily visualized. In patients unable to take oral contrast material, Magnetic Resonance cholangiopancreatography may be very helpful for the detection of radiolucent gallstones. 2The preferred therapy approach is endoscopy because patients are commonly poor surgical candidates. If endoscopic treatment fails, surgery is needed.1Fast removal of an obstructing stone is important because this condition causes significant morbidity and mortality. For that reason, prompt diagnosis is crucial.2References[1]Nickel F, Müller-Eschner MM, Chu J, von Tengg-Kobligk H, Müller-Stich BP. Bouveret’s syndrome: presentation of two cases with review of the literature and development of a surgical treatment strategy. BMC Surg. 2013;13:33. Published 2013 Sep 4. doi:10.1186/1471-2482-13-33[2]Brennan GB, Rosenberg RD, Arora S. Bouveret syndrome. Radiographics. 2004;24(4):1171-1175. doi:10.1148/rg.244035222

Background: Recent data found a correlation between lymphopenia occurring early during craniospinal irradiation (CSI) and risk of disease recurrence in newly-diagnosed childhood medulloblastoma. 1 However, the population included patients that received myelosuppressive chemotherapy prior to or during RT. Here we investigate the effect of lymphopenia during RT in patients with newly-diagnosed pediatric medulloblastoma who did not receive myelosuppressive chemotherapy with RT. Procedure: We analyzed 54 patients with newly-diagnosed medulloblastoma (ages 2-21 years) treated between 1997-2013 with CSI. Log-rank tests were used to determine survival differences, and Cox proportional hazards regression was used to assess associations between patient characteristics and lymphopenia with disease recurrence risk. Results: 78% of patients (40/51) had grade ≥3 lymphopenia by RT week 3; 49% (23/47) improved to grade ≤2 lymphopenia by week 5. Similarly, the lowest median absolute lymphocyte count (ALC) occurred during RT week 3. Sixteen of 54 (30%) patients recurred an average of 30.2 months post-diagnosis. There was higher risk of disease recurrence in patients with grade ≥3 lymphopenia during weeks 4 (log-rank p=0.015; Cox p=0.03) and 5 (log-rank p=0.0009; Cox p=0.004) of RT. Recurrence-free survival was lower in patients with ALC Conclusions: Lymphopenia during RT weeks 4 and 5 correlates with increased risk of tumor recurrence in pediatric patients with newly-diagnosed medulloblastoma. Future studies should correlate baseline numbers of tumor-infiltrating lymphocytes with risks of lymphopenia during RT and tumor recurrence.

Tissues including lung, heart, and bone in the body are subjected to biological, electrical, and mechanical stimulations. These stimulations greatly affect their growth, phenotype, and function, and play an important role in modeling tissue physiology. With the goal of understanding the molecular mechanisms underlying the response of tissues to external stimulations, in vitro models of tissue stimulation have been developed with the hopes of recapitulating in vivo tissue function. Herein we review the efforts to create and validate tissue stimulators responsive to electrical or mechanical stimulation including tensile, compression, torsion, and shear. These bioengineered platforms have designed such that tissues can be subjected to select types of mechanical stimulation from simple uniaxial to humanoid robotic stain through complex equal-biaxial strain. Electrical stimulators have been developed to subject tissues to select electrical signal shapes, amplitudes, and loading cycles were used in tissue development derived from stem cell, maturation of tissue, and regeneration of tissue function. Some stimulators allow for the observation of tissue morphology in real-time while cells undergo stimulation. We also discuss the limitations and challenges in the development of tissue simulators. Despite advances in creating useful tissue stimulators, there remain opportunities for improvements to recreate physiological functions including: replicating complex loading cycles, electrical and mechanical induction combined with biological stimulation, and taking into account the change of strain affected by the applied inputs. We expect that the use of tissue simulator platforms will play an increasingly vital role in tissue modeling, stem cell development, and drug development.

Lignocellulosic material is the most prominent carbon source to obtain profitable biotechnological processes, but compounds like furfural and acetic acid are highly toxic to yeasts. Nonetheless, research about the molecular mechanism of furfural and acetic acid toxicity is still scarce in yeasts like Scheffersomyces stipitis. Thus, this work aimed to identify the role of furfural and acetic acid on S. stipitis in bioenergetic and fermentation parameters. Here, we provide evidence that furfural and acetic acid caused a cell growth delay and extension of the lag phase. The mitochondrial membrane potential decreased in all treatments without differences among inhibitors or concentrations. Interestingly, the reactive oxygen species increased when the inhibitors concentrations were from 0.1 to 0.3% (v/v). The glycolytic flux was not significantly ( p>0.05) altered by acetic acid, but furfural caused different effects. The ethanol production decreased significantly (4.32 g/L in furfural and 5.06 g/L in acetic acid) compared to the control (26.3 g/L). At the same time, biomass was not significantly different in almost all treatments compared to the control. This study provides additional understanding of the effects of furfural and acetic acid at mitochondrial level in a pentose-fermenting yeast like S. stipitis.

Flickering visual stimulation targeting the entire visual field can evoke steady-state visual evoked potentials (SSVEPs), and these SSVEPs can potentially influence ongoing brain activity. Here, we aimed at extending previous findings to evoke high-frequency SSVEPs. We hypothesized that the sequential targeting of neighboring retinal areas allows evoking a high-frequency series of visual evoked potentials which sum to a high-frequency SSVEP across the visual cortex. By selectively and sequentially targeting neighboring retinal areas with high-frequency flickering light, each area was only stimulated every 10ms, but neighboring areas were stimulated at a lag of 8.33ms, 6.06ms, 5.55ms, and 5.26ms (i.e., 120, 165, 180 and 190Hz), for 60 trials of 2s, while we recorded 64-channel EEG from 10 participants. In line with our hypothesis, we measured SSVEPs for 120Hz and 180Hz stimulation with an occipital topography. For the first time, we show that it is possible to evoke high-frequency SSVEPs as high as 180Hz across the visual cortex by using a spatially organized noninvasive visual brain stimulation. This critically extends previous findings on SSVEPs following full-field visual stimulation. Spatially organized noninvasive visual stimulation could potentially be used as a tool to influence high-frequency oscillations, which opens the possibility of targeted therapeutic interventions.