In today’s world, Free Space Optical (FSO) communication under atmospheric turbulence continues to be an active area of research and development across various applications. Through the application of advanced techniques and technologies, FSO systems strive to achieve reliable, high-capacity data transmission in challenging atmospheric conditions. Due to the specific characteristics of gamma-gamma turbulence, it poses signal fading, scintillation, and link failures caused by turbulence can lead to service interruptions and impact the overall connectivity and network performance. However, it requires careful consideration of the environmental conditions and the use of appropriate techniques to ensure reliable and high-quality data transmission. Hence, there is a need to develop a low-complexity parameter estimation using an improved deep learning technique with low Bit Error Rate (BER) and low Mean Square Error (MSE). This paper propose a Hierarchical Attention-Echo State Network (HA-ES Net) model to estimate the parameters over gamma-gamma turbulence channels in FSO communications. HA-ES Net model leverages deep learning, attention mechanisms, and the ESN architecture. In this, the attention mechanism allows the network to selectively attend to informative channel characteristics and suppress noise and irrelevant information. Echo state property helps in learning and capturing the underlying dynamics of the FSO channel, enabling robust estimation even in the presence of noise and interference. Hence the hierarchical structure of HA-ES Net enables the network to learn and model the FSO channel in a more efficient manner. This reduces the complexity of training the network compared to other traditional approaches, making it feasible to implement HA-ES Net for FSO channel estimation. The simulation outcomes illustrate that the HA-ES Net model achieves strong estimation performance, characterized by low BER, low MSE, and minimal computational complexity.

Objective: This case report describes the second reported case of ectopic production of beta-hCG in anal cancer Case: 53-year-old female presented with a new anal lesion. Biopsy showed a poorly differentiated squamous cell cancer (SCC) with undifferentiated sarcomatoid features, stage IIIA (cT2cN1cM0). Before starting concurrent chemotherapy and radiation, the patient had

Extracellular vesicles (EVs) in urine are a promising source to develop non-invasive biomarkers. However, urine concentration and content are highly variable and dynamic, and actual urine collection and handling often is nonideal, which presents an enormous challenge for urine-based biomarker studies. Furthermore, patients such as those with prostate diseases have challenges in sample collection due to difficulties in holding urine at designated time points. Here, we simulated the actual situation of clinical sample collection to examine the stability of EVs in urine under different circumstances, including urine collection time and temporary storage temperature, as well as the stability of EVs in daily urine sampling under different diet conditions. EVs were isolated by functionalized EVTRAP magnetic beads, and analyzed by nanoparticle tracking analysis (NTA), Western blotting, electron microscopy, and mass spectrometry (MS). EVs in urine remained relatively stable during temporary storage for 6 hours at room temperature and for 12 hours at 4°C, while significant fluctuations were observed in EV amounts from urine samples collected at the different time points from the same individuals, especially under certain diets. Sample normalization with creatinine reduced the coefficient of variation (CV) value among EV samples from 17% to approximately 6%, and facilitated downstream MS analyses. Finally, we based on the results and applied them to screen for potential biomarker panels in prostate cancer by data-independent acquisition (DIA) MS, presenting the recommendation that can facilitate biomarker discovery with nonideal handling conditions.

The relationship of plant diversity and several ecosystem functions strengthens over time. This suggests that the restructuring of biotic interactions in the process of a community’s assembly and the associated changes in function differ between species-rich and species-poor communities. An important component of these changes is the feedback between plant and soil community history. In this study, we examined the interactive effects of plant richness and community history on the trophic functions of the soil fauna community. We hypothesized that experimental removal of either soil or plant community history would diminish the positive effects of plant richness on the multitrophic functions of the soil food-web, compared to mature communities. We tested this hypothesis in a long-term grassland biodiversity experiment by comparing plots across three treatments (without plant history, without plant and soil history, controls with ~20 years of plot specific community history). We found that the relationship between plant richness and belowground multitrophic functionality is indeed stronger in communities with shared plant and soil community history. Our findings indicate that anthropogenic disturbance can impact the functioning of the soil community through the loss of plant species but also by preventing feedbacks that develop in the process of community assembly.

In proteomics, fast, efficient and highly reproducible sample preparation is of utmost importance, particularly in view of fast scanning mass spectrometers enabling analyses of large sample series. To address this need, we have developed the web application MassSpecPreppy that operates on the open science OT-2 liquid handling robot from Opentrons. This platform can prepare up to 96 samples at once, performing tasks like BCA protein concentration determination, sample digestion with normalization, reduction/alkylation and peptide elution into vials or loading specified peptide amounts onto Evotips in an automated and flexible manner. The performance of the developed workflows using MassSpecPreppy was compared with standard manual sample preparation workflows. The BCA assay experiments revealed an average recovery of 101.3% (SD: ±7.82%) for the MassSpecPreppy workflow, while the manual workflow had a recovery of 96.3% (SD: ±9.73%). The species mix used in the evaluation experiments showed that 94.5% of protein groups for OT-2 digestion and 95% for manual digestion passed the significance thresholds with comparable peptide level coefficient of variations. These results demonstrate that MassSpecPreppy is a versatile and scalable platform for automated sample preparation, producing injection-ready samples for proteomics research.

We review some known bounds for eigenvalues of matrices and use similar techniques to derive bounds for nonlinear eigen problems and the eigenvalues for LTI systems with delays as a special case. There are two classes of results. The first are based on Hermitian decompositions, the second on Gershgorin's theorem. The bounds are easily computable. We reflect on implications for stability theory, which may be contrasted with bounds that have been obtained via Riccati stability based on Lyapunov-Krasovskii theory.

Objective: This study aimed to investigate the efficacy and safety of prophylactically administered sildenafil during the early life stages of preterm infants to prevent mortality and bronchopulmonary dysplasia (BPD). Data Sources: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Ichushi. Study Selection: Published randomized controlled trials (RCTs), non‐RCTs, interrupted time series, cohort studies, case–control studies, and controlled before‐and-after studies were included. Data Extraction: Two reviewers independently screened the title, abstract, and full text, extracted data, assessed the risk of bias, and evaluated the certainty of evidence (CoE) following the Grading of Recommendations Assessment and Development and Evaluation approach. The random‐effects model was used for a meta‐analysis of RCTs. Results: This review included three RCTs (162 infants). The prophylactic sildenafil and placebo groups demonstrated no significant differences in mortality (risk ratio [RR]: 1.32; 95% confidence interval [CI]: 0.16–10.76; very low CoE) and BPD (RR: 1.20; 95% CI: 0.79–1.83; very low CoE), as well as in any other outcome assessed (very low CoE). Limitations: The sample sizes were less than the optimal sizes for all outcomes assessed, indicating the need for further trials. Conclusions: The prophylactic use of sildenafil in individuals at risk of BPD did not indicate any advantageous effects in terms of mortality, BPD, and other outcomes, or increased side effects.

A document by Eva Villalba-Riquelme. Click on the document to view its contents.

Some properties of the Dawson Integral are presented first in the current work, followed by the introduction of the Dawson Integral Transform. Iteration identities and relationships, similar to the Parseval Goldstein type, are established involving various well-known integral transforms, such as the Laplace Transform, the L 2 -Transform, and the Dawson Integral for the new integral transform. Furthermore, improper integrals of well-known functions, including the Dawson Integral, Exponential Integral, and the Macdonald Function, are evaluated using the results obtained.

Background: CFTR-Related Metabolic Syndrome/ Cystic Fibrosis Screen Positive, Inconclusive Diagnosis (CRMS/CFSPID) is the diagnosis in infants who have a positive Cystic Fibrosis (CF) newborn screen (NBS), 2 CF-causing mutations, and borderline or normal sweat test. NY State implemented a new CF NBS algorithm (IRT-DNA-SEQ) in December 2017 with significant improvement in positive predictive value. This algorithm also resulted in detection of more CRMS cases. For these infants repeat sweat testing is recommended at 6, 12, and 18 months to monitor for risk of rising sweat chloride over time and 6-48% of infants with CRMS develop clinical features suggestive of CF. Infants with CRMS and sweat test results in the normal range are often lost to follow and parents were unwilling to return for recommended repeat sweat testing during the statewide lockdown during the peak of COVID-19 pandemic. We recognized the practice gap exacerbated during the pandemic and underscore the importance of establishing a medical home in a CF Center for longitudinal care. Methods: Retrospective analysis of infants with CRMS from December 2017 to December 2020 were collected by 10 NY CF Centers and the NBS program with NYU as the data collection and statistical analysis site. Infants with CRMS without repeat sweat chloride testing at 6 months of age were considered lost to follow up, and their parents were contacted via mail or telephone. Families completed a questionnaire that was developed with the assistance of CF Voice to evaluate parental understanding of CRMS and the recommendation for repeat sweat chloride testing. Primary care providers (PCPs) caring for infants with CRMS were also contacted and provided educational materials about CRMS. A subcommittee of CF Center Directors met to develop a statewide approach for the management of infants with CRMS. Results: Of 350 infants diagnosed with CRMS, 179 (51.1%) infants were lost to follow up. As an outcome of this QI effort 31 (17.3%) were scheduled for repeat sweat tests and follow up at CF Centers. This QI effort explored the knowledge and practice gap among PCPs with limited understanding of the implications of a CRMS diagnosis. CF Center Directors subcommittee issued a consensus statement regarding evaluation and follow up for infants with CRMS in NY. Conclusions: This QI effort effectively recaptured infants with CRMS previously lost to follow up. Consensus recommendations for CRMS include annual visits until 2-6 years of age for repeat sweat testing and in adolescence to educate the patient about clinical and reproductive implications of CRMS.

The novel coronavirus (SARS-CoV-2) has caused a global pandemic, which can cause cough, fever, muscle aches, fatigue and, sore throat. However, most people do not know how to cope with them so that some patients may progress to pneumonia and even severe disease. Therefore, it’s crucial to effectively cope with COVID-19 infection at home to reduce the rate of hospitalization, ease the burden of healthcare systems, alleviate patients’ suffering, and shorten the illness duration. In this regard, we aim to describe the symptom groups of the recently epidemic BF.7 variant strain infection, and summarize previous clinical experience and expert guidelines, the following home care measures for the five main symptoms were proposed. We hope that these strategies will serve as a reference for home care of patients and help them take appropriate measures to manage their symptoms.

Pathogenic variants in the Surfactant Protein C gene ( SFTPC) result in fibrotic childhood interstitial lung disease (chILD). We previously reported three children with SFTPC pathogenic variants with respiratory failure who were supported by chronic invasive ventilation via tracheostomy as an alternative to lung transplantation or comfort care [(1)](#ref-0001). We present two children with SFTPC pathogenic variants treated with non-invasive ventilation (NIV) (Figure 1).

Background: Accurate prediction of SARS-CoV-2 severity remains a challenge. Torque Teno Virus (TTV), recognized as a surrogate marker for cellular immunity in solid organ transplant recipients, holds potential for assessing infection outcomes. Objectives: We investigated whether quantifying TTV in nasopharyngeal samples upon emergency ward (ED) admission could serve as an early predictor of SARS-CoV-2 severity. Study design: Retrospective single-center study in the ED of Saint-Louis Hospital in Paris, France. TTV DNA was quantified in nasopharyngeal swab samples collected for SARS-CoV-2 testing. Results: Among 295 SARS-CoV-2 infected patients, 92 returned home, 160 were admitted to medical wards, and 43 to the intensive care unit. Among 295 SARS-CoV-2 patients, 92 were discharged, 160 hospitalized, and 43 admitted to the intensive care unit (ICU). Elevated TTV loads were observed in ICU patients (Median: 3.02 log copies/mL, interquartile range [IQR]: 2.215-3.825), exceeding those in discharged (2.215, [0; 2.962]) or hospitalized patients (2.24, [0; 3.29]) (p=0.006). Multivariate analysis identified diabetes, obesity, hepatitis, fever, dyspnea, oxygen requirement, and TTV load as predictors of ICU admission. A 2.91 log 10 copies/mL TTV threshold independently predicted ICU admission. Conclusion: Nasopharyngeal TTV quantification in SARS-CoV-2 infected patients is linked to the likelihood of ICU admission and might reflect respiratory immunosuppression.

A document by Rezy Pradipta. Click on the document to view its contents.

Background: Children vulnerable to Human cytomegalovirus ( HCMV ) infection, most of them are recessive infection, easy to lead to missed diagnosis. However, missing early diagnosis and treatment may have adverse consequences for the child. Therefore, the purpose of this study was to evaluate the hematological parameters in HCMV-infected infants or children less than 6 years. Method：A retrospective analysis of 223 children aged 0-6 years who had accepted urine HCMV-DNA testing in Luohu People’s Hospital. The children were divided into 0 day-21 days, 22 days-6 months, 7 months-11 months, 12 months-23 months, and 2 years-6 years groups according to their age when they were tested, and total white blood cell count (WBC), lymphocyte percentage (L%), lymphocyte count (LYM), alanine transaminsase (ALT), aspartate transaminase (AST), γ-glutamy1 transferase (GGT), urea nitrogen (UREA), and creatinine (CREA) of different age groups were compared. Results: The L% and LYM of HCMV-infected children aged 0d-6y were significantly higher than those of the control group ( P<0.05); The ALT and GGT of HCMV-infected children aged 0-12m and AST of HCMV-infected children aged 0d-2y were significantly higher than control group ( P<0.05), but this difference did not show up among older children ( P<0.05); Compared with control group, there was no significant difference in UREA and CREA of HCMV-infected children aged 0d-6y ( P>0.05). In addition, we found that GGT was highest in HCMV-infected children aged 0-21d and decreased with the increase of age. Conclusion：HCMV infection can increase lymphocytes in the peripheral blood of children from 0 to 6 years old, and cause more serious hepatobiliary injury to younger children. However, renal damage caused by HCMV is rare in childhood.

The problem of explainable recommendation—supporting the recommendation of a product or service with an explanation of why the item is a good choice for the user—is attracting substantial research attention recently. Recommendations associated with an explanation of how the aspects of the chosen item may meet the needs and preferences of the user can improve the transparency and trustworthiness of consumer-oriented applications, which is the motivation driving this research area. Current methods are far from ideal because they do not necessarily consider the following issues: users’ opinions are influenced not only by individual aspects but also by the dependency between sentiments towards aspect; not all users place the same value on all aspects; and, any explanation are not provided for how the item aspects have led to the recommendation. We introduce a personalized explainable aspect-based recommendation method that can address these challenges. To identify the aspects that a user cares about, our semantics-aware method learns the likelihood of an aspect being mentioned in a user’s review. To capture dependency between the users’ sentiments towards an aspect, reviews that express opinions with similar polarities towards sets of aspects are clustered together in latent opinion groups. To construct aspect-based explanations, item aspects are rated according to their importance based on these latent opinion groups and the preferences of the target user. Finally, to provide a user with a (set of) useful recommendation(s) of an item, our method selects and synthesizes the aspects important for the target user. We evaluate our method over two datasets from (a) Yelp and (b) Tripadvisor. Our results demonstrate that our method outperforms previous methods in both recommendation performance and explainability.

Artificial intelligence (AI) will impact many aspects of clinical pharmacology including drug discovery and development, clinical trials, personalised medicine, pharmacogenomics, pharmacovigilance and clinical toxicology. The rapid progress of AI in healthcare means clinical pharmacologists should have an understanding of AI and its implementation into clinical practice. As with any new therapy or health technology, it is imperative that AI tools are subject to robust and stringent evaluation to ensure that they enhance clinical practice in a safe and equitable manner. This review serves as an introduction to AI for the clinical pharmacologist, highlighting current applications, aspects of model development and issues surrounding evaluation and deployment. The aim of this article is to empower clinical pharmacologists to embrace and lead on the safe and effective use of AI within healthcare.

Although reports have shown an association between coronavirus disease 2019 (COVID-19) and a reduction in male semen parameters, no population big-data analyses have been verified. This ecological comparative study aimed to explore the effects of the COVID-19 pandemic on semen quality. This ecological comparison study was based on the nationwide loosening of COVID-19 curbs in China on 2022-12-07, 1 month after which, an 89% infection rate was reported in Henan Province, China. We compared semen quality and serum hormone levels from 2023-01-07 to 4-30 and 2022-01-07 to 4-30 at the Reproductive Center of Henan Provincial People’s Hospital. Our results indicated a significant decrease in semen volume ( P<0.0001), sperm concentration ( P=0.0004), total sperm count ( P<0.0001), progressive motility ( P<0.0001), and nonprogressive motility ( P<0.0001) after the nationwide loosening of COVID-19 curbs. The effects on semen volume and total sperm count lasted for a long time. An increase in the rate of sperm neck defects was observed ( P<0.0001). Infection also caused hormone disruption in prolactin ( P<0.0001), testosterone ( P=0.0220), sex hormone-binding globulin ( P<0.0001), and free testosterone index ( P=0.0126), and an increase in estrogen ( P<0.0001), osteocalcin ( P<0.0001), and 25-OH-VD ( P<0.0001). The present study revealed that mild COVID-19 appeared to have a detrimental effect on semen parameters.

Background Immunoglobulin E (IgE) is highly related to a variety of atopic diseases, and several genome-wide correlation studies (GWASs) have demonstrated the association between genes and IgE. In this study, we conducted the largest genome-wide association study of IgE in a Taiwanese Han population and aimed to elucidate the genetic architecture of IgE. Methods Genome-wide association study was used to discover the association between variants and IgE. Through HLA imputation, we explored the association between HLA alleles and IgE. In order to explore the pleiotropy relationship between IgE and atopic diseases, we performed both global and local genetic correlation analysis. Moreover, we divided our cohort into a training group and a validation group to construct the polygenic risk score (PRS) of IgE and applied it to test the risk of asthma and atopic dermatitis. Results A total of 8 independent variants showed genome-wide significance, and rs147642819 at 6p21.32 was the most significant signal (p= 1.8×10 -19). Seven of the loci were replicated successfully after a meta-analysis of the Japanese population. Among all the HLA alleles, HLA-DQB1*03:03 is the most significant allele. The global genetic correlation showed significance between IgE and asthma. The IgE PRS significantly correlated with the total IgE level. Furthermore, the top 10 quantile IgE PRS group had a potentially higher risk for asthma, which was replicated in the Japanese population as well. Conclusions Our study provided a more comprehensive understanding of the impact of genomic variants including complex HLA alleles on serum IgE.

Polyadenylation occurs at numerous sites within 3’ untranslated regions (3’ UTRs) but rarely within coding regions. How does Pol II travel through long coding regions without generating poly(A) sites, yet then permits promiscuous polyadenylation once it reaches the 3’ UTR? The cleavage/polyadenylation (CpA) machinery preferentially associates with 3’ UTRs, but it is unknown how its recruitment is restricted to 3’ UTRs during Pol II elongation. Unlike coding regions, 3’ UTRs have long AT-rich stretches of DNA that may be important for restricting polyadenylation to 3’ UTRs. Recognition of the 3’ UTR could occur at the DNA (AT-rich), RNA (AU-rich), or RNA:DNA hybrid rU:dA- and/or rA:dT-rich) level. Based on the nucleic acid critical for 3’ UTR recognition, there are three classes of models, not mutually exclusive, for how the CpA machinery is selectively recruited to 3’ UTRs, thereby restricting where polyadenylation occurs: 1) RNA-based models suggest that the CpA complex directly (or indirectly through one or more intermediary proteins) binds long AU-rich stretches that are exposed after Pol II passes through these regions. 2) DNA-based models suggest that the AT-rich sequence affects nucleosome depletion or the elongating Pol II machinery, resulting in dissociation of some elongation factors and subsequent recruitment of the CpA machinery. 3) RNA:DNA hybrid models suggest that preferential destabilization of the Pol II elongation complex at rU:dA- and/or rA:dT-rich duplexes bridging the nucleotide addition and RNA exit sites permits preferential association of the CpA machinery with 3’ UTRs. Experiments to provide evidence for one or more of these models are suggested.

Terrorist attacks, war, violent acts, and their media coverage remind us of our own mortality, which may provoke stress and coping mechanisms. The terror management health model (TMHM) proposes that even subliminal thoughts about existential threats trigger worldview defense and self-esteem-related behaviors. Based on the TMHM, our field experiment (N=228) examines the impact of a terrorist attack on death-thought accessibility, the choice between alcoholic and nonalcoholic beverages, and if the impact on this choice is moderated by the importance of alcohol to one’s self-esteem (i.e., alcohol-based self-esteem), and the consciousness of the terrorist attack. Results show that thoughts about the terrorist attack increased death-thought accessibility. The salience of the terrorist attack had no main effect on beverage choice, but alcohol-based self-esteem predicted choosing an alcoholic beverage. However, in the unconscious thought condition, participants who had low alcohol-based self-esteem and were provoked with death-related thoughts about terrorism were more likely to choose an alcoholic beverage. In the conscious thought condition, participants who had high alcohol-based self-esteem were less likely to choose alcohol. This study suggests that thoughts about terrorism and, therefore, the threat of death, can be provoked in everyday situations and affect substance use behaviors with potentially adverse health consequences.

Objective: Institutions of higher education (IHE) have faced increasing pressure to comply with federal regulations and reform their response to campus sexual assault (CSA). This study explores whether decoupling, or organizational resistance to change, is associated with the number and timing of CSA reforms adopted. Participants: A web-based survey of IHE employees familiar with sexual assault policy implementation on their campus asked about types of reforms, timing, decoupling, and campus characteristics. Method: Correlations and t-tests were run to examine the types of reforms across time periods, and regression assessed the degree to which decoupling was associated with the number and timing of reforms. Results: Higher decoupling was associated with fewer reforms in the early period and more in the late period, though not with the overall number of reforms adopted. Conclusions: Findings highlight the importance of understanding factors that influence change on campuses.

Small extracellular vesicles (sEVs) such as exosomes are nanoscale membranous particles (<200 nm) that have emerged as crucial targets for liquid biopsy and as promising drug delivery vehicles. They play a significant role in tumor progression as intercellular messengers. They can serve as biomarkers for tumor diagnosis and as drug carriers for cancer treatment. This article reviews recent studies on sEVs in oncology and explores their potential as biomarkers and drug delivery vehicles. Following tumorigenesis, sEVs in the tumor microenvironment (TME) and circulatory system undergo modifications to regulate various events in the TME, including angiogenesis, epithelial-mesenchymal transition (EMT), and tumor immunity, with either pro- or anti-tumor effects. sEVs have been investigated for use as diagnostic and prognostic biomarkers for a variety of tumors, including lung cancer, melanoma, breast cancer, prostate cancer, and hepatocellular carcinoma. sEVs can be used for cancer therapy by packaging drugs or proteins into them through pre- and post-isolation modification techniques. The clinical trials of sEVs as biomarkers and drug carriers are also summarized. Finally, the challenges in the use of sEVs are described and the possible approaches to tackling them are suggested. Overall, sEVs will advance the precision cancer medicine and has shown great potential in clinical applications.

An increase in alternative activation in cerebral lateralisation with the ultradian rhythm dominates sympathetic or parasympathetic phases. In this study, we tested the reaction time (RT) of right-handed younger people to an auditory stimulus by shifting the ultradian rhythm to the sympathetic activation (SA) period. Twenty-three women and 7 men students volunteered for our study. In the resting period and SA phase, after measuring the participants’ blood pressure, heart rate, and nasal dominance, we assessed their right and left-hand RTs against regular and irregular auditory stimuli. SA was provided by running for 5 minutes on a treadmill at a rate that doubled the resting heart rate. In the SA phase, right-and left-hand RTs were accelerated in both stimulus types compared to pre-exercise (p<.05). With regular stimuli, the difference between right and left-hand RTs was insignificant in both the resting period and SA (p>.05). However, with irregular stimuli, the left-hand RT was faster than the right-hand RT for the resting period and after SA (p<.01). We conclude that the known superiority of the right hemisphere in processing non-verbal sounds, and its greater functionality in the formation of attention compared with the left hemisphere, accelerated the left-hand RT against irregular stimuli. Although the right hand and the motor area of the left hemisphere have an advantage of learned automatic motor skills, we suppose that the right hemisphere is superior in reaching the non-verbal sounds to the auditory cortex and the right auditory cortex processes these sensory signals faster via short-cut pathways.