IntroductionPulmonary alveolar microlithiasis (PAM) is an uncommon, autosomal recessive lung disease with high penetrance (OMIM #265 100) and is considered to be a monogenic disorder. 1 The only known pathogenic gene is solute carrier family 34 member 2 (SLC34A2) (Entrez Gene ID 10568).2-4 SLC34A2 mutations lead to the accumulation of calcium phosphate in the alveoli, restrict alveolar dilatation, and then progress to a restrictive lung function complicated with reduced dynamic and static volumes.5, 6 Dyspnea is the most frequent symptom, followed by dry cough, chest pain, asthenia, pneumothorax, pulmonary fibrosis, and cor pulmonale.7-10While children are always in the onset at the early stage of PAM and usually remain asymptomatic when diagnosed; however, some can present with dry cough, exertional dyspnea, and chronic hypoxic signs, including clubbing.3 Recently, some complications with PAM have been reported, such as asthma, pneumomediastinum, subcutaneous emphysema, and so on.11-14PAM is difficult to be diagnosed because of nonspecific symptoms in children. The diagnosis of PAM is often based on radiographic studies at first, and an exact diagnosis requires at least one additional clinical feature including genetic testing demonstrating a mutation in SLC34A2, microlith analysis, or histopathology.15 Gradually, it has been a tendency that gene analysis would play an increasingly important role in the diagnostic procedure. Bendstrup et al. summarized 30 genetic variants of SLC34A2 in 2020.16In this case, we identified a PAM patient complicated with bronchitis obliterans by computerized tomography (CT), bronchoscopy and whole-exome-sequencing. Two novel compound heterozygous gene mutations, gain (EXON:2-6 duplication) and c.1218C>A (p. Phe406Leu) were identified to expand the spectrum of gene mutations.

First Reported Rhodotorula mucilaginosa Brain Abscess: Found As Coinfection in Woman with Common Variable Immune DeficiencyAuthors: Arjun Bhatt, B.A.1Melinda S. Dunlap, M.D.2Han Pham, M.D.3Kimmo J. Hatanpaa, M.D., Ph.D3Philip Boyer, M.D., Ph.D3Rita M. Gander, Ph.D3Anna G. Symmes, M.D.1Affiliations: Department of Internal Medicine1Brody School of MedicineGreenville, North CarolinaDepartments of Internal Medicine2 and Pathology3University of Texas Southwestern Medical CenterDallas, Texas

The solution to human-leopard conflict requires novel insights into the phenomenon. For mitigating its commonest cause i.e., livestock depredation, most spatial studies map the different livestock species as a single entity. Contradictory to it, we discretely mapped the species vulnerable to livestock depredation. Along with the spatial factors, both time and season impacted the phenomenon. The livestock were more vulnerable during the day while grazing with the attacks peaking between January to March, and were comparatively less vulnerable in corrals. The cattle, killed in the largest numbers, was less vulnerable to attacks throughout the landscape. In comparison, the goats and sheep were killed successively in smaller numbers, were more widely vulnerable in the landscape. The latter two species were generally killed in sparse vegetation in a rugged terrain around the peripheral areas of forests, while cattle were killed in denser vegetation, deep inside the forests. When compared under the different landuse landcover classes, attacks in corrals differed from all three livestock species, while the attacks on cattle spatially differed from goats and sheep, but there was no difference between the latter two. The larger cattle offer more food but is difficult to kill, while goats and sheep are easier to subdue. These strategies are usually an outcome of the trade-offs between reward (biomass) and the risks (persecution risk) when hunting within a human-wildlife interphase landscape. The leopards living close to humans uses differential strategies for specific livestock, which require species specific mitigation interventions.

The nonsense-mediated mRNA decay (NMD) pathway was initially identified as a surveillance pathway that degrades mRNAs containing premature termination codons (PTCs). NMD is now also recognized as a post-transcriptional regulatory pathway that regulates the expression of natural mRNAs. Earlier studies demonstrated that regulation of functionally related natural mRNAs by NMD can be differential and condition-specific in Saccharomyces cerevisiae. Here, we investigated the regulation of MAC1 mRNAs by NMD in response to copper as well as the role which the MAC1 3′-UTR plays in this regulation. MAC1 is a copper-sensing transcription factor that regulates high-affinity copper transport and is activated under low copper conditions in S. cerevisiae. We discovered that MAC1 mRNAs are regulated by NMD under complete minimal (CM) but escaped NMD under low and high copper conditions. Mac1p-regulated genes escape NMD in conditions where MAC1 mRNAs are NMD sensitive. We also found that the MAC1 3′-UTR is the NMD targeting feature on the mRNAs, and that MAC1 mRNAs lacking 3′-UTRs were stabilized during copper deprivation. Our results demonstrate a mechanism of regulation for a metal-sensing transcription factor, at both the post-transcriptional and post-translational levels, where MAC1 mRNA levels are regulated by NMD and copper, while the activity of Mac1p is controlled by copper levels.

Agaricus subrufescens, also known as the “mushroom of the sun,” has significant nutritional and medicinal value. However, its short shelf life due to the browning process results in post-harvest losses unless it’s quickly dehydrated. This restricts its availability to consumers in the form of capsules. A genome sequence of A. subrufescens may lead to new cultivation alternatives or the application of gene editing strategies to delay the browning process. We assembled a chromosome-scale genome using a hybrid approach combining Illumina and Nanopore sequencing. The genome was assembled into 13 chromosomes and 31 unplaced scaffolds, totalling 44.5 Mb with 96.5% completeness and 47.24% GC content. 14,332 protein-coding genes were identified, with 64.6% of the genome covered by genes and 23.41% transposable elements. The mitogenome was circularized and encoded fourteen typical mitochondrial genes. Four PPO genes and the Mating-type locus were identified. Phylogenomic analysis supports the placement of A. subrufescens in the Agaricomycetes clade. This is the first available genome sequence of a strain of the “mushroom of the sun.” Results are available through a Genome Browser (https://plantgenomics.ncc.unesp.br/gen.php?id=Asub) and can support further fungal biological and genomic studies.

Key Points Primary and recurrent/residual Pharyngeal Pouches up to 3cm can be safely treated with Endoscopic LASER division with primary mucosal repair Primary mucosal repair after Pharyngeal Pouch division using LASER may make Endoscopic LASER pharyngeal pouch surgery safer than cases where it is not undertaken. There is no significant difference in the number of complications for patients treated with Endoscopic LASER surgery vs Endoscopic Stapling The modal duration of inpatient stay for patients treated with Endoscopic LASER surgery with primary mucosal repair is 2 days, as opposed to 1 day for Endoscopic Stapling surgery Post-operative IV antibiotics, Nasogastric feeding, antiemetics are helpful in reducing adverse effects from Endoscopic LASER surgery for Pharyngeal Pouches

Cameroon was among the most affected African countries during the first wave of the COVID-19 pandemic; however, the true prevalence of SARS-CoV-2 remains unknown. From October-December 2020 we conducted a cross-sectional, age-stratified SARS-CoV-2 seroepidemiological survey at 30 purposively selected community-based sites across Cameroon’s 10 regional capitals, sampling 10,000 individuals aged 5 years or older. We employed a parallel SARS-CoV-2 antibody testing algorithm (WANTAI ELISA and Abbot Architect) to improve both the positive predictive value and negative predictive value of seroprevalence. The overall weighted and adjusted seroprevalence of SARS-CoV-2 antibodies across the 10 urban capitals of Cameroon was 10.5% (95% CI: 9.1%-12.0%) among participants aged ≥5 years. Of the 9332 participants, 730 males (13.1%, 95% CI: 11.5%-14.9%) had SARS-CoV-2 antibodies compared to 293 females (8.0%, 95% CI: 6.8%—9.3%). Among those who reported a comorbidity at the time of testing, 15.8% (95% CI: 12.8%-19.4%) were seropositive. We estimated that over 2 million SARS-CoV-2 infections occurred in the 10 regional capitals of Cameroon between October and December 2020, compared to 21,160 cases officially reported at that time translating to one laboratory-confirmed case was reported for every 110 SARS-CoV-2 infections across the 10 urban capitals. This study’s findings point to extensive and under-reported circulation of SARS-CoV-2 in Cameroon– an almost 100-fold more cases compared to the number of cases reported to the World Health Organization. This finding highlights the importance of conducting serosurveys, especially in settings where access to testing may be limited and to repeat such surveys as part of pandemic tracking.

A document by Marhaba Iqbal. Click on the document to view its contents.

A document by Mohammad Hazique . Click on the document to view its contents.

Medically qualified clinical pharmacologists specialise in drugs and their usage. Thus, a clinical pharmacologist should be involved in patient education, drug development, access and utilisation research, policy and procedure development, and safer medicine use. India has 5.2 million medication errors yearly, which are just a fraction of healthcare system incidents. Clinical pharmacological reconciliation, review, and feedback (CPRRF) is essential to reduce medication-related tragedies. Clinical pharmacologists can employ CPRRF principles to improve patient safety and efficacy.To improve patient safety, the World Health Organisation wants to integrate Clinical Pharmacology into the health care system. However, this is taking time. Policymakers should design and execute novel strategies to speed up this process.

Monitoring is a prerequisite for evidence-based wildlife management, yet conventional monitoring approaches are often ineffective for species occurring at low densities. However, some species such as large mammals are often observed by lay people and this information can be leveraged through citizen science monitoring schemes. Assessing the quantity, quality, and potential biases of such data sources is crucial before making inferences at scale. For Eurasian moose (Alces alces), a species currently reoccurring in north-eastern Germany in low numbers, we compared three different citizen science tools: a mail/email report system, a smartphone application, and a webpage. Among these monitoring tools, the mail/email report system yielded the greatest number of moose reports in absolute and in standardized (corrected for time effort) terms. The reported moose were predominantly identified as single, adult, male individuals, and reports occurred mostly during late summer. Overlaying citizen science data with independently generated habitat suitability and connectivity maps showed that members of the public detected moose in suitable habitats but not necessarily in movement corridors. Also, moose detections were often recorded near roads, suggestive of spatial bias in sampling effort. Our results suggest that citizen science-based data collection can be facilitated by brief, intuitive digital reporting systems. However, inference from the resulting data can be limited due to unquantified and possibly biased sampling effort. To overcome these challenges, we offer specific recommendations such as engaging outdoor enthusiasts in suitable moose habitats, for improving quantity, quality and analysis of citizen science-based data for making robust inferences about wildlife populations.

1. Grassy ecosystems cover ~40% of the global land surface and are an integral component of the global carbon cycle. Grass litter decomposes via a combination of ultraviolet radiation degradation (which returns carbon to the atmosphere rapidly) and biological decomposition (a slower carbon pathway). As such, decomposition and carbon storage in grasslands may vary with climate and exposure to solar radiation. We investigated rates of grass litter decomposition in Australian temperate grasslands along a climate gradient to uncouple the relative importance of UV radiation and climate on decomposition. 2. Litterbags containing two common native grass species were deployed at six grassland sites across a precipitation gradient (380-890 mm) in south-eastern Australia. Bags were retrieved over 39 weeks to measure mass loss from decomposition. We used shade treatments to partition UV degradation from biological decomposition. 3. The shade treatment consistently reduced the rate of decomposition relative to full-sun treatments at all sites; there was no significant difference in the effect size of the shade treatment among sites. The rate of decomposition was positively correlated with rainfall midway through the experiment, but there were no significant differences in total decomposition among sites after 39 weeks. In general, the shape of decomposition curves was more linear than has typically been observed in global decomposition studies. 4. Synthesis: We found that UV exposure was a strong contributor to litter decomposition in temperate Australian grasslands. This effect was not influenced by climatic variables and may be related to a period of photopriming prior to further biotic decomposition. This study highlights the importance of litter composition and UV exposure in our understanding of how decomposition patterns contribute to global carbon cycling.

A common 400V dc bus for industrial motor drives advantageously allows the use of high-performance 600V power semiconductor technology in the inverter drive converter stages and to lower the rated power of the supplying rectifier system. Ideally, this supplying rectifier system features unity power factor operation, bidirectional power flow and nominal power operation in the three-phase and the single-phase grid. This paper introduces a novel bidirectional universal single-/three-phase-input unity power factor differential ac-dc converter suitable for the above mentioned requirements: The basic operating principle and conduction states of the proposed topology are derived and discussed in detail. Then, the main power component voltage and current stresses are determined and simulation results in PLECS are provided. The concept is verified by means of experimental measurements conducted in both three-phase and single-phase operation with a 6kW prototype system employing a switching frequency of 100 kHz and 1200V SiC power semiconductors.

In this paper, a conceptual overview of the Integrated version of Fault-Tolerant Control is presented. When dealing with uncertainty, the interconnected design needs an integrated approach to make a balance between performance and robustness. Indeed the integrated approach is very significant for the design and development of fault-tolerant control schemes. In this paper, the Integrated Fault-Tolerant Control (IFTC) approaches are investigated in two FDI-based IFTC and FE-based IFTC classes depending on the applications of either Fault Estimation (FE) or Fault Detection and Isolation (FDI) techniques. These two classes are delicately distinguished and reviewed from the integration strategy’s perspective and according to the design methodology criteria. A comparison of these categories is concisely conducted. The integration is manifested in the coupling of FE and FTC, and the synthesis of the FDI unit. Moreover, the history of “integration” theory including its development process according to today’s industry requirements, and its successful consequences that have been noticed in recent years are presented to make an overall vision in this area.

Effective treatment, but also proper diagnosis of cardiovascular diseases, remains a major challenge in everyday practice. A quick, safe, and economically acceptable non-invasive procedure should play a leading role in cardiovascular risk assessment before invasive diagnostics is performed. The staging of subclinical atherosclerosis may help in further clinical decisions. Safe, widely available, and relatively inexpensive, ultrasonography is a promising examination that should find wider application in clinical practice. The latest ESC guidelines emphasize the usefulness of carotid ultrasound in the diagnosis of coronary artery disease (CAD) and subclinical assessment of atherosclerosis, which help to determine the level of cardiovascular risk. Ultrasound examination of peripheral arteries, especially superficial vessels such as the femoral arteries, is quite easy, quick, and accurate. Other vascular beds, such as iliac and renal, are more demanding to examine, but can also provide valuable information. This review summarizes important studies comparing the severity of atherosclerosis in ultrasound-visible vascular beds in patients with established CAD. We especially emphasize the benefits of the combined assessment of atherosclerosis features, which were characterized by high sensitivity and specificity in the diagnosis of CAD and other serious cardiovascular diseases.

Background: The occurrence of prodromes has been associated with swelling in hereditary angioedema (HAE). The aim of the study was to analyse the frequency of prodromal signs, the level of awareness among HAE patients and to understand the actions taken by patients when they experienced them. Methods: An online survey to assess patient experiences of prodromal symptoms was conducted among 208 HAE patients from the UK and Spain. Results: 60% of HAE patients who experience prodromes can always or usually predict an impending swelling. Almost 40% of participants noticed prodromes within the 2 hours preceding an HAE attack. Tiredness/fatigue (64%), pressure or tightness in the skin (53%) and abdominal pressure (52%) were the most reported early symptoms. C1-esterase inhibitor (C1-INH) and icatibant were prescribed to 75% and 65% of participants, respectively. 56% of participants in the UK reported self-medicating at the time of prodrome, whereas 65% of patients in Spain preferred to wait or relax when early symptoms began. 30% of patients said they usually took their medication within 1 hour of experiencing the prodrome. The percentage of patients who needed only one injection to treat the attack increased when patients took their medication early in the prodrome (from 55 to 66%). Conclusions: The majority of patients who have early symptoms were usually or always able to predict that a swelling would occur. Early treatment of HAE attacks is associated with less medication usage, but there is still no common understanding of what ‘early treatment’ means.

The increasing demand for energy, coupled with concerns about the environment and finite resources, has made the use of renewable energy sources (RESs) crucial. Although wind and solar energy are one of the most promising sources of renewable energy, their random and uncertain nature poses a challenge for energy management systems. The integration of RESs into distribution networks (DNs) is a challenging task that requires optimizing DN planning. This involves incorporating distributed generation (DG) systems such as wind turbines (WTs) and photovoltaics (PVs) into the distribution networks, which can be optimized to reduce costs, additionally, the resulting configuration can noticeably improve stability by enhancing the voltage stability index and reducing voltage deviation. In this paper, a novel Modified Reptile Search Algorithm (MRSA) is proposed for the optimal planning problem (OPP) of the DN under uncertainties such as solar irradiance, wind speed, load, temperature, and energy prices. The proposed MRSA is based on two strategies, including the fitness-distance balance method and the Levy flight motion, to boost the searching ability of the standard RSA and avoid local optima. The suggested MRSA algorithm has been evaluated on typical benchmark functions and a real 112-bus Algerian distribution network.

The present study expands on previous research regarding the correlation between parental overprotection (POP) and non-suicidal self-injury (NSSI) in Chinese adolescents. Drawing from self-determination theory, the study aims to investigate the mediating effect of psychological need satisfaction on the relationship between POP and adolescent NSSI, as well as the potential moderating effect of anger expression. A sample of 1248 adolescents (Mage = 13.34 years; SD = 0.96 years) completed anonymous questionnaires to measure the study variables. The results of the regression analysis indicate that: (1) the positive link between POP and adolescent NSSI is mediated by low psychological need satisfaction; (2) this indirect relationship is particularly pronounced in adolescents who report high levels of anger expression. These findings suggest that psychological need frustration may serve as a mechanism linking POP to adolescent NSSI, and that adolescents who tend to express more anger may be at an increased risk for engaging in NSSI. Systemic family therapy is recommended for clinicians and consultant to help them better understand the adolescents with NSSI in overprotective family system and adopt targeted intervention programs.

The composite indices have been widely used in different fields and different settings to measure and quantify a variety of multidimensional and complex concepts into a single construct. While many composite health indices are produced and applied in developed countries, there are relatively few studies for developing countries, and even considerably less in Asia. However, the indicators of health relevant in high-income countries will not be suitable for use in developing countries such as India due to differences in health system characteristics, differences in disease patterns, and data availability and quality. Therefore, it is important to consider the specific context and characteristics of a country when developing a composite health index to ensure its relevance and usefulness for policy and decision-making. In this paper, we review published studies on the multidimensional composite health indices in India, specifically focussing on the purpose of the index, the indicators chosen to represent population health, methods used in the calculation of the indices, geographical level of aggregation, sources of data, the application and validation of index. While doing so, we also assessed the policy or practical relevance of such indices.

Background Sinonasal anatomical variations are common and its knowledge plays an integral part in the management of sinonasal disease. Although sinonasal anatomic variations have been postulated as a risk factor for sinus disease, its role in the pathogenesis of nasal polyp is still unclear. This study was done to determine the prevalence of sinonasal anatomical variations by CT imaging and examine its association with sinonasal polyposis. Methodology A descriptive cross sectional study was conducted from January, 2019 to January, 2020 at a tertiary care center in Nepal after receiving ethical approval from the Institutional Review Committee of the hospital. Patients above 17 years of age having sinonasal polyp and not responding to 3-4 weeks of medical treatment were included in the study. Convenience sampling was done. Data were collected and entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 24.0. Results Among 72 patients, the prevalence of anatomical variations of nose and paranasal sinuses was found to be in 62 patients (86.11%). Agger nasi (79.09%) and deviated nasal septum (72.5%) were the common variations noted. Single variation was found in 29% and multiple variations in 70.9% Conclusion Our study showed that the prevalence of sinonasal anatomical variations was higher in patients with sinonasal polyp and the severity of polyp increases with the presence of more than one variation in a patient. Key words Computed tomography scan, sinonasal anatomical variations, sinonasal polyp

Fear can cause people to panic, make wrong decisions, and behave inappropriately. This study aims to investigate the effects of fear of COVID-19 on the perception of the reliability and the use of health information sources. The participants in this study were 323 students attending a state university in Turkey. The Fear of COVID-19 Scale (FCV-19S) and the Health Information Sources Survey were used as data collection tools. The Pearson correlation coefficient was used to determine the relationships between the perception of the reliability of health information sources and their use. Simple linear regression analyses were used to determine the effect of fear on the perception of the reliability of health information sources and their use. The participants’ mean FCV-19S score was 2.30±0.93 on a five-point Likert scale. As a result of the evaluations made, in the range of 0–10, the information source with the highest reliability perception mean score was the doctor (7.10±2.74), whereas that with the highest usage was the Internet (7.98±2.77). Although the fear of COVID-19 had a negative effect on Internet use ( b =-0.38; p<0.05), the effects on the use of other health information sources was positive ( b=0.37-0.83; p<0.05). Trust in radio ( b=0.60; p<0.05) and newspapers/magazines ( b=0.49; p<0.05) also increased with fear. These results showed that as university students’ fear of COVID-19 increased, the use of the Internet for health information decreased; however, use of doctors, nurses, pharmacists, other health workers, scientific articles, television, radio, and newspapers/journals increased. The findings can guide health policies to be followed. Talks of health professionals and their videos with both educational and scientific content should be given more space on the Internet, social media, traditional media, and other mass media.

In this study, an extended version of the Technology Acceptance Model (TAM) was used to understand the factors that might influence patient behaviour. In addition to the “typical” TAM variables (positive attitude or technological readiness), this study examines the role of social and individual benefits and COVID-19 anxiety on willingness to try, intention to use, actual use and satisfaction in a country in the Central and Eastern European region. This extension and the chosen region add novelty to the research. The results of linear and logit regression analysis based on an online questionnaire show that individual benefits and positive attitudes have a strong effect on willingness to try and use, but perceived social benefits do not have a significant effect. These results highlight the importance of awareness campaigns that highlight the personal benefits of e-health and address the general mistrust of the technology.

This paper fuses ideas from Reinforcement Learning (RL), Learning from Demonstration (LfD), and Ensemble Learning into a single paradigm. Knowledge from a mixture of control algorithms (experts) are used to constrain the action space of the agent, enabling faster RL refining of a control policy, by avoiding unnecessary explorative actions. Domain-specific knowledge of each expert is exploited. However, the resulting policy is robust against errors of individual experts, since it is refined by a RL reward function without copying any particular demonstration. Our method has the potential to supplement existing RLfD methods when multiple algorithmic approaches are available to function as experts. We illustrate our method in the context of a Visual Servoing (VS) task, in which a 7-dof robot arm is controlled to maintain a desired pose relative to a target object. We explore four methods for bounding the actions of the RL agent during training. These methods include using a hypercube and convex hull with modified loss functions, ignoring actions outside the convex hull, and projecting actions onto the convex hull. We compare the training progress of each method with and without using the expert demonstrators. Our experiments show that using the convex hull with a modified loss function significantly improves training progress. Furthermore, we demonstrate faster VS error convergence while maintaining higher manipulability of the arm, compared to classical image-based VS, position-based VS, and hybrid-decoupled VS.

A color fusion image color harmony assessment framework based on joint features is proposed. In this framework, the fused images are firstly segmented into image patches for evaluation separately. Secondly, the memory color theory is proposed to calculate the color harmony score of image patches. Meanwhile, the topic model is improved to extract global natural statistical features. Finally, a quality assessment module is designed to fuse global natural statistical features and local spatial features to evaluate color fusion images. We compare the results of the proposed method CHA with six existing traditional image quality assessment methods and six deep learning-based methods. Experimental results demonstrate the promising performance of the proposed method.