Opportunistic observation of Erabu sea snakes (Laticauda semifaciata) provide evidence that these species undertake a novel foraging tactic; coordinated communal hunting. Erabu sea snakes prey on cryptic fish species in highly complex reef habitats. Intra- and interspecific cooperative hunting strategies may increase chances for all members of the hunting party to encounter and capture prey in these complex habitats. Here we recorded 52 instances of communal hunting by Erabu sea snakes with conspecifics and other predatory fishes at recreational dive sites in Southern Lombok, Indonesia. These observations highlight the potential higher cognitive capacity of sea snakes to coordinate activities around communal hunting events.

Aim Prevalence of potentially suboptimal prescribing and associated risk factors were investigated among older patients attending primary care via Aboriginal Community Controlled Health Services (ACCHSs). Methods Prescription medications were audited for 420 systematically selected patients aged ≥50 years at three ACCHSs in urban, rural, and remote settings. Polypharmacy, potentially inappropriate medications (PIMs), and anticholinergic burden (ACB) were estimated and associated risk factors explored with logistic regression. Results The prevalence of polypharmacy, use of PIMs, and ACB score ≥3, was 43%, 18%, and 12%, respectively. In multivariable logistic regression analyses, polypharmacy was less likely in rural (OR=0.43, 95% CI=0.24-0.77) compared to urban health service patients, and more likely in those with heart disease (OR=2.62, 95% CI=1.62-4.25), atrial fibrillation (OR=4.25, 95% CI=1.08-16.81), hypertension (OR=2.14, 95% CI=1.34-3.44), diabetes (OR=2.72, 95% CI=1.69-4.39), or depression (OR=1.91, 95% CI=1.19-3.06). PIMs were more frequent in females (OR=1.88, 95% CI=1.03-3.42), and less frequent in rural (OR=0.41, 95% CI=0.19-0.85) and remote (OR=0.58, 95% CI=0.29-1.18) patients. Factors associated with PIMs were kidney disease (OR=2.60, 95% CI=1.37-4.92), urinary incontinence (OR=3.00, 95% CI=1.02-8.83), depression (OR=2.67, 95% CI=1.50-4.77), heavy alcohol use (OR=2.83, 95% CI 1.39-5.75) and subjective cognitive concerns (OR=2.69, 95% CI=1.31-5.52). High anticholinergic burden was less common in rural (OR=0.10, 95% CI 0.03-0.34) and remote (OR=0.51, 95% CI 0.25-1.04) patients, and more common in those with kidney disease (OR=3.07, 95% CI 1.50-6.30), or depression (OR=3.32, 95% CI 1.70-6.47). Conclusion Associations between potentially suboptimal prescribing and depression or cognitive concerns highlights the importance of considered medication review and deprescribing for these patients.

One of the most common warnings in dietary guidelines worldwide is to avoid saturated fat. However, there is no clear definition of what a saturated fat is. There are four definitions that have been used to describe saturated fat: amount of saturated fatty acids in grams per 100 grams, % fatty acid profile, iodine value, and solid fat. The current description of “saturated fat” does not distinguish between fats and oils, which are mainly triglycerides of fatty acids, and whole food items, which contain proteins and minerals and much lower amounts of triglycerides. Secondly, the current classification of saturated fat ignores the difference in the cholesterol content of vegetable oils and animal fats. The first definition of saturated fat was based on iodine values which does not give fatty acid composition. This classification is still used today by various dietary guidelines. The use of solid fat as a defining property of saturated fat is based on the melting of a fat at room temperature. This is not scientifically precise. This paper discusses the confusion due to the multiple definitions of saturated fat. The following are proposed to overcome this situation: first, fats and oils and animal-derived whole food items should be considered in separate categories based on their lipid content; second, the saturated fatty acid composition measured in grams per 100 grams (g/100 g) should be used as the basis for classifying fats and oils as saturated fat; and third, a new category of meso-fat is proposed.

Staphylococcus aureus (S. aureus) is an important pathogen that is involved in causing various infections. In recent years, attempts to treat infections caused by these strains have led to resistance to most antibiotics, especially methicillin and vancomycin. In this study, we evaluated genes capsule in MRSA isolated from clinical samples of hospitals affiliated with the Tehran University of Medical Sciences. 73 clinical samples suspected of MRSA were collected and confirmed phenotypically and biochemically. PCR was done by studying the presence of cap8, cap5, vanA, and mecA genes. All 73 samples were confirmed as MRSA both by biochemical tests and by examining the presence of the mecA gene. Wound with 21 (28.77%) was the most, and synovial fluid with 1 (1.36%) was the least analyzed sample. The ICU department had the highest amount of MRSA samples, with 25 (34.24%), and the ENT, with 1 (1.36%), had the lowest amount. 32 isolates (43.84%) contained the cap5 gene, 27 (36.99%) cap8 gene, and 5 (6.84%) had the vanA gene. Among the isolated VRSAs, 2 (40%) isolates contained both cap5&8 genes simultaneously. The results of antimicrobial tests showed multi drugs resistance in these isolates.

Life history variation in trees is a ubiquitous feature of tropical forests that may facilitate the niche partitioning of light. However, many tests have failed to detect light partitioning by saplings in gaps, which may reflect the stochastic nature of understory light penetration and recruitment. We argue that tree size is a critical component of niche partitioning that is more tightly linked to light availability. To account for size, we use a scaling framework to assess patterns of growth, abundance, mortality, and richness across life histories from >114,000 trees in a primary, neotropical forest. Relative abundance, productivity, and richness shift ~1−2 orders of magnitude with tree size: from shade tolerant, slow trees dominating the understory to parity with rapidly growing fast and long-lived pioneer species in the canopy. Life history tradeoffs promote vertical niche partitioning in tropical forests.

Background: Left ventricular ejection fraction (LVEF) has prognostic value and is used to guide medical treatment and device implantation. The preferred technique is two-dimensional echo (2DE), although three-dimensional echo (3DE) is more accurate when compared to cardiac magnetic resonance imaging. Our study evaluates the agreement between 2D and 3D LVEF and the potential clinical impact of disagreements. Methods: Participants ≥50 years were included from the Copenhagen City Heart Study. Means of difference (MD) between 2D and 3D volumes and LVEF were assessed, Cox regression models were used to estimate the association between 2D and 3D LVEF <40% and outcome. 3DE were used as reference. Results: In all 1606 participants were included. Median age was 65.4 (IQR: 57.89‒73.6) and 702 (43.7%) were males. Median follow-up was 5.5 (IQR: 4.72‒6.3) in which 102 (6.4%) died and 142 (8.8%) experienced a major adverse cardiovascular event (MACE) and 194 (12.1%) any cardiovascular event. The MD between 2D and 3D LVEF as the LV deteriorated the LV got (LVEF <40%, MD: -14.4 (-15.9 ‒ -13.0) vs. LVEF 40-49% -9.2 (-9.8 ‒ -8.7) vs. LVEF >50%, MD: -0.96 (-1.4 ‒ -0.51)). 3D LVEF <40% was significantly associated with all outcomes (2.85 (95% CI: 1.64‒4.95), (all-cause mortality), 2.71 (95% CI: 1.68‒4.36), (MACE) and 2.41 (95% CI: 1.68‒4.36) (any cardiovascular event). 2D LVEF <40% was only associated to MACE 2.69 (95% CI: 1.25‒5.77). 2DE misclassified (defined as ≥10 percentage units of difference between 2D and 3d LVEF) LVEFs in 508 (31.6%) of all exams. Conclusion: In this population study in low-risk subjects, only 3D LVEF was associated with excess mortality, whereas 2D LVEF was not.

Multilevel inverters (MLIs) have attracted the attention of researchers for their needs in industrial applications, renewable energy systems, and electric vehicles. MLIs require a large number of power electronic components to synthesize higher levels at the output voltage. However, overuse of power electronic devices increases the complexity, losses, and cost of MLIs. In this study, a new MLI has been proposed with a reduced number of power switches. The basic unit of the proposed MLI comprises only three independent DC sources and ten switches (eight unidirectional, and two bidirectional) to produce 21 levels at the output voltage waveform. The nearest level control (NLC) modulation method has been used to produce gate pulses. Furthermore, three extension topologies have been proposed to generate a higher number of levels and the extension parameters have been compared with recently introduced and conventional topologies. The comparative study shows that the proposed MLI topology requires fewer components in terms of power electronics parameters than the others. On the other hand, the presented first extension study can be used for all non-extendable basic units is one of the prominent values of the study. Simulation studies showing modulation methods, switching patterns, and signal outputs were performed with Matlab/Simulink. A prototype of the proposed main module has been realized and tested in the laboratory with an FPGA processing board. Experimental results have been verified with simulation results, and the performance of the proposed topology has been proven.

Background: Hepatitis B virus (HBV) infection is one of the major causes of chronic liver disease which progresses from hepatitis to liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Early detection and laboratory based screening test of HCC is still a major challenge. HBV induces hepatocarcinogenesis through viral genome integration, chromosomal aberrations and modulation of host signaling pathways. Molecular alterations of cancer hallmark genes occur during the process of hepatocarcinogenesis. These signatures may release into the circulation through . circulating tumor DNA (ctDNA). Detection of these mutations in ctDNA may serve as liquid biopsy marker for screening, early detection and prognosis of HCC for which this study was undertaken. Methods: Consecutive patients of CHB-HCC (n=80), chronic hepatitis B (n=35) and healthy (n=15) controls were included for blood sample collection. The ctDNA was isolated from serum. Amplification and sequencing TP53 exon 7 and β-catenin exon 3 was carried out for predominant mutations in the ctDNA of HCC patients. Highly sensitive dual-probe based droplet digital PCR (ddPCR) assays were performed for TP53 (p.R249M & p.R249S) and β-catenin (p.S45P) driver mutations in healthy, CHB-noncirrhotic, cirrhotic and HCC patients. Results: Both TP53 gene exon 7 and CTNNB1 gene exon 3 region was amplified and sequenced in 32 HCC patient whereas sensitive ddPCR assay TP53 (p.R249M & p.R249S) and β-catenin (p.S45P) mutation for all 130 subjects. In sanger sequencing TP53 c.746 G˃T, p.R249M mutation was predominant. In ddPCR assay, 58.75% of HCC patients (n=47) ctDNA had at least one driver mutation in the ctDNA. Combined TP53 and CTNNB1 mutation was observed in 12.5% of HCC patients. Increased mutation frequency was observed in CHB-cirrhotic. CHB-HCC than CHB-noncirrhotic and healthy subjects. Percentage mutant fraction was highest in CHB-HCC than only CHB patients. Significant association TP53. R249M with smoking was observed in CHB-HCC patients. Poor survival was observed in HCC patients with combined TP53 and CTNNB1 gene mutation. Conclusion: Driver mutation screening for TP53 and CTNNB1 gene can be done in ctDNA for early diagnosis and prognosis.

Functional microbes have important application potential in the remediation of contaminated sites. The research on the application of chlorobenzenes (CBs) degrader in situ remediation is still limited. This study focused on the degradation performance of CBs degrader Serratia marcescens strain TF-1 in laboratory culture and contaminated soil. TF-1 assimilated chlorobenzene (CB) with degradation rate of 0.22-0.66 mg·g cell -1·h -1 in concentration of 20-200 mg·L -1. In addition, TF-1 also used sodium succinate and sodium citrate as substrates to co-metabolize CB, with degradation rates of 0.26-2.00 and 0.31-1.72 mol·g cell -1·h -1, respectively. The addition of TF-1 and sodium succinate in contaminated soil can remarkably promote the removal of CBs. Finally, combination of biostimulation and bioaugmentation using sodium succinate and TF-1 were carried out in a test field and CBs were almost completely removed by TF-1 within 10 d. Sequence analysis suggested that TF-1 colonized successfully in field soil, and the indigenous microorganism Azoarcus could be enriched. The novel strain was used for in-situ CBs biodegradation for the first time, and the results provide guidance for remediation of organic contaminated soil.

HIV-related neuropathic pain (HRNP) is a neurodegeneration that gradually develops during the long-term course of acquired immune deficiency syndrome (AIDS) and manifests as abnormal sock/sleeve-like symmetrical pain and nociceptive hyperalgesia in the extremities, which seriously reduces patient quality of life. To date, the pathogenesis of HRNP is not completely clear, and there is a lack of effective clinical treatment for HRNP. HRNP is becoming a challenge and hot spot for medical research. Herein, we conducted a systematic review of the progress of HRNP research in recent years including (1) the etiology, classification and clinical symptoms of HRNP, (2) the establishment of HRNP pathological models, (3) the pathological mechanisms underlying HRNP from three aspects: molecules, signaling pathways and cells, (4) the therapeutic strategies for HRNP, and (5) the limitations of recent HRNP research and the future research directions and prospects of HRNP. This detailed review provides new and systematic insight into the pathological mechanism of HRNP, which establishes a theoretical basis for the future exploitation of novel target drugs.

During biological motion perception, individuals with perceptual experience learn to use more global processing, simultaneously extracting information from multiple body segments. Less-experienced observers may use more local processing of individual body segments. In this study, we examined how skill impacts the neural processing of motion information. Skilled (N = 21) and less-skilled (N = 19) soccer players anticipated temporally occluded videos of penalty kicks under normal, blurred, or spatially occluded (hips-only) viewing conditions, with the latter two conditions emphasizing global and local information respectively. EEG was used to measure parietal alpha and beta oscillations. Skilled players outperformed less-skilled players, albeit both skill groups were less accurate under blurred and hips-only conditions. Skilled performers showed significant decreases in bilateral parietal beta power in the hips-only condition, suggesting a greater reliance on global information. Additionally, the hips-only condition evoked significantly greater beta relative to alpha power (beta – alpha) and lower overall alpha power than the control condition for both skill groups, suggesting this condition elicited a shift towards more local processing. Our novel findings demonstrate that skill and experience impact how motion is processed.

Schizophrenia and Autism Spectrum Disorder (ASD) can disrupt cognition and consequently behaviour. Traits of ASD and the subclinical manifestation of schizophrenia, schizotypy, have been studied in healthy populations with overlap found in trait profiles linking ASD social deficits to negative schizotypy, and ASD attention to detail to positive schizotypy. Here, we probed the relationship between sub-trait profiles, cognition and behaviour, using a predictive tracking task to measure individual eye movements under three gravity conditions. 48 healthy participants tracked an on-screen bouncing ball under familiar gravity, inverted antigravity and horizontal gravity control conditions while eye movements were recorded and dynamic performance quantified. Participants completed ASD and Schizotypy inventories generating highly correlated scores, r = 0.73. All tracked best under the gravity condition, producing anticipatory downward responses from stimulus onset under gravity which were delayed upwards under antigravity. Tracking performance was not associated with overall ASD or schizotypy trait levels. Combining measures using Principal Components Analysis (PCA), we decomposed the inventories into sub-traits unveiling interesting patterns. Positive Schizotypy was associated with ASD dimensions of rigidity, odd behaviour and face processing, and which all linked to anticipatory tracking responses under atypical antigravity. In contrast, negative schizotypy was associated with ASD dimensions of social interactions and rigidity, and to early stimulus-driven tracking under gravity. There was also substantial nonspecific overlap between ASD and Schizotypy dissociated from tracking. Our work links positive-odd traits with anticipatory tracking when physics rules are violated, and negative-social traits with the application of expected physics.

This paper outlines an experimental investigation into the durability of large-scale adhesively bonded joints immersed in a 3.5 wt% NaCl solution for 10 weeks at 50°C. Two aged and one unaged specimen were subjected to tensile testing up to failure, and three aged and one unaged specimen were loaded up to ~3.5 million fatigue cycles followed by a residual tensile test. The shear, longitudinal, and peel strain values in adhesive bulk (evaluated by the digital image correlation (DIC) technique) are significantly higher at the gripped sides due to the asymmetrical design of the steel brackets. The shear strength and stiffness of statically and fatigue tested specimens are found to be identical. The shear strength values are significantly higher than the requirements following from the design. All specimens failed by sudden delamination of the composite plate. Post-mortem analysis showed no corrosion travel at the interface of steel and adhesive.

LSA and morphea are chronic diseases, characterized by the sclerosis of the connective tissues. Bullous type of both diseases and coexistence of LSA and morphea are very rare manifestations. Herein. we report a case consistent with bullous combined LSA and morphea that was treated with methotrexate and pulse of methylprednisolon

Inertial Measurement Units (IMU) are commonly used in inertial attitude estimation from engineering to medical sciences. There may be disturbances and high dynamics in the environment of these applications. Also, their motion characteristics and patterns also may differ. Many conventional filters have been proposed to tackle the inertial attitude estimation problem based on IMU measurements. There is no generalization over motion and environmental characteristics in these filters. As a result, the presented conventional filters will face various motion characteristics and patterns, which will limit filter performance and need to optimize the filter parameters for each situation. In this paper, two end-to-end deep-learning models are proposed to solve the problem of real-time attitude estimation by using inertial sensor measurements, which are generalized to motion patterns, sampling rates, and environmental disturbances. The proposed models incorporate accelerometer and gyroscope readings as inputs, which are collected from a combination of five public datasets. The models consist of convolutional neural network (CNN) layers combined with Bi-Directional Long-Short Term Memory (LSTM) followed by a Fully Forward Neural Network (FFNN) to estimate the quaternion. To evaluate the validity and reliability, we have performed an extensive and comprehensive evaluation over five publicly available datasets, which consist of more than 120 hours and 200 kilometers of IMU measurements. The results show that the proposed method outperforms the state-of-the-art methods in terms of accuracy and robustness. Furthermore, it demonstrates that this model generalizes better than other methods over various motion characteristics and sensor sampling rates.

A 49-year-old male presented with a gradually progressive loss of vision in both eyes. Funduscopic examination revealed bilateral optic disc swelling and two yellowish elevated choroidal lesions in the LE. Ophthalmic imaging raised suspicion of choroidal metastasis. Adenocarcinoma of the lung was detected in further systemic evaluation.

We consider the cauchy problem for the modified Kawahara equation with cubic nonlinear term in analytic Gevrey space. Utilizing linear and trilinear estimates in analytic Bourgain-Gevrey space, we establish the local well-posedness in Gevrey space G δ , s and show the radius of spatial analyticity persists during the lifespan. Finally, using an approximate conservation law, we extend this to a global result in such a way that the radius of analyticity of solutions is uniformly bounded, that the uniform radius of spatial analyticity of solutions at later time t can decay no faster than 1 /| t| as | t|→∞.

Objectives This study aims to investigate the readiness and resilience of health system against COVID-19 and the impact of the pandemic on economy and foreign trade in the Middle East and North Africa (MENA) region with Turkey. Methods By descriptive analysis, we evaluated the readiness and resilience of the health system and the impact of the pandemic on economy and foreign trade in the MENA region with Turkey. We tested the normality of the indicators by Jarque-Bera (JB), Shapiro-Wilk (SW) and Kolmogorov-Smirnov (KS) tests. We ranked the countries by min-max standardization method. Results As of the end of July 2021, the number of COVID-19 related cases was more than 12.4 million in MENA and 5.7 million in Turkey and deaths were more than 212 thousand in MENA and 51 thousand in Turkey. After the analysis in order, we have found Israel, Saudi Arabia, United Arab Emirates, Turkey and Qatar as the most resilient countries and Yemen, Syria, Palestine, Iraq and Libya as the most vulnerable countries against pandemic. Conclusion The pandemic has affected the life and the economies in the region negatively and the health system for some of them was not sufficient to fight with it.

Background: Pregnancy complications and adverse birth outcomes are among the major contributors to poor maternal and child health. Mothers in remote communities are at higher risk of adverse birth outcomes due to constraints in access to maternal healthcare services. In Ghana, a community-based primary healthcare program called the Ghana Essential Health Interventions Program (GEHIP) was implemented in a rural region to help strengthen primary healthcare delivery and improve maternal and child healthcare services delivery. This study assessed the effect of this program on adverse birth outcomes. Methods: Secondary household survey data from reproductive-aged women from the GEHIP project were used in this analysis. Difference-in-differences regression and logistic regression were used to examine the effect of GEHIP on adverse birth outcomes and equity in the distribution of adverse birth outcomes using household wealth index and maternal educational attainment as equity measures. The analysis involves the comparison of project baseline and end-line outcomes in intervention and non-intervention districts. Results: The intervention had a significant effect in the reduction of adverse pregnancy outcomes (DiD=-0.043; p-value=0.010). Although disadvantaged groups experience larger reductions in adverse pregnancy outcomes, controlling for covariates, there was no statistically significant equity effect of GEHIP on adverse pregnancy outcomes using either the household wealth index or maternal educational attainment as equity measures. Conclusion: GEHIP’s community-based healthcare program reduced adverse birth outcomes but no effect on relative equity was established. Factoring in approaches for targeting disadvantaged populations in the implementation of community-based health programs is crucial to ensuring equity in health outcomes.

In pre-pandemic period (1999‒2019), we analyzed mortality data for the Krasnoyarsk Territory (Central Siberia, Russia) with population about 2.9 million people. Causes of death affecting life expectancy at birth (LE) were analyzed based on cause-specific and age-specific indicators. Based on the cause-elimination life-table analysis, we estimated the mortality rate and the contribution of a specific cause of death to LE using an alternative approach (altPGLE) and included the contribution of a single case of death. In 2019, ischemic heart disease, cerebrovascular disease, and malignant neoplasms of digestive organs provided the most significant contribution to LE primarily due to its high mortality rate. Intentional self-harm, HIV, and tuberculosis provide the most outstanding contribution of a single case of death to LE since they affect younger people. Over the period, deaths from cardiovascular diseases shifted to the elderly groups, but from liver diseases became ten years ‘younger’. However, circulatory diseases still provide the most significant impact on LE. Health policymakers should take into account and improve three leading indicators: mortality rate, the contribution of all death cases to LE (altPGLE), and the contribution of a single case of death to LE. The improvement can be achieved by preventing diseases that affect the younger population (in our case, intentional self-harm, HIV, tuberculosis, and liver diseases) and delaying death from diseases that are common in older people (circulatory system diseases and cancer). It is also important to identify and govern diseases that get ‘younger’ over time.

Introduction: Non-communicable diseases have been currently leading as the major cause of death all over the world for the past few decades, NCDs kill about 41 million people each year this equates to 71% of all deaths across the globe [1](#ref-0001). Primary health care (PHC) facilities are a very important factor in preventing and controlling chronic NCDs. PHC are vital and can be used if strengthened by health policies to help manage these chronic NCDs in LMICs. This paper will give a review and a summary on readily available data on the readiness of health facilities that are in African LMICs to incorporate WHO PEN guidelines (which are designed for PHCs). Methods: A search appraisal following PRISMA guidelines was conducted. A literature search of databases on records of WHO-PEN implementation in LMICs was conducted in March 2022. All publications done with no specific study design that recorded data regarding a country’s health system and its ability offer services in the prevention and control NCDs, according to WHO-PEN guidelines in regards to medicines essential for NCD management, basic equipment, availability of staff and treatment guidelines, and diagnostic investigations were considered. Results: A total of four articles were included in the review, no primary healthcare facility was recorded to have the required readiness score to provide required services as per WHO PEN guidelines. Conclusion: The Readiness of the health facilities in African LMICs for the implementation of WHO-PEN intervention was found to be unsatisfactory in all the studies included in this Review.

Brucellosis is a thousand-face disease and a common zoonotic infection in the endemic region. A 42-year-old female was admitted with sternoclavicular arthritis and breast abscess. After laboratory investigation and imaging, positive serological test results and positive blood culture for brucella revealed acute sternoclavicular arthritis and breast abscess due to brucellosis.

Short running title: Relevance and roadmap for sustainable prognosis model

Plants, as immobile organisms, depend on their roots to access soil resources efficiently and cost-effectively. To achieve this goal as well as develop more productive crops and adapt to variable challenging conditions plants rely on root phenotypic plasticity. This includes changes in root morphology, growth angles, diameter, elongation, branching density, and rotation rate. In simpler terms, a plant root system is a dynamic structure that can change its branching structure in response to changes in biotic and abiotic conditions such as water availability, soil mineral nutrient content, soil compaction, salinity, and the formation of symbiotic relationships with other organisms or anchored in the substrate. However, the complexity of these responses and their impact on plant fitness are not well understood. In this study, we have reviewed different aspects of the morphological plasticity of the root system. The results show that root flexibility can greatly help plant adaptation. Thus, gaining a comprehensive understanding of root plasticity can lead to improved and sustainable plant production.