Introduction Lung biopsy is infrequently utilized in the population of infants with severe bronchopulmonary dysplasia (BPD). Yet, its presentation may overlap with other infant diffuse lung diseases, including those within the spectrum of childhood interstitial lung diseases (chILD). Lung biopsy might differentiate between these entities, or discern those with an extremely poor prognosis. Both might alter the clinical management of a subset of infants diagnosed with BPD. Methods In this tertiary referral center, we drew on a retrospective cohort of 306 preterm infants with severe BPD. Of these, nine underwent lung biopsy between 2012 and 2017. Our aim was to assess the indication of lung biopsy, the prior clinical history, safety of the procedure, and describe the biopsy findings. Finally, we considered management decisions in relation to the biopsy results in these patients. Results The average gestational age and birth weight of the 9 patients were 30±3 (range 27-34) weeks and 1421±571 (range 611-2140) grams. All infants had serial echocardiograms to assess for pulmonary hypertension, genetic testing, and computed tomography angiography (CTA) prior to biopsy. All patients showed moderate to severe alveolar simplification and 8 had some degree of pulmonary interstitial glycogenosis (PIG) ranging from focal to diffuse. Following biopsy, 2 infants with findings of PIG received high dose systemic steroids and 2 separate infants had care redirected. Conclusion In our cohort, lung biopsy was safe and well tolerated. Findings from lung biopsy may aid decision making in selected patients when used as a part of a step-wise diagnostic algorithm.

Introduction: Preterm children with bronchopulmonary dysplasia (BPD) frequently require supplemental oxygen in the outpatient setting. In this study, we sought to determine patient characteristics and demographics associated with need for supplemental oxygen at initial hospital discharge, timing to supplemental oxygen liberation, and associations between level of supplemental oxygen and likelihood of respiratory symptoms and acute care usage in the outpatient setting. Methods: A retrospective analysis of subjects with BPD on supplemental oxygen (O 2) was performed. Subjects were recruited from outpatient clinics at Johns Hopkins University and the Children’s Hospital of Philadelphia between 2008 and 2021. Data were obtained by chart review and caregiver questionnaires. Results: Children with BPD receiving > 1 liter of O 2 were more likely to have severe BPD, pulmonary hypertension and be older at initial hospital discharge. Children discharged on higher levels of supplemental O 2 were slower to wean to room air compared to lower O 2 groups (p<0.001). Additionally, weaning off supplemental O 2 in the outpatient setting was delayed in children with gastrostomy tubes and those prescribed inhaled corticosteroids, on public insurance or with lower estimated household incomes. Level of supplemental O 2 at discharge did not influence outpatient acute care usage or respiratory symptoms. Conclusion: BPD severity and level of supplemental oxygen use at discharge did not correlate with subsequent acute care usage or respiratory symptoms in children with BPD. Weaning of O 2 however was significantly associated with socioeconomic status and respiratory medication use, contributing to the variability in O 2 weaning in the outpatient setting.

A 37-year-old woman with chronic progressive myelopathy and syringomyelia and scoliosis presented with difficulty in walking at presentation. Dorsal CVJ CSF collection and adhesive arachnoiditis, compressing cerebellum, brainstem and upper cervical spinal cord with holocord syrinx was detected in neuroimaging beside thoracic scoliosis.

The common dolphin (Delphinus delphis) is widely distributed worldwide and well adapted to various habitats in temperate, subtropical, and tropical seas. Animal genomes store clues about their pasts, and can reveal the genes underlying their evolutionary success. Here, we report the first high-quality chromosome-level genome of D. delphis. The assembled genome size was 2.56 Gb with a contig N50 of 63.85 Mb and a scaffold N50 of 108.93 Mb. Approximately 93.81% of contigs were anchored onto 22 chromosomes. Phylogenetically, D. delphis was located close to Tursiops truncatus and T. aduncus, and exhibited high synteny with T. truncatus. The genome of D. delphis exhibited 428 expanded and 1,885 contracted gene families, and 120 genes were identified as positively selected. The expansion of the HSP70 gene family indicated that D. delphis has a powerful system for buffering stress, which might be associated with its broad adaptability, longevity, and detoxification capacity. The expanded IFN-α and IFN-ω gene families, as well as the positively selected genes encoding tripartite motif-containing protein 25, peptidyl-prolyl cis-trans isomerase NIMA-interacting 1, and p38 MAP kinase, were all involved in pathways for antiviral, anti-inflammatory, and antineoplastic mechanisms in D. delphis. The genome data also revealed dramatic fluctuations in the effective population size of D. delphis during the Pleistocene. Overall, the high-quality genome assembly and annotation represent significant molecular resources for ecological and evolutionary studies of Delphinus and help support their sustainable treatment and conservation.

Camellia oleifera is a high quality woody oilseed crop that produces a low yield in the central subtropics of China. Although fertilization can efficiently increase C. oleifera yield in these areas, the influences of fertilization continuously on soil microbiota and soil fertility remain poorly understood. The purpose of this study was to determine the influences of the type and amount of fertilizer on the soil properties of C. oleifera. Here, we compared the effects of organic fertilizer, organic–inorganic compost, no fertilizer control, and low (F1), medium (F2), and high (F3) amounts of continuously applied organic–inorganic compost at the sapling stage All chemical indicators and copiotropic bacteria measured were significantly lower in organic fertilizer and without fertilizer. Successive fertilization over two years with organic-inorganic compost significantly altered the relative abundance of the dominant bacterial groups at the phylum levels. the abundance of these phyla was the same in F2 and F3 treatments which was higher than their abundance in the other treatments. The relative abundance of kopiotrophic bacteria, especially proteobacteria and gemmatimonadetes, increased significantly and similarly with F2 and F3 treatments. With successive fertilizations, the levels of total nitrogen (TN), total phosphorus (TP) and organic matter (OM) were the vital factors affecting bacterial communities, which was confirmed by structural equation models, redundant analyzes and random forest models. These results suggest that the continuous application of moderate amounts of organic-inorganic compost is the main driver for the improvement of soil bacterial communities, and this was mainly achieved by altering the levels of OM, TN and TP, thus affecting the copiotropic bacterial abundance. This study provides a scientific basis for optimal fertilization of C. oleifera forest.

Most animals undergo ontogentic niche shifts during their life. Yet, standard ecological theory builds on models that ignore this complexity. Here, we study how complex life cycles, where juvenile and adult individuals each feed on different sets of resources, affect community richness. Two different modes of community assembly are considered: gradual adaptive evolution and immigration of new species with randomly selected phenotypes. We find that under gradual evolution complex life cycles can lead to both higher and lower species richness when compared to a model of species with simple life cycles that lack an ontogenetic niche shift. Thus, complex life cycles do not per se increase the scope for gradual adaptive diversification. However, complex life cycles can lead to significantly higher species richness when communities are assembled trough immigration, as immigrants can occupy isolated peaks of the dynamic fitness landscape that are not accessible via gradual evolution.

The functional networks of the brain play a crucial role in cognitive impairment in temporal lobe epilepsy (TLE). However, it is unclear how abnormal functional homotopy alters effective connectivity. Therefore, we investigated the neuroimaging features of the right TLE (rTLE) and their correlation with cognitive impairment using voxel-mirrored homotopic connectivity (VMHC), Granger causality analysis (GCA), and neuropsychological tests. The data from twenty-seven rTLE patients and twenty-seven healthy controls were used to construct a functional network and analyze the relationship between connectivity and cognition. VMHC analysis revealed that the homotopy was disrupted in the middle frontal gyrus (MFG), middle temporal gyrus, dorsolateral superior frontal gyrus, and supramarginal gyrus (SMG) in rTLE group. In GCA, the abnormal connectivity with brain areas was observed in several functional subnetworks, such as the default mode network, sensorimotor network, and visual network. Besides, both phasic and tonic alertness reaction times were positively correlated with the connectivity from the left MFG to the left precentral gyrus (PreCG), from the left SMG to the right PreCG, and from the left SMG to the right supplementary motor area (SMA). Executive control effect reaction time was positively correlated with the connectivity from the left MFG to the left calcarine fissure surrounding cortex. Our findings indicated that the disordered effective connectivity can exacerbate the cognitive impairment and the compensatory effect of functional network can improve cognitive performance in rTLE.

introduction Due to the high volatility in the healthcare market and financing of healthcare services, outsourcing has been developed as an efficient method to facilitate financing and providing quality services to the clients. The purpose of this paper was to determine the challenges and issues healthcare centers confront during the process of outsourcing while proposing some solutions to overcome the challenges in order to facilitate the process of outsourcing as far as possible. Methods: We reviewed papers in multiple databases including PubMed, Scopus and ProQuest; While a qualitative content analysis was done in order to obtain the major challenges and solutions regarding the process of outsourcing in the healthcare units. Results: Payment and management reforms were recognized as the most prominent challenges in the process of outsourcing while solutions like adopting innovative initiatives and new resources proposed as the fundamental solutions to facilitate the process of outsourcing. Highlights: Payment and management reforms are the most prominent challenges in the process of outsourcing. adopting innovative initiatives and new resources are proposed as the fundamental solutions to facilitate the process of outsourcing. There is a need for a more robust and deeply involved research on the existing solutions to overcome the challenges within the process of outsourcing in healthcare units There is a need to focus on the leasing form of outsourcing by the future researchers

To test the hypothesis that the effect of valproate on dose-adjusted lamotrigine troughs was moderated by the ABCG2 c.421C>A (rs2231142) polymorphism, we conducted two studies in adults with epilepsy. Since Study 2 replicated the findings of Study 1, we analysed combined data [total N=471; 140 exposed to valproate (treated), 331 not exposed (controls)]. With adjustment for cotreatments and comorbidities, age, sex, body weight and polymorphisms (and linked polymorphisms) suggested to affect exposure to lamotrigine (UGT1A4*3 c.142T>G, rs2011425; UGT2B7 -161C>T, rs7668258; ABCB1 1236C>T, rs1128503) (by entropy balancing), primary analysis indicated: in variant carriers, geometric means ratio (GMR) [treated (n=21) vs. controls (n=72)] was around 60% higher than in wild-type subjects [treated (n=119) vs. controls (n=259)] – ratio of GMRs 1.61 (95%CI 1.23-2.11) and 1.63 (95%CrI 1.26-2.10), in the frequentist and Bayesian analysis, respectively. Similar differences in valproate effects between ABCG2 c.421C>A variant carriers and wild-type subjects were found in secondary analysis (adjustment by exact matching) when exposure to valproate was defined as valproate troughs up to 364 mol/L or ≥364 mol/L (vs. no exposure to valproate). Susceptibility of the estimates to (hypothetical) unmeasured confounding was low. Data suggests that polymorphism rs2231142 moderates the effect of valproate on exposure to lamotrigine.

In an outcome-based education, teaching learning methodology made students to learn the concepts and apply on real world scenario in developing a project. To enrich the project development skill of the students, a self-study component course was introduced in the curriculum named “Cloud Computing” for the under graduate students, where students learn the concept and strategies in cloud scenario and developed a project to solve some real-world challenges in cloud. Self-study component introduced in the cloud computing course helped the students to learn the CloudSim simulation tool and carry out the project on real world strategies in cloud. Even self-study component helped the faculties to review the students based on rubrics and evaluate. The self-study approach helped the students to solve the problems with project techniques than learning programming construct.

Ageing is accompanied by numerous changes within the sensory and motor component of the muscle spindle pathway. To further document these age-related changes, this study compared the characteristics of the Hoffmann (H) reflex and M wave, evoked with several pulse durations, between young and old adults. The H-reflex and M-wave recruitment curves were analysed from recordings performed at rest in the flexor carpi radialis of 12 young (21-36 yrs) and 12 old adults (62-80 yrs). For each pulse duration (0.05-ms, 0.2-ms, and 1-ms), the maximal H-reflex amplitude (HMAX), the associated M wave (MHmax), and the H-reflex amplitude for a stimulus intensity evoking an M-wave of 5% MMAX (HM5%) were measured. The strength-duration time constant and response threshold were estimated from the charge/stimulus-duration relation for H reflex and M wave. The main results indicate that varying pulse duration mainly induces similar effect on H-reflex and M-wave recruitment curves between young and old adults. However, regardless of pulse duration, old adults had lesser HMAX (p = 0.029) but greater HM5% (p<0.001) and MHmax (p<0.001). The strength-duration time constant was lesser in old than young adults for the H reflex (p=0.048) but not the M wave (p=0.21). The H-reflex and M-wave response thresholds were greater in old than young adults (p=0.003). These results suggest greater age-related changes in the sensory than motor component of the H-reflex pathway, which may be indicative of a greater loss of sensory than motor axons or alterations of synapses between Ia afferents and motor neurones.

The huge amount of bank operations that occur every day makes it extremely hard for financial institutions to spot malicious money laundering related operations. Although some predefined heuristics are used they aren't restrictive enough, still leaving to much work for human analyzers. This motivates the need for intelligent systems that can help financial institutions fight money laundering in a diversity of ways, such as: intelligent filtering of bank operations, intelligent analysis of suspicious operations, learning of new detection and analysis rules. In this paper, we present a multiagent based approach to deal with the problem of money laundering by defining a multiagent system designed to help financial institutions in this task, helping them to deal with two main problems: volume and rule improvement. We define the agent architecture , and characterize the different types of agents, considering the distinct roles they play in the process.

The success of machine learning algorithms generally depends on data representation, and we hypothesize that this is because different representations can entangle and hide more or less the different explanatory factors of variation behind the data. Although specific domain knowledge can be used to help design representations, learning with generic priors can also be used, and the quest for AI is motivating the design of more powerful representation-learning algorithms implementing such priors. In this review paper, statistics of AI incidents and areas are presented along with the social impact. Using the online AI Incident Database, some areas of AI applications have been identified, which shows unethical use of AI. Applications like Language and Computer vision models, intelligent robots and autonomous driving are in top ranking. Ethical issues also appear in various forms like incorrect use of technology, racism, non-safety and malicious algorithms with bi-asness. Data collection has helped to identify the AI ethical issues based on Time, Geographic Locations, Application Areas, and Classifications.

Granulosa cell tumour (GCT) is a benign tumour that affects a mare’s ovaries. In this report, a case of unilateral GCT in an ovary, which weighed 24 kg, of a 7-year-old warmblood mare is described, including ultrasonographic, clinical appearance and successful surgical removal of the tumour. The GCT was the cause of an acute hemoperitoneum and after a first stabilization of the mare, the GCT was removed through a ventral midline incision. Because of the enormous dimensions of the GCT, intra-abdominal partial resection of the tumor using a tenotomy knife was performed to exteriorize the ovarian pedicle. The technique can cause an intra-abdominal hemorrhage and the time between GCT resection and sealing of the respective ovarian pedicle should be as short as possible. After 3.5 months, the mare had a good cosmetic and functional outcome and was ridden for her intended use. Metastasis of GCT is rare, but not impossible. The mare therefore should be followed up for a longer period of time to investigate if metastasis develops.

Objective: To identify and characterize all European Medicines Agency (EMA) approvals that made use of adaptive designs in clinical trials and to evaluate the conditions where adaptive designs were required. Methods: We gathered relevant files derived from the EMA database based on a list of the keywords related to adaptive designs between 2008 and 2020. We collected the trial characteristics from approvals and Fisher exact test was used to compare the characteristics. Results: We found 41 approvals derived from 91 original EMA files contained adaptive designs. Group sequential was the most popular adaptive design (17/41). Most of the approvals (32/41) were pivotal trials and were not under accelerated assessment (38/41). Among 32 confirmatory trials planned with adaptive designs, the proportion of AM status showed a statistically significant increase (P < 0.0001) from 0% in 2008–2012 to 90.48% in 2017–2020. The percentage of antitumor drugs in approved drugs with ongoing clinical trials was 82.35%, compared to 20.83% with completed trials (P=0.0001). The proportion of companies that required post-authorization safety or efficacy studies or that were granted CMA for drugs that were approved but still had ongoing clinical trials significantly differed from the other group (P = 0.0230). Conclusion: An increasing trend was observed in the number of EMA approvals related to adaptive designs from 2008 to 2020. Extra regulations will be necessary for ongoing trials due to unknown, uncertain circumstances raised from adaptive design, such as addtitonal monitoring, conditional marketing authorization.

Trophic networks describe interactions between species at a given location and time. Due to environmental changes, anthropogenic perturbations or sampling effects, trophic networks may vary in space and time. The collection of network time series or networks in different sites thus constitutes a metanetwork. A crucial step toward the understanding of those metanetworks is to build appropriate tools to handle and represent them. We present here the R package metanetwork, which will ease the exploration and the analysis of trophic metanetwork datasets that are increasingly available. Our main methodological advance consists in suitable layout algorithm for trophic networks, which is based on trophic levels and dimension reduction of a graph diffusion kernel. In particular, it highlights relevant features of trophic networks (trophic levels, energetic channels). In addition, we developed graphical tools to handle, compare and aggregate those networks. Static and dynamic visualisation functions have been developed to represent large networks. We apply our package workflow to several trophic network data sets.

Upon uptake of toxins, insects launch a detoxification program. This program is deployed in multiple organs and cells to raise their tolerance against the toxin. The molecular mechanisms of this program inside the insect body have been studied and understood in detail. Here, we report on a yet unexplored extra-corporeal detoxification of insecticides in Drosophila melanogaster. Wild-type D. melanogaster incubated with DDT, a contact insecticide, in a closed environment die as expected. However, incubation of a second cohort in the same environment after removal of the dead flies was not lethal. Consistent to the kin selection theory, the effect is significantly lower if the flies of the two cohorts are unrelated. Incubation assays with Chlorpyrifos, another contact insecticide, yielded identical results, while incubation assays with Chlorantraniliprole, again a contact insecticide, was toxic for the second cohort of flies. A cohort of flies incubated in a DDT environment after an initial incubation of a honeybee survived treatment. Together, our data suggest that insects including Apis mellifera and D. melanogaster have the capacity to modify their proximate environment. Consequently, in their ecological niche, following individuals might be saved from intoxication thereby facilitating colonisation of an attractive site.

In organisms reproducing sexually, speciation occurs when increasing divergence results in pre- or post-zygotic reproductive isolation between lineages. Studies focusing on reproductive isolation origin in early stages of speciation are common. Many rely on indirect measures of introgression providing limited information on the genomic architecture of reproductive isolation maintenance in the long term. This study focuses on direct measures of introgression between two species in a late stage of speciation. We used ddRADseq genotyping in a natural hybrid zone between Podarcis bocagei and P. carbonelli to examine admixture extent, estimate effective selection, analyse hybrid zone stability, and assess variation in selection against introgression across the genome. Hybridization was confirmed the narrow and bimodal hybrid zone demonstrating the existence of strong mechanisms of reproductive isolation. Simulations suggested that simple premating barriers were not enough to explain the observed distribution of admixture classes, pointing out the role of post-mating isolation. A geographic cline approach confirmed strong reproductive isolation and high effective selection preventing extensive introgression outside of the contact zone; and detected a signal of hybrid zone movement towards P. bocagei distribution. Genomic cline analysis revealed heterogeneous patterns of introgression among loci within the syntopy zone, but most of the loci do not introgress more or less than the genomic average maintaining a strong association with the genomic background of origin. However, genomic clines can be driven by confounding effects resulting in incongruences between both cline approaches. Importantly, overall patterns of introgression seem to result from strong intrinsic barriers across the genome, without clear “islands of differentiation”. Last, an important role of the Z chromosome in reproductive isolation is suggested.

Cyst nematodes comprise a group of soil-born pests that globally cause severe damage to cash crops like soybeans, cereals, potatoes and sugar beet. Density of nematode cysts in the soil is a key factor to determine the risk for crop cultivation. The nematodes threaten crop production they colonize crop roots and parasitize them, resulting in significant yield losses. Vice versa, development of nematode resistant cultivars require determination of cysts in-vitro to discriminate resistant from susceptible plant genotypes. Determining cysts per soil sample can be achieved by imaging and image processing. After extraction of cysts from soil samples, they are displayed on filter papers, which are traditionally scored by human eye. By developing an imaging setup for this sample type and a related image processing procedure, it was possible to optimize this scoring process. Imaging and image processing is faster, more comparable, and better documented than visual scoring by human operators. The imaging and image processing method was referenced with the traditional rating method as it is common practice in the German agricultural monitoring lab at the Julius Kühn Institute. The counting accuracy was highly comparable to the accuracy of visual counting. The optical sensing method delivers a set of additional data beyond the cyst count for phenotyping nematode populations. These comprise length, width, and area of the cyst that enable analyzing cyst dimensions. Sensing measured dimensions were found to be in accordance to literature data. Moreover, image processing enables analyzing cyst colors, a feature that could be important for age determination.

Multi-granulation decision-theoretic rough set effectively combines Bayesian decision approaches with multi-granulation rough set theory, and provides an important theoretical framework for studying rough set. We mainly explore some extensional models of multi-granulation decision-theoretic rough set under the condition that the decision loss function is normally distributed. According to the 3σ rule of normal distribution, the decision loss of multi-granulation decision-theoretic rough set is transformed into a set of interval values, and the upper and lower approximations are constructed from the optimistic, weakly optimistic, pessimistic, weakly pessimistic, optimistic-pessimistic, weakly optimistic-pessimistic, pessimistic-optimistic, weakly pessimistic-optimistic viewpoints, and the decision rules of the proposed rough set models are given. The work in this paper makes the decision behavior based on multi-granulation decision-theoretic rough set more close to the actual situation.

Waste sorting and recycling is an important part of achieving sustainable development, relying on the good environmental awareness of community residents. Residents’ environmental awareness determines the preference choice of garbage classification scheme, and the ambiguous preference of the group directly affects the consensus effect of the scheme. Social network analysis can effectively solve the decision-making consensus problem of community group garbage classification scheme, which makes the research on the large-group decision-making (LGDM) consensus problem for social network has important practical significance. The research proposes an interactive consensus model based on social network consensus: Firstly, according to the social relationship between decision makers, the social network formed by decision makers is clustered using methods. Second, the preference of the categorical subgroup is represented based on the probability distribution of hesitant fuzzy elements. Then calculate the consensus level. Finally, the unreasonable decision-making level is improved through the interactive feedback mechanism, and the decision-making consensus of the garbage classification scheme is gradually reached. Considering that the choice of garbage classification scheme is actually a large group decision-making problem, the advantages and reliability of social network consensus analysis in selecting garbage classification schemes are verified through the case analysis of four types of garbage classification scheme selection.

In this work, we propose a generalized Levenberg-Marquardt method for nonlinear inverse problems. Compared with the conventional Levenberg-Marqurdt method, the proposed method could be independent of the Fréchet derivative of forward operator F and the iteration points. So it can be used to solve both smooth and non-smooth inverse problems. This method is also designed with general convex penalty terms to detect special features of solutions such as sparsity and piecewise constancy. Convergence analysis of this method is established under a general tangential cone condition (GTCC). In addition, we derive the convergence rate of the proposed method under Hölder-type stability condition. As byproduct, we prove that the general tangential cone condition holds for some PDE inverse problems. Finally, numerical simulations are presented to show the efficiency of the proposed method.

As an important factor that drives the economic growth of local tourism industry, the promotion strategy of tourism products affects the overall tourism market planning. As a rapidly developing type of tourism in recent years, rural parent-child tourism, which combines two characteristics of rural experience and parent-child experience, occupies an important market of tourism industry. The fast pace of urban life is inundating urban residents, but also makes more urban residents willing to calm down, to experience the fun of rural parent-child life, to enhance the emotions with the family. At present, the development of China's rural parent-child tourism is lagging behind, and the tourism products are very single and not attractive enough to tourists. Based on the promotion strategy of tourism products, this paper selects Hainan Province as the research base of rural parent-child tourism, and builds a three-dimensional digital model to formulate the promotion strategy of rural parent-child tourism in Hainan in order to create a market of rural parent-child tourism in Hainan with high brand value, diversified product portfolio and rich industrial chain, and also hopes to provide theoretical value for the development of rural parent-child tourism in other regions in China.

The study focused on the link between school-based mindfulness program activities using the facets: explaining, observing, reacting with awareness, non-judging, and non-reacting to students ' level of test anxiety. Two self-report measures were undertaken through survey questionnaire. The findings showed that through Mindfulness, the students perceived a moderate level of mindfulness in all facets and conversely low level anxiety during examinations period. The hypothesis that mindfulness and level of test anxiety are inversely related was verified in the findings. Therefore, the practice of Mindfulness in school context is perceived to lessen the test anxiety of students and it is recommended on the basis of results by strengthening the program institution through enhancing a formal practice measures that will continue to address anxiety-related factors. Moreover, to provide information on its impact, researchers may uplift the study into experimental type and or a case study design.