The Deep Reef Refugia Hypothesis suggests that disturbances decrease with increasing depth, thus, reefs at the mesophotic zone potentially serve as refuges for communities found in shallower areas. This study aimed to evaluate fish diversity at shallow and mesophotic reefs at Parque Nacional Espíritu Santo (PNZMAES) and compare them to determine if deep reefs indeed serve as refuges for shallow communities. During 2021-2022 we conducted five-minute video-transects using remotely operated vehicles to document species richness and abundance at shallow and mesophotic habitats. For the recorded species, six biological traits were compiled (length, mobility, position, gregariousness, diet, and activity period) to estimate four functional indices (number of entities, richness, originality, and divergence) as well as Hill’s numbers for taxonomic and functional indices. Furthermore, monthly water turbidity (Kd490) satellite data products were transformed into a light attenuation coefficient (KdPAR) to locate the mesophotic zone (area between 10 and 0.1% of light penetration). At PNZMAES, the mesophotic zone was identified to extend to 21 m under optimal conditions (high stratification and low primary production), which is shallower compared to what is typically observed in oligotrophic regions. The PERMANOVA revealed significant variations in reef fish composition across spatial (site and zone) and temporal (season and year) dimensions. Additionally, univariate tests of functional richness, originality, and taxonomic Hill’s numbers exhibited significantly higher values in the shallow zone. However, functional divergence and functional Hill’s numbers indicated similarities in fish assemblages. Despite differences in fish taxonomic diversity among zones that could be related to less habitat complexity, environmental variation, and resource availability at deep strata, mesophotic reef fish assemblages presented similar functions. This maintenance of functions at mesophotic reefs suggests connectivity between zones and their potential role as a partial refugia in the face of current and near-future disturbances that could affect shallow zones.

Introduction: Disrespect and abuse during childbirth represents a pervasive issue worldwide. In Rwanda, however, research in this area remains scarce. This study evaluated the factors linked to disrespect and abuse during labor and delivery in two Rwandan district hospitals. Methods: Employing a mixed method, cross-sectional design, we studied 280 women giving birth at Kabutare and Kibagabaga hospitals. Analysis was conducted with SPSS version 22, using the Chi-square test to identify factors correlated with childbirth-related disrespect and abuse. Results: Our findings revealed that 27% of women reported verbal abuse and 27.5% reported abandonment by healthcare providers, with 12% experiencing physical abuse during childbirth. Factors increasing the likelihood of experiencing disrespect and abuse included residing in rural areas [AOR=4.06, 95% CI (1.12, 14.7); p=0.03], having only primary education [AOR=2.9, 95% CI: 1.10-8.9, p=0.04], and night-time delivery [AOR=2.23, 95% CI (1.34, 3.03); p=0.03]. However, having a cesarean delivery [AOR=0.23, 95% CI: 0.09-0.59, p=0.002] or having attended antenatal care [AOR=0.28, 95% CI: 0.13-0.81, p=0.029] significantly reduced the risk of such experiences. Conclusion: The study uncovers a high incidence of disrespect and abuse during labor and delivery in Rwanda. The identified risk factors, namely rural residence, lower education, and night-time delivery, highlight specific areas requiring targeted intervention. The results advocate for effective measures to ensure dignified and equitable maternity care for all women.

Main title: Unusual Manifestation of Retained Product of Conception in the Cervix: A Case Study

Syncope secondary to recurrent episodes of torsade de pointes following androgen-deprivation therapy: a case report

A document by Efrat Schurr. Click on the document to view its contents.

Objective: To describe the profile of probable cases of anaphylaxis attended at a private pediatric hospital emergency service in São Paulo, encompassing triggering factors, the presence of cofactors, treatments performed, and the follow-up of these cases through interviews with the patients’ families. Methods: A single-center cross-sectional study that analyzed medical records of children and adolescents treated between 2016 and 2020. Cases with symptoms compatible with anaphylaxis were evaluated by allergist physicians to select probable cases, and the parents or legal guardians of these cases were interviewed to collect detailed information about the episodes. Results: 69 probable cases of anaphylaxis (PCA) were identified among 460,434 attendances. Of the 51 PCAs, the majority presented cutaneous and respiratory symptoms, with a male predominance (63%), and 27% were under 2 years old. Foods, especially nuts and peanuts, were the main triggers. Nearly a third of the patients did not undergo investigation after the episode, and intramuscular adrenaline (37%) and auto-injectable (AI) adrenaline (4%) were underutilized as treatments. Eight cases showed recurrence of symptoms after improvement, suggesting a possible biphasic reaction. Conclusion: This study revealed that the majority of PCAs occurred in male children. Nuts and peanuts were the main triggers. The approach to PCAs was not ideal, with underutilization of intramuscular adrenaline as first-line treatment and low prescription of AI adrenaline in follow-up. Awareness and education about anaphylaxis in children and the importance of proper treatment are crucial to reduce the risk of morbidity and mortality in this vulnerable population.

Background: Injury resulting in proliferative new bone formation on the dorsal aspect of the middle phalanx (P2) has been recognised by equine veterinarians and is generally referred to as capsulitis. Objectives: Describe the clinical features, treatment, and outcomes of this condition. Study Design: Case series (n=19) Methods: Clinical cases in which the horse presented for lameness and were diagnosed with acute formation of proliferative bone on the dorsal aspect of P2 were included in the study (cases collected from 2005-2022). Signalment, history, presenting clinical signs, diagnostics, treatments administered, and outcome were evaluated. Results: Horses presented with unilateral lameness that were all classified as either a moderate lameness at a trot (n=6), or a moderate to severe lameness at a walk (n=13). The presentation of lameness was recorded as acute in 15/19 horses and not reported in the remainder. Bone proliferation on the dorsal aspect of P2 was diagnosed on radiographic evaluation in all horses (as part of the inclusion criteria). In horses with sequential radiographs made from the time of acute presentation, the bone production developed rapidly over a period of a few weeks to 2 months. A variety of therapeutic options were implemented, and 13/19 (68%) of the cases were subject to humane euthanasia with only one horse returning to its previous athletic function. Milder cases were more likely to have better outcomes. Main Limitations: Small sample size. Conclusions: Acute new bone proliferation on the dorsal aspect of P2 may be associated with moderate to severe lameness and carries a poor prognosis for return to athletic performance and survival.

A recently castrated 4-year-old Selle Français gelding was presented for evaluation of a renal failure. Abdominal and transrectal ultrasonography revealed a large volume of anechoic free fluid within the peritoneal cavity with high creatinine concentration and a tear at the cranial pole of the bladder. Medical management was initiated for two days, then a standing laparoscopy was performed to close the defect using barbed suture. After a transient acute renal injury, the gelding recovered and was discharged from the hospital 13 days post-operatively. To our knowledge, this case is the first report using barbed sutures on the equine bladder.

Purpose: Mirogabalin has a mechanism similar to that of pregabalin in the treatment of neuropathic pain. However, it remains unclear whether these drugs differ in terms of serious side effects, such as fall-related fractures, in older patients. This study aimed to investigate whether mirogabalin is associated with a decrease in fractures compared with pregabalin. Methods: We performed a retrospective cohort study using the DeSC database, a large administrative claims database in Japan. This study involved 49,393 patients ≥ 65 years taking mirogabalin or pregabalin between April 2019 and March 2020.The cumulative incidence of fractures was compared between those receiving mirogabalin and those receiving pregabalin using Kaplan-Meier curves and multivariable Cox proportional hazards models. A sensitivity analysis was performed for patients who received mirogabalin or pregabalin without other analgesic medications at the initial dose. Results: During a median follow-up of 20 months, 8,152 (16.5%) and 41,241(83.5%) received pregabalin, respectively. The proportions of fractures in the mirogabalin and pregabalin groups were 24.2% and 25.5%, respectively. Cox regression analysis showed that mirogabalin was associated with a lower risk of fractures (hazard ratio, 0.88; 95% confidence interval, 0.84–0.93). Sensitivity analysis also demonstrated a significant difference in fracture events between the mirogabalin and pregabalin groups without other analgesic medications (hazard ratio, 0.88; 95% confidence interval, 0.82–0.96). Conclusions: Our analyses suggest that the administration of MGB was associated with a decreased probability of fracture compared with PGB, although further studies are warranted to confirm these findings.

In this study, we sought to understand how the Linnean shortfall (i.e., the lack of knowledge about species taxonomy) interacts with the Darwinian shortfall (i.e., the lack of knowledge about phylogenetic relationships among species), potentially jeopardizing geographical patterns in estimates of speciation rates, using New World coralsnakes as a case study. For this purpose, we created an index of taxonomic uncertainty that measures the likelihood of current species being split after undergoing future taxonomic revisions. Next, we conducted simulations in which branches of species with high taxonomic uncertainty are split in the phylogenetic trees to generate new hypothetical species along their geographic ranges. We found that a high number of coralsnake species display substantial taxonomic uncertainty, positively correlated with the latitude of the species’ geographical range centroid. The estimated speciation rates based on currently available data have a weak relationship with latitude. However, after incorporating taxonomic uncertainty into the phylogeny, we detect a higher positive correlation between speciation rate and latitude. This shift demonstrates that taxonomic uncertainty can undermine empirical evaluation of the geographical pattern estimates in speciation rates, revealing an interaction between the latitudinal taxonomic gradient and the latitudinal diversity gradient. Given that taxonomic changes can alter the number of species recognized as valid over time, our study highlights the need to incorporate taxonomic uncertainty into macroecological and macroevolutionary studies, enhancing the robustness of patterns inferred from these data.

This paper investigates the Quantum Entanglement Coefficient (QEC), a key metric in quantum entanglement. A theoretical framework is proposed, exploring its implications for quantum information processing. While no experiments are provided, mathematical derivations and simulations highlight the QEC's significance in characterizing entanglement. This work suggests potential applications in quantum cryptography and computing.

Measurement is an essential activity in the field of allergy and due to the subjective nature of the results that are being measured, it is increasingly necessary to have valid, reproducible, and reliable methods. There are some reviews or task forces that present different methods or techniques to develop a validation study, which may cause some confusion. With this review, we intend to bring together and synthesize some of the information found, to help researchers and clinicians to interpret or understand the varied nomenclature read in the literature. Before any data collection, a translation of the questionnaire is needed. Psychometry involves the application of statistical techniques to test the measurement properties of an instrument. There are several measures to evaluate an instrument, the main ones being: classical test theory and modern test theory. Regarding the classical test theory, the key psychometric characteristics are scale structure, accuracy (validity), precision (reliability) and responsiveness. Modern test theory models are techniques to assess the psychometric characteristics of an instrument, focused on the dimensionality of the questionnaire. Responsiveness, validity, and precision are interlinked. Following these steps ensures the development of validated questionnaires that provide valuable insights into allergy prevalence, impact, and management.

Light transmittance is a closely related and inseparable key environmental limiting factor shaping the presence and distribution of macrophytes in aquatic environments. However, little is known about the responses of the morphology and photosynthetic capacity of macrophytes to different light conditions. Here, we conducted a short-term mesocosm experiment with Vallisneria denseserrulata as subjects, exposing them to the light transmittance of 10%, 20%, 30%, 60%, and 100%. Plant growth indicators and photosynthesis-related indicators were monitored during the 28-day experiment. The results showed that V. denseserrulata responded rapidly to changes in the light environment. Under high light transmittance conditions, V. denseserrulata rapidly expanded to obtain more resources. In low light transmittance conditions, V. denseserrulata mainly maintained its growth, rarely forming ramet, and grew longer leaves and larger leaf areas to improve light acquisition ability. There were 158, 47, 192, and 554 differentially expressed genes (DEGs) were identified in the pairwise comparison of 10%VS100%, 20%VS100%, 30%VS100%, and 60%VS100%, respectively. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis suggested that the DEGs were mainly involved in “pigment biosynthetic” and “photosynthesis”. Furthermore, genes involved in the photosynthesis pathway obtained different expression levels in V. denseserrulata between different treatments. The lower the light transmittance, the higher the expression of genes involved in photosynthesis in V. denseserrulata. Therefore, macrophytes have strong plasticity to maintain growth in stressful environments. Synthesis: V. denseserrulata exhibits strong plasticity in morphology, cytochrome production, and photosynthetic pathway regulation to maintain its growth in low-light environments. However, our results also indicated that the degraded underwater light climate surely results in a decreased macrophyte community. These results help elucidate the degradation process of submerged macrophytes in turbid lakes and guide the restoration of aquatic plants in eutrophic lakes.

Soybean seed size is a factor that still requires studies, as the connection between seed size and production performance of plants in the field is controversial. Thus, the objective of the present work was to evaluate the production performance of individual soybean plants grown from seeds of different sizes. The cultivars BS-2606-SOYTECH, NS-6700-IPRO, NA-5909-RR, BS-IRGA-1642-IPRO, and LANÇA-58i60-IPRO were evaluated in two crop seasons. A randomized block experimental design was used; the treatments consisted of three seed sizes for each cultivar, with four replications. Seeds that had the highest percentage of retention in a set of sieves were used in the experiment. The following variables were evaluated at harvest: plant height, first node height, number of nodes per plant, number of stems, number of pods on the main stem, number of pods per plant, number of seeds per plant, seed weight per plant, 1000-seed weight, and percentage of seeds retained on the sieves. Soybean seeds of the cultivars BS-2606-SOYTECH, NS-6700-IPRO, NA-5909-RR, BS-IRGA-1642-IPRO, and LANÇA-58i60-IPRO from sieves S1, S2, and S3 did not result in plants with different agronomic performance. Seeds of the cultivars BS-2606-SOYTECH, NS-6700-IPRO, and NA-5909-RR BMX from sieves S1, S2, and S3 exhibited higher yields for the 6.5-mm sieve in both crop seasons. The cultivar BS-IRGA-1642-IPRO produced the highest percentage of seeds with a diameter of 7.0 mm in both crop seasons, regardless of seed size.

Background The last major North American cooperative group clinical trial for relapsed favorable histology Wilms tumor (FHWT) was completed in 2002. The outcomes of patients with relapsed Wilms tumor subsequently treated outside of clinical trials is unknown. The aim of this study was to assess the efficacy and toxicity of salvage therapies used for patients with FHWT suffering first relapse. Methods We conducted a retrospective chart review of patients treated for first relapse of FHWT at six large North American institutions from January 2002 through August 2018. Results Ninety-four patients were identified. Thirty-six patients were classified as standard-risk relapse (SRR), 49 patients as high-risk relapse (HRR) and seven patients as very high-risk relapse (VHRR). Twenty-one patients with SRR were treated with Regimen I. The 4-year EFS and OS for SRR was 82.4% and 93.3%, respectively, with median follow up of 72 months. Twenty-eight HRR/VHRR patients were treated with ICE therapy while 13 received NWTS5 Stratum C. No patient completed protocol therapy per stratum C; median maintenance cycles administered was 2. The 4-year EFS and OS for HRR/VHRR was 32.6% and 58.3%, respectively, with median follow up of 33 months. Conclusions Outcomes for all strata of relapsed WT patients treated in a non-clinical setting appear to have similar outcomes as historical cohorts treated on NWTS5. Improved strategies are urgently needed for HRR and VHRR relapses.

Atypical teratoid/rhabdoid tumors (AT/RT) rarely occur in the cauda equina; thus, the clinical behavior and optimal treatment remain unclear. A 9-year-old boy presented with a rapidly progressing intradural extramedullary tumor at the L2–5 level, underwent tumor resection, and was diagnosed with AT/RT. His gait disturbance improved postoperatively, and he received adjuvant chemotherapy and radiotherapy. In 5 months of follow-up, recurrence was not observed. Although extremely rare, AT/RT should be included in the differential diagnosis, as it requires prompt therapeutic intervention. Safe resection with minimal functional impairment, followed by postoperative chemoradiation, can lead to tumor control and improve neurological function.

Link prediction aims at predicting future links or inferring missing links based on observed partial networks or graphs. Active link prediction has recently been shown to be highly effective at reducing the amount of data needed to train a link predictor by leveraging active learning. Existing research on active link prediction concentrated solely on the information gain caused by Shannon entropy to actively select samples. Few studies consider information gain brought by rule uncer- tainty in the process of actively selecting samples. This will cause the existing active link prediction research to be unable to use the rich semantic information contained in the knowl- edge graph rules, which is not conducive to further reducing the amount of data needed to train a link predictor. In this paper, we address the aforementioned challenge by propos- ing a Rule Guided Active Link Prediction (RGAL) approach. Through the joint modeling of information uncertainty based on Shannon entropy and information uncertainty based on rules, our proposed method can select the most informative triples while taking into account the latent semantics informa- tion contained in the triples. Extensive experiments on real- world datasets verify the effectiveness of RGAL compared with state-of-the-art methods.

Teleoperated driving is a leading approach for operating unmanned ground vehicles (UGVs) in unstructured environments, where driving stability is crucial. However, time delays may compromise this stability. In this letter, we propose a computational delay compensation method based on deep learning models to address the control transmission delay. Initially, we collect teleoperated driving data from simulated unstructured environments and then design a delay compensation method utilizing time-series forecasting models. This method generates future control inputs equivalent to the delayed time steps. Our evaluation demonstrates the possibility of our delay compensation method for teleoperated driving in unstructured environments.

This article addresses the optimal formation control for unmanned aerial vehicles (UAVs) and unmanned ground vehicles (UGVs) system via a distributed optimal control approach. A user-friendly global cost function is well designed in a linear quadratic regulator (LQR) form. The proper choice of the weighting matrices for optimizing the cost function are given. To deal with the graph coupling of optimal control and distributed control, we propose a distributed optimal formation control protocol, and the protocol is independent of the communication graph. The proposed protocol can guarantee the optimization of the cost function and the achievement of the formation control. Three simulation examples are provided to demonstrate the results.

Key Points The impact of hyperlactatemia following facial gender affirmation surgery (FGAS) remains unclear The present study sought to examine implications of intraoperative hyperlactatemia during FGAS This retrospective cohort study included patients undergoing FGAS between 2015 and 2023 with at least two intraoperative lactate levels Included 17 patients with peak lactate levels ranging from 1.2-10.9 mmol/L, all of which normalized by the end of surgery or on the first postoperative day This study highlights the reassuring lactate normalization within one day of surgery, cautiously concluding that intraoperative lactatemia may be managed expectantly

In China, the mandatory family planning policy that lasted for half a century was once considered a necessary measure to control population, alleviate resource pressure, and promote economic development. However, over time, the long-term consequences of this policy gradually became apparent, triggering a series of serious social problems. After the policy, China's population structure has undergone drastic changes, with an increase in the elderly population, a decrease in labor force, and gender imbalance, which have put pressure on social and economic development. The family size has shrunk, and traditional concepts have been impacted. The policy has changed the concept of childbirth, and young people tend to have one or no children, exacerbating aging and uncertainty in population development. The past impact of family planning policies cannot be denied, and in-depth research is needed to find solutions and contribute to future population and social stability.

Aim: This study aimed to provide comprehensive information on translated versions of the SDM-Q-9 questionnaire, which is widely used to measure patient involvement in shared decision-making, by combining psychometric validation information. Subject and Methods: We researched various databases, developer websites, and validated studies to gather pertinent information on item characteristics, content validity, and factor analysis. Our evaluation was based on predetermined cut-off values for item difficulty, discrimination index, Cronbach’s alpha, KMO, Bartlett’s test of sphericity, and factor extraction and rotation, CFA range. Results: The final analysis included eight studies with a total of 2934 participants from various countries and most participants had adequate literacy and age range was 30-60 years. Most model versions had a good fit and all studies reported satisfactory results, except for one study’s discrimination index values. The tool’s validity was satisfactory. Most of the studies reported convenient sample was the main limitation, along with recall bias in the final responses. Conclusion: The SDM-Q-9 tool can be used to measure patient involvement in shared decision-making in validated language-respected countries, as proper evaluation procedures reported satisfactory results in the confirmatory analysis models and reliability testing.

This project provides a method to calculate the water balance for small estuaries, known as Intermittently Open or Closed Lakes/Lagoons (ICOLLs) in Australia. Their management requires the prediction of lake water levels and the probability of breaching of the entrance barrier in real time for management and long term for planning. The open water evaporation is a key quantity in the water balance. The project developed and demonstrated a method to determine evaporation for ICOLLs from data routinely available, primarily from government agencies, without using external parameter values. It has been applied in case studies of two ICOLLs on the South Coast of NSW, Australia with very different morphologies: Durras Lake, a drowned stream valley with a largely steep forested catchment, and Lake Wollumboola, a back-dune lagoon ICOLL with a wider, shallow lake. The calculated seasonal curve of evaporation and the correlation of evaporation with incident solar radiation developed in this study are two simple but powerful tools for use in predicting or hindcasting evaporation in an ICOLL. The calculated evaporation agreed with the data intensive formulas of Makkink (1957) and Priestly and Taylor (1972), with calibration of the latter. The results indicate that the use of regional parameter values is quite unreliable for these small catchments.

This study aimed to investigate the relationship between arsenic exposure (as measured in urine) and both allostatic load and cardiovascular disease (CVD) risk markers within a representative group of participants from the U.S. noninstitutionalized civilian population. The results revealed individuals with high arsenic levels were significantly older than those with lower arsenic levels. Other findings indicated no significant associations between cardiovascular variables by degree of arsenic exposure as measured by total urinary arsenic. These results underscore the need to assess numerous biomarkers when examining the potential health implications of exposure to arsenic as markers of longer-term Arsenic exposure or consideration of specificity of arsenic species   may have yielded different results.