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Nick K. Jones1,2*, Lucy Rivett1,2*, Chris Workman3, Mark Ferris3, Ashley Shaw1, Cambridge COVID-19 Collaboration1,4, Paul J. Lehner1,4, Rob Howes5, Giles Wright3, Nicholas J. Matheson1,4,6¶, Michael P. Weekes1,7¶1 Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK2 Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK3 Occupational Health and Wellbeing, Cambridge Biomedical Campus, Cambridge, UK4 Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK5 Cambridge COVID-19 Testing Centre and AstraZeneca, Anne Mclaren Building, Cambridge, UK6 NHS Blood and Transplant, Cambridge, UK7 Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK*Joint first authorship¶Joint last authorshipCorrespondence: [email protected] UK has initiated mass COVID-19 immunisation, with healthcare workers (HCWs) given early priority because of the potential for workplace exposure and risk of onward transmission to patients. The UK’s Joint Committee on Vaccination and Immunisation has recommended maximising the number of people vaccinated with first doses at the expense of early booster vaccinations, based on single dose efficacy against symptomatic COVID-19 disease.1-3At the time of writing, three COVID-19 vaccines have been granted emergency use authorisation in the UK, including the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). A vital outstanding question is whether this vaccine prevents or promotes asymptomatic SARS-CoV-2 infection, rather than symptomatic COVID-19 disease, because sub-clinical infection following vaccination could continue to drive transmission. This is especially important because many UK HCWs have received this vaccine, and nosocomial COVID-19 infection has been a persistent problem.Through the implementation of a 24 h-turnaround PCR-based comprehensive HCW screening programme at Cambridge University Hospitals NHS Foundation Trust (CUHNFT), we previously demonstrated the frequent presence of pauci- and asymptomatic infection amongst HCWs during the UK’s first wave of the COVID-19 pandemic.4 Here, we evaluate the effect of first-dose BNT162b2 vaccination on test positivity rates and cycle threshold (Ct) values in the asymptomatic arm of our programme, which now offers weekly screening to all staff.Vaccination of HCWs at CUHNFT began on 8th December 2020, with mass vaccination from 8th January 2021. Here, we analyse data from the two weeks spanning 18thto 31st January 2021, during which: (a) the prevalence of COVID-19 amongst HCWs remained approximately constant; and (b) we screened comparable numbers of vaccinated and unvaccinated HCWs. Over this period, 4,408 (week 1) and 4,411 (week 2) PCR tests were performed from individuals reporting well to work. We stratified HCWs <12 days or > 12 days post-vaccination because this was the point at which protection against symptomatic infection began to appear in phase III clinical trial.226/3,252 (0·80%) tests from unvaccinated HCWs were positive (Ct<36), compared to 13/3,535 (0·37%) from HCWs <12 days post-vaccination and 4/1,989 (0·20%) tests from HCWs ≥12 days post-vaccination (p=0·023 and p=0·004, respectively; Fisher’s exact test, Figure). This suggests a four-fold decrease in the risk of asymptomatic SARS-CoV-2 infection amongst HCWs ≥12 days post-vaccination, compared to unvaccinated HCWs, with an intermediate effect amongst HCWs <12 days post-vaccination.A marked reduction in infections was also seen when analyses were repeated with: (a) inclusion of HCWs testing positive through both the symptomatic and asymptomatic arms of the programme (56/3,282 (1·71%) unvaccinated vs 8/1,997 (0·40%) ≥12 days post-vaccination, 4·3-fold reduction, p=0·00001); (b) inclusion of PCR tests which were positive at the limit of detection (Ct>36, 42/3,268 (1·29%) vs 15/2,000 (0·75%), 1·7-fold reduction, p=0·075); and (c) extension of the period of analysis to include six weeks from December 28th to February 7th 2021 (113/14,083 (0·80%) vs 5/4,872 (0·10%), 7·8-fold reduction, p=1x10-9). In addition, the median Ct value of positive tests showed a non-significant trend towards increase between unvaccinated HCWs and HCWs > 12 days post-vaccination (23·3 to 30·3, Figure), suggesting that samples from vaccinated individuals had lower viral loads.We therefore provide real-world evidence for a high level of protection against asymptomatic SARS-CoV-2 infection after a single dose of BNT162b2 vaccine, at a time of predominant transmission of the UK COVID-19 variant of concern 202012/01 (lineage B.1.1.7), and amongst a population with a relatively low frequency of prior infection (7.2% antibody positive).5This work was funded by a Wellcome Senior Clinical Research Fellowship to MPW (108070/Z/15/Z), a Wellcome Principal Research Fellowship to PJL (210688/Z/18/Z), and an MRC Clinician Scientist Fellowship (MR/P008801/1) and NHSBT workpackage (WPA15-02) to NJM. Funding was also received from Addenbrooke’s Charitable Trust and the Cambridge Biomedical Research Centre. We also acknowledge contributions from all staff at CUHNFT Occupational Health and Wellbeing and the Cambridge COVID-19 Testing Centre.

Scene flow tracks the three-dimensional (3D) motion of each point in adjacent point clouds. It provides fundamental 3D motion perception for autonomous driving and server robot. Although the Red Green Blue Depth (RGBD) camera or Light Detection and Ranging (LiDAR) capture discrete 3D points in space, the objects and motions usually are continuous in the macro world. That is, the objects keep themselves consistent as they flow from the current frame to the next frame. Based on this insight, the Generative Adversarial Networks (GAN) is utilized to self-learn 3D scene flow with no need for ground truth. The fake point cloud of the second frame is synthesized from the predicted scene flow and the point cloud of the first frame. The adversarial training of the generator and discriminator is realized through synthesizing indistinguishable fake point cloud and discriminating the real point cloud and the synthesized fake point cloud. The experiments on Karlsruhe Institute of Technology and Toyota Technological Institute (KITTI) scene flow dataset show that our method realizes promising results without ground truth. Just as human, the proposed method can identify the similar local structures of two adjacent frames even without knowing the ground truth scene flow. Then, the local correspondence can be correctly estimated, and further the scene flow is correctly estimated.   Corresponding author(s) Email: [email protected]

Leukocyte differential test is a widely performed clinical procedure for screening infectious diseases. Existing hematology analyzers require labor-intensive work and a panel of expensive reagents. Here we report an artificial-intelligence enabled reagent-free imaging hematology analyzer (AIRFIHA) modality that can accurately classify subpopulations of leukocytes with minimal sample preparation. AIRFIHA is realized through training a two-step residual neural network using label-free images of isolated leukocytes acquired from a custom-built quantitative phase microscope. By leveraging the rich information contained in quantitative phase images, we not only achieved high accuracy in differentiating B and T lymphocytes, but also classified CD4 and CD8 cells, therefore outperforming the classification accuracy of most current hematology analyzers. We validated the performance of AIRFIHA in a randomly selected test set and cross-validated it across all blood donors. Owing to its easy operation, low cost, and accurate discerning capability of complex leukocyte subpopulations, we envision AIRFIHA is clinically translatable and can also be deployed in resource-limited settings, e.g., during pandemic situations for the rapid screening of infectious diseases.  Corresponding author(s) Email:    [email protected],  [email protected]

Tam Hunt [1], Jonathan SchoolerUniversity of California Santa Barbara Synchronization, harmonization, vibrations, or simply resonance in its most general sense seems to have an integral relationship with consciousness itself. One of the possible “neural correlates of consciousness” in mammalian brains is a combination of gamma, beta and theta synchrony. More broadly, we see similar kinds of resonance patterns in living and non-living structures of many types. What clues can resonance provide about the nature of consciousness more generally? This paper provides an overview of resonating structures in the fields of neuroscience, biology and physics and attempts to coalesce these data into a solution to what we see as the “easy part” of the Hard Problem, which is generally known as the “combination problem” or the “binding problem.” The combination problem asks: how do micro-conscious entities combine into a higher-level macro-consciousness? The proposed solution in the context of mammalian consciousness suggests that a shared resonance is what allows different parts of the brain to achieve a phase transition in the speed and bandwidth of information flows between the constituent parts. This phase transition allows for richer varieties of consciousness to arise, with the character and content of that consciousness in each moment determined by the particular set of constituent neurons. We also offer more general insights into the ontology of consciousness and suggest that consciousness manifests as a relatively smooth continuum of increasing richness in all physical processes, distinguishing our view from emergentist materialism. We refer to this approach as a (general) resonance theory of consciousness and offer some responses to Chalmers’ questions about the different kinds of “combination problem.”  At the heart of the universe is a steady, insistent beat: the sound of cycles in sync…. [T]hese feats of synchrony occur spontaneously, almost as if nature has an eerie yearning for order. Steven Strogatz, Sync: How Order Emerges From Chaos in the Universe, Nature and Daily Life (2003) If you want to find the secrets of the universe, think in terms of energy, frequency and vibration.Nikola Tesla (1942) I.               Introduction Is there an “easy part” and a “hard part” to the Hard Problem of consciousness? In this paper, we suggest that there is. The harder part is arriving at a philosophical position with respect to the relationship of matter and mind. This paper is about the “easy part” of the Hard Problem but we address the “hard part” briefly in this introduction.  We have both arrived, after much deliberation, at the position of panpsychism or panexperientialism (all matter has at least some associated mind/experience and vice versa). This is the view that all things and processes have both mental and physical aspects. Matter and mind are two sides of the same coin.  Panpsychism is one of many possible approaches that addresses the “hard part” of the Hard Problem. We adopt this position for all the reasons various authors have listed (Chalmers 1996, Griffin 1997, Hunt 2011, Goff 2017). This first step is particularly powerful if we adopt the Whiteheadian version of panpsychism (Whitehead 1929).  Reaching a position on this fundamental question of how mind relates to matter must be based on a “weight of plausibility” approach, rather than on definitive evidence, because establishing definitive evidence with respect to the presence of mind/experience is difficult. We must generally rely on examining various “behavioral correlates of consciousness” in judging whether entities other than ourselves are conscious – even with respect to other humans—since the only consciousness we can know with certainty is our own. Positing that matter and mind are two sides of the same coin explains the problem of consciousness insofar as it avoids the problems of emergence because under this approach consciousness doesn’t emerge. Consciousness is, rather, always present, at some level, even in the simplest of processes, but it “complexifies” as matter complexifies, and vice versa. Consciousness starts very simple and becomes more complex and rich under the right conditions, which in our proposed framework rely on resonance mechanisms. Matter and mind are two sides of the coin. Neither is primary; they are coequal.  We acknowledge the challenges of adopting this perspective, but encourage readers to consider the many compelling reasons to consider it that are reviewed elsewhere (Chalmers 1996, Griffin 1998, Hunt 2011, Goff 2017, Schooler, Schooler, & Hunt, 2011; Schooler, 2015).  Taking a position on the overarching ontology is the first step in addressing the Hard Problem. But this leads to the related questions: at what level of organization does consciousness reside in any particular process? Is a rock conscious? A chair? An ant? A bacterium? Or are only the smaller constituents, such as atoms or molecules, of these entities conscious? And if there is some degree of consciousness even in atoms and molecules, as panpsychism suggests (albeit of a very rudimentary nature, an important point to remember), how do these micro-conscious entities combine into the higher-level and obvious consciousness we witness in entities like humans and other mammals?  This set of questions is known as the “combination problem,” another now-classic problem in the philosophy of mind, and is what we describe here as the “easy part” of the Hard Problem. Our characterization of this part of the problem as “easy”[2] is, of course, more than a little tongue in cheek. The authors have discussed frequently with each other what part of the Hard Problem should be labeled the easier part and which the harder part. Regardless of the labels we choose, however, this paper focuses on our suggested solution to the combination problem.  Various solutions to the combination problem have been proposed but none have gained widespread acceptance. This paper further elaborates a proposed solution to the combination problem that we first described in Hunt 2011 and Schooler, Hunt, and Schooler 2011. The proposed solution rests on the idea of resonance, a shared vibratory frequency, which can also be called synchrony or field coherence. We will generally use resonance and “sync,” short for synchrony, interchangeably in this paper. We describe the approach as a general resonance theory of consciousness or just “general resonance theory” (GRT). GRT is a field theory of consciousness wherein the various specific fields associated with matter and energy are the seat of conscious awareness.  A summary of our approach appears in Appendix 1.  All things in our universe are constantly in motion, in process. Even objects that appear to be stationary are in fact vibrating, oscillating, resonating, at specific frequencies. So all things are actually processes. Resonance is a specific type of motion, characterized by synchronized oscillation between two states.  An interesting phenomenon occurs when different vibrating processes come into proximity: they will often start vibrating together at the same frequency. They “sync up,” sometimes in ways that can seem mysterious, and allow for richer and faster information and energy flows (Figure 1 offers a schematic). Examining this phenomenon leads to potentially deep insights about the nature of consciousness in both the human/mammalian context but also at a deeper ontological level.

Cannabis sativa is an extraordinarily versatile species. Hemp and its cousin marijuana, both C. sativa, have been used for millennia as a source of fibre, oil and for medicinal, spiritual and recreational purposes. Because the consumption of Cannabis can have psychoactive effects, the plant has been widely banned throughout the last century. In the past decade, evidence of its medicinal properties did lead to the relaxation of legislation in many countries around the world. Consequently, the genetics and development of Cannabis as well as Cannabis-derived products are the subject of renewed attention.Here, we review the biology of C. sativa, including recent insights from taxonomy, morphology and genomics, with an emphasis on the genetics of cannabinoid synthesis. Because the female Cannabis flower is of special interest as the site of cannabinoid synthesis, we explore flower development, flowering time well as the species’ unique sex determination system in detail. Furthermore, we outline the tremendous medicinal, engineering, and environmental opportunities that Cannabis bears. Together, the picture emerges that our understanding of Cannabis biology currently progresses at an unusual speed. A future challenge will be to preserve the multi-purpose nature of Cannabis, and to harness its medicinal properties and sustainability advantages simultaneously.

Quantum chemistry must evolve if it wants to fully leverage the benefits of the internet age, where the world wide web offers a vast tapestry of tools that enable users to communicate and interact with complex data at the speed and convenience of a button press. The Open Chemistry project has developed an open source framework that offers an end-to-end solution for producing, sharing, and visualizing quantum chemical data interactively on the web using an array of modern tools and approaches. These tools build on some of the best open source community projects such as Jupyter for interactive online notebooks, coupled with 3D accelerated visualization, state-of-the-art computational chemistry codes including NWChem and Psi4 and emerging machine learning and data mining tools such as ChemML and ANI. They offer flexible formats to import and export data, along with approaches to compare computational and experimental data.

This paper responds to one by Graham Martin and colleagues, who offered a critique of my previous publications on masks for the lay public in the Covid-19 pandemic. I address their charges that my co-authors and I had misapplied the precautionary principle; drawn conclusions that were not supported by empirical research; and failed to take account of potential harms. But before that, I remind Martin et al that the evidence on mask wearing goes beyond the contested trials and observational studies they place centre stage. I set out some key findings from basic science, epidemiology, mathematical modelling, case studies and natural experiments, and use this rich and diverse body of evidence as the backdrop for my rebuttal of their narrowly-framed objections. I challenge my critics’ apparent assumption that a particular kind of systematic review should be valorised over narrative and real-world evidence, since stories are crucial to both our scientific understanding and our moral imagination. I conclude by thanking my academic adversaries for the intellectual sparring match, but exhort them to remember our professional accountability to a society in crisis. It is time to lay straw men to rest and engage, scientifically and morally, with the dreadful tragedy that is unfolding across the world.

This Supporting information includes interactive plots, videos, and data captured while performing evaluation and validation experiments for our paper. 

The construct of wellbeing has been criticised as a neoliberal construction of western individualism that ignores wider systemic issues including increasing burden of chronic disease, widening inequality, concerns over environmental degradation and anthropogenic climate change. While these criticisms overlook recent developments, there remains a need for biopsychosocial models that extend theoretical grounding beyond individual wellbeing, incorporating overlapping contextual issues relating to community and environment. Our first GENIAL model \cite{Kemp_2017} provided a more expansive view of pathways to longevity in the context of individual health and wellbeing, emphasising bidirectional links to positive social ties and the impact of sociocultural factors. In this paper, we build on these ideas and propose GENIAL 2.0, focusing on intersecting individual-community-environmental contributions to health and wellbeing, and laying an evidence-based, theoretical framework on which future research and innovative therapeutic innovations could be based. We suggest that our transdisciplinary model of wellbeing - focusing on individual, community and environmental contributions to personal wellbeing - will help to move the research field forward. In reconceptualising wellbeing, GENIAL 2.0 bridges the gap between psychological science and population health health systems, and presents opportunities for enhancing the health and wellbeing of people living with chronic conditions. Implications for future generations including the very survival of our species are discussed.  

Floral plantings are promoted to foster ecological intensification of agriculture through provisioning of ecosystem services. However, a comprehensive assessment of the effectiveness of different floral plantings, their characteristics and consequences for crop yield across global regions is lacking. Here we quantified the impacts of flower strips and hedgerows on pest control and pollination services in adjacent crops using a global dataset of 529 sites. Flower strips, but not hedgerows, enhanced pest control services in adjacent fields by 16% on average. However, effects on crop pollination and yield were more variable. Our synthesis identifies several important drivers of variability in effectiveness of plantings: pollination services declined exponentially with distance from plantings, and perennial and older flower strips with higher flowering plant diversity enhanced pollination more effectively. These findings provide promising pathways to optimize floral plantings to more effectively contribute to ecosystem service delivery and ecological intensification of agriculture in the future.

Researchers' ability to accurately screen fossil and subfossil specimens for preservation of DNA and protein sequences remains limited. Thermal exposure and geologic age are usable proxies for sequence preservation on a broad scale but are of nominal use for specimens of similar depositional environments. Cell and tissue biomolecular histology is thus proposed as a novel proxy for determining sequence preservation potential of ancient specimens with improved accuracy. Biomolecular histology as a proxy is hypothesized to elucidate why fossils/subfossils of some depositional environments preserve sequences while others do not and to facilitate selection of ancient specimens for use in molecular studies.

IntroductionConsistent with World Health Organization (WHO) advice [1], UK Infection Protection Control guidance recommends that healthcare workers (HCWs) caring for patients with coronavirus disease 2019 (COVID-19) should use fluid resistant surgical masks type IIR (FRSMs) as respiratory protective equipment (RPE), unless aerosol generating procedures (AGPs) are being undertaken or are likely, when a filtering face piece 3 (FFP3) respirator should be used [2]. In a recent update, an FFP3 respirator is recommended if “an unacceptable risk of transmission remains following rigorous application of the hierarchy of control” [3]. Conversely, guidance from the Centers for Disease Control and Prevention (CDC) recommends that HCWs caring for patients with COVID-19 should use an N95 or higher level respirator [4]. WHO guidance suggests that a respirator, such as FFP3, may be used for HCWs in the absence of AGPs if availability or cost is not an issue [1].A recent systematic review undertaken for PHE concluded that: “patients with SARS-CoV-2 infection who are breathing, talking or coughing generate both respiratory droplets and aerosols, but FRSM (and where required, eye protection) are considered to provide adequate staff protection” [5]. Nevertheless, FFP3 respirators are more effective in preventing aerosol transmission than FRSMs, and observational data suggests that they may improve protection for HCWs [6]. It has therefore been suggested that respirators should be considered as a means of affording the best available protection [7], and some organisations have decided to provide FFP3 (or equivalent) respirators to HCWs caring for COVID-19 patients, despite a lack of mandate from local or national guidelines [8].Data from the HCW testing programme at Cambridge University Hospitals NHS Foundation Trust (CUHNFT) during the first wave of the UK severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic indicated a higher incidence of infection amongst HCWs caring for patients with COVID-19, compared with those who did not [9]. Subsequent studies have confirmed this observation [10, 11]. This disparity persisted at CUHNFT in December 2020, despite control measures consistent with PHE guidance and audits indicating good compliance. The CUHNFT infection control committee therefore implemented a change of RPE for staff on “red” (COVID-19) wards from FRSMs to FFP3 respirators. In this study, we analyse the incidence of SARS-CoV-2 infection in HCWs before and after this transition.

Discrimination of myocardial function changes: evolution of chronic kidney disease or hemodialysis effect?Kalliopi Keramida, MD, MSc, PHD, FESC, FHFA, FICOS,1Konstantinos Papadopoulos, MD, PhD, FESC, FEACVI21 Cardiology Department, General Anti-Cancer, Oncological Hospital Agios Savvas, Athens, Greece2Echocardiography department, Interbalkan Medical Center, Thessaloniki, GreeceCorresponding author: Kalliopi Keramida, General Anti-Cancer Oncological Hospital, Agios Savvas Athens, GreeceAleksandras Avenue 171, 11522, Athens, Greece,[email protected] on “Effect of hemodialysis on left atrial function in patients with end-stage renal failure evaluated by two-dimensional speckle-tracking imaging”Chronic kidney disease, often advancing to end-stage renal disease (ESRD), poses a significant challenge to public health, as costly treatments like dialysis or kidney transplantation become essential for survival. Globally, the number of individuals with ESRD that need renal replacement therapy is estimated to range between 4.902 and 9.701 million with a trend to double by 2030 (1). Cardiovascular (CV) disease is a prevalent complication and the leading cause of mortality among individuals with ESRD undergoing hemodialysis (HD). Heart failure (HF), sudden cardiac death, ischemic cardiomyopathy and stroke are the main causes of CV mortality (2). Echocardiography is the main imaging modality used for the long-term surveillance of ESRD patients.Myocardial remodeling and dysfunction, are prevalent in different stages of chronic kidney disease (CKD), leading to uremic cardiomyopathy and HF with either preserved (3) or reduced ejection fraction later in the course of the disease (4). However, myocardial remodeling, including left ventricular (LV) hypertrophy, dilatation, fibrosis, and dysfunction are not confined to the LV only. The left atrium (LA) is also affected by this remodeling process. LA dilatation and dysfunction have been studied in several trials, revealing their prognostic value in patients with CKD (5, 6). Miao Y et colleagues (7) used two-dimensional speckle tracking imaging to assess concurrently LA and LV function changes induced by HD in ESRD patients. The authors demonstrated LV and LA remodeling in ESRD patients compared to controls (increased LV wall thickness, LV volumes and LA volume), with higher rates of diastolic dysfunction and elevated filling pressures measured by E/E’ ratio, but LV systolic performance, assessed by LV ejection fraction (LVEF) and LV Global Longitudinal Strain (LVGLS) similar to controls. Further assessment of LA function indices [reservoir (LASr), conduit (LAScd) and contractile (LASct) strain], demonstrated significantly baseline reduced LA strain values, compared to controls, and further reduction of LASr and LAScd after HD. LASct remained stable without further deterioration after HD (7).This elegant study included a control group to compare the left heart strain values between patients with ESRD and healthy subjects and delineated the undeniable remodeling of both left heart chambers (7). Although the baseline echocardiographic parameters used for LV systolic function assessment (LVEF, LVGLS) did not differ between controls and ESRD patients in this study, previously published trials have shown that ESRD patients have impaired LVGLS (8) and myocardial work indices (9, 10). Furthermore, there is consensus in literature, that these patients have diastolic dysfunction expressed by increased LA volume and E/e’, findings relevant to the LV remodeling with wall thickening and increased filling pressures. A more sensitive marker of diastolic dysfunction in HF, irrespective of LVEF, is the LA strain (11) that has already proven its prognostic role in ESRD patients (6). However, clinicians and researchers need to be careful, as the three different LA strain parameters, reflect different properties of LA and LV and are related to volume status. More specifically, LASr expresses LA pressure and/or LA stiffness. LAScd reflects LV relaxation and/or LV pressure in early diastole, while LASct is indicative of LV compliance, LV end-diastolic pressure and/or LA contractility (5). LA strain is load-dependent and previous research has demonstrated that it is more accurate in depressed EF rather than in normal and if we are about to be specific for increased LV filling pressures, we need to use the LASr<18% as a cut-off value (12).The changes induced by HD in strain-related parameters of LV and LA, are explained by their pre- and after-load dependency. LVGLS was decreased after HD due to decrease of preload and afterload (decreased systolic blood pressure), decrease of LV end-diastolic volume and myocardial stunning and troponin release (13). The inclusion of myocardial work (MW) analysis in the echocardiographic assessment of these patients, can help in the clarification of the cause of LVGLS change after HD (9). Myocardial work includes the afterload of the patient by measuring the blood pressure with a simple brachial cuff and it is less-load dependent than GLS. A meta-analysis for LV strain evaluation showed reduction of LV GLS when afterload is increased, which may lead to false conclusions about the LV performance (14). In HD patients, reduction of both LVGLS and MW would suggest true deterioration of systolic performance, while reduction of GLS with increase of MW would detect blood pressure changes and not LV systolic impairment.LASr and LAScd components are decreased immediately after HD, confirming their load dependency, while LASct remains unchanged, being independent of volume status and preload (7). LASct mainly reflects LA systolic function and LV compliance (7), related to the disease progression. The effects of blood pressure changes induced by HD, are not included in the assessment of LA function. A less-load dependent marker of LA function, maybe similar to LV MW (namely “LA Myocardial Work”), taking into account volume and pressure changes, would be more sensitive in detecting acute LA cardiomyopathy and diastolic dysfunction in ESRD patients after HD. Research should be done in that way, including large series of healthy subjects first and patients as well with different stages of diastolic and systolic dysfunction. If such marker is developed, this will detect definitely atrial myopathy in different populations with applicability in CKD patients. The current application of MW is validated for LV function and with afterload involvement only (15). No preload data or increased LV diastolic pressures are included into the equation. This method looks promising for accurate evaluation of the true LV work, but more research should be done in different populations.In concluding, LV GLS and LA strain are sensitive markers that can detect subclinical LV dysfunction and atrial myopathy but with the restrictions of load and pressure dependency. Myocardial Work may further help discriminate the true impairment of the LV function in ESRD patients and can be included into the echocardiographic follow-up protocol of these patients (Figure). A new marker of LA function, independent from volume changes and LV filling pressures should be developed in order to detect subtle changes of LA function and possibly guide the treatment in this high-risk population.

(1) Background: Jiyuan 531 Project is a three-line construction constructed by the state from 1970 to 1975, which occupies a large area with complex and diverse types, but there is a lack of analysis of its landscape spatial pattern, and even a lack of ways to protect and update its utilization. (2) Methods: Through the national geographic information public service platform to collect its geographic coordinates and satellite images combined with on-site investigation and literature collection, the use of ArcGIS to analyze the horizontal and vertical distance measurement between the factory, living area, mountains, water system, villages, farmland. (3) Results: The overall spatial distribution pattern of “mountain-water-factory-village-cropland” is found to be embedded and cohesive, which reveals the “Peach Blossom Garden” landscape spatial imagery. (4) Conclusions: In the context of urban stock renewal, combined with the overall thinking system of Jiyuan urban development and construction, and with reference to other cases of excellent industrial heritage protection and utilization, three modes are proposed to explore the functional reorganization and structural optimization of the 531 industrial heritage, landscape protection and precise design at the macro, meso and micro levels, so as to realize the comprehensive benefits of the economy, society, culture and environment in the region.

Influenza circulation was significantly affected in 2020–21 by the COVID-19 pandemic. During this time, few influenza cases were recorded. However, in the summer of 2021–22, an increase in atypical influenza cases was observed, leading to the resurgence of influenza in the southernmost state of Brazil, Rio Grande do Sul (RS). The present study aimed to identify FLUAV, FLUBV, and SARS-CoV-2 circulation and characterize influenza genomes in suspected COVID-19 patients using high-throughput sequencing technology. Respiratory samples (n = 694) from patients in RS were selected between July 2021 and August 2022. The samples were typed reverse transcriptase real-time PCR (RT-qPCR) and showed 32.13% (223/694) of the samples to be positive for SARS-CoV-2, 7.06% for FLUAV (49/694). FLUBV was not detected. RT-qPCR data also showed 0.57% of the cases had FLUAV and SARS-CoV-2 co-infections. Whole genome sequencing of the FLUAV positive specimens produced 15 complete genomes of H3N2 subtype with phylogenetic placement in the 3C.2a1b.2a.2a.3 subclade. Mutation analysis showed 73 amino acid substitutions in addition to several nonsynonymous mutations. The detected percentage of FLUAV (7.06%) is relatively similar to the total number of flu cases requiring hospitalization in RS state (8.9%), including those admitted to intensive care units for severe complications. This study provides insights into influenza virus circulation in the south of Brazil during the Omicron wave of the COVID-19 pandemic and reinforces the importance of H3N2 as a major driver of severe respiratory disease in the region along with the SARS-CoV-2 Omicron wave at the beginning of 2022.

Abstract Background: Health workforce supply is critical to ensuring the delivery of essential healthcare, and may be enhanced via mechanisms which alter the scopes of practice of health professions. The aim of this paper is to study the collective perspectives of allied health decision-makers on factors which influence their development and implementation of advanced and extended scope of practice initiatives, and the timing/catalyst and application of their decision-making. Methods: A grounded-theory, qualitative study of the experiences of allied health directors and senior managers across two Australian jurisdictions. Results: Twenty allied health decision-makers met study eligibility criteria. Data coding of interview transcripts identified 14 factors specific to scope of practice change, spanning rational (n=8) and non-rational (n=6) decision-making approaches. Leadership, Governance, Organisational need, Resourcing, Knowledge & Skills – clinical, Supporting resources, Knowledge & skills – change and Sustainability were identified as being rational and enabling in and of themselves, with Leadership seen as being most influential. Comparatively, the non-rational factors of Socio-economic & political environment, Perceived patient need, Organisational environment, Change culture & appetite, Perceived professional territorialism and Actual professional territorialism were more varied, and primarily influenced the timing/catalyst and application of decision-making. Conclusion : Allied health decision-makers hold a complex, systems-level understanding of scope of practice change. Whilst rational decision criteria were predominant and seen to enable scope change, non-rational influences reflected greater variation in decision timing/catalyst and application, thus emphasising the human dimensions of decision-making. Further research is required to better understand how decision-makers integrate and weight decision-making factors to inform the development of structured decision tools.

Metal-doped nitrogen clusters serve as effective models for elucidating the geometries and electronic properties of nitrogen-rich compounds at the molecular scale. Herein, we have conducted a systematic study of VIB-group metal chromium (Cr) doped nitrogen clusters through a combination of mass spectrometry techniques and density functional theory (DFT) calculations. The laser ablation is employed to generate CrNn+ clusters. The results reveal that CrN8+ clusters exhibited the highest signal intensity in mass spectrometry. The photodissociation experiments with 266 nm photons confirm that the chromium heteroazide clusters are composed of chromium ions and nitrogen molecules. Further structural searches and electronic properties calculations of chromium-nitrogen clusters indicate that the cationic CrN8+ cluster is an X-shaped geometry with D2 symmetry exhibiting robust stability. Molecular orbital and chemical bond analyses demonstrate the existence of strong interactions between Cr+ cation and N2 ligands. The present findings enrich the geometries of metal doped nitrogen clusters and provide valuable guidance for the rational design and synthesis of novel transition metal nitrides.

Effectively enhancing the room temperature phosphorescence (RTP) emission of pure organic phosphors is the goal that scholars continue to pursue. In this study, as a novel strategy, diacetylene monomers were introduced into a pure organic molecule, 2-(9H-carbazol-9-yl) ethanol (CZEO). Upon UV-irradiation, the formed polydiacetylene (PDA) backbones caused a significant enhancement of the RTP emission. RTP emission was continuously enhanced with the time UV-irradiation. In addition, the synergistic enhancement with the help of halogen bonds was realized by introducing Br atoms into the CZEO unit.

The liver is one of the most important organs in the human body. It performs many important functions, including being responsible for the metabolism of most drugs, which is often associated with its drug-induced damage. Currently, there are no ideal pharmacological models that would allow the evaluation of the effect of newly tested drugs on the liver in preclinical studies. Moreover, the influence of hepatic metabolism on the effectiveness of the tested drugs is rarely evaluated. Therefore, in this work we present an advanced model of the liver, which reflects most of the morphologically and metabolically important features of the liver in vivo, namely: three-dimensionality, cellular composition, presence of extracellular matrix, distribution of individual cell types in the structure of the liver model, high urea and albumin synthesis efficiency, high cytochrome p450 activity. In addition, the work, based on the example of commonly used anticancer drugs, shows how important it is to take into account hepatic metabolism in the effective assessment of their impact on the target organ, in this case cancer.

Objective Caesarean section (CS) rates are increasing in Sri Lanka. More than half of births will occur through CS by 2025. CS should be medically indicated to reduce maternal morbidity. Robson classification is useful in assessing the indications for CS. It is difficult to obtain high-quality prospective data using traditional data collection methods. We intend to assess the use of new technology for this purpose. Design A prospective audit, comparing smart phone app based data collection with the previous studies. Setting Professorial unit De Soysa Hospital for Women (DSHW) in Sri Lanka Study population 1712 deliveries were taken for the study from April to October 2019 Methods We used the RobsApp® which is a newly developed smart phone application for prospective data collection according to the Robson classification. This data is compared with Robson standards and previous traditional data collection methods. Outcome measures The caesarean section rates according to each Robson category and data quality. Results The quality of data gathered matched the recommendations by Robson guidance. The overall CS rate was 33.0%. Majority of the CS were carried out for Robson category 5a. Breech presentation accounted for 11.6% of CSs. Emergency CS contributed to 49.6% with CTG abnormalities being the most frequent indication. Conclusions RobsApp® is a convenient method for prospective data collection which allows achievement of the data quality recommended by the Robson guidance. The CS rates are rising in professorial unit DSHW. Increasingly CS are being performed for reasons other than for past sections.

The coupling between the magnetosphere and solar wind contributes to the energy, momentum, and mass transfer between the systems. However, geomagnetic pulsations facilitate the continuation of this process in the magnetosphere and the production of discrete auroral arcs. Therefore, remote-sensing the magnetospheric conditions. Data analytics with machine learning (ML) gives insight into scalability, adaptability, and feature extraction compared to traditional empirical models. The availability of big data in the Svalbard network spanning 25years from 1996 motivated the current study. Hence, we present the forecasting of auroral Pc5 pulsations from solar wind parameters using the ML technique. In the training phase, there was a regression of 0.75 and MSE=11.90 nT2. The relationship between Pc5 forecast and observations in low and high geomagnetic activity and solar activity showed good consistency with R=0.76 and MSE= 11.4 nT2. For instance, the model adapted well to the St. Patrick geomagnetic storm of March 17th, 2015 despite uncertainties in the data. In addition, the model also adapted well with stunning performance in all Svalbard observatories with HOP leading with 6949 prediction events and NAL with the least. Thus, this was consistent with previous studies in terms of Pc5 pulsations latitudinal or L-shell dependence. Finally, validation with Kp and F10.7 indices presented excellent coherence between the models. Overall, The ML studied the connection between solar wind and interplanetary magnetic field properties to the ground magnetic field perturbations with good correlation results. Hence, the model will be fit for use by the magnetospheric community for space weather studies.

A large and growing corpus of epidemiologic studies suggests that the population-level burden of pediatric FA is not equitably distributed across major sociodemographic groups, including race, ethnicity, household income, parental educational attainment, sex). As is the case for more extensively studied allergic disease states such as asthma and atopic dermatitis) epidemiologic data suggest that FA may be more prevalent among certain populations experiencing lower socioeconomic status (SES), particularly those with specific racial and ethnic minority backgrounds living in highly urbanized regions. Emerging data also indicate that these patients may also experience more severe FA-related physical health, psychosocial and economic outcomes relating to chronic disease management. However, many studies that have identified sociodemographic inequities in FA burden are limited by cross-sectional designs that are subject to numerous biases, which can reduce the epidemiologic utility of the resulting estimates. Compared to cross-sectional study designs or cohorts that are recruited during childhood, birth cohorts can offer advantages relative to other study designs when investigators seek to understand causal relationships between exposures occurring during the prenatal or postnatal period and the atopic disease status of individuals later in life. Numerous birth cohorts have been established across recent decades, which include evaluation of food allergy-related outcomes, and a subset of these also have measured sociodemographic variables that, together, have the potential to shed light on the existence and possible etiology of sociodemographic inequities in food allergy. This manuscript attempts to survey the current state of this birth cohort literature and draw insights regarding what is currently known, and what further information can potentially be gleaned from thoughtful examination and further follow-up of ongoing birth cohorts across the globe.

We study the nonlinear coupling of kinetic Alfv\’{e}n waves with ion acoustic waves applicable to the Earth’s radiation belt and near-Sun streamer belt solar wind using dynamical equations in the form of modified Zakharov systems. Numerical simulations show the formation of magnetic field filamentary structures associated with density humps and dips which become turbulent at later times, redistributing the energy to higher wavenumbers. The magnetic power spectra exhibit an inertial range Kolmogorov-like spectral index value of \(-5/3\) for \(k_\perp\rho_i < 1\), followed by a steeper dissipation range spectra with indices \(\sim -3\) for the radiation belt case and \(\sim-4\) for the near-Sun streamer belt solar wind case, here \(k_\perp\) and \(\rho_i\) represent the wavevector component perpendicular to the background magnetic field and the ion gyroradius, respectively. Applying quasilinear theory in terms of the Fokker-Planck equation in the region of wavenumber turbulent spectra, we find the particle distribution function flattening in the superthermal tail population which is the signature of particle energization and plasma heating.

In most large-scale MHD models of Earth’s space environment, coupling between the magnetosphere and the ionosphere-thermosphere (IT) is addressed by representing the latter as a two-dimensional spherical shell. Similarly, most empirical models of IT electrodynamics are based on solving the height-integrated ionospheric Ohm’s law on a spherical shell. We show that there is in general no single suitable definition of the neutral wind term in high-latitude, height-integrated IT electrodynamics. Instead, two neutral wind terms weighted by Hall and Pedersen conductivities appear. We show that a commonly used expression for Joule heating in terms of height-integrated quantities is a lower bound of the actual Joule heating. Using neutral wind profiles derived from sounding rocket chemical release experiments near Poker Flat, Alaska, and Poker Flat Incoherent Scatter Radar (PFISR) measurements, we find differences of order 10–100 m/s between the two neutral wind terms.