Comparing cases of parasitism and predation that lead to victim death, parasites need more time to complete victim exploitation. This longer “interaction durability” delays energy transfer from host to parasite. During exploitation, parasite virulence differentiates the infected from the susceptible host dynamics. However, how this parasite characteristic influences the dynamics of their host and nonhost (insusceptible) species in the same community is largely unknown. Here, we use mathematical modelling to investigate the influence, exemplifying an experimental plankton community. In this community, nonhost zooplankton feeds on edible nonhost phytoplankton (resource competitor of the host) and parasite propagules released from infected inedible phytoplankton (“mycoloop” pathway). To assess the effects of parasite-host durability, we contrast parasite-host implementations as Lotka-Volterra predator-prey interaction (immediate energy transfer) with susceptible-infected (SI) host-parasite interactions. For the latter, parasite energy intake depends on infected host density but not susceptible hosts directly (delayed transfer). We further consider the difference between susceptible and infected host dynamics modulated by parasite virulence via its effect on host nutrient uptake. To assess the within-community effects, subcommunities are also investigated, excluding/including the parasite without/with the mycoloop. Our results show that, besides host elimination, longer interaction durability of the host-parasite interaction delays parasite attacks on susceptible hosts, allowing them to increase further (a hydra effect), independent of parasite virulence level. This effect observed in the isolated host-parasite systems is preserved in larger communities with negative consequences for the nonhost species, independent of the mycoloop. These theoretical results are supported by empirical observations within and beyond plankton realms. Our study reveals distinctive influences of parasites on community shot-term dynamics, which stem from the longer interaction durability.

Multidisciplinary treatment with adjunctive orthodontics, surgical crown lengthening, and esthetic rehabilitation

Key clinical Message:We present a patient who incurred strokes on two different factor Xa inhibitors and was successfully treated with a direct thrombin inhibitor and discuss the literature on switching to an anticoagulant with a different mechanism of action in case of failure. There is limited research on this common scenario.

Hundreds of experiments conducted over the last decades demonstrate a positive relationship between species diversity and ecosystem functions. Following good experimental practice, most of these studies have manipulated species richness artificially by assembling communities randomly. Yet, natural communities along ecological gradients often show niche-based responses to selection gradients and species extinction order is generally not a random process. Such responses are commonly trait-mediated and the effects of communities on ecosystems’ functions also depend on species traits. In an effort to disentangle the relationship of trait mean value and diversity with ecosystem functioning, we revisited a community assembly mesocosm experiment that simulated habitat heterogeneity and a typical gradient of productivity to test how body size diversity and composition of cladocerans responded to such gradients and whether and how such trait responses impacted top-down control of unicellular algae, a key ecosystem function in aquatic systems. Nutrient addition and habitat heterogeneity lead to an increase in community average size (CAS), which ultimately resulted in an increased zooplankton resource use efficiency (RUEZP). This increase in CAS acted as a buffer for ecosystems functions despite the decline in species richness under high phosphorus levels. Habitat heterogeneity also increased size diversity (SD) and species richness (S) and modified CAS and SD responses along the nutrient gradient. CAS proved to be more powerful in explaining variation in RUEZP than SD and S. Our results suggest that exploring the response of the mean value of a key trait, such as zooplankton body size, to eutrophication might offer a much better understanding of variations in the top-down control of algae compared to relying solely on taxonomic and functional diversity metrics.

Postpartum placental choriocarcinoma is a rare gestational trophoblastic tumor with an incidence of approximately 1 in 50,000. Patients often present with persistent postpartum hemorrhage, leading to potential delayed diagnosis, hematogenous metastasis, and ultimately, poor prognosis. We report a successful case of early diagnosis and timely administration of FAV chemotherapy for 5 cycles in a patient with postpartum choriocarcinoma following cesarean section. During the follow-up period, the patient’s serum β-hCG levels normalized, and imaging lesions resolved completely. Introduction: Pregnancy-related causes must always be ruled out in women of childbearing age who present with irregular vaginal bleeding, even in the postpartum and lactation periods. In patients with postpartum bleeding, vigilance should be heightened to rule out the possibility of pregnancy-related sertoli cell tumor. We describe a woman with irregular vaginal bleeding after childbirth who was eventually diagnosed with postpartum choriocarcinoma.

Objective To evaluate costs and cost-effectiveness to the healthcare system, and costs to families, of a national prenatal exome sequencing (pES) service additional to standard testing, compared to standard testing alone. Design A cost-effectiveness analysis combining costs, outcomes, parent and professional interview and professional survey data. Setting The English National Health Service (NHS) Genomic Medicine Service. Sample 413 cases referred for pES testing from 01/10/2021 to 30/06/2022. Methods We costed the incremental resource required to deliver the pES clinical pathway, synthesising this with unit costs and outcomes data on additional cases diagnosed to analyse cost-effectiveness. We estimated the annual NHS budget requirement based on case numbers. We determined parental costs from interviews. Main Outcome Measures Incremental costs of pES to the NHS and families, incremental cost per additional diagnosis, NHS budget impact. Results Of 413 referred cases, 241 were tested, at a cost of £2,331 (95% credibility interval £1,894-£2,856) per referred case, or £3,592 (£2,959-£4,250) per case that proceeded with testing. The incremental cost per diagnosis (yield 35.3%) was £11,326 (£8,582-£15,361). At current demand levels pES costs the NHS approximately £1.7m annually. Family costs could not be separated from other pregnancy related appointments but were not considered burdensome as most appointments were concurrent or remote. Conclusions pES is more expensive than predecessor prenatal genetic testing technologies, has a higher diagnostic yield and informs pregnancy management and decision making. Further research into potential savings from the foregone diagnostic odyssey resulting from pES may be informative.

Public health transformation aims to instigate enduring changes in healthcare services, staff roles, and patient involvement, fostering heightened satisfaction among patients and staff while bolstering financial sustainability. This scoping review maps evidence of public health transformation. Searches encompassed databases including EBSCOHost, Academic Search Complete, Africa-Wide Information, Dentistry & Oral Sciences Source, Health Source - Consumer Edition, Health Source: Nursing/Academic Edition, PUBMED, and Scopus. Abstracts and full-text articles were screened by two independent reviewers against predefined criteria. Inclusion criteria spanned peer-reviewed articles in all languages published between 2013 and 2023. The quality of the included studies was assessed using the 2018 version of the mixed method appraisal tool. Screening results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA ScR) guidelines. Of 9509 articles retrieved, 808 duplicates were excluded, leaving 8692 for title and abstract screening. Following title and abstract screening, 105 articles were deemed relevant and underwent full article screening, which resulted in 20 that became eligible for data extraction. Emergent themes included: 1) Transformation in Public Healthcare; 2) Evaluation of Health Transformation Programs; 3) Financial Implications; 4) Public Health Access; and 5) Job Satisfaction. Theme 4 featured a subtheme addressing healthcare access for minority groups. Overall, the review highlights a dearth of evidence guiding policymakers in decision-making on public health transformation, oversight of vulnerable populations, financial implications, and healthcare accessibility. Solutions should prioritize a people-centered approach in both practice and research to effectively address these gaps.

Background Toxoplasmosis has public health importance, particularly in immunocompromised individuals such as pregnant women leading to congenital abnormalities and fetal losses. In this study, we aimed to determine the sero-prevalence of toxoplasmosis in sheep at Mandeeq Slaughter House in Hargiesa and pregnant women attending antenatal care at Hargiesa Group Hospital. Methods Cross-sectional study design with systematic random sampling method and Questionnaire surveys were used for the collection data from sheep and pregnant women. Sera were collected and examined for anti- Toxoplasma gondii antibodies using latex agglutination test. Results The overall prevalences of toxoplasmosis were 25.5% and 28% in sheep and human, respectively. Multivariable logistic regression analysis indicated that female (AOR = 2.18; 95% CI: 1.38 - 3.47; p = 0.001) and young age groups of sheep (AOR = 3.04; 95% CI: 1.04-8.86; p = 0.041) were significantly associated with Toxoplasma gondii sero-positivity. In pregnant women, age groups between 25-34 (AOR = 2. 76; 95% CI: 1.07 - 7.14; P = 0.037), pregnant women who have cats in their home (AOR = 6.45; 95% CI: 2.37-17.52; P = 0.000), women who have close contact with garden soil (AOR = 6.74; 95% CI: 2.55-17.81; P = 0.000), poor hand washing practices before food eating (AOR = 29.5; 95% CI: 5.41– 161.11; P= 0.000) and drinking tap water (AOR = 8.4; 95% CI: 2.54 – 28.08; P = 0.000) were significantly associated with Toxoplasma gondii sero-positivity. Conclusion This is the first report regarding to toxoplasmosis in Hargeisa, where pregnant women should avoid eating uncooked mutton and close contact with cats besides good hygienic practices related to food handling.

More species-rich communities are often assumed to contain more specialist species, typically characterized by narrower niche breadths or smaller ranges. Stronger interspecific competition in species-rich communities is thought to be a key mechanism explaining these patterns. Yet, the relationship between richness and specialization has so far only been studied for a few taxa, and characterizing the effects of interspecific competition on species niches and distributions is challenging. Thus, it remains unclear how general richness-specialization relationships are. Here, we assess relationships between specialization and interspecific competition along richness gradients of bats across four understudied global biodiversity hotspots. Using a novel, integrated species distribution modeling approach that combines expert range maps and occurrence records of 49 bat species, we produced fine-scale distribution and species richness maps, allowing us to assess environmental niche breadth and range sizes. Further, contrasting potential ranges obtained from traditional distribution models with realized ranges obtained through the integration of expert ranges, we assessed range filling and derived indicators of geographic exclusion that characterize how interspecific competition is limiting species' ranges. Our results highlight that the narrowest niche breadths and strongest geographic exclusion occur in species-poor, not species-rich bat communities, in contrast to what was found for other taxa. While niche breadth peaked at intermediate richness, range sizes decreased continuously with richness. These findings show that increasing bat species richness is not closely linked to environmental specialization across the entire richness gradient and that decreasing range sizes in species-rich communities could be driven by the number of interacting species, rather than by environmental specialization or individually stronger interactions. Our study shows how innovative distribution modeling approaches can shed new light on the interplay of species richness, interspecific competition, and community structure. More generally, our findings caution against generalizing relationships between richness and specialization across taxa and geographies.

Understanding the drivers of spatially and temporally correlated (synchronous) fluctuations in abundance is a fundamental challenge in ecology and conservation. Synchronous fluctuations in different demographic rates can potentially drive or dampen abundance synchrony, but demographic synchrony is generally poorly understood. Using long-term count and demographic data for breeding land-birds at sites across Europe, we show that the strength and scale of synchrony are greatest in productivity, followed by adult survival rates and then counts. However, count fluctuations are more synchronous with survival than with productivity. Despite migratory and resident species having similar periodicities of count synchrony, synchrony in both demographic rates was more common over long-timescales in resident species and short-timescales in migrant species. These findings suggest local impacts of synchronous fluctuations in adult survival rates on count synchrony, potentially dampening effects of large-scale synchrony in productivity, and that the environmental drivers of synchrony may differ between residents and migrants.

Flagship species are used to promote conservation and tourism. Africa’s famous ‘Big Five’, have become marketing flagships that fundraisers and tourism promoters emulate on other continents, choosing regional groups of species for marketing campaigns. Selections can be based on characteristics identified as appealing: colour, size, or behaviour, but this approach may overlook unique flagships or homogenise seelctions. Polling the public to reveal existing preferences for animals may identify suitable species more directly. We used questionnaires with tourists in the Peruvian Amazon to identify existing biases for species suitable for tourism and conservation marketing. Without a species list, preferences were expressed at inconsistent taxonomic levels. The response ‘monkeys’ (infraorder Simiiformes) was highest ranked, followed by ‘jaguar’ (Panthera onca), ‘Amazon dolphin’ (Inia geoffrensis), ‘sloths’ (suborder Folivora), ‘caiman’ (subfamily Caimaninae) and ‘birds’ (class Aves). When ranking species from a preselected shortlist, jaguar, Amazon dolphins, and sloths (represented by Bradypus variegatus) remained popular, while vote splitting within higher taxonomic levels, in particular monkeys, made room in the top rankings for green-winged macaw (Ara chloropterus) and anaconda (Eunectes murinus). When asked about their willingness to pay for excursions or donate to conservation, tourists were overwhelmingly more likely to quote larger figures to see or conserve jaguars than any other species, but results for other species were more homogenous. Important species for tourism in rainforest regions are often from diverse taxonomic groups; monkeys may be represented by 8-14 species at single sites in Amazonia, birds by several hundred species. A big five strategy obscures this diversity. Similarly, using physical characteristics as selection criteria underplays diversity and can overlook popular taxa. A strategy of polling the public to identify regional flagships more directly identifies salient species for marketing and is especially useful where budgets are limited, but diversity may trump the Big five approach in megadiverse areas.

Ramaria has been a remarkable taxon throughout the history of macrofungi. However, there is a lack of information on these macrofungi. This study determined the order of nucleotides in the mitochondrial genomes (mitogenomes) of three Ramaria species, followed by a detailed investigation of the obtained genetic information. Circular mitogenomes of Ramaria brunnecliacina, R. ichnusensis, and R. flavescens had sizes of 78,960, 61,851, and 81,282 bp, respectively. The genomes exhibited variations in genetic content, gene length, tRNA, and codon usage. Ramaria mitogenomes demonstrated variable evolutionary rates across several protein-coding genes. Results revealed significant gene rearrangements in Ramaria mitogenomes, including gene displacement and tRNA duplication. Bayesian inference and maximum likelihood methods, yielded well-supported phylogenetic trees for Basidiomycota. Phylogenetic analysis, using a comprehensive collection of conserved mitochondrial proteins, yielded a strong and reliable phylogenetic tree for Basidiomycetes, which clarified the evolutionary connections between Ramaria and other Basidiomycetes members. R. brunnecliacina and R. flavescens were identified as closely related species. Species of Ramaria, a paraphyletic group, exhibited a close genetic relationship with other species belonging to the subclass Phallomycetidae. This study presents a basic structure for understanding the evolutionary dynamics, genetic makeup, and taxonomy categorization of this significant fungal community.

Background With the rapid development of artificial intelligence technology, highly intelligent and unmanned factories have become an important trend. In the complex environments of smart factories, the long-term tracking and inspection of specified targets such as operators and special goods, as well as comprehensive visual recognition and decision-making capabilities throughout the whole production process, are critical components of automated unmanned factories. It is inevitable that issues such as target occlusion and disappearance will occur, thus exacerbating the long-term tracking challenge. Currently, there are no long-term tracking studies specifically addressing occlusions in these environments. Methods We first construct three new benchmark datasets in the complex workshop environment of a smart factory (referred to as SF-Complex3 data), which include challenging conditions such as complete occlusion and partial occlusion of targets. Next, utilising a brain memory inspired approach, we determine uncertainty estimation parameters: confidence, peak-to-sidelobe ratio (PSR), and average peak to correlation energy (APCE), to derive a continual learning based adaptive model update method. Additionally, we design a lightweight target detection model to automatically detect and locate targets in the initial frame and during re-detection. Finally, we integrate the algorithm with ground mobile robots and UAV-based imaging and processing equipment to build a new visual detection and tracking framework, termed SFC-RT (Smart Factory Complex Tracking and Identification). Results We conducted extensive tests on the benchmark UAV20L and SF-Complex3 datasets. Compared to state-of-the-art tracking algorithms, our proposed algorithm demonstrates an average performance improvement of 6% when facing key challenging attributes. Moreover, it can smoothly run on embedded platforms, including mobile robots and UAVs, at a real-time speed of 36.4 fps. Conclusions The proposed SFC-RT framework is shown to efficiently and accurately address the challenges of target loss and occlusion for long-term tracking within complex smart factory environments. It meets the requirements of real-time performance, robustness, and lightweight design.

Main ManuscriptKey Clinical Messages: This case report underlines the diagnostic problems of bilateral lung involvement caused by popcorn kernel aspiration in a 13-month-old infant. It emphasizes the importance of comprehensive clinical evaluation, chest x-ray interpretation, and understanding of the hazards of popcorn aspiration in young children to avoid misdiagnosis and complications.

An agricultural experimental setup has been constructed with the aim of assessing the impact of soil conservation practices on surface runoff and water quality. The site is located at Saint-Lambert-de-Lauzon (near Québec City, Canada) and is composed by twelve 624 m 2 catchments for which surface and tillage runoffs, water quality (suspended matter, phosphorus, nitrate-nitrite, dissolved metals), soil physical and chemical properties, and crop yields are monitored. The experimental design allows the comparison of four agricultural treatments: two compaction treatments (with and without soil compaction) and two conservation regimes (conventional and soil conservation agricultural practices), each regime being duplicated three times. Generalized Additive Mixed Model (GAMM) highlighted significant relations between the conservation regimes and suspended matter charges, and surface runoff. In other words, conservation practices allow a significant short-term reduction of suspended matter at the field scale. On the other hand, they appear to favour an increase of surface runoff in the springtime. Since only one three-year rotation cycle has been conducted, no effect was observed on soil properties, and crop yields. Long term impacts of soil conservation practices were estimated by implementing a physically based hydrologic model SWAT over each catchment. Restored soil properties were scenarized using measurements conducted over surrounding unperturbed sites. Modelling results suggest that a restoration of soil physical properties would translate into a moderate decrease surface runoff (-5%) at the field scale. The study brings an advanced and multidimensional understanding of the field-scale processes driving soil health, quantitative hydrology, and water quality. It also quantifies potential long-term benefits of implementing soil conservation practices.

As of today, TCP remains the de-facto transport protocol in the Internet. However, TCP may incur high delays, especially when retransmitting lost packets as they have to be retransmitted only by the source and after a timeout that is roughly equal to a round trip time. To reduce such delay, recent work [1–3] proposed to deploy a special network function, called Transport Assistant (TA), that is able to detect and retransmit lost TCP packets from inside the network rather than the source, and thereby, reduces retransmission delays. Unfortunately, there is no study on the impact of the placement of the TA on its performance benefits in terms of packet delivery delay. In this paper, we focus on the TA placement problem. We discuss the trade-offs and parameters to be considered to select the best placement for the TA. We first mathematically model the TCP packet delivery delay, i.e., the time needed to deliver TCP packets, when the TA is deployed. We also formulate, as an Integer Linear Program (ILP), the problem of placing multiple TAs in order to reduce TCP packet delivery delays while minimizing their deployment costs. We consider use-cases, one where a TA could handle a single flow and another where a TA could handle multiple flows. We then propose two heuristics to solve the problem with minimal execution time. Through experiments, we demonstrated that the deployment of TAs could reduce TCP packet delivery delays by up to 30% and could be leveraged to guide routing and load balancing. Moreover, we show that using the proposed heuristics for placing TAs could lead to performance that is close to optimal solutions obtained with the ILP but with lower execution time.

SARS-CoV-2, a positive-strand RNA virus, utilizes both genomic replication and subgenomic mRNA transcription. Whole genome sequencing (WGS) from clinical samples can estimate viral gene expression levels. We conducted WGS on 529 SARS-CoV-2 positive clinical samples from Assam and northeastern India to track viral emergence and assess gene expression patterns. Our results reveal differential expression across structural, non-structural, and accessory genes, with notable upregulation of the M gene, especially in the Omicron variant, followed by E and ORF6. The mean Transcript Per Million (TPM) expression levels of the M gene were significantly higher in Omicron variants (175611±46921), peaking in the KP.1/KP.2 sublineage (220493±34917), compared to the Delta variant (129717±33773). The relative fold change of M gene expression between Delta and Omicron 2024 subvariants showed a 1.6-fold change. Variant-wise gene expression analysis suggests a correlation between gene expression and viral mutation, impacting replication and transmission. As anticipated, the expression levels of genes surge with the increase in the virus mutation. The Chi-square trend for average substitution count vs. average TPM of the M gene was highly significant (72.78, p<0.0001). The M gene’s high expression and low mutation rate make it an ideal target for designing a real-time RT-PCR kit assay. These findings highlight the need for continuous surveillance and understanding of viral gene expression dynamics for effective COVID-19 management. Further studies are necessary to elucidate the significance of these observations in viral pathogenesis and transmission dynamics.

Aims: The primary objective was an evaluation of the correlation between the lymphocyte-to-C-reactive protein ratio (LCR) and the prevalence of overactive bladder (OAB) within the adult United States population. Methods: Data was collected from the National Health and Nutrition Examination Survey (2005‒2010), and involved a non-pregnant cohort aged ≥20 years of age, with available LCR index and OAB information. We employed weighted univariate and multivariate logistic regression to assess the link between LCR and OAB risk. Subgroup, examinations of interaction, and restricted cubic spline analyses were also performed. Results: In all, 13723 subjects were recruited for analysis. Among them, 14.99% exhibited OAB and the mean LCR value was 2.61±0.07. The OAB risk decreased with higher quartiles of LCR. In model 2, subjects in the highest LCR quartiles showed 48% (OR: 0.52, 95%CI: 0.38–0.71, P < 0.001) reductions in the OAB risk, relative to those in the lowest LCR quartiles. These negative associations were found to be independent of various factors, shown in the subgroup analyses and interaction tests. Additionally, based on the restricted cubic spline analyses, there was a negative, non-linear relationship between LCR and OAB risk.