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

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

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

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

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

A document by Evan Cantor. Click on the document to view its contents.

Decentralized cryptocurrency systems, known as blockchains, have shown promise as an infrastructure for mutually distrustful parties to securely agree on transactions. Nevertheless, blockchain systems are constrained by the CAP Trilemma. Due to performance degradation, it is impossible to address this issue by improving simply the consensus layer or the network layer. To alleviate the CAP constraint in consortium blockchains, we propose a topological construction method to optimize the physical layer based on multi-dimensional hypercubes with excellent partition tolerance in probability. The basic topology has the advantage of solving the mismatch problem between the overlay network and the underlying network. It is further extended to hierarchical recursive topologies with more intermediate links or short links to balance the reliability requirement with the cost of building the physical network. We prove that the proposed hypercube topology has better partition tolerance than the regular rooted tree and ring lattice topologies, and effectively fits the upper-layer protocols at the consensus and network layers. As a result, combined with suitable transmission and consensus protocols that satisfy strong consistency and availability, the proposed topology-constructed blockchain can reach the CAP guarantee bound.

Background International consensus statements on depression and anxiety in adolescents and adults with CF recommend assessment for comorbid substance misuse. However, at CF centers, the frequency and impact of substance misuse have not been well characterized, and best practices for prevention, identification, and evidence-based treatment have not been routinely implemented. Methods Medical records of 148 adults with CF over 3 years were reviewed to determine the prevalence of substance misuse (alcohol or opiates) and its relationship with clinical variables and healthcare utilization. Independent-sample t-test for continuous outcomes and chi-square test for binary outcomes were used to compare groups with and without substance misuse. Results Substance misuse was documented in 28 (19%) adults with CF, equally distributed between alcohol (n=13) and opiates (n=15). Adults with substance misuse were more likely to be male. The prevalence of diagnosed anxiety and depression did not differ significantly between groups, but those with substance misuse had more severe anxiety (GAD-7: 10.0±6.1 vs. 3.3±4.4; p<0.001) and depressive symptoms (PHQ-9: 10.4±6.5 vs. 4.0±4.8; p<0.001). Adults with substance misuse had higher annual rates of missed outpatient CF visits and inpatient hospitalizations, with hospital admissions of longer mean duration. Conclusions In adults with CF, substance misuse is common and is associated with adverse indicators of emotional and physical health and service utilization, suggesting that systematic approaches to addressing substance misuse in CF clinics should be considered. Prospective, longitudinal study is warranted to elucidate the complex relationships between depression, anxiety, substance misuse, and health outcomes in individuals with CF.

Unperceived button battery ingestion in infants may be associated with significant morbidity, especially when medical assistance is restricted.

The interaction of recent orographic uplift and climate heterogeneity acted as a key role in the East Himalaya-Hengduan Mountains (EHHM) has been reported in many studies. However, how exactly the interaction promotes clade diversification remains poorly understood. Here, we both studied genetic structure of the chloroplast trnT-trnF region and 11 nuclear microsatellite loci in Hippophae gyantsensis and examined what role geological barriers or ecological factors play in the spatial genetic structure. The results showed that this species had a strong east-west phylogeographic structure, with several mixed populations identified from microsatellite data in central location. The intraspecies divergence time was estimated to about 3.59 Ma, corresponding well with the recent uplift of the Tibetan Plateau. Between the two lineages there was significant climatic differentiation without geographic barriers. High consistency between lineage divergence, climatic heterogeneity and Qingzang Movement demonstrated that climatic heterogeneity but not geographic isolation drives the divergence of H. gyantsensis, and the recent regional uplift of the QTP, as the Himalayas, create heterogeneous climates by affecting the flow of the Indian monsoon. The east group of H. gyantsensis experienced population expansion c. 0.12 Ma, closely associated with the last interglacial interval. Subsequently, a genetic admixture event between east and west groups happened at 26.90 ka, a period corresponding to the warm inter-glaciation again. These findings highlight the importance of the Quaternary climatic fluctuations in the recent evolutionary history of H. gyantsensis. Our study will improve the understanding of the history and mechanisms of biodiversity accumulation in the EHHM region.

Gestational surrogacy for women with recurrent pregnancy loss due to refractory chronic histiocytic intervillositis: Research Letter

Granular parakeratosis is an acquired keratinization disease. We describe the unusual presentation of granular parakeratosis. A 27-year-old healthy female presented with multiple erythematous and brown discoloration plaques on the dorsal aspect of her hands for eight months. Repeated washing, using detergents, and maceration of the skin could develop her lesion.

Hepatitis E virus (HEV) is transmitted via the fecal-oral route and can cause chronic infection in immunocompromised individuals. A 23-year-old man with no medical history visited our hospital after testing HEV positive during blood donation. Although he did not develop acute hepatitis, HEV IgA remained positive for over eight months.

DectiSomes are anti-infective drug-loaded liposomes targeted to pathogenic cells by pathogen receptors including the Dectins. We have previously used C-type lectin (CTL) pathogen receptors Dectin-1, Dectin-2, and DC-SIGN to target DectiSomes to the extracellular oligoglycans surrounding diverse pathogenic fungi and kill them. Dectin-3 (a.k.a. MCL, CLEC4D) is a CTL pathogen receptor whose known cognate ligands are partly distinct from other CTLs. We expressed and purified a truncated Dectin-3 polypeptide (DEC3) comprised of its carbohydrate recognition domain and stalk region. We prepared amphotericin B (AmB)-loaded pegylated liposomes (AmB-LLs) and coated them with this isoform of Dectin-3 (DEC3-AmB-LLs), and we prepared control liposomes coated with Bovine Serum Albumin (BSA-AmB-LLs). DEC3-AmB-LLs bound to the exopolysaccharide matrices of Candida albicans, Rhizopus delemar (f.k.a. R. oryzae), and Cryptococcus neoformans from one to several orders of magnitude more strongly than untargeted AmB-LLs or BSA-AmB-LLs. The data from our quantitative fluorescent binding assays were standardized using a CellProfiler program, AreaPipe, that was developed for this purpose. Consistent with enhanced binding, DEC3-AmB-LLs inhibited and/or killed C. albicans and R. delemar more efficiently than control liposomes, which significantly reduced the effective dose of AmB. In conclusion, Dectin-3 targeting has the potential to advance our goal of building pan-antifungal DectiSomes.

A document by E. Heist. Click on the document to view its contents.

Stony coral tissue loss disease (SCTLD) remains an unprecedented disease outbreak due to its high mortality rate and rapid spread throughout Florida’s Coral Reef and wider Caribbean. A collaborative effort is underway to evaluate disease intervention strategies that mitigate the spread of SCTLD across coral colonies and reefs. We conducted an in-situ experiment in Southeast Florida to assess molecular responses among SCTLD-affected Montastraea cavernosa pre- and post-application of the most widely-used intervention method, CoreRx Base 2B with amoxicillin. Through Tag-Seq gene expression profiling of apparently healthy, diseased, and treated corals, we identified modulation of metabolomic and immune pathways following antibiotic treatment. In a complementary ex-situ disease challenge experiment, we exposed nursery-cultured M. cavernosa and Orbicella faveolata fragments to SCTLD-affected donor corals to compare transcriptomic profiles among clonal individuals from unexposed controls, those exposed and displaying disease signs, and corals exposed and not displaying disease signs. Suppression of metabolic functional groups and activation of stress gene pathways as a result of SCTLD exposure were apparent in both species. Amoxicillin treatment led to a ‘reversal’ of the majority of gene pathways implicated in disease response, suggesting potential recovery of corals following antibiotic application. In addition to increasing our understanding of molecular responses to SCTLD, we provide resource managers with transcriptomic evidence that disease interventions with antibiotics appear to be successful and may help to modulate coral immune responses to SCTLD. These results contribute to feasibility assessments of intervention efforts following disease outbreaks and improved predictions of coral reef health in Southeast Florida.

Seasonal dietary shifts of animals are important ecological adaptation strategies. An increasing number of studies have shown that seasonal dietary shifts can influence or even determine the composition of gut microbiota. The turpan wonder gecko Teratoscincus roborowskii lives in extreme desert environments, which have flexible dietary shift to fruit-eating in warm seasons. But the impact of such shifts on gut microbiota is poorly understood. Here, 16SrRNA sequencing and LC-MS metabolomics we used to examine the changes of gut microbiota composition and metabolic pattern of T. roborowskii. The results demonstrated that the gut microbes of T. roborowskii had significant seasonal changes, the diversity and abundance of gut microbiota in autumn were higher than those of in spring. Firmicutes, Bacteroidetes and Proteobacteria were the core gut microbes of T. roborowskii. Verrucomicrobia and Proteobacteria exhibit dynamic pattern of ebb and flow between spring and autumn.The composition and structure of gut microbes in different seasons perform specific metabolic functions, and this change may be an important adaptation for T. roborowskii to cope with dietary shifts and improve energy acquisition. Our study will provide a theoretical basis for exploring the adaptive evolution to special frugivorous behavior of the T. roborowskii, which is an important supplement to the study of the gut microbiology of desert lizards.

Environmental DNA (eDNA) metabarcoding has gained growing attention as a strategy for monitoring biodiversity in ecology. However, taxa identifications produced through metabarcoding require sophisticated processing of high-throughput sequencing data from taxonomically informative DNA barcodes. Various sets of universal and taxon-specific primers have been developed, extending the usability of metabarcoding across archaea, bacteria, and eukaryotes. Accordingly, a multitude of metabarcoding data analysis tools and pipelines have also been developed. Often, several developed workflows are designed to process the same amplicon sequencing data, making it somewhat puzzling to choose one amongst the plethora of existing pipelines. However, each pipeline has its own specific philosophy, strengths, and limitations, which should be considered depending on the aims of any specific study, as well as the bioinformatics expertise of the user. In this review, we outline the input data requirements, supported operating systems, and particular attributes of thirty-one amplicon processing pipelines with the goal of helping users to select a pipeline for their metabarcoding projects.