Background: Currently, none of the diagnostic procedures for detecting female genital tuberculosis (FGTB) are 100 percent reliable, and the same is true for endoscopic results. There are several studies accessible on hysteroscopic and laparoscopic findings that are suggestive of TB. However, no study to our knowledge summarises the findings of laparoscopic and hysteroscopic examination in subfertile female patients with biopsy, culture, or other laboratory test-proven endometrial tuberculosis. Objective: Evaluation of hysteroscopic and laparoscopic findings in subfertile women suffering from proven endometrial tuberculosis. Materials and methods: 16,784 infertile women had a diagnostic hysterolaparoscopy between February 2014 and June 2021, among which 1084 patients were prescribed anti-tubercular medication based on the results of their findings; however, only 309 individuals had endometrial tuberculosis verified via positive on histopathology examination, AFB demonstration, Culture, and GeneXpert MTB/RIF. We retrospectively observed the diagnostic hysterolaparoscopy findings in those proven cases of subfertile women suffering from FGTB. Results: The major findings on hysteroscopy were periosteal fibrosis (209/309,67.63%), pale endometrium(179/309,57.92%), and micro polyp(138/309,44.66%). Other notable hysteroscopic findings were intrauterine adhesions (88/309,28.47%), endometrial tubercle (78/309,25.24%), endometrial polyp(54/309,14.88%), caseation(42/309,13.59%), focal hyperemia(29/309,9.38%) and diffuse hyperemia(18/309,5.82%). The most common finding on laparoscopy was abdominopelvic adhesions of various grades (297/309,96.11%). The major findings of laparoscopy were tubercle (155/309,50.16%), isthmo ampullary block (118/309,38.18%), tubal diverticula (116/309,37.54%), hydrosalpinx (97/309,31.39%) and TO mass (96/309,31.06%). 5.50% (17/300) had a normal appearance on hysteroscopy, and 1.29% (4/309) had a normal-looking pelvis on laparoscopy. Conclusions: In proven endometrial tuberculosis, significant hysteroscopic findings are periosteal fibrosis, pale endometrium, micro-polyp, and intrauterine adhesions, whereas major laparoscopic findings are various grades of abdominal pelvic adhesions, including perihepatic adhesions, miliary tubercle, isthmo ampullary block, tubal diverticula, caseous material, and hydrosalpinx. Tuberculosis should be considered if these signs are discovered during a diagnostic work-up in infertile people.

Although three-dimensional (3D) host is effective in restricting Li dendrite growth, problems associated with the unstable electrode/electrolyte interphase becomes more severe due to increased interfacial area that is intrinsic of the 3D structures, being a major cause for the low Coulombic efficiency.While building a desirable solid electrolyte interphase (SEI) serves as an effective solution to improve the electrode/electrolyte interfacial stability, the 3D nature of the electrode makes the task challenging.Herein,we demonstrated the in-situ formation of SEI on chemically/structurally modified carbon cloth that is used as the 3D host.We shown that ZnS/ZnO nanotube arrays uniformly grown on the carbon cloth served as precursors for the in-situ formation of Li2S/Li2O/LiZn containing artificial SEI. While Li2S and Li2O are preferred components in SEI, Zn functions as lithiophilic site that guides the uniform lithium deposition.The present work shed light on effective design strategies for SEI formation on 3D electrode host with controllable SEI composition.

A 41-year-old female patient was referred to the head and neck surgery department because of a large midline submandibular mass that was diagnostic for functioning thyroid tissue in a totally ectopic location.

The Nanling Mountains are an important mountain range and watershed in southcentral China. Because of the abundance in relictual plant species and geological stability throughout the Cenozoic, the mountains are considered a “museum” of subtropical biological diversity. With respect to birds, however, the roles of the Nanling Mountains in impeding the dispersal of the subtropical birds and, as a result, shaping their population and community structures have received little consideration. To examine these roles, we compiled and analyzed two datasets. (1) To test the mountains’ influence on gene flow, we undertook a population phylogeographic study comparing mitochondrial COI and Cytb DNA sequences of 5 sylvioid resident bird species of the mountains (Huet’s Fulvetta Alcippe hueti, Red-billed Leiothrix Leiothrix lutea, Greater Necklaced Laughingthrush Pterorhinus pectoralis, Indochinese Yuhina Staphida torqueola, and Mountain Bulbul Ixos mcclellandii). (2) To examine differentiated community development over the history of modern birds, we examined distributional data of all species of the Nanling region using public species occurrence records. For part (1), we sampled 327 individuals from 36 sites and conducted correlation analysis of genetic and geographic distances, taking into account the landscape of the mountains. We found that the mountains do not seriously impede gene flow among populations but influenced species differently. For part (2), comparative analysis of 446 species in 81 families indicated that family membership influenced the community composition of birds in Nanling region. Variation in family distributions is attributable to both environmental and evolutionary factors. Overall, we found that the Nanling Mountains are not currently a substantial barrier to gene flow among the species we studied but act as a corridor and refuge for these birds. However, analyses on higher ranked community data suggest the mountains acted as a barrier in older times, corresponding to the known diversification events in southeast Asian avifauna.

Anemia is one of the global public health challenges that particularly affect children and pregnant women. A study by WHO indicates that 42% of children below 6 years and 40% of pregnant women worldwide are anemic. This affects the world’s total population by 33%, due to the cause of iron deficiency. The non-invasive technique, such as the use of machine learning algorithms, is one of the methods used in the diagnosing or detection of clinical diseases, which anemia detection cannot be overlooked in recent days. In this study, machine learning algorithms were used to detect iron-deficiency anemia with the application of Naïve Bayes, CNN, SVM, k-NN, and Decision Tree. This enabled us to compare the conjunctiva of the eyes, the palpable palm, and the colour of the fingernail images to justify which of them has a higher accuracy for detecting anemia in children. The technique utilized in this study was categorized into three different stages: collecting of datasets (conjunctiva of the eyes, fingernails and the palpable palm images), preprocessing the images; image extraction, segmentation of the Region of Interest of the images, obtained each component of the CIE L*a*b* colour space (CIELAB). The models were then developed for the detection of anemia using various algorithms. The CNN had an accuracy of 99.12% in the detection of anemia, followed by the Naïve Bayes with an accuracy of 98.96%, while Decision Tree and k-NN had 98.29% and 98.92% accuracy respectively. However, the SVM had the least accuracy of 95.4% on the palpable palm. The performance of the models justifies that the non-invasive approach is an effective mechanism for anemia detection. Keywords: Iron deficiency, anemia, non-invasive, machine learning, data augmentation, algorithms, region of interest.

The purpose of this paper is to construct generating functions in terms of hypergeometric function and logarithm function for finite and infinite sums involving higher powers of inverse binomial coefficients. These generating functions provide a novel way of examining higher powers of inverse binomial coefficients from the perspective of these sums, assessing how several of these sums and these coefficients related to each other. A unique relation between the Euler-Frobenius polynomial and B-spline associated with exponential Euler spline is reported. Moreover, with the aid of derivative operator and functional equations for generating functions, many new computational formulas involving the special finite sums of higher powers of (inverse) binomial coefficients, the Bernoulli polynomials and numbers, Euler polynomials and numbers, the Stirling numbers, the harmonic numbers, and finite sums are derived. Moreover, A few recurrence relations containing these particular finite sums are given. Using these recurence relations, we give a solution of the problem which was given by Charalambides7, Exercise 30, p. 273. We give calculations algorithms for these finite sums. Applying these algorithms and Wolfram Mathematica 12.0, we give some plots and many values of these polynomials and finite sums.

Reliably scoring and ranking candidate models of protein complexes and assigning their oligomeric state from the structure of the crystal lattice represent outstanding challenges. A community-wide effort was launched to tackle these challenges. The latest resources on protein complexes and interfaces were exploited to derive a benchmark dataset consisting of 1677 homodimer protein crystal structures, including a balanced mix of physiological and non-physiological complexes. The non-physiological complexes in the benchmark were selected to bury a similar or larger interface area than their physiological counterparts, making it more difficult for scoring functions to differentiate between them. Next, 252 functions for scoring protein-protein interfaces previously developed by 13 groups were collected and evaluated for their ability to discriminate between physiological and non-physiological complexes. A simple consensus score generated using the best performing score of each of the 13 groups, and a cross-validated Random Forest (RF) classifier were created. Both approaches showed excellent performance, with an area under the Receiver Operating Characteristic (ROC) curve of 0.93 and 0.94 respectively, outperforming individual scores developed by different groups. Additionally, AlphaFold2 engines were shown to recall the physiological dimers with significantly higher accuracy than the non-physiological set, lending support for the pertinence of our benchmark dataset. Optimizing the combined power of interface scoring functions and evaluating it on challenging benchmark datasets appears to be a promising strategy.

Background: A quasi-experimental study investigated a pharmacist-led intervention aimed at deprescribing among patients with type 2 diabetes at risk of hypoglycaemia. Objective: To evaluate the process of implementing the intervention in primary care in order to understand variations in implementation and outcomes. Methods: Mixed-methods study based on the Grant-framework, with 10 domains, including recruitment of patients, delivery of the intervention, and response of pharmacists and patients. Data collected were: administrative logs, semi-structured observations of patient consultations (n=8), interviews with pharmacists (n=16), and patient-reported experience measure (PREM) questionnaires (n=66; response 73%). Results: Ninety patients from 14 pharmacies were included. Although the selection of patients based on high hypoglycaemia-risk was considered useful, pharmacists experienced barriers to proposing deprescribing in patients with recent medication changes, patients without current health problems or hypoglycaemic events, and patients treated in secondary care. The consultation aid and deprescribing tool provided were evaluated positively by the pharmacists. The majority of patients were satisfied with the service and information that the pharmacists provided. Conclusion: Pharmacists and patients were positive about the intervention. Both groups valued the consultation on deprescribing, supported by tools. To optimise the effect, improvements can be made to patient selection and local agreements on proactive deprescribing.

A document by Mehul Mahrishi. Click on the document to view its contents.

To date (2/5/2023), nearly three years after the official declaration of the COVID-19 pandemic, a total of 754, 018, 841 cases and 6,817,478 deaths have been officially reported to the world health organization (WHO) ([https://covid19.who.int/](https://covid19.who.int/)). During this time, the global populace has witnessed the devastating effects of this pandemic, which can undoubtedly be considered the sanitary event of the century. In my opinion, understanding the mechanisms associated with the evolution of SARS-CoV-2 is the most important aspect of understanding the course of this pandemic. In this respect, the millions of viral sequences generated during the pandemic (1) have significantly aided in the tracking of the pandemic, resulting in the identification of multiple variants of concern.

(Sceloporus undulatus) is a female-larger, sexually-size dimorphic lizard species that is heavily parasitized by chigger mites (Eutrombicula alfreddugesi). In particular, the intensity of mite parasitism is higher in male than in female juveniles during the period of time when sex differences in growth rate lead to the development of sexual size dimorphism (SSD). Sex-biased differences in fitness costs of parasitism have been documented in other species. We tested whether a sex-biased growth cost of parasitism contributes to the development of SSD in S. undulatus. We measured growth and mite loads in two cohorts of unmanipulated, field-active yearlings by conducting descriptive mark-recapture studies during the activity seasons of 2016 and 2019. Yearling males had consistently higher mid-summer mite loads and consistently lower growth rates than females. However, we found that growth rate and body condition were independent of mite load in both sexes. Furthermore, growth rates and mite loads were higher in 2019 than in 2016. Our findings suggest that juveniles of S. undulatus are highly tolerant of chigger mites and that any costs imposed by mites must be at the expense of functions other than growth. We conclude that sex-biased mite ectoparasitism does not contribute to sex differences in growth rate and the development of SSD.

The integration of ecosystem processes over large spatial extents is critical to predicting whether and how global changes may impact biodiversity and ecosystem functions. Yet, there remains an important gap in meta-ecosystem models to predict multiple functions (e.g., carbon sequestration, elemental cycling, trophic efficiency) across ecosystem types (e.g., terrestrial-aquatic, benthic-pelagic). We derive a flexible meta-ecosystem model to predict ecosystem functions at landscape extents by integrating the spatial dimension of natural systems as spatial networks of different habitat types connected by cross-ecosystem flows of materials and organisms. We partition the physical connectedness of ecosystems from the spatial flow rates of materials and organisms, allowing the representation of all types of connectivity across ecosystem boundaries as well as the interaction(s) between them. Through simulating a forest-lake-stream meta-ecosystem, our model illustrated that even if spatial flows induced significant local losses of nutrients, differences in local ecosystem efficiencies could lead to increased secondary production at regional scale. This emergent result, which we dub the ‘cross-ecosystem efficiency hypothesis’, emphasizes the importance of integrating ecosystem diversity and complementarity in meta-ecosystem models to generate empirically testable hypotheses for ecosystem functions.

The climate drives species distribution and genetic diversity; the latter defines the adaptability of populations and species. The ongoing climate crisis induces tree decline in many regions, compromising the mitigation potential of forests. Scientific-based strategies for prioritising forest tree populations are critical to managing the impact of climate change. Identifying future climate refugia, which are locations naturally buffering the negative impact of climate change, may facilitate local conservation. In this work, we conducted the populations’ prioritisation for Castanea sativa (sweet chestnut), a Neogene relict growing in the Caucasus global biodiversity hotspot. We generated genetic and ecological metrics for 21 sites in Georgia and Azerbaijan, which cover the natural range of sweet chestnut across the region. We demonstrated that climate primarily drives the pattern of genetic diversity in C. sativa, proved with a significant Isolation-by-Environment model. In future, climate change may significantly reorganise the species genetic diversity, inducing even some genetic loss, especially in the very distinct eastern fringe of the species range in Azerbaijan. Based on our combined approach, we mapped populations suitable for ex-situ and in-situ conservation, accounting for genetic variability and the location of future climate refugia.

Workers in the ant genus Pheidole show an extreme degree of morphological differentiation, with at least two distinct subcastes: minor workers are smaller and perform most of the colony tasks, whereas majors are larger, display disproportionately massive heads, and specialize in roles as defense and food processing. There is considerable interspecific variation in head shape within worker subcastes of Pheidole, which could affect how the stresses generated by the mandibular closing muscle contraction (0md1) spread throughout the head and influence bite force. To assess the role of head shape in stress patterns of Pheidole workers, we solve a set of Finite Element Analysis (FEA) while exploring variation in Pheidole worker head morphospace. We hypothesize that majors possess head shapes optimized for the generation of stronger bites. In addition, we expect that head shapes corresponding to the edges of morphological space in the genus would show mechanical limitations that could prevent further expanding the occupied morphospace. We vectorized Pheidole head shapes based on images of worker heads, considering species that represent mean shapes and the edges of the two main axes of each morphospace, for a total of five head shapes for each worker subcaste. We performed linear static FEA simulating the contraction of 0md1. Our results demonstrate that head shapes of majors are optimized to generate stronger bites given that stress generated on those shapes is distinctly directed towards the mandibles. Head shapes of minors tended to concentrate stresses around the mandibular articulations, with substantially lower and more diffuse stresses spreading throughout the head, indicating that such shapes are associated with weaker bites. Our results agree with the expectations regarding the main colony tasks performed by each worker subcaste, and we find some evidence of biomechanical limitations on extreme head shapes for majors and minors.

A 30-year-old man presented with sudden chest pain and evidence of multiple cystic lesions in both long and left-sided pneumothorax in HRCT. H&E stained section and IHC for CD1a and S100 were positive in lung samples. The patient was treated with the diagnosis of Isolated pulmonary langerhans cell histiocytosis.

Key Clinical Message: An elevated middle cerebral artery peak systolic velocity in the setting of non-diabetic hypertrophic cardiomyopathy may portend an especially poor prognosis.

Spinal intramedullary lipoma within the craniovertebral region is extremely rare. These lesions are often associated with spinal dysraphism. Here we present a non-dysraphic one. Our patient was a 56-year-old female who presented with progressive right shoulder pain and gait disturbance.

Papillary thyroid carcinoma of the pyramidal lobe is rare. We describe a case of a 77-year-old woman who corroborates current literature findings, namely greater presence of adverse prognostic factors. Upper Neck Papillary Thyroid Cancer is a new entity, proposed to group these tumors with potential clinical and therapeutic implications.