Background: Prolonged endurance exercise is associated with an increased risk of atrial fibrillation (AF) in men. Left atrial (LA) dilation is a marker of pathological atrial remodeling and associated with AF in the general population. In athletes, however, atrial dilation is part of a physiological response to exercise, and functional parameters may help separate physiological from pathological atrial remodeling in this group. LA mechanical dispersion (LA MD) is a novel marker of LA mechanical dyssynchrony associated with AF in the general population. The associations between prolonged endurance exercise, LA MD and AF are yet to be investigated. Purpose: To investigate LA MD in male veteran athletes who had regularly participated in an annual 54-kilometer cross-country (XC) ski race in Norway with and without paroxysmal AF and to investigate the ability of LA MD to identify veteran athletes with paroxysmal AF. Methods: Two hundred and ninety-three men from four groups, veteran XC skiers with (n=57) and without (n=87) AF, and men from a non-athletic population with (n=61) and without AF (n=88) underwent an echocardiographic exam while in sinus rhythm. Using speckle-tracking echocardiography, LA strain was measured in each of the six atrial segments in an atrial-focused apical four-chamber view. We defined LA MD as the standard deviation of time-to-peak strain (SD-TPS) and report the average from three consecutive loops. Results: XC-skiers (mean age 70.9 ± 5.7 years) reported an average of 40-50 years of regular endurance exercise and an average of 16 completed annual Birkebeiner XC ski races. LA volumes were associated with both AF and athletic status (p<0.001). SD-TPS was associated with AF (p<0.001), but not with athletic status (p=0.173). We found no significant trend between years of endurance exercise and SD-TPS in individuals without AF (p=0.846). SD-TPS did not add incremental value in identifying athletes with AF in addition to clinical markers, QRS width, LA volume, and LA reservoir strain (p=0.056). Conclusion: LA MD was associated with paroxysmal AF regardless of athletic status. However, it was not associated with years of performing endurance exercise, suggesting LA MD could be a promising marker of pathological atrial remodeling in endurance athletes, less affected by physiological exercise-induced atrial remodeling than absolute volumetric measurements. We found no incremental value of LA MD in identifying veteran athletes with paroxysmal AF when LA reservoir strain was included in the model.

Background: Reactive thrombocytosis (Platelets >500K/μl) is estimated between 3-13% in hospitalized children and has been associated with RSV infection and younger age. We aimed to examine the clinical significance of thrombocytosis in children admitted to the hospital with an influenza-like illness (ILI). Methods: We performed an analysis of a database of patients evaluated at our Medical Centers with an ILI between 2009 and 2013. We included pediatric patients and examined the association between platelet count, respiratory viral infections, and admission outcomes (hospital length of stay (LOS) and admission to the pediatric intensive care unit (PICU() using regression models adjusting for laboratory, clinical and demographic parameters. Results: Of 19,192 adults and children in the database, 5,171 children met inclusion criteria (median age 0.8 years (Interquartile range, 0.2-1.8), 58% male, median LOS of 3 days (Interquartile range, 2-5)). Younger age and not the type of viral infection was associated with a high platelet count (p<0.001). Elevated platelet count independently predicted admission outcomes, adjusted for multiple covariates (p≤0.006). Furthermore, the presence of thrombocytosis was associated with an increased risk for a prolonged LOS (odds ratio=1.2 (95% Confidence interval=1.1-1.4, p=0.003)) and admission to the PICU (odds ratio=1.5 (95% Confidence interval =1.1-2.0, p=0.002)). Conclusions: In children admitted with an ILI, a high platelet count is associated with younger age and is an independent predictor of hospital LOS and admission to the PICU. Our results show that platelet count may be used to improve risk assessment and management decisions in these pediatric patients.

Scrub typhus caused by Orientia tsutsugamushi is a vector-borne, zoonotic disease which is common in the tsutsugamushi triangle. Scrub typhus causes AUFI in patients with non-specific clinical features and is difficult to diagnose when the highly characteristic but not pathognomonic eschar is not seen. As the eschar is not always present, laboratory tests are needed for confirmation. Serological assays are the main stay of laboratory diagnosis of scrub typhus thus far. In this review, we present the salient clinical features and clinical algorithms suggestive of this disease that help in better selection of diagnostics. The various scrub typhus assays along with their advantages and disadvantages have also been discussed. Furthermore, we have also discussed the upcoming diagnostics, both serological and molecular assays which can be available in the near future.

Background: Croup caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging disease, and data on the risk factors associated with disease severity are still limited. The Westley croup score (WS) is widely used to assess croup severity. The current study aimed to analyze biomarkers associated with the WS and clinical outcomes in patients with croup and coronavirus disease 2019 in the pediatric emergency department (PED). Population and Method: Patients diagnosed with croup caused by SARS-CoV-2 were admitted at two PEDs. Clinical data including age, WS, length of hospital stay, initial laboratory data, and treatment were analyzed. Clinical parameters were evaluated via multivariate logistic regression analysis. The best cutoff values for predicting croup severity and outcomes were identified using the receiver operating characteristic curve. Result: In total, 250 patients were assessed. Moreover, 128 (51.2%) patients were discharged from the PED, and 122 (48.8%) were admitted to the hospital. Mild, moderate, and severe croup accounted for 63.6% (n = 159), 32% (n = 80), and 4.4% (n = 11) of all cases, respectively. A high mean age (years), neutrophil count (%), neutrophil-to-lymphocyte ratio (NLR), ALT (U/L), procalcitonin (ng/mL), and hemoglobin (g/dL) level, and length of hospital stay (days), and a low lymphocyte count (%) and blood pH were associated with croup severity and need for intensive care. Based on the multivariate logistic regression model, the NLR remained independent factors associated with croup severity and prognosis. Further, NLR was significantly correlated with WS. The area under the receiver operating characteristic curve of NLR for predicting a WS of ≥ 3 was 0.895 (0.842–0.948, p < 0.001), and that for predicting ICU admission was 0.795 (0.711–0.879, p < 0.001). The best cutoff values for a WS of ≥3 and ICU admission were 1.65 and 2.06, respectively. Conclusion: WS is associated with the severity of croup caused by SARS-CoV-2. Furthermore, NLR is correlated with WS and is a cost effective, easily accessible prognostic biomarker in the PED.

In this paper, we will derive the Formable integral transform of the Hilfer-Prabhakar and its regularized version of the Hilfer-Prabhakar fractional derivative. Then, we will use the Formable and Fourier transforms, which involve the three-parameter Mittag-Leffler function, to find the solution of some Cauchy type fractional differential equations with Hilfer-Prabhakar fractional derivatives.

AbstractBackground: Bronchial asthma is a non-communicable disease that is highly prevalent globally, and the incidences of this drug increase daily with the increased environmental pollution. The most common interventional treatment for asthma includes methylxanthines, mainly doxofylline and aminophylline (ethylenediamine salt of theophylline). This study compared the efficacy of these two methylxanthines in treating bronchial asthma. Methodology: A literature search was performed through PubMed, MEDLINE, Google Scholar, and Cochrane. The Cochrane RevMan 5.4 software was used to perform a meta-analysis for the included studies.Results: Ten studies were included based on the satisfaction of the eligibility criteria. From the analysis, the spirometric values of FEV1, PEFR, FVC, and FEV/FVC demonstrated a statistically significant change/improvement from the baseline when using both aminophylline and doxofylline in the treatment of bronchial asthma. There was significant difference in mean FEV1 and FVC between the two drugs of (MD -0.02, 95% CI -0.03 to -0.01; P = 0.01) and (MD 0.02, 95% CI 0.01 to 0.04; P = 0.009), respectively. However, FEV1/FVC was not significant between aminophylline and doxofylline (MD 0.15, 95% CI -0.34 to 0.64; P = 0.55). Safety assessment between the two drugs shows significant differences with the use of both aminophylline and doxofylline OR 2.26, 95% CI 1.72 to 2.98; P < 0.00001). The heterogeneity across different analyses was high.Conclusion: The current study concluded that both doxofylline and aminophylline significantly improved the baseline conditions and functions of the lungs during the treatment of bronchial asthma. Doxofylline was superior to aminophylline in its efficacy and was also associated with lower incidences of adverse events and complications compared to aminophylline.

Abstract Background and objective: For individuals with asymptomatic or symptomatic carotid artery stenosis, CEA (carotid endarterectomy) has been demonstrated to be beneficial in preventing stroke. There are still very few long-term data contrasting carotid artery stenting (CAS) with CEA, despite multiple prospective randomized trials showing that CAS is a different but not better therapeutic method. The purpose of the study was to compare the treatment effectiveness of CEA and CAS.Methods: We searched five electronic databases in-depth for RCTs examining the effects of CEA and CAS therapies on people with carotid artery stenosis. The databases include Embase, MEDLINE, Cochrane, Scopus, and PubMed.Results: Ten trials included both short- and long-term results. The risk of death (OR 1.14, 95% CI 0.57 to 2.27; I2 = 0%) and the composite endpoint mortality or disabling stroke (OR 0.73, 95% CI 0.53 to 1.00; I2 = 46%) did not significantly differ between CEA and CAS during the periprocedural period (OR 0.72, 95% CI 0.54 to 0.95; I2 = 40%). This difference was primarily attributable to a lower risk of stroke. The risks of periprocedural myocardial infarction were higher in the CEA group than in the CAS group (OR 2.80, 95% CI 1.12 to 6.99; I2 = 0%) as well as the odds of cranial nerve injury were higher in the CEA group (OR 12.81, 95% CI 5.10 to 32.12; I2 = 0%).Conclusion: For short-term outcomes, CEA was discovered to be superior to CAS; nonetheless, the difference was not statistically significant for intermediate-term results; the difference was primarily caused by non-disabling stroke. With CAS, there were fewer myocardial infarctions and damage to cranial nerves.

Working memory (WM) impairment has been well characterized in normal ageing. Various studies have explored changes in either the regional activity or the interregional connectivity underlying the WM ageing process. We proposed that brain activity and connectivity would independently alter with ageing and affect WM performance. WM was assessed with a classical N-back task during functional magnetic resonance imaging in a community-based sample comprising 168 elderly subjects (aged 55 to 86 years old). Following the rationale of background functional connectivity, we assessed age-related alterations in brain activity and seed-based interregional connectivity independently. Analyses revealed age-related decrease in the activity of the inferior parietal lobule (IPL) and an increase in the activity of the ventral anterior cingulate cortex (ACC), and the local functional dysfunctions were accompanied by alterations in their connectivity to other cortical regions. Importantly, regional activity impairments in the IPL and ACC could mediate age-related effects on accuracy rate and reaction time, respectively, and those effects were further counterbalanced by enhancement of their background functional connectivity. We thus claimed that age-induced alterations in regional activity and interregional connectivity occurred independently and contributed to WM changes in ageing. Our findings presented the way brain activity and functional connectivity interact in the late adulthood, thus providing a new perspective for understanding WM and cognitive ageing.

This letter presents the design and measurement results of a 2.5 GS/s 7-bit successive approximation register (SAR) analog-to-digital converter (ADC) with real-time data output via the JESD204B protocol using two lanes at 12.5 Gb/s each. The ADC is implemented in a 22-nm fully-depleted silicon-on-insulator (FDSOI) technology and consists of four time interleaved ADC cores. It consumes 43 mW overall, while the analog frontend including the four ADC cores and the interleaver consumes only 7.8 mW. In the first Nyquist zone, the effective number of bits (ENOB) is larger than 6.1 bit leading to a Walden Figure-of-Merit (FOM_W) of 45 fJ/conv.-step and a Schreier Figure-of-Merit (FOM_S) of 150.5 dB. Integral (INL) and differential nonlinearity (DNL) are both well below 0.5 LSB for all measurement scenarios.

A robust distributed state estimation algorithm for AC/DC system with AC tie lines and high voltage direct current (LCC-HVDC) tie line is proposed. The proposed algorithm consists of the robust distributed AC state estimation and the robust DC state estimation in the coordinator. For AC state estimation, a distributed state estimation algorithm based on the bilinear algorithm is designed, which can not only achieve the same accuracy as the centralized algorithm, but also simplify the nonlinear iterative process of the exponential objective function robust algorithm and reduce the operation scale. For DC state estimation, the objective function adopts the maximum absolute value of exponential to make it better convergent. Finally, the correctness and effectiveness of the algorithm are verified by the simulation of three IEEE 118 bus interconnected systems.

Considering the sensitivity of HVDC-transmission system protection and the difficulty in identifying high-resistance earth-faults,this paper presents three methods for fault location and classification in VSC-HVDC transmission lines.These methods are evaluated in terms of efficiency and reliability.The current and voltage signals obtained from the network are pre-processed by performing DWT,and then using feature extraction methods,special and unique features are extracted for different states of the signals,and then using these features and proposed algorithms,network learning was performed to detect faults.In addition,the effectiveness of the proposed plan has been confirmed for different fault scenarios related to extensive changes in fault resistance,fault starting angle and fault location.These algorithms were also investigated in unwanted noise-conditions and the reliability of these algorithms was confirmed.In this article methods,k nearest neighbor(KNN),support vector machine(SVM) and deep-neural network(DNN) have been investigated.The strength of this research is use of a new method of extracting features from the fractal dimension,which has been able to provide outstanding capabilities that can lead to improved diagnosis with a small number of study data and different conditions.The main advantages of proposed-method are higher speed and accuracy than conventional methods.The test results show that the proposed method can reliably and accurately identify and classify high-impedance faults.

Disturbance by humans and climatic change are thought to be two important factors contributing to ongoing declines in migratory bird species, especially during the breeding season when they may impact productivity. Ground-nesting species with precocial offspring are likely to be susceptible to both disturbance and extreme weather events, but more work is needed to understand these processes. Here, we investigate the factors affecting reproductive success in the common sandpiper (Actitis hypoleucos), a declining, ground-nesting migratory wader. We colour-ringed individuals and monitored nests over three years to study the impact of disturbance, habitat and rainfall on hatching success and fledging success. First, we investigated whether the distance of nests from footpaths and rivers, and the amount of vegetation cover, predicted hatching success. We also recorded the distance at which incubating adults flushed from the nest in response to an approaching observer. Second, we investigated whether fledging success was associated with rainfall in the period following hatching. We found that hatching success was higher when nests were further away from footpaths, but only when nests were also far from rivers. Also, individuals on nests that were far from footpaths left their nests more readily when approached by observers, particularly when their nests had less vegetation cover. Further, our data showed that adults sitting tightly on nests, and having large amounts of vegetation cover around them, had higher hatching success. Finally, our results showed that fledging success was correlated with heavy rainfall in the week after hatching. This suggests that extreme rainfall events are likely to have important consequences for chick survival. Further work is needed to determine the interacting effects of human disturbance and predation events on both hatching and fledging success, particularly in the face of the increasing frequency of extreme weather events.

Fluid flow and pore-pressure cycling are often invoked as controls to slow slip events (SSEs), such as those that frequently occur at the northern Hikurangi margin (HM) of New Zealand. To better understand fluid flow in the forearc system, we examined the relationship between elastic properties, compaction, porosity, and permeability of Cretaceous to Pliocene mudstones from the Raukumara peninsula. We found that the permeability of the deep wedge is too low to drain fluids, but fracturing increases permeability by orders of magnitude, making fracturing key for fluid flow. In weeks to months, plastic deformation and clay swelling heal the fractures restoring the initial permeability. We conclude that overpressures at the northern HM might partly dissipate during SSEs due to enhanced permeability near faults. However, in the weeks to months following an SSE, healing in the prism will lower permeability, forcing pore pressure to rise and a new SSE to occur.

The thermal interface material technologies used for electronic packages encompass several classes of materials. However, there is still a need for thermal interface materials and methods for making thermal interface materials having improved thermal conductivity property by maximizing the anisotropic benefit of exfoliated graphite platelets to the fullest extent. The effect of filler volume fraction on the thermal resistivity of the thermal contact and the thermal conductivity of the thermal interface material is investigated for graphite platelets and carbon black. The effect of pressure on the bond line thickness of the thermal interface material is evaluated for smooth and rough surfaces. The present study aims to provide a thermal interface material with aligned graphite nanofibers in the thermal interface material to enhance the material performance. Particular emphasis is placed upon the heat conduction properties of thermally conductive interface materials with exfoliated graphite platelets. The results indicate that polymeric elastomer materials offer both high thermal performance and reasonable gap filling capability to enable good contact between a semiconductor component and a heat sink. Under mechanical pressure, the soft thermal interface material conforms to the microscopic surface contours of the adjacent solid surfaces and increases the microscopic area of contact between the thermal solution surface and the silicon die surface and therefore reduces the temperature drop across this contact. The heat dissipating component should advantageously be relatively anisotropic, as compared to a metal and exhibit a relatively high ratio of thermal conductivity to weight. Thermal interface materials provide a limited heat-conduction path and may include flexible heat-spreading materials and one or more layers of soft thermal interface material. Reducing the strain on the thermal interface material may reduce the potential for pump-out and the associated increase in thermal resistance due to loss of material from the interface. Thermal conductivity is driven primarily by the nature of the filler, which is randomly and homogeneously distributed throughout the matrix. Pump-out of the thermal interface material results in increased thermal resistance due to loss of material from the interface. The thermal interface material can migrate out of the interface volume between the thermal conducting members and onto the power input pads, resulting in excessive heating and part failure at the power interconnect.Keywords: Interface materials; Thermoplastic materials; Smooth surfaces; Rough surfaces; Graphite platelets; Carbon black

Key Points: 10 • We improve a long-standing stratocumulus (Sc) dim bias in a high-resolution Mul-11 tiscale Modeling Framework. 12 • Incorporating intra-CRM hypervisocity hedges against the numerics of its momen-13 tum solver, reducing entrainment vicinity. 14 • Further adding sedimentation boosts Sc brightness close to observed, opening path 15 to more faithful low cloud feedback analysis. Abstract 17 High-Resolution Multi-scale Modeling Frameworks (HR)-global climate models that 18 embed separate, convection-resolving models with high enough resolution to resolve bound-19 ary layer eddies-have exciting potential for investigating low cloud feedback dynam-20 ics due to reduced parameterization and ability for multidecadal throughput on mod-21 ern computing hardware. However low clouds in past HR have suffered a stubborn prob-22 lem of over-entrainment due to an uncontrolled source of mixing across the marine sub-23 tropical inversion manifesting as stratocumulus dim biases in present-day climate, lim-24 iting their scientific utility. We report new results showing that this over-entrainment 25 can be partly offset by using hyperviscosity and cloud droplet sedimentation. Hypervis-26 cosity damps small-scale momentum fluctuations associated with the formulation of the 27 momentum solver of the embedded LES. By considering the sedimentation process ad-28 jacent to default one-moment microphysics in HR, condensed phase particles can be re-29 moved from the entrainment zone, which further reduces entrainment efficiency. The re-30 sult is an HR that is able to produce more low clouds with a higher liquid water path 31 and a reduced stratocumulus dim bias. Associated improvements in the explicitly sim-32 ulated sub-cloud eddy spectrum are observed. We report these sensitivities in multi-week 33 tests and then explore their operational potential alongside microphysical retuning in 34 decadal simulations at operational 1.5 degree exterior resolution. The result is a new HR 35 having desired improvements in the baseline present-day low cloud climatology, and a 36 reduced global mean bias and root mean squared error of absorbed shortwave radiation. 37 We suggest it should be promising for examining low cloud feedbacks with minimal ap-38 proximation. 39 Plain Language Summary 40 Stratocumulus clouds cover a large fraction of the globe but are very challenging 41 to reproduce in computer simulations of Earth's atmosphere because of their unique com-42 plexity. Previous studies find the model produces too few Stratocumulus clouds as we 43 increase the model resolution, which, in theory, should improve the simulation of impor-44 tant motions for the clouds. This is because the clouds are exposed to more conditions 45 that make them evaporate away. On Earth, stratocumulus clouds reflect a lot of sun-46 light. In the computer model of Earth, too much sunlight reaches the surface because 47 of too few stratocumulus clouds, which makes it warmer. This study tests two methods 48 to thicken Stratocumulus clouds in the computer model Earth. The first method smooths 49 out some winds, which helps reduce the exposure of clouds to the conditions that make 50 them evaporate. The second method moves water droplets in the cloud away from the 51 conditions that would otherwise make them evaporate. In long simulations, combining 52 these methods helps the model produce thicker stratocumulus clouds with more water. 53

In the ocean, temperature extremes have adverse effects on precipitation patterns, sea level change, and migration/damage of ecosystems. It has been found that most species are more sensitive to extreme events like marine heatwaves (MHWs), implying the severe impacts of MHWs on ecology. These events are driven by various atmospheric and oceanic processes. In recent years, these extreme events are more frequent and intense globally and their increasing trend is expected to continue in the upcoming decades. They have the potential to devastate marine habitats, and ecosystems together with ensuing socioeconomic consequences. It recently attracted public interest and scientific researchers, which motivates us to analyze the recent MHW events in the Bay of Bengal region. we have isolated 107 MHW events (above the 90th percentile threshold) in this region of the Indian Ocean and investigated the variation in duration, intensity, and frequency of MHW events during our test period (1982-2021). Our study reveals that the average of three MHW events per year in the study region with an increasing linear trend of 1.11 MHW events per decade. In the analysis, we found the most intense event has a maximum intensity was 5.29°C (above the climatology mean), while the mean intensity was 2.03°C. In addition, we observed net heat flux accompanied by anticyclonic eddies to be the primary cause of these events. Also, an effort has been made to understand the relationship between climate modes, sea surface height, and the difference between evaporation and precipitation with the occurrence of MHW events.

Crop growth model simulates the response of photosynthetic rate to nitrogen (N) dynamic by calculating critical N concentration. However, critical N concentration cannot describe the physiological effect of N dynamic to photosynthesis. In this paper, a Two-leaf Photosynthetic Model Sensitive to Chlorophyll Content (TPMSCC) was developed and coupled with the crop growth model (WheatGrow) to improve the mechanism of N dynamics on photosynthesis. The simulating results of TPMSCC revealed the high sensitivity of LCC on photosynthesis. The relationships of LCC to the maximum photosynthetic rate (A max) and the initial light use efficiency (ɑ) simulated by TPMSCC were linear and logarithmic. In addition, canopy photosynthetic rate benefited from the increase of diffuse radiation fraction (DRF) except for the condition of dense canopy at high solar zenith angle. The optimized WheatGrow performed better than WheatGrow on describing the response of N level on biomass accumulation and distribution in different organs.

Volatile organic compounds (VOCs) may communicate stress between plants. However little appears to be documented on how such VOCs affect transpiration. Changes in transpiration in response to some VOCs was examined by measurement of flow ( Q) at high resolution into detached leaves of Vitis vinifera (cv. Shiraz) and Arabidopsis (Col 0). Sensors recorded arrival and decay of volatiles at the leaf lamina. Moderate xylem tensions were developed in V. vinifera leaves by incorporating a hydraulic resistance in the flow pathway. Simultaneous recording of leaf gas exchange (Assimilation, A, and Transpiration, E) for both V. vinifera and Arabidopsis revealed that for Arabidopsis Q was stochastically restricted by the gas exchange cuvette but not E in the short term. Depending on the applied supply pressure cavitation could be controlled in V. vinifera evident from reduced Q, and leaf wilting. Stomatal closure occurred upon cavitation after a transitory increase in E and A, and after wilting began and was reversed by re-pressurization. VOCs were emitted from leaves corresponding to changes in flow rate, and light to dark transitions but not to cavitation. Volatile methanol but not ethanol or methyl salicylate induced a localised dose-dependent reversible stomatal closure in both V. vinifera and Arabidopsis.

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Full article title: Social media and the rise of the far rightAcknowledgments and credits: Not applicable Each author’s complete name and institutional affiliation(s): Ryan Thomas Williams, University of SunderlandGrant numbers and/or funding information: Not applicable Key words (four or five): social media, digital communication, think piece, reflection Corresponding author (name, address, phone/fax, e-mail): Ryan Thomas Williams, University of Sunderland, Sir Tom Cowie Campus, St Peter's Way, Sunderland, SR6 0DD, ryan.williams@sunderland.ac.uk 

Disturbance and environmental change may cause communities to converge on a steady state, diverge towards multiple alternative states, or remain in long-term transience. Yet, empirical investigations of successional trajectories are rare, especially in systems experiencing multiple concurrent anthropogenic drivers of change. We examined succession in old field grassland communities subjected to disturbance and nitrogen fertilization using data from a long-term (22-year) experiment. Regardless of initial disturbance, after a decade communities converged on steady states largely determined by resource availability, where species turnover declined as communities approached dynamic equilibria. Species favored by the disturbance were those that eventually came to dominate the highly fertilized plots. Furthermore, disturbance made successional pathways more direct under low nutrients, revealing an important interaction effect between nutrients and disturbance as drivers of community change. Our results underscore the dynamical nature of grassland and old field succession, demonstrating how community properties such as beta-diversity change through transient and equilibrium states.

Accurate diagnosis of Alzheimer’s disease(AD) and Mild Cognitive Impairment(MCI) was identified on an early stage is essential in the healthcare industry to stop degeneration. The Smooth Support Vector Machine (SSVM) model, Principal Component Analysis (PCA), feature extraction, and Magnetic Resonance Imaging (MRI) image preprocessing are the components for the diagnosis of AD is proposed in this research at early stage. To assist in the classifier’s training, we proposed a novel Improved Weighed Quantum Lion Optimization (IWQLO). The SSVM parameters are specifically proposed to be optimized using a new Switching delayed Lion Optimization (SLO) algorithm.The IWQLO-SSVM approach was effectively used to classify AD and MCI utilizing MRI scans of the [Alzheimer’s disease Neuroimaging Initiative](https://adni.loni.usc.edu/)(ADNI) database and Outcome and Assessment Information Set (OASIS) database. For six example scenarios, the classification accuracy of our proposed method is acceptable. Testing show that the proposed approach improves the performance measures such as accuracy, precision, specificity, sensitivity and recallfor detecting the early stage AD diagnosis.

The rapid loss of Arctic Sea Ice (ASI) in the last decades is one of the most evident manifestations of anthropogenic climate change. A transition to an ice-free Arctic during summer would impact climate and ecosystems, both regionally and globally. The identification of Early-Warning Signals (EWSs) for the loss of the summer ASI could provide important insights into the state of the Arctic region. We collect and analyze CMIP6 model runs that reach ASI-free conditions (area below 10^6 km^2) in September. Despite the high inter-model spread, with the range for the date of an ice-free summer spanning around 100 years, the evolution of the summer ASI area right before reaching ice-free conditions is strikingly similar across the CMIP6 models. When looking for EWSs for summer ASI loss, we observe a significant increase in the variance of the ASI area before reaching ice-free conditions. This behavior is detected in the majority of the models, and also averaged over the ensemble. We find no increase in the 1-year-lag autocorrelation in model data, possibly due to the multiscale characteristics of climate variability, which can mask changes in serial correlations. However, in the satellite-inferred observations, increases in both variance and 1-year-lag autocorrelation have recently been revealed.

Background: Deprescribing is a complex process requiring a patient-centred approach. One frequently expressed deprescribing barrier is patients’ attitudes and beliefs toward reducing or stopping a medication. This study aims to identify the willingness to deprescribe predictors in a sample of Portuguese older patients. Methods: Cross-sectional study with community-dwelling patients aged ≥ 65 and taking at least one regular medication. Data collection included patients’ demographic and clinical characteristics and the Portuguese Revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire. Descriptive statistics were used to present patients’ characteristics and attitudes towards deprescribing. A multiple binary logistic regression analysis was performed to identify willingness to desprescribe predictors. Results: 192 participants (median age 72 years; 65.6% female) were included. A large majority (83.33%) were willing to deprescribe if recommended by their doctor. The willingness to desprescribe predictors were age (adjusted odds ratio (aOR)= 1.136), female sex (aOR= 3.036), and the rPATD concerns about stopping (aOR= 0.391). Conclusions: Most patients were willing to deprescribe if recommended by their doctor. Older age and female sex increase the odds of willingness to deprescribe; conversely, higher concerns about stopping medications decrease the odds. These findings suggest that addressing patients’ concerns about stopping their medicines may contribute to deprescribing success.