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Background: Predicting and explaining species occurrence using environmental characteristics is essential for nature conservation and management. Species distribution models consider species occurrence as the dependent variable and environmental conditions as the independent variables. Suitable conditions are estimated based on a sample of species observations, where one assumes that the underlying environmental conditions are known. This is not always the case, as environmental variables at broad spatial scales are regularly extrapolated from point-referenced data. However, treating the predicted environmental conditions as accurate surveys of independent variables at a specific point does not take into account their uncertainty., Methods: We present a joint hierarchical Bayesian model where models for the environmental variables, rather than a set of predicted values, are input to the species distribution model. All models are fitted together based only on point-referenced observations, which results in a correct propagation of uncertainty. We use 50 plant species representative of the Dutch flora in natural areas with 8 soil condition predictors taken during field visits in the Netherlands as a case study. We compare the proposed model to the standard approach by studying the difference in associations, predicted maps, and cross-validated accuracy., Findings: We find that there are differences between the two approaches in the estimated association between soil conditions and species occurrence (correlation 0.64-0.84), but the predicted maps are quite similar (correlation 0.82-1.00). The differences are more pronounced in the rarer species. The cross-validated accuracy is substantially better for 5 species out of the 50, and the species can also help to predict the soil characteristics. The estimated associations tend to have a smaller magnitude with more certainty., Conclusion: These findings suggests that the standard model is often sufficient for prediction, but effort should be taken to develop models which take the uncertainty in the independent variables into account for interpretation., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Viljanen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Modifications of mRNA, especially methylation of adenosine, have recently drawn much attention. The much rarer modification, 5-hydroxymethylation of cytosine (5hmC), is not well understood and is the subject of this study. Vertebrate Tet proteins are 5-methylcytosine (5mC) hydroxylases and catalyze the transition of 5mC to 5hmC in DNA. These enzymes have recently been shown to have the same function in messenger RNAs in both vertebrates and in Drosophila. The Tet gene is essential in Drosophila as Tet knock-out animals do not reach adulthood. We describe the identification of Tet-target genes in the embryo and larval brain by mapping one, Tet DNA-binding sites throughout the genome and two, the Tet-dependent 5hmrC modifications transcriptome-wide. 5hmrC modifications are distributed along the entire transcript, while Tet DNA-binding sites are preferentially located at the promoter where they overlap with histone H3K4me3 peaks. The identified mRNAs are preferentially involved in neuron and axon development and Tet knock-out led to a reduction of 5hmrC marks on specific mRNAs. Among the Tet-target genes were the robo2 receptor and its slit ligand that function in axon guidance in Drosophila and in vertebrates. Tet knock-out embryos show overlapping phenotypes with robo2 and both Robo2 and Slit protein levels were markedly reduced in Tet KO larval brains. Our results establish a role for Tet-dependent 5hmrC in facilitating the translation of modified mRNAs primarily in cells of the nervous system., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Singh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Biodiversity loss is a major global challenge and minimizing extinction rates is the goal of several multilateral environmental agreements. Policy decisions require comprehensive, spatially explicit information on species' distributions and threats. We present an analysis of the conservation status of 14,669 European terrestrial, freshwater and marine species (ca. 10% of the continental fauna and flora), including all vertebrates and selected groups of invertebrates and plants. Our results reveal that 19% of European species are threatened with extinction, with higher extinction risks for plants (27%) and invertebrates (24%) compared to vertebrates (18%). These numbers exceed recent IPBES (Intergovernmental Platform on Biodiversity and Ecosystem Services) assumptions of extinction risk. Changes in agricultural practices and associated habitat loss, overharvesting, pollution and development are major threats to biodiversity. Maintaining and restoring sustainable land and water use practices is crucial to minimize future biodiversity declines., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

In the last decades, illegal logging has posed a serious threat for the integrity of forest ecosystems and for biodiversity conservation in tropical Africa. Although international treaties and regulatory plans have been implemented to reduce illegal logging, much of the total timber volume is harvested and traded illegally from tropical African forest regions. As a result, the development and the application of analytical tools to enhance the traceability and the identification of wood and related products is critical to enforce international regulations. Among available techniques, DNA barcoding is a promising approach for the molecular identification of plant species. However, although it has been used successfully for the discrimination of animal species, no set of genetic markers is available for the universal identification of plant species. In this work, we firstly characterized the genetic diversity of 17 highly-valuable African timber species from five genera (Afzelia, Guibourtia, Leplea, Milicia, Tieghemella) across their distribution ranges in West and Central Africa using the genome skimming approach in order to reconstruct their chloroplast genomes and nuclear ribosomal DNA. Next, we identified single-nucleotide polymorphisms (SNPs) for the discrimination of closely-related species. In this way, we successfully developed and tested novel species-specific genetic barcodes for species identification., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Mascarello et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Using respiratory virus rapid diagnostic tests in the emergency department could allow better and faster clinical management. Point-of-care PCR instruments now provide results in less than 30 minutes. The objective of this study was to assess the impact of the use of a rapid molecular diagnostic test, the cobas® Influenza A/B & RSV Assay, during the clinical management of emergency department patients., Methods: Patients (adults and children) requiring admission or suffering from an underlying condition at risk of respiratory complications were prospectively recruited in the emergency department of four hospitals in the Brussels region. Physicians' intentions regarding admission, isolation, antibiotic, and antiviral use were collected before and after performing the rapid molecular test. Additionally, a comparison of the analytical performance of this test against antigen rapid tests and viral culture was performed as well as a time-to-result evaluation., Results: Among the 293 patients recruited, 90 had a positive PCR, whereas 44 had a positive antigen test. PCR yielded a sensitivity of 100% for all targets. Antigen tests yielded sensitivities ranging from 66.7% for influenza B to 83.3% for respiratory syncytial virus (RSV). The use of PCR allowed a decrease in the overall need for isolation and treatment by limiting the isolation of negative patients and antibiotic use for positive patients. Meanwhile, antiviral treatments better targeted patients with a positive influenza PCR., Conclusion: The use of a rapid influenza and RSV molecular test improves the clinical management of patients admitted to the emergency department by providing a fast and reliable result. Their additional cost compared to antigen tests should be balanced with the benefit of their analytical performance, leading to efficient reductions in the need for isolation and antibiotic use., Competing Interests: The authors have declared that no competing interests exist.

The practice of female genital mutilation (FGM) is a social norm embedded in the patriarchal system and is resistant to change due to its roots in the tradition of the practising communities. Despite this difficulty in change, some women succeed in changing their attitudes towards the practice. In trying to understand what makes these women change their attitudes, we identified in a previous study, the critical life events at which change occurs (turning point). These turning points were described with emotions and conflicting feelings based on which we hypothesised that emotion regulation and the resolution of conflicts of loyalty might be possible mechanisms that explain the change of attitudes by the women. In this article, we sought to investigate how the mechanisms interact and how they were at play to explain the change. We, therefore, triangulated our previous data, fifteen women interviewed twice, with the published life stories and public testimonies of 10 women with FGM, and interviews of six experts chosen for their complementary fields of expertise to discuss the emerging concepts and theory, generated by our study. The data were analysed using framework analysis and an element of the grounded theory approach (constant comparison). As a result of our theorisation process, we propose a model of change in five stages (Emotion suppression, The awakening, The clash, Re-appropriation of self, and Reconciliation). This describes the process of a woman's journey from compliance with FGM and community norms to non-compliance. Our study reveals how the women whose stories were analysed, moved from being full members of their community at the cost of suppressing their emotions and denying their selves, to becoming their whole selves while symbolically remaining members of their communities through the forgiveness of their mothers., Competing Interests: The authors have declared that no competing interests exist.

Use of equipment-free, "manual" blood cultures is still widespread in low-resource settings, as requirements for implementation of automated systems are often not met. Quality of manual blood culture bottles currently on the market, however, is usually unknown. An acceptable quality in terms of yield and speed of growth can be ensured by evaluating the bottles using simulated blood cultures. In these experiments, bottles from different systems are inoculated in parallel with blood and a known quantity of bacteria. Based on literature review and personal experiences, we propose a short and practical protocol for an efficient evaluation of manual blood culture bottles, aimed at research or reference laboratories in low-resource settings. Recommendations include: (1) practical equivalence of horse blood and human blood; (2) a diverse selection of 10 to 20 micro-organisms to be tested (both slow- and fast-growing reference organisms); (3) evaluation of both adult and pediatric bottle formulations and blood volumes; (4) a minimum sample size of 120 bottles per bottle type; (5) a formal assessment of usability. Different testing scenarios for increasing levels of reliability are provided, along with practical tools such as worksheets and surveys that can be used by laboratories wishing to evaluate manual blood culture bottles., Competing Interests: The authors have declared that no competing interests exist.

Introduction: The concept of frailty extends beyond chronological age. Identifying frailty using a two-step approach, starting with the use of a screening tool (G8) followed by comprehensive geriatric assessment (CGA), may be useful in guiding treatment decisions and follow-up. This study evaluated the association between G8 and CGA, and the risk of 90-day postoperative complications risk, in oncogeriatric patients., Methods: Data on geriatric patients with major oncological abdominal surgery was retrospectively collected from our hospital records between 2016 and 2019. Patients with an impaired G8 screening score, who subsequently underwent CGA geriatric screening, were included. Postoperative complications were classified using the Clavien-Dindo classification (CD), and the Comprehensive Complication Index (CCI). The association between the individual components of the geriatric assessment tools and the 90-day postoperative complications risk was analyzed., Results: One hundred and twelve patients, aged ≥ 70 years, operated for an intra-abdominal tumor with curative intent, were included. Seventy-six patients (67.9%) presented with an impaired G8, out of whom sixty-six (58.9%) had a CGA performed. On univariate analysis, altered nutritional status assessed by the Mini-Nutritional Assessment-Short Form was the only variable associated with higher postoperative total complication rate (p = 0.01). Patients with an impaired G8 had significantly more postoperative complications and higher 1-year mortality rates than patients with normal G8. Fifteen patients (13.4%) had grade III-IVb complications. A CCI > 50 was recorded in 16 patients (14.3%). All-cause 90-day postoperative mortality was 10.7%., Conclusion: Identifying an altered preoperative nutritional status, as part of the CGA, in patients screening positive for frailty, is a potentially modifiable risk factor that can enhance preoperative management and optimize treatment decision making. G8 may be a predictive factor for postoperative complications in oncogeriatric patients., Competing Interests: The authors have declared that no competing interests exist.

Background: In 2010, the government of Sierra Leone implemented the Free Health Care Initiative (FHCI) in the country with the objective of reducing the high maternal, infant, and child mortality rates and improving general health indicators. The objective of this study was to assess the trends in the prevalence of health care-seeking and to identify the determinants of healthcare service utilization by caregivers of children younger than five years., Methods: The analysis of health-care-seeking behavior was done using data from four population-based surveys in Sierra Leone before (2008) and after (2013, 2016, 2019) the FHCI was implemented. Care-seeking behavior was assessed with regard to caregivers seeking care for children under-five in the two weeks prior to each survey. We compared the percentages of healthcare-seeking behavior change and identify factors associated with healthcare-seeking using a modified Poisson regression model with generalized estimating equations., Results: In 2008, a total of 1208 children with fever were recorded, compared with 2823 children in 2013, 1633 in 2016, and 1464 in 2019. Care-seeking for children with fever was lowest in 2008 (51%; 95% CI (46.4-55.5)) than in 2013 (71.5%; 95% CI (68.4-74.5)), 2016 (70.3%; 95% CI (66.6-73.8)), and 2019 (74.6%; 95% CI (71.6-77.3)) (p < 0.001). Care-seeking in 2013, 2016 and 2019 was at least 1.4 time higher than in 2008 (p < 0.001) after adjusting for mother's age, wealth, religion, education level, household head and the child's age. Care-seeking was lowest for children older than 12 months, mothers older than 35 years, children living in the poorest households, and in the northern region. A trend was observed for the sex of the household head. The level of care-seeking was lowest when the household head was a man., Conclusions: The increase in healthcare-seeking for children under-five with fever followed the introduction of the FHCI in Sierra Leone. Care-seeking for fever varied by the child's age, caregiver's age, household wealth, the sex of the household head and region. Maintaining the FHCI with adequate strategies to address other barriers beyond financial ones is essential to reduce disparities between age groups, regions and, households., Competing Interests: The authors have declared that no competing interests exist.

Objective: Different visual stimuli are classically used for triggering visual evoked potentials comprising well-defined components linked to the content of the displayed image. These evoked components result from the average of ongoing EEG signals in which additive and oscillatory mechanisms contribute to the component morphology. The evoked related potentials often resulted from a mixed situation (power variation and phase-locking) making basic and clinical interpretations difficult. Besides, the grand average methodology produced artificial constructs that do not reflect individual peculiarities. This motivated new approaches based on single-trial analysis as recently used in the brain-computer interface field., Approach: We hypothesize that EEG signals may include specific information about the visual features of the displayed image and that such distinctive traits can be identified by state-of-the-art classification algorithms based on Riemannian geometry. The same classification algorithms are also applied to the dipole sources estimated by sLORETA., Main Results and Significance: We show that our classification pipeline can effectively discriminate between the display of different visual items (Checkerboard versus 3D navigational image) in single EEG trials throughout multiple subjects. The present methodology reaches a single-trial classification accuracy of about 84% and 93% for inter-subject and intra-subject classification respectively using surface EEG. Interestingly, we note that the classification algorithms trained on sLORETA sources estimation fail to generalize among multiple subjects (63%), which may be due to either the average head model used by sLORETA or the subsequent spatial filtering failing to extract discriminative information, but reach an intra-subject classification accuracy of 82%., Competing Interests: The authors have declared that no competing interests exist.

While shifts to high-intensity land cover have caused overwhelming biodiversity loss, it remains unclear how important natural land cover is to the occurrence, and thus the conservation, of different species groups. We used over 4 million plant species' observations to evaluate the conservation importance of natural land cover by its association with the occurrence probability of 1 122 native and 403 exotic plant species at 1 km resolution by species distribution models. We found that 74.9% of native species, 83.9% of the threatened species and 77.1% rare species preferred landscapes with over 50% natural land cover, while these landscapes only accounted for 15.6% of all grids. Most species preferred natural areas with a mixture of forest and open areas rather than areas with completely open or forested nature. Compared to native species, exotic species preferred areas with lower natural land cover and the cover of natural open area, but they both preferred extremely high and low cover of natural forest area. Threatened and rare species preferred higher natural land cover, either cover of natural forest area or cover of natural open area than not threatened and common species, but rare species were also more likely to occur in landscapes with 0-25% cover of natural open area. Although more natural land cover in a landscape will not automatically result in more native species, because there is often a non-linear increase in species occurrence probability when going from 0% to 100% natural land cover, for conserving purposes, over 80% natural land cover should be kept in landscapes for conserving threatened and very rare species, and 60% natural land cover is the best for conserving common native species. Our results stress the importance of natural areas for plant species' conservation. It also informs improvements to species conservation by increasing habitat diversity., Competing Interests: The authors have declared that no competing interests exist.

Milgram's classical studies famously suggested a widespread willingness to obey authority, even to the point of inflicting harm. Important situational factors supporting obedience, such as proximity with the victim, have been established. Relatively little work has focused on how coercion affects individual cognition, or on identifying the cognitive factors that underlie inter-individual differences in the tendency to yield to coercion. Here, we used fMRI to investigate the neural systems associated with changes in volitional processes associated with sense of agency and sense of responsibility under coercion. Participants either freely chose, or were instructed by the experimenter, to give mildly painful electric shocks to another participant, or to refrain from doing so. We have previously shown that coercion reduces temporal binding, which has been proposed as an implicit proxy measure of sense of agency. We tested how reduced agency under coercion related to differences in neural activity between free choice and coercion. In contrast to previous studies and to participants performing the task outside the MRI scanner, on average there was no effect of coercion on agency for participants in the scanner. However, greater activity in the medial frontal gyrus was reliably associated with greater agency under coercion. A similar association was found using explicit responsibility ratings. Our findings suggest that medial frontal processes, perhaps related to volition during action planning and execution, may help to preserve a sense of accountability under coercion. Further, participants who administered more shocks under free choice showed reduced activity during free choice trials in brain areas associated with social cognition. Possibly, this might reflect participants cognitively distancing themselves from the recipient of the shocks under free choice, whereas this was not observed under coercion., Competing Interests: The authors have declared that no competing interests exist.

Background: IgE characterizes the humoral response of allergic sensitization but less is known about what modulates its function and why some patients present clinical symptoms for a given IgE level and others do not. An IgE response also occurs during helminth diseases, independently of allergic symptoms. This response could be a model of non-functional IgE., Objective: To study the IgE response against environmental allergens induced during natural helminth infection., Methods: In 28 non allergic subjects from the periphery of Ho Chi Minh city with (H+, n = 18) and without helminth infection (H-, n = 10), we measured IgE and IgG4 against several components of Dermatophagoïdes pteronyssinus (Dpt) and Ascaris (a marker of immunization against nematodes), and determined the IgE component sensitization profile using microarray ISAC biochips. The functional ability of IgE to induce degranulation of cultured mast cells was evaluated in the presence of Dpt., Results: Non allergic H+ subjects exhibited higher levels of IgE against Dpt compared to H- subjects. Dpt IgE were not functional in vitro and did not recognize usual Dpt major allergens. IgE recognized other component allergens that belong to different protein families, and most were glycosylated. Depletion of IgE recognizing carbohydrate cross-reactive determinant (CCD) did not induce a reduction in Dpt IgE. The Dpt IgG4 were not significantly different., Conclusion: Helminth infections induced IgE against allergens such as Dpt and molecular components that belong to different sources as well as against CCD (such as β-1,2-xylose and/or ⍺-1,3-fucose substituted N-glycans). Dpt IgE were not able to induce degranulation of mast cells and were not explained by sensitization to usual major allergens or N-glycans., Competing Interests: FDB declares financial interests with ALYATEC. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Other authors declare that they have no conflict of interest associated with the present paper.

Background: Subgroups of precarious populations such as homeless people are more exposed to infection and at higher risk of developing severe forms of COVID-19 compared to the general population. Many of the recommended prevention measures, such as social distancing and self-isolation, are not feasible for a population living in shelters characterised by physical proximity and a high population density. The objective of the study was to describe SARS-CoV-2 infection prevalence in homeless shelters in Brussels (Belgium), and to identify risk factors and infection control practices associated with SARS-CoV-2 positivity rates., Methods: A total of 1994 adults were tested by quantitative PCR tests in 52 shelters in Brussels (Belgium) between April and June, 2020, in collaboration with Doctors of the World. SARS-CoV-2 prevalence is here described site by site, and we identify risk factors associated with SARS-CoV-2 positivity rates. We also investigate associations between seropositivity and reported symptoms., Results: We found an overall prevalence of 4.6% for the period, and a cluster of high rates of SARS-CoV-2 positivity (20-30% in two shelters). Among homeless people, being under 40 years of age (OR (CI95%) 2.3 (1.2-4.4), p = 0.02), having access to urgent medical care (AMU) (OR(CI95%): 2.4 (1.4-4.4)], p = 0.02), and sharing a room with someone who tested positive (OR(CI95%): 5.3 (2.9-9.9), p<0.0001) were factors associated with SARS-CoV-2 positivity rates. 93% of those who tested positive were asymptomatic., Conclusion: This study shows high rates of SARS-COV-2 infection positive tests in some shelters, with a high proportion of asymptomatic cases. The survey reveals how important testing and isolation measures are, together with actions taken by medical and social workers during the outbreak., Competing Interests: The authors have declared that no competing interests exist.

Background: Like other helminths, hookworms (HW) induce a regulatory immune response able to modulate and dampen reactivity of the host to antigens. No data about the evolution of the immune response after treatment are available. We aim to phenotype the regulatory immune response during natural HW infection and its evolution after treatment., Methodology: Twenty hookworm infected (HW+) and 14 non-infected subjects HW-from endemic area in the periphery of Ho Chi Minh City were included. Blood and feces samples were obtained before, 2 and 4 weeks after treatment with Albendazole 400mg. Additional samples were obtained at 3 and 12 months in the HW+ group. Hematological parameters, Treg (CD4+CD25hiFoxP3hi) and surface molecules (CD39, CD62L, ICOS, PD-1, CD45RA) were measured as well as inflammatory and lymphocytes differentiation cytokines such as IL-1β, IL-6, IFNγ, IL-4, IL-17, IL-10, IL-2 and TGFβ., Results: HW+ subjects showed higher Treg, TregICOS+, Treg PD1-, TregCD62L+ and CD45RA+FoxP3lo resting Treg (rTreg). CD45RA-FoxP3lo non-suppressive Treg cells were also increased. No preferential Th1/Th2 orientation was observed, nor difference for IL-10 between two groups. After treatment, Treg, TregICOS+, TregCD62L+, Treg PD1- and rTreg decreased while IL-4 and IL-6 cytokines increased., Conclusion: During HW infection, Treg are increased and characterized by a heterogeneous population: a highly suppressive as well as a non-suppressive T cells phenotype. After treatment, Treg with immune-suppressive phenotype exhibited a decrease parallel to an inflammatory Th2 response., Competing Interests: The authors have read the journal’s policy and have the following competing interests: JFF is an employee of Ars Statistica. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.

Introduction: Early alcohol consumption can irreversible damage the adolescents' brain and may affect their quality of life. In order to better prevent such a deleterious behaviour, knowing its determinants is needed. So far, only few studies among adolescents aged <15 years exist, of which the majority failed to include gender differences. Therefore, the aim of this study was to investigate whether gender differences in the association between alcohol use and sociodemographic and psychosocial characteristics among 10-14-year olds exist., Methods: Data came from the 2018 Health Behaviour in School-Aged Children (HBSC) study conducted in French-speaking schools of Belgium. The sample analysed here comprised 4,364 10-14-year olds from the Walloon Region. Associations of the recent alcohol consumption (at least one glass during the past month) with sociodemographic and psychosocial characteristics were estimated using gender-stratified multivariable logistic regression modelling., Results: Prevalence of early alcohol consumption was 14% (boys: 16%; girls: 12%). Migration status and family affluence scale (FAS) were associated with early alcohol consumption only in boys. Second-generation immigrant boys (vs. natives: OR = 0.66 [0.47-0.92]) and boys from "low" FAS families (vs. "high": OR = 0.56 [0.32-0.98]) or "medium" FAS (vs. "high": OR = 0.63 [0.43-0.92]) were less likely to have consumed alcohol in the past month. In both genders, alcohol consumption was positively associated with age and inversely associated with school satisfaction and family support. No association was observed with family structure, peer support and life satisfaction in the multivariable models., Conclusion: Our findings showed that gender differences may exist in the determinants of alcohol consumption among young adolescents. They will contribute to the development of public health policies and actions for the most vulnerable adolescents, which should take gender differences into account., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Coronavirus disease 2019 (COVID-19) appeared in China in December 2019 and has spread around the world. High Interleukin-6 (IL-6) levels in COVID-19 patients suggest that a cytokine storm may play a major role in the pathophysiology and are considered as a relevant parameter in predicting most severe course of disease. The aim of this study was to assess repeated IL-6 levels in critically ill COVID-19 patients admitted to our Intensive Care Unit (ICU) and to evaluate their relationship with patient's severity and outcome., Methods: We conducted a retrospective study on patients admitted to the ICU with a diagnosis of COVID-19 between March 10 (i.e. the date of the first admitted patients) and April 30, 2020. Demographic, clinical and laboratory data were collected at admission. On the day of IL-6 blood concentration measurement, we also collected results of D-Dimers, C-Reactive Protein, white blood cells and lymphocytes count, lactate dehydrogenase (LDH) and ferritin as well as microbiological samples, whenever present., Results: Of a total of 65 patients with COVID-19 admitted to our ICU we included 41 patients with repeated measure of IL-6. There was a significant difference in IL-6 levels between survivors and non-survivors over time (p = 0.001); moreover, non survivors had a significantly higher IL-6 maximal value when compared to survivors (720 [349-2116] vs. 336 [195-646] pg/mL, p = 0.01). The IL-6 maximal value had a significant predictive value of ICU mortality (AUROC 0.73 [95% CI 0.57-0.89]; p = 0.01)., Conclusions: Repeated measurements of IL-6 can help clinicians in identifying critically ill COVID-19 patients with the highest risk of poor prognosis., Competing Interests: The authors have declared that no competing interests exist.

The tumour micro-environment (TME) plays a crucial role in the onset and progression of prostate cancer (PCa). Here we studied the potential of a selected panel of TME-markers to predict clinical recurrence (CLR) in PCa. Patient cohorts were matched for the presence or absence of CLR 5 years post-prostatectomy. Tissue micro-arrays (TMA) were composed with both prostate non-tumour (PNT) and PCa tissue and subsequently processed for immunohistochemistry (IHC). The IHC panel included markers for cancer activated fibroblasts (CAFs), blood vessels and steroid hormone receptors ((SHR): androgen receptor (AR), progesterone receptor (PR) and estrogen receptor (ER)). Stained slides were digitalised, selectively annotated and analysed for percentage of marker expression with standardized and validated image analysis algorithms. A univariable analysis identified several TME markers with significant impact on CR: expression of CD31 (vascular marker) in PNT stroma, expression of alpha smooth muscle actin (αSMA) in PCa stroma, and PR expression ratio between PCa stroma and PNT stroma. A multivariable model, which included CD31 expression (vascular marker) in PNT stroma and PR expression ratio between PCa stroma and PNT stroma, could significantly stratify patients for CLR, with the identification of a low risk and high-risk subgroup. If validated and confirmed in an independent prospective series, this subgroup might have clinical potential for PCa patient stratification., Competing Interests: The authors have declared that no competing interests exist.

The overlap/distinctiveness between Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) has been increasingly investigated in recent years, particularly since the DSM-5 allows the dual diagnosis of ASD and ADHD, but the underlying brain mechanisms remain unclear. Although both disorders are associated with brain volumetric abnormalities, it is necessary to unfold the shared and specific volume abnormalities that could contribute to explain the similarities and differences in the clinical and neurocognitive profiles between ADHD and ASD. In this voxel-based morphometry (VBM) study, regional grey matter volumes (GMV) were compared between 22 children with ADHD, 18 children with ASD and 17 typically developing (TD) children aged 8 to 12 years old, controlling for age and total intracranial volume. When compared to TD children or children with ASD, children with ADHD had a larger left precuneus, and a smaller right thalamus, suggesting that these brain abnormalities are specific to ADHD relative to ASD. Overall, this study contributes to the delineation of disorder-specific structural abnormalities in ADHD and ASD., Competing Interests: Isabelle Massat received an investigator-initiated research grant from Shire Pharmaceutical Development Limited, a member of the Takeda group of companies (Study ID: IST-BEL- 00520). This does not alter our adherence to PLOS ONE policies on sharing data and materials. Ariadna Albajara Sáenz is supported by a grant from the Belgian Kids’ Fund (www.belgiankidsfund.be), the David et Alice Van Buuren Fund and by the Fondation Jaumotte-Demoulin. Isabelle Massat and Ariadna Albajara Sáenz are supported by the Fonds National de la Recherche Scientifique (FNRS)-Belgium and the Fonds Erasme. The funders had no role in the study design, the data collection and analysis, the decision to publish, or the preparation of the manuscript.

Can people categorize complex visual scenes unconsciously? The possibility of unconscious perception remains controversial. Here, we addressed this question using psychophysical methods applied to unmasked visual stimuli presented for extremely short durations (in the μsec range) by means of a custom-built modern tachistoscope. Our experiment was composed of two phases. In the first phase, natural or urban scenes were either absent or present (for varying durations) on the tachistoscope screen, and participants were simply asked to evaluate their subjective perception using a 3-points scale (absence of stimulus, stimulus detection or stimulus identification). Participants' responses were tracked by means of two staircases. The first psychometric function aimed at defining participants' proportion of subjective detection responses (i.e., not having seen anything vs. having seen something without being able to identify it), while the second staircase tracked the proportion of subjective identification rates (i.e., being unaware of the stimulus' category vs. being aware of it). In the second phase, the same participants performed an objective categorization task in which they had to decide, on each trial, whether the image was a natural vs. an urban scene. A third staircase was used in this phase so as to build a psychometric curve reflecting the objective categorization performance of each participant. In this second phase, participants also rated their subjective perception of each stimulus on every trial, exactly as in the first phase of the experiment. Our main result is that objective categorization performance, here assumed to reflect the contribution of both conscious and unconscious trials, cannot be explained based exclusively on conscious trials. This clearly suggests that the categorization of complex visual scenes is possible even when participants report being unable to consciously perceive the contents of the stimulus., Competing Interests: The authors have declared that no competing interests exist.

The ability to infer how confident other people are in their decisions is crucial for regulating social interactions. In many cooperative situations, verbal communication enables one to communicate one's confidence and to appraise that of others. However, in many circumstances, people either cannot explicitly communicate their confidence level (e.g., in an emergency situation) or may be intentionally deceitful (e.g., when playing poker). It is currently unclear whether one can read others' confidence in the absence of verbal communication, and whether one can infer it as accurately as for one's own confidence. To explore these questions, we used an auditory task in which participants either had to guess the confidence of someone else performing the task or to judge their own confidence, in different conditions (i.e., while performing the task themselves or while watching themselves perform the task on a pre-recorded video). Results demonstrate that people can read the confidence someone else has in their decision as accurately as they evaluate their own uncertainty in their decision. Crucially, we show that hetero-metacognition is a flexible mechanism that relies on different cues according to the context. Our results support the idea that metacognition leverages the same inference mechanisms as those involved in theory of mind., Competing Interests: The authors have declared that no competing interests exist.

Background: In their mission to achieve better access to quality healthcare services, mutual health organisations (MHOs) are not limited to providing health insurance. As democratically controlled member organisations, MHOs aim to make people's voices heard. At national level, they seek involvement in the design of social protection policies; at local level, they seek to improve responsiveness of healthcare services to members' needs and expectations., Methods: In this qualitative study, we investigated whether MHOs in the Democratic Republic of Congo (DRC) succeed in defending members' rights by improving healthcare quality while minimising expenses. The data originate from an earlier in-depth investigation conducted in the DRC in 2016 of the performance of 13 MHOs. We re-analysed this existing dataset and more specifically investigated actions that the MHOs undertook to improve quality and affordability of healthcare provision for their members, using a framework for analysis based on Hirschman's exit-voice theory. This framework distinguishes four mechanisms for MHO members to use in influencing providers: (1) 'exit' or 'voting with the feet'; (2) 'co-producing a long voice route' or imposing rules through strategic purchasing; (3) 'guarding over the long voice route of accountability' or pressuring authorities to regulate and enforce regulations; and (4) 'strengthening the short voice route' by transforming the power imbalance at the provider-patient interface., Results: All studied MHOs used these four mechanisms to improve healthcare provision. Most healthcare providers, however, did not recognise their authority to do so. In the DRC, controlling quality and affordability of healthcare is firmly seen as a role for the health authorities, but the authorities only marginally take up this role. Under current circumstances, the power of MHOs in the DRC to enhance quality and affordability of healthcare is weak., Conclusion: On their own, mutual health organisations in the DRC do not have sufficient power to influence the practices of healthcare providers. Greater responsiveness of the health services to MHO members requires cooperation of all actors involved in healthcare delivery to create an enabling environment where voices defending people's rights are heard., Competing Interests: The authors have declared that no competing interests exist

Objective: Although high intensity physical activities may represent a great proportion of the total energy expenditure in active people, only sparse studies have investigated the accuracy of wearable monitors to assess activity related energy expenditure (AEE) during high intensity exercises. Therefore, the purpose of the present study was to investigate the accuracy of the Actiheart, a light portable monitor estimating AEE based on heart rate (HR) and activity counts (ACT), during two popular activities (running and cycling) performed at high intensities. The benefit of an individual calibration of the HR-AEE relationship established during a preliminary maximal test was also evaluated., Methods: AEE was estimated in eighteen active adults (4 women and 14 men; 25 ± 4 yr) with indirect calorimetry using a respiratory gas analysis system (reference method) and the Actiheart during 5-min running and cycling at 60, 75 and 85% of maximal oxygen uptake (VO2max) previously determined during a maximal test performed on a treadmill or cycle ergometer. For the Actiheart, AEE was estimated either using the group or individual calibrated equations available in the dedicated software, and their respective HR, ACT or combined HR/ACT algorithms., Results: When the HR algorithm was used for cycling and the HR or HR/ACT algorithms for running, AEE measured by the Actiheart increased proportionally to exercise intensity from 60 to 85% VO2max (P<0.001). Compared to indirect calorimetry, the Actiheart group calibrated equations slightly to moderately underestimated (3 to 20%) AEE for the three exercise intensities (P<0.001). Accuracy of AEE estimation was greatly improved by individual calibration of the HR-AEE relationship (underestimation below 5% and intraclass correlation coefficient [ICC]: 0.79-0.93) compared to group calibration (ICC: 0.64-0.79)., Conclusion: The Actiheart enables to assess AEE during high intensity running and cycling when the appropriate algorithm is applied. Since an underestimation was present for group calibration, an individual and sport-specific calibration should be performed when a high accuracy is required., Competing Interests: The authors have declared that no competing interests exist.

Insect damage on trees can severely affect the quality of timber, reduce the fecundity of the host and render it susceptible to fungal infestation and disease. Such pathology weakens or eventually kills the host. Infestation by two insect woodborer species (a moth and a beetle) is causing mortality of Sonneratia alba, a wide-ranging pioneer mangrove species of the Indo-Pacific. Establishing the infestation mechanism of the two insect woodborer species is an initial and essential step towards understanding their ecological role in the mangroves and in determining sustainable management priorities and options. Our main objectives were to investigate the infestation mechanism employed by the two insect woodborers which infest S. alba trees, to establish the occurrence of secondary infestation by endophytic fungi in the infested S. alba branches, and to explore a control management option to the woodborer infestation. We conducted an external inspection of infested branches in two large embayments in Kenya, Gazi Bay and Mida Creek, and by splitting infested branches we determined the respective internal infestation mechanisms. Infested wood samples from Gazi Bay and Mida Creek were incubated at 28±1°C for 3-5 days to establish the presence of fungi. A survey was conducted in both Gazi Bay and Mida Creek to ascertain the presence of ants on S. alba. The infestation characteristics of the two insect woodborer species were different. It took 6-8 months for the beetle to kill a branch of 150 cm-200 cm long. For the moth to kill a branch, it depended upon several factors including the contribution by multiple species, other than the moth infestation alone. A total of 15 endophytic fungal species were identified. Two ant species Oecophylla longipoda and a Pheidole sp. inhabited 62% and 69% respectively of sampled S. alba trees in Gazi Bay whereas only Pheidole sp. inhabited 17% of the sampled S. alba trees in Mida Creek. In summary, we have documented the time it takes each woodborer species to kill a branch, the infestation mechanism of the two insect woodborers, and we hypothesized on the role of two ant species. The presence of several different fungal species was ascertained, and we discussed their possible role in the infested wood. Our results cannot unambiguously associate the woodborers and identified fungi. We recommend further studies to investigate the presence or absence, and if present, the nature of fungi in the gut of the woodborers., Competing Interests: The authors have declared that no competing interests exist.

A personalized pelvis and femur shape is required to build a finite element buttock thigh model when experimentally investigating seating discomfort. The present study estimates the shape of pelvis and femur using a principal component analysis (PCA) based method with a limited number of palpable anatomical landmarks (ALs) as predictors. A leave-one-out experiment was designed using 38 pelvises and femurs from a same sample of adult specimens. As expected, prediction errors decrease with the number of ALs. Using the maximum number of easily palpable ALs (13 for pelvis and 4 for femur), average errors were 5.4 and 4.8 mm respectively for pelvis and femur. Better prediction was obtained when the shapes of pelvis and femur were predicted separately without merging the data of both bones. Results also show that the PCA based method is a good alternative to predict hip and lumbosacral joint centers with an average error of 5.0 and 9.2 mm respectively., Competing Interests: The authors have declared that no competing interests exist.

Many studies on collective animal behavior seek to identify the individual rules that underlie collective patterns. However, it was not until the recent advancements of micro-electronic and embedded systems that scientists were able to create mixed groups of sensor-rich robots and animals and study collective interactions from the within a bio-hybrid group. In recent work, scientists showed that a robot-controlled lure is capable of influencing the collective decisions of zebrafish Danio rerio shoals moving in a ring and a two-room setup. Here, we study a closely related topic, that is, the collective behavior patterns that emerge when different behavioral models are reproduced through the use of a robotic lure. We design a behavioral model that alternates between obeying and disobeying the collective motion decisions in order to become socially accepted by the shoal members. Subsequently, we compare it against two extreme cases: a reactive and an imposing decision model. For this, we use spatial, directional and information theoretic metrics to measure the degree of integration of the robotic agent. We show that our model leads to similar information flow as in freely roaming shoals of zebrafish and exhibits leadership skills more often than the open-loop models. Thus, in order for the robot to achieve higher degrees of integration in the zebrafish shoal, it must, like any other shoal member, be bidirectionally involved in the decision making process. These findings provide insight on the ability to form mixed societies of animals and robots and yield promising results on the degree to which a robot can influence the collective decision making., Competing Interests: The authors have declared that no competing interests exist.

Background: Increasingly studies show that immigrants have different perinatal health outcomes compared to native-born women. Nevertheless, we lack a detailed examination of the combined effects of maternal immigrant trajectory and socioeconomic status on perinatal outcomes. Our objective was to analyze the influence of time since naturalization on low birth weight and maternal socioeconomic status in Belgium., Methods: The data came from the linkage between the Brussels birth and death registers, the national register of migrant trajectories and the social security register for the years 2004-2010. We used logistic regression to estimate the odds ratios of the associations between low birth weight (LBW) and time since naturalization, by nationality groups, taking into account socioeconomic status (SES), parity and maternal age., Results: Data relate to all singleton births to Belgian, Maghrebi, Sub-Saharan African and Turkish women (n = 76 312). The results show an U-shaped of LBW according to time since naturalization for all migrant groups. LBW declines for women naturalized since less than one year and increases significantly thereafter (p<0.0001). In parallel, we observe an increase of SES among all migrant groups. Compared to Belgians, we found a lower risk of LBW among women from Maghreb (p<0.0001) and this protection is maintained even after 10 years since naturalization. In contrast, the risk of LBW for Sub-Saharan African and Turkish mothers is lower than for Belgians after one year of naturalization but similar to that of Belgians after 10 years of naturalization., Conclusion: Our results show that, despite an improvement of their SES, LBW increases among Maghrebi, Sub-Saharan African and Turkish women with time since naturalization. Mothers from Maghreb have lower rates of LBW compared to Belgians and maintain their protection even after more than 10 years of having acquired the Belgian nationality. Additional studies need to be carried out in order to gain a better understanding of the association between migration trajectories, SES and perinatal health of immigrants., Competing Interests: The authors have declared that no competing interests exist.

Background: The relationships between hedonic deficits, type D personality and suicidal ideation were explored in a group of medical students., Methods: In a cross-sectional study, 382 medical students filled out several questionnaires measuring suicide risk, depression (using the Beck Depression Inventory, i.e. BDI), type D personality (using the type D personality scale-14, i.e. DS-14) and anhedonia (using the anhedonia subscale of the BDI, the Snaith Hamilton Pleasure Scale, the Anticipatory and Consummatory subscales of the Physical Anhedonia Scale)., Results: State anhedonia and, in particular, recent change of state anhedonia and not trait anhedonia was significantly associated with suicidal ideation, specifically when depression was controlled for. Negative affectivity component of type D personality and anhedonia were independent predictors of suicidal ideation even when depression was controlled for. Loss of pleasure and not loss of interest was a significant predictor of suicidal ideation., Conclusions: Change of state anhedonia and its component of loss of pleasure measuring dissatisfaction in life could be a risk factor of suicidal ideation in medical students. Dissatisfaction, particularly in the medical course, could be a strong predictor of suicidal ideation in medical students., Competing Interests: The authors have declared that no competing interests exist.

Toxin-antitoxin (TA) systems in bacteria and archaea are small genetic elements consisting of the genes coding for an intracellular toxin and an antitoxin that can neutralize this toxin. In various cases, the toxins cleave the mRNA. In this theoretical work we use deterministic and stochastic modeling to explain how toxin-induced cleavage of mRNA in TA systems can lead to excitability, allowing large transient spikes in toxin levels to be triggered. By using a simplified network where secondary complex formation and transcriptional regulation are not included, we show that a two-dimensional, deterministic model captures the origin of such toxin excitations. Moreover, it allows to increase our understanding by examining the dynamics in the phase plane. By systematically comparing the deterministic results with Gillespie simulations we demonstrate that even though the real TA system is intrinsically stochastic, toxin excitations can be accurately described deterministically. A bifurcation analysis of the system shows that the excitable behavior is due to a nearby Hopf bifurcation in the parameter space, where the system becomes oscillatory. The influence of stress is modeled by varying the degradation rate of the antitoxin and the translation rate of the toxin. We find that stress increases the frequency of toxin excitations. The inclusion of secondary complex formation and transcriptional regulation does not fundamentally change the mechanism of toxin excitations. Finally, we show that including growth rate suppression and translational inhibition can lead to longer excitations, and even cause excitations in cases when the system would otherwise be non-excitable. To conclude, the deterministic model used in this work provides a simple and intuitive explanation of toxin excitations in TA systems., Competing Interests: The authors have declared that no competing interests exist.

In human societies, agents are assumed to experience being the author of their own actions. These basic motoric experiences of action are influenced by social hierarchies, leading to surprising and morally significant results. Here we ask whether, under coercion, the sense of agency and responsibility pass from the person who receives orders to the person who gives them. Volunteers took turns to play the roles of 'commander', 'agent' or 'victim' in a task where the commander coerced the agent to deliver painful shocks to the 'victim'. We used 'intentional binding' as an implicit measure of sense of agency in both commanders and agents, in conditions of coercion and free-choice. We observed a reduced sense of agency when agents received coercive instructions, relative to when they freely chose which action to execute. We also found that sense of agency in the commanders was reduced when they coerced agents to administer the shock on their behalf, relative to when they acted by themselves. This last effect was associated with the commander's self-reported level on a psychopathy scale. Thus, coercion resulted in neither commander nor agent feeling agency for the effect of the action, as measured through implicit methods. Our results could have profound implications for social decision-making and social regulation of moral behaviour., Competing Interests: The authors declared that they had no conflicts of interest with respect to their authorship or the publication of this article.

Onchocerciasis is a severely debilitating yet neglected tropical disease (NTD) that creates social stigma, generates and perpetuates poverty, and leads ultimately in some cases to irreversible unilateral or bilateral blindness if untreated. Consequently, the disease is a major impediment to socioeconomic development. Many control programs have been launched for the disease with moderate successes achieved. This mitigated hit is partially due to the lingering need for reliable, non-invasive and easily applicable tools for mapping endemic regions and post-elimination surveillance. In this work, bioinformatics analyses combined with immunological assays were applied in a bid to develop potential tools for diagnosis and assessing the success of drug treatment programs. We report that (i) the O. volvulus antigen, Ov58GPCR is a G-protein coupled receptor (GPCR) conserved in related nematodes, (ii) synthetic peptides predicted to be in the extracellular domain (ECD) of Ov58GPCR are indeed immunogenic epitopes in actively-infected individuals, (iii) synthetic peptide cocktails discriminate between actively-infected individuals, treated individuals and healthy African controls, (iv) polyclonal antibodies against one of the peptides or against the bacterially-expressed ECD reacted specifically with the native antigen of O. volvulus total and surface extracts, (v) Ov58GPCR is transcribed in both larvae and adult parasite stages, (vi) IgG and IgE responses to the recombinant ECD decline with ivermectin treatment. All these findings suggest that the extracellular domain and synthetic peptides of Ov58GPCR, as well as the specific immune response generated could be harnessed in the context of disease diagnosis and surveillance., Competing Interests: The authors have declared that no competing interests exist.

Background: Due to a lack of relevant data on induced abortions in the Democratic Republic of the Congo (DRC), as well as the persistence of maternal deaths in the country, this study aims to analyze the extent and characteristics of induced abortion-related complications in women who were admitted to referral health facilities in Kinshasa, including the duration of hospitalization, the mortality rate due to induced abortion complications and their characteristics, and the deaths that occurred after two days of hospitalization., Methods: This is a cross-sectional study on 843 obstetric and gynecological patients who were admitted as emergency cases to five referral health facilities in Kinshasa during 2014. These facilities were selected as being representative of five types of districts in Kinshasa, according to their cultural, socioeconomic, and infrastructural characteristics. Patient data were collected from patient records and analyzed., Results: From the 843 patients admitted to receive obstetric and gynecological emergency care services in 2014 at the health facilities surveyed, 14.7% (95% CI: 12.4-17.3%) had complications due to induced abortion. These complications were significantly diagnosed in adolescents (p = 0.003) and in single, separated, divorced, or widowed women (p = 0.03). The median duration of hospitalization was nine days, and this period of time was significantly longer for the patients who underwent surgery for pelvic peritonitis due to uterine perforation compared with the patients who underwent Caesarean section/hysterectomy. Furthermore, it was significantly longer for the patients who were treated for other induced-abortion related complications compared with patients treated for spontaneous abortion. The mortality rate related to induced abortions was 5.6% (95% CI: 2.3-11.3%), with an increase in risk of death in the presence of a postabortive pelvic peritonitis-type complication; 42.9% of deaths occurred after two days of hospitalization., Conclusion: The complications of induced abortions are a major public health problem due to their frequency among patients admitted to Kinshasa's referral health facilities, their mortality, and their poor medical management. Therefore, there is a need to understand the reason for its poor medical management in order to provide an adequate intervention program., Competing Interests: The authors have declared that no competing interests exist.

Collective decision-making plays a central role in group-living animals and can be crucial to the survival of a group and the fitness of its members. As group-level properties emerge from individual decisions, personality variation can be a major determinant of collective behaviours. Here, we explore the relationship between personality and social interactions to explain the speed and cohesion of collective decision making during the aggregation process of the American cockroach (Periplaneta americana). We composed groups solely with shy individuals (spending a long time sheltered) or bold individuals (spending a short time sheltered) and tested them in a binary setup (arena with two shelters) for 3 consecutive days. We analysed the shelter use of individuals and groups to compare behavioural consistency among days and analyse the collective decision-making process. Contrary to the bold groups, shy groups had a faster aggregation process with more individuals sheltered mainly because shy individuals found the shelter more rapidly. Moreover, we show that personality is modulated by social interactions. We show high behavioural plasticity in bold groups, where some individuals act shy. This also suggests that learning and regulation mechanisms may take place. This study sheds some light on the implications of individual personality for collective decision making and the key role of shy individuals in gregarious species, such as P. americana., Competing Interests: The authors have declared that no competing interests exist.

Satellite data and aerial photos have proved to be useful in efficient conservation and management of mangrove ecosystems. However, there have been only very few attempts to demonstrate the ability of drone images, and none so far to observe vegetation (species-level) mapping. The present study compares the utility of drone images (DJI-Phantom-2 with SJ4000 RGB and IR cameras, spatial resolution: 5cm) and satellite images (Pleiades-1B, spatial resolution: 50cm) for mangrove mapping-specifically in terms of image quality, efficiency and classification accuracy, at the Setiu Wetland in Malaysia. Both object- and pixel-based classification approaches were tested (QGIS v.2.12.3 with Orfeo Toolbox). The object-based classification (using a manual rule-set algorithm) of drone imagery with dominant land-cover features (i.e. water, land, Avicennia alba, Nypa fruticans, Rhizophora apiculata and Casuarina equisetifolia) provided the highest accuracy (overall accuracy (OA): 94.0±0.5% and specific producer accuracy (SPA): 97.0±9.3%) as compared to the Pleiades imagery (OA: 72.2±2.7% and SPA: 51.9±22.7%). In addition, the pixel-based classification (using a maximum likelihood algorithm) of drone imagery provided better accuracy (OA: 90.0±1.9% and SPA: 87.2±5.1%) compared to the Pleiades (OA: 82.8±3.5% and SPA: 80.4±14.3%). Nevertheless, the drone provided higher temporal resolution images, even on cloudy days, an exceptional benefit when working in a humid tropical climate. In terms of the user-costs, drone costs are much higher, but this becomes advantageous over satellite data for long-term monitoring of a small area. Due to the large data size of the drone imagery, its processing time was about ten times greater than that of the satellite image, and varied according to the various image processing techniques employed (in pixel-based classification, drone >50 hours, Pleiades <5 hours), constituting the main disadvantage of UAV remote sensing. However, the mangrove mapping based on the drone aerial photos provided unprecedented results for Setiu, and was proven to be a viable alternative to satellite-based monitoring/management of these ecosystems. The improvements of drone technology will help to make drone use even more competitive in the future., Competing Interests: The authors have declared that no competing interests exist.

We theoretically study the dynamics of two interacting microbial species in the chemostat. These species are competitors for a common resource, as well as mutualists due to cross-feeding. In line with previous studies (Assaneo, et al., 2013; Holland, et al., 2010; Iwata, et al., 2011), we demonstrate that this system has a rich repertoire of dynamical behavior, including bistability. Standard Lotka-Volterra equations are not capable to describe this particular system, as these account for only one type of interaction (mutualistic or competitive). We show here that the different steady state solutions can be well captured by an extended Lotka-Volterra model, which better describe the density-dependent interaction (mutualism at low density and competition at high density). This two-variable model provides a more intuitive description of the dynamical behavior than the chemostat equations., Competing Interests: The authors have declared that no competing interests exist.

Background: Mycoplasma genitalium (MG) is a cause of urethritis. While resistance to azithromycin is increasing, routine detection of MG is not performed in Belgium, where its prevalence is unknown. The aim of this study is to determine prevalence of MG in men with urethritis., Method and Findings: An "in-house" amplification assay detecting MG was performed on urine of men with complaints of urethritis who consulted the emergency unit or the Sexually Transmitted Infection clinic of our public hospital in Brussels. Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were tested on the same sample. A total of 187 men were tested. Prevalence of MG was 9% (95% Confidence Interval: 5 to 13.2%). CT was detected in 20%, NG in 22% and 56% of samples were negative for these three pathogens. Neither age, ethnic origin, sexual orientation nor HIV infection were associated with MG urethritis., Conclusion: M. genitalium was identified in 9% of men with complaints of urethritis indicating that amplification assay detecting MG should be implemented in routine testing for those patients.

Background: The relationships between anhedonia and suicidal ideation or suicide attempts were explored in a large sample of physicians using the interpersonal psychological theory of suicide. We tested two hypotheses: firstly, that there is a significant relationship between anhedonia and suicidality and, secondly, that anhedonia could mediate the relationships between suicidal ideation or suicide attempts and thwarted belongingness or perceived burdensomeness., Methods: In a cross-sectional study, 557 physicians filled out several questionnaires measuring suicide risk, depression, using the abridged version of the Beck Depression Inventory (BDI-13), and demographic and job-related information. Ratings of anhedonia, perceived burdensomeness and thwarted belongingness were then extracted from the BDI-13 and the other questionnaires., Results: Significant relationships were found between anhedonia and suicidal ideation or suicide attempts, even when significant variables or covariates were taken into account and, in particular, depressive symptoms. Mediation analyses showed significant partial or complete mediations, where anhedonia mediated the relationships between suicidal ideation (lifetime or recent) and perceived burdensomeness or thwarted belongingness. For suicide attempts, complete mediation was found only between anhedonia and thwarted belongingness. When the different components of anhedonia were taken into account, dissatisfaction-not the loss of interest or work inhibition-had significant relationships with suicidal ideation, whereas work inhibition had significant relationships with suicide attempts., Conclusions: Anhedonia and its component of dissatisfaction could be a risk factor for suicidal ideation and could mediate the relationship between suicidal ideation and perceived burdensomeness or thwarted belongingness in physicians. Dissatisfaction, in particular in the workplace, may be explored as a strong predictor of suicidal ideation in physicians.

Objective: To assess the reliability of maternal deaths surveillance system (MDSS) and to determine the factors that influence its completeness in one region of Morocco., Methods: We conducted a retrospective survey in "Gharb Chrarda Bni Hssen" region (GCBH) between January the 1st, 2013 and September the 30th, 2014 using multiple sources approach. All deaths of women of reproductive age (WRA) were investigated using certificates with medical cause, medical records and interviews with household members and relatives to ascertain a pregnancy-related or maternal death. An External Expert Committee reviewed the information collected to assign a cause for each death. Our results were compared to those reported in the same period by the MDSS., Findings: Our study identified 690 deaths of WRA and 69 maternal deaths of which 34.8% occurred outside health facilities. The MDSS recorded during the study period 538 deaths of WRA and 29 maternal deaths (including only one outside health facility) representing respectively an underreporting of 22.0% and 58.0%. Late maternal deaths represented 11.4% of all deaths of women with a registered pregnancy within 12 months prior to the death, while the MDSS identified none. The maternal mortality ratio (MMR) was estimated at 103, approximately 2.5 times higher than that reported in the MDSS., Conclusion: Our study has shown weaknesses in the current notification system for maternal deaths in the region of GCBH. Therefore, more attention must be given to the regional committees in charge of auditing the cases and defining actions to be implemented to prevent further maternal deaths.

Diatoms constitute a major group of phytoplankton, accounting for ~20% of the world's primary production. It has been shown that iron (Fe) can be the limiting factor for phytoplankton growth, in particular, in the HNLC (High Nutrient Low Chlorophyll) regions. Iron plays thus an essential role in governing the marine primary productivity and the efficiency of biological carbon pump. Oceanic systems are undergoing continuous modifications at varying rates and magnitudes as a result of changing climate. The objective of our research is to evaluate how changing environmental conditions (dust deposition, ocean warming and acidification) can affect marine Fe biogeochemistry and diatom growth. Laboratory culture experiments using a marine diatom Chaetoceros socialis were conducted at two temperatures (13°C and 18°C) and under two pCO2 (carbon dioxide partial pressure) (400 μatm and 800 μatm) conditions. The present study clearly highlights the effect of ocean acidification on enhancing the release of Fe upon dust deposition. Our results also confirm that being a potential source of Fe, dust provides in addition a readily utilizable source of macronutrients such as dissolved phosphate (PO4) and silicate (DSi). However, elevated atmospheric CO2 concentrations may also have an adverse impact on diatom growth, causing a decrease in cell size and possible further changes in phytoplankton composition. Meanwhile, ocean warming may lead to the reduction of diatom production and cell size, inducing poleward shifts in the biogeographic distribution of diatoms. The changing climate has thus a significant implication for ocean phytoplankton growth, cell size and primary productivity, phytoplankton distribution and community composition, and carbon (C), nitrogen (N), phosphorus (P), silicon (Si) and Fe biogeochemical cycles in various ways.

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.