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The impact and effectiveness of policies to support collaboration for Research & Development (R&D) and Innovation is critical to determining the success of regional economic development. (O’Kane, 2008) The purpose of this paper is to evaluate the level of success of the Innovation Vouchers Program operated by Invest Northern Ireland (Invest NI) from 2009 to 2013 and address if attitudinal views towards innovation development should play in a role in future policy design in peripheral EU regions.

Abstract Understanding the architecture of the human deep brain is especially challenging because of the complex organization of the nuclei and fascicles that support most sensorimotor and behaviour controls. There are scant dedicated tools to explore and analyse this region. Here we took a transdisciplinary approach to build a new deep-brain MRI architecture atlas drawing on advanced clinical experience of MRI-based deep brain mapping. This new tool comprises a young-male-adult MRI template spatially normalized to the ICBM152, containing T1, inversion-recovery, and diffusion MRI datasets (in vivo acquisition), and an MRI atlas of 118 labelled deep brain structures. It is open-source and gives users high resolution image datasets to describe nuclear-based and axonal architecture, combining pioneering and recent knowledge. It is a useful addition to current 3D atlases and clinical tools.

Abstract Background The single-inhaler triple combination of beclometasone dipropionate, formoterol fumarate, and glycopyrronium (BDP/FF/G) is available for maintenance therapy of chronic obstructive pulmonary disease (COPD). Cardinal features of COPD are lung hyperinflation and reduced exercise capacity. TRIFORCE aimed to evaluate the effect of BDP/FF/G on lung hyperinflation and exercise capacity in patients with COPD. Methods This double-blind, randomised, active- and placebo-controlled, crossover study recruited adults with COPD aged ≥ 40 years, who were hyperinflated and symptomatic, and were receiving mono- or dual inhaled maintenance COPD therapy. In the three treatment periods, patients were randomised to receive BDP/FF/G, BDP/FF, or placebo, each for 3 weeks, with a 7–10-day washout between treatment periods. Assessments included slow inspiratory spirometry (for resting inspiratory capacity [IC]) and constant work-rate cycle ergometry (for dynamic IC and exercise endurance time). The primary objective was to compare BDP/FF/G and BDP/FF vs. placebo for resting IC at Week 3. Key secondary objectives were to compare BDP/FF/G and BDP/FF vs. placebo for dynamic IC and exercise endurance time during constant work rate cycle ergometry at Week 3. Results Of 106 patients randomised, 95 completed the study. Resting IC adjusted mean differences vs. placebo were 315 and 223 mL for BDP/FF/G and BDP/FF, respectively (p

Abstract Background Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory condition. Given patients with COPD continue to experience exacerbations despite the availability of effective therapies, anti-inflammatory treatments targeting novel pathways are needed. Kinases, notably the phosphoinositide 3-kinases (PI3K), are thought to be involved in chronic airway inflammation, with this pathway proposed as a critical regulator of inflammation and oxidative stress response in COPD. CHF6523 is an inhaled PI3Kδ inhibitor that has shown positive preclinical results. This manuscript reports the results of a study of CHF6523 in patients with stable COPD (chronic bronchitis phenotype), and who had evidence of type-2 inflammation. Methods This randomised, double-blind, placebo-controlled, two-way crossover study comprised two 28-day treatment periods separated by a 28-day washout. Patients (N = 44) inhaled CHF6523 in one period, and placebo in the other, both twice daily. The primary objective was to assess the safety and tolerability of CHF6523; the secondary objective was to assess CHF6523 pharmacokinetics. Exploratory endpoints included target engagement (the relative reduction in phosphatidylinositol (3,4,5)-trisphosphate [PIP3]), pharmacodynamic evaluations such as airflow obstruction, and hyperinflation, and to identify biomarker(s) of drug response using proteomics and transcriptomics. Results CHF6523 plasma pharmacokinetics were characterised by an early maximum concentration (Cmax), reached 15 and 10 min after dosing on Days 1 and 28, respectively, followed by a rapid decline. Systemic exposure on Day 28 showed limited accumulation, with ratios

Abstract Peatlands, constituting over half of terrestrial wetland ecosystems across the globe, hold critical ecological significance and are large stores of carbon (C). Irish oceanic raised bogs are a rare peatland ecosystem offering numerous ecosystem services, including C storage, biodiversity support and water regulation. However, they have been degraded over the centuries due to artificial drainage, followed by peat extraction, afforestation and agriculture. This has an overall negative impact on the functioning of peatlands, shifting them from a moderate C sink to a large C source. Recognizing the importance of these ecosystems, efforts are underway for conservation (rewetting and rehabilitation), while accurately accounting for C stock and greenhouse gas (GHG) emissions. However, the implementation of these efforts requires accurate identification and mapping of artificial drainage ditches. This study utilized very high‐resolution (25 cm) aerial imagery, and a deep learning (U‐Net) approach to map the visible artificial drainage (unobstructed by vegetation or infill) in raised bogs at a national scale. The results show that artificial drainage is widespread, with ~20 000 km of drains mapped. The overall accuracy of the model was 80% on an independent testing dataset. The data were also used to derive the Fracditch which was 0.03 (fraction of artificial drainage on industrial peat extraction sites). This is lower than IPCC Tier 1 Fracditch and can aid in IPCC Tier 2 reporting for Ireland. This is the first study to map drains with diverse sizes and patterns on Irish‐raised bogs using optical aerial imagery and deep learning methods. The map will serve as an important baseline dataset for evaluating the artificial drainage ditch conditions. It will prove useful for sustainable management, conservation and refined estimations of GHG emissions. The model's capacity for generalization implies its potential in mapping artificial drains in peatlands at a regional and global scale, thereby enhancing the comprehension of the global effects of artificial drainage ditches on peatlands.

Abstract Because of their unique proton-conductivity, chains of phosphoric acid molecules are excellent proton-transfer catalysts. Here we demonstrate that this property could have been exploited for the prebiotic synthesis of the first oligopeptide sequences on our planet. Our results suggest that drying highly diluted solutions containing amino acids (like glycine, histidine and arginine) and phosphates in comparable concentrations at elevated temperatures (ca. 80 °C) in an acidic environment could lead to the accumulation of amino acid:phosphoric acid crystalline salts. Subsequent heating of these materials at 100 °C for 1–3 days results in the formation of oligoglycines consisting of up to 24 monomeric units, while arginine and histidine form shorter oligomers (up to trimers) only. Overall, our results suggest that combining the catalytic effect of phosphate chains with the crystalline order present in amino acid:phosphoric acid salts represents a viable solution that could be utilized to generate the first oligopeptide sequences in a mild acidic hydrothermal field scenario. Further, we propose that crystallization could help overcoming cyclic oligomer formation that is a generally known bottleneck of prebiotic polymerization processes preventing further chain growth.

Abstract Background The Duchenne and Becker muscular dystrophies (DMD, BMD) are neuromuscular disorders commonly associated with diverse cognitive and behavioral comorbidities. Genotype–phenotype studies suggest that severity and risk of central defects in DMD patients increase with cumulative loss of different dystrophins produced in CNS from independent promoters of the DMD gene. Mutations affecting all dystrophins are nevertheless rare and therefore the clinical evidence on the contribution of the shortest Dp71 isoform to cognitive and behavioral dysfunctions is limited. In this study, we evaluated social, emotional and locomotor functions, and fear-related learning in the Dp71-null mouse model specifically lacking this short dystrophin. Results We demonstrate the presence of abnormal social behavior and ultrasonic vocalization in Dp71-null mice, accompanied by slight changes in exploratory activity and anxiety-related behaviors, in the absence of myopathy and alterations of learning and memory of aversive cue-outcome associations. Conclusions These results support the hypothesis that distal DMD gene mutations affecting Dp71 may contribute to the emergence of social and emotional problems that may relate to the autistic traits and executive dysfunctions reported in DMD. The present alterations in Dp71-null mice may possibly add to the subtle social behavior problems previously associated with the loss of the Dp427 dystrophin, in line with the current hypothesis that risk and severity of behavioral problems in patients increase with cumulative loss of several brain dystrophin isoforms.

Abstract $$U(N)^{\otimes r} \otimes O(N)^{\otimes q}$$ U ( N ) ⊗ r ⊗ O ( N ) ⊗ q invariants are constructed by contractions of complex tensors of order $$r+q$$ r + q , also denoted (r, q). These tensors transform under r fundamental representations of the unitary group U(N) and q fundamental representations of the orthogonal group O(N). Therefore, $$U(N)^{\otimes r} \otimes O(N)^{\otimes q}$$ U ( N ) ⊗ r ⊗ O ( N ) ⊗ q invariants are tensor model observables endowed with a tensor field of order (r, q). We enumerate these observables using group theoretic formulae, for tensor fields of arbitrary order (r, q). Inspecting lower-order cases reveals that, at order (1, 1), the number of invariants corresponds to a number of 2- or 4-ary necklaces that exhibit pattern avoidance, offering insights into enumerative combinatorics. For a general order (r, q), the counting can be interpreted as the partition function of a topological quantum field theory (TQFT) with the symmetric group serving as gauge group. We identify the 2-complex pertaining to the enumeration of the invariants, which in turn defines the TQFT, and establish a correspondence with countings associated with covers of diverse topologies. For $$r>1$$ r > 1 , the number of invariants matches the number of (q-dependent) weighted equivalence classes of branched covers of the 2-sphere with r branched points. At $$r=1$$ r = 1 , the counting maps to the enumeration of branched covers of the 2-sphere with $$q+3$$ q + 3 branched points. The formalism unveils a wide array of novel integer sequences that have not been previously documented. We also provide various codes for running computational experiments.

Abstract Operational steganalysis contends with a major problem referred to as the cover-source mismatch (CSM), which is essentially a difference in distribution caused by different parameters and settings over training and test data. Despite it being of fundamental importance in an operational context, the CSM problem is often overlooked in the literature. With the goal to increase the visibility of this problem and attract the interest of the community, the present paper proposes a systematic review of the literature. It summarizes gathered knowledge and major open questions over the last 20 years of active research on CSM: terminology, methods of measurement, known causes, and mitigation strategies. Over 100 papers exploring, mitigating, assessing, or discussing steganalysis under train-test mismatch were collected by sampling scholar databases, and tracing references, cited and generated. For image steganalysis, the literature provided enough evidence to quantify the impact of causes, and the effectiveness of mitigation strategies.

The mosquito-borne alphavirus o’nyong-nyong virus (ONNV) has proven its potential to cause major human outbreaks. On the African continent, ONNV causes unspecific febrile illness and co-circulates with the close relative chikungunya virus (CHIKV). The true scale of ONNV burden is poorly understood in Africa, because of the scarce availability of molecular in-house and commercial assays, strong cross-reactivity between ONNV and CHIKV in serological assays and a lack of surveillance. We designed a new RT-qPCR assay targeting the E1 gene for the detection of ONNV that can be used in monoplex or in duplex format, combined with a previously published CHIKV monoplex assay targeting the nsp1. The lower limit of detection with 95% positivity rate was determined to be

Introduction First-line oxygenation strategy in patients with acute hypoxaemic respiratory failure consists in standard oxygen or high-flow nasal oxygen therapy. Clinical practice guidelines suggest the use of high-flow nasal oxygen rather than standard oxygen. However, findings remain contradictory with a low level of certainty. We hypothesise that compared with standard oxygen, high-flow nasal oxygen may reduce mortality in patients with acute hypoxaemic respiratory failure.Method and analysis The Standard Oxygen versus High-flow nasal Oxygen-trial is an investigator-initiated, multicentre, open-label, randomised controlled trial comparing high-flow nasal oxygen versus standard oxygen in patients admitted to an intensive care unit (ICU) for acute respiratory failure with moderate-to-severe hypoxaemia. 1110 patients will be randomly assigned to one of the two groups with a ratio of 1:1. The primary outcome is the number of patients who died 28 days after randomisation. Secondary outcomes include comfort, dyspnoea and oxygenation 1 hour after treatment initiation, the number of patients intubated at day 28, mortality in ICU, in hospital and until day 90, and complications during ICU stay.Ethics and dissemination The study has been approved by the central Ethics Committee ‘Sud Méditerranée III’ (2020-07-05) and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration number NCT04468126.

An increasing body of evidence confirms the effectiveness of physical exercise (PE) in promoting brain health by preventing age-related cognitive decline and reducing the risk of neurodegenerative diseases. The benefits of PE are attributed to neuroplasticity processes which have been reported to enhance cerebral health. However, moderate to high-intensity PE is necessary to induce these responses and these intensities cannot always be achieved especially by people with physical limitations. As a countermeasure, electrical stimulation (ES) offers several benefits, particularly for improving physical functions, for various neurological diseases. This review aims to provide an overview of key mechanisms that could contribute to the enhancement in brain health in response to ES-induced exercise, including increases in cerebral blood flow, neuronal activity, and humoral pathways. This narrative review also focuses on the effects of ES protocols, applied to both humans and animals, on cognition. Despite a certain paucity of research when compared to the more classical aerobic exercise, it seems that ES could be of interest for improving cerebral health, particularly in people who have difficulty engaging in voluntary exercise.

Abstract Infectious diseases can cause considerable mortality in vertebrate populations, especially when a new pathogen emerges. Quantifying the impact of diseases on wild populations and dissecting the underlying mechanisms requires longitudinal individual monitoring combining demographic and epidemiologic data. Such longitudinal population studies are rare. Rabbit hemorrhagic disease (RHD) is one of the main causes of the decline in European wild rabbit (Oryctolagus cuniculus) populations. A new genotype of RHD virus (RHDV), called RHDV2 or GI.2, emerged in 2010, posing a new threat to previously weakened populations, particularly as this virus can infect individuals already immune to classical RHDV strains. Taking advantage of intensive monitoring from 2009 to 2014 by physical captures and microchip detections of a semi‐captive population of rabbits, we finely assessed the demographic impact of an initial RHDV2 outbreak that occurred in the population and identified the most affected demographic parameters. A multi‐event modeling analysis revealed decreased survival in both juveniles and adults in 2011 and 2012, suggesting an RHDV2 outbreak for two consecutive years. The short‐term survival benefit of vaccination against classical RHDV strains only during these years, and the recovery of carcasses with RHDV2 detection, supported this hypothesis. Variations in population vaccination coverage also explain the difference in adult survival between the two years of the outbreak. And the transient protective effect of vaccination could explain the prolonged duration of the outbreak. A brief episode of myxomatosis in 2011 seems to have had only a limited impact on the population. During outbreak years, in individuals not recently vaccinated, monthly juvenile survival crashed (0.55), and annual adult survival was three times lower than in normal years (0.21 vs. 0.69). The combination of successive juvenile and adult survival estimates for unvaccinated rabbits during the outbreak years resulted in a very low recruitment rate in the breeding population. Finally, RHDV2 outbreaks appear to have caused mortalities comparable to those caused by older classical RHDV strains and may have a strong demographic impact on wild populations of European rabbit. This work highlights the importance of long‐term observational and experimental studies to better understand the impact of epidemics on animal populations.

Abstract The more science advances, the more questions are asked. This compounding growth can make it difficult to keep up with current research directions. Furthermore, this difficulty is exacerbated for junior researchers who enter fields with already large bases of potentially fruitful research avenues. In this paper, we propose a novel task and a recommender system for research directions, RecSOI, that draws from statements of ignorance (SOIs) found in the research literature. By building researchers’ profiles based on textual elements, RecSOI generates personalized recommendations of potential research directions tailored to their interests. In addition, RecSOI provides context for the recommended SOIs, so that users can quickly evaluate how relevant the research direction is for them. In this paper, we provide an overview of RecSOI’s functioning, implementation, and evaluation, demonstrating its effectiveness in guiding researchers through the vast landscape of potential research directions.

Background: Extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) is systematically associated with decreased respiratory system compliance (CRS). It remains unclear whether transportation to the referral ECMO center, changes in ventilatory mode or settings to achieve ultra-protective ventilation, or the natural evolution of ARDS drives this change in respiratory mechanics. Herein, we assessed the precise moment when CRS decreases after ECMO cannulation and identified factors associated with decreased CRS. Methods: To rule out the effect of transportation and the different modes of ventilation on CRS, we conducted a retrospective, single-center, observational cohort study from January 2013 to May 2020, on 22 patients with severe ARDS requiring on-site ECMO and ventilated in pressure-controlled mode to achieve ultra-protective ventilation. CRS was assessed at different time points ranging from 12 h before ECMO cannulation to 72 h after ECMO cannulation. The primary outcome was the relative change in CRS between 3 h before and 3 h after ECMO cannulation. The secondary outcomes included variables associated with the relative changes in CRS within the first 3 h after ECMO cannulation and the relative changes in CRS at each time point. Results: CRS decreased within the first 3 h after ECMO cannulation (−28.3%, 95% confidence interval [CI]: −38.8 to −17.9, P

Abstract Background Modern agriculture has undoubtedly led to increasing wildlife-human conflicts, notably concerning bird damage in productive and attractive crops during some parts of the annual cycle. This issue requires utmost attention for sedentary birds that may impact agricultural crops at any stage of their annual life cycle. Reducing bird-human conflicts requires a better understanding of the relationship between bird foraging activity and the characteristics of agricultural areas, notably with respect to changes in food-resource availability and crop sensitivity across the year. Methods We explored how GPS-tagged adult male western jackdaws– sedentary corvids– utilize agricultural areas throughout their annual cycle, in a context of crop depredation. More precisely, we described their daily occurrence distribution and the extent of habitat use and selection consistency with respect to landscape composition across time. Results Jackdaws moved in the close agricultural surroundings of their urban nesting place over the year (

Abstract Data on the SARS-CoV-2 infection among primary health care workers (PHCWs) are scarce but essential to reflect on policy regarding prevention and control measures. We assessed the prevalence of PHCWs who have been infected by SARS-CoV-2 in comparison with modeling from the general population in metropolitan France, and associated factors. A cross-sectional study was conducted among general practitioners (GPs), pediatricians, dental and pharmacy workers in primary care between May and August 2021. Participants volunteered to provide a dried-blood spot for SARS-CoV-2 antibody assessment and completed a questionnaire. The primary outcome was defined as the detection of infection-induced antibodies (anti-nucleocapsid IgG, and for non-vaccinees: anti-Spike IgG and neutralizing antibodies) or previous self-reported infection (positive RT-qPCR or antigenic test, or positive ELISA test before vaccination). Estimates were adjusted using weights for representativeness and compared with prediction from the general population. Poisson regressions were used to quantify associated factors. The analysis included 1612 PHCWs. Weighted prevalences were: 31.7% (95% CI 27.5–36.0) for GPs, 28.7% (95% CI 24.4–33.0) for pediatricians, 25.2% (95% CI 20.6–31.0) for dentists, and 25.5% (95% CI 18.2–34.0) for pharmacists. Estimates were compatible with model predictions for the general population. PHCWs more likely to be infected were: GPs compared to pharmacist assistants (adjusted prevalence ratio [aPR] = 2.26; CI 95% 1.01–5.07), those living in Île-de-France (aPR = 1.53; CI 95% 1.14–2.05), South-East (aPR = 1.57; CI 95% 1.19–2.08), North-East (aPR = 1.81; CI 95% 1.38–2.37), and those having an unprotected contact with a COVID-19 case within the household (aPR = 1.48; CI 95% 1.22–1.80). Occupational factors were not associated with infection. In conclusion, the risk of SARS-CoV-2 exposure for PHCWs was more likely to have occurred in the community rather than at their workplace.

Wood has a lower carbon footprint compared to many other materials used in construction. However, its hygroscopic nature poses significant challenges, including dimensional fluctuations in response to humidity shifts. Here we investigate a new treatment method mitigating swelling and shrinkage using dairy by-product named whey ultrafiltration permeate (mainly composed of lactose) and citric acid. Trembling aspen and black spruce samples were impregnated with ultrafiltration permeate and citric acid. Infrared and Raman spectroscopy were used to evaluate the esterification reaction and the location of the impregnates. We found increased ester bonds in the cell walls and the middle lamella (leaving the lumens empty), explaining the improved wood stability. Trembling aspen was more receptive to the treatment than black spruce, as shown by a higher weight gain (39 % vs. 13 %) and anti-swelling efficiency (54 % vs. 37 %). No leaching was observed during characterization of the treated wood. The modulus of elasticity and rupture, and the Brinell hardness were only slightly affected for both wood species. Upon combustion, esterified wood samples degraded at a lower temperature, but the stability of the residues was increased. This study highlights a promising use of ultrafiltration permeate in wood esterification.

Soils are the largest terrestrial reservoir of organic carbon, yet they are easily degraded. Consistent and accurate monitoring of changes in soil organic carbon stocks and net greenhouse gas emissions, reporting, and their verification is key to facilitate investment in sustainable land use practices that maintain or increase soil organic carbon stocks, as well as to incorporate soil organic carbon sequestration in national greenhouse gas emission reduction targets. Building up on an initial review of monitoring, reporting and verification (MRV) schemes with a focus on croplands, grasslands, and forestlands we develop a framework for a modular, scalable MRV system. We then provide an inventory and classification of selected MRV methodologies and subsequently “score” them against a list of key characteristics. It appears that the main challenge in developing a unified MRV system concerns the monitoring component. Finally, we present a conceptual workflow that shows how a prototype for an operational, modular multi-ecosystem MRV tool could be systematically built.

Resumo Esta investigação buscou entender as causas da evasão no curso de Saúde Coletiva da Universidade de Brasília, no campus de Ceilândia. A coleta de dados foi efetuada por meio de questionário aplicado aos estudantes evadidos e não evadidos do curso, alcançando uma amostra de 147 respondentes. A análise dos resultados ocorreu pela regressão logística multinomial, identificando as causas que levam o estudante a mudar de curso ou deixar o ensino superior. As causas da evasão estiveram associadas com questões individuais, familiares e institucionais, porém se manifestando de forma diversa na evasão do curso e do ensino superior. Os resultados corroboram que esses fenômenos são distintos e influenciados de forma variada, pelas mesmas ou por diferentes variáveis.

Abstract Eruptive dynamics is influenced by gas escape from the ascending magma. Gas pathways form in the magma via bubble coalescence, leading to gas channeling. Magmatic crystals play a key role in gas channel formation. This work constrains experimentally decompression‐induced coalescence in high‐crystallinity silicic magmas without external deformation, focusing on low gas content and bimodal crystal size (microlites and phenocrysts). All percolating samples have permeabilities of 10−14 m2 at bulk porosities of 7–10 vol% and bulk crystallinities up to 75 vol%. Our results demonstrate the possibility of coalescence‐related outgassing at high pressure (120–350 MPa) and without external strain, which corresponds to magma stagnating deep in a volcanic conduit. Channeling at such low gas content implies that bimodal crystallinity favors effusive over explosive volcanic behavior. It may also be the missing physical mechanism explaining gas transfer across magmatic systems despite high melt viscosity and low or absent magma extrusion.

Abstract Background The benefit–risk balance and optimal timing of surgery for severe infective endocarditis (IE) with ischemic or hemorrhagic strokes is unknown. The study aim was to compare the neurological outcome between patients receiving surgery or not. Methods In a prospective register-based multicenter ICU study, patients were included if they met the following criteria: (i) left-sided IE with an indication for heart surgery; (ii) with cerebral complications documented by cerebral imaging before cardiac surgery; (iii) with Sequential Organ Failure Assessment score ≥ 3. Exclusion criteria were isolated right-sided IE, in-hospital acquired IE and patients with cerebral complications only after cardiac surgery. In the primary analysis, the prognostic value of surgery in term of disability at 6 month was assessed by using a propensity score-adjusted logistic regression. Results 192 patients were included including ischemic stroke (74.5%) and hemorrhagic lesion (15.6%): 67 (35%) had medical treatment and 125 (65%) cardiac surgery. In the propensity score-adjusted logistic regression, a favorable 6-month neurological outcome was associated with surgery (odds ratio 13.8 (95% CI 6.2–33.7). The 1-year mortality was strongly reduced with surgery in the fixed-effect propensity-adjusted Cox model (hazard ratio 0.18; 95% CI 0.11–0.27; p

Abstract Background Little attention has been paid to potential differences in prognosis between mechanically ventilated males and females in intensive care units (ICUs). We hypothesized that a sex gap in the risk of extubation failure in ICUs may exist. Methods Post hoc analysis of a large-scale clinical trial including patients at high risk of extubation failure in ICUs, with the aim of assessing the risk of extubation failure according to sex. The primary outcome was reintubation within the 7 days following extubation. Results Out of 641 patients, 425 (66%) were males and 216 (34%) were females. Males were more likely to be admitted for cardiac arrest and to have underlying ischemic heart disease whereas females were more likely to be admitted for coma and to have obesity. Whereas the rate of reintubation at 48 h was significantly higher in males than in females (11.0% vs. 6.0%; difference, + 5.0 [95% CI, 0.2 to 9.2]; P = 0.038), the rate of reintubation at day 7 did not significantly differ between males and females (16.7% vs. 11.1%; difference, + 5.6% [95%CI, − 0.3 to 10.8], P = 0.059). Using multivariable logistic regression analysis, male sex was independently associated with reintubation within the 7 days following extubation (adjusted OR 1.70 [95% CI, 1.01 to 2.89]; P = 0.048), even after adjustment on reason for admission, body-mass index, severity score, respiratory rate before extubation, and noninvasive ventilation after extubation. Conclusion In this post hoc analysis of a clinical trial including a homogeneous subset of patients at high risk of extubation failure, sex was independently associated with reintubation. The role of sex on outcomes should be systematically examined in future studies of critically ill patients.

Abstract Aims From a patient and health system perspective, managing worsening heart failure (WHF) as an outpatient has become a priority. Remote management allows early detection of WHF, enabling timely intervention with the aim of preventing hospitalization. The objective of the study was to evaluate the feasibility and safety of remotely managing WHF events using a multiparametric platform. Methods and results All patients enrolled in the heart failure remote management programme of the Bordeaux University Hospital Telemedicine Center between 1 January and 31 December 2021 were included in the study. Follow‐up data were collected until 1 March 2022. Inclusion criteria were chronic heart failure (HF) with New York Heart Association ≥II symptoms and an elevated B‐type natriuretic peptide (BNP > 100 pg/mL or N‐terminal‐pro‐BNP > 1000 pg/mL). Patient assessments were performed remotely and included measurements of body weight, blood pressure, heart rate, symptoms, biochemical parameters, and data from cardiac implantable electronic devices when available. In total, 161 patients (71 ± 11 years old, 79% male) were followed for a mean of 291 ± 66 days with a mean adherence to the remote monitoring system of 80 ± 20%. Over this period, 52 (32.3%) patients had 105 WHF events, of which 66 (63%) were successfully managed remotely, the remaining requiring hospitalization. Freedom from WHF events and hospitalization at 300 days were 66% and 85%, respectively (P

Epidermodysplasia verruciformis (EV) is a rare genodermatosis caused by β-human papillomaviruses (HPV) in immunodeficient patients. EV is characterized by flat warts and pityriasis-like lesions and might be isolated or syndromic, associated with some other infectious manifestations. We report here three patients from two independent families, with syndromic EV for both of them. By whole exome sequencing, we found that the patients carry new homozygous variants in STK4, both leading to a premature stop codon. STK4 deficiency causes a combined immunodeficiency characterized by a broad infectious susceptibility to bacteria, viruses, and fungi. Auto-immune manifestations were also reported. Deep immunophenotyping revealed multiple cytopenia in the three affected patients, in particular deep CD4+ T cells deficiency. We report here the fourth and the fifth cases of the syndromic EV due to STK4 deficiency.

The Earth Observing System Microwave Limb Sounder measures several atmospheric chemical species (OH, H[O.sub.2], [H.sub.2]O, [O.sub.3], HCl, ClO, HOCl, BrO, HN[O.sub.3], [N.sub.2]O, CO, HCN, C[H.sub.3] CN, volcanic S[O.sub.2]), cloud ice, temperature, and geopotential height to improve our understanding of stratospheric ozone chemistry, the interaction of composition and climate, and pollution in the upper troposphere. All measurements are made simultaneously and continuously, during both day and night. The instrument uses heterodyne radiometers that observe thermal emission from the atmospheric limb in broad spectral regions centered near 118, 190, 240, and 640 GHz, and 2.5 THz. It was launched July 15, 2004 on the National Aeronautics and Space Administration's Aura satellite and started full-up science operations on August 13, 2004. An atmospheric limb scan and radiometric calibration for all bands are performed routinely every 25 s. Vertical profiles are retrieved every 165 km along the suborbital track, covering 82[degrees]S to 82[degrees]N latitudes on each orbit. Instrument performance to date has been excellent; data have been made publicly available; and initial science results have been obtained. Index Terms--Microwave, remote sensing, stratosphere, submillimeter wave.

The Bollobás–Riordan (BR) polynomial [(2002), Math. Ann.323 81] is a universal polynomial invariant for ribbon graphs. We find an extension of this polynomial for a particular family of combinatorial objects, called rank 3 weakly coloured stranded graphs. Stranded graphs arise in the study of tensor models for quantum gravity in physics, and generalize graphs and ribbon graphs. We present a seven-variable polynomial invariant of these graphs, which obeys a contraction/deletion recursion relation similar to that of the Tutte and BR polynamials. However, it is defined on a much broader class of objects, and furthermore captures properties that are not encoded by the Tutte or BR polynomials. [ABSTRACT FROM AUTHOR]

BackgroundAbout 10–20% of pancreas allografts are still lost in the early postoperative period despite the identification of numerous detrimental risk factors that correlate with graft thrombosis.MethodsWe conducted a multicenter study including 899 pancreas transplant recipients between 2000 and 2018. Early pancreas failure due to complete thrombosis, long-term pancreas, kidney and patient survivals were analyzed and adjusted to donor, recipient and perioperative variables using a multivariate cause-specific Cox model stratified to transplant centers.ResultsPancreas from donors with history of hypertension (6.7%), as well as with high body mass index (BMI), were independently associated with an increased risk of pancreas failure within the first 30 post-operative days (respectively, HR= 2.57, 95% CI from 1.35 to 4.89 and HR= 1.11, 95% CI from 1.04 to 1.19). Interaction term between hypertension and BMI was negative. Donor hypertension also impacted long-term pancreas survival (HR= 1.88, 95% CI from 1.13 to 3.12). However, when pancreas survival was calculated after the postoperative day 30, donor hypertension was no longer a significant risk factor (HR= 1.22, 95% CI from 0.47 to 3.15). A lower pancreas survival was observed in patients receiving a pancreas from a hypertensive donor without RAAS (Renin Angiotensin Aldosterone System) blockers compared to others (50% vs 14%, p < 0.001). Pancreas survival was similar among non-hypertensive donors and hypertensive ones under RAAS blockers.ConclusionDonor hypertension was a significant and independent risk factor of pancreas failure. The well-known pathogenic role of renin-angiotensin-aldosterone system seems to be involved in the genesis of this immediate graft failure.

In endemic areas, the genetic diversity among co-circulating dengue virus (DENV) strains is considerable and new, highly divergent strains are identified on a regular basis. It is thus critical to ensure that molecular diagnostic tools effectively detect virus genomes even in case of important genetic variation. Here, we tested both the pan-DENV detection capacity and the limit of detection of two real-time RT-PCR assays: (i) the commercial RealStar Altona 3.0 system and (ii) a laboratory developed test (LDT) combining two RT-PCR systems in a single reaction tube (DenAllDUO). We used a panel of DENV strains representative of the genetic diversity within DENV species, combined with three in vitro transcribed RNAs as surrogates for unavailable strains corresponding to recently discovered strains with substantial genetic divergence: DENV serotype 1 (DENV-1) Brun2014, DENV-2 QML22 and DENV-4 DKE121. Both systems (i) targeted the genome 3′ untranslated region, (ii) displayed a broad detection spectrum, encompassing most of DENV species diversity, and (iii) detected the three aforementioned divergent strains. DenAllDUO detected all the strains tested, whereas the RealStar system failed to detect strains from DENV-4 genotype III. Altogether, our findings support the value of these two RT-PCR systems as part of the Dengue diagnostic arsenal.

Dissolved organic matter (DOM) plays a crucial role in freshwater ecosystem function. Monitoring of DOM in aquatic environments can be achieved by using fluorescence spectroscopy. Particularly, DOM fluorescence can constitute a signature of microbiological contamination with a potential for high frequency monitoring. However, limited data are available regarding urban waterbodies. This study considers fluorescence data from field campaigns conducted in the Paris metropolitan region: two watercourses (La Villette basin and the river Marne), two stormwater network outlets (SO), and a wastewater treatment plant effluent (WWTP-O). The objectives of the study were to characterize the major fluorescence components in the studied sites, to investigate the impact of local rainfall in such components and to identify a potential fluorescence signature of local microbiological contamination. The components of a PARAFAC model (C1-C7), corresponding to a couple of excitation (ex) and emission (em) wavelengths, and the fluorescence indices HIX and BIX were used for DOM characterization. In parallel, fecal indicator bacteria (FIB) were measured in selected samples. The PARAFAC protein-like components, C6 (ex/em of 280/352 nm) and C7 (ex/em of 305/340 nm), were identified as markers of microbial contamination in the studied sites. In the La Villette basin, where samplings covered a period of more than 2 years, which also included similar numbers of wet and dry weather samples, the protein-like components were significantly higher in wet weather in comparison to dry weather. A positive relationship was obtained between C6 and FIB. In urban rivers, the high frequency monitoring of C6 levels would support the fecal contamination detection in rivers. In addition, it could help targeting specific field campaigns to collect comprehensive dataset of microbiological contamination episodes.