Optimal encephalitis/meningitis roadmap via precise diagnosis and treatment (IMPROVE): a study protocol for a randomized controlled trial

Background Encephalitis/meningitis brings a heavy disease burden, and the origin of disease remains unknown in 30–40% of patients. It is greatly significant that combinations of nucleic acid amplification and autoimmune antibody testing improves the diagnosis and treatment of encephalitis/meningitis. Moreover, though several diagnostic methods are in clinical use, a recognized and unified diagnosis and treatment process for encephalitis management remains unclear. Methods IMPROVE is a multicenter, open label, randomized controlled clinical trial that aims to evaluate the diagnostic performance, applications, and impact on patient outcomes of a new diagnostic algorithm that combines metagenomic next-generation sequencing (mNGS), multiplex polymerase chain reaction (PCR) and autoimmune antibody testing. The enrolled patients will be grouped into two parallel groups, multiplex PCR test plus autoimmune antibody group (Group I) or the mNGS plus autoimmune antibody group (Group II) with a patient ratio of 1:1. Both groups will be followed up for 12 months. The primary outcomes include the initial time of targeted treatment and the modified Rankin scale score on the 30th day of the trial. The secondary outcomes are the cerebrospinal fluid index remission rate on the 14th day, mortality rate on the 30th day, and an evaluation of diagnostic efficacy. The two groups are predicted to comprise of 484 people in total. Discussion To optimize the roadmap of encephalitis/meningitis, precise diagnosis, and treatment are of great significance. The effect of rapid diagnosis undoubtedly depends on the progression of new diagnostic tests, such as the new multiplex PCR, mNGS, and examination of broad-spectrum autoimmune encephalitis antibodies. This randomized-controlled study could allow us to obtain an accurate atlas of the precise diagnostic ability of these tests and their effect on the treatment and prognosis of patients. Trial registration ClinicalTrial.gov, NCT04946682. Registered 29 June 2021, ‘Retrospectively registered’, https://clinicaltrials.gov/ct2/show/NCT04946682?term=NCT04946682&draw=2&rank=1

The Influence of Leaf Fertilizer Media on Multiplication of Barangan Banana (Musa acuminate L.) in vitro

Barangan banana (Musa acuminata L.) is a plant that has the biggest contribution to national fruit production. The increasing demand for the banana requires the availability of seedlings, while conventional cultivation is unable to produce healthy, disease-free seedlings in a short time and large amount. In vitro culture is considered to be able to handle the constraints of the conventional seed supply. The purpose of this study was to determine the effect of foliar fertilizers on in vitro multiplication of barangan bananas. The method used was a single factor of Completely Randomized Design (CRD), the addition of leaf fertilizer consisting of five levels of media treatment, media MS (control), and 0.50 ml L-1 (p1); 0.75 ml L-1 (p2); 1.00 ml L-1 (p3); 1.25 ml L-1 (p4); 1.50 ml L-1 (p5) of leaf fertilizer media repeated five times. The data were analyzed with Analysis Variance then followed by Duncan Multiple Ranged Test of 5%. The results showed MS media still gave the best results compared to other leaf fertilizer media. Meanwhile, the leaf fertilizer media used in this study still gave good results on the initial time of buds appearance (p3 treatment), the number of shoots and the number of leaves in the p5 treatment, as well as the height of the plant in the p4 and p5 treatments. Therefore, the leaf fertilizer can be used to substitute MS media

Study on the Influence of Silica Fume (SF) on the Rheology, Fluidity, Stability, Time-Varying Characteristics, and Mechanism of Cement Paste

In this study, the rheology, fluidity, stability, and time-varying properties of cement paste with different substitute contents of silica fume (SF) were investigated. The result showed that the effects of SF on macro-fluidity and micro-rheological properties were different under different water–cement ratios. The addition of SF increased the yield stress and plastic viscosity in the range of 2.61–18.44% and 6.66–24.66%, respectively, and reduced the flow expansion in the range of 4.15–18.91%. The effect of SF on cement paste gradually lost its regularity as the w/c ratio increased. The SF can effectively improve the stability of cement paste, and the reduction range of bleeding rate was 0.25–4.3% under different water–cement ratios. The mathematical models of rheological parameters, flow expansion, and time followed the following equations: τ(t) = τ0 + k0t, η(t) = η0eat, and L(t) = L0 − k1t, L(t) = L0 − k1t − a1t2. The SF slowly increased the rheological parameters in the initial time period and reduced the degree of fluidity attenuation, but the effect was significantly enhanced after entering the accelerated hydration period. The mechanism of the above results was that SF mainly affected the fluidity and rheology of the paste through the effect of water film thickness. The small density of SF particles resulted in a low sedimentation rate in the initial suspended paste, which effectively alleviated the internal particle agglomeration effect and enhanced stability. The SF had a dilution effect and nucleation effect during hydration acceleration, and the increase of hydration products effectively increased the plastic viscosity.

Resettlement pattern model of internally displaced persons due to insurgency

In this paper, the derivation and analysis of a model is considered for resettlement pattern of internally displaced persons due to insurgency. In the derived model, a number of homeless people at some initial time after the insurgency attack are considered. The flow of the population to a temporary state until their final resettlement is analyzed. The analytic solution for the stability analysis is obtained using Routh Harwitz Criterion and the behavior of the model is obtained numerically, using MATLAB R2010a. The result obtained indicates that majority of displaced persons get resettled after a long period of time.

Approximate Valuation of Life Insurance Portfolio with the Cluster Analysis: Trade-Off Between Computation Time and Precision

Valuation of the insurance portfolio is one of the essential actuarial tasks. Life insurance valuation is usually based on a projection of cash flows for each policy which is demanding computation time. Furthermore, modern financial management requires multiple valuations under different scenarios or input parameters. A method to reduce computation time while preserving as much accuracy as possible based on cluster analysis is presented. The basic idea of the method is to replace the original portfolio by a smaller representative portfolio based on clusters with some weights that would ensure the similarity of the valuation results to the original portfolio. Valuation is then significantly faster but requires initial time for clustering and the results are only approximate – different from the original results. The difference is studied for a different number of clusters and the trade-off between the approximation error and calculation time is evaluated.

Applying Behavioral and Physiological Measures to Assess the Relative Impact of the Prolonged COVID-19 Pandemic Closure on Two Mammal Species at the Oregon Zoo: Cheetah (A. jubatus) and Giraffe (G. c. reticulata and G. c. tippelskirchii)

The effect of visitor presence on zoo animals has been explored in numerous studies over the past two decades. However, the opportunities for observations without visitors have been very limited at most institutions. In 2020, the Oregon Zoo was closed, in response to the global SARS-CoV-2 (COVID-19) pandemic, from 15 March 2020 to 12 July 2020, resulting in approximately four consecutive months without visitor presence. This study aimed to quantify potential behavioral and hormonal changes expressed during two transition periods in zoo visitor attendance: the initial time period before and after closure in March 2020 and time before and after reopening in July 2020. Fecal glucocorticoid metabolite (fGM) concentrations of resident giraffes (n = 2) and cheetahs (n = 2) were tracked using enzyme immunoassay (EIA) analyses. Average fGM concentrations during the two transition periods were compared using a two-way mixed ANOVA. Additionally, twice-weekly scan sampling was used to quantify behavioral observations across the transitions, which were analyzed as individual behavior proportions. Individual behavior proportions were compared across the Zoo’s opening status and time of day using Kruskal–Wallis (H) tests. The results of our analyses showed the following outcomes: (1) significant increases in fGM concentrations for cheetahs and giraffes between the transition periods but not within them; (2) a significant increase in time spent ‘not visible’ in the cheetahs in the second transition period; and (3) increased vigilance behaviors in the giraffes immediately after the Zoo’s closure. However, the changes observed in fGM concentrations may be more strongly correlated with concomitant social changes (giraffes) and some medical events (cheetahs) rather than with the Zoo’s opening status. Nevertheless, this study was able to quantify differences in behavioral frequencies and fGM concentration in cheetahs and giraffes at the Oregon Zoo during the times of transition between visitor’s presence and absence. The results indicate that, while there was a possible, but relatively minor impact of the presence and absence of visitors on some behaviors, the differences observed in fGM concentration may have been more affected by some of the concomitant social changes and medical events that happened during the same period than by the presence or absence of visitors.

Relative dispersion with finite inertial ranges

Relative dispersion experiments are often analysed using theoretical predictions from two- and three-dimensional turbulence. These apply to infinite inertial ranges, assuming the same dispersive behaviour over all scales. With finite inertial ranges, the metrics are less conclusive. We examine this using pair separation probability density functions (PDFs), obtained by integrating a Fokker–Planck equation with different diffusivity profiles. We consider time-based metrics, such as the relative dispersion, and separation-based metrics, such as the finite scale Lyapunov exponent (FSLE). As the latter cannot be calculated from a PDF, we introduce a new measure, the cumulative inverse separation time (CIST), which can. This behaves like the FSLE, but advantageously has analytical solutions in the inertial ranges. This allows the establishment of consistency between the time- and space-based metrics, something which has been lacking previously. We focus on three dispersion regimes: non-local spreading (as in a two-dimensional enstrophy inertial range), Richardson dispersion (as in an energy inertial range) and diffusion (for uncorrelated pair motion). The time-based metrics are more successful with non-local dispersion, as the corresponding PDF applies from the initial time. Richardson dispersion is barely observed, because the self-similar PDF applies only asymptotically in time. In contrast, the separation-based CIST correctly captures the dependencies, even with a short (one decade) inertial range, and is superior to the traditional FSLE at large scales. Nevertheless, it is advantageous to use all measures together, to seek consistent indications of the dispersion.

Making Things for People: An Iterative Design Procedure Informed by Human Behaviour

<p>Technology inevitably evolves and develops rapidly in the modern era, industries and professions continue to strive in integrating, adapting and utilising these advancements to improve, optimise and improve the process of design to manufacture to the user experience. Although disruptive at first causing a reluctance of technological adoption within a workplace and ultimately progression of an industry, the eventual impact and benefits noticeably outweigh the initial time and cost within industry adoption, adaptation and development. Architecture and design is not immune to this phenomenon; from computational 2D and 3D modeling, BIM and cloud based data to physical prototyping with 3D printing, laser cutting and automated CNC routing, these are a few select examples that has forced the industry of design to rethink processes, possibilities and realistic opportunities where none existed prior. One such system that fits into this category is the advent of Virtual Reality and Augmented Reality. The numerous possibilities to which these visually and spatially immersive systems opportune for immense innovation often lacks direction or an ultimate goal thus rendering this piece of software to often be little more than a visualisation tool. This thesis recognises the unique position that VR allows and seeks to interrogate and deconstruct current, traditional design processes to better utilise VR in aiding and reinforcing the idea of partial testing of ideas and concepts throughout the design cycle. Different sciences such as psychology, processes and automation from computational design and considerations within software development will be employed and injected into the broader architectural context in which this research presides. In addition to the VR headset, external hardware that better capture human metrics such as EEG, eye tracking, GSR will be considered to developed a seamless tool and workflow that allows us, as designers to better interrogate clients behaviour within our designed digital representations which leads to validations, evaluations and criticisms of our actions within the architectural realm.</p>

Making Things for People: An Iterative Design Procedure Informed by Human Behaviour

<p>Technology inevitably evolves and develops rapidly in the modern era, industries and professions continue to strive in integrating, adapting and utilising these advancements to improve, optimise and improve the process of design to manufacture to the user experience. Although disruptive at first causing a reluctance of technological adoption within a workplace and ultimately progression of an industry, the eventual impact and benefits noticeably outweigh the initial time and cost within industry adoption, adaptation and development. Architecture and design is not immune to this phenomenon; from computational 2D and 3D modeling, BIM and cloud based data to physical prototyping with 3D printing, laser cutting and automated CNC routing, these are a few select examples that has forced the industry of design to rethink processes, possibilities and realistic opportunities where none existed prior. One such system that fits into this category is the advent of Virtual Reality and Augmented Reality. The numerous possibilities to which these visually and spatially immersive systems opportune for immense innovation often lacks direction or an ultimate goal thus rendering this piece of software to often be little more than a visualisation tool. This thesis recognises the unique position that VR allows and seeks to interrogate and deconstruct current, traditional design processes to better utilise VR in aiding and reinforcing the idea of partial testing of ideas and concepts throughout the design cycle. Different sciences such as psychology, processes and automation from computational design and considerations within software development will be employed and injected into the broader architectural context in which this research presides. In addition to the VR headset, external hardware that better capture human metrics such as EEG, eye tracking, GSR will be considered to developed a seamless tool and workflow that allows us, as designers to better interrogate clients behaviour within our designed digital representations which leads to validations, evaluations and criticisms of our actions within the architectural realm.</p>

Age-dependent normalisation functions for T-lymphocytes in healthy individuals

Lymphocyte numbers naturally change through age. Normalisation functions to account for this are sparse, and mostly disregard measurements from children in which these changes are most prominent. In this study, we analyse cross-sectional numbers of mainly T-lymphocytes (CD3+, CD3+CD4+ and CD3+CD8+) and their subpopulations (naive and memory) from 673 healthy Dutch individuals ranging from infancy to adulthood (0-62 years). We fitted the data by a delayed exponential function and received parameter estimates for each lymphocyte subset. Our modelling approach follows general laboratory measurement procedures in which absolute cell counts of T-lymphocyte subsets are calculated from observed percentages within a reference population that is truly counted (typically the total lymphocyte count). Consequently, we receive one set of parameter estimates per T-cell subset representing both the trajectories of their counts and percentages. We allow for an initial time delay of half a year before the total lymphocyte counts per µl of blood start to change exponentially, and we find that T-lymphocyte trajectories tend to increase during the first half a year of life. Thus, our study provides functions describing the general trajectories of T-lymphocyte counts and percentages of the Dutch population. These functions provide important references to study T-lymphocyte dynamics in disease, and allow one to quantify losses and gains in longitudinal data, such as the CD4+ T-cell decline in HIV-infected children, and/or the rate of T-cell recovery after the onset of treatment.