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Abstract The authors propose a compression strategy for a 3D human pose estimation model based on a transformer which yields high accuracy but increases the model size. This approach involves a pruning‐guided determination of the search range to achieve lightweight pose estimation under limited training time and to identify the optimal model size. In addition, the authors propose a transformer‐based feature distillation (TFD) method, which efficiently exploits the pose estimation model in terms of both model size and accuracy by leveraging transformer architecture characteristics. Pruning‐guided TFD is the first approach for 3D human pose estimation that employs transformer architecture. The proposed approach was tested on various extensive data sets, and the results show that it can reduce the model size by 30% compared to the state‐of‐the‐art while ensuring high accuracy.

Abstract In the video compression industry, video compression tailored to machine vision tasks has recently emerged as a critical area of focus. Given the unique characteristics of machine vision, the current practice of directly employing conventional codecs reveals inefficiency, which requires compressing unnecessary regions. In this paper, we propose a framework that more aptly encodes video regions distinguished by machine vision to enhance coding efficiency. For that, the proposed framework consists of deep learning-based adaptive switch networks that guide the efficient coding tool for video encoding. Through the experiments, it is demonstrated that the proposed framework has superiority over the latest standardization project, video coding for machine benchmark, which achieves a Bjontegaard delta (BD)-rate gain of 5.91% on average and reaches up to a 19.51% BD-rate gain.

Why did the French neurotropic vaccine against yellow fever remain in global use from 1945 to the early 1980s, despite mounting evidence that it could cause fatal encephalitis in small children? This paper investigates debates over the safety and efficacy of the French Dakar-strain vaccine at the World Health Organization (WHO) in the postwar years. French microbiologists argued for retaining the vaccine, citing millions of successful jabs in colonial Africa during World War II. Critics pointed to well-documented postwar cases of serious adverse effects, and the availability of a safer alternative – the Rockefeller 17-D strain. Investigating the WHO-s debate reveals how postwar decisions to retain the Dakar strain as an emergency option, next to the 17-D vaccine, were shaped by prewar epidemiological data. These, in turn were limited by colonial infrastructure and racialized logics of wartime vaccination campaigns. Though the vaccine was supposed to be used only as an emergency alternative, in practice, its ease of use in West African settings made it the default option during outbreaks for decades.

Standards and infrastructures have become ubiquitous objects of study in STS. They are critical to the global work of microbiology. However, the role of early twentieth-century colonial, military, and capitalist expansion in the production of these infrastructures is underappreciated. Further, the role of microbial “resistance” in shaping and changing the global microbiological order needs better elucidation. This requires connecting the technical work done in laboratories across the world with the global processes that have shaped much of the twentieth century. The articles in this thematic collection cast light on neglected temporal and geographic areas of human-microbial interactions, explore new ways of (re)reading historical sources to reveal (post)colonial distortions of scientific practice and acts of resistance, and underline the need to trace microbes and associated biomedical interventions not only within laboratories, but also within wider human and non-human environments.

Background Subaortic stenosis (SAS) is characterized by a fibromuscular membrane located just below the aortic valve, causing fixed outflow tract obstruction. There is a paucity of studies evaluating this condition. This cohort study reviewed the contemporary characteristics and outcomes of SAS in adult patients in a single large referral center. Methods and Results We retrospectively studied adult patients with SAS evaluated at our center during 2011 to 2022. The primary outcome was all‐cause mortality and heart failure hospitalizations during follow‐up, with secondary end points including recurrence of SAS and repeat surgery after initial SAS surgery. Among 484 patients with SAS, key characteristics included mean age 55±18 years, 67.5% female, left ventricular outflow tract peak velocity 352±140 cm/s and gradient 57±40 mm Hg, left ventricular ejection fraction 60%±14%, 54.8% had prior SAS surgery, and 45.1% had surgery during follow‐up. Over a median follow‐up of 5.5 (1.5–12.3) years, 11.5% (n=56) died, 6.8% (n=33) had heart failure hospitalizations, 8.0% (n=39) experienced SAS recurrence, and 14 (5.9%) underwent repeat SAS surgery. Multivariable analyses identified older age per 10‐years (hazard ratio [HR], 1.37 [95% CI, 1.12–1.68]) and baseline New York Heart Association class (HR, 2.48 [95% CI, 1.54–3.99]) to be statistically significantly associated with the primary end point; higher body mass index, New York Heart Association class, and peak left ventricular outflow tract gradient were also statistically significantly associated with SAS recurrence and redo surgery. Conclusions Almost half of patients with SAS had surgery in the past or during follow‐up, and a significant minority had mortality or morbidity events during follow‐up. Identified prognosticators warrant further research to guide management.

This study determines the critical success factors of teaching mathematics to special education (SPED) students wherein a list of success factors is identified through a literature survey and analyzes the causal relationships among the identified factors to evaluate the key success factors using the integration of the grey system theory and decision-making trial and evaluation laboratory (DEMATEL), named as the grey-DEMATEL. Results reveal that professional development (PD), institutional support (IS), and individual factors (IF) are categorized as net causes. They influence other factors considered as net effects, including mentoring, self-efficacy, teaching capacity, student feedback, teaching knowledge, instructional accommodation, and use of technology. Among those net causes, only PD yields as the key factor, while IS and IF are the minor key factors. Thus, decision-makers must allocate resources that provide PD to teachers in delivering SPED mathematics teaching. A sensitivity analysis suggests these findings are robust to linguistic evaluation scale changes. The insights outlined in this study would aid educational managers and decision-makers of educational institutions in carefully designing initiatives to improve the quality of mathematics education provided to SPED students. Some potential directions for future research agenda are also discussed.

Background Takotsubo cardiomyopathy (TC) is an established differential diagnosis of myocardial infarction with non-obstructive coronaries with significant interest but limited data on prognostication. We reviewed the characteristics and in-hospital outcomes and developed a novel risk score for TC.Methods Using the National Inpatient Sample data from 2016 to 2020, we identified adult patients (≥18 years) with acute coronary syndrome (ACS) and TC. We divided the cohort into ACS with and without TC and retrieved baseline data. Multivariable regression analysis was conducted to identify factors associated with TC diagnosis and adverse outcomes, leading to the development of a risk-scoring system.Results Among 7 219 004 adult ACS admissions, 78 214 (1.0%) were diagnosed with TC, with a mean age of 68.2 years, 64 526 (82.5%) being female and 5475 (7.0%, compared with 8.4% for other ACS) in-hospital mortality events. Factors significantly associated with TC were female sex (OR 6.78 (95% CI 6.47 to 7.09), p70 years, non-white race, hypertension, hyperlipidemia, history of coronary artery bypass grafting, history of percutaneous coronary intervention, cardiac arrhythmias, renal failure, cardiogenic shock and vasopressor use. The area under curves for in-hospital mortality was 0.716 in the derivation and 0.725 in the validation cohorts.Conclusions TC remains a high-risk diagnosis in a minority of ACS cases, with mortality rates similar to other ACS causes. Our novel risk score offers a valuable tool for risk stratification in patients with TC, but external validation is needed to confirm its utility.

Key Clinical Message Our case depicts a challenging diagnosis of catastrophic antiphospholipid syndrome in a young patient with a heterogenous presentation with extensive clinical course, a wide range of investigations, including multimodality imaging, and multidisciplinary expertise, to initiate prompt treatment addressing multiorgan thrombotic injury.

Background Pregnancy in patients with pulmonary hypertension (PH) is associated with a heightened risk of medical complications including right heart failure, pulmonary edema, and arrhythmias. Our study investigated the association between PH and these complications during delivery. Methods and Results The National Inpatient Sample was used to identify delivery hospitalizations from 2011 to 2020. Multivariable logistic regression was performed to study the association of PH with the primary outcomes of in‐hospital medical and obstetric complications. A total of 37 482 207 delivery hospitalizations in women ≥18 years of age were identified, of which 9593 patients had PH. Pregnant patients with PH had higher incidence of complications during delivery including preeclampsia/eclampsia, arrhythmias, and pulmonary edema among others, compared with those without PH. Pregnant patients with PH also had a higher incidence of in‐hospital mortality compared with those without PH (0.51% versus 0.007%). In propensity‐matched analyses, PH was still significantly associated with a higher risk of in‐hospital mortality (odds ratio [OR], 5.02 [95% CI, 1.82–13.90]; P=0.001), pulmonary edema (OR, 9.11 [95% CI, 6.34–13.10]; P

The factors influencing consumer purchase decisions in electronic commerce platforms and the interrelationships of each element are prevalent in the domain literature. However, a comprehensive analysis of the complex interrelationships among the success factors remains unexplored, especially in a social commerce context. To address the gap, this work evaluates the relationship structure and determines the critical factors using interpretive structural modelling (ISM). On the other hand, the Matrice d’Impacts Croisés Multiplication Appliquée á un Classement (MICMAC) is introduced to analyse the interaction of the factors and recognise the most relevant among them. In demonstrating the ISM-MICMAC analysis, this work performed a case study evaluating 13 factors of social commerce success for food products derived from a previous study. The findings of this work suggest that timeliness, data privacy policy, and Internet connectivity drive most other factors. Thus, focusing the resources on augmenting these factors consequently improves other factors. These findings suggest that sellers must streamline their overall service chain to maintain timeliness in their transactions, safeguard consumers’ data privacy, and uphold consumer communication efficiency to maximise Internet connectivity. These insights provide useful information to help decision-makers in the food industry allocate resources and encourage more consumers for social commerce. Several managerial insights were discussed.

Objetivo: determinar la relación entre el Ret-He con diferentes categorías según la concentración de hemoglobina en candidatos a donar sangre. Materiales y Métodos: Se realizó un estudio transversal a partir de la revisión de 227 historias clínicas de candidatos a donar sangre durante el mes de diciembre del 2021 en el Servicio de Banco de Sangre y Hemoterapia del Hospital Cayetano Heredia. Se categorizó en 3 grupos según los niveles de hemoglobina: Grupo 1: ≥12,5 g/dl (mujeres) - ≥13,5 g/dl (varones). Grupo 2: 12 g/dl ≥ mujeres

Abstract Background Mental health disorders are a major public health concern especially among undergraduates, globally and within Egypt. Most individuals suffering from mental illnesses either do not seek care at all or seek it only after a large delay. It is therefore critical to identify the barriers that prevent them from seeking professional help to solve the problem from its roots. Thus, the objectives of the study were to assess the prevalence of psychological distress, the need for professional mental health care, and the barriers to seeking available services among undergraduate students in Egypt. Methods A proportionate allocation technique was used to recruit 3240 undergraduates from 21 universities. Symptoms of psychological distress were evaluated using the Arabic General Health Questionnaire (AGHQ-28) and a score of above nine was used to identify positive cases. The pattern for utilization of mental health care was assessed using a multi-choice question and barriers to mental health care were assessed using the Barriers to Access to Care Evaluation (BACE- 30) tool. Logistic regression was adopted to identify the predictors of psychological distress and seeking professional health care. Results The prevalence of psychological distress was 64.7% and the need for professional mental health care was 90.3% of those with psychological distress. The top barrier to receiving professional mental health services was wanting to solve the problem on their own. Logistic regression revealed that female sex, living away from family and positive family history of mental disorders were independent predictors of psychological distress. Students from urban backgrounds were more likely to seek help than students from rural ones. While age above 20 and positive family history of mental disorders were independent predictors for seeking professional help. There is no significant difference between medical and non-medical students in terms of psychological distress. Conclusion The findings of the study showed there is a high prevalence of psychological distress and a lot of instrumental and attitudinal related barriers to seeking mental health care and highlighted the urgent need to develop interventions and preventive strategies to address the mental health of university students.

Parasitic constrictive pericarditis is a rare entity. We present a case of a 75-year-old man who presented with dyspnea, ascites, and pedal edema and was found to have constrictive pericarditis on multimodality imaging with positive serology for Strongyloides Stercoralis. Treatment required ivermectin and radical pericardiectomy with significant clinical improvement. (Level of Difficulty: Intermediate.)

Infective endocarditis is a complex heterogeneous condition involving the infection of the endocardium and heart valves, leading to severe complications, including death. Surgery is often indicated in patients with infective endocarditis but is associated with elevated risk compared with other forms of cardiac surgery. Risk models play an important role in many cardiac surgeries as they can help inform clinicians and patients regarding procedural risk, decision-making to proceed or not, and influence perioperative management; however, they remain under-utilized in the infective endocarditis settings. Another crucial role of such risk models is to assess predicted versus found mortality, thereby allowing an assessment of institutional performance in infective endocarditis surgery. Traditionally, general cardiac surgery risk models such as European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, and Society of Thoracic Surgeon’s score have been applied to endocarditis surgery. However, there has been the development of many endocarditis surgery-specific scores over the last decade. This review aims to discuss clinical characteristics and applications of all contemporary risk scores in the setting of surgical treatment of infective endocarditis.

Human embryonic kidney (HEK) 293 cells are widely used in protein and viral vector production owing to their high transfection efficiency, rapid growth, and suspension growth capability. Given their antiviral, anticancer, and immune-enhancing effects, type I interferons (IFNs) have been used to prevent and treat human and animal diseases. However, the binding of type I IFNs to the IFN-α and-β receptor (IFNAR) stimulates the expression of IFN-stimulated genes (ISGs). This phenomenon induces an antiviral state and promotes apoptosis in cells, thereby impeding protein or viral vector production. In this study, we generated an IFNAR subtype 1 knockout (KO) HEK 293 suspension (IFNAR-KO) cell line by using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein-9 nuclease (Cas9) technology. Upon treatment with human IFN-α, the IFNAR-KO cells showed a constant expression of ISGs, including 2ʹ-5ʹ-oligoadenylate synthetase 1 (OAS1), myxovirus resistance 1 (Mx1), protein kinase RNA-activated (PKR), and IFN-induced transmembrane protein 1 (IFITM1), when compared with the wild-type HEK 293 (WT) cells, wherein the ISGs were significantly upregulated. As a result, the titer of recombinant adenovirus expressing porcine IFN-α was significantly higher in the IFNAR-KO cells than in the WT cells. Furthermore, the IFNAR-KO cells continuously produced higher amounts of IFN-α protein than the WT cells. Thus, the CRISPR-Cas9-mediated IFNAR1 KO cell line can improve the production efficiency of proteins or viral vectors related to IFNs. The novel cell line may be used for producing vaccines and elucidating the type I IFN signaling pathway in cells.

Foot-and-mouth disease (FMD) is an acute contagious infectious disease that affects cloven-hoofed animals. Although current emergency FMD vaccines only take effect 7 days after vaccination, antiviral agents, such as quercetin, which is a common flavonoid, could reduce the spread of FMD virus (FMDV) during outbreaks. We investigated the in vitro and in vivo antiviral effects of quercetin against FMDV. Analysis of viral copy numbers showed that quercetin had a dose-dependent inhibitory effect on FMDV at concentrations between 19.5 and 1,250 μM in porcine cells. In addition, we observed a quercetin-induced interferon (IFN)-α protein and interferon-stimulated gene (ISG) upregulation in swine cells. Enzyme-linked immunosorbent assay of sera revealed that quercetin induces the production of IFN-α, IFN-β, IFN-γ, interleukin (IL)-12, and IL-15 in mice. Inoculation of mice with quercetin or a combination of quercetin with an inactivated FMD vaccine enhanced both the survival rate and neutralizing antibody titer. Therefore, we suggest the use of quercetin as a novel and effective antiviral agent for controlling FMDV infection; however, further investigation of its application in livestock is required.

BackgroundAlthough the number of new HIV infections is declining in most regions of the world, the Middle East is one of the regions with a rapidly growing HIV epidemic, with Egypt having the fastest-growing epidemic, with a 76 percent increase in the number of cases. One of the major factors contributing to this trend is the general public's lack of knowledge about the disease. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) is one of the most widely used instruments for assessing HIV/AIDS knowledge and has been translated into several languages. This study examined the validity of the Arabic version of the HIV-18-KQ as well as its adaptation among Arab undergraduates.MethodsThe HIV-18-KQ was both forward and back-translated. The translation was reviewed by an expert committee of eight experts. The final version was created and distributed to undergraduates from five Arabic countries: Egypt, Sudan, Yemen, Jordan, and Algeria. The validity of the Arabic version of the HIV-18-KQ was evaluated using internal consistency and construct validity. Internal consistency was tested using the Kuder-Richardson formula 20 (KR-20), and construct validity was evaluated using an exploratory factor analysis with a polychoric correlation matrix.ResultsThe majority of the translated items were easy to understand. The Arabic HIV-18-KQ was deemed culturally appropriate by the expert committee. This study included 1745 university students, including 956 (54.5%) males and 798 (45.5%) females, with 33.4% from Egypt. Based on the acceleration factor approach to interpreting the scree plot in the factor analysis, it was preferable to use only one factor, which is consistent with the original version of HIV-45-KQ. The KR-20 value was 0.73, indicating good internal reliability.ConclusionThis study demonstrates that the Arabic version of the HIV-18-KQ is a valid and reliable tool for assessing HIV-related knowledge in Arabic-speaking countries.

Abstract With over 25,000 species, orchids are among families with remarkable high rate of diversification. Since Darwin's time, major advances attributed the exceptional diversity of orchids to plant–pollinator interactions. However, unraveling the processes and factors that determine the phenotypic and genotypic variation of natural orchid populations remains a challenge. Here, we assessed genetic population structure and floral differentiation in recently diverged leafless Vanilla species in a world biodiversity hotspot, Madagascar, using seven microsatellite loci and 26 morphometric variables. Additionally, analyses were performed to test for the occurrence of any patterns of isolation by distance, isolation by environment, and isolation by adaptation and to detect possible physical barriers that might have caused genetic discontinuities between populations. Positive inbreeding coefficients detected in 22 populations were probably due to the presence of null alleles, geitonogamy and/or some admixture (sympatric species). In contrast, the only high‐altitude population showed an important rate of clonality leading to heterozygote excess. Genetic diversity was maximum in western populations, suggesting a postglacial colonization to the north and south. Clustering analyses identified seven genetic groups characterized by specific floral traits that matched five botanical descriptions in the literature. A contribution of montane refugia and river barriers on population differentiation was detected. We also detected combined effects of IBD/IBE and IBE/IBA on genetic differentiation and suggested this pattern is more likely determined by ecological isolation, although pollinator‐mediated divergent selection could not be ruled out for some of the species. Overall, this study provides further insights on speciation in orchids, a group for which Madagascar shows one of the world's highest level of endemism and confirms the importance of the peculiar biogeography of the island in shaping species differentiation.

This article looks at how the discourse of an emerging information society in 1990s Estonia both rejected and depended on expertise from the Soviet Period. It traces the influence 1960s-trained cyberneticians and sociologists had on expanding the concept of an information society in the 1990s, to encompass issues such as regional inequality, national culture, and poverty, instead of focusing solely on hardware purchasing and telecomms liberalization. This process was both enabled and occluded through "rupture-talk,” a rhetorical strategy emphasizing the novelty of digital infrastructure development compared to the Soviet past. The article argues that a shared belief in the power of information processing for both empowering and containing civil society enabled ideologically divergent actors to work together. The resulting vision diverged from neoliberal visions of information societies in hitherto unacknowledged ways.

Infective endocarditis (IE) remains to be a heterogeneous disease with high morbidity and mortality rates, which can affect native valves, prosthetic valves, and intra-cardiac devices, in addition to causing systemic complications. The combination of clinical, laboratory, and cardiac imaging evaluation is critical for early diagnosis and risk stratification of IE. This can facilitate timely medical and surgical management to improve patient outcomes. Key imaging findings for IE include vegetations, valve perforation, prosthetic valve dehiscence, pseudoaneurysms, abscesses, and fistulae. Transthoracic echocardiography continues to be the first-line imaging modality of choice, while transesophageal echocardiography subsequently provides an improved structural assessment and characterization of lesions to facilitate management decision in IE. Recent advances in other imaging modalities, especially cardiac computed tomography and 18F-fluorodeox-yglucose positron emission tomography, and to a lesser extent cardiac magnetic resonance imaging and other nuclear imaging techniques, have demonstrated important roles in providing complementary IE diagnostic and prognostic information. This review aims to discuss the individual and integrated utilities of contemporary multi-modality cardiac imaging for the assessment and treatment guidance of IE.

This study investigated the development of study engagement from the end of upper secondary school through the first and second years of higher education. The participants experienced the challenges related to the first wave of the COVID-19 pandemic while they were either university students or preparing for university entrance exams. The study employed a person-oriented approach to determine what kind of developmental trajectories emerge in study engagement when following the student participants from the end of upper secondary school through the first and second years of higher education. Furthermore, the study investigated whether socio-emotional skills obtained by the end of secondary school and before the pandemic play a role in more adaptive development through demanding restrictions related to the worldwide pandemic and general changes in the learning environment. The 852 participants answered questionnaires on study engagement and socio-emotional skills in spring 2019, and of them, 426 individuals who continued their education answered regarding study engagement again in spring 2020 and winter 2020/2021. The grades in math and Finnish language were also included. The results indicated that most students tended to experience a drop in study engagement during the first wave of COVID-19 compared to the pre-pandemic level; however, they managed to boost their engagement back to previous levels approximately 6 months later. Students who managed to recover their engagement also tended to have higher socio-emotional skills than students who were struggling with study engagement before the pandemic or who started to struggle during the pandemic.

Background People with human immunodeficiency virus (PWHIV) who have hepatitis C virus (HCV) coinfection are at a higher risk of progression of liver disease than the general population. Direct acting antivirals provide a therapeutic option for HCV cure, however access to HCV specific care for PWHIV can be challenging. A paucity of specialist providers is a barrier to this care. Objectives This study aims to assess knowledge gained about HIV/HCV coinfection among health care providers. Methods AIDS Education Training Centers (AETC) have developed a modular national HIV/HCV coinfection curriculum consisting of a free selfdirected online curriculum to educate health care providers, including nonspecialist providers, involved in the care of PWHIV on HCV care and management. The effectiveness of this curriculum was evaluated with pre and post module assessment completion by learners compared with a paired t -test. Results 716 people received links to the curriculum and 277 modules were completed by 221 unique individuals. 86% completed one module, 9% complete 2 modules, and the remaining 5% completed between 3 and all 6 modules. There were statistically significant increases in knowledge in the epidemiology module.

This study examines longitudinal associations among reading skills, math skills and emotional well-being in a Finnish sample (n = 586) followed from the end of comprehensive school (Grade 9, age 15-16) to age 20. In particular, we determine whether the associations between skills and well-being are mediated by self-concept beliefs. In Grade 9, the participants' reading fluency, PISA reading comprehension and math skills were assessed in classrooms, and questionnaires were used to assess self-concept (global and skill-specific) and internalising problems. At age 20, questionnaires were used to self-report emotional well-being and educational attainment. The results showed no direct predictive association between academic skills and age-20 emotional well-being, while indirect effects from academic skills on emotional well-being were found for reading skills through reading comprehension self-concept belief and educational attainment and for math skills through global self-concept belief. In addition, adolescent global self-concept and internalising problems predicted age-20 emotional well-being. The results suggest that adolescent self-concept beliefs and internalising problems, rather than academic skills per se, can predict emotional problems in young adulthood.

MICAL is an oxidoreductase that participates in cytoskeleton reorganization via actin disassembly in the presence of NADPH. Although three MICALs (MICAL1, MICAL2 and MICAL3) have been identified in mammals, only the structure of mouse MICAL1 has been reported. Here, the first crystal structure of human MICAL3, which contains the flavin-containing monooxygenase (FMO) and calponin-homology (CH) domains, is reported. MICAL3 has an FAD/NADP-binding Rossmann-fold domain for monooxygenase activity like MICAL1. The FMO and CH domains of both MICAL3 and MICAL1 are highly similar in structure, but superimposition of the two structures shows a different relative position of the CH domain in the asymmetric unit. Based on kinetic analyses, the catalytic efficiency of MICAL3 dramatically increased on adding F-actin only when the CH domain was available. However, this did not occur when two residues, Glu213 and Arg530, were mutated in the FMO and CH domains, respectively. Overall, MICAL3 is structurally highly similar to MICAL1, which suggests that they may adopt the same catalytic mechanism, but the difference in the relative position of the CH domain produces a difference in F-actin substrate specificity.