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With the level of automation increases in vehicles, such as conditional and highly automated vehicles (AVs), drivers are becoming increasingly out of the control loop, especially in unexpected driving scenarios. Although it might be not necessary to require the drivers to intervene on most occasions, it is still important to improve drivers' situation awareness (SA) in unexpected driving scenarios to improve their trust in and acceptance of AVs. In this study, we conceptualized SA at the levels of perception (SA L1), comprehension (SA L2), and projection (SA L3), and proposed an SA level-based explanation framework based on explainable AI. Then, we examined the effects of these explanations and their modalities on drivers' situational trust, cognitive workload, as well as explanation satisfaction. A three (SA levels: SA L1, SA L2 and SA L3) by two (explanation modalities: visual, visual + audio) between-subjects experiment was conducted with 340 participants recruited from Amazon Mechanical Turk. The results indicated that by designing the explanations using the proposed SA-based framework, participants could redirect their attention to the important objects in the traffic and understand their meaning for the AV system. This improved their SA and filled the gap of understanding the correspondence of AV's behavior in the particular situations which also increased their situational trust in AV. The results showed that participants reported the highest trust with SA L2 explanations, although the mental workload was assessed higher in this level. The results also provided insights into the relationship between the amount of information in explanations and modalities, showing that participants were more satisfied with visual-only explanations in the SA L1 and SA L2 conditions and were more satisfied with visual and auditory explanations in the SA L3 condition.

Understanding how trust is built over time is essential, as trust plays an important role in the acceptance and adoption of automated vehicles (AVs). This study aimed to investigate the effects of system performance and participants' trust preconditions on dynamic situational trust during takeover transitions. We evaluated the dynamic situational trust of 42 participants using both self-reported and behavioral measures while watching 30 videos with takeover scenarios. The study was a 3 by 2 mixed-subjects design, where the within-subjects variable was the system performance (i.e., accuracy levels of 95\%, 80\%, and 70\%) and the between-subjects variable was the preconditions of the participants' trust (i.e., overtrust and undertrust). Our results showed that participants quickly adjusted their self-reported situational trust (SST) levels which were consistent with different accuracy levels of system performance in both trust preconditions. However, participants' behavioral situational trust (BST) was affected by their trust preconditions across different accuracy levels. For instance, the overtrust precondition significantly increased the agreement fraction compared to the undertrust precondition. The undertrust precondition significantly decreased the switch fraction compared to the overtrust precondition. These results have important implications for designing an in-vehicle trust calibration system for conditional AVs.

Spinal cord injury (SCI) causes motor impairment and the proper excitation/inhibition balance in motoneurons is important for recovery. Diabetes mellitus impairs regenerative capacity following SCI. The purpose of this study was to assess the short-term plasticity (STP) of lumbar spinal cord motoneurons in conditions of (1) lateral hemisection (SCI), (2) fructose-induced diabetes (D), and (3) diabetes associated with hemisection (D + SCI). We show that in the cases of SCI, D, and D + SCI, the ratio of percentage share of excitatory and inhibitory combinations of motoneurons responses to high-frequence stimulation of sciatic nerve is multidirectional. In the SCI and D + SCI groups, the cumulative changes in generalized baseline frequencies decreased significantly. When we compared the cumulative changes in the intensity of excitatory and inhibitory responses relative to baseline during high-frequency stimulation (tetanization epoch), we found that there was a significant intensification in tetanic depression in the D + SCI groups versus SCI, as well as an intensification in tetanic potentiation in the D + SCI vs. D and D + SCI vs. SCI groups. Thus, in conditions of traumatic and/or metabolic pathology, the distinct synaptic inputs exhibit opposing plasticity for homeostatic control of neurotransmission and these integral changes most likely shape postsynaptic STP in the spinal motor network.

Since the 90s'Retrospective AE case finding was carried out at main multi-profile medical centers equipped with the modern diagnostic means. The medical records of all patients with liver surgery admitted between January 2008 and June 2020 were reviewed. A specific form was developed in EpiInfo v.7.2. Annual national incidence was estimated using population denominators provided by the National Institute of Statistics.Overall, 11 AE cases have been identified. All patients were diagnosed at advanced stages, with subsequent poor prognosis and costly treatment. Confirmation was based on tissue biopsy and medical imaging results. Age ranged from 12 to 58 years with a median of 33 yrs. Patients were from rural communities, mostly in the Gegharkunik region (6 cases, 55%). Annual average incidence of AE was 0.033/100,000 varying between 0.032 in 2008 and 0.1 in 2017.There are human AE cases happening in Armenia since more a decade ago. In the absence of an AE surveillance system, the burden of AE disease is difficult to estimate. Development of national AE guidelines with a case definition should help enforcing registry of all cases, early diagnosis and also clinical and public awareness.

Introduction: We aimed to investigate the prevalence of liver involvement in pediatric patients with ARI using both routine tests of hepatic panel, and ornithine carbamoyltransferase (OCT) to identify the most sensitive indicators of early hepatic injury. Methodology: A prospective cohort study of 84 armenian children with ARI was conducted to evaluate the associated liver involvement. The diagnostic variables of interest were the signs of clinical disease severity, and enzymatic profile of the patients. Results: Serum levels of OCT were increased in 94% of patients versus routine tests of hepatic panel (AST in 41.7%, ALT in 15.5%, etc). Variance analysis by severity groups showed the serum levels of OCT (p < 0.001), ammonia (p < 0.001), phospholipides (p = 0.05), glucose (p = 0.01), TNF-α (p = 0.01), IL-8 (p < 0.001), AST (p < 0.001), and ALP (p < 0.001) were associated with the severity of underlying disease. Moreover, regression analysis revealed the serum activity of OCT (p value < 0.001, OR = 1.27) and ammonia (p value 0.002, OR = 1.1) significantly predict the severity of the disease. Conclusions: Using more sensitive marker of liver damage can detect more cases of ARI with hepatic manifestations. For evaluation of the liver involvement we are suggesting the testing of serum OCT levels as a more sensitive and specific marker. Pediatric patients with ARI and with higher serum OCT levels have 27% more chance to experience increased disease severity, which can affect on liver state and prolong hospitalization time and cost.

A retrospective analysis was conducted of human cases and outbreaks of tularemia in the Republic of Armenia from 1996 to 2012 utilizing geographic information system software. A total of 266 human cases of tularemia were recorded in Armenia from 1996 to 2012, with yearly incidence ranging from 0 to 5.5 cases per 100,000 people. Cases predominantly affected the male population (62.8%), 11–20 year age group (37.2%), agricultural workers (49.6%), and persons residing in rural areas (93.6%). In 2003, a waterborne outbreak involving 158 cases occurred in Kotayk Marz, and in 2007, a foodborne outbreak with 17 cases occurred in Gegharkunik Marz, attributed to exposure of food products to contaminated hay. Geospatial analysis of all cases showed that the majority were associated with the steppe vegetation zone, elevations between 1,400 and 2,300 m, and the climate zone associated with dry, warm summers, and cold winters. Characterization of these environmental factors were used to develop a predictive risk model to improve surveillance and outbreak response for tularemia in Armenia.

Objective The goal of this study was to identify gaps in the severe acute respiratory infection sentinel surveillance system at Surb Astvatsamayr Medical Center. Introduction Influenza is a priority in Armenia. There are two influenza surveillance systems in Armenia: population and sentinel. The medical center (MC) has been included in sentinel surveillance since 2012. In 2015 a study was undertaken to identify gaps in severe acute respiratory infection (SARI) sentinel surveillance system in Surb Astvatsamayr MC. Methods Medical records and reporting forms of SARI cases were generated for individuals meeting the case definition and analyzed for age groups, risk factors, sentinel surveillance detection methods, laboratory conformation, number of days hospitalized and reporting. Results In 2014, 3016 patients were admitted in the hospital with ARI, of whom 2982 were younger than 18 years. During the 2014-2015 influenza season (week 40, 2014-week 20, 2015), 77 swabs have been taken in total, of which five were influenza positive (4 B and 1 AH1N1). Also in the 2013-2014 influenza season, five samples tested positive (all influenza A). Sixty-one (48%) patients with respiratory disease met the WHO SARI case definition (2011), 84 (66%) of all reviewed patients would have met the SARI case definition. The numbers for the ICU (25 records reviewed) do not reflect the actual percentage of patients admitted with respiratory symptoms. The 33 additional cases taken from the sampling logbook were mainly hospitalized in the ICU. Influenza tests were performed on 34 patients (mainly ICU), five were positive for influenza (four B--all adults—and one AH1N1), and four tested positives for other respiratory pathogens (two RSV, one RV, one BV). All influenza positives had fever or a history of fever and 80% met the WHO SARI case definition (2011). Non-sampled cases generally have fewer reported symptoms, but still 44% of cases fits the WHO SARI case definition (2011). Conclusions The percentages of patients meeting the WHO SARI 2011 case definition and the WHO SARI 2014 definition shows that mainly caused by the absence of shortness of breath in the SARI 2014 definition 52% (2011) vs 66% (2014) in Surb Asvatsamayr. A large number of children from Neonatal and Children’s departments fulfil the SARI case definition and could potentially be swabbed in addition to ICU patients. There are gaps in WHO SARI case definitions. The sentinel surveillance system should be improved.

Composed of trillions of individual microbes, the human gut microbiota has adapted to the uniquely diverse environments found in the human intestine. Quickly responding to the variances in the ingested food, the microbiota interacts with the host via reciprocal biochemical signaling to coordinate the exchange of nutrients and proper immune function. Host and microbiota function as a unit which guards its balance against invasion by potential pathogens and which undergoes natural selection. Disturbance of the microbiota composition, or dysbiosis, is often associated with human disease, indicating that, while there seems to be no unique optimal composition of the gut microbiota, a balanced community is crucial for human health. Emerging knowledge of the ecology of the microbiota-host synergy will have an impact on how we implement antibiotic treatment in therapeutics and prophylaxis and how we will consider alternative strategies of global remodeling of the microbiota such as fecal transplants. Here we examine the microbiota-human host relationship from the perspective of the microbial community dynamics.

Objective In the spring of 2014, people from vulnerable households in all marzes of Armenia were examined with the aim of active surveillance. Introduction Brucellosis is a serious disease caused by bacteria of the Brucella genus. It principally affects ruminants but may be transmitted to humans. Registration of cases in cattle farms causes considerable economic losses and creates favorable conditions for mass infection among humans. In Armenia the expansion of animal industries and urbanization are the main reasons for occurrence and development of brucellosis. Methods Blood was sampled from people on farms reported as having infected animals. Blood samples were tested by the Wright- Huddleston method. The standard case definition of brucellosis was used for diagnosis. A questionnaire-based interview was carried out among the population to identify the form of contact with animals and to analyze epidemiological links. During the investigation provisions were followed in governmental decree RA 19.01.2006 N480-N and brucellosis prevention, epidemiology, diagnosis, treatment, preventive measures. Results A total of 11160 people from 1054 households were enrolled in the study, of which 3625 (32.5%) underwent a laboratory examination. Nearly 6% (641) refused to be tested. Over 6% of those tested (226) were positive for antibodies to Brucellae. Of these, 129 (3.5%) had chronic brucellosis. Those testing positive for brucellosis were treated appropriately. These included 203 (90%) adults and 23 (10%) below 14 years old; 147 (65%) were male and 79 (35%) were female. Of those diagnosed with brucellosis, working in animal husbandry accounted for 46.6% (106), while those who harvested milk accounted for 37.6% (85) and those using raw milk made up 15.4% (35). Conclusions Cases were most frequently reported among people 20-55 years of age; the highest percentage of positives were among 41-45 year old males who had contact with infected animals. The main risk factor for acquiring brucellosis is animal husbandry.