Traditionally, adolescent drinking cultures differed between Nordic and Mediterranean countries; the former being characterised by low volume and relatively frequent heavy episodic drinking (HED). Across these drinking cultures, we examined the associations between alcohol volume and HED with respect to (i) secular trends at the country level and (ii) individual-level associations over time. The data stem from the European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted among 15–16-year-olds in Finland, Iceland, Norway, Sweden, France and Italy, employing six cross-sectional surveys from 1999 to 2019 . Both consumption volume and HED frequency decreased in all Nordic countries and displayed a curvilinear trend in France and Italy. In all countries, consumption volume and HED correlated highly over time at the country level. At the individual level, the correlation was positive but with a varying magnitude over time and between countries. In 1999/2003, the alcohol volume–HED correlation was significantly higher in the Nordic compared to the Mediterranean countries but became significantly weaker in Finland, Norway and Sweden and remained stable in France, Iceland and Italy during the period. In conclusion, while trends in consumption volume and drinking patterns went hand in hand at the aggregate level, the association at the individual level weakened over time in several Nordic countries, along with the substantial decline in adolescent drinking since 2000. Alcohol consumption is a significant and modifiable risk factor for health and social harms , and alcIn European countries, total consumption in the adult population varies substantially, both over time and between countries . DrinkinIt is also found that consumption volume and HED frequency display different patterns across socio-demographic groups within populations. For instance, volume of consumption often peaks in middle age and increases with socioeconomic status (SES), whereas HED frequency typically peaks in young adulthood and tends to decrease with increasing SES . These oA growing amount of literature shows that over the past two decades, the prevalence of drinking and the overall amount of drinking have declined among adolescents in many European countries ,17,18,19(1)Are country-level changes in the volume of alcohol consumption associated with country-level changes in HED?(2)Are the individual-level associations between the volume of consumption and HED different between and within countries with different levels of HED?By examining the alcohol volume—HED association in populations from a time dynamic perspective, we empirically test the idea that the drinking pattern is relatively stable within a population irrespective of changes in the overall consumption volume. Specifically, we asked: Data stem from the European School Survey Project on Alcohol and Other Drugs (ESPAD) trend database. The ESPAD survey was conducted among samples of 10th graders in nearly all European countries at four-year intervals from 1995 to 2019 . IdenticWe applied a semi-continuous measure of drinking frequency. The students were asked: “On how many occasions (if any) have you had any alcohol beverage to drink during the past 30 days?”, with response alternatives: ‘0’, ‘1–2’, ‘3–5’, ‘6–9’, ‘10–19’, ‘20–39’ and ‘40 or more’. The responses were recoded to the number of days per month; 0, 1.5, 4, 7.5, 14.5, 30 and 30, respectively. Notably, the response category ‘40 or more’ was coded 30 because it is the maximum possible number of days in a 30-day period; however, less than 1% of the respondents ticked off this response option. The volume of consumption past 30 days was calculated by multiplying the measure of drinking frequency past 30 days and the amount of alcohol consumed on the most recent drinking occasion. The latter was obtained from beverage-specific questions on volume consumed on the most recent drinking occasion; that is, the students were asked: “If you drank beer/cider/premixed drinks/wine/spirits that last day you drank any alcohol, how much did you drink?”. The response categories  were calculated into centiliters of pure alcohol, using the midpoints of the categories  and the following alcohol content for the various beverages: beer/cider, 5%; premixed drinks, 4.5%; wine, 12%; spirit, 38% [The frequency of heavy episodic drinking (HED) was assessed by asking how many times in the past 30 days the students had drunk a certain number of drinks or more on one occasion. This corresponded to five or six drinks, depending on country-specific container sizes and average alcohol content per beverage. Response options were ‘none’, ‘1 time’, ‘2 times’, ‘3–5 times’, ‘6–9 times’, ‘10 or more times’, and by employing mid-point values, these response categories took the values ‘0’, ‘1’, ‘2’, ‘4’, ‘7.5’, and ‘12’, respectively. For some respondents who reported drinking frequency ‘1–2 times’ and HED frequency ‘2 times’, the latter took the value ‘1.5 times’. We applied an indicator of HED-oriented drinking pattern by calculating the ratio of HED frequency: to drinking frequency . Thus, the ratio is equivalent to the proportion of drinking occasions that were HED occasions, and the larger the ratio, the more HED-oriented drinking pattern. We analysed the data both at the aggregate level and at the individual level. At the aggregate level, we examined co-variation in trends for volume and drinking pattern, thereby reflecting trends in drinking prevalence. Hence, in these analyses, we included all students. At the individual level, we examined the extent to which volume and drinking pattern  co-varied among drinkers and whether the magnitude of association changed over time, and in these analyses, we included only past 30 days drinkers . Thus, we first examined the aggregate-level associations between the mean volume of alcohol consumption and mean number of HED occasions, for which each survey year represents a data point. Trends in consumption volume and HED frequency were depicted for each country and survey year in graphs for visual inspection, and bi-variate associations were estimated employing Pearson’s correlation coefficient. In these analyses, we also applied the measure of drinking frequency (described above) as an indicator—or proxy measure—of consumption volume. The reasons for this are that drinking frequency is inherently and closely correlated with the overall volume of consumption, and the reliability of the estimated volume at the most recent drinking occasion may differ systematically with drinking cultures across countries and over time. Regarding the latter, the reliability of reported consumption is better when the recall period is short . Thus, fp < 0.05) [Next, we examined the individual-level association between consumption volume and drinking patterns among drinkers only. For these analyses, we applied two types of analyses of association for each country. First, we estimated the proportion of drinking occasions that were HED occasions for each survey year. Next, we regressed HED frequency on drinking frequency (as a proxy measure for volume) in linear regression models and thereby estimated how much a change in drinking frequency predicted a change in HED frequency. In these analyses, we applied pairs of survey years  to increase robustness when examining whether these associations changed over time within each country. Hence, we tested differences between each country’s estimated regression coefficients at the two endpoints of the observation period (1999/2003 versus 2015/2019). Furthermore, we tested whether the regression coefficients differed between countries at the two endpoints of the observation period. Regression coefficients with non-overlapping 95% confidence intervals were considered statistically significantly different ( < 0.05) . The number of missing responses varied across the country, survey year and variable. We employed weighted data in all analyses for those countries that provided sampling weights . Weights were calculated to account for gender, the geographical distribution of the target population, type and size of schools and immigrant background (only Finland). We employed SPSS  for the statistical analyses.We first examined the aggregate level data.Thus, from visual inspection of the diagrams, we observe a roughly similar patterning of trends in drinking frequency, volume and HED frequency in each country and the two groups of countries by drinking culture: a downward trend in the four Nordic countries and a peak in the middle of the period in the Mediterranean countries. We estimated the associations between the three aggregate measures of drinking frequency, volume and HED frequency by country, as reported in We further examined the HED/drinking frequency ratio by year and country, as depicted in Throughout the whole period, this ratio was higher in the Nordic countries compared to the Mediterranean countries, and we observed a slightly decreasing trend in the Nordic countries over time compared to the other countries. Next, we explored associations between consumption volume and HED at the individual level and among past 30 days drinkers only. Moreover, we estimated to what extent drinking frequency was associated with HED frequency, and we regressed HED frequency on drinking frequency for pairs of years and each country. The associations as linear regression coefficients are displayed in Hence, the north–south gradient in the magnitude of the drinking frequency–HED association was less clear at the end of the period than at the start. Alcohol consumption is a major risk factor for morbidity and premature mortality among young people , and a HWe will offer some possible explanations for the observed findings in the following sections. First, within each country, we found that among all students, including non-drinkers, the secular trends in consumption volume and HED frequency were highly correlated, irrespective of drinking culture or consumption trends. Obviously, these trends are influenced by changes in the prevalence of drinking, which will impact the correlation between volume and drinking pattern. Hence, the individual-level analyses of drinkers only add to and nuance this picture. In three of the Nordic countries, the association weakened over time, implying that drinking occasions, to a lesser extent, involved HED. This suggests that the drinking culture among drinkers had changed from HED-oriented to a more moderation-oriented way of drinking. It is this latter observation that intuitively contradicts the idea about a strong, culturally rooted drinking pattern which is highly robust and fairly insensitive to influences over time. So, how can we explain these apparent changes in drinking culture in Nordic countries? Let us first start by rephrasing the question and ask: why did HED occasions decline relatively more than drinking occasions? Some tentative explanations can be found in recent qualitative studies of adolescent drinking and drinking patterns ,27,28,29While, as noted above, many studies have examined possible explanations for the declining trends in adolescent drinking in the Nordic countries, less is known about likely explanations for changes in drinking behaviour among youth in Mediterranean countries. Two recent studies, employing data from many European countries, including France and Italy, found that neither computer-based activities nor parental control and support could explain population-level trends in adolescent drinking ,31. ThusPolicymakers and the industry often state their interest in changing the drinking culture by reducing HED without reducing total alcohol consumption. Such ideas have been referred to as the “dream of a better society”  and “dreassociations between the two are substantially biased. Another issue pertains to the measure of alcohol quantity consumed at the last drinking occasion to calculate consumption volume. While this measure, as compared to the usual quantity per occasion, is considered less subject to under-reporting [Some study limitations should be noted. The ESPAD data on alcohol consumption stem from self-reports, and the volume of reported alcohol consumed is likely underestimated both at high levels  and amoneporting , it may Overall, aggregate-level findings suggest that declining trends in consumption volume are accompanied by similar trends in HED frequency. Individual-level findings suggest that among drinkers, the HED-oriented drinking culture in Nordic countries became less prominent over time along with the decline in consumption volume, while it remained fairly stable in the Mediterranean countries. Thus, the clear differences found between Nordic and Mediterranean countries at the start of the observation period may have weakened over the two decades from 1999 to 2019. More studies are needed to address the association between volume and pattern of drinking over time, also from other countries and drinking cultures. A better understanding of why consumption volume and HED frequency may go hand in hand will be important to inform policy making and prevention.


Comparative approaches that examine floras with similar environments, but different diversity patterns, provide good opportunities to elucidate how uneven distributions of biodiversity were assembled. Eastern Asia (EA) and North America north of Mexico  share similar geographical environments with comparable latitude, land area and climate, except that NA has a coastline in the west. The two regions harbor more than 12% of all angiosperm species in the world . HoweverMuch of the earlier work focused on comparing taxonomic diversity between eastern EA and eastern NA. However, recent studies have suggested phylogenetic diversity, which incorporates both taxonomic diversity and evolutionary histories of taxa, to be a better measure of biodiversity than only counting and comparing species number . One recChina and the United States of America (USA) cover almost half of the land areas of EA and NA Fig. S1B), respectively, and harbor much of the plant diversity in the two regions. We herein explore the floristic differences between EA and NA using the well-studied floras of China and the 48 contiguous states of the USA as exemplars, by integrating a newly generated dated phylogeny covering ∼90% of the angiosperm genera of the two countries , complete species-level trees  and comprehensive spatial distribution data. We calculate generic richness and phylogenetic diversity patterns of 1749 grid cells (each of 100 km × 100 km) from China and the USA within a robust dated phylogenetic framework  of angiosperm genera than the USA. Focusing on eastern parts of China and the USA, previous work demonstrated that eastern China has higher phylogenetic diversity than the eastern USA [Investigation of temporal divergence patterns reveals that China has more angiosperm genera that originated during each geological timespan than the USA Fig. B and hasOur study reveals that China shows stronger east-west heterogeneity in diversity than the USA across both temporal and spatial scales . Eastern China has more genera that originated during each geological timespan and shows higher richness and PD than either western China or the USA, but western China has fewer genera that originated during each geological time interval and lower richness and PD than the USA  [The pattern of divergence times within the USA is more complex than within China; the east has more genera that originated during the Paleogene than the west, but the west then surpassed the east after the middle Miocene Figs B and S6B. (2020) .Although China shows greater east-west deviation in divergence times and diversity than the USA, the two floras share the signature of an older east and a younger west. Heterogeneity in phylogenetic diversity between eastern and western China and the potential driving forces have been well documented by previous studies . Our stuet al. (2018) [An increasing number of studies indicate that conservation efforts should focus on the protection of regions with high phylogenetic diversity, rather than species richness, to better prepare for uncertain environmental changes in the future . This as. 2018) , but is 8 , but iThe species-level analyses did not detect any phylogenetic diversity hotspots in the eastern USA Fig. J. This rOur current study provides novel insights into the assembly of disjunct floras across much of the northern hemisphere, a topic that has been of interest to biologists for more than 250 years . In partnwab199_Supplemental_FileClick here for additional data file.


The ileal pouch-anal anastomosis is a commonly accepted neorectum after total proctocolectomy for familial adenomatous polyposis and ulcerative colitis. Generally, patients have decent bowel control, but ileal pouches are not without complications. One relatively uncommon complication is ileal pouch prolapse. Prolapse can be either mucosal or full thickness, similar to rectal prolapse. There is limited literature detailing the frequency and management of ileal pouch prolapse. The majority of the literature is case reports with a few small retrospective studies. Fibrin glue has been described for sutureless mesh fixation in total extraperitoneal hernia repairs. Here, we describe a fibrin glue pouch pexy for ileal pouch prolapse after total proctocolectomy with ileal pouch-anal anastomosis. Ileal pouch prolapse is defined as a protrusion of the pouch wall into the lumen or through the anal canal . BlazebyRisk factors for ileal pouch prolapse are unknown; however, the onset could be related to low body weight and a family history of ulcerative colitis . SymptomThere are two primary categories of ileal pouch prolapse: mucosal prolapse and full-thickness prolapse. Mucosal prolapse is generally managed conservatively with a high fiber diet and biofeedback ,8,13. ReIn general surgical literature, fibrin sealant has been documented to provide adequate, sutureless fixation of mesh during total extraperitoneal hernia repairs -16. WhenOur patient was a 56-year-old woman with a BMI of 23.2, who presented in April 2019, approximately 11 years status post total proctocolectomy with ileal J-pouch creation secondary to ulcerative colitis. The patient’s medical history was significant for diabetes, gastroesophageal reflux, hypertension, anxiety, fibromyalgia, migraines, and vulvodynia. Previous abdominal surgical history included a total abdominal hysterectomy and ventral hernia repair in addition to total proctocolectomy and ileostomy reversal. The patient’s initial complaints included increased bowel frequency, constant urge to defecate, and sensation of incomplete evacuation. She also had some blood per rectum, which she attributed to internal hemorrhoids.For these symptoms, she was seen by her primary care provider, who had previously ordered stool studies, which were negative. She had never had a pouchoscopy but was treated for presumed pouchitis. After treatment, her symptoms persisted. A physical exam showed no significant hemorrhoids and a normal digital rectal exam. Two months after the initial presentation in June of 2019, she had an episode of complete pouch prolapse requiring surgical reduction under anesthesia  was applied posteriorly to the pouch and on the left side of the pelvis. The pressure was held for five minutes to ensure a good seal. The pouch did not appear to move during the release of the pneumoperitoneum. The patient tolerated the procedure well and was admitted to the floor postoperatively.Her hospital course was complicated by worsened baseline vertigo and urinary retention. Bowel function returned on postoperative day two, and she was ultimately discharged on postoperative day five. Since surgery, bowel regularity has been maintained with a high fiber diet and fiber supplementation. She remained symptom-free but unfortunately recurred after 13 months. She had multiple episodes of prolapse that required a reduction in the emergency room. She has not undergone any further surgical repair. The long-term efficacy of fibrin glue for ileal pouch prolapse repair is still under investigation.Ileal pouch prolapse is a rare complication following ileal J-pouch creation, occurring in approximately 0.3-0.35% of cases ,10. WithAs expected, transabdominal approaches to ileal pouch prolapse are similar to laparoscopic rectopexy . HoweverTherefore, we opted for fixation with fibrin glue as an alternative modality for pouch pexy. Fibrin sealant has been studied in hernia literature as a means for temporary fixation. For cases of ileal pouch prolapse, fibrin sealant may provide temporary but durable fixation to allow adhesive fixation of the ileal pouch. While our repair has yet to prove durable in long-term follow-up, short-term resolution of symptoms has been promising. Fibrin fixation may be useful in high-risk patients to avoid more extensive intervention including extensive pouch mobilization or takedown and ileostomy creation.In conclusion, ileal pouch prolapse is an uncommon complication after total proctocolectomy with an ileal pouch. Fibrin glue is an alternative to mesh or suture pexy to repair ileal pouch prolapse. The long-term durability of such a repair is still to be seen.


One of the most difficult challenges of multimedia transmission during the last two decades has been the retrieval of degraded or missing regions of images and videos while maintaining satisfactory perceptual accuracy. The objective is to retrieve lost data by using the similarity between frames. Usually, error concealment (EC) schemes depend on replacing incorrect data with data that are identical to the initial. This is possible because video contains a high degree of self-similarity. This research focuses on applying an EC approach in transform-domain video sequences. To conduct EC on films, they must first be translated to frames and then transformed using one of the available transformations into frequency-domain images. Using successive frames, it is possible to recover lost or incorrect data from images. Intra-coded frames (I-frames) may be used to recreate lost knowledge in predictive (P-frames) and bidirectional predictive frames (B-frames). I-frame knowledge that has been lost may be restored using previous intra-coded frames. The use of wavelet error concealment generated more precise results than the other techniques. In this study, it was discovered that covering faults in the density sector with wavelets produces more reliable results than the other techniques. Generally, the standard of service is not assured during online video transmission. If files have been made or corrupt, reinstalling them is a huge pain, but seeing them as bad as before and seeing them again as well is much worse. As the information is subjected to poor channel conditions, its transmission via the coded/decoding process is threatened, data may be corrupted, or it may have errors at the receiving end. Although avoiding packet losses or compromised data may often help mitigate quality loss due to transmitting errors; in general, data reduction  usually affects the overall quality of the video. When errors are concealed, one can discover the missing details by expanding the preceding information or unnecessary information . BecauseThe primary objective of video error concealment systems is to mitigate the effect of failure on picture quality. These schemes use the image's redundancy in the wavelength, spatial, and temporal realms. Under these systems, a portion of the missing data can be retrieved by interpolating the majority of it in any of these realms .Error concealment is a critical feature of every error-tolerant video codec. The effectiveness of an error concealment strategy is heavily contingent on the reliability of the re-synchronization system. In essence, once the re-synchronization mechanism effectively localizes the error, the error concealment problem becomes even more tractable. The current re-synchronization scheme produces very acceptable results for low bit-rate, low delay applications by using a simple concealment strategy, such as copying blocks from the previous image .Data partitioning is an extra error-tolerant mode that improves the decoder's ability to locate errors. The addition of a second re-synchronization marker between the motion and texture data is required by this process. If texture experience is not accessible, this solution employs motion details to mask errors in previously decoded VOPs by motion compensating them .One of the most challenging aspects of multimedia communication is recovering damaged or missing images and videos while retaining an acceptable degree of perceived quality. The goal of error concealment is to recover lost data by using frame correlation. Typically, error concealment techniques rely on making a duplicate of the erroneous data that is similar to the original. This is possible because of the high degree of self-similarity of information, such as video. The goal of this study is to provide an error concealing method for frequency-domain video sequences. To conceal defects in movies, they must first be transformed to frames and then into frequency-domain images using one of the many transformations available. It is possible to recover lost or incorrect data from movies by using successive frames.This study covers error control methods used in image or video transmissionBecause data are lost during transmission due to connection failure or packet congestion and loss, the goal of this method is to protect data from these errorsBoth the techniques are briefly explained such as error detection coding and error correction coding, and both are types of error control techniquesSeveral error control techniques, including re-transmission, forward error correction, error concealment, and error resilience, are also briefly addressed in this studyThe remaining sections of this study are organized as follows. Knorr et al.  developeThe calculation used to execute the more sophisticated repair techniques rises significantly as compared to the simplified repair alternatives. However, the quality enhancement obtained by these systems is at the best gradual. As a result, using packet replication with fading is suggested as a good balance between achieved efficiency and unnecessary complexity. In Several of these methods may be used for data on only one or both sides of the failure. Many audio and speech coders expect decoder state consistency. When a loss happens, it may be impossible to decipher audio data on both sides of the loss for use in the fix since the decoded audio after the loss may begin in an incorrect condition. Furthermore, two-sided processes have a higher computing overhead and are normally just somewhat better. In certain instances, one-sided repair is adequate .In general, error concealment research includes three kinds of domains, to name a few: spatial, frequency, and time. This section delves deeply into each topic, starting with the most basic.Assume that the image I is a projection of scene S . The spatial domain is standard picture space, where a shift in position in I explicitly projects to a change in position in S. Distances in I (in pixels) equate to actual distances in S .In spatial concealment, one interpolates directly inside the spatial domain , for exaAssume that image I under scrutiny is the product of a projection from scene S . According to , the freIt may make explicit periodic relationships in the spatial domainSome image processing operators are more efficient or indeed only practical when applied in the frequency domainThe spatial frequency domain is attractive in the research field of image processing becauseThe concept “time domain” refers to the study of mathematical processes or physical signals in relation to time . In the Loss of information in the videoChange in spatiotemporal informationErrors that occur in videos can be broadly classified as errors due to following two main reasons:Information loss may occur as a result of transmission errors caused by missed blocks. Errors that occur due to mistakes in knowledge distribution lead to image or meaning shift in pixel .Because of encoding, transmission, decompression, and other digital effects, video is subject to broad variations. Subjective digital video output can be used for video systems where the video is meant to be watched by people. However, for certain purposes, the same is true. That is because techniques that can calculate how a user feels about perceived picture and video quality would gain more prominence .The most commonly employed metric is the mean square error (MSE), which is the amount of intensity variations of skewed and reference pixels with their corresponding peak signal intensity ratios (PSNR). Mathematically speaking, MSE and PSNR are straightforward to work with and have easily discernible physical definitions. Critics, though, say that they do not relate well to consistency measurements. Therefore, image quality assessment dependent on human judgment is more accurate and a large amount of work has been invested in the creation of qualities that exploit the human visual system (HVS) including blockiness and blurriness (SSIM) .The MSE and the peak signal-to-noise ratio are two separate error metrics that are used to evaluate various image compression techniques (PSNR). MSE denotes the average squared error between the compressed and original files, while PSNR denotes the peak error. Below are the two mathematical formulas:M and N represent the rows and columns of the input images, respectively. The PSNR is then calculated by the block using the following equation:I is the original image, I' is the approximated version , and M and N are the dimensions of the images. A lower value for MSE means a lesser error, and as seen from the inverse relation between the MSE and PSNR, this translates to a high value of PSNR. Logically, a higher value of PSNR is good because it means that the ratio of signal to noise is higher. Here, the ‘signal' is the original image, and the ‘noise' is the error in the frame.In the preceding equation, The primary objective of this work is to derive an algorithm for optimum error concealment of online stream video blocks with missing or corrupted packets. This research study suggests a scheme for frequency-domain error concealment that allows good use of all useable knowledge at the decoder. It uses a mathematical model to predict the evolution of transform coefficients from frame to frame and then computes the optimal approximation of the reconstructed coefficient using both current base-layer and previous online stream video-layer results. Additionally, this density-field error concealment (DFEC) scheme naturally allows and complements postprocessing of correctly obtained blocks in order to diagnose and minimize error propagation due to previous losses. The tests obtained significant PSNR improvements.This study proposes a low-complexity error concealment system for video sequences. The innovation relates to methods and apparatus for concealing errors in transform-domain pictures. Transform coding is a necessary part in many image/video production systems today . TransfoThe input video is divided into frames and saved in the databaseThe audio is separated and saved as a .wav fileErrors (loss of information and change in information) are introduced in the framesError frames are savedTo correct the error in the frame, the consecutive frame is selected as a reference frameThe error frame and the reference frame are converted to frequency domain using transformsThe energy matrix of the transformed error frame and reference frame is foundAll pixels contributing to 90% of the total energy in the error frame is foundThese pixels are replaced as they are in the corrected frame.For all other pixels, the average pixel value of the error frame energy matrix and the reference frame energy matrix is taken and substituted in the corrected frameThen, the corresponding transform matrix and the inverse transform are found, i.e., the corrected frame is obtainedMSE and PSNR of the corrected frame and reference frame are calculated using formulas of  and 2)2)The corrected frame is replaced in place of the error frame and the video is obtainedThe audio is then added back to the videoThe following steps are implemented in the energy averaging technique:Video data can be compressed into a sequence of frames using techniques such as difference coding and are supported by the majority of video encoding specifications, including H.264 . DiffereVideo error concealment is a technique for hiding errors in video. The demand for error concealment in video applications has recently increased. The Internet, entertainment media, such as television and DVD, video conferencing, and video surveillance all make extensive use of video applications. The goal of this project is to show how to conceal video errors using spatiotemporal image sequence. Errors are detected using frame invariance, and they are repaired using a spatiotemporal image sequence technique. Moment invariance divides the error frame into four subframes and compares them to the previous frames. The proposed algorithm for frame invariance consists of three steps. The first step is to identify a set of possible motion vectors. The second stage involves adaptively calculating the error in the current and reference frames used for feature extraction. The error function is then calculated using frame invariance. The structural similarity index (SSIM) and the peak signal-to-noise ratio determine the video's quality (PSNR). The outcome suggests that the quality of various error videos has improved. (i)The input video is divided into frames and saved in database.(ii)The audio is separated and saved as a .wav file.(iii)The image is divided into pixelsFour new subimages are createdFirst four pixels of the image are placed in the subimages, respectivelyOn doing this the four subimages obtained are downsampled versions of the original imageSince most of the information is available in all four subimages, an error in any one of the subimages can now be corrected using any of the other subimagesOnce error concealment is applied, the image is again rearranged to obtain the original imageThe pixels are rearranged as follows:The following steps are involved in rearranging pixels:The input video to be corrected is broken down into framesThe frames are then subjected to error attacksTwo frames, an error frame and a reference frame, are selected from the sequence of framesThe frames are converted to frequency domain by applying 3-level wavelet transformOnce in the frequency domain, scaled average of both the frames is taken and the averaged value is replaced in the error frameThe averaged frame is then converted back to the spatial domain by applying inverse wavelet transformThe image obtained on taking the inverse transform is the corrected frame and is almost similar to the reference imageThe effectiveness of the error concealment algorithm is determined by calculating MSE and PSNR of the corrected frame and the reference frameThe corrected frame is then replaced in the sequence of frames and the corrected video is obtainedThe following steps are involved in wavelet error concealment algorithm.In general, video transmission via the Internet does not ensure service quality. An whole video frame may be lost due to a single packet loss . While mTechniques for concealing temporal errors assume that video motion is smooth or continuous. The fundamental approach is to replace the damaged block at the motion-compensated location with the previous frame's content. The drawback of this technique is that it is reliant on motion information, which may not be available in all situations, especially when a whole frame is lost. As a consequence, techniques for estimating lost motion vectors have been thoroughly investigated.The majority of temporal error concealing methods are entirely dependent on previous frame information. Indeed, since we are unaware of the loss of the current frame until we get the next frame, the information for the next frame is often accessible as well.Using the forward and backward methods, we may get two estimations of the present frame. It has been shown that a weighted average of multiple candidate concealment's improves performance , 24. ThiIndeed, we found that simply repeating the motion vectors from the previous frame outperformed all other techniques in stationary or low-motion conditions. A multicovered pixel is one that has several extrapolated MBs covering it. In general, scenes with a lot of motion feature a lot of multicovered pixels.Forward error concealing approaches make a trade-off between efficiency and robustness, necessitating the employment of more sophisticated encodersPostprocessing error concealment techniques do not require additional redundancy and can be applied to any visual systemThey take advantage of the characteristics of the video signal, and temporal/spatial interpolation is straightforward to apply with noticeable benefitsThey can be used in conjunction with forward error masking tactics to improve outcomesThe cost is the reduction in coding efficiency that these factors induceTo develop collaboration between the coder and decoder, interactive error concealment strategies rely on feedback information They are the ones that have provided the best results thus far because the information is updated at both ends (coder and decoder)Second generation error concealing approaches construct statistical models of the image's various objects and use them to replace the affected area whenever an error occursBecause the model is unique to an object, it can capture the variations in that object more precisely throughout the video series, producing the greatest results of any techniqueAdditionally, the model may be updated online, ensuring that all pertinent data are always available.If the channel being utilized has a very low error rate, the overhead incurred by these approaches is virtually negligible, and their usage may be unnecessaryThe downside is the level of complexity produced throughout the process of developing the numerous statistical models for the itemsThe disadvantage is that they may not be applicable (no feedback channel) and, depending on the system, require more complex encoders and decoders.In this research, proposed algorithm is experimented using a MPEG-5 EVC codec. In the following, we report results related to two parts of the online video frame sequence. The first part ranges from frame 35 to 49 and contains relatively low motion, whereas the second part ranges from frame 180 to 199, and contains fast motion of the camera and the speaker. The sequence has been coded at 300 kbps with 35 fps.Figures 3Three algorithms for error concealment were built in the proposed project. These algorithms were capable of concealing errors caused by knowledge shift and failure. It is well established that the majority of a frame's energy is contained in its low-frequency components and that the more important in formation is situated in these components. This fact is exploited in this project's energy averaging method, which conceals errors by retaining the pixels that contribute the majority of the frame's energy. After rearranging the pixels, the final image collected includes downsampled copies of the initial file. These downsampled versions may be used to retrieve some missing or incorrect data in the picture, since the majority of information is present in all downsampled versions at various resolutions. The use of wavelet error concealment generated more precise results than the other techniques.Future work may be done in the video processing extension. It entails using motion vector knowledge to insert the following P-watermark frames in the existing I-frame. Another potential way for this is to find locations in the image/video frame that have little or no motion and embed the watermark there. This may be advantageous, since audiences often concentrate on locations with a lot of motion. Another potential future path is to develop a rigorous watermarking methodology for this program. Due to the simplicity of which spread spectrum watermarking can be implemented in the DCT domain, it was used here as a proof of concept. However, due to its strong spreading advantage and increased entropy, it is not optimal for this use. Watermarking using quantization can be an option. A robust watermarking methodology suitable for error control applications is also lacking.


The Mini Nutrition Assessment (MNA) is a widely used and valid tool for screening and assessment of malnutrition among the elderly population worldwide. However, MNA has not been validated among the Ethiopian elderly population and this study assessed the validity of the tool for the target population.Cross-sectional validation study design employed to validate MNA in Meki town, East Ethiopia. This study included 176 randomly selected elders living in the community, whereas amputated, bedridden, visible deformity, known liver and/or renal disorders were excluded. The original MNA questionnaires were translated to local language and administered to each participant after doing the pretest. The anthropometric, self-perception of nutritional status and serum albumin concentrations were measured. Reliability, validity, sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated. Receiver-operating characteristic (ROC) curve analysis was plotted to identify the area under the curve (AUC) and optimal cut-off value for the prediction of malnutrition.p < 0.001) and concurrent validity  with serum albumin concentration and self-perception of nutritional status respectively. Using the original cut-off point, the sensitivity, specificity, PPV and NPV of the tool were 93.5%, 44.6%, 65.4% and 86.0%, respectively. By modifying, the cut-off point to a value of <20.5, the sensitivity and specificity of the tool increases to 97.6% and 82.8% respectively. The AUC (95%CI) showed an overall accuracy of 92.7% .A total of one hundred and seventy-six elders participated in this study. Of the total participants, 78(44.3%) were males. The mean (SD) age of the participants was 67.6 (±5.8) years and ranged from 60 to 84 years. The prevalence of malnutrition based on the MNA criteria (MNA < 17 points) was 18.2%, and 13.1% based on serum albumin concentration (<3 g/dl).The MNA had an overall Internal consistency of Cronbach’s alpha 0.61. The tool also demonstrated significant criterion-related validity (0.75, The MNA tool can be used as a valid malnutrition screening tool for the Ethiopian elderly population by modifying the original cut-off point. Elderly people refer to those who are 60 years and above , and curProtein-energy malnutrition, a condition resulting from inadequate consumption of nutrients , is a spIn Africa, among community populations, the prevalence is reported to be 26.5% in Egypt , and 28.There are different valid screening tools used to screen malnutrition among geriatrics, and the Mini nutrition assessment (MNA) is the most widely used . This toIt is the only nutritional screening and assessment tool that incorporates functionality, mobility, and depression . MoreoveEven though MNA is validated and used in a different country, it is not readily applicable to other countries. In part this is due to varying characteristics of the population’s anthropometric measurement and nutritional characteristics; from one setting to the other. For instance, MNA was not applicable in the Chilean population . The oriThe study was conducted in Meki town, Eastern part of Ethiopia from March to April 2020. Initially, we conducted a house-to-house survey to estimate the total number of elderly people (aged 60 and above) living in the setting. Each were given a unique identifier to help us develop a sampling frame. At this stage, we have also secured contact information to make data collection smooth. Following this, we calculated the sample size needed using BUNDER’S FORMULA , and ourhttps://www.jourilabs.com/). All samples were handled according to WHO guidelines on standard operating procedures for clinical chemistry (https://www.jourilabs.com/). It classifies as malnutrition if score is <3.0 gram/deciliter (g/dl), at risk of malnutrition if score is 3 to 3.5 g/dl, and well-nourished for score between 3.5 to 5 g/dl (A human blood sample (4 mL) was collected in the morning before 9:30 am, after a full overnight fast, using a cupper-and zinc-free syringe. Serum albumin concentration was measured by automated Bromocresol green method using BCG reagent and its standard manufactured by Jourilabs , frequencies, and percentage (%). A ectively . Also, STo calculate the criterion-related validity of the tool by comparing it with the gold standard , we haveAgreement between the two methods the MNA tool and serum albumin concentration was assessed by calculating a weighted kappa coefficient. A kappa value of 0.80−1.0 is considered perfect agreement . The senThe markers of malnutrition considered for the analysis are if the MNA score is <24 points or serum albumin concentration is <3.5 g/dl. A receiver operating characteristic curve (ROC) was plotted using serum concentration <3.5 g/dl as a marker of malnutrition. The area under the ROC curve (AUC) was evaluated to determine the overall accuracy of the MNA tool and usually, a value ≥ 0.9 is considered excellent . The optThis study was conducted according to the guidelines laid down in the World Medical Association (WMA) Declaration of Helsinki and all procedures involving research study participants were reviewed and approved by Jimma University, Institute of Health, Ethical review committee (ERC) with ref no IRB 0063/2020. Written informed consent was obtained from all participants.A total of 176 elders participated in the study, and the response rate was 100%. The mean (SD) age of the participants was 67.86 (±5.8) years and 98 (55.7%) were females. Overall, mean (SD) of the total MNA score was 20.7(3.5), and the mean (SD) of the serum albumin concentration was 3.7 (0.60) .α = 0.61). Homogeneity between the eighteen MNA items was adequate with Cronbach’s Alpha of 0.61. Cronbach’s alpha if an item deleted ranged from 0.526 to 0.633. The Scale’s Cronbach’s alpha would be 0.633 if the acute stress item were removed from the scale .The internal consistency of the MNA tool was adequate . Similarly, the concurrent validity of the tool was calculated by correlating the total scores of the item with the BMI classification of nutritional status and the result was again significant . Similarly, the MNA tool and self-perceived nutritional status correlated significantly   . Accordi < 0.05) .i.e., merged at risk of malnutrition and malnutrition). Based on this cut-off value, the MNA total score of <20.5 points, as markers of malnutrition, the sensitivity increased to 97.6%, and specificity increased to 82.8%.The area under ROC curves using the serum albumin concentration level as golden standard area showed the highest values of 0.927 . The AUCThe MNA long-form had adequate predictive ability of markers of malnutrition as compared to serum albumin concentration level, among the elderly community population. It showed high sensitivity and specificity, with a somewhat modified optimal cut-off value. Using the original cut-off value, its sensitivity, diagnostic accuracy and overall diagnostic accuracy were 93.5%, 70.45%, and 92.7% respectively. Our data also suggests that the MNA long-form is valid, with a cut-off value of 20.5, using serum albumin concentration (<3.5 g/dl) as a golden standard. This optimal cut-off value had a sensitivity of 97.6% and a specificity of 82.8%. Moreover, the MNA long-form had a strong agreement with serum albumin concentration, for identifying elderly individuals with malnutrition or those at risk of malnutrition . The prevalence of malnutrition using serum albumin concentration was found to be 13.1%. Compared to the gold standard, the MNA long-form overestimates malnutrition by 5.1%.We evaluated the reliability and validity of the MNA tool among the elderly population of Ethiopia living in Meki town. Similar to other reports, we have found that the tool is easy to administer and use . Our resrs = 0.746), contributing to the tools’ criterion-related validity. Similarly, the tool demonstrated statistically significant concurrent validity with BMI nutritional status classification and self-perceived nutritional status. Furthermore, the MNA tool had a moderate agreement with serum albumin concentration level with a weighted kappa value of 0.556. All these results indicate the appropriateness of the tool for the population under study.To demonstrate the validity of the MNA tool, it is common practice in the field to calculate the correlation of the MNA tool with serum albumin concentration. In this regard, a strong significant positive correlation was detected , the sensitivity increased to 97.6% and specificity increased to 82.8%. This new optimal cut-off value, however, decreased the diagnostic accuracy to 80.4%. Therefore, all in all, with the updated cut-off value, the sensitivity, and specificity of the MNA tool become more comparable to the original developers . Neverthi.e., serum albumin, to validate the tool. The correlation between the MNA tool and BMI scores should also be interpreted with caution. It is repeatedly reported that BMI is a limited application in the nutritional assessment of obese individuals but otherwise are malnourished. This may have influenced the result to some degree. Third, the sample size is low, and larger sample size could have provided more statistically robust results. Among the strengths of this study was the inclusion of the community-dwelling elderly population, and the use of a random sampling method to recruit households.Readers should take note of the following limitations while interpreting the results of our study. First, dietary assessment methods were not applied and indicators for micronutrient status were not assessed for the participants. Second, we only applied a single golden standard method, This study indicated that the MNA tool was a valid and reliable tool for the Ethiopian elderly population in the community setting. Future studies should explore the cost-effectiveness of MNA long-form to establish if the tool is suitable for low resource settings, cost-wise.10.7717/peerj.14396/supp-1Supplemental Information 1Click here for additional data file.


Spore Discharge in Land Plants and Spore Liberation review mechanisms for spore release and dispersal based on real‐time observations, basic histology, and light microscopy. Many mechanisms underlying spore liberation are explosive and have evolved independently multiple times. These mechanisms involve physiological processes such as water gain and loss, coupled with structural features using different plant tissues. Here we review how high‐speed video and analyses of ultrastructure have defined new biomechanical mechanisms for the dispersal of gametophytes through the dissemination of haploid diaspores, including spores, pollen, and asexual reproductive propagules. This comparative review highlights the diversity and importance of rapid movements in plants for dispersing gametophytes and considerations for using combinations of high‐speed video methods and microscopic techniques to understand these dispersal movements. A deeper understanding of these mechanisms is crucial not only for understanding gametophyte ecology but also for applied engineering and biomimetic applications used in human technologies.Dispersal of gametophytes is critical for land plant survivorship and reproduction. It defines potential colonization and geographical distribution as well as genetic mixing and evolution. C. T. Ingold's classic works on  Marchantia L. (Marchantiaceae) and Lunularia Adans. (Lunulariaceae) and the fern genus Vittaria Sm. (Pteridaceae)  such as mosses and liverworts, spores are produced in the capsule structure of the sporophyte generation and rely on this capsule for spore dispersal  and are dispersed via numerous abiotic and biotic agents Figure . FinallyDispersal of these various gametophytes is essential in determining the geographic distribution of plants. This is especially true for non‐seed plants; for instance, the distribution of bryophytes and ferns is influenced by both local and long‐distance dispersal, resulting in most families and genera having broad, multicontinental distributions  with detailed illustrations of the varying drying stages of the sporophyte capsule, depictions of cellular components, and in some cases insights from experimental work. These discoveries were made using careful observation of these mechanisms by watching plants in action (under a microscope or not) and with basic microscopic techniques to understand overall cell structure. During the latter half of the 20th century, researchers such as Karl J. Niklas and Josef D. Ackerman devised unique solutions to document rapid movements, such as the use of bubble‐trace photography, particle analysis, and stroboscopic illumination, to define our understanding of abiotic pollination  and analysis of ultrastructure (structure only visible using electron microscopy or other techniques) has enabled further understanding of these extraordinary dispersal mechanisms beyond what researchers were capable of in Ingold's time.We searched the literature for publications that used high‐speed video and/or microscopy to understand the dispersal of gametophytic diaspores  as hinged catapults or trebuchets by filming at 10,000 fps , which straighten in 25 µs  Hoffm. (Marattiaceae) filmed at 2000 fps show that a sudden cavitation of the spore propels it several millimeters , which reverse their trajectory from downward to upward, documenting the importance of elaters in facilitating the glide of these spores . They show pollinator efficiency varies, with the hawkmoth (Macroglossum pyrrhosticta) making fewer contacts with anthers and/or stigma than those made by the butterfly (Papilio dehaanii) or carpenter bee (Xylocopa appendiculata). Switzer et al.  at 5000 fps and were able to document bumble bees, the main pollinators, actively pulling stamens out of the petal pockets. Below we report on the use of a high‐speed video camera and an iPhone camera to film insect visitors to flowers, which can define how the insects interact with the flowers they visit.Finally, high‐speed video can also add to our understanding of flower–pollinator interactions. With an estimated 87.5% of angiosperms pollinated by animals  Dumort. (Frullaniaceae), where dehiscence can only be induced by drying if the capsules are “perfectly ripe.”Knowing the natural history and specifics of the study plant related to dispersal  is important for getting useful video footage and interpreting the adaptive significance of the fast motion. Although most filming to date has been done in the lab, knowledge of a plant's habitat and behavior is critical to getting the best material and interpreting the plant's responses. For example, in western Massachusetts and southern Vermont, Equally important is the staging for filming. Features to consider include physical setup, frame rate, lighting, air movement, electrostatic interference, direction of filming, magnification, and film quality. It is useful to look at the successful setups used for the studies reported in Table Marchantia included filming through a dissecting microscope on an adjustable platform, special considerations for exposure to water droplets, protection from air currents, and backlighting specific to this system , whereas distant shots can reveal patterns of spore dispersal .The direction of filming and magnification are critical. For measurements taken from successive frames, filming perpendicular to the direction of movement is important so that the full range of motion can be analyzed. Magnification is also important as images taken at higher magnifications are useful for dissecting the biomechanics of an action  format. However, once videos and images were produced, analysis could be done on either Windows or Macintosh machines. Our analyses were mostly done on MacBook Pros  without any supplementary computational power. We note that technologies for computational storage and power are continually changing, and that there are many systems that are suitable for storing and working with these types of data.Video cameras have continued to improve and become more accessible, such that filming with the most sophisticated professional high‐speed cameras can achieve frame rates as high as over one million frames per second. Although these professional models are expensive, the development of affordable options has made high‐speed video more broadly accessible. We group high‐speed videos into three categories: high‐end professional cameras, point‐and‐shoot cameras, and iPhone (Apple) cameras Figure .Much of the published work uses professional cameras  capability will record videos at 120 fps, and newer models (iPhone 8 and newer) that are powered by the A11 Bionic chip can record at up to 240 fps. We have used these cameras successfully to capture the behavior of insects visiting flowers and discuss the merits of each below.Spiraea alba Du Roi (Rosaceae) filmed at 240, 480, and 960 fps  to film visitors to flowers. This camera has the option of filming at 240, 480, or 960 fps. It also has the option of post‐event triggering, where the camera is constantly buffering and, when triggered, will save the last frames filmed. We used this camera in three setups: hand‐held, hand‐held with a straw to indicate focal distance Figure , and on s Videos –S3. ThesSyrphus sp.) visits the flowers of Diervilla lonicera Mill., it collects pollen, feeding first from the anther sac and then feeding directly off the stigma. This file is 60 MB in size, 1080p, for a real‐time length of 6.25 s. The advantages of the iPhone setup include portability, affordability, high‐resolution video (1080p), video length that typically is not limited, macro lens options, and automatic adjustable focusing and exposure while filming. The drawbacks are that the maximum film speed is only up to 240 fps and the focal distance with the macro lens is short (5 cm), making it difficult to film insects that are easily scared off. For filming without the macro lens, the shortest filming distance is 7 cm. The playback speed for iPhone videos is set at 30 fps but can be changed after recording using video editing software.We have used the iPhone 12 Mini (Apple Inc.) with the ProMovie Version 1.10 app  and an added macro lens  to film insects visiting flowers Figure . The ProUltimately, the choice of a camera system for high‐speed video depends upon the study question, details of the study system, as well as cost and filming location. Although we have summarized some advantages and disadvantages of a subset of example cameras above, there are many options for each broad camera category  Royle (Hydrocharitaceae), dissecting microscope images of male flowers before, during, and after anther movement displayed the positioning and importance of the sepals and the overall catapult‐like structure involved in pollen dispersal  and light (compound) microscope images are still invaluable for observing the overall external morphological structure and organization of the organs involved in the dispersal of gametophytes. Magnifications of up to 100× are crucial for observing relatively small structures such as anthers involved in pollen dispersal, and specimens can be observed at varying stages of dehiscence . Images captured using dissecting microscopes have been used to observe the mechanics of explosive pollination in flowering plants, including the positioning and shape of floral organs that allow for the “catapult”‐like dehiscence of stamens documented by high‐speed video , staining of organs with ruthenium red and hydroxylamine hydrochloride–ferric chloride revealed that cell walls in the “hinge” section of stamens are high in acidic pectin and low in esterified pectin, resulting in tissue softening  of interest at up to 1000× magnification. Viewing longitudinal sections of organs in enclosed buds and floral structures helps to understand the development of these organs and how their positioning affects explosive pollination, beyond what is observable on the surface through high‐speed video or when viewed using a dissecting microscope  and scanning electron microscopy (SEM) were in use during Ingold's time, they were not yet commonly used to understand gametophyte dispersal. Using SEM, researchers can observe surface topography at over 1,000,000× magnification while imaging a greater field of depth than a light microscope. SEM can also image the surface of objects without destroying the sample , Duckett and Pressel  drives spore ejection in this system. We suggest that future studies use TEM to study the subcellular components that differ between cell layers or tissues in the organs of plants involved in explosive gametophyte dispersal.TEM is used to image specimens at the near atomic level  and, thus, for our purposes, can be used to image subcellular components in plants Table . Studies Pressel  used TEM Pressel  to dispr Pressel  used TEMEquisetum . They documented the presence and location of vasculature, pollen chambers, and aerenchyma in the stamens involved in the “bellows” action that propels pollen in this system.Some studies have moved beyond the above‐mentioned microscopy techniques to gain additional insights into gametophyte dispersal. The combination of SEM with chemical spectral techniques displays the distribution of elements and polymers involved in spore dispersal in the horsetail Angiopteris evecta; this was also documented visually using high‐speed video and TEM . Ingold recognized the importance of hydration status in many of these dispersal mechanisms, and recent studies have used different preparation techniques to observe tissues with different hydration statuses and under different environmental conditions during the actual microscopic imaging process. For light microscopy, comparisons of spore samples observed in either water, lactic acid (to inhibit rehydration), or glycerol (to induce dehydration) confirmed the role of cavitation in creating gas bubbles that facilitate spore dispersal in the fern e Figure . These pIn this review, we summarized how the combination of high‐speed video techniques and microscopy of ultrastructure of plant materials has enabled the discovery of novel mechanisms of gametophyte dispersal across the plant tree of life. We emphasize that the nature of these rapid movements involving the projection of small diaspores can be understood more fully with the ability to film at very high frame rates that can then be slowed down, while simultaneously visualizing the organ‐level, tissue‐level, cellular, and/or subcellular components involved using advanced microscopy. Here, we discuss future directions for the use of high‐speed video and microscopy in understanding rapid movements in plants, some limitations of these methods, and finally how insights from these movements can inform human technologies through biomimetics.Frullania dilatata  Dumort. , and could serve as models for self‐propelled objects for human use . Numbers are milliseconds.Click here for additional data file.Appendix S2. Setup for filming high‐speed video of gemmae dispersal by gemmae‐dispersing splash cups of Marchantia.Click here for additional data file.Video S1. Insects visiting Spiraea alba (Rosaceae) filmed at 240 fps. File is 182 MB in size, 1080p, for a real‐time length of approximately 3.2 seconds. Insects were collecting nectar from the deep red nectar disc at the base of the flowers. Videos were filmed with the Sony camera using a tripod setup with post‐event triggering with a remote cable trigger. Playback is at 24 fps.Click here for additional data file.Video S2. Insects visiting Spiraea alba (Rosaceae) filmed at 480 fps. Files is 198 MB in size, 1080p, for a real‐time length of approximately 1.6 seconds. Insects were collecting nectar from the deep red nectar disc at the base of the flowers. Videos were filmed with the Sony camera using a tripod setup with post‐event triggering with a remote cable trigger. Playback is at 24 fps.Click here for additional data file.Video S3. Insects visiting Spiraea alba (Rosaceae) filmed at 960 fps. Files is 348 MB in size, 1080p, for a real‐time length of approximately 1.4 seconds. Insects were collecting nectar from the deep red nectar disc at the base of the flowers. Videos were filmed with the Sony camera using a tripod setup with post‐event triggering with a remote cable trigger. Playback is at 24 fps.Click here for additional data file.


By connecting multiple short, local low-density parity-check (LDPC) codes with a global parity check, the globally coupled (GC) LDPC code can attain high performances with low complexities. The typical design of a local code is a quasi-cyclic (QC) LDPC for which the code length is proportional to the size of circulant permutation matrix (CPM). The greatest common divisor (GCD)-based full-length row multiplier (FLRM) matrix is constrained by a lower bound of CPM size to avoid six length cycles. In this paper, we find a new lower bound for the CPM size and propose an algorithm to determine the minimum CPM size and the corresponding FLRM matrix. Based on the new lower bound, two methods are proposed to construct the GC-QC-LDPC code of grith 8 based on the GCD based FLRM matrix. With the proposed algorithm, the CPM size can be 45% less than that given by sufficient condition of girth 8. Compared with the conventional GC-LDPC construction, the codes constructed with the proposed method have improved performance and are more flexible in code length and code rate design. Channel coding has always been one of the most important underlying technologies in communication systems. Capacity-achieving codes such as turbo codes, low-density parity-check (LDPC) codes, polar codes, and quantum codes have been proposed together with various near-maximum likelihood(ML)-decoding algorithms such as belief-propagation, list-decoding, guessing random additive noise decoding (GRAND), etc. ,2,3. LDPJ rows and L columns. The exponent matrix of FLRM matrix is derived from the product of row coefficient vector and column indexes. Girth in Tanner graph is one of the most important characters of LDPC codes for it determines the minimum distance of the code. In addition, short cycles will produce trapping sets, stopping sets, and absorption sets, resulting in heavy error-floor and performance degradation [The full-length row multiplier (FLRM) matrix is a typical regular matrix used in construction of QC-LDPC codes. The FLRM matrix consists of multiple circulant permutation matrices (CPMs) ,16,17,18radation . Hence, radation ,21,22. Iradation . RecentlA globally coupled (GC) LDPC code is a new type of coupled LDPC code proposed by Juane Li  where mu1.P to achieve girth 8 for the GCD-based FLRM matrix and propose an algorithm that can output the minimum P and the corresponding FLRM matrix for the given We find a new lower bound of CPM size 2.The two new methods for constructing the GC-LDPC code is proposed based on the FLRM matrix with a new lower bound.3.We find that the performance of GC-LPDC is more sensitive to the number of six length cycles than the girth.Since the existing GC-LPDC code cannot achieve girth 8, in this paper, we consider the construction of a GC-LDPC code based on the FLRM matrix. The main contributions of this paper are as follows:P, code length, or code rate. In addition, the simulation results show that the code constructed with proposed method has improved performances than the code constructed with existing methods.The finding of this study is particularly meaningful for the code designer for they will have more freedom in choosing P. An algorithm is proposed to find the smallest P and the corresponding FLRM matrix for a given The sections of this paper are organized as follows. In P and an exponent matrix of size The parity check matrix of the QC-LPDC is generated through a CPM of size is eight . The GCDis eight  is an efThe girth of GC-LDPC code is essentially the length of the shortest cycle in uch that (2)∑i=0lA length of four cycles in P) indicates the existence of P cycles of length 6. The possible paths of these cycles are illustrated in A length of six cycles lies in a tisfying  will deftisfying , if we dP can guarantee Since P, ’X’ type cycles may exist for Even with infinite For the ’X’ type length 6 cycles, the condition The condition for the girth 8 FLRM matrix can be derived from the analysis above, and the conclusion is summarized as (Lemmas 1 and 2 of )(9a)(naEquation (9a) is the necessary and sufficient condition for avoiding the type ’X’ cycle of length 6. However, (9b) is only a sufficient condition to avoid type ’L’ cycle of length 6.The type ’L’ cycle of length 6 exists if and only if any of However, (9b) is only a sufficient condition for avoiding the length 6 cycle. It is possible that, for some With the new lower bound Theorem 1.The Tanner graph corresponds to the FLRM matrix for all triples Sum where the Algorithm 1: Construct Require: Ensure: 1:construct  (9a) as ;2:Initialize 3:for , and the matrices are provided by the following: In , the GC-c is the primitive factor of n. Since the n’s smallest prime factor is A Reed–Solomon code has been used in  to constnstraint . The cona denotes the scaling factor, and b and d are the numbers of columns and rows of The Reed-Solomon-Like construction is proposed in  which maTo avoid the length 4 cycles between global and local parts, the number of rows of local codes and global check should be constrained to The GC-LDPC can be obtained through the matrices designed above with some operations without changing the property of the cycle. In the following, we will apply the GCD method to construct girth eight GC-LDPC codes.Construction 1.We generate the girth 8 FLRM matrix through Algorithm 1 for the code with column weight L. The number of rows, .J. Since the lower bound of P increases rapidly with the increase in J, the code length With Construction 1, the code rate is given by Construction 2.In Construction 2, the FLRM matrix generated via Algorithm 1 is split into two parts, namelyand, with size the asand, respectively. Then, the two sub-matrices are copied t times and interleaved along columns, as shown in .The rate of this code is c is the randomly selected initial offset. For example, if all local codes have the same size of If necessary, the column cyclic mask can be used in the construction to reduce the column’s weight. Let The focus of the code’s construction is to achieve girth 8. For the decoding of LDPC codes, the short cycles will lead to inappropriate messages passing among nodes or error propagation. Moreover, these short cycles can form the local structure of trapping set and stopping set. All these issues will cause performance degradation. Therefore, the LDPC code should be carefully designed to avoid short cycles.In this section, we use simulations to verify the proposed GC-LDPC code. All codes in this section were simulated in the AWGN channel with BPSK modulations. The min-sum algorithm with a scaling factor 0.55 is used in decoding, and the maximum iteration number of local/global decoding is 50.We also use the extrinsic information transfer (EXIT) chart to compare the conventional GC-LDPC code and the proposed codes. The mutual information is given by the following:In the following, the proposed code is referred to as code1. We use notation code2, code3, and code4 to denote the baseline codes used for the comparison. The details of these codes are as follows.code1: The construction of code1 begins with Algorithm 1, which outputs the matrix E comprises three RS(code2: This code is constructed with a Reed–Solomon-Like scheme . E comprcode3: This code is constructed to observe the relationship between the performance of GC-LDPC code and the number of length 6 cycles. We construct the grith 6 FLRM matrix code4: The matrix P corresponds to the zero element of Sum in Algorithm 1. A p value for which L and In this section, we consider some GC-LDPC codes for which GCD-based FLRM matrices are generated with case 1 In this case, we consider two codes, code5 and code6, with parameters listed in In the AWGN channel, the best range of column weight is case 2 In this case, the In this paper, we show that the lower bound of CPM’s size can be even lower than what we known from the previous literature. An algorithm is proposed to find the minimum size of CPM for the GCD-based FLRM matrix. Based on this algorithm, two construction methods were proposed to construct girth 8 GC LPDC codes. In addition, we find that the dominant factor that affects the performance is the number of length 6 cycles rather than the girth. With the proposed algorithm, the CPM size can be 45% less than that given by a sufficient condition of girth 8. Compared with the conventional GC-LDPC construction, the codes constructed with the proposed method have better performances and are more flexible in code length and code rate design.


To investigate the nutritional risk, malnutrition, severe malnutrition, and malnutrition prevalence of different stages in chronic kidney disease (CKD) patients with and without diabetes mellitus using the Global Leadership Initiative on Malnutrition (GLIM), and to analyze the causes of malnutrition and to improve the clinical outcomes of patients for early intervention. 2 with poor general condition, 3 points for nutritional deficiency in nutritional risk screening), combined with clinical research on the main causes of malnutrition, the intervention measures were discussed.  A total of 683 patients with CKD who were hospitalized in our hospital from January 2020 to January 2021 were enrolled and divided into subgroups 1 to 5 according to whether they were complicated with diabetes and glomerular filtration rate. Using the second step of the malnutrition (GLIM) diagnostic tool and 2 previously commonly used malnutrition assessment methods  in the patients included in the survey using the diagnostic criteria of malnutrition (GLIM) (excluding whole body muscle mass index). The prevalence of malnutrition in CKD patients with and without diabetes was 23.7% and 12.6%, respectively. The overall prevalence rate of severe malnutrition was 14.2%, and the prevalence rates of those with and without diabetes were 19.0% and 11.4%, respectively; the results of the two methods of malnutrition assessment showed that the prevalence of malnutrition in CKD patients with diabetes was higher than that in the uncombined group. There was no severe malnutrition in patients with CKD stages 1 and 2. From CKD stage 3 onwards, the severe malnutrition in the diabetic group was significantly higher than that in the uncombined group.  With the progression of CKD, the incidence of malnutrition also gradually increased, indicating that malnutrition is related to primary diseases and concomitant diseases. Attention should be paid to the malnutrition of CKD patients with diabetes, and clinical medical staff need to pay early attention to various diseases that lead to the progression of CKD, such as diabetes, primary nephropathy, and other factors, to prevent complications and delay the progression of CKD. A nationwide cross-sectional survey of a representative sample of Chinese adults showed that the prevalence of chronic kidney disease (CKD) in China was about 10.8% , 3. AlthIn this study, the general data of inpatients in the Nephrology Department of Ningbo First Hospital from January 2020 to January 2021 were collected, and a total of 683 cases of CKD patients were selected as the research objects..Inclusion criteria: (1) patients who met the criteria for chronic kidney disease (CKD) defined by the Kidney Diseases Outcome Quality Initiative (K/DOQI) established by the Kidney Foundation International (NKF) in 2002. (2) The length of hospitalization is more than 1 day. (3) The age is 18 to 90 years old, and effective language communication can be carried out [Exclusion criteria: (1) those with mental disorders who cannot cooperate or who are critically ill and unable to complete relevant assessments; (2) incomplete data on body weight, diet, and disease conditions in the past 3 months; (3) excluding the possibility of acute renal failure, and having no recent severe heart failure, unstable angina, active liver disease, trauma, surgery, chronic wasting diseases , etc. The research protocol was reviewed and approved by the ethics committee of our hospital, and the research was approved.2 with poor general condition, nutritional deficiency in nutritional risk screening, 3 points). Research flow chart is shown in Basic information was collected and recorded, including gender, age, height, weight, and past history; the patients were divided into 2 groups with or without diabetes (diagnosed with diabetes), and were divided into subgroups of stages 1 to 5 according to the glomerular filtration rate; nutritional risk screening NRS2002 was carried out, the NRS2002 screening scale was filled, and malnutrition was diagnosed according to the assessment standard of malnutrition (GLIM). At the same time, the enrolled CKD patients were used as a reference by the data of two other malnutrition assessment methods  was performed within 48 hours of admission.According to the second step of the malnutrition (GLIM) assessment criteria, at least one of the phenotypic indicators and etiological indicators are met to be diagnosed as malnutrition . Due to At the same time, two sources of malnutrition assessment data were used as a reference: (1) BMI < 18.5 kg/m2, with poor general clinical observation , and (2)Referring to CSPEN's “Clinical Diagnosis and Treatment Guidelines - Parenteral and Enteral Nutrition Volume (2008 Edition),” the “nutritional screening-undernutrition” established by the Chinese Medical Association Parenteral and Enteral Nutrition Society-support outcome cost/effectiveness ratio, NUSOC) Multicenter Data Sharing Collaborative Group” research results as preinvestigation training content to conduct unified training for investigators .Definition of statistical power: the probability of correctly rejecting H0 (probability of not making type II error).t-test; count data were compared using χ2 test; P < 0.05 was considered statistically significant.SPSS 19.0 statistical software was used for analysis, normally distributed measurement data were expressed as mean ± standard deviation, using the A total of 683 CKD hospitalized patients were included, including 433 males and 250 females, aged 60.7 ± 16.6 years, 253 CKD patients with diabetes (37.04%), and 430 CKD patients without diabetes (62.96%). Stage 3 and above patients accounted for 85.2% . The nutritional risk prevalence rates of CKD stage 1–5 patients with diabetes were 5.6%, 16.7%, 16.1%, 32.7%, and 50% , and nutritional risk prevalence rates of CKD stage 1–5 patients without diabetes were 5.1%, 6.3%, 11.6%, 13.8%, and 36.4%, respectively . Among them, the prevalence of nutritional risk increased significantly in CKD stages 2 and 3, respectively, with or without diabetes , and the prevalence of nutritional risk in CKD patients with and without diabetes was 33.2% (84/253) and 20.5% (88/430), respectively. The difference between the two groups was statistically significant . The prevalence of malnutrition in CKD stages 1 to 5 with diabetes was 5.6%, 8.3%, 16.1%, 21.8%, and 33.9%, respectively; the prevalence of CKD stage 1 to 5 without diabetes was 2.8%, 3.1%, 5.4%, 10.7%, and 23%. At the same time, the poor general condition of clinical observation and the 3-point assessment of nutritional deficiency in the NRs 2002 scale were recorded as BMI < 18.5 kg/m2, and the prevalence of malnutrition was 13.5% (92/683), 18.7% (128/683)). The results of malnutrition assessment and diagnosis from the three sources showed that the prevalence of malnutrition in patients with CKD with diabetes was significantly higher than that in patients with CKD without diabetes, and with the decrease of eGFR, the prevalence of malnutrition also gradually increased. CKD stage 3 malnutrition was significantly higher regardless of diabetes, as shown in The overall prevalence of malnutrition was 16.7% (114/683), and the prevalence of malnutrition in CKD patients with and without diabetes was 23.7% and 12.6% , respectively. The difference between the two groups was statistically significant . The prevalence of severe malnutrition in CKD stages 1 to 5 with diabetes was 0%, 0%, 9.7%, 18.2%, and 30.2%, respectively; the prevalence of severe malnutrition in CKD stages 1 to 5 in diabetes was 0%, 0%, 5.4%, 9.2%, and 21.8%, respectively. Severe malnutrition occurred since CKD stage 3 in the group with or without diabetes , and the prevalence of severe malnutrition in CKD patients with and without diabetes was 19% and 11.4% , respectively. There was a statistically significant difference between the two groups . The nutritional risk of the same CKD stage was similar except for stage 1, and the prevalence of the other stages was higher in the diabetic group, which suggested that CKD patients with diabetes mellitus were more prone to nutritional risks. The nutritional risk is 11.0% in CKD stages 1–3 and 35.8% in stages 4–5. The results of the study are similar to those of Li Jing et al. [As shown in In this study, the overall prevalence of malnutrition was 16.7% 114/683) diagnosed by the assessment criteria of malnutrition (GLIM). The prevalence of malnutrition with or without diabetes was 23.7% (60 / 253) and 12.6% (54 / 430). From 4/683 diaZhang et al.  statistiStudies have also shown that , 16 a vaThere are still some limitations in this study. Since the subjects of this study are mainly CKD patients with diabetes and without diabetes, the malnutrition of other CKD patients with different comorbidities has not been studied in depth, nor is it a multicenter, large-sample study, and it is necessary to collect larger samples in the future for related research prospective study. In addition, this study has not yet analyzed the influencing factors of malnutrition in CKD patients, the mechanism of malnutrition and intestinal microbial imbalance in CKD patients, and more in-depth analysis will be conducted in future studies.In conclusion, DRM in CKD patients is positively correlated with CKD stage and diabetes. The Chinese Clinical Practice Guidelines for Nutritional Treatment of Chronic Kidney Disease  proposed


Background: The exact influence of tourniquet ischemia on a treated extremity remains unclear. Methods: Twenty patients received an operation on one hand under tourniquet ischemia. Twenty healthy volunteers received 10 min of tourniquet ischemia on one of their arms. Measurements of tissue oxygen saturation using near-infrared reflectance-based imaging and skin temperature of the dorsum of the hand were performed at five different timepoints . Results: In both groups, tissue oxygen saturation dropped after the application of the tourniquet ischemia compared to t0 and increased after the release of the tourniquet ischemia. In the patient group, tissue oxygen saturation at t4 was higher compared to t0; in contrast, the level of tissue oxygen saturation in the participant group dropped slightly at t4 compared to t0. The measured skin temperature in the patient group showed an increase during the observation period, while it continuously decreased in the group of healthy participants. Conclusions: Short-term ischemia did not appear to permanently restrict perfusion in this study design. The non-invasive imaging modalities used were easy to handle and allowed repetitive measurement. Using an upper arm tourniquet that enables a bleeding-free situs is the state of the art in the context of hand surgery . HoweverThe aim of the present study was to measure the changes in blood flow to the hand in the context of ischemia and reperfusion after application of a tourniquet. Near-infrared imaging (NIRI) and thermographic imaging were used to measure the changes in temperature and tissue oxygen saturation. These imaging modalities are already used in reconstructive plastic surgery and in the context of solid organ transplantation ,10,11,12The study was approved by the institutional ethics committee (310_19 B9). Twenty patients received an operation on one of their hands and tourniquet ischemia was applied. Furthermore, 20 healthy participants, who voluntarily participated in the study, received 10 min of tourniquet ischemia in one of their arms. Both patients and healthy participants were prospectively included in the study. In both groups, the tourniquet pressure was set at 300 mmHg, which is the standardized pressure for adults in our clinic and, after exsanguination, measurements of tissue oxygen saturation and skin temperature of the dorsum of the hand were performed at five different timepoints. The first measurement (t0) was performed just before application of the tourniquet ischemia, the second (t1) directly after application of the tourniquet ischemia, the third (t2) before release of the ischemia, the fourth (t3) directly after release of the ischemia and the last (t4) was performed on the following day . The numThree measuring points (MP) were defined at the dorsum of the hand: at the head of the third metacarpal bone (MP1), the middle of the third metacarpal bone (MP2) and the base of the third metacarpal bone (MP3). The mean value of these three measuring points was used for statistics.®  to measure tissue oxygenation in superficial tissue   or a smaThe statistics were performed using GraphPad Prism . For every patient/participant, mean values for each timepoint were calculated. The mean values for each timepoint either of the patient or of the participant group were compared to t0. If the values were normally distributed, the Repeated-Measures ANOVA Test was used; if not, the Friedman Test in combination with the Dunn’s Multiple Comparisons Test was used. Subgroup analysis was performed for gender and age . Age subgroups were divided in such a way that each subgroup consisted of the same number of individuals (n = 10).Between April 2019 and December 2021, 20 patients  were included in this study with a mean age of 57.85 years (±10.52 years). All operations  were performed under local anesthesia including 10 right and 10 left hands. The mean time for ischemia was 14.35 min .Furthermore, between September 2020 and November 2021, 20 healthy participants  were recruited with a mean age of 49.3 years (±22.69 years). The participants received tourniquet ischemia to the left (n = 2) or right arm (n = 18) with a pressure of 300 mmHg for 10 min.Oxygen saturation in patients:p = 0.04; t2: p < 0.0001) compared to t0 .After the application of the tourniquet ischemia, there was a statistically significant drop in oxygen saturation , t3 (p < 0.01) and t4 (p < 0.01) were, in contrast to the value at t2 (p = 0.18), statistically significant.The measured skin temperature  increaseOxygen saturation in healthy participants:p = 0.01; t2: p < 0.0001). After opening the tourniquet, tissue oxygen saturation increased statistically significantly above the level of t0 (t3: p = 0.02). At t4, tissue oxygen saturation decreased slightly compared to the beginning (t4: p > 0.99).Tissue oxygen saturation  decreaseSkin temperature in healthy participants:p = 0.85; t2: p = 0.99; t3: p = 0.72; t4: p = 0.50).The measured temperature  decreaseIn the patient group, the subgroup analysis did not show a statistically significant difference in tissue oxygen saturation or skin temperature at any time point, neither by age nor by gender.p = 0.005). Furthermore, skin temperature was in the older subgroup 2 (27.60 °C) statistically significantly lower compared to the younger subgroup 1 (32.22 °C) at t2 (p = 0.0006).In the subgroup analysis of the healthy participant group, there was no difference in tissue oxygen saturation or skin temperature between the male and the female subgroups. In contrast, tissue oxygen saturation was, in the older subgroup 2 (20.17%), statistically significantly lower compared to the younger subgroup 1 (48.87%) at t4 (In this study, the influence of tourniquet ischemia on the perfusion of the affected limb was examined by measuring tissue oxygen saturation and skin temperature.Both patients who received surgery on the corresponding hand and healthy participants were examined with a longer follow-up of 24 h compared to other studies ,21. InteIt has already been shown that tourniquet ischemia influences temperature not only of the treated extremity, but also of the whole body. Akata et al. showed that the tourniquet ischemia of one leg resulted in an increase in body temperature followed by a decrease in body temperature after the release of the ischemia . They asIn both groups, tissue oxygen saturation dropped after the application of the tourniquet ischemia compared to t0 and increased after the release of the tourniquet ischemia. In both groups, the tissue oxygen saturation decreased from timepoint t3 to t4 but resulted in higher levels compared to t0 in the patient group, while measured values at t4 in the participant group dropped to the level of t0. The decrease in saturation during ischemia was expected. The results of this study using two different imaging modalities confirmed the subsequent rapid increase in saturation to baseline or even beyond as has already been described in other studies.Babilas et al. measured the transcutaneous partial oxygen pressure before, during and after tourniquet ischemia using luminescence lifetime imaging and the application of transparent sensor foils . ReperfuAs in our study, where we observed an increase in tissue oxygen saturation after the release of the tourniquet ischemia compared to the baseline values, Lin et al. measured this reactive hypersaturation after the release of the tourniquet ischemia in patients undergoing ankle surgery using NIRI . In contThe necessity of tourniquet ischemia should be evaluated carefully as ischemia and the following reperfusion cause complex processes that can end in muscle degeneration and loss of function . The locWhile the short duration of ischemia in our study does not seem to have left any permanent visible damage, harmful side effects of tourniquet ischemia have already been described. Total knee arthroplasty with a tourniquet is associated with an increased risk of severe adverse events, pain, and a marginally longer hospital stay compared to the same operation without tourniquet ischemia. The only finding in favor of tourniquet use is a shorter time in theatre . TourniqThe lower values of skin temperature and tissue oxygen saturation at two timepoints in the healthy participant group might be explained as increasing age is an independent risk factor for the development of atherosclerosis  and due In contrast to others , we evalOur study evaluated the perfusion of tissue using two non-invasive imaging modalities, whose application was simple, easy to repeat and easy to handle with small portable devices and without exposing the participants to harmful radiation. Perfusion was determined indirectly by measuring temperature and tissue oxygen saturation. More precise parameters of perfusion, for example, postischemic skeletal muscle blood flow can be estimated using contrast enhanced MRI . HoweverOne limitation of the study was that the participant and patient groups could be compared with each other to a limited extent. The patients who had surgery received a dressing or splint that was still in place at the time of the last measurement and could have warmed the treated hand, while the participants did not receive a dressing. In addition, it can be assumed that the patients probably did not use their operated hand during the observation period, whereas the participants may have done exactly the opposite, such as during sport. This different behavior might have influenced the measured tissue oxygen saturation and skin temperature. Furthermore, perfusion was evaluated only indirectly via the measurement parameters of oxygen saturation and temperature. Therefore, small measurement inaccuracies must be assumed. For example, thermal imaging using FLIR ONE in a rat perforator model showed a sensitivity, specificity, and accuracy with a temperature difference of 80.8, 83.6, and 82 percent, respectively . The assThis study aimed to investigate the influence of short-term ischemia on the perfusion of an affected limb indirectly by measuring tissue oxygen saturation and temperature. The non-invasive imaging modalities used were easy to handle and allowed for repetitive measurement. Short-term ischemia does not appear to restrict perfusion permanently in this study design with a longer follow-up of 24 h. Further studies would be useful in order to investigate the influence of a longer ischemia duration in a larger patient collective.