Background: Predicting whether extracorporeal membrane oxygenation (ECMO) treatment duration affects prognosis is important both medically and economically. We conducted a retrospective, multicenter study to better understand the outcomes of patients treated with VV ECMO for a prolonged duration, analyzing data from the Israel ECMO registry. The study included all adult patients treated with VV-ECMO due to COVID-19-induced respiratory failure. The primary outcomes were survival rates up to 180 days from cannulation. Results: One hundred and eighty-eight patients were included in the study. The median age was 50 years (IQR 42, 50) and 69% were male. Patients were mechanically ventilated for a median of 2.5 days before cannulation (IQR 0.5, 5). The mean ECMO support duration was 29.9 days, with a maximal duration of 189.9 days. Survival rate for 180 days was 56%. We found no change in survival for patients on ECMO for 14, 28, or 56 days. Every day of mechanical ventilation before cannulation correlated with an 11% greater risk for prolonged ECMO treatment (p=0.01). Conclusions: For COVID-19-induced ARDS patients treated with VV-ECMO, ECMO treatment duration did not affect mortality. The longer the duration of mechanical ventilation before ECMO cannulation, the higher the risk for prolonged ECMO treatment.

Introduction: Within primary ARDS, SARS-CoV-2-associated ARDS (C-ARDS) emerged in late 2019, reaching its peak during the subsequent two years. Recent efforts in ARDS research have concentrated on phenotyping this heterogeneous syndrome to enhance comprehension of its pathophysiology. Methods and Results: A retrospective study was conducted on C-ARDS patients from April 2020 to February 2021, encompassing 110 participants with a mean age of 63.2±11.92 (26-83 years). Of these, 61.2% (68) were male, and 25% (17) experienced severe ARDS, resulting in a mortality rate of 47.3% (52). Ventilation settings, arterial blood gases, and chest X-ray (CXR) were evaluated on the first day of invasive mechanical ventilation and between days two and three. CXR images were scrutinized using a convolutional neural network (CNN). A binary logistic regression model for predicting C-ARDS mortality was developed based on the most influential variables: age, PaO2/FiO2 ratio (P/F) on days one and three, CNN-extracted CXR features, and age. Initial performance assessment on test data (23 patients out of the 110) revealed an area under the receiver operating characteristic (ROC) curve of 0.862 CI (0.654-0.969). Conclusion: Integrating data available in all intensive care units enables the prediction of C-ARDS mortality by utilizing evolving P/F ratios and CXR. This approach can assist in tailoring treatment plans and initiating early discussions to escalate care and extracorporeal life support. Machine learning algorithms for imaging classification can uncover otherwise inaccessible patterns, potentially evolving into another form of ARDS phenotyping. The combined features of these algorithms and clinical variables demonstrate superior performance compared to either element alone.

Introduction: COVID-19's emergence caused devastating consequences worldwide, with high morbidity and mortality rates. Critically ill patients face challenges like acute respiratory failure requiring intensive measures, including mechanical ventilation. Mortality rates in ARDS are influenced by various factors. This paper focuses on describing characteristics, management, and survival factors of mechanically ventilated ICU patients in Saudi Arabia. Methods: a retrospective, noninterventional approach, we reviewed charts and data of all COVID-19-infected patients who were admitted to the ICU, particularly those requiring ventilation support at Aseer Central Hospital (ACH) in the southern region of Saudi Arabia. Results: The study enrolled 594 COVID patients, mean age 60.5 ± 17.3 years, with 67% males. Approximately half had O negative blood group. Common chronic health issues: diabetes mellitus (35.5%). Positive culture findings in almost 340 (57.2%), with Klebsiella pneumoniae being the most isolated microorganism (45.5%). Significant correlations found with mortality: age, blood culture, Rh positive group (P<0.05). Conclusion: this study provides critical insights into the clinical and epidemiological aspects of COVID-19 patients admitted to the ICU in a Saudi Arabian hospital. The research underscores the impact of age, comorbidities, laboratory markers, and treatment interventions on patient out-comes, emphasizing the significance of tailored management strategies in this context.

Sepsis is an inflammatory disorder caused by the host’s dysfunctional response to infection. Septic patients present diverse clinical characteristics, and in the recent years it has been the main cause of death in intensive care units (ICU). Aquaporins, membrane proteins with role in water transportation, have been reported to participate in numerous biological processes. Their role in sepsis progression has been studied extensively. This review aims to examine recent literature on aquaporin expression and regulation in clinical sepsis, as well as established experimental models of sepsis. We will present how sepsis affects aquaporin expression at the molecular and protein level. Moreover, we will delve into the importance of aquaporin regulation at the transcriptional, post-transcriptional, translational, and post-translational level in sepsis, by presenting data on aquaporin regulation by non-coding RNAs and selected chemical molecules. Finally, we will focus on the importance of aquaporin single nucleotide polymorphisms in the setting of sepsis.

Although, severe acute respiratory syndrome coronavirus – 2 (SARS-CoV 2) represents one of the biggest challenges in the world today, the exact immunopathogenic mechanism that leads to severe or critical Coronavirus Disease 2019 (COVID-19) has remained incompletely understood. Several studies have indicated that high systemic plasma levels of inflammatory cytokines result in the so-called “cytokine storm”, with subsequent development of microthrombosis, disseminated intravascular coagulation, and multiorgan-failure. Therefore, we reasoned that elevated inflammatory cytokine might act as prognostic factors. Here, we analyzed 245 serum samples of patients with COVID-19, collected at hospital admission. We assessed the levels of heat shock protein 27 (HSP27), soluble suppressor of tumorigenicity- 2 (sST2), caspase cleaved cytokeratin 18 (cCK18), 20S proteasome, and tumor necrosis factor receptor 1 (TNFR-1) and explored their associations with overall-, 30-, 60-, 90-day- and in-hospital mortality. Moreover, we investigated their association with the risk of ventilation. We demonstrated that increased serum sST2 was uni- and multivariably associated with all endpoints. However, we also identified 20S proteasome as independent prognostic factor for in-hospital mortality. Furthermore, elevated HSP27, sST2, and 20S proteasome levels at hospital admission were univariably associated with higher risk of invasive ventilation. These findings could help to identify high-risk patients early in the course of COVID-19.

The influence of the secondary process of evaporation of the reaction product on the kinetics of interaction of gases (O₂, Cl₂, NH₃, H₂O and N₂H₄ vapors) with the surface of some metals (Cr, Pb, Si, Ge) and compounds (BN, SiO₂, SiC) is discussed. Also is considered the case when the growth of the scale is preceded by the process of gas etching of the metal surface. A general equation is given that describes the scale growth-evaporation kinetic (sample mass change - time) curves during the interaction of gases with the surface of metals and compounds. Special cases of parabolic, cubic and fourth degree processes are discussed.

Endothelin-1 (ET-1) is a potent vasoconstrictor produced by endothelial cells and cleared from circulating blood mainly in the pulmonary vasculature. In a healthy pulmonary circulation, the rate of local production of ET-1 is less than its rate of clearance. In the present study we aimed to investigate whether abnormal pulmonary circulatory handling of ET-1 relates to poor clinical outcomes in patients with COVID-19-induced ARDS. Plasma ET-1 levels were measured in 18 mechanically ventilated COVID-19-induced ARDS patients, with simultaneous central venous and systemic arterial blood sampling on Days 1 and 3 following ICU admission. Two age- and sex-matched non-COVID-19 control groups were also used [mechanically ventilated non-COVID-19 critically ill and ARDS patients]. On ICU admission, COVID-19-induced ARDS patients had higher systemic arterial and venous ET-1 levels compared to non-COVID-19 ARDS and critically ill patients (p< 0.05). The arterial:venous (A:V) ET-1 ratio was higher in the non-COVID-19 ARDS patients [1.06 (0.93-1.20)] compared to the other two groups (p< 0.05). The A:V ratio was 0.63 (0.49-1.02) in the COVID-19-induced ARDS patients and 0.79 (0.52-1.11) in the non-COVID-19 critically ill patients. On Day 3, the A:V ratio in all three groups was < 1. The COVID-19 patient group was then divided based on 28-day ICU mortality. Although arterial and venous levels did not differ, the A:V ratio was statistically significantly higher on ICU admission in the non-survivors [0.95 (0.78-1.34)] vs 0.57 (0.48-0.92), p= 0.027]. Measurement of ET-1 clearance via A:V plasma ET-1 levels on ICU admission may assist in predicting outcomes in COVID-19 critically ill patients.

Ventilation in prone position (PP) for 12 to 16 hours per day improves survival in ARDS. However, the optimal duration of the intervention is unknown. We performed a prospective observational study to compare the efficacy and safety of a prolonged PP protocol with conventional prone ventilation in COVID-19-associated ARDS. Prone position was undertaken if P/F <150 with FiO2>0.6 and PEEP>10cmH2O. Oxygenation parameters and respiratory mechanics were recorded before the first PP cycle, at the end of PP cycle and 4 hours after supination. We included 63 consecutive intubated patients with mean age 63.5 years. Of them, 37 (58.7%) underwent prolonged prone position (PPP group) and 26 (41.3%) standard prone position (SPP group). Median cycle duration for SPP group was 20 hrs and for PPP group 46 hrs (p<0.001). No significant differences in oxygenation, respiratory mechanics, number of PP cycles and rate of complications were observed between groups. The 28-day survival was 78.4% in the PPP group versus 65.4% in the SPP group (p=0.253). Extending the duration of PP was as safe and efficacious as conventional PP, but did not confer any survival benefit in a cohort of patients with severe ARDS due to COVID-19.

Background: Cytokine storm in COVID-19 is heterogenous. There are at least three subtypes: cytokine release syndrome (CRS), macrophage activation syndrome (MAS), and sepsis. Methods: A retrospective study comprising 276 patients with SARS-CoV-2 pneumonia. All patients were tested for ferritin, interleukin-6, D-Dimer, fibrinogen, calcitonin, and C-reactive protein. According to the diagnostic criteria, three groups of patients with different subtypes of cytokine storm syndrome were identified: MAS, CRS or sepsis. In each group, treatment results were assessed depending on whether or not tocilizumab was used. Results: MAS was diagnosed in 9.1% of the patients examined, CRS in 81.8%, and sepsis in 9.1%. Median serum ferritin in patients with MAS was significantly higher (5894 vs. 984 vs. 957 ng/ml, p &lt;0.001) than in those with CRS or sepsis. Hypofibrinogenemia and pancytopenia were also observed in MAS patients. In CRS patients, a higher mortality rate was observed among those who received tocilizumab, 21 vs. 10 patients (p=0.043), RR = 2.1 (95% CI 1.0-4.3). In MAS patients, tocilizumab decreased the mortality, 13 vs. 6 patients (p=0.013), RR = 0.50 (95% CI 0.25-0.99). Сonclusions: Tocilizumab therapy in patients with COVID-19 and CRS was associated with increased mortality, while in MAS patients it contributed to reduced mortality.

Introduction: The exponential growth of the SARS-CoV-2 virus transmission during the first months of 2020 has placed substantial pressure on health systems worldwide. The complications derived from the novel coronavirus disease (COVID-19) vary in due to comorbidities, sex and age, with more than 50% of the patients who require some level of intensive care developing acute respiratory distress syndrome (ARDS). Areas covered: Various complications caused by SARS-CoV-2 infection have been identified, the most lethal being the acute respiratory distress syndrome, caused most likely by the presence of severe immune cell response and the concomitant alveolus inflammation. The authors carried out an extensive and comprehensive literature review on SARS-CoV-2 infection, the clinical, pathological and radiological presentation as well as the current treatment strategies. Expert Opinion Elevation of inflammatory biomarkers is a common trend among seriously ill patients. The information available strongly suggests that in COVID-19 patients, their altered immune response, including a massive cytokine storm, is responsible for the further damage evidenced among ARDS patients. The increasingly high number of scientific articles and evidence available can only suggest that the individualization of each case is the norm, not all patients with acute respiratory failure due to COVID-19 meet the Berlin definition and therefore ARDS should be considered as a heterogeneous disease, with a wide range in the expression of its severity and clinical manifestations.

The SARS-Cov-2 virus, which causes COVID 19, uses the cell surface protein ACE2 as receptor for entry into cells. Critically ill COVID-19 patients often require prolonged mechanical ventilation which can cause mechanical stress to lung tissue. In vitro studies have shown that expression of ACE2 in alveolar cells is increased following mechanical stretch and inflammation. Therefore, we analyzed transcriptome datasets of 480 (non-COVID-19) lung tissues in the GTex tissue gene expression database. We found that mechanical ventilation of the tissue donors increased the expression of ACE2 by more than two-fold (p<10^-6). Analyses of transcriptomes of mechanically ventilated mice in the GEO database indicate that this alveolar cell response to stretch and inflammation is mediated by the chemokine midkine. Using a novel big knowledge network approach (SPOKE) we also found in transcriptomes of pharmacological perturbations (LINCS) that corticosteroids down-regulate midkine in pulmonal cells, and confirmed this in GEO transcriptomes of animal studies. Thus, mechanical ventilation of patients with COVID-19 pneumonia may eo ipso facilitate viral propagation in the lung, further accelerating the pulmonal pathology that has necessitated mechanical ventilation in the first place. This vicious cycle presents a rationale for the temporary treatment with corticosteroids to modulate the midkine-ACE2 axis in ventilated COVID19 patients and for gentler ventilation protocols.

Human respiratory beta coronavirus are emerging causes for Public Health Emergencies of International Concern (PHEIC). SARS-CoV2 is circulating worldwide since November 2019. We review here the cardiovascular morbidity and mortality in COVID-19, and data supporting the role for dysregulation of the RAS counterregulatory axis due to binding of SARS-CoV2 S protein to ACE2 receptor. Since this counterregulatory axis provides benefits not only on the cardiovascular front but also in acute lung injury, we speculate on potential use of ACE inhibitors and AT₁R blockers in critically ill COVID-19 patients, and report current evidences.

We report a case of an adult patient with newly diagnosed human immunodeficiency virus (HIV) infection, Acquired Immune Deficiency Syndrome (AIDS), and acute respiratory distress syndrome (ARDS) secondary to pneumocystis and cytomegalovirus pneumonia present on presentation that was successfully managed with veno-venous extracorporeal membrane oxygenation (VV-ECMO). A 40-year-old female with a past medical history of asthma was admitted to a local hospital due to dyspnea, cough, and wheezing where she was diagnosed with HIV infection, ARDS, and combined pneumocystis and cytomegalovirus pneumonia. Her pulmonary function quickly declined neces-sitating mechanical ventilation (MV). After she failed all conventional therapies, she was trans-ferred to a tertiary medical center for VV-ECMO therapy. Patient was successfully treated with antiretroviral therapy (ART), antibiotics, antivirals, steroids, and 48 days of VV-ECMO support, with complete resolution of her respiratory symptoms. She was discharged on hospital day 82. HIV positive patients with ARDS complicated by opportunistic pulmonary infections can be successfully managed with ART, appropriate anti-infective therapies, and VV-ECMO.

Some COVID-19 patients develop interstitial pneumonia that can evolve into Acute Respiratory Distress Syndrome (ARDS). This is accompanied by an inflammatory cytokine storm. SarS-CoV has proteins capable of promoting cytokine storm, especially in patients with comorbidities, including obesity. Since there is currently no resolutive therapy for ARDS and given the scientific literature regarding the use of adenosine, its application has been hypothesized. Adenosine through its receptors is able to inhibit the acute inflammatory process, increase the protection capacity of the epithelial barrier and reduce the damage due to an overactivation of the immune system, such as in cytokine storms. These features are known in ischemia / reperfusion models and could also be exploited in acute lung injury, with hypoxia. In light of these hypotheses, for compassionate use, a COVID-19 patient, with unresponsive respiratory failure, was treated with adenosine. The results showed a rapid and clear improvement in clinical conditions, with the negative effect of detection of SarS-CoV2.

Mitochondria are classically termed as powerhouse of a mammalian cell. Most of the cellular chemical energy in the form of adenosine tri phosphate (ATP) is generated by mitochondria and dysregulation of mitochondrial functions thus can be potentially fatal of cellular homeostasis and health. Acute respiratory distress has been earlier linked to mitochondrial dysfunction. SARS-CoV-2 infection severity leads to acute respiratory distress syndrome (ARDS) and can be fatal. We tried to investigate possible connection between SARS-CoV-2, ARDS and mitochondria. Here, we report identification of SARS-CoV-2 non-structural proteins (particularly Nsp12 and 13) that have recognition sequence with respect to mitochondrial entry. We also report that these proteins can potentially shuttle between cytoplasm and mitochondria based on the localization signals and help in downstream maintenance of the virus. Their properties to use ATP for enzymatic activities may cause ATP scavenging allowing viral RNA functions in lieu of host cell health.

With the emergence of COVID-19 we are confronted with a new clinical picture of acute respiratory distress syndrome in the intensive care unit. In the majority of patients, the respiratory mechanics are very different from the “normal” ARDS patient. We measured transpulmonary pressure and dead space ventilation to assess the effects of high and low PEEP levels on lung compliance and ventilation-perfusion mismatching. Advanced respiratory mechanics were assessed in 14 patients. Compared to ARDS patients, lung compliance was relatively high (61 ± 5 mL/cmH₂O). COVID-19 patients had high dead space ventilation and gas exchange impairment (Bohr 52 ± 3%; Enghoff modification 67 ± 2%; ventilatory ratio 2.24 ± 0.23). we show that higher PEEP levels decrease lung compliance and in most cases increase dead space ventilation, indicating that high PEEP levels probably cause hyperinflation in patients with COVID-19. We suggest using prone position for an extended period of time, and apply lower PEEP levels as much as possible.

With frequencies varying up to 20%, treatment resistant pulmonary failure is a major life-threatening complication in COVID-19 (SARS-CoV-2, HCoV19) disease pathology. Both acute respiratory distress syndrome (ARDS), proposed to be caused by an over-reacting immune system which floods the lung with edema, a liquid consisting of inflammatory cells, and diminished lung perfusion, have been postulated to cause this treatment resistant lung failure. Aging, co-morbidities, male gender and obesity are pre-existing factors associated with the more severe outcome. Thrombosis is more frequently observed than usually seen during ICU admission. Different hypotheses explaining the pathophysiological cascade leading to fast progressing severe COVID-19 disease and how to counteract it have been proposed. A variety of intervention studies to control severity are ongoing or planned. Not suggested so far, we here hypothesize that the inflammatory lipid modulator prostaglandin E₂ (PGE₂) executes a prominent role in COVID-19 pathophysiology. Based on this we suggest measuring PGE₂ in patients and evaluating selective inhibition of the human microsomal prostaglandin E synthase-1 (mPGES-1) as a potential innovative therapeutic approach in this devastating condition for which sonlicromanol, a drug currently in phase 2b studies for mitochondrial disease, is a candidate.

Most striking observations in COVID-19 patients are the hints on pulmonary edema (also seen on CT scans as ground glass opacities), dry cough, fluid restrictions to prevent more severe hypoxia, the huge PEEP that is needed while lungs are compliant, and the fact that anti-inflammatory therapies are not powerful enough to counter the severity of the disease. We propose that the severity of the disease and many deaths are due to a local vascular problem due to activation of B1 receptors on endothelial cells in the lungs. SARS-CoV-2 enters the cell via ACE2, a cell membrane bound molecule with enzymatic activity that next to its role in RAS is needed to inactivate des-Arg⁹ bradykinin, the potent ligand of the bradykinin receptor type 1 (B1). In contrast to bradykinin receptor 2 (B2), the B1 receptor on endothelial cells is upregulated by proinflammatory cytokines. Without ACE2 acting as a guardian to inactivate the ligands of B1, the lung environment is prone for local vascular leakage leading to angioedema. Angioedema is likely a feature already early in disease, and might explain the typical CT scans and the feeling of people that they drown. In some patients, this is followed by a clinical worsening of disease around day 9 due to the formation antibodies directed against the spike (S)-antigen of the corona-virus that binds to ACE2 that could contribute to disease by enhancement of local immune cell influx and proinflammatory cytokines leading to damage. In parallel, inflammation induces more B1 expression, and possibly via antibody-dependent enhancement of viral infection leading to continued ACE2 dysfunction in the lung because of persistence of the virus. In this viewpoint we propose that a bradykinin-dependent local lung angioedema via B1 and B2 receptors is an important feature of COVID-19, resulting in a very high number of ICU admissions. We propose that blocking the B1 and B2 receptors might have an ameliorating effect on disease caused by COVID-19. This kinin-dependent pulmonary edema is resistant to corticosteroids or adrenaline and should be targeted as long as the virus is present. In addition, this pathway might indirectly be responsive to anti-inflammatory agents or neutralizing strategies for the anti-S-antibody induced effects, but by itself is likely to be insufficient to reverse all the pulmonary edema. Moreover, we provide a suggestion of how to ventilate in the ICU in the context of this hypothesis.

Background: Electrical Impedance Tomography (EIT), combined with variable ventilation strate-gies and Artificial Intelligence (AI), is poised to revolutionize critical care by transitioning from reactive to predictive approaches. This integration aims to enhance patient outcomes through personalized interventions and real-time monitoring. Methods: This narrative review explores the principles and applications of EIT, variable ventilation, and AI in critical care. EIT’s impedance sensing creates dynamic images of internal physiology, aiding in the management of conditions like Acute Respiratory Distress Syndrome (ARDS). Variable ventilation mimics natural breathing variability to improve lung function and minimize ventilator-induced lung injury. AI enhances EIT through advanced image reconstruction techniques, neural networks, and digital twin technology, offering more accurate diagnostics and tailored therapeutic interventions. Conclu-sions: The confluence of EIT, variable ventilation, and AI represents a significant advancement in critical care, enabling a predictive, personalized approach. EIT provides real-time insights into lung function, guiding precise ventilation adjustments and therapeutic interventions. AI inte-gration enhances EIT's diagnostic capabilities, facilitating the development of personalized treatment plans. This synergy fosters interdisciplinary collaborations and sets the stage for in-novative research, ultimately improving patient outcomes and advancing the future of critical care.

Background: The role of inhaled Nitric Oxide (iNO) in managing Acute Respiratory Distress Syndrome Covid-19 related (C-ARDS) is debatable. The study aimed to analyze the effect of iNO administration in patients with persistent severe hypoxia and Intensive Care Unit (ICU) mortality. Methods: This retrospective study included 98 consecutive critically ill patients with C-ARDS admitted to ICU from 1 October 2020 to 31 October 2021. Results: Of these patients, 28% had received iNO. Twelve (44.4%) were responders. Kaplan-Mayer plot shows mortality was higher in non-responders (86.6 vs 25.0%). Non-response to iNo was the most important predictive value (p. 0.01). The Receiver Operating Characteristic (ROC) curve for a percentage increase in PaO2 from baseline confirmed that it had a higher predictive value for in-hospital survival. A value of 19% can predict the death event with a sensitivity of 81.8% and a specificity of 81.2%. Conclusions: Therefore, we propose to use iNO as a vasoreactivity test for prognostic stratification in patients with persistent severe hypoxia.

Introduction and Aims: COVID-19-associated invasive pulmonary aspergillosis (CAPA) is common and is associated with poor outcomes in critically ill patients. This prospective observational study aimed to explore the association between CAPA development and the incidence and prognosis of cytomegalovirus (CMV) reactivation in critically ill COVID-19 patients. Materials and Methods: We included all consecutive critically ill adult patients with confirmed COVID-19 infection who were admitted to three COVID-19 intensive care units (ICUs) in an Italian hospital from February 25, 2020, to May 8, 2022. A standardized procedure was employed for early detection of CAPA. Risk factors associated with CAPA and CMV reactivation and the association between CMV recurrence and mortality were estimated using adjusted Cox proportional hazard regression models. Results: CAPA occurred in 96 patients (16,6%) of the 579 patients analyzed. Among the CAPA population 40 (41,7%) patients developed CMV blood reactivation with a median time of 18 days (IQR 7-27). The CAPA+CMV group did not exhibit a significantly higher 90-day mortality rate (62.5% vs. 48.2%) than the CAPA alone group (p=0.166). The CAPA+CMV group had a longer ICU stay, fewer ventilation-free days, and a higher rate of secondary bacterial infections than the control group of CAPA alone. In the CAPA population, prior immunosuppression was the only independent risk factor for CMV reactivation (HR 2.33, 95% C.I. 1.21-4.48, p=0.011). Conclusions: In critically ill COVID-19 patients, CMV reactivation is common in those with a previous CAPA diagnosis. Basal immunosuppression before COVID-19 appeared to be the primary independent variable affecting CMV reactivation in patients with CAPA. Furthermore, the association of CAPA+CMV versus CAPA alone appears to impact ICU length of stay and secondary bacterial infections but not mortality.

During the COVID-19 pandemic, percutaneous tracheostomy proved to be an effective option in the management of patients with prolonged periods of intubation; in fact, among other things, it allowed early discharge from ICUs and contributed to reducing overcrowding in intensive care settings, a central critical point in the COVID pandemic. As a direct consequence, the management and the weaning of frail, tracheostomized and ventilated patients was diverted to sub-intensive or normal hospitalisation wards. One central challenge in this setting is the resumption of swallowing and oral feeding, which needs an interdisciplinary management involving Phoniatrician, ENT, Pneumologist and Speech Therapist. With this article, we aim to share the experience of a Swiss COVID-19 Center[1] and to draw up a narrative review on the issues concerning the management of the tracheostomy cannula during swallowing resumption, integrating the most recent evidence from the literature with the clinical experiences of the professionals directly involved in the management of tracheostomized COVID-19 patients. In view of the heterogeneity of COVID-19 patients, we believe that the procedures described in the article are applicable to a larger population of patients undergoing tracheostomy weaning.

Bio-absorbable stents are a novel tool which relieve stenosis and then resorb as the patient grows, avoiding obligatory re-intervention. This case describes the novel use of an iron bio-absorbable stent in a child with surgically repaired Tetralogy of Fallot who post-operatively developed a severely stenotic right ventricular outflow tract.

Background: Vasoactive Intestinal Peptide (VIP) is known to bind to and protect the Alveolar Type II cell by blocking replication of the SARS-CoV-2 virus, upregulating surfactant production, blocking apoptosis, and blocking cytokine effects. RLF-100 (Aviptadil), a synthetic form of Vasoactive Intestinal Peptide (VIP) has been granted Fast Track Designation and is currently in phase 2/3 placebo-controlled trials. FDA has granted Emergency Use IND and Expanded Access Protocol approval for the use of RLF-100 in patients whose comorbidities render them ineligible for inclusion in the ongoing pivotal trial. Methods: This report describes the first 6 patients with Acute Respiratory Failure in Critical COVID-19, enrolled under Emergency Use IND were treated with three successive 12-hour infusions of intravenous Aviptadil at 50/100/150 pmol/kg/hr, while continuing to receive maximal ICU care. Results: Median patient follow-up time is 14 days. So far, all treated patients have survived. Improved radiographic appearance of typical “ground glass” COVID-19 features to varying degrees is seen in all patients within 72 hours. Improvement in blood oxygenation is seen in all patients, with complete remission from respiratory failure in 4 of 6 patients. An average 56% reduction in inflammatory markers was seen, together with a median 4 point reduction in the NIAID Ordinal Scale. 2/6 patients were discharged from the hospital and 1 patient was downgraded to the general medicine floor. Comment: The short term survival of 6/6 patients with respiratory failure in the setting of COVID-19 and major comorbidity is the most dramatic response ever seen with an antiviral agent. Improvement in radiographic appearance, oxygenation requirement, and inflammatory markers is consistent with in vitro evidence of direct anti-viral effect.

The rapidly evolving understanding of Coronavirus Disease 2019 (COVID-19) respiratory failure pathogenesis, limited disease-specific evidence and demand-resource imbalances have posed significant challenges for intensive care clinicians. In this single-centre retrospective cohort study we describe the outcomes of COVID-19 patients admitted to Guy’s and St. Thomas’ NHS Foundation Trust (GSTT) critical care service. Patients were managed according to a local respiratory failure management pathway that was predicated on timely invasive ventilation when indicated and tailored ventilatory strategies according to pulmonary mechanics. Between 2nd March and 25th May 2020 GSTT critical care service admitted 316 patients with confirmed COVID-19. Of the 201 patients admitted directly through the Emergency Department with a completed critical care outcome, 71.1% survived to critical care discharge. These favourable outcomes may serve to inform the wider debate on the optimal ventilatory management in COVID-19.

Purpose: To assess the clinical safety and possible effectiveness of Vasoactive Intestinal Peptide in the treatment of Acute Respiratory Distress Syndrome (ARDS) related to sepsis. Methods: Under FDA Investigational New Drug clearance, 8 patients with ARDS related to sepsis were treated with 50 pmole/kg/hr – 100 pmole/kg/hr of Vasoactive Intestinal Peptide by intravenous infusion for 12 hours. All patients were on mechanical ventilation and full telemetery. Results: No drug-related serious adverse events were seen. Hypotension was seen in association with two infusions and diarrhea in association with one, but did not necessitate cessation of therapy. Bigeminy was seen in association with one infusion without sequelae. Seven of eight patients demonstrated a successful course during intensive care and were successfully removed from mechanical ventilation and discharged from intensive care. The eighth patient succumbed to purulent secretions in the lungs. Of those who were discharged from the ICU, six demonstrated successful 30 day survival. The seventh died from a cerebral infract at day 30, deemed unrelated to treatment with VIP. Serum levels of Tumor Necrosis Factor α were obtained in 6 patients at baseline and 24 hours and were seen to decrease with treatment in five patients. Conclusions: Initial clinical results of treatment with VIP in patients with ARDS demonstrated a safety profile consistent with previous studies in normal volunteers. The successful clinical course seen in 7 of 8 patients in the setting of an expected 50% survival may suggest that VIP shows promise in the treatment of other infectious conditions that damage the pulmonary epithelium, particularly COVID-19.

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mainly affects the respiratory system with some patients rapidly progressing to acute respiratory distress syndrome (ARDS). The most common symptoms of the patients are fever, cough, dyspnea, myalgia, and fatigue. Nasopharyngeal and oropharyngeal swab specimens tested by real-time reverse transcription-polymerase chain reaction (RT-PCR) are the most commonly used methods to diagnose COVID-19. Herein, we investigate and discuss a young case of COVID-19, without any pre-existing medical conditions, whose both nasopharyngeal and oropharyngeal swab tests of SARS-CoV-2 were negative in the prodromal phase. However, after three days, with severe dyspnea and rapidly progressed acute respiratory distress syndrome (ARDS), the case was identified as infected by COVID-19 by testing bronchoalveolar lavage fluid (BALF). The patient was intubated in the intensive care unit (ICU) but expired on the fourth day. This case shows the importance of active and accurate monitoring of the patients showing COVID-19 symptoms. Although the BALF test has a higher exposure risk, it is considered more accurate and recommended if performed by an expert operator.

The ocean of the planet Earth, which is as thin as a cicada's wings, play a role of catalyst to the evolving of the ancient plates. The ocean and the ancient plates of the planet Earth formed a magic Whirlpool of the Cross “十” shape with double whirl arms. The central core of the Cross “十” shape Ocean-Plate Whirlpool is the Hint Black Hole (HBH) located at the Northwestern Pacific Ocean floor which is decorated with invisible geological age distribution of clam shell. The double whirl arms of ancient plates are distinguished to be left and right at Bering Strait and just formed the ring of fire of the Pacific Ocean.The Cross “十” shape Ocean-Plate Whirlpool of the planet Earth was born at the equatorial area about 66 Ma ago and is rotating anticlockwise and drifting northward by a mini footprint of spiral at s speed of as slow as a snail moves. Obviously, it would come to an end at the North Pole about 100 Ma in the future. So, the lifespan of the Cross “十” shape Ocean-Plate Whirlpool would be about 166 Ma, from birth to death on the planet Earth.What is hidden behind of the evolving of the oceans and the ancient plates is the golden law of geometrical progression of ladder pagoda of attributes evolving of them, which is “1➨2➨4➨2➨1”, including upgrading and downgrading process. It seems to hint that what is happening on the planet Earth, including the top-level species of human race, is actually unique in the Milky Way galaxy in essence.The property roles of expanding and shrinking are existing in the Cross “十” shape Ocean-Plate Whirlpool by face to face and the exchange of property roles took place tens of millions of years ago. And that situation would happen again tens of millions of years in the future. It seems a giant circle of evolving of the exchange of property roles would be drawn by the Cross “十” shape Ocean-Plate Whirlpool in her lifetime.

A cross-sectional survey was distributed to 1322 members of a 1-on1 personalized strength training studio. 366 respondents (n=134 male and n=232 female), all aged over 20 years reported considerable training experience; 55% of males and 42% of females reporting 5+ years. Data were analyzed and reported descriptively with differences &gt;5% identified based on use of the 5-point likert scale, sample size and nature of the observations. Disparity between males and females were identified; males reported higher perceptions of managing effort, technique, and programming without supervision compared to females. Safety was noted as being more important to females compared to males. Qualitatively, additional themes were raised including analogy of the personal relationship between trainer and trainee being similar to that of medical professionals. This was validated where participants discussed their adaptations from supervised strength training including quality of life in aging, and recovery from medical conditions and injury. Data is discussed in context of a previous body of literature suggesting males falsely report higher confidence in tasks compared to females, particularly in relation to effort, role models, and verbal encouragement. This research proves beneficial for strength training practitioners in enhancing their understanding and expectations of clients, as well as hopefully proving insightful in engaging more people in strength training.

The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a significant surge of critically ill patients and an unprecedented demand on intensive care services. The rapidly evolving understanding of pathogenesis, limited disease specific evidence and demand-resource imbalances have posed significant challenges for intensive care clinicians. COVID-19 is a complex multisystem inflammatory vasculopathy with a significant mortality implication for those admitted to intensive care. Institutional strategic preparation and meticulous intensive care support are essential to maximising outcomes during the pandemic. The significant mortality variation observed between institutions and internationally, despite a single aetiology and uniform presentation, highlights the potential influence of management strategies on outcome. Given that optimal organ support and adjunctive therapies for COVID-19 have not yet been well defined by trial-based outcomes, strategies are predicated on existing literature and experiential learning. This review outlines the relevant pathophysiology and management strategies for critically ill patients with COVID-19, and shares some of the collective learning accumulated in a high volume Severe Respiratory Failure centre in London.

This study aims to assess the impact of deforestation and carbon sequestration within the Gandoca-Manzanillo Wildlife Refuge, Costa Rica, using high-resolution satellite imagery from Planet NICFI and Sentinel-2. The research evaluates the impact of forest degradation on forest health and carbon absorption during two periods in 2024 (January and August). Advanced vegetation indices (NDVI, GNDVI, EVI, and SAVI) were applied to assess changes in forest cover and health. Planet NICFI data revealed a 0.41% loss in forest cover, identifying subtle degradation less detectable with Sentinel-2. In terms of carbon sequestration, Sentinel-2 showed a modest increase in CO₂ absorption from 180,231.88 tons to 186,211.33 tons, while Planet NICFI indicated a decrease from 3,984,470.82 tons to 3,820,917.83 tons, suggesting forest degradation. These findings highlight the importance of high-resolution satellite imagery in detecting fine-scale disturbances that lower-resolution data might miss. However, the study’s short timeframe, covering only two periods in 2024, limits long-term trend analysis. The research underscores the need for improved remote sensing technologies and stronger legal frameworks to protect areas like Gandoca-Manzanillo from illegal logging. Despite programs like Payment for Ecosystem Services (PES) in Costa Rica, significant challenges remain in protecting biodiversity-rich regions.

Burnout, characterized by emotional and physical exhaustion, poses a significant challenge to adolescent athletes, particularly in high-intensity sports like basketball. Emotional Intelligence (EI) is the ability to manage emotions, which is negatively associated with burnout. Emotional labor, including strategies of surface acting (SA), deep acting (DA), and genuine expression (GE), is a potential key role in emotion management between EI and burnout for athletes. This study aims to investigate the relationship between EI and burnout, as well as the mediating role of emotional labor strategies among adolescent basketball players. Our cross-sectional study, conducted in youth sports schools in four different places of China, involved 260 basketball players. Our study found EI to be negatively associated with burnout. SA and GE were identified as significant mediators in this relationship, with SA positively associated with burnout and GE negatively associated. These findings suggest that enhancing EI and optimizing emotional labor strategies could be key in mitigating burnout among young athletes, thereby improving their well-being and performance.

The boosted interest in the use of rare earth elements (REEs) in modern technologies had also increase the necessity of their recovery from various sources, including raw materials and wastes. Though Hydrometallurgy plays a key role in these recovery processes, some drawbacks (apparent or not) of these processes, had led to the development of a more environmental friendship subclass named Solvometallurgy, in which non-aqueous solvents substituted to the aqueous media of the hydrometallurgical processing. The non-aqueous solvents chosen for these usages are, besides ionic liquids (ILs), the so-named Deep Eutectic Solvents (DEEs). The utilization of DEEs included the leaching of REEs from the different sources containing them, and also in the separation-purification steps necessary for the yielding of these elements, normally as oxides or salts, in the most purified form. This work reviewed the most recent literature (2023 year) about the utilization of deep eutectic solvents in the recovery of REEs from various sources, and in the coupling of these two (DESs and REEs) to derived compounds to be used in other fields.

The freshwater bodies of Nepal host a great deal of fish diversity; however, the molecular study of Nepalese fish is still in its early stages. Conservation management tactics require knowledge of the real species composition, often impeded by descriptions of intermittent species based on traditional taxonomy. Catfish, one of the most overfished taxa on the planet are abundant and heavily exploited in the eastern region of Nepal. Hence, actual catfish diversity in this region needs to be examined using a combined morphological and molecular DNA barcoding approach. In this study, we sequenced the cytochrome oxidase subunit I (COI) gene in Nepalese fish species for the first time and used it for molecular identification. Altogether, 99 specimens representing 29 species belonging to 21 genera and 8 families were successfully barcoded. They were found to be 98.5–100% identical to the known sequences deposited in the GenBank and BOLD databases. Of these, two species, Amblyceps arunachalense and Erethistoides sicula were recorded for the first time in Nepal. Out of 29 species, one species was found to be Endangered, one species as Vulnerable, two species were classified as Near Threatened, one species as Data Deficient, and 24 species were categorized as Least Concern. The intraspecific genetic distances within species ranged from 0 to 5%. The highest intraspecific genetic distances (Kimura 2 parameter) were found among the individuals of two species, namely E. sicula (4%) and Glyptothorax telchitta (5%), indicating the presence of putative (sub) species. The interspecific genetic distances among the catfishes in eastern Nepal ranged between 8.47% (between Glyptothorax trilineatus and G. cavia) and 26.38% (between Amblyceps arunachalense and Chaca chaca). The GC content at the 1st, 2nd, and 3rd positions of the codons was found to be 42.4%, 49.3% and 43.8%, respectively. These findings will support future initiatives for fish resource inventory, monitoring and management. It is also an important input to the DNA barcode library of catfish in the eastern region of Nepal.

The Ali-Cesaro Stolz theorem, introduced in this paper, extends the classical Cesaro-Stolz theorem by addressing cases where the latter does not yield results or provides a "Does Not Existe (DNE) form. This novel theorem leverages the properties of limits and Z-transforms, offering a robust framework for analyzing sequences and series. The theorem is particularly effective in scenarios where traditional approaches fail, providing new insights and tools for mathematical analysis. This paper presents a detailed formulation of the Ali-Cesaro Stolz theorem, including proofs, applications, and a discussion on its implications and advantages over existing methods.

Bands of interdendritic porosity and positive macrosegregation are commonly observed in pressure die castings, with previous studies demonstrating their close relation to dilatant shear bands in granular materials. Despite recent technological developments, the micromechanism governing dilatancy in the high pressure die casting (HPDC) process for alloys between liquidus and solidus temperature region is still not fully understood. To investigate the influence of fluid flow and the size of externally solidified crystals (ESCs) on the evolution of dilatant shear bands in HPDC, various filling velocities were trialled to produce HPDC samples of Al8SiMnMg alloy. This study demonstrates that crystal fragmentation is accompanied by a decrease in dilatational concentration, thus producing an indistinct shear band. Once crystal fragmentation stagnates, the enhanced deformation rate associated with a further increase in filling velocity (from 2.2 ms^-1 to 4.6 ms^-1) localises dilatancy into a highly concentrated shear band. The optimal piston velocity is 3.6 ms-1, under which the average ESC size reaches the minimum and the average yield stress and overall product of strength and elongation reaches the maximum value of 144.6 MPa and 3.664 GPa%, respectively. By adopting the concept of force chain buckling in granular media, the evolution of dilatant shear bands in equiaxed solidifying alloys can be adequately explained based on further verification with DEM-type modelling in OpenFOAM. Three mechanisms for ESC enhanced dilation are presented, elucidating previous reports relating the presence of ESCs to the subsequent shear band characteristics. By applying the physics of granular materials to equiaxed solidifying alloys, unique opportunities are presented for process optimization and microstructural modelling in HPDC.

Abstract. The remarks by the Supreme Leader of the Islamic Revolution on the toll of the famines that afflicted occupied Iran in World War I and World War II indicate a desire to incorporate these calamities in Iran’s national narrative and collective memory. His criticism of famine historiography and stated toll numbers, and the unfolding catastrophic famine in Gaza, justify and necessitate a fresh look at each famine’s historiography and toll. This article re-estimates the toll of each famine by including many overlooked and neglected primary sources and in ways not previously done. It builds a trajectory of Iran’s demographic development from 1810 to 1944, and derives the toll of each famine. The World War II famine and typhus epidemics had claimed 5.5 million. World War I famine was also more deadly, though the 1869-73 famine was not far behind. At least 15.5 million Iranians died in the two world wars, a fact nowhere reflected in the history of the conflicts. Iran’s 1944 population of 12 million was unchanged from that of 1850 and a century of population growth obliterated

The Indorama Eleme Petrochemical Limited (IEPL) is found in the southern part of Nigeria more specifically on the Rivers State southern religion Nigeria. It consists of five distinct units, each of which generates its own unique trash at a rate of around 3115.98 tonnes per year. This study had the goal of concentrating on the management of the processing wastes in order to minimize the negative effects that they have on the environment. It is necessary to have an understanding of the number, nature, and make-up of IEPL's industrial wastes in order to effectively manage and regulate the development of waste there. As a result, we decided to collect data through the use of questionnaires. The classification of industrial wastes was accomplished by doing a comparative study and synthesis of research that were relevant to the management of petrochemical waste. Because an individual coding system is required for the integrated management of industrial waste, we gave each type of trash a code that consists of thirteen digits. The primary components of trash were catalysts (9.58 percent), metallic materials (7.62 percent), plastic barrels (35.77 percent), coke (12.66 percent), wood (4.47%), oil (4.15%), glass (0.028 percent), cooling tower packaging (6.7 percent), and other material (18.83 percent). According to the findings of the investigation into the physical qualities of the wastes, only 11.81% of these residues were liquid, while 88.19% were solid. The current handling of these wastes has been experiencing significant difficulties as of late. garbage management at IEPL was particularly challenging due to the wide variety of wastes produced there and the dangerous nature of the wastes themselves (88.19% of garbage was hazardous waste). Recycling and reuse of garbage may have been the greatest decision in some situations; yet, incineration and disposal of waste are also necessary options.

This article examines air sampling as an environmental surveillance strategy for early pathogen detection and offers a preliminary comparison of air and wastewater surveillance. Air sampling involves collecting bioaerosols to analyze the microbial composition of the air, utilizing techniques like PCR and metagenomic sequencing. Air sampling appears especially promising for detecting respiratory pathogens and highly transmissible pandemic agents, as these spread primarily via aerosols and droplets. The article details various air sampling techniques, their efficiency, and practical considerations, categorizing them into filtration, impaction, impingement, electrostatic precipitation, and condensation methods. It also explores the composition of airborne microbes, emphasizing the low concentration of viral nucleic acids and the challenges this poses for metagenomic sequencing. The selection of sampling locations, including indoor environments and airplanes, is discussed as critical for effective pathogen detection. Finally, the article contrasts air and wastewater sampling, concluding that while both methods should ideally be explored as layered defenses, air sampling does not collectively appear more promising than wastewater sampling.

Acute Respiratory Distress Syndrome (ARDS) is a severe lung condition with a high mortality rate for which there are no effective therapeutics. The failure of the alveolar-capillary barrier, composed of lung endothelial (EC) and alveolar epithelial (AEC) cells, is a critical factor leading to excessive inflammation and edema characteristics of acute lung injury (ALI). Phosphodiesterases (PDE) are enzymes well-recognized for their roles in regulating endothelial permeability and inflammation. Although PDE inhibitors are used as therapeutics for inflammatory diseases like COPD (chronic obstructive pulmonary disease), their efficacy in treating ARDS has not yet been established. In this study, we investigate the effects of ensifentrine, an FDA-approved novel dual PDE 3/4 inhibitor, on lung endothelial and epithelial dysfunction caused by methicillin-resistant S. aureus (MRSA), a pathogen involved in bacterial ARDS. Human primary lung endothelial cells and alveolar epithelial cell lines (A549 and immortalized AEC) were treated with heat-killed MRSA, and their responses were assessed in the presence or absence of ensifentrine. Ensifentrine given either pre- or post exposure attenuated MRSA-induced increased lung endothelial permeability. VE-cadherin junctions, which serve to stabilize the EC barrier, were disrupted by MRSA; however, ensifentrine effectively prevented this disruption. Pre-treatment with ensifentrine protected against MRSA-induced EC pro-inflammatory signaling by inhibiting the expression of VCAM-1, ICAM-1, and by reducing the IL-6 release. In AEC, MRSA caused upregulation of ICAM-1, activation of NF-kB and production of IL-8, all of which were inhibited by ensifentrine. These results indicate that dual inhibition of phosphodiesterases 3 and 4 by ensifentrine is barrier protective and attenuates MRSA-induced inflammation in both lung endothelial and epithelial cells. The PDE3/4 inhibitor ensifentrine may represent a promising novel strategy for the treatment of ALI.

The artificial intelligence (AI) is a machine or computing platform that is capable of making intelligent decision similarly to the human mind. The AI could improve diagnosis, treatment prognosis, and clinical workflow, particularly in the field of radiology. Concerning acute respiratory distress syndrome (ARDS) is a rather heterogeneous syndrome characterized by an inflammatory lung edema leading to an increased lung weight, decreased lung aeration with the presence of alveolar collapse and interstitial opacities mainly in the dependent area. Thus, lung imaging is an essential tool to assess not only the morphology but also the mechanical characteristics of ARDS patients. Chest computed tomography (CT) and ultrasound have a higher sensitivity and specificity than conventional chest radiography. This narrative review summarizes the state of art of AI in the field of lung imaging, focusing on CT and ultrasound technique in ARDS patients. A total number of 18 articles were retrieved. The application of AI in lung imaging was mainly devoted to assess the prediction of ARDS, the quantification of alveolar recruitment, the possible alternative diagnosis and the outcome. Although the presence of a physician is still essential to ensure a high quality of examinations the AI could assist the clinical team to provide the best possible care.

Sepsis is a life-threatening condition caused by the body's overwhelming response to an infection, such as pneumonia or urinary tract infection. It occurs when the immune system releases cytokines into the bloodstream, triggering widespread inflammation. If not treated, it can lead to organ failure and death. Unfortunately, sepsis has a high mortality rate, with studies reporting rates ranging from 20% to over 50%, depending on the severity and promptness of treatment. According to the World Health Organization (WHO), the annual death toll in the world is about 11 million. One of the main toxins responsible for inflammation induction are lipopolysaccharides (LPS, endotoxin) from Gram-negative bacteria, which ranks among the most potent immunostimulants found in nature. Antibiotics are consistently prescribed as a part of anti-sepsis-therapy. However, antibiotic therapy (i) is increasingly ineffective due to resistance development and (ii) most antibiotics are unable to bind and neutralize LPS, a prerequisite to inhibit the interaction of endotoxin with its cellular receptor complex, namely Toll-like receptor 4 (TLR4)/MD-2, responsible for the intracellular cascade leading to pro-inflammatory cytokine secretion. The pandemic virus SARS-CoV-2 has infected hundreds of millions of humans worldwide since its emergence in 2019. The COVID-19 (Coronavirus disease-19) caused by this virus is associated with high lethality, particularly for elderly and immunocompromised people. As of August 2023, nearly 7 million deaths were reported worldwide due to this disease. According to some reported studies, upregulation of TLR4 and the subsequent inflammatory signaling detected in COVID-19 patients “mimics bacterial sepsis”. Furthermore, the immune response to SARS-CoV-2 was described by others as “mirror image of sepsis”. Similarly, the cytokine profile in sera from severe COVID-19 patients was very similar to those suffering from the acute respiratory distress syndrome (ARDS) and sepsis. Finally, the severe COVID-19 infection was frequently accompanied by bacterial co-infections, as well as by the presence of significant LPS concentrations. These data indicate similarity and interdependences of both syndromes, but also significant differences which will be discussed in the present review.

Celecoxib as adjuvant therapy has been shown in a small randomized trial for Covid-19 to prevent clinical deterioration and rapidly improve thoracic computerized axial tomography (CT-chest)¹. Multiple descriptive trials of high dose famotidine (both inpatient and outpatient) have demonstrated clinical response^2,3,4. We describe the rapid clinical responses after increasing the celecoxib dosage to 400mg bid with high dose famotidine 80mg qid in both a critical inpatient who on baseline required 40 liters per minute high flow nasal insufflation and an outpatient who declined admission but had critical Covid-19 biomarkers.

This article seeks to strengthen efforts in technological developments based on the classification of PET plastic that positively impacts sustainable development and contributes to suitable solutions in collection centers in Mexico. Three experiment designs and machine learning tools for data processing were developed. For the experimentation, three factors were considered: the bottle's size, the amount of liquids inside the bottle, and the label on the bottle. The first experiment was to identify the distance of the sensor from post-consumer PET bottles. The second experiment was to determine the detection ability of the sensor with different levels of liquids inside the bottles, and the third was to determine the detection ability on the bottle labels. A digital lux meter on a microcontroller was developed to monitor illuminance on post-consumer PET plastic when it contains liquid as it passes through a conveyor belt for processing at an average rate of three bottles per second. With the implemented methodology, liquids were satisfactorily detected inside the transparent PET bottles when they had beverages between 25% and 100% of their capacity. Finally, this paper highlights that it is possible to implement an affordable design to identify bottles with liquids for collection centers.

Over the last two months, as oncology specialists, we have frequently been contacted for estimating prognosis for cancer patients affected by COVID-19 infection. Until now, there have been no clear markers to guide decision making regarding the appropriateness of invasive ventilation in cancer patients affected by COVID-19 infection. Therefore, we developed a practical tool encompassing a prognostic score. We aimed at identifying a subgroup of patients likely to have a better outcome and therefore may be potential candidates for invasive ventilation, "The Milano Policlinico ONCOVID-ICU score". The score is composed by three groups of variables: patient’s characteristics such as sex, age, BMI and comorbidities; oncological variables (treatment intent, life expectancy, on or off-treatment status) and clinical parameters in association with laboratory values (SOFA score and D-dimer). The SOFA score includes six different clinical parameters and during the first few days of ICU admissions has an important prognostic role. The oncological history should never represent, per se, a contraindication to intensive care and must be considered together with other variables, such as laboratory values, clinical parameters and patient characteristics, in order to make the hardest but best possible choice. The Milano Policlinico ONCOVID-ICU score, to our knowledge, is the first prognostic score proposed in this setting of patients and may be a useful tool to assess the prognosis of cancer patients being in this critical condition.

In general, during emergencies, healthcare is provided by tents and temporary structures that do not consider the environmental and social impact of the structure as a first term, in favor of swift response. The resultant construction intended as a temporary solution often persists long-term. This paper aims to analyze an alternative and innovative modular structure designed as a transitory solution in emergency and everyday life. In the first part of the paper, the conceptual framework, and the preliminary design for the new approach to basic non-conventional sanitary spaces are described, by investigating the benefits of a safe space as a generator space for care services and community. In the second part, the technological requirements of the system, its energy efficiency, and environmental impact are analyzed.

Ensuring the security of vertical applications in fifth-generation (5G) mobile communication systems and previous generations is crucial. These systems must prioritize maintaining the confidentiality, integrity, and availability of services and data. Examples of vertical applications include smart cities, smart transportation, public services, Industry 4.0, smart grids, smart health, and smart agriculture. Each vertical application has specific security requirements and faces unique threats within the mobile network environment. Thus, it is essential to implement comprehensive and robust security measures. This approach helps minimize the attack surface and effectively manage risks. This survey thoroughly examines mobile networks and their security challenges in vertical applications, shedding light on associated threats and potential solutions. Our study considers the interplay between security considerations in 5G, legacy networks, and vertical applications. We emphasize the challenges, opportunities, and promising directions for future research in this field and the importance of securing vertical applications in the evolving landscape of mobile technology.

This document serves as supplemental information to Shapero et al. (2023), which is itself a comment on Nowell et al. (2022). Environmental Health Perspective’s publishing standards for article comments have strict word counts and do not allow the addition of new primary data analyses; therefore, this document provides an additional level of detail and supporting analyses that serve as an important backup to and expansion of Shapero et al. (2023) and that also respond to some comments within the author’s reply to our comments (Holmes and Nowell, 2023). Nowell et al. (2022) evaluated potential PM_2.5 community impacts from sugarcane harvesting. However, their analysis is flawed by erroneous assumptions and misapplied technical approaches, as discussed in Shapero et al. (2023) and as detailed in this supplemental information document. Additionally, the authors ended their analysis with 2018 data, but later data shows no marginal increase in PM_2.5 during sugarcane harvest following 2019 even using the authors’ approach (Holmes and Nowell, 2023). Therefore, the authors’ evaluations have no relevance to current conditions. Nonetheless, even their evaluation and conclusions regarding PM_2.5 concentrations purportedly attributable to sugarcane harvesting prior to 2019 are unsupported and technically unsound as detailed below.

Bearing fault diagnosis is crucial for ensuring the stable operation of mechanical equipment. With the continuous development of deep learning technology, Convolutional Neural Networks (CNNs) have demonstrated significant advantages in the field of fault diagnosis. This paper proposes a new method that combines various CNN architectures to improve the accuracy of bearing fault diagnosis. We designed five different convolutional network structures, including SerConv, ResConv, One-Shot Aggregation Convolution (OSAConv), Cross-Stage Aggregation Convolution (CSAConv), and MD-DAConv. Experimental results on the Case Western Reserve University (CWRU) bearing dataset show that the proposed method exhibits high accuracy and robustness in fault diagnosis. The results indicate that strategies such as multi-directional, multi-scale, and residual connections play a crucial role in enhancing the depth and breadth of feature extraction, while simple and effective feature fusion and information transmission mechanisms are key to ensuring the robustness and generalization ability of the model.

Nepal is witnessing a significant rise in obesity as traditional agrarian lifestyles give way to urbanization and sedentary behaviors. The dissolution of agriculture as a cultural practice has led to a reduction in daily physical activity, contributing to an alarming increase in non-communicable diseases such as cardiovascular diseases, type 2 diabetes, and hypertension. This article explores how Nepal can adopt new health-oriented cultural practices to combat obesity, drawing inspiration from the gym culture in the United States and the cycling culture in Europe. It advocates for the promotion of physical activity through community-based fitness programs, active transportation, and integrating exercise into educational curriculums. Additionally, it emphasizes the importance of reviving traditional dietary practices and supporting mental well-being. The article underscores the need for government support in implementing policies and infrastructure that foster a culture of health, ensuring a healthier future for Nepal's population.

first_pagesettingsOrder Article ReprintsOpen AccessArticleThe Carbon Footprint of Spanish University Websitesby Sonia Sanchez-Cuadrado ¹ andJorge Morato ^2,*1Department of Library and Information Science, Complutense University of Madrid, 28010 Madrid, Spain²Department of Computer Science, Carlos III University of Madrid, Leganes, 28911 Madrid, Spain^*Author to whom correspondence should be addressed.Sustainability 2024, 16(13), 5670; https://doi.org/10.3390/su16135670 (registering DOI)Submission received: 31 May 2024 / Revised: 22 June 2024 / Accepted: 23 June 2024 / Published: 3 July 2024(This article belongs to the Special Issue Sustainable Education in the Digital Society: Applying Communication Technologies and Digital Tools to Education) Downloadkeyboard_arrow_down Browse Figures Versions NotesAbstractThe consumption of digital content is essential for economic and scientific development, leading to a high dependence on information and communication technologies, which significantly impacts the environment. Quantifying this ecological impact is challenging due to its intangible nature and the diversity of factors. This research focuses on assessing the energy consumption and CO₂ production of Spanish university websites to evaluate their levels of digital pollution and environmental impact. The calculation of the carbon footprint considers factors related to energy consumption and the use of green or renewable energies. The findings indicate that only 17% of university websites can be considered environmentally friendly. There are significant differences in CO₂ consumption and emissions depending on whether the websites implement environmentally sound practices. This study highlights the lack of initiatives aimed at reducing energy consumption and greenhouse gas emissions associated with web information management. The study shows that Spanish universities have the potential to contribute to the reduction in CO₂ emissions by implementing sustainable development practices on their websites. Furthermore, it fosters awareness about technology usage and its environmental impact, promoting the adoption of green and sustainable approaches.

Cities are complex systems requiring urban design models that balance order and disorder. Collective creativity initiatives engage citizens in these processes, empowering bottom-up approaches that prioritize people and social well-being within urban development. This paper investigates an 'Urban Laboratory' as a case study, examining the potential of collective creativity to address urban complexity. The successful and ongoing project 'El Campo de Cebada' in Madrid, Spain, demonstrates how a community transformed a vacant lot into a vibrant social hub. The phases of this study include case selection, data collection, data analysis, and presentation of the results. This study identifies key enabling factors, including agents, management, social dynamics, infrastructure, and actions. These insights offer a methodological framework for designing future collaborative, resilient, and inclusive urban spaces, addressing the complex needs of communities within our cities.

The aim of this study was to quantify methane (CH4) emissions from dairy cows during milking by maximum amplitude of eructation peaks and compare estimates with other metrics for CH4 emissions. Spot measurements of CH4 and carbon dioxide (CO2) emissions were recorded for at least 7 days of continuous sampling using an infrared gas analyser in a robotic milking station whilst cows were milked. Concentrations of CH4 and CO2 were measured at 1 second intervals. A total of 105,701 CH4 spot measurements were obtained from 2,206 dairy cows on 18 farms. Methane emissions per individual cow were quantified by maximum amplitude of eructation peaks, average area under eructation peaks (integral of eructation), average concentration during milking and ratio of CH4 to CO2 concentration. There was a high correlation (r = 0.71) between CH4 emissions quantified by maximum amplitude and integral of eructation peaks. The correlation between maximum amplitude and average CH4 concentration was low, and there was no correlation between maximum amplitude and ratio of CH4 to CO2. As both approaches identify and extract eructation peaks to quantify enteric CH4 emissions, the substantial association between maximum amplitude and eructation integral was expected.

The mechanistic Target of Rapamycin Complex 1 (mTORC1) regulates ribosome biogenesis and the transcription of ribosomal genes. Its inactivation impacts protein synthesis necessary for transport of cell adhesion molecule. In Dictyostelium discoideum, the activity of mechanistic Target of Rapamycin Complex 2 (mTORC2) is crucial for cAMP synthesis and relay, processes that depend on heterotrimeric G-proteins and Ras GTPases. Mutants lacking rip3 or lst-8 genes exhibit impaired adenyl cyclase activation and cAMP signaling, resulting in deficient expression of the cell adhesion protein CsaA. Despite this, rip3^- cells, which have impaired mTORC2, upregulate Cad-1 expression, a cell adhesion protein regulated by Ras-GTPases, to compensate for the loss of CsaA. lst-8^- cells, which have both mTORC1 and mTORC2 inactivated, show reduced nutrient sensing, premature CsaA expression and solitary cell behavior. These cells also show defective transport of adhesion proteins to the cell surface, impeding aggregation. Similar defects are observed with caffeine treatment, suggesting both mTORC1 and mTORC2 inhibition. This study highlights the interplay between mTORC1 and mTORC2 in regulating cell adhesion and aggregation through cAMP signaling and protein synthesis pathways in Dictyostelium.

Attention Deficit Hyperactivity Disorder (ADHD) diagnosis poses significant challenges due to its heterogeneous nature and reliance on subjective assessments. This study leverages deep learning to develop a robust diagnostic model by integrating a comprehensive set of EEG biomarkers. We incorporate parameters such as theta/beta ratio, coherency measures, delta power, event-related potentials (ERPs), power spectral density (PSD), microstates, entropy measures, fractal dimension, and source localization. Our convolutional neural network (CNN) model, designed to process these diverse features, demonstrates high accuracy and stability in distinguishing ADHD patients from controls, from all ages. The model's architecture includes convolutional layers for spatial feature extraction, followed by dense layers that integrate additional EEG parameters. The results indicate that deep learning, coupled with a rich feature set, can significantly enhance the predictive accuracy of ADHD diagnosis, offering a promising tool for clinical application.

Phytopathogenic fungi are living organisms that cause plant diseases and great damage to agri-cultural products. Despite the wide range of commercial fungicide products in use, there is a clear need for new and environmentally friendly fungicides. Here we propose a new ecological fun-gicide, copper alginate microspheres prepared by ionic gelation. The microspheres were charac-terized (morphology and topography, encapsulation efficiency, load capacity, swelling behavior, rheology, kinetics and mechanism of copper ions release) and their in vitro antifungal potential against selected genera of phytopathogenic fungi was evaluated. Novel copper alginate micro-spheres inhibited spore germination of Botrytis cinerea and mycelial growth of Cercospora beticola and Phytophthora ramorum. They offer effective disease control while minimizing environmental impact and promoting sustainable agriculture practices.

Raru’s plants bark has long been used as traditional medicine in Batak’s tribe. Raru’s bark is derived from several trees that are usually used in a mixture in Batak traditional beverages. This bark is generally used as antidiabetic remedies. This study aims to combine the rarus’s bark extract and mocaf activated-carbon (MAC) in order to study antidiabetics in rats. The combination of raru’s bark extract and MAC were tested on male rats as of Sprague Dawley strain for testing antidiabetic bioactivity. The result showed that antidiabetic activity of raru’s extract and MAC exposed the antidiabetic level declines in rat’s blood. The various treatments of different concentration ratios of raru’s extract and MAC useful in the experiments showed that the levels of blood level reduction were slightly different (14-21%). The raru’s extract pure was observed more effective in decreasing the blood glucose level in rat’s blood, in comparison the positive control. The mixture of raru’s extract and MAC with 75:25 ratio is better than 50:50 ratio. The involvement of MAC in the alleged antidiabetic agent did little in improving the blood glucose level decrease in rat’s blood. Raru’s extract and MAC indicate its potential utilization as an antidiabetic agent.

Objectives: Few studies have evaluated and compared artificial intelligence (AI) models for breast cancer detection on the same database. The purpose is to compare the performances of 3 artificial intelligence algorithms on the same dataset at a free operative threshold and to evaluate how the performance is impacted by the chosen threshold. Materials: In this retrospective single-center study, a dataset of 314 2D screening mammograms performed between 2012 and 2020 was established with a prevalence of 19.6% of histologically proven cancer. Three AI constructors using CE (European conformity) marking algorithms have agreed to take part in the study by submitting the cancer-enriched cohort to their algorithm. They chose a free operative threshold to distinguish benign and malignant mammograms. The most suspicious lesion was marked and correctly located by the AI algorithm. Statistical parameters were analyzed and compared between the algorithms. Results: Regarding both sensitivity and specificity, at the chosen threshold, AI 1 had the best compromise between sensitivity (74%) and specificity (79%). AI 2 had a statistically lower sensitivity (52%; p<0.05) with a higher specificity (98.4%) than the other AI algorithms. AI 3 had a nonsignificant sensitivity difference (69.9%) but a significantly lower specificity (45.3%; p<0.001) than the other two. The performances varied depending on the chosen threshold; when the AI 2 threshold was lowered, the sensitivity increased (69.9%), while a higher specificity (86.1%) was maintained. Conclusion: Two AI algorithms stood out in terms of performance when the threshold was optimized, resulting in an acceptable sensitivity and specificity.

The diagnosis of a chronic disease, such as multiple sclerosis, has both psychological and physical effects. Living with the disease and its uncertain consequences requires a great deal of psychological resilience in order to employ more comprehensive coping strategies in stressful situations. This study investigated the effect of a four-week online self-directed resilience training on the perception of psychological resilience among multiple sclerosis patients. A total of 64 MS patients were recruited for a randomized controlled trial. The experimental group underwent a 28-day online self-directed training program consisting of daily exercises aimed at strengthening a resilient mindset. Psychological resilience was measured through self-assessment immediately before, immediately after, and three months after the training. A repeated measures ANOVA revealed a statistically significant improvement in the perception of four factors related to stress: perceived worries, tension, joy and demands. Two resilience coping strategies were measured, of which one, a resilient orientation, improved significantly in the short and long term. The study suggests that online self-directed resilience training might provide an easily accessible, low-cost option for patients with MS to improve their psychological resilience. The transferability to other patient groups should be examined.

The removable partial denture, despite new technologies and new materials, continues to play a significant role in clinical dental practice. The purpose of the following study was to evaluate the design of new retention devices in Kennedy's second grade classrooms. For the study of "lamellar" retentive devices, 4 prosthetists were chosen and selected, according to inclusion and exclusion criteria, 16 patients, 8 women and 8 men, whose upper arch had to be rehabilitated with a removable partial prosthesis. The results showed that the parameters taken into consideration such as satisfaction, stability, aesthetics and retention had an average score higher than 3.30 (range 1-4), with an average standard deviation of 0.6225 in the 4 indicative parameters that the data they are relatively homogeneous and coherent. In conclusion we can state that the skeletonized prosthesis with lamellar retentions, designed in Kennedy's second grade classes, has shown good acceptance in selected patients

Actually, the study aimed to manage and to analyse the results of the laboratory methods, using liver samples, preparing and analizing in pathology service. This mentioned, are known as routinally practice for hepatitis C diagnosis, which conduct to hepatic cirrhosis. In this study direction, chronic liver diseases stimulate a degree of hepatocyte injury. So previously mentioned modifications, alters thet affect the liver architecture and finally ends in cirrhosis are well analyse on microscopic preparates. Folowing morphological steps, it is possible to analyse normal and alterate liver structure, on colored preparates.

Theoretical physics addresses the fundamental principles of nature and the mysteries of the universe. In the last century, the theory of relativity challenged people's understanding of time and space, while quantum mechanics revealed various forms of energy. However, the concept of gravity remains elusive. All matter in the universe is composed of energy that can be converted into other forms, yet it is always conserved. However, achieving a state of equilibrium, represented by the equal sign, can be challenging to achieve on both macro and quantum scales. A phenomenon that can transition from one state to infinity is called collision and is essential for understanding natural phenomena and physical processes throughout the universe. In the study of general relativity cannot be three-dimensional problems to gain mathematical inspiration, understand the application of new dimensions. Here, we elucidate the nature of gravity, which inspires the solution of the Riemann hypothesis. Our results show that the conduction mode of dimensional energy is defined by Euler's formula. And a special mode of collision is derived which translates into vibration.

Background: Glutathione and its related enzymes constitute one of the most important antioxidant defense mechanisms against oxidative stress and cancer formation in the body. Bladder cancer is the second most common urological malignancy after prostate cancer. Oxidative stress plays a significant role in the development and prognosis of bladder cancer. The aim of this study was to examine the effect of glutathione on the prognosis of non-muscle-invasive bladder cancer. Methods: The 98 patients with bladder tumors were those with T1G3 pathology who had undergone intravesical Bacillus Calmette-Guérin therapy, while the 30 controls were healthy individuals with no history of transitional cell carcinoma of the bladder. The 128 participants were divided into four groups: Group 1 comprised 41 patients who did not experience recurrence during follow-up, Group 2 included 28 patients who had recurrent tumors, Group 3 consisted of 29 patients who progressed to muscle-invasive stages, and Group 4 was composed of 30 healthy volunteers. Blood samples were collected from all participants. Glutathione levels were measured, and statistical analysis were performed. Results: There was a statistically significant difference in reduced glutathione levels among the groups (p < 0.001), attributed to Group 4 exhibiting higher reduced glutathione levels compared to Groups 1, 2, and 3 (p < 0.001). No significant differences were observed in reduced glutathione levels between Groups 1 and 2, Groups 1 and 3, or Groups 2 and 3 (p > 0.999). Total glutathione levels varied significantly among the groups (p < 0.001), with Group 4 having higher levels than Groups 1, 2, and 3 (p < 0.001). However, there were no significant differences between Groups 1 and 2, Groups 1 and 3, or Groups 2 and 3 in terms of total glutathione levels (p = 0.473, p = 0.747, and p > 0.999, respectively). Regarding oxidized glutathione levels, a significant difference was observed (p < 0.001), with Group 4 showing lower levels than the remaining three groups (p < 0.001). No significant differences were found between Groups 1 and 2, Groups 1 and 3, or Groups 2 and 3 in relation to oxidized glutathione levels (p > 0.999, p = 0.171, and p > 0.999, respectively). Conclusions: The current study revealed that glutathione is a factor influencing the development of new bladder cancer but did not affect its prognosis. Nevertheless, we recommend that future studies with larger bladder cancer patient cohorts should be conducted to comprehensively determine the effect of glutathione on the prognosis of bladder cancer.

Melanoma, one of the most aggressive forms of skin cancer, is also one of the most diagnosed cancer types. While surgical excision of the lesions is the primary treatment for melanoma, not all cases are candidates for surgical procedures. New treatments and complementary options are necessary, given the increasing diagnosis rate. In the present study, a norcantharidin-containing nanoemulsion was developed and evaluated in vivo using a syngeneic graft murine model. Our model contemplates an amputation surgery simulating the standard treatment and the role of the nanoemulsion as a potential adjuvant therapy. We observed a significant decrease in the growth rate of the melanoma lesion in the treated groups compared to the control group, both at the 20th and 30th days of treatment. Moreover, we evaluated the drug bioavailability in serum samples, and the results showed that norcantharidin was detectable in a range of 0.1 to 0.18 mg per mL in the treated groups. Furthermore, histopathological analysis was performed on the amputated tumors, where significant differences were found regarding size, mitosis rate, lymphocytic infiltration, and multispectral quantitative image analysis compared to the control group. The norcantharidin-containing nanoemulsion could be a potential alternative or adjuvant therapy if more clinical studies are conducted. Topical nanosystems can become or complement standard therapies, which is needed as melanoma affects not only in terms of mortality but also the patient's morbidity and life quality.

Glycerol conversion to valuable biomolecules has been a research avenue that has attracted a significant interest in recent years due to its increasing over production, with possibilities for chemical transformation for eco-friendly processes and distinct compounds with biological activities. Also, in the current climate change in which a major emphasis is being placed on the design of green processes, solvents are key factors from both an economic and environmental point of view. In this context, due to its abundance and low-price, glycerol represents an innovative solvent coming from biomass and produce in high amount. On the other hand, Epichlorydrin, Glycidol and Solketal have become useful intermediates in chemical transformations when using glycerol as a raw material. This review focuses on glycerol as a green solvent in the synthesis of complex molecules, Epichlorydrin, Glycidol, Solketal and Tosyl solketal as an efficient recycling process for glycerol, as well as building blocks in the synthesis of glycerol derivatives, which are undeniable new source of potentials drugs.

Background: Gender differences characterize the prevalence and attitudes toward weight management. Despite limited evidence suggesting greater weight loss in women with anti-obesity pharmacotherapy, gender-specific analysis remains underexplored. This retrospective study aimed to evaluate the gender-specific response to liraglutide 3.0 mg treatment in people with obesity without type 2 diabetes (T2D). Methods: Data were collected from 47 patients (31 women, 16 men), with age > 18 years, BMI ≥ 30 kg/m^2, absence of T2D, and with exclusion of prior anti-obesity treatment, comorbidities, or bariatric surgery. Only patients who maintained the liraglutide 3.0 mg dose for at least 6 months were included. Results: Both sexes showed significant reductions in weight and BMI at 3 and 6 months. Men achieved greater weight loss (WL), BMI reduction, % WL, WL >5% and >10% than women, and they also showed more significant improvements in metabolic parameters (total and LDL cholesterol, Fibrosis-4 Index FIB-4). No significant gender differences were observed in glucose metabolism or renal function. Conclusion: This study showed a greater therapeutic effect of liraglutide 3.0 mg in men. Given men's higher risk of cardiovascular disease (CVD), and underrepresentation in clinical weight loss programs, these findings may increase male engagement and improve their CVD risk.

Per- and polyfluoroalkyl substances (PFAS) are arguably the most common water contaminants in the world today. While several research experiments have been done to understand and remove PFAS from the environment, there is still a lot of unknown. Little has been known about the use of Machine learning (ML) to understand PFAS. This work hence reviews some leading ML approaches and applications in PFAS studies in the distribution, transport, removal, and occurrence predictions of PFAS. Several evaluation matrices were examined and used to perform this function. There are still a lot of areas whereby ML can be used to improve our PFAS knowledge base, some of these were briefly stated in this review.

Antiphospholipid antibody syndrome (APS) is an autoimmune disorder characterised by thrombosis and the presence of antiphospholipid antibodies (aPL): lupus anticoagulant and/or IgG/IgM anti-β2-glycoprotein I and anticardiolipin antibodies. APS carries significant morbidity for a relatively young patient population from recurrent thrombosis in any vascular bed (arterial, venous or microvascular), often despite current standard of care, which is anticoagulation with vitamin K antagonists (VKA). Platelets have established roles in thrombosis at any site, and platelet hyperreactivity is clearly demonstrated in the pathophysiology of APS. Together with excess thrombin generation, platelet activation and aggregation are the common end result of all the pathophysiological pathways leading to thrombosis in APS. However, antiplatelet therapies play little role in APS, reserved as a possible option of low dose aspirin in addition to VKA in arterial or refractory thrombosis. This review outlines the current evidence and mechanisms for excessive platelet activation in APS, how it plays a central role in APS-related thrombosis, what evidence for antiplatelets is available in clinical outcomes studies and potential future avenues to define how to target platelet hyperreactivity better with minimal impact on haemostasis.

Presenting a case report about a 14-year-old female patient presenting with a history of weakness in all four limbs since the age of 5. The patient has a history of difficulty in walking, wearing footwear, climbing stairs, and performing fine motor tasks. During the neurological examination showed mild spasticity, muscle weakness, areflexia, ill-sustained clonus, and sensory deficits. Radiological examination, including a contrast-enhanced MRI of the brain was done which showed findings that are consistent with Megalencephalic leukoencephalopathy with subcortical cysts, also known as Van der Knaap disease.

A high-resolution catalog for the 2014 Ms6.5 Ludian aftershocks was constructed based on the deep learning phase-picking model (CERP) and the seismic-phase association technology (PALM). A specific training strategy, which combines the advantages of the conventional short-long window average energy ratio algorithm (STA/LTA) and AI algorithm, is employed to retrain the CERP model. The P & S phases were accurately detected and picked on continuous seismic waveforms by the retained AI model. Hypoinverse and HypoDD were utilized for precise location of 3286 events. Compared to the previous results, our new catalog exhibits superior performances in terms of location accuracy and the number of aftershock events, thereby enabling a more de-tailed depiction of the deep-seated tectonic features. According to the distribution of aftershocks, it can be inferred that, (1) the seismogenic fault of Ludian earthquake is the NW-trending Baogunao-Xiaohe Fault. (2) the Ludian aftershocks interconnected the discontinuous NW-trending Baogunao-Xiaohe Fault, and intersected with the Zhaotong-Ludian Fault. (3) It suggests that the NE-trending Zhaotong-Ludian Fault may have been intersected by the NW-trending Baogunao -Xiaohe Fault, indicating that the Baogunao-Xiaohe Fault is likely a rela-tively young Neogene fault.

Excessive neutrophil influx and activation in lungs during infections, such as manifest during the ongoing SARS CoV-2 pandemic, have brought neutrophil extracellular traps (NETs) and the con-comitant release of granule contents that damage surrounding tissues into sharp focus. Neutro-phil proteases, which are known to participate in NET release, also enable the binding of the viral spike protein to cellular receptors and assist in the spread of infection. Blood and tissue fluids normally also contain liver-derived protease inhibitors that balance the activity of proteases. In-terestingly, neutrophils themselves also express the protease inhibitor alpha-1-antitrypsin (AAT), the product of the SERPINA-1 gene, and store it in neutrophil cytoplasmic granules. The absence of AAT or mutations in the SERPINA-1 gene promote lung remodeling and fibrosis in diseases such as chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS) and increase the risk of allergic responses. Recent observations point to the fact that re-duced activity of AAT presents a major susceptibility factor for severe COVID-19. Here, we focus attention on the mechanism of neutrophil elastase (NE) in NET release and its inhibition by AAT as an additional factor that may determine the severity of COVID-19

This study seeks to comprehend the complex and diverse dynamics of women's encounters with urban green areas in the specific setting of Jordan. The utilization of the focus group methodology facilitated the organization of unstructured talks involving a cohort of twenty-seven female participants, which yielded intricate and perceptive perspectives on their opinions. This study revealed a widespread pattern of stigmatization and unfavorable assessment of women who utilize public areas, which is strongly ingrained in cultural norms and gender expectations. Women were also concerned about the potential harm to their reputation and the censure of society, which ultimately deterred women from participating in public spheres. The research thus centers on the close proximity and insufficiency of urban green areas in Jordan, which is worsened by high urban density. Insufficient lighting and security measures are responsible for further limiting women's access to areas like these, which also raises concerns about safety. Recent evidence has revealed deficiencies in infrastructure designed to accommodate the needs of women, particularly in public restroom facilities. This study emphasizes the immediate necessity for a fundamental change in urban policy and planning, towards more inclusive approaches. Within this strategic framework for urban policy, there is a strong emphasis on incorporating aesthetics, comfort, and safety elements to enhance the whole urban experience for women. Consequently, addressing this issue necessitates using gender-responsive strategies in urban design and planning. This includes enhancing the quality, cleanliness, and privacy aspects of facilities to cater to the specific needs of women and improve their overall well-being. This study contends that any ongoing discussion on sustainable urban development in Jordan must take into account the interaction between urbanization, accessibility to public spaces, and the well-being of women. Therefore, it is necessary to implement a worldwide effort to advocate for urban policies that include both genders. This program aims to propose innovative approaches to governance, security measures, and municipal infrastructures that are sensitive to gender-related issues.

In this paper, aiming at the safety evaluation of ultimate bearing safety capacity of composite pile bridge foundation, the symmetrical reliability method with forward and inverse analysis con-sidering the randomness of parameters is proposed to evaluate the safety performance of com-posite pile foundation. The proposed method, considering the randomness of parameters, was used to calculate the safety factor of ultimate bearing capacity of composite pile foundation to meet the prescribed target reliability requirements. Through the example calculation of the safety coefficient of pile foundation, the results show that the statistical characteristics of random vari-ables that affect the safety coefficient of pile foundation have a significant impact. The degree of the safety coefficient depends on the probability distribution type and distribution parameters of the random parameters, among which the more important is the variation characteristics of the random variables. The stronger the parameter variability, the lower the safety level of the struc-ture. During design and evaluation, it is necessary to measure the safety reserve of pile founda-tions in accordance with engineering practice to ensure the safe construction and well operation of the pile.

This article presents a comprehensive overview of recent discoveries and advancements in the field of steroid chemistry, highlighting the isolation and characterization of various steroidal compounds from natural sources. The paper discusses a wide range of steroids, including pregnane steroids, steroidal alkaloids, ketosteroids, and novel triterpenoids, derived from marine organisms, fungi, and plants. Significant findings include the isolation of bioactive compounds such as the cytotoxic erectsterates from microorganisms, soft corals, the unusual tetracyclic steroid penicillitone from a fungal culture, and innovative steroidal derivatives with potential anti-inflammatory and anticancer activities. The synthesis of steroids from microorganisms as a tool for pharmaceutical development is also explored, showcasing the role of microbial biotransformation in generating steroidal drugs. Additionally, the paper emphasizes the ecological and medicinal relevance of these compounds, which are often used in traditional medicine and have potential therapeutic applications in treating diseases like cancer and microbial infections. This article serves as a vital resource for researchers interested in the chemical diversity of steroids and their applications in drug discovery and development.

Background: Infective endocarditis (IE) is the result of infections by gram-positive bacteria and, in this condition, the redox homeostasis is lost by overproduction of H2O2 resulting in overstimulation of the immune system and up- regulation of the production of proinflammatory cytokines. Objectives: The aim of this preliminary study of three cases with IE, was to evaluate the levels of oxidative biomarkers and of the enzymatic and non-enzymatic antioxidant system, in subjects with IE. This is a preliminary retrospective analytical study of cases that had undergone aortic valve replacement surgery complicated by IE. Methods: We determined malondialdehyde (MDA), total antioxidant capacity (TAC), carbonyl groups, glutathione (GSH), thiols and the nitrate/nitrite ratio (NO3−/NO2−) in homogenized tissue of cardiac valves. We also measured the activities of GST, GPx, GR and TrxR. The super oxide dismutase (SOD) isoforms and peroxidase activities were determined using native gels. Results: There were increases in the activities of antioxidant enzymes such as GST, SOD isoforms and peroxidases (p=0.01) and decreases in OS markers such as GSH, TAC, (p=0.01); however, MDA was increased (p=0.01). Conclusions: The results suggest that there is loss of the intricate redox homeostasis system in the patients with EI in the aortic valve may be favors the bacterial process and damages the patient probably leading to a fatal outcome.

The collection of forty-nine 8-hydroxyquinoline derivatives, substituted at C5, C6 or C7, was designed and studied by computational methods of modified POM analysis, using SwissADME, Osiris and Molinspiration tool. POM analysis (Petra/Osiris/Molinspiration) and its modified version using SwissADME instead of Petra software are indisputably tools of modern chemoinformatics, often published in the professional literature as well as in the field of research of new antibacterial active compounds, developed to replace existing antibiotics that fail due to increased resistance of bacteria. NitroxolineTM and the group of 8-hydroxyquinoline derivatives with their broad antibacterial effect and the possibility of extensive derivatization of the skeleton, represent a promising direction in the research of new antibacterial active substances. Twenty 8-hydroxyquinoline derivatives were also evaluated on their antibacterial activity against eight selected G+ and G- bacterial strains with a defined resistance mechanism. All structures were in accordance with Lipinski's criteria, twenty-one structures were interesting from the point of view of individual or average value of the bioactivity prediction score and fourteen structures showed one or more mechanisms of toxicity prediction. Furthermore, eleven structures showed a low rate of GI absorption or the inability to cross the BBB barrier, fourteen substances showed a BRENK or PAIN warning, eleven substances are an undesirable substrate of P-glycoprotein and all structures predicted the same level of bioavailability and a relatively low rate of metabolism in the liver. Five structures were selected by the intersection of the POM criteria. The virtual structures 17, 25, 35 and 43 can be favored for the continuity of next study. The resulting scores of bioactivity can indicate the potential of studied structures to be used for the design and development of new active antibacterial agents.

Recent advancements in mass spectrometry have significantly enhanced our understanding of complex lipid profiles, opening new avenues for oncological diagnostics. This review highlights the importance of lipidomics in the comprehension of certain metabolic pathways and its potential for the detection and characterization of various cancers, in particular melanoma. Through detailed case studies, we demonstrate how lipidomic analysis has led to significant breakthroughs in the identification and understanding of cancer types and its potential for detecting unique biomarkers that are instrumental in its diagnosis. Additionally, the review addresses the technical challenges and future perspectives of these methodologies, including their potential expansion and refinement for clinical applications. The discussion underscores the critical role of lipidomic profiling in advancing cancer diagnostics, proposing a new paradigm in how we approach this devastating disease, with particular emphasis on its application in comparative oncology.

Background: Angiogenesis is essential for various physiological and pathological processes, such as embryonic development and cancer cell proliferation, migration, and invasion. Long noncoding RNAs (lncRNAs) play pivotal roles in normal homeostasis and disease processes by regulating gene expression through various mechanisms, including as competing endogenous RNAs (ceRNAs) of target microRNAs (miRNAs). The lncRNA MYU is known to promote prostate cancer proliferation via the miR-184/c-Myc regulatory axis, and to be upregulated in vascular endothelial cells under hypoxic conditions, which often occurs in solid tumors. In the present study, we investigated whether MYU might affect cancer growth by regulating angiogenesis in vascular endothelial cells under hypoxia. Methods: The expression of MYU-regulated miR-23a-3p and interleukin-8 (IL-8) in HUVEC cell lines was examined using qRT-PCR. CCK-8 assay, EdU assay, Wound-healing assay and Tube-formation assay were used to assess the effect of MYU on cell proliferation, migration and tube formation of HUVEC cells in vitro. Dual-luciferase reporter assay was performed to examine the effect of miR-23a-3p on MYU and IL-8 expression. Results: We found that overexpression of MYU and knockdown of miR-23a-3p in human umbilical vein endothelial cells (HUVECs) under hypoxia promoted cell proliferation, migration, and tube formation. Mechanistically, MYU was shown to bind competitively to miR-23a-3p, thereby preventing miR-23a-3p binding to the 3′ untranslated region of IL-8 mRNA. In turn, increased production of pro-angiogenic IL-8 promoted HUVEC proliferation, migration, and tube formation under hypoxia. Conclusion: This study identified a new role for lncRNA MYU as a ceRNA for miR-23a-3p, and uncovered a novel MYU–miR-23a-3p–IL-8 regulatory axis for angiogenesis. MYU and/or miR-23a-3p may thus represent new targets for the treatment of hypoxia-related diseases by promoting angiogenesis.

The role of the microbiome in cancer and its crosstalk with the tumor microenvironment (TME) has been extensively studied and characterized. An emerging field in the cancer microbiome research is the concept of the intratumoral microbiome, which refers to the microbiome residing within the tumor. This microbiome primarily originates from the local microbiome of the tu-mor-bearing tissue or from translocating microbiome from distant sites, such as the gut. Despite the increasing number of studies on intratumoral microbiome, it remains unclear whether it is a driver or a bystander of oncogenesis and tumor progression. This review aims to elucidate the intricate role of the intratumoral microbiome in tumor development by exploring its effects on reshaping the multi-leveled ecosystem in which tumors thrive, the TME. To dissect the complexity and the multitude of layers within the TME, we distinguish six specialized tumor microenvironments, namely the immune, metabolic, hypoxic, acidic, mechanical and innervated microenvironments. Accordingly, we attempt to decipher the effects of the intratumoral microbiome on each specialized microenvironment and ultimately decode its tumor-promoting or tumor-suppressive impact. Additionally, we portray the intratumoral microbiome as an orchestrator in the tumor milieu, fine-tuning the responses in distinct, specialized microenvironments and remodeling the TME in a multi-leveled and multi-faceted manner.

This research explores the application of Support Vector Machine (SVM) and Digital Surface Models (DSM) derived from Unmanned Aerial Vehicle (UAV) data for a vertical-horizontal classification of mangrove ecosystems in Tongke-tongke and Samataring Village. The study focuses on integrating high-resolution DSM subtracted from Digital Terrain Models (DTM) to classify mangrove vegetation into sixteen distinct vertical-horizontal classes based on vegetation type and elevation. The analysis revealed that older mangroves, particularly those within the 25-35 meters elevation range, dominate the landscape, accounting for 43.40% of the total classified area. This dominance suggests a mature and ecologically stable mangrove ecosystem, which is crucial for biodiversity conservation and carbon storage. The study demonstrates the effectiveness of SVM and UAV technologies in providing detailed and accurate ecological assessments of mangrove forests. The classification results contribute valuable insights into the structural diversity and health of mangrove ecosystems, facilitating targeted conservation and management strategies. Additionally, the research highlights the utility of advanced remote sensing and machine learning techniques in enhancing the precision of environmental monitoring and the assessment of carbon sequestration capabilities within mangrove ecosystems. The findings underscore the potential of UAV-based remote sensing for ecological studies, offering a replicable method for similar assessments in other regions, thereby supporting global environmental management and climate action initiatives.

Clinical and laboratory diagnostics are particularly important in monitoring the internal homeostasis of the body in high-yielding animals, especially in dairy cows, whose metabolism is under constant pressure to obtain high parameters of milk production and reproduction. Knowledge of laboratory test results and relationships based on significant correlations between various milk and blood parameters may be very useful in veterinary diagnostics and helpful in cattle practice in order to protect animal health and the quality of milk production. The aim of the study was to analyze the correlation between selected hematological biomarkers such as white blood corpuscles (WBC), red blood corpuscles (RBC), hemoglobin concentration (HGB), hematocrit (HCT), platelets (PLT), erythrocyte mean corpuscular volume (MCV), mean corpuscular hemoglobin content (MHC), mean corpuscular hemoglobin concentration (MCHC) and selected quantitative-qualitative parameters of cow’s milk such as current milk production, somatic cells count (SCC), colony of bacteria forming units (CFU), milk fat (MF), milk protein (MP), milk lactose (ML), milk solids (S), solids non-fat in milk (SNF), daily milk production. Samples were collected three times at daily intervals from 11 clinically healthy late-lactation dairy cows obtaining 33 sets of test results. This repeated study of cows allowed for obtaining a homogeneous group in order to determine statistical correlations between selected blood and milk parameters. Many significant correlations were found between the examined parameters. In cows, significant positive correlations were recorded between milk production and HGB, HCT, MCV or MHC. Significant negative correlations were also found between SCC and HGB, SCC and HCT, SNF and MCV, SNF and MHC, and between MF and RBC.

Cardiopulmonary resuscitation (CPR) is a widely practiced lifesaving skill. Conventional CPR is based on manual chest compressions and delivering mouth-to-mouth breaths. There has been advancement in biomedical technology over the last few decades which has led to the introduction of new techniques and devices in CPR as well. In light of these advancements, we propose SMEAR (Standard, Mechanical, ECMO Assisted, Augmented virtual and Remote) classification system to provide structured overview from traditional to novel methods and devices. The standard or Manual CPR, widely practiced by the general public during out-of-hospital cardiac arrests, combines active chest compressions with or without mouth breathing. However, to enhance CPR’s efficacy, various mechanical devices have been developed, encompassing Active Chest Compression, Passive Decompression, and those integrated with Automated External Defibrillators. Feedback sensor-equipped devices, include the Metronome, Accelerometer, Barometer, and Triaxial Field Induction. Mechanical devices, classified by their compression mechanisms, can be isolated – like the Piston-driven, Load-distributing, and Active Compression-Decompression (ACD) – or combined, as in ACD-ITV (Impedance Threshold Device), ACD-IAC (Interposed Abdominal Compression), and ACD-ITV-EECP (Enhanced External Counter Pulsation). Beyond mechanics, Extracorporeal CPR offers veno-arterial Extracorporeal Membrane Oxygenation in refractory cardiac arrest and can improve outcomes. Augmented Virtual Reality usage in training and provision of CPR is at the early stages. It has the potential of expanded usage in training public to provide high-quality CPR. A provider can be remotely guided step by step via telephone or smartphone applications, ensuring continuous support until professional assistance arrives.

The prevalence of patients on buprenorphine therapy presenting for elective surgery has increased. Buprenorphine is a widely used medication for management of patients with chronic pain. It is also used for maintenance therapy for patients with a history of opioid use disorder (OUD). Due to lack of standardized protocol for managing patients on buprenorphine peri-operatively, we performed a retrospective analysis to compare pain score outcomes and post-operative opiate requirements between patients who continued versus discontinued buprenorphine. We identified 35 patients, 11 continued buprenorphine and 24 discontinued buprenorphine. The average Post-Anesthesia Care Unit (PACU) pain score was 7.54 for those who discontinued pre-operative buprenorphine and 5.59 for those who continued (P value 0.0339). The average post-operative Morphine Milligram Equivalent (MME) use was 86.13 for those who continued pre-operative buprenorphine and was 107.70 for those who discontinued buprenorphine (P value 0.6439). The results from our study correlate with several previous studies which showed lower PACU pain scores in patients who continued buprenorphine. There is a benefit of decreased pain post-operatively when pre-operative buprenorphine is continued and having a decrease in relapse in those with a history of OUD.

Nystagmus induced by applying an intense vibratory stimulus to the skull (SVIN) indicates vestibular functional asymmetry. In unilateral vestibular loss, a 100-Hz bone-conducted vibration given to either mastoid immediately causes a primarily horizontal nystagmus. Test is performed in darkness to avoid visual fixation (VF) but there is no data about how much VF affects the often-intense SVIN. The aim is to analyze the amount of reduction of SVIN when VF is allowed during testing. Thus, all patients seen in a tertiary hospital for vertigo or dizziness with positive SVIN were included. SVIN was recorded for 10 seconds for each condition: without VF (aSVINwo) and VF (aSVINw). We obtained an aSVINwo and aSVINw as average slow-phase velocities (SPV) without and with VF. VF index (FISVIN) was calculated as the ratio of SPV. Among the 124 patients included, spontaneous nystagmus (SN) was found in 25% and the mSPV (without VF) of SN was 2.62.4º/s. Mean FISVIN was 0.270.29. FISVIN was 0 in 42 patients and &gt;0 FISVIN &lt;1 in 82 (mean FISVIN 0.390.02). Fixation suppression was found in all patients with SVIN in cases of peripheral vestibulopathy. FISVIN clearly delineates two populations of patients: with or without complete visual reduction of nystagmus.

The Shimensi super-large tungsten polymetallic deposit is located in Late Jurassic- Early Cretaceous Porphyry-Skarn tungsten ore belt in the south Yangtze metallogenic belt. There are 3 types of mineralization: veinlet-disseminated type, thick quartze vein type and hydrothermal crypto-explosive breccia type. Based on geological studies, this paper presents new petrographic, microthermometric, laser Raman spectroscopic and hydrogen and oxygen isotope research of the fluid inclusions from the deposit. The results show that there are five different types of fluid inclusions: liquid-rich inclusions, vapor-rich inclusions, pure liquid inclusions, pure vapor inclusions, and fluid inclusions containing a solid crystal. The homogenization temperatures of the fluid inclusion range from 140℃-270℃, the salinities are 3%-5% NaCleq and the densities of ore-forming fluid range from 0.64 g/cm3 to 0.99 g/cm3. For the analyses of Laser Raman spectroscopic, the ore-forming fluids can be approximated by a Ca2+-Na+-SO42--Cl- fluid system with small amount of CO2, CH4 and N2. Otherwise, the datas of the pressure, pH and Eh show a fluid metallogenic environment of low pressure, weak acid and weak reduction. The values of the homogenization temperature in 3 types of orebodies suggest that the mineralization is characterized by the decrease of the temperature under the condition of the fluid immiscibility. The H-O isotope values are interpreted to indicate that the ore-forming fluids are mainly composed of magmatic water, and also the meteoric water was added with the process of the magma rising.

Measurement of Globe temperature is essential for investigating thermal comfort in street canyon. Globe thermometer is the most common instrument used to measure globe temperature (GT), however its application in scale models is still uncertain and not thoroughly investigated as of today. Therefore, this study is explicitly conducted to investigate globe thermometer measurements and proposed an improvised customization of the globe thermometer size to enhance reliability in scale models. The experiments were carried out outdoors using a typical street canyon model (scale 1:100) with East-West street orientation. The experiment presented a comparison between a low solar reflective street canyon (albedo of 0.4) and a high solar reflective canyon (albedo of 0.6) in terms of surface temperatures, heat flux and globe temperature. Furthermore, this study also investigated the influence of solar orientation on the globe temperature using both experimental using scale models and microclimatic modelling using ENVI-met. It is observed that although the surface temperatures are lower with high solar reflective canyon compared to that with low solar reflective canyon, GT is higher in high reflective canyon during daytime, which could be due to combined effect of direct radiation and shortwave reflection. However, for hours after the sun set, GT becomes lower (up to 1°C) in the case of high reflective canyon compared to low reflective canyon.

This study used Dutch potatoes at the end of dormancy as the material to explore the impact of menthol (0.2 and 0.5 g/kg based on potato mass) treatment on sprouting inhibition and potato quality. The findings revealed that a menthol concentration of 0.5 g/kg effectively inhibited potato tuber sprouting and significantly reduced glucoside alkaloids production. After a storage period of 15 days, the sprouting percentage and glucoside alkaloids content of potatoes treated with 0.5 g/kg menthol were observed to be significantly lower at 4.17% and 68.63 mg/kg, respectively, compared to the control group which exhibited values of 100% and 282.01 mg/kg, respectively (P < 0.05). Throughout the storage period, 0.5 g/kg of menthol promoted respiration, reduced malondialdehyde production in potatoes, inhibited polyphenol oxidase activity, and slowed down tissue browning. Additionally, it mitigated the decline in starch and soluble protein content, inhibiting the accumulation of reducing sugars.

Breast cancer brain metastasis (BCBM) is a challenging condition with limited treatment options and poor prognosis. Understanding the interactions between tumor cells and the blood-brain barrier (BBB) is critical for developing novel therapeutic strategies. One promising target is estrogen receptor β (ERβ), which promotes the expression of key tight junction proteins, sealing the BBB and reducing its permeability. In this study, we investigated the effects of 17β-estradiol (E2) and the selective ERβ agonist diarylpropionitrile (DPN) on endothelial and cancer cells. Western blot analysis revealed the expression patterns of ERs in these cell lines, and estrogen treatment upregulated claudin-5 expression in brain endothelial cells. Using in vitro models of the BBB, we found that DPN treatment significantly increased BBB tightness about suppressed BBB transmigration activity of representative HER2-positive (BT-474) and triple-negative (MDA-MB-231) breast cancer cell lines. However, the efficacy of DPN treatment decreased when cancer cells were pre-differentiated in the presence of E2. Our results support ERβ as a potential target for the prevention and treatment of BCBM and suggest that targeted vector-based approaches may be effective for future preventive and therapeutic implications.

This study focused on evaluating the potential of natural fermentation of pea flour (F) to improve the release of antioxidant compounds. Two fermentation conditions of F were performed: 1: 36.4% w/w, 24 h, 30°C (FF1); 2: 14.3% w/w, 24 h, 37°C (FF2); pH values decreased to 4.4-4.7, with a predominance of lactic acid bacteria. An increment of the proteolysis degree (TNBS method) (greater for FF2), polypeptides aggregation and decrease of solubility, increase of &lt; 2 kDa peptides, and increase in the ORAC potency of PBS-soluble fractions after fermentation was demonstrated. After simulated gastrointestinal digestion (SGID, COST-INFOGEST), FF1D and FF2D showed greater proteolysis degrees (63 and 53%) than F1D and F2D (45%), with differences in the molecular composition of the different digests. ORAC and HORAC potencies increased in all cases. FF2D presented the greater ORAC value, with higher activities for &gt; 4 kDa, some in the range 2 to 0.3 kDa. and &lt; 0.10 kDa fractions. Fermentation also increased the 60 % ethanol extracted phenolic compounds, mainly flavonoids, and the ORAC activity. After SGID, the flavan-3-ols disappeared but some phenolic acids increased respect to F. Fermentation in condition 2 was considered the most appropriate to obtain a functional antioxidant ingredient.

Patients with COVID-19 have coagulation and platelet disorders, with platelet’s alterations and thrombocytopenia representing negative prognostic parameters, being associated with severe forms of the disease, and increase lethality. Methods: Aim of this study was to study expression of platelet glycoprotein IIIa (CD61), playing a critical role in platelet aggregation, together with TRL-2 as a marker of innate immune activation Results: a total of 25 patients were investigated, with the majority (24/25, 96%) having co-morbidities and dying from a fatal form of SARS-CoV-2(+) infection (COVID-19 +), with 13 men and 12 females ranging in age from 45 to 80 years. When compared to a control group of SARS CoV-2 (-) negative lungs (COVID-19 -), TLR-2 expression was up-regulated in a subset of patients with deadly COVID-19 fatal lung illness. The proportion of Spike-1 (+) patients found by PCR and ISH correlates to the proportion of Spike-S1 positive cases as detected by digital pathology examination. Furthermore, CD61 expression was considerably higher in the lungs of dead patients. In conclusion, we demonstrate that innate immune prolonged hyperactivation is related to platelet/megakaryocytes over-expression in the lung. Conclusions: microthrombosis in deadly COVID-19+ lung disease is associated with an increase in the number of CD61+ platelets and megakaryocytes in the pulmonary interstitium as well as their functional activation; this phenomenon is associated with increased expression of innate immunity TLR2+ cells, which binds the SARS-CoV-2 E protein, and significantly with the persistence of the Spike-S1 viral sequence.

Air pollution has been a major environmental issue worldwide from the last few decades. It is a man-made issue that has a serious harmful impact on the environment and the health of humans. There are different sources of emission, but industrial processes and motor vehicles contribute to a chief part of air pollution. It has acute as well as chronic effects on the health of humans and affects different organs. It is thought the main environmental risk factor in the incidence and progression of several diseases such as lung cancer, asthma, Alzheimer's and Parkinson's diseases. Long-term exposure to air pollution has different toxicological impacts on humans such as respiratory and cardiovascular diseases, neuropsychiatric complications, eye irritation and skin diseases. As per the study by the World Health Organization (WHO), nitrogen oxides (NOx), carbon monoxide (CO), ozone (O₃), sulfur dioxide (SO₂), volatile organic compounds (VOCs) and heavy metals are the major air contaminants. These pollutants are different in their properties, composition and time of disintegration. The aim of this study is to review the different sources, types, impacts, challenges and mitigation of air pollution in detail.

Metabolic syndrome (MetS), first conceptualized in 1923, encompasses a cluster of metabolic abnormalities, including insulin resistance (IR), hyperglycemia, dyslipidemia, hypertension, and central obesity. This syndrome significantly increases the risk for cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Its global prevalence has surged, largely attributed to lifestyle factors such as poor diet and physical inactivity. Recent research highlights the crucial role of caveolae, small cellular structures, in the pathophysiology of MetS, particularly in insulin signaling, lipid metabolism, and vascular function. Managing MetS effectively requires a comprehensive strategy focused on lifestyle modifications and pharmacological treatments. Dietary approaches, environmental factors, regular physical activity and behavioral changes have demonstrated positive impacts on metabolic health. Despite current pharmacological options to individual conditions of MetS, emerging therapies targeting caveolae offer promising new avenues for treatment. While, microbiome modulation and certain natural agents may assist in managing the syndrome. Public health initiatives, including educational campaigns and stress reduction programs, are essential for the prevention and management of MetS. A multifaceted approach combining lifestyle changes, pharmacotherapy, and personalized interventions is vital for effective management. Future strategies may benefit from precision medicine and the integration of emerging biomarkers for targeted therapies.

We propose a universal approach for modeling complex integrated photonic resonators based on the scattering matrix method. By dividing devices into basic elements including directional couplers and connecting waveguides, our approach can be used to model integrated photonic resonators with both unidirectional and bidirectional light propagation, with the simulated spectral response showing good agreement with experimental results. A simplified form of our approach, which divides devices into several independent submodules such as microring resonators and Sagnac interferometers, is also introduced to streamline the calculation of spectral transfer functions. Finally, we discuss the deviations introduced by approximations in our modeling, along with strategies for improving modeling accuracy. Our approach is universal across different integrated platforms, providing a useful tool for designing and optimizing integrated photonic devices with complex configurations.

This study presents the Bayesian-Optimized Attentive Neural Network (BOANN), a novel approach enhancing image classification performance by integrating Bayesian optimization with channel and spatial attention mechanisms. Traditional image classification struggles with the extensive data in today's big data era. Bayesian optimization has been integrated into neural networks in recent years to enhance model generalization, while channel and spatial attention mechanisms improve feature extraction capabilities. This paper introduces a model combining Bayesian optimization with these attention mechanisms to boost image classification performance. Bayesian optimization optimizes hyperparameter selection, accelerating model convergence and accuracy; the attention mechanisms augment feature extraction. Compared to traditional deep learning models, our model utilizes attention mechanisms for initial feature extraction, followed by a Bayesian-optimized neural network. On the CIFAR-100 dataset, our model outperforms classical models in metrics such as accuracy, loss, precision, recall, and F1 score, achieving an accuracy of 77.6%. These technologies have potential for broader application in image classification and other computer vision domains.

Titanium alloys, notably Ti6Al4V, are frequently employed in biomedical applications due to their high mechanical strength and biocompatibility. But improving their surface qualities like biocompatibility and resistance to corrosion remains a crucial topic of study. This study investigates the effects of rhenium-carbon coatings deposited on Ti6Al4V substrates using magnetron sputtering technique with a molybdenum anchoring layer. Despite successful formation of rhenium carbides, elemental rhenium, and rhenium oxides confirmed by EDS and XRD analysis, the coatings exhibited poor adhesion, resulting in significant delamination as observed in SEM images. Corrosion resistance tests revealed that the coatings adversely affected the Ti6Al4V substrate, as indicated by increased corrosion current densities and more negative corrosion potentials in potentiodynamic polarization tests. Biocompatibility assessments using PK15 cells showed a notable reduction in cell viability and metabolic activity, particularly with coatings of higher surface roughness. These findings underscore the need for improved surface preparation and coating processes to enhance adhesion and biocompatibility of rhenium-carbon coatings on Ti6Al4V substrates. Future research should focus on optimizing coating adhesion, investigating cytotoxicity mechanisms related to surface roughness, and expanding biocompatibility evaluations to various cell types and biological environments.

Segregating one space from another is a rudimentary act of architecture and the basic principle of this act is creating differentiation between outside and inside. Thresholds, in their expanded or summed form, also produce spaces. They establish the staging for threshold areas in conjunction with space-defining elements. Threshold spaces are typically complicated spatial formations that serve as transition points. They pose a challenge to the interacting human senses in terms of perception. In this research threshold areas have been studied under a specific typology of architecture i.e the traditional housing in historic cities of India. The traditional dwelling settlements have evolved and grown over multiple layers of history, influenced by the culture, society, economy, climate and topography. The purpose of this research is to examine the characteristics of these transition spaces of the traditional dwelling units in relation to the symbolic reference and social meanings assigned to them that influence the architectural and urban spaces attached to them. It seeks to describe transition space in terms of its nature, character, morphology, and social significance. Transparency and material articulation, as well as hierarchy and enclosure, will be investigated. The importance and quality of the nature of "transition" will be examined from the inside to the outside. The research reveals that the space has great functional and socio-cultural importance. It allows multiple activities, provides protection from sun and rain, defines boundaries, connects people within the neighborhood, enhances security and gives an identity to the owner. The contributions made by this research have the potential to improve design considerations for transition areas between the dwelling units and the street.

In order to explore the effect of Wickerhamomyces on the production of flavor compounds in Xiaoqu Baijiu, this study examined the correlation between the fungal communities in Xiaoqu and ester compounds. It was hypothesized that Wickerhamomyces contributes to the aroma of Xiaoqu. Enhanced fermentation methods were used to validate the role of Wickerhamomyces in Xiaoqu Baijiu brewing. Compared to traditional Xiaoqu, enhanced fermentation significantly increased the acidity of fermented grains and starch utilization rate (P<0.05). The fungal communities in fermented grains were analyzed by high-throughput sequencing technology. The dominant fungi in both control and test groups were Saccharomyces, Cyberlindnera, Rhizopus, and Meyerozyma, with Wickerhamomyces replacing Saccharomymycopsis in the enhanced group. Flavor compounds in the fermentation experiments were analyzed, revealing that ethyl acetate content in Xiaoqu Baijiu increased by 949.94 mg/L in the test group, while isoamyl alcohol decreased by 23.62 mg/L and isobutanol decreased by 34.81 mg/L. Functional prediction analysis using PICRUSt2 confirmed a higher relative abundance of enzymes involved in ethyl acetate metabolism and a lower relative abundance of enzymes involved in higher alcohol metabolism in the test group. These findings demonstrate that Wickerhamomyces enhances ethyl acetate production and reduces higher alcohols during Xiaoqu Baijiu brewing, offering a theoretical foundation for enhancing the quality of Xiaoqu Baijiu.

Background: Symmetry is a special kind of balance. This study aims to systematically explore and apply the role of balanced composition in aesthetic judgments by focusing on balanced composition features and employing research methods from computational aesthetics and Neuroaesthetics. Methods: First, experimental materials were classified by quantifying balanced composition using several indices, including symmetry, center of gravity, and negative space. An EEG experiment was conducted with 18 participants, who were asked to respond dichotomously to the same stimuli under different judgment tasks (balance and aesthetics), with both behavioral and EEG data being recorded and analyzed. Subsequently, participants' data were combined with balanced composition indices to construct and analyze various SVM classification models. Results: Participants largely used balanced composition as a criterion for aesthetic evaluation. ERP data indicated that from 300-500ms post-stimulus, brain activation was more significant in the aesthetic task, with unbeautiful and imbalanced stimuli eliciting larger frontal negative waves and occipital positive waves. From 600-1000ms, beautiful stimuli caused smaller negative waves in the PZ channel. The results of the SVM models indicated that the model incorporating aesthetic subject data (ACC=0.9989) outperforms the model using only balanced composition parameters of the aesthetic object (ACC=0.7074). Conclusions: Balanced composition is a crucial indicator in aesthetics, with similar early processing stages in both balance and aesthetic judgments. Multimodal data models validated the advantage of including human factors in aesthetic evaluation systems. This interdisciplinary approach not only enhances our understanding of the cognitive and emotional processes involved in aesthetic judgments but also enables the construction of more reasonable machine learning models to simulate and predict human aesthetic preferences.

Introduction: Known for its persistent blood-feeding behavior from dawn to dusk, Aedes albopictus is recognized as one of the most dangerous mosquito species due to its role as a vector for diseases such as dengue. Studies have demonstrated that Aedes albopictus thrives in micro-breeding sites predominantly located on private properties, including abandoned containers and manholes used for rainwater and irrigation. This study investigates an innovative methodology, the TombiniNet, to mitigate the proliferation of Aedes albopictus by engaging citizens in the active management of micro-breeding sites on their properties. Materials and Methods: The study was conducted in Alessandria, a city with approximately 100,000 inhabitants, focusing on a sample of 200 houses and a population of about 5,000 people. Researchers conducted a comprehensive survey and analysis of micro-breeding sites for Aedes albopictus on both private and communal properties. The larval control measures were conducted from April to October, aligning with the peak mosquito breeding season. The study's sample included 51% of houses that allowed researchers access, and within these, 81% had Aedes albopictus larvae, often found in diverse water Containers holes of which basically manholes on villa garden floors. For monitoring the adult populations were used ovitraps that were not placed in private homes but in public areas to monitor and control the mosquito population. Results: The study identified that up to 70% of micro-breeding sites for Aedes albopictus in northern Alessandria were located on private properties. Citizen participation was critical to the success of the intervention, with a marked decrease in the number of adult tiger mosquitoes observed in areas where residents actively managed breeding sites using the TombiniNet. The TombiniNet was particularly effective in private areas, as it could be regularly maintained by residents, preventing debris accumulation that could hinder drainage. Discussion: The findings highlight the importance of engaging citizens in mosquito control programs to effectively manage Aedes albopictus populations in urban areas. The TombiniNet intervention demonstrated that a simple, cost-effective solution could significantly reduce mosquito breeding sites on private properties. By addressing both communal and private breeding sites, a comprehensive and sustainable approach to mosquito management can be achieved, thereby reducing the risk of disease transmission. Future studies should focus on long-term monitoring and the development of additional innovative solutions to enhance citizen participation and control measures. The study's success also pointed out the limitations of applying such interventions in public areas where debris could impede the net's effectiveness.

Pesticides are chemical compounds or mixtures of hazardous substances that are used by humans to increase and protect crops from pests and control disease-carrying insects. Because of its wide use, it may be poisonous to helpful and non-targeting plants and animals. Spraying or spreading pesticides over whole fields of crops can cause runoff to transfer the chemicals into aquatic ecosystems, and wind can carry the chemicals to nearby grazing regions, farms, and populated areas, where they can endanger other animals. This review summarises recent studies on pesticide combination toxicity to aquatic biota and approaches used to anticipate toxic effects. When toxicants harm economically significant organisms that humans consume, the negative effects become more severe and can cause stress conditions, vital organ damage, biochemical damage, or even the death of living things in both terrestrial and aquatic environments. Pesticides are highly toxic to aquatic organisms such as snails, fish, etc. Neurological dysfunction in freshwater organisms is also caused by pesticides. By producing excessive ROS, pesticides can cause severe biochemical and histological changes in freshwater organisms. So, it is therefore easy to understand the attention of the public on these substances. Because aquatic organisms play a major part in the food chain. However, through the biomagnification process, the quantity of pesticides increases in the higher organisms through the food chain. Which results play a terrific role in the higher organism’s body. So, It's essential to comprehend the way that insecticides work on aquatic organisms. In this review article, we are focusing on the way that pesticides work, which will help in the system of biomonitoring.