UEDVT still remains an underdiagnosed entity due to a significant percentage of patients who remain asymptomatic. The etiology of UEDVT is overwhelmingly attributed to secondary causes including but not limited to central venous access devices and malignancy. Treatment modalities include anticoagulation, catheter directed thrombolysis, percutaneous mechanical thrombectomy or a multimodality approach along with the management of underlying etiology. We describe a case of a female with breast cancer, who came with left UEDVT and CVC malfunction and was successfully treated using the ClotTriever system to maintain continuous intravenous access.

The purpose of this study was to quantify characteristics of bimanual movement intensity during 30-hour Hand Arm Bimanual Intensive Therapy (HABIT) and bimanual performance (activities and participation) in real-world using accelerometers in children with unilateral cerebral palsy (UCP). Twenty-five children with UCP participated in a 30-hour HABIT program. Data was collected from bilateral wrist-worn accelerometers during 30-hours HABIT to quantify the movement intensity, and three days pre- and post-HABIT to assess real-world performance gains. Movement intensity and performance gains were measured using six standard accelerometer-derived variables. Bimanual capacity (body function and activities) was assessed using standardized hand function tests. We found that accelerometer variables increased significantly during HABIT, indicating increased bimanual symmetry and intensity. Post-HABIT, children demonstrated significant improvements in all accelerometer metrics, reflecting real-world performance gains. Children also achieved significant and clinically relevant changes in the hand capacity following HABIT. Therefore, our findings suggest that accelerometers can objectively quantify bimanual movement intensity during HABIT. Moreover, HABIT enhances hand function as well as activities and participation in real-world situation in children with UCP.

This randomized controlled prospective trial evaluated the impact of neuro‐athletic training (NAT) on flexibility, serve speed, and upper extremity performance in elite volleyball players. Thirty professional players aged 18‐35 were initially recruited and randomly assigned to either the NAT intervention or control group. However, the study was completed with a final sample of 26 participants. Performance assessments, including the Sit and Reach Test, Pocket Radar Ball Coach for serve speed, and Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), were conducted pre‐ and post‐intervention. The NAT group showed significant improvements in flexibility (p=0.005, d=2.32), serve speed (p<0.001, d=2.54), and upper limb performance (p<0.001, d=2.61), while the control group displayed no significant changes. These findings highlight NATʹs effectiveness in enhancing neuromuscular function and coordination, emphasizing its potential as a training approach in competitive volleyball.This randomized controlled prospective trial evaluated the impact of neuro‐athletic training (NAT) on flexibility, serve speed, and upper extremity performance in elite volleyball players. Thirty professional players aged 18‐35 were initially recruited and randomly assigned to either the NAT intervention or control group. However, the study was completed with a final sample of 26 participants. Performance assessments, including the Sit and Reach Test, Pocket Radar Ball Coach for serve speed, and Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), were conducted pre‐ and post‐intervention. The NAT group showed significant improvements in flexibility (p=0.005, d=2.32), serve speed (p<0.001, d=2.54), and upper limb performance (p<0.001, d=2.61), while the control group displayed no significant changes. These findings highlight NATʹs effectiveness in enhancing neuromuscular function and coordination, emphasizing its potential as a training approach in competitive volleyball.

The present study aims to evaluate the capability of the TRMM-3B42-(V7) precipitation product to estimate appropriate precipitation rates in the Upper Indus basin (UIB) and the analysis of the dependency of the estimates’ accuracies on the time scale. To that avail statistical analyses and comparison of the TMPA- products with gauge measurements in the UIB are carried out. The dependency of the TMPA estimates’ quality on the time scale is analysed by comparisons of daily, monthly, seasonal and annual sums for the UIB. The results show considerable biases in the TMPA- (TRMM) precipitation estimates for the UIB, as well as high false alarms and miss ratios. The correlation of the TMPA- estimates with ground-based gauge data increases considerably and almost in a linear fashion with increasing temporal aggregation, i.e. time scale. The BIAS is mostly positive for the summer season, while for the winter season it is predominantly negative, thereby showing a slight over-estimation of the precipitation in summer and under-estimation in winter. The results of the study suggest that, in spite of these discrepancies between TMPA- estimates and gauge data, the use of the former in hydrological watershed modelling, endeavoured presently by the authors, may be a valuable alternative in data- scarce regions, like the UIB, but still must be taken with a grain of salt.

In this paper, a seamless connection between sensor technology and machine learning (ML) has been presented which has wide applicability in rehabilitation and physical medicine. The intent is to identify an ML algorithm which has a better performance, easy to deploy, and has less training time and consumes less computational resources. In short, we propose an algorithm which maximizes the synergy between a sensor and ML by maximizing classification performance and easy to do implementation, which is robust in computational power and lower in resource consumption. The premise of the work is to show the important considerations for evaluating ML algorithms for Upper-limb activity recognition for Physical medicine and rehabilitation field.

A large proportion of chronic stroke survivors still struggle with upper limb (UL) problems in daily activities. We investigated clinical outcomes and assessed the quality of movement before and after a 5-hour error-enhancement training. The pilot study had a pre-post intervention design, recruiting 22 patients in the chronic phase post-stroke with UL motor impairments. Patients received 1-hour robot treatment for five days. Patients were assessed at baseline and after training, collecting (1) clinical (UL Fugl-Meyer assessment (FMA-UE)), action research arm test (ARAT), motor assessment scale UL and tone), (2) patient-reported (hand subscale of the stroke impact scale, motor activity log (MAL), visual analogue scale of pain and tone) and (3) kinematic (KINARM, BKIN Technologies Ltd., Canada) outcome measures. Our analysis revealed significant improvements (median im-provement (Q1-Q3); p<0.05) in (1) FMA-UE (1.0 (0.8–3.0), p<0.001) and ARAT (2 (0.8–2.0), p<0.001); (2) MAL amount of use (0.1 (0.0–0.3), p<0.001) and MAL quality of use (0.1 (0.1–0.5), p<0.001); (3) KINARM-evaluated position sense ((-0.45 (-0.81–0.09), p=0.030) after training. These findings provide insight into kinematic, clinical, and self-reported improvements in UL functioning after five hours of error-enhancement UL training.

The purpose of this scoping review was to comprehensively clarify the methodology of Mental practice (MP) to date by systematically mapping studies that have performed MP on post-stroke paralytic upper extremity function. Specifically, (1) When is the most common timing of MP in-tervention after stroke onset? (2) What is the MP load (intervention time, number of interven-tion days, and intervention period)? (3) What are the most common methods of Motor Imagery (MI) recall and MI tasks during MP? (4) Is MP often used in conjunction with individual rehabili-tative therapies? (5) What is the paralyzed side's upper limb and cognitive function level at the start of MP intervention? Our scoping review was performed ac-cording to PRISMA-ScR to iden-tify research questions. Then, the PubMed, Scopus, Medline, and Cochrane Library databases were used to screen articles published by July 19, 2022. Eligible articles were selected all study designs were included, including studies involving the use of MP for post-stroke paralytic upper extremity function. Selection of eligible papers was done by two or more independent persons. Data were extracted from the eligible papers for items necessary to identify the research ques-tions. English-language articles identified for this study were 694, of which 62 were accepted. The most common intervention time was 30 minutes or less and the duration of the intervention was 5 times a week in MP. The most common method of recalling MI during MP was using an audio guide. In the future, it will be important to conduct accumulation of research to unify the varied widely MP methodologies identified in this study.

This paper proposes an upper bound for mine productivity and also a simple truck dispatch rule that demonstrates how tight the upper bound can be using simulation. It also proposes a greedy search to approximate the productivity upper bound, which is faster and often exact. Uncertainty is added to the simulation in order to verify how the productivity responds to it. Typically, the productivity upper bound is less tight close to its saturation point as a function of the number of trucks, where adding more trucks only increases queues. Furthermore, more uncertainty in the model typically leads to a less tight upper bound. The results are conducted using real data from an open pit mine in Brazil.

Quantum coherence is an important physical resource in quantum information science, and also as one of the most fundamental and striking features in quantum physics. In this paper, we obtain a symmetry-like relation of relative entropy measure $C_r(\rho)$ of coherence for $n$-partite quantum states $\rho$, which gives lower and upper bounds for $C_r(\rho)$. Meanwhile, we discuss the conjecture about the validity of the inequality $C_r(\rho)\leq C_{\ell_1}(\rho)$ for any state $\rho$. We observe that every mixture $\eta$ of a state $\rho$ satisfying $C_r(\rho)\leq C_{\ell_1}(\rho)$ and any incoherent state $\sigma$ also satisfies the conjecture. We also note that if the von Neumann entropy is defined by the natural logarithm $\ln$ instead of $\log_2$, then the reduced relative entropy measure of coherence $\bar{C}_r(\rho)=-\rho_{\rm{diag}}\ln \rho_{\rm{diag}}+\rho\ln \rho$ satisfies the inequality ${\bar{C}}_r(\rho)\leq C_{\ell_1}(\rho)$ for any mixed state $\rho$.

Background. Upper respiratory infections (URIs) remains as significant cause of morbidity in children. Evidence on efficacy of probiotics to prevent URIs in children is increasing. This systematic review was assembled to analyze evidence about the efficacy of probiotics to reduce duration of upper respiratory infections in ambulatory children. Methods. Randomized controlled trials (RCTs) comparing probiotics vs. placebo to prevent URIs, published between 2001 and 2016 were considered. Quality evaluation was evaluated using CONSORT. Standard mean difference (SMD) or risk ratio (RR) was calculated. Network Meta-Analysis (NMA), using a random effect model was assembled. Results. 31 RCTs were evaluated and 20 studies were included with 3,635 children randomized to probiotics and 3,433 to placebo. Lactobacillus reuteri [SMD -0.56 CI95% (-0.72 to -0.41), p 0.0001] and Lactobacillus acidophillus [SMD -0.33 CI95% (-0.60 to -0.06), p 0.01] were superior to placebo to reduce duration of URIs. L. rhamnosus GG showed tendency [SMD -0.14 CI95% (-0.28 to 0.0), p 0.048]. On the network forest plot L. reuteri showed preventive equivalence when was compared to L. rhamnosus GG, L. casei and BB12. Conclusions. Lactobacillus reuteri, Lactobacillus rhamnosus GG and Bifidobacterium BB12 are evidence-based alternatives to be considered to prevent URIs in children.

Background: Patients undergoing dual antiplatelet therapy (DAPT) may experience recurrent gastrointestinal bleeding (GIB). We investigated the clinical characteristics and risk factors for recurrent non-variceal upper gastrointestinal bleeding (NVUGIB) in patients who had experienced NVUGIB during receiving DAPT. Methods: We enrolled patients diagnosed with NVUGIB during receiving DAPT between 2006 and 2020. Definite bleeding was confirmed by esophagogastroduodenoscopy in all NVUGIB patients. Results: A total of 124 patients were diagnosed with NVUGIB during receiving DAPT. Male was predominant (n = 103, 83.1%), bleeding mostly from the stomach (n = 94, 75.8%) and peptic ulcers (n = 72, 58.1%). After successful hemostasis of NVUGIB, 36 patients (29.0%) experienced at least one episode of recurrent upper GIB, 19 patients (15.3%) died, and 7 (5.6%) patients had a bleeding-related death. Multivariate analysis showed that age was a significant factor for re-bleeding (odds ratio [OR],1.050; 95% confidence interval [CI]:1.001-1.102, P-value:0.047), all-cause mortality (OR,1.096; 95% CI:1.020-1.178, P=0.013), and re-bleeding related mortality (OR,1.187; 95% CI:1.032-1.364, P-value:0.016). In Kaplan-Meier analysis, the cumulative probabilities of re-bleeding, death, and bleeding-related death were significantly higher in patients aged 70 and older (P=0.008, &lt;0.001, and 0.009, respectively). Conclusion: Clinicians should be cautious about re-bleeding and mortality when elderly patients who experienced NVUGIB during receiving DAPT.Keywords: dual antiplatelet therapy; upper gastrointestinal tract; bleeding; mortality

MAD is the gold standard therapy for mild/moderate OSA and is a second-choice treatment in patients with severe OSA not responding to CPAP. The aim of this study was to analyze the upper airway characteristics of OSA patients and the morphological changes in the upper airway, inducted by four different types of mandibular advancement devices, using CBCT 3D imaging. Twenty-two patients were recruited after OSA diagnosis with polysomnography. Four different customized and titratable MAD were used and an initial CBCT scan was obtained for each patient. After 6 months to the end of the MAD titration phase, all the subjects showed an AHI of &lt; 5 or a decrease of 50% in AHI with MAD when compared with initial AHI and a second CBCT scan with MAD in situ was performed. An important improvement of the airway was observed (+33.76%) and a significant difference in the enlargement ratio between the posterior soft palate (+32.41%) and the posterior tongue (+36.96%) region was also found. The greatest increase in airway volume was achieved in patients treated with the MAD Forward and TAP (respectively +42.77% and + 41.63%). MAD therapy is effective to treat mild/severe OSA with increased upper airway volume. The design of the MAD can influence the effectiveness of the treatment.

The practice of physical activity is an effective non-pharmacological strategy for preventing and treating chronic diseases. A large body of evidence has contributed to establishing a positive correlation between a physically active lifestyle and health benefits, including enhanced vaccination responses, lower numbers of senescent T-cells, increased T-cell proliferative capacity, lower levels of inflammatory cytokines, and improved neutrophil and macrophage function. While females are generally thought to exert more robust immune responses than males in response to a variety of challenges, and both male and female sex hormones have been suggested as mediators of immune function, research on this topic has not always been designed with a sex-specific lens. The goal of this review is to summarize the available experimental and clinical evidence linking exercise and immune function in male and female subjects, with an emphasis on sex differences and sex-specific mechanisms. Overall, the available evidence indicates that moderate exercise and physical activity improves immune function in both sexes, whereas prolonged and high-intensity exercise temporarily impairs immune responses at a higher degree in females. A role of male and female sex hormones in these sex-specific effects is also discussed.

This article presents a methodology for the design of rehabilitation devices that considers factors involved in a clinical environment. This methodology integrates different disciplines that work together. The methodology is composed by 3 phases and 13 stages with specific tasks, the first phase includes the clinical context considering the requirements of the patient and therapist during the rehabilitation, the second phase is focused in engineering based on the philosophy of digital twin, and in the third phase is evaluated the device. This article explains the characteristics of the methodology and how it was applied in the design of an exoskeleton for passive rehabilitation of the upper limb.

Upper confidence bound multi-armed bandit algorithms (UCB) typically rely on concentration in- equalities (such as Hoeffding’s inequality) for the creation of the upper confidence bound. Intu- itively, the tighter the bound is, the more likely the respective arm is or isn’t judged appropriately for selection. Hence we derive and utilise an optimal inequality. Usually the sample mean (and sometimes the sample variance) of previous rewards are the information which are used in the bounds which drive the algorithm, but intuitively the more infor- mation that taken from the previous rewards, the tighter the bound could be. Hence our inequality explicitly considers the values of each and every past reward into the upper bound expression which drives the method. We show how this UCB method fits into the broader scope of other information theoretic UCB algorithms, but unlike them is free from assumptions about the distribution of the data, We conclude by reporting some already established regret information, and give some numerical simulations to demonstrate the method’s effectiveness.

Background: Studies on infectious endocarditis (IE) are mostly limited to institutions, which highlights the need for more comprehensive epidemiological studies. Objective: To verify the profile of deaths due IE and the relationship with deaths from other causes and conditions in Brazil and regions. Method: Study in database from the Brazilian Mortality Information System, from 2000 to 2019. Mentions of deaths due to IE, other causes and conditions were identified according to ICD-10. Cluster analysis was performed to verify the relationship between variables. Results: 52,055 deaths from IE were found, with a predominance of males, aged 60 to 79 years, in the Southeast, with deaths from the circulatory system most frequent. Three profiles were identified: 1 - age equal to or greater than 80 years, women, deaths due endocrine, circulatory and metabolic diseases, in the South and Southeast; 2 - also in the South and Southeast, age between 30 and 79 years, men, deaths due infectious and genitourinary diseases; 3 - 0 to 29 years, no genders differences, deaths due diseases of the respiratory system, in the North, Northeast and Central-West. Conclusion: Cluster analysis showed diversity in the profiles of deaths due IE, indicating heterogeneity in regions of the country.

This paper provides the straight proof for the Riemann Hypothesis.The proof has been formulated with the modified version of Riemann Xi function ξ(s) , that shows the relationship with upper incomplete gamma function.

We compare the well known Rayleigh-Ritz variational method (RRVM) with a recently proposed approach based on supersymmetric quantum mechanics and the Gram-Schmidt orthogonalization method (SSQMGS). We apply both procedures to a particular class of double-well harmonic oscillators that had been conveniently chosen for the application of the latter approach. The RRVM eigenvalues converge smoothly from above providing much more accurate results with less computational effort. Present results show that the unproved SSQMGS upper bounds do not hold.

El Olivo Cave (Pruvia de Arriba, Llanera, Asturias, Spain) is a small karst cave located in the Aboño River basin and formed in the Cretaceous limestone of the Mesozoic cover of the Cantabrian Mountains (north of the Iberian Peninsula). It contains an important upper Pleistocene sedimen-tary, archaeological and paleontological record, with abundant technological evidence and faunal remains. The archaeological record shows a first occupation that could correspond to the Middle Paleolithic and a second occupation in the Middle Magdalenian. The stratigraphic sequence inside and outside the cave was studied with geoarchaeological methodology. In this paper, the lithostratigraphic sequence is analyzed and the data from the granulometric, mineralogical, edaphological and radiometric analyses are presented. The results of these analyses enable an accurate interpretation of both the lithostratigraphy of the deposit as well as the processes re-sponsible for its formation and subsequent evolution. The available numerical dates allow us to locate the first sedimentation episode in the cave in OIS 7a, in the Middle Pleistocene, the base of the outer fluvial sedimentation in the cold OIS 3a stage of the Upper Pleistocene and the Magdalenian occupation in the Last Glacial Maximum (OIS 2) at the end of the Late Pleistocene.

Background: The incidence of intravesical recurrence (IVR) following radical nephroureterectomy (RNU) is reported in up to 50% of patients with upper tract urothelial carcinoma (UTUC). It was suggested that preoperative diagnostic ureteroscopy (URS) could increase the IVR rate after RNU, however, the available data are often conflicting. Thus, in this systematic review and meta-analysis we sought to synthesize that available data for the impact of pre-RNU URS for UTUC on IVR and other oncological outcomes; Materials and methods: A systematic literature search of the PubMed, Embase and Cochrane Library databases was performed in June 2020. Cumulative analyses of hazard ratios (HRs) and their corresponding 95% confidence intervals (CI) were conducted. The primary endpoint was intravesical recurrence-free survival (IVRFS), with the secondary endpoints being cancer-specific survival (CSS), overall survival (OS), and metastasis-free survival (MFS); Results: Among a total of 5489 patients included in the sixteen selected papers, 2387 (43.4%) underwent diagnostic URS before RNU and 3102 (56.6%) did not. Pre-RNU diagnostic URS was significantly associated with worse IVRFS after RNU (HR=1.44, 95% CI: 1.29-1.61, p&lt;0.001) than RNU alone. However, subgroup analysis including patients without biopsy during URS revealed no significant impact of diagnostic URS on IVRFS (HR=1.28, 95% CI: 0.90-1.80, p=0.16). The results of other analyses showed no significant differences in CSS (HR=0.94, p=0.63), OS (HR: 0.94, p=0.56), and MFS (HR: 0.91, p=0.37) between patients who underwent URS before RNU and those who did not. Conclusions: The results of this meta-analysis confirm that diagnostic URS prior to RNU is significantly associated with worse IVRFS, albeit with no concurrent impact on the other long-term survival outcomes. Our results indicate that URS has a negative impact on IVRFS only when combined with endoscopic biopsy. Future studies are warranted to assess the role of immediate postoperative intravesical chemotherapy in patients undergoing biopsy during URS for suspected UTUC.

Optimal upper extremity motor control and range of motion are necessary to achieve even the basic Activities of Daily Living (ADL) function. Stroke, with resulting hemiparesis, can significantly and negatively impact an individual’s ADL function. Functional Independence Measure (FIM) self-care score can provide assessment of what aspects and to what degree ADL functions are impaired. FIM self-care assessment can also track changes in ADL function during stroke recovery and rehabilitation. Recently, sensor-acquired 3D motion analysis of stroke patients’ upper extremity has shown promise as a potential alternative to assess ADL function. This observational study evaluates whether the sensor-acquired upper extremity reachable workspace (RWS) measure correlates with clinician-evaluated FIM self-care score in stroke patients. Seventeen patients with stroke were enrolled in the study. FIM self-care, NeuroQoL upper extremity, and reachable workspace outcome measures (relative surface area, RSA) were collected upon rehabilitation hospital admission, at discharge, and at 3-month visit. Pearson and Spearman’s rank correlation coefficients as well as multiple linear regression analyses were used to determine the relationships between FIM self-care, NeuroQoL, and reachable workspace RSAs. Moderately strong correlation between total reachable workspace RSA and total FIM self-care score at discharge and at 3-month were noted (r=0.619, r=0.661, p&lt;0.05), and similarly strong correlation was also noted with the upper extremity NeuroQoL total score (r=0.690, r=0.815, p&lt;0.05). Multiple linear regression analyses revealed a change in bilateral total RSA of 0.1 unit from admission to 3-month follow up correlated with respective change in FIM self-care score of 2.011 points (95%CI: 0.663-3.360). Longitudinal improvement in ADL function during stroke rehabilitation and recovery process is correlated with improvement in reachable workspace.

This study evaluates the R3THA™ technology-supported assessment protocol for home-based rehabilitation in children with cerebral palsy (CP). It focuses on the reliability and validity of R3THA™ in assessing hand and arm function, comparing kinematic assessments with standard clinical assessments. Conducted during a 4-week summer camp, the study involved children with CP aged 3-18, assessing their functional and impairment levels. The findings suggest that R3THA™ is more reliable for children aged 8 and older, indicating that age significantly influences the protocol's effectiveness. Results also showed that R3THA-AP's kinematic measurements of hand and wrist movements were positively correlated with the Box and Blocks Test Index (BBTI), reflecting hand function and dexterity. Additionally, R3THA-AP's accuracy metrics for hand and wrist activities aligned with the Melbourne Assessment 2's Range of Motion (MA2-ROM) scores, suggesting a meaningful relationship between R3THA-AP data and clinical assessments of motor skills. However, no significant correlations were observed between R3THA-AP and MA2's accuracy and dexterity measures, indicating areas for further research. These findings validate R3THA-AP's utility in assessing motor abilities in CP, supporting its integration into clinical practice.

This study aims to assess trends and significant changes in precipitation and river flow in the Senegal River basin and its upper basin over the period 1982-2021. Eight hydroclimate indicators, namely maximum river discharge (QMAX), standardized flow index, mean daily rainfall intensity index (SDII), maximum 5-day consecutive precipitation (RX5DAY), annual precipitation exceeding the 95th percentile (R95p), annual precipitation exceeding the 99th percentile (R99P), annual flows exceeding the 95th percentile (Q95p), and annual flows exceeding the 99th percentile (Q95p) were considered.. The modified Mann-Kendall test (MMK) was used to analyze trends in extremes while standard normal homogeneity and Pettit’s tests were employed to detect potential breakpoints in these trends. The results indicated an irregular precipitation pattern, with high values of extreme precipitation indices (R95p, R99p, SDII, and RX5DAY) in the southern part, while the northern part exhibits lower values. Inter-annual analysis revealed a significant increase in extreme precipitation events between 1982 and 2021, with a notable breakpoint around the years 2006 and 2007. This breakpoint marks a transition to a much wetter period starting from 2008. Regarding extreme flows, a significant increase was observed between 1982 and 2021. This study provides insights into past hydrological extremes in the study area and can serve as a basis for future research in this field.

The importance of performance excellence and operator’s safety is fundamental not only when operators perform repetitive and controlled industrial tasks, but also in case of abrupt gestures due to inattention and unexpected circumstances. Since optical systems work at too low frequencies and they are not able to detect gestures as early as possible, combining the use of wearable magneto-inertial measurement units (MIMUs) with the adoption of deep learning techniques can be useful to instruct the machine about human motion. To improve the initial training phase of neural networks for high classification performance, gestures repeatability over time has to be verified. Since test-retest approach has been poorly applied based on MIMUs signals in a context of human-machine interaction, the aim of this work was to evaluate the repeatability of pick-and-place gestures composed of both normal and abrupt movements. Overall, results demonstrated an excellent test-retest repeatability for normal movements and a fair-to-good test-retest repeatability for abrupt movements. Moreover whereas the reduction of time between test and retest sessions increased repeatability indices.. In detail, results of the test suggested how to improve the reinforcement learning for the identification of gestures onset, whereas results of the retest gave important information about the time necessary to retrain the network.

This paper describes the design and development of an active device that was applied to shoulder rotation rehabilitation. It implements a force control in a similar way to the haptic devices that reflect a force on the user’s hand according to the rehabilitation parameters. This device was tested with patients, combining clinician manipulation and programmed exercises. The results were excellent, given that the range of movement of the shoulder increased in most of the pa-tients. The results of the Usability Scale questionnaire were also promising.

The fluid flow field at the upper airways is highly complex due to the complex structure of the airway. The inhaled particle flow, the air streamline and the interaction of the continuum and discrete phase could significantly affect the transport behaviour of the inhaled particles. A range of analytical, mathematical and computational fluid dynamics (CFD) models analyzed the airflow and particle transport in different idealized and asymmetric airway models. A precise understanding of the continuum and discrete phase interaction in realistic human airways is missing, and this study aims to develop a CFD-DEM model for particle transport in realistic airways. This study uses the CFD model for the continuum phase and the discrete element method (DEM) for the discrete phase. A soft sphere approach is used for the interaction of the discrete phase. Proper validation is performed for particle transport efficiency. The CFD-DEM model analyzed the particle transport in an idealized and realistic airway model, and different methods are used to analyze the transport behaviour. During the particle-particle interaction, a stagnation point and a high-pressure zone are observed at the airway model's carinal angle. The numerical results report higher deposition efficiency (DE) for particle-particle interaction than without interaction. The flow field becomes highly complex with the spring constant values, and higher DE is found for high spring constant values. The spring dashpot friction-dshf method shows higher deposition at the upper part of the airways than other interaction methods. The findings of this study and more case-specific analysis would improve the knowledge of aerosol transport in airways and the health risk assessment of the patient.

In this work we introduce a novel approach to generate lower and upper L2 estimates for solution derivatives of arbitrary order to a general class of dissipative systems in the case that such estimates are available for the solutions themselves. Our method also works in reverse order: from the L2 estimates of solution derivatives of some (arbitrary) order we can derive lower and upper L2 estimates for the solutions and then to their derivatives of any order. This procedure is based on very simple monotonicity properties combined with standard energy estimates in physical space, following previous ideas of Kreiss, Hagstrom, Lorenz and Zingano. For simplicity, it is applied here in the context of algebraic rates, but the method can be used in other contexts as well (exponential, logarithm, and so forth).

The aim of this study was to evaluate the Hapo ms, a passive upper limbs exoskeleton developed to assist workers for tasks with arms in front of the body. Twelve participants had to perform a static task, a manual handling task and a load carrying task two times: with and without the exoskeleton. In all cases subjective (perceived effort in arm and back areas, comfort) and objective (muscular activity, postural balance) criteria were evaluated. Results have shown a decrease in anterior deltoid (-12 to -18% depending of the task) and in biceps brachii (-19% to -33% depending of the task) muscular activity. No significant difference was pointed out in back muscle and postural balance was not significantly perturbed due to the wear of the exoskeleton. Finally, perceived effort reduction was observed during the three tasks (except in back area for task 1). To conclude, the Hapo ms seems well adapted to assist upper arms during tasks with arms in front of the body.

Background: Probiotics can provide health benefits to an individual by regulation of the immune system. Many clinical trials have found that probiotics can prevent upper respiratory tracts infections. Aim: To perform a systematic review and meta-analysis of available trials to investigate the effectiveness of probiotics in the prevention of upper respiratory tract infections in individuals of all ages. Conclusion: Probiotics were found to be better in reducing the number of participants who experienced acute URTI, the average duration per episode of acute URTI, use of antibiotics in URTI related cases and absence due to URTI. Side effects were found to be minor, making probiotics a good candidate for clinical use. This shows that probiotics are effective in preventing acute URTIs. However, due to limited studies and small sample size, the results are subjected to bias and should be interpreted with care.

Presented is semivariogram and the Ordinary Kriging analyses of porosity data from the Sava Depression (Northern Croatia), as part of the Croatian part of the Pannonian Basin System. Data are taken from hydrocarbon reservoirs of the Lower Pontian (Upper Miocene) age, which belongs to the Kloštar-Ivanić Formation. Original datasets had been jack-knifed with purpose to “artificially” increased data and calculate the more reliable semivariograms. The results showed that such improvements can assist in the interpolation of more reliable maps. The both sets, made by original and jack-knifed data, need to be compared using geological recognition of non-allowed shapes (“bull-eyes”, “butterfly effects”) as well as cross-validation results. That comparison made possible to select the most appropriate porosity interpolation.

In this paper, an upper bound of the longitudinal elastic modulus of unidirectional fibrous composites is proposed according to strength of materials approach, on the premise that the fiber is much stiffer than the matrix. In the mathematical derivations, the concept of boundary interphase between fiber and matrix was also taken into account and the main objective of this work is the attainment of an upper bound for the interphase stiffness with respect to fiber concentration by volume. The novel element here is that the authors have not taken into consideration any specific variation law to approximate the interphase modulus. The theoretical results arising from the proposed formula were compared with those obtained from some reliable theoretical models as well as with experimental data found in the literature, and a satisfactory agreement was observed.

This paper introduces a novel method for accurately calculating the upper biomass of single trees using Light Detection And Ranging (LiDAR) point cloud data. The proposed algorithm involves classifying the tree point cloud into two distinct ones: the trunk point cloud and the crown point cloud. Each part is then processed using specific techniques to create a 3D model and determine its volume. The trunk point cloud is segmented based on individual stems, with each stem further divided into slices that are modeled as cylinders. On the other hand, the crown point cloud is analyzed by calculating its footprint and gravity center. The footprint is further divided into angular sectors, with each being used to create a rotating surface around the vertical line passing through the gravity center. All models are represented in a matrix format, simplifying the process of minimizing and calculating the tree’s upper biomass, consisting of crown biomass and trunk biomass. To validate the proposed approach, both terrestrial and airborne datasets are utilized. A comparison with existing algorithms in the literature confirms the effectiveness of the new method. The study shows that the proposed algorithm achieves an average fit between 0.01 m and 0.49 m for individual trees.

Climate and land use changes are major factors affecting runoff in regional basins. Understanding variation by considering interactions among hydrological components is an important process for water resource management. This study aimed to assess the variation of future runoff in the Upper Chi Basin, Northeastern Thailand. QSWAT hydrological model was integrated to 3 CMIP6 GCMs including ACCESS-CM2, MIROC6, and MPI-ESM1-2-LR under SSP245 and SSP585 scenarios during 2023 – 2100. Land Change Modeler (LCM) was also used for future land use simulation. The results revealed that future average of long-term precipitation and temperature tended to increase while forest land tended to decrease and be replaced by sugarcane plantations. The accuracy assessment of baseline year runoff calculation by QSWAT during 1997 – 2022 showed acceptable result as can be seen from R2, NSE, RSR, and PBIAS indices. This result could lead to temporal and spatial simulation of future runoff. Likewise, runoff of 2 SSPs scenarios tended to increase consecutively, especially in SSP585 scenario. In addition, in case of long-term spatial changes in the subbasins scale, over 90% of the area, from upstream to outlet point, tended to get higher due to 2 major factors including future increased precipitation and changes in cultivation, which would be influential to groundwater and interflow components respectively. Methodology and result of this study can be useful to stakeholders in understanding changes in hydrological system so that they can apply it to develop a strategy for water resource management and handling factors affecting different dimensions properly and sustainably.

The history of saline nasal irrigation (SNI) is indeed a long one, beginning from the ancient Ayurvedic practices and starting to gain a foothold in the west at the beginning of 20th century. Today, there is a growing number of papers covering effects of SNI from in vitro studies to randomized clinical trials and literature overviews. Based on the recommendations of most of the European and American professional associations, seawater, alone or in combination with other preparations, has its place in treatment of numerous conditions of the upper respiratory tract (URT), primarily in chronic (rhino)sinusitis, allergic rhinitis, acute URT infections and postoperative recovery. Additionally, taking into account its multiple mechanisms of action and mounting evidence from recent studies, locally applied seawater preparations may have an important role in prevention of viral and bacterial infections of the URT. Therefore, in this review we discuss results published in the past years focused on the seawater preparations and their use in clinical and everyday conditions, since such products are superior to saline, have an excellent safety profile and are recommended by most professional associations in the field of otorhinolaryngology.

Background and Objectives: Renal cell carcinomas and upper tract urothelial carcinomas are types of malignancies that originate in the kidneys. Each of these examples shows an increasing trend in the frequency and the mortality rate. This study aims to comprehensively define carcinomas by analysing clinical, paraclinical, and histological aspects to predict aggressiveness and mortality. Materials and Methods: We conducted a retrospective investigation on a group of patients suspected with kidney cancers. Results: We identified 188 cases. We observed a higher mortality rate and older age in individuals with urothelial carcinomas. Anemia, acute kidney injury, hematuria and perineural invasion were the main risk factors that predicted their mortality. Tumour size in renal cell carcinomas correlates with the presence of necrosis and sarcomatoid areas. Factors that indicate a higher rate of death are older age, exceeding of the renal capsule, the lesion that includes the entire kidney, lymphovascular invasion, acute kidney injury, and anemia. Conclusions: Even if they originate at the renal level, and the clinical-paraclinical picture is similar, the histopathological characteristics make the difference. In addition, to these are added the previously mentioned common parameters that can represent important prognostic factors. In conclusion, the characteristics commonly identified in one type of cancer may act as risk factors for the other tumor. The detected data include threshold values and risk factors, making a significant contribution to the existing literature.

In the last decade, robotic-mediated rehabilitation has emerged as a potential solution to improve repetitive task training. Each device in this field has a unique development history shaped by engineers’ expertise in specific programming languages or platforms. In this work we adopt an approach that tries to abstract from the final implementation with the aim to make control logic more shareable and understandable. The authors will present the outcomes of the application of a Rapid Control Prototyping strategy to an upper-limb robotic exoskeleton. A model-based design approach implemented on a real-time target machine is presented. This modern design approach was explored with several control strategies and was used to test the exoskeleton’s performances. The proposed method highlights how it is possible to develop the entire control architecture in a single programming environment.

Background and Objectives: Intramedullary spinal cord tumors (IMSCT) are rare entities. Especially, a location in the upper cervical spine as a highly eloquent region carries the risk of postoperative neurological deficits, such as tetraparesis or respiratory dysfunction. Evidence for respiratory dysfunction is scarce. The aim of this study was to describe the early and late postoperative clinical course of this highly eloquent tumours. Patients and Methods: This is a single-centre retrospective cohort study. We included 35 patients with IMSCT at levels of craniocervical junction to C4 who underwent surgical treatment between January 2008 and December 2022. The authors analysed the patients' preoperative status, tumour- and surgery-specific characteristics, and follow-up functional status. Results: The study cohort included 22 patients with grade II ependymoma (62.9%), 2 low-grade astrocytomas (5.7%), 2 glioblastomas (5.7%), 6 hemangioblastomas (17.1%), 2 metastases (5.7%), and 1 patient with partially intramedullary schwannoma (2.9%). Gross total resection was achieved in 76% of patients. Early dorsal column related symptoms and motor deterioration occurred in 64% and 44% of patients, respectively. At a follow-up of 3.27 ± 3.83 years, 43% and 33% of patients preserved postoperative sensory and motor deterioration, respectively. The median McCormick Scale grade was 2 in the preoperative and late postoperative periods, respectively (p=0.0897, α=0.05). Only two out of 35 patients (5.7%) developed new intermittent respiratory dysfunction, of whom two were transient. There were no surgery-related deaths. Conclusions: The surgery of IMSCT of the upper cervical spine could be performed without major procedure-related risk. Roughly a half of the patients develop new neurological deficit in the immediate postoperative period. However, most of the patients still maintain functional independence. The rate of respiratory insufficiency is low and is strongly influenced by the rapid neurological deterioration in high-grade tumours.

Pore fluid pressure is very important to the generation, migration and accumulation of petroleum. The previous studies indicate that the Chezhen sag region is typically characterized by pore fluid overpressure (the difference between pore fluid pressure and hydrostatic pressure). To date, the formation mechanism of pore overpressure and the accumulation regularity of “upper source-lower reservoir” type in this region remains unknown. In order to investigate these problems, a 2-D finite element model is established with regards to the fluid-solid coupling in Chegu 25 block of Chezhen depression, fully considering the existing seismic, logging data and regional tectonic stress environment. Meanwhile, we calculate the abnormal overpressure generated at the source rock during hydrocarbon generation and the process of hydrocarbon migration and accumulation along the faults, analyzing the dynamic conditions of hydrocarbon downward accumulation. The results show that overpressure can accelerate migration of hydrocarbon and improve the efficiency of hydrocarbon accumulation. However, when the overpressure is too large, tensile fractures and shear fractures may occur, resulting in hydrocarbon dissipation, and changing the results of oil and gas accumulation. The overpressure at the source rock is mainly caused by hydrocarbon generation, while the overpressure at the reservoir is primarily created by unbalanced compaction. As the dominant channel of hydrocarbon migration, overpressure will change the direction and path of hydrocarbon migration in the fault. Therefore, the “upper source-lower reservoir” hydrocarbon accumulation model is strongly explained by the high permeability of faults and the presence overpressure. In summary, the simulated overpressure results are in good agreement with the mud weight equivalent overpressure and the drill stem tests (DSTs).

Background: Arm elevation plays an important role in simple and complex daily tasks. Muscles that stabilize the shoulder girdle also function as respiratory accessory muscles. Dual demand on these muscles, particularly in patients with chronic respiratory conditions, leads to dyspnea and fatigue of the upper limb, making simple daily activities difficult. Various tests, including Grocery Shelving Task (GST), are designed to assess functional performance during upper limb activities. The aim of the study is to derive reference values for GST among the population of the United Arab Emirates Methods: This cross-sectional study was conducted with 220 healthy individuals of both genders between the ages of 20 and 69. Duration required to complete GST was recorded. The correlation between duration and age, height, body mass and body mass index (BMI) were also assessed. Results: Reference values for duration (in seconds) in females for age groups 20-29, 30-39, 40-49, 50-59 and 60-69 are 43.5±5.5, 43.1±8.08, 48.1±6.7, 44.9±7.1, 46.7±6.5 respectively. Values for males of age groups 20-29, 30-39, 40-49, 50-59 and 60-69 are 45.7±6.7, 44.8±8.9, 42.5±10.01, 53.4±4.2, and 53.9±5.4 respectively. Conclusion: Reference values for GST duration were obtained. Weak correlations were found between duration and age, height, body mass, BMI of the participants.

Diversified techniques have been applied in many research papers for the optimization of rehabilitation robotic movements in order to maintain smoothness and accuracy. Smooth and precise control is needed necessarily for upper limb rehabilitation robotic applications having five degree of freedom. The preferred parameters which are used for the controlling were validated by mathematical model and these tuning parameters were optimized. Designing optimization algorithms to control complex physical robots has been a challenging task. In this study, a number of optimization techniques will be analyzed to determine the optimal parameters of a PID controller with a dynamic model of the upper limb rehabilitation system. For determining optimal control parameters for PID, there exists a number of tuning methods such as Zeigler Nichols and fuzzy logic which are classical methods. Swarm intelligence-based optimization algorithms are inspired by the behaviors of living things in nature. Several researchers have reported the optimal design of PID controller parameters using optimization techniques. The proposed control technique has been implemented on a 5-DOF RAX hardware and before any clinical trials, six healthy subjects went for trials under strict protocol. It has been discovered that the proposed control technique rejects the external unwanted disturbances as well as keeps the system stable under extreme perturbed and harsh conditions. In this research paper mathematical models have been validated to determine the PID parameters for the optimization. The comparative study is carried out with four different cost functions since a well-designed objective function leads to better performance of the system and indicates control design expectations. These objective functions are an integral squared error (ISE) and integral absolute error (IAE). In this research work, the effects of different cost functions on optimization techniques for controller parameters were analyzed. The performance of the controller with different cost functions has examined for robustness analysis. The cost function of particle swarm optimization, Firefly, Ant Bee Colony and Ant Colony optimization were developed for the better optimization results.

Multisource meteorological re-analyses are the most reliable forcing data for driving hydrological models to simulate streamflow. We aimed to assess the different hydrological responses through hydrological modeling in the upper Lancang-Mekong River Basin (LMRB) using the two gridded meteorological datasets, climate forecast system reanalysis (CFSR) and the China Meteorological Assimilation Driving Datasets for the SWAT model (CMADS). We selected the Pearson’s correlation coefficient (R), percent bias (PBIAS), and root mean square error (RMSE) indices to compare the six meteorological variables of the two datasets. The spatial distributions of the statistical indicators in the CFSR and CMADS, namely, the R, PBIAS, and RMSE values, were different. Furthermore, the soil and water assessment tool plus (SWAT+) model was used to do hydrological modeling based on CFSR and CMADS meteorological re-analyses in the upper LMRB. Different meteorological datasets resulted in significant differences of hydrological responses, which reflected by different sensitive parameters and their optimal value. These different calibrated optimal values of sensitive parameters further lead to the different simulated water balance components between CFSR- and CMADS-based SWAT+ model. These findings can help in a better understanding of the strengths and weaknesses of different meteorological re-analysis datasets and the roles on the hydrological modeling.

The purpose of the study was to find the source of complaints and to diagnose dynamic upper respiratory tract problems, which were derived from the horse owners, trainers, and jockeys, and to evaluate the overground endoscopic examination efficiency to determine the subclinical upper respiratory tract (URT) abnormalities, which were unable to diagnose with resting endoscopy. In the study, overground endoscopy has been used which nowadays there is a more useful and safe technique of performing endoscopy during ridden exercise in the natural field to diagnose dynamic upper respiratory tract (URT) abnormalities in comparison with the more traditional method of resting endoscopy. This study focused on 25 racehorses (Thoroughbred, n:22 and Arabian n: 3), which were admitted to Racehorse Hospital with complaints of fade abruptly and/or abnormal respiratory noise during the last meters of the race. All horses were examined for the complaints to be associated with systemic disorders and/or lameness, the racehorses with lameness and/or systemic disorders findings were excluded. Resting (post-exercise) and overground endoscopy by using Dr. Fritz® ETL-Equine Overground Endoscopy was performed on a polytrack racecourse in all racehorses. Observed abnormalities were recorded as simple and complex cases and the results of resting and dynamic examination were compared. It was concluded the overground endoscopic examination has a useful diagnostic value in determining the cause of abnormal respiratory noise and/or fade abruptly.

This study uses Landsat 8 and Digital Elevation Models (DEM) to show the dominant orientations of digital lineaments and morphotectonic features between measured trends and the tectonic evolution of the Upper Guajira, Colombia, in the northernmost region of the South American plate. Data from Landsat-8 and hillshaded images of three Digital Elevation Model (DEM) images with different resolutions (SRTM: 90m, ASTER-GDEM: 30m and Alos-Palsar: 12.5m), were used for the extraction and mapping of morpholineaments, drainage network and morphological features. Lineaments were analyzed by means of north azimuth frequency, length, density distributions, lithological distributions and geochronological periods. Tectonic control was supported by using the digitized geological map created by the Colombian Geological Service (SGC). Lineaments and faults were analyzed through the interpretation of a Riedel shear model as a result of the transtensional/transpressional tectonic arrangement of the Caribbean and South American plates. The directional trends of lineaments and faults indicate two dominant directions: NE-SW and E-W. The azimuth distribution analysis of measured structures and drainage channels show similar trends, except for some differences in the predominant directions of some drainage channels. The similarity in the orientation of lineaments, faults and drainage system highlights the degree of control exerted by underlying structures on the surface geomorphological features. Drainage channel classification illustrates the morphological and neo-tectonic complexity of the region. The extracted lineaments were divided into five geochronological groups based on the main ages of host rock formations according to the Colombian Geological Service (SGC) geological map. From the Cretaceous onward, the lineament azimuth frequency rotates from a NE-SW trend to a prominent E-W direction, which resembles the translation that Caribbean plate has been undergoing since the Cretaceous. Our results confirm that Remote Sensing techniques are reliable and useful to study the morphotectonic of an area and can be applied to zones of difficult access.

This study focusses on identifying a set of representative future climate projections for the Upper Indus Basin (UIB). Although a large number of GCM’s predictor sets are nowadays available in the CMIP5 archive, the issue of their reliability for specific regions must still be confronted. This situation makes it imperative to sort out the most appropriate, single or small-ensemble set of GCMs for the assessment of climate change impacts in a region. Here a set of different approaches is adopted and applied for a step-wise shortlist and selection of appropriate climate models for the UIB under two RCPs: RCP 4.5 and RCP 8.5, based on, a) range of projected mean changes, b) range of projected extreme changes, and c) skill in reproducing the past climate. Furthermore, because of higher uncertainties in climate projection for high mountainous regions like the UIB, a wider range of future GCM climate projections is considered by using all possible future extreme scenarios (wet-warm, wet-cold, dry-warm, dry-cold). Based on this two-fold procedure, a limited number of climate models is pre-selected, out of which the final selection is done by assigning ranks to the weighted score for each of the mentioned selection criteria. The dynamically downscaled climate projections from the Coordinated Regional Downscaling Experiment (CORDEX) available for the top-ranked GCMs are further statistically downscaled (bias-corrected) over the UIB. The downscaled projections up to year 2100 indicate temperature increases ranging between 2.3 °C and 9.0 °C and precipitation changes that range, from a slight annual increase of 2.2% under the drier scenarios, to as high as 15.9% for the wet scenarios. Moreover, for all scenarios, the future precipitation will be more extreme, as the probability of wet days will decrease, while, at the same time, the precipitation intensities will increase. The spatial distribution of the downscaled predictors across the UIB also shows similar patterns for all scenarios, with a distinct precipitation decrease over the south-eastern parts of the basin, but an increase in the northeastern parts. These two features are particularly intense for the “Dry-Warm” and the “Median” scenarios over the late 21st century.

As the most active plateau on the Earth, the Qinghai-Tibet Plateau has a complex crust-mantle structure. Knowledge of the distribution of such a structure provides information for understanding the underlying geodynamic processes. We obtains a three-dimensional density model of crustal and upper mantle beneath Qinghai-Tibet plateau and its surrounding areas from the residual geoid anomalies using the Earth Gravitational Model (EGM) 2008. We estimate a refined density model by iterations, using an initial density contrast model. We confirm that the EGM2008 mission products can be used to constrain the crust-mantle density structures. Our major findings are: (1). At 300-400 km depth, high-D anomalies terminate around Jinsha River Suture (JRS) in the central TP, suggesting that the Indian plate has been reached over the Bangong Nujiang Suture (BNS) and almost reach to the JRS. (2). On the eastern TP, low-D anomalies at the depth of 0-300 km together with high-D anomalies at 400-670 km further verified the current eastward subduction of Indian plate. The ongoing subduction provides forces to the occurrences of frequent earthquakes and volcano. (3). At 600 km depth, low-D anomalies inside the TP illustrate the existence of hot weak material beneath there, contributing to the external material inward-thrusting.

Recently, the integration of neural networks into robotic exoskeletons for physical rehabilitation has become popular due to their ability to interpret complex physiological signals. Surface electromyography (sEMG), electromyography (EMG), electroencephalography (EEG), and other physiological signals enable communication between the human body and robotic systems. Utilizing physiological signals for communicating with robots plays a crucial role in robot assisted neurorehabilitation. This systematic review synthesizes 44 peer-reviewed studies, exploring how neural networks can improve exoskeleton robot assisted rehabilitation for individuals with impaired upper limbs. By categorizing the studies based on robot assisted joints, sensor systems, and control methodologies, we offer a comprehensive overview of neural network applications in this field. Our findings demonstrate that neural networks, such as Convolutional Neural Networks (CNN), Long Short-Term Memory (LSTM), and Radial Basis Function Neural Networks (RBFNN), and other forms of neural network significantly contribute to patient specific rehabilitation by enabling adaptive learning and personalized therapy. CNNs improve motion intention estimation and control accuracy, while LSTM networks capture temporal muscle activity patterns for real-time rehabilitation. RBFNNs improve human-robot interaction by adapting to individual movement patterns, leading to more personalized and efficient therapy. This review highlights the potential of neural networks to revolutionize upper limb rehabilitation, improving motor recovery and patient outcomes in both clinical and home-based settings. It also recommends the future direction to customize existing neural networks for robot assisted rehabilitation applications.

Background: Upper respiratory tract infections (URTIs) are a major public health concern due to their high incidence and potential for complications. Pharmacists often serve as the first point of contact for patients with URTIs. This study aims to develop and evaluate the RESP-8 tool to assist pharmacists in determining the need for medical evaluation. Methods: This prospective interventional cohort study was conducted over six months (October 2023 to March 2024) in community pharmacies. Participants included adults aged 18 years and older presenting with URTI symptoms. Pharmacists used the RESP-8 tool, which comprises eight criteria to assess the need for medical referral. Data on medical history, symptom duration, and progression were recorded. The primary outcome was the feasibility of implementing the RESP-8 tool. Secondary outcomes included the accuracy of the tool, the percentage of patients recommended for medical evaluation, and compliance with these recommendations. Results: A total of 64 participants were included, with an average age of 55.7 years. Pharmacists recommended medical evaluation for 75% (48/64) of patients using the RESP-8 tool. Among these, 70.83% (34/48) complied with the recommendation. The tool demonstrated high accuracy in identifying patients needing further medical evaluation, with only two noted errors. All compliant patients received appropriate treatment without complications. The tool was easy to implement, taking less than 5 minutes per patient. Discussion: The RESP-8 tool effectively guided pharmacists in recommending medical evaluations for URTI patients. The high compliance rate indicates patient trust in pharmacists' guidance. While the study's small sample size limits generalizability, the results are promising. Future studies with larger populations are necessary to validate these findings and further refine the tool. Conclusion: The RESP-8 tool shows potential in enhancing pharmacists' ability to make informed decisions about medical referrals for URTIs, ultimately improving patient outcomes and optimizing healthcare resource management.

In order to deal with imprecision, ambiguity, and uncertainty in data analysis, Pawlak introduced rough set theory in 1982. This paper aims to expand the scope of basic set theory developed by presenting the notions of δP-upper and δP-lower approximations, that are based on the notion of δP-open sets, we additionally examine a few of their fundamental characteristics.

In volleyball, the jump serve is a fundamental and crucial skill that is one of the most commonly used serving techniques. This study aimed to examine the kinematic differences between straight line (SL) and diagonal line (DL) in volleyball jump serves by focusing on torso and attack arm joint motions. Three-dimensional coordinate data were captured using a motion capture system (200 Hz) in 14 right-handed male professional volleyball players who performed SL and DL jump serves. This result suggests that the pelvis and torso backward rotation angles during the arm-clocking phase were smaller when performing DL serves. During ball contact, the servers exhibited greater forward rotation angles of the pelvis and torso to control the upper body facing the diagonal direction of the target zone. In addition, lowering the forward tilt angle of the trunk helped the servers maintain body balance in the air and increased their wrist flexion angle, preventing the ball from flying out of bounds when performing DL. These findings highlight the importance of controlling pelvic and torso rotations in the transverse plane when adjusting for different serving lines. These insights can guide volleyball athletes and coaches in refining their serving techniques.

The aim of this study was to examine the relationship of the distance between the apex tip of the upper central tooth (U1A) and the anterior nasal spine (ANS) and the nasal floor (NF) with the vertical cephalometric values using cone-beam computerized tomography (CBCT). A total of 122 patients who applied to Department of Orthodontics between January 2011-June 2019 were included. On the CBCT’s, distances between the U1A and the NF and ANS were measured. Statistical significance was considered as p&lt;0.05. Of 122 individuals 73.8% (n=90) were female and 26.2% (n=32) were male with an mean age of 22,8±3,3 years. A statistically significant moderate positive correlation was found between the NF-U1A mean values and the measurements of N-Me, ANS-Me and ANS-Gn, S-Go, and N-ANS measurements (p &lt;0.01). A statistically significant positive correlation was found between the ANS-U1A mean values and Ar-Go-Me, total posterior angles, N-Me, SN/GoGn and Y-axis angle, ANS-Me and ANS-Gn (p &lt;0.01). In this study, we found that the distance of U1A from ANS and NF points was related to orthodontic vertical direction parameters. It was demonstrated that the ANS-U1A and NF-U1A points can serve as reference points for identifying the orthodontic vertical growth pattern on CBCT scans.

Omicron variants have higher infectivity, more immune escape but lower risk of severe clinical outcomes than the ancestral variants. However, people are still wondering whether SARS-CoV-2 may become lethal again or whether some highly-pathogenic strain may emerge in the future. Omicron is more selective proliferation in the upper respiratory tract (URT). The temperature of human URT is 33–34°C, and the virus strains other than Omicron cannot replicate effectively at this temperature. While Omicron adapted to the low temperature environment, so its distribution mainly depends on the expression levels of ACE2 in cells. Similar distribution switch from lungs to URT has been observed for the 1918 H1N1 influenza virus, who vanished after 1921 and has been turned to be the seasonal human influenza A viruses. However, some relatively high-pathogenic SARS-CoV-2 strains and influenza-virus strains may still emerge in the future. Dynamic changes in the viral virulence should be monitored constantly.

An early hypothesis in robot-assisted stroke therapy was that sensorimotor stimulation through robotic assistance is beneficial for recovery. Despite 25 years of upper-limb rehabilitation robotics research, this hypothesis remains untested barring a few studies with small sample sizes. This review aims to provide a critical summary of the current state of this hypothesis by collating evidence from rehabilitation robotics and other related therapeutic approaches. The review starts with a causal model to expose the various direct and indirect routes through which robotic assistance can aid sensorimotor recovery. The indirect routes include the influence of robotic assistance on therapy intensity, patient motivation, and active participation. The direct route is through changes in cortical networks through Hebbian(-like) learning and changes in peripheral tissue properties. There is currently mixed evidence for the direct causal effect of robotic assistance on recovery from the upper-limb rehabilitation robotics literature. However, evidence from the neuromuscular electrical stimulation literature provides some support for this causal role. Based on the data at hand, we hypothesize that the enhanced movement-related sensory feedback from robotic assistance has a direct, possibly small, causal role in the sensorimotor recovery of the upper-limb, and this effect might be detectable with high-intensity therapy. Large, high-intensity, controlled studies are warranted to support or refute the role of robotic assistance on recovery, which is both scientifically and practically important.

Photovoltaic power generation has high variability and uncertainty because it is affected by uncertain factors such as weather conditions. Therefore, probabilistic forecasting is useful for optimal operation and risk hedging in power systems with large amounts of photovoltaic power generation. However, deterministic forecasting is the mainstay of photovoltaic generation forecasting; there are few studies on probabilistic forecasting and feature selection from weather or time-oriented features in such forecasting. In this study, prediction intervals were generated by the lower upper bound estimation using neural networks with two outputs to make probabilistic predictions. The objective was to improve prediction interval coverage probability (PICP), mean prediction interval width (MPIW), and loss, which is the integration of these two metrics, by removing unnecessary features through feature selection. When features with high gain were selected by random forests (RF), in the forecast of 14.7-kW PV systems, loss improved by 1.57 kW, PICP by 0.057, and MPIW by 0.12 kW on average over two weeks compared to the case where all features were used without feature selection. Therefore, the low gain features from RF act as noise in LUBE and reduce the prediction accuracy.

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified constraint-induced movement therapy(mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were: quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp-release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the QUEST scale, the SHUEE Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of 8 children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p&lt;0.05). The greatest increase occurred in spontaneous use from assessment 1-4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb obtained a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 hours) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

Background: Stroke is the third leading cause of disability, primarily due to motor, sensory, and cognitive impairments. Virtual reality (VR) has shown promising results in post-stroke rehabilita-tion, particularly for upper limb recovery. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), aligned with the International Classification of Functioning, Disa-bility, and Health (ICF) principles, is a valid tool for measuring disability regardless of its cause. This study aimed to investigate the feasibility of VR TRAVEE system in upper limb rehabilitation for stroke patients. Methods: 14 stroke patients with residual hemiparesis were enrolled in the study. They underwent a 10-day program combining conventional therapy (CnvT) with VR rehabilitation. At baseline (T0), upper limb was assessed using the Modified Ashworth Scale (MAS), Active Range of Motion (AROM), and the Numeric Rating Scale (NRS) for pain. These assessments were repeated after the 10-day rehabilitation program (T1). Additionally, disability was measured using WHODAS 2.0 at T0 and again 30 days after completing the program. Results: Significant im-provements were observed in AROM, MAS scores for the shoulder, elbow, wrist, and metacar-pophalangeal joints as well as in the reduction of shoulder pain (p˂0.001). WHODAS scores de-creased across all six domains, with a statistically significant improvement in the cognition domain (p=0.011). Conclusions: Combining CnvT with VR as a rehabilitation approach enhances motor function in the upper limb. This method has the potential to reduce disability scores and promote neuroplasticity.

Despite copious research, the methods for assessing upper- and lower-limb motor coordination are limited. We devised a simplified evaluation method based on upper- and lower-limb motor coordination jumping and conducted a practical examination of the characteristics of the motion and applicability of the evaluation method. Overall, 88 high-school athletes with comparable competitive abilities were included in this study. The participants were divided into two groups based on their prior experience with motor coordination training (24 in the experienced group; 64 in the inexperienced group). First, a population proportion test was employed to assess the success rate of the four upper- and lower-limb motions in each task. This revealed significant difference between all tasks, except for the fourth motion, indicating that different motions have varying degrees of difficulty and that the combination of motions with differing difficulty coefficients can result in the creation of entirely new tasks with varying degrees of difficulty. Second, the experienced group demonstrated significantly superior performance compared to the inexperienced group by a t-test. These results confirmed that athletes (with the same level of competitive ability) trained in upper and lower limb motor coordination were able to excel in this evaluation method, confirming its validity.

This paper examines the response of the ionosphere to the impact of two moderate geomagnetic storms observed in January 17 and 26-27, 2013 under conditions of strong sudden stratospheric warming. The study uses data from ground-based ionosonde measurements at the Alma-Ata ionospheric station (43.25 N, 76.92 E) combined with optical observation data (The Spectral Airglow Temperature Imager (SATI)). Ionosonde data showed that the geomagnetic storms under consideration do not generate ionospheric storms, but demonstrate some unusual types of diurnal foF2 variations with large (up to 60%) deviations of foF2 from median values observed during the night/morning periods on 13-15 and 20-23 January which do not have any relation to solar or geomagnetic activity. Wave-like disturbances in foF2, h’F and daily averaged foF2 values with quasi-period of 5-8 days and peak-to-peak amplitude from about 1MHz to 2 MHz (from 20% to 40%) and ~40 km are observed during the 9-28 January, after registration the occurrence of the major SSW event on 6-7 January. The observed variations in the OH emission rate are found to be quite similar to those observed in the ionosheric parameters that assume a community of processes in the stratosphere/mesosphere/ionosphere system. The study shows that the F-region of the ionosphere is influenced by processes in the lower ionosphere, in this case by processes associated with sudden stratospheric warming SSW-2013, which led to modification of the structure of the ionosphere and compensation of processes associated with the development of the ionospheric storms.

At present paper, we aim to study the long-time behavior of a stochastic semi-linear degenerate parabolic equation on bounded or unbounded domain and driven by a nonlinear noise and defined. Since the theory of pathwise random dynamical systems can not be applied directly to the equation with nonlinear noise, first, we establish the existence of weak pullback mean random attractors for the equation by applying the theory of mean-square random dynamical systems; then, we prove the existence of (pathwise) pullback random attractors for the Wong-Zakai approximate system of the equation. In addition, we establish the upper semicontinuity of pullback random attractors for the Wong-Zakai approximate system of the equation under consideration driven by a linear multiplicative noise.

This paper considers the general ocean circulation within the thermodynamical closure of our climate theory, which aims to deduce the generic climate state from first principles. The preceding papers of the theory have reduced planetary fluids to warm/cold masses and determined their bulk thermal properties, which provide prior constraints for the derivation of the upper-bound circulation when the potential vorticity is homogenized in moving masses. In a companion paper on the atmosphere, this upper bound is seen to reproduce the prevailing wind, forsaking therefore previous discordant explanations of the easterly trade and the polar jet stream. In this paper on the ocean, we again show that this upper bound may replicate broad features of the observed circulation, including a western-intensified subtropical gyre and a counter-rotating tropical gyre feeding the equatorial undercurrent. Together, we posit that PV homogenization may provide a unifying dynamical principle of the large-scale planetary circulation, which may be interpreted as the maximum macroscopic motion extractable by microscopic stirring --- within the confine of the thermal differentiation.

Satterthwaite and Toepke (1970 Phys. Rev. Lett. 25 741) discovered that Th₄H₁₅-Th₄D₁₅ superhydrides exhibit superconductivity and have no isotope effect. The latter is fundamental contradiction with the concept of electron-phonon mediated superconductivity of Bardeen-Cooper-Schrieffer (BCS) theory. Soon after this work, Stritzker and Buckel (1972 Zeitschrift für Physik A Hadrons and nuclei 257 1-8) reported that superconductors in PdH_x-PdD_x system exhibit reverse isotope effect. Yussouff et al (1995 Solid State Communications 94 549) extended this finding on PdH_x-PdD_x-PdT_x system. Recent interest to hydrogen- and deuterium-rich superconductors is based on the discovery of near-room-temperature superconductivity in highly-compressed H₃S (Drozdov et al. 2015 Nature 525 73) and LaH₁₀ (Somayazulu et al 2019 Phys. Rev. Lett. 122 027001). To date, there is no clarity about isotope effect in H₃S-D₃S system, because thorough examination of available experimental data reported by Drozdov et al (2015 Nature 525 73) shows that H₃S-D₃S system perhaps has reverse isotope effect. In attempt to reaffirm/disprove our primary idea that the mechanism for near-room-temperature superconductivity in hydrogen-rich superconductors is not BCS electron-phonon interaction, we analyse the upper critical field data, B_c2(T), in Th₄H₁₅-Th₄D₁₅ phases (Satterthwaite and Toepke 1970 Phys. Rev. Lett. 25 741) and two recently discovered high-pressure hydrogen-rich phases of ThH₉ and ThH₁₀ (Semenok et al 2019 arXiv:1902.10206). As the result, it is found that all known to date thorium super-hydrides/deuterides are unconventional superconductors which have T_c/T_F ratios within a range of 0.008 < T_c/T_F < 0.120, where T_c is the superconducting transition temperature and T_F is the Fermi temperature.

Stroke is a significant global health concern, ranking among the top causes of death and disability. Timely post-stroke recovery hinges on structured upper limb rehabilitation within the first 24–48 hours. Although virtual reality (VR) rehabilitation is promising, its accessibility is complex and cost-limited, especially in less developed regions. In this study, we developed and assessed nonimmersive VR rehabilitation games using the Kinect Xbox One and UNITY game engine, targeting upper limb movement sequences vital for post-stroke recovery. The developed games involved simple to progressively challenging movements, engaging the deltoid, biceps, and triceps muscles, and aligning with post-stroke rehabilitation criteria. We used peak-to-peak electromyography signal detection with a 20% threshold and three distinct feature extractions to represent muscle contractions during gameplay. Our cosine similarity analysis revealed the efficacy of games in meeting movement sequence criteria, benefiting mostly the shoulder motor and deltoid muscles (93% improvement) with more moderate improvements in the biceps (73%) and triceps (47%). Our results suggest that these games could contribute to upper limb stroke rehabilitation, particularly that of the deltoid muscle. This study highlights the potential of VR-based rehabilitation games in post-stroke upper limb recovery, emphasizing muscle engagement, target distances, and rehabilitation criteria in game design. Although healthy participants were involved here, future research involving post-stroke patients and the exploration of more immersive, multiplanar movements hold the potential for a more comprehensive rehabilitation experience. Our study contributes to advancing the common knowledge related to VR-based stroke rehabilitation, focusing on upper limb movement sequences with implications for therapeutic engagement and recovery.

Papillomaviruses (PVs) are oncogenic and infect the skin and mucosa of various host species. Considering the recent advances in research on PVs using rolling circle amplification (RCA) followed by high-throughput sequencing (HTS), in this study, we aimed to investigate the bovine papillomavirus (BPV) types associated with proliferative lesions in the upper alimentary tract of an affected bull and characterize the viral strains through complete genome sequencing using this strategy. We analyzed the PV strains associated with two hyperplastic esophageal lesions through PCR using degenerate primer pairs and RCA, followed by HTS. HTS of the libraries generated using RCA products provided the whole genome sequence of BPV4 present in squamous papilloma, whereas, the complete genome sequence of BPV2 and subgenomic fragments of BPV4 were identified in carcinoma in situ (CIS). We, for the first time, have sequenced BPV2 identified from the CIS of the bovine upper alimentary canal. Additionally, RCA followed by HTS allowed characterization of the mixed infection by BPV2 and BPV4 in this lesion. These data reveal that BPV4 is not the only BPV type present in CIS of the esophageal mucous membrane; moreover, a mixed infection caused by BPV2 and BPV4 at the tested anatomical site was demonstrated.

Stroke causes disability and significantly affects patient quality of life. Post-stroke rehabilitation of upper limb function is crucial, as it affects daily activities and individual autonomy. Traditional rehabilitation methods often require frequent visits to specialized centers, which can be costly and challenging. This study investigated the effectiveness of a home-based self-training device, "Kenko Yusuri," in improving upper limb function in patients with chronic stroke. This multicenter prospective intervention study used a quasi-randomized controlled trial design. Ninety-three outpatients from five hospitals in Japan were enrolled and assigned to either the intervention group who used the "Kenko Yusuri" device or the control group who underwent conventional rehabilitation. All patients received botulinum toxin type A (BoNT-A) injections to treat upper limb spasticity. The primary outcome measure was the Fugl-Meyer Assessment (FMA) of upper-extremity motor function. Secondary outcomes included the modified Ashworth scale (MAS) score, range of motion (ROM), and chronic pain assessments. The intervention group demonstrated significantly greater improvements in FMA total scores than the control group. Patients with moderate paralysis experienced the greatest benefits from the intervention. There were no significant between-group differences in MAS scores or ROM measurements. Pain and wrist ROM showed improvement in the intervention group. Home-based training with a shaking device significantly improved upper limb function in patients with moderate chronic post-stroke paralysis. This approach aligns with the principles of use-dependent plasticity and offers a feasible and cost-effective alternative to traditional rehabilitation methods.

This study aimed to introduce a novel machine learning (ML) model designed to predict the need of interventions during endoscopy in patients with upper gastrointestinal bleeding (UGIB). The risk stratification tools in current use, such as the Glasgow Blatchford Score (GBS) and pre-endoscopic Rockall score, have limitations in accurately predicting the need for endoscopic interventions. All patients diagnosed with UGIB from January 2013 to October 2023 who underwent endoscopy were included in the study. Variables extracted included demographics, social history ,clinical history, clinical presentation and symptoms, drug history, management prior to endoscopy, findings during endoscopy, laboratory variables and vitals, and post-endoscopic results. Three machine learning models including Random Forest Classifier (RFC), Gradient Boosting Classifier (GBC), and AdaBoost Classifier were used to evaluate the need for intervention during endoscopy in our study. A total of 1372 patients were included from three major hospitals in Jordan, of whom 242 underwent endoscopic intervention. The GBC outperformed all other models and pre-endoscopic scores in predicting the need for endoscopic intervention with an area under the curve of 0.861. Findings during endoscopy, platelet count, pulse rate and systolic blood pressure during admission were the most contributing features in predicting the need for the need of endoscopic intervention. This study highlights the potential of machine learning models in enhancing decision making for UGIB management.

Keywords: pelvic ultrasound, follicle number per ovary, FNPO, ovarian volume, PCOM, upper normal limits, referral population

Agarwood, a highly valuable fragrant wood of Aquilaria spp. has been widely used in perfumes, traditional medicine, religious rites and cultural activities. Due to the presence of aromatic and medicinal properties, the Agarwood has gained its economic importance in recent years. It has been providing livelihood and employment facilities to many people who are cultivating those. Owing to high demand and profitability, the people of Assam has started to cultivate Agarwood in a commercial manner in recent days. This study was conducted to examine the economic viability of Agarwood cultivation in Assam and to understand the problems of the cultivators to consider Agarwood cultivation as the primary source of income. The primary data were collected during the months of May and June, 2022 from 210 households using structured questionnaire. The cost-benefit analysis revealed that INR 100 of initial investment yields a net benefit of INR 623 which indicates that the return from the Agarwood cultivation among the cultivators are very high. Thus, the present study argues that the government should encourage the cultivators by providing the necessary support in the form of a legalized market, credit requirement, creating the awareness about the demand of Agarwood and making provision of training.

There is a great need to develop research-based models for supporting collaboration between educational institutions. Collaboration models are needed, for example, to assist the transition from lower educational level to higher education or from higher education to work life. In this research, collaboration was conducted through a joint upper-secondary school and university course that addressed global challenges by using a project-based learning approach. There is a shortage of research exploring students’ perceptions of collaboration. Therefore, the main purpose of this qualitative case study is to explore the relevance of the joint course for students and university students. The research was guided by the following research question: What kind of relevance did the students experience in the joint project-based learning course? The data was gathered using questionnaires, interviews, and reflective study reports. The data was analyzed via theory-based content analysis where research-oriented relevance model was used as the analysis framework. The analysis framework enabled categorizing experienced relevance on individual, vocational and societal dimensions. Altogether, the analysis produced 7 relevance categories for upper-secondary students and 9 for university students. According to the analysis, upper-secondary school students felt that the course offered the most on an individual relevance dimension whereas university students experienced the vocational relevance dimension most diverse. As the main conclusion, this research produced new insights on the experienced relevance of upper-secondary level and higher education cooperation from the students’ point of view. The acquired knowledge can be useful for everyone developing new cross-institutional cooperation models.

Our image recognition system mainly judges whether the left upper limb in the image is the left upper limb or the right upper limb through our deep learning model in the image. The doctor then could give the correct surgical position. From the experimental results, it could be found that the precision rate and recall rate of the intelligent image recognition system proposed in this paper for preventing the upper limb dislocation surgery could reach 98% and 93%, respectively. It proved that our artificial intelligent image recognition system, AIIRS, could indeed assist orthopedic surgeons to prevent the occurrence of left and right dislocation in upper limb surgery. At the same time, this paper also completes the IRB application approval through the prototype experimental results and will conduct the second phase of human trials in the future. It showed that the research results of this paper will be of great benefit and research value to upper limb orthopedic surgery.

Running is a basic form of human locomotion and one of the most popular sports worldwide. While the leg biomechanics of running have been studied extensively, few studies have focused on the upper-body movement. However, an effective arm swing and longitudinal rotation of the shoulders play an important role in running efficiency as they must compensate for the longitudinal torques generated by the legs. The aim of this study is to assess the upper-body rotation using wearable inertial sensors and to elucidate its relation to energy expenditure. Eighty-six junior elite middle and long-distance runners (37 female, 49 male) performed an incremental treadmill test with sensors attached on both shoulders, tibiae and the sacrum. Mean and total horizontal shoulder and pelvis rotation per stride were derived while energy costs were determined using respiratory gas analysis and blood sampling. Results show that shoulder and pelvis rotation increase with running speed. While shoulder rotation is more pronounced in female than in male runners, there is no sex difference for pelvis rotation. Energy cost of running and upper trunk rotation prove to be slightly negatively correlated. In conclusion, upper body rotation appears to be an individual characteristic influenced by a sex-specific body mass distribution.

Our image recognition system mainly judges whether the left upper limb in the image is the left upper limb or the right upper limb through our deep learning model in the image. The doctor then could give the correct surgical position. From the experimental results, it could be found that the precision rate and recall rate of the intelligent image recognition system proposed in this paper for preventing the upper limb dislocation surgery could reach 98% and 93%, respectively. It proved that our intelligent image recognition system could indeed assist orthopedic surgeons to prevent the occurrence of left and right dislocation in upper limb surgery. At the same time, this paper also completes the IRB application approval through the prototype experimental results and will conduct the second phase of human trials in the future. It showed that the research results of this paper will be of great benefit and research value to upper limb orthopedic surgery.

Background: Micro-RNAs (miRNA) are emerging as biomarkers in the detection and prognosis of cancers due to their inherent stability and resilience. Methods: To summarize evidence regarding urinary miRNA (umiRNAs) role in the detection, prognosis and therapeutic management of urological cancers, we performed a systematic review of the most important scientific databases using the following keywords: (urinary mir-na)AND(prostate cancer); (urinary mirna)AND(bladder cancer); (urinary mirna)AND(renal cancer); (urinary mirna)AND(testicular cancer); (urinary mirna)AND(urothelial cancer). Results: Of all, 1364 articles were initially selected. Only original studies in the English language on human specimens were considered for inclusion in our systematic review. Thus, a convenient sample of 60 original articles was identified. Urinary miRNA (UmiRNAs) are downregulated in prostate cancers and may serve as potential non-invasive molecular biomarkers. Several umiR-NAs have been identified as diagnostic biomarkers of urothelial carcinoma and bladder cancer (BCa), allowing to discriminate malignant from non-malignant forms of haematuria. UmiRNAs could serve as therapeutic targets or recurrence markers of non-muscle invasive BCa and could predict the aggressivity and prognosis of muscle-invasive BCa. In renal cell carcinoma, miRNAs have been identified as predictors of tumour detection, aggressiveness, and progression to metastasis. Conclusion: umiRNAs could play an important role in the diagnosis, prognosis, and therapy of urological cancers.

In this work the close relation between vorticity and micro-rotation in micropolar flows in Rn (n = 2 or 3) is identified and used to explain the faster decay by t^(-1/2) of the angular velocity of the micro-rotation of fluid particles, as well as establishing its optimality. For this purpose important upper and lower bounds for Leray solutions in homogeneous Sobolev spaces are derived, using the monotonicity approach recently introduced by the authors for dissipative systems in general. Several related results of interest are also given along the discussion.

This paper deals with the design and kinematic analysis of a novel mechanism for the elbow joint of an upper-limb exoskeleton, with the aim of helping operators, in terms of effort and physical resistance, in carrying out heavy operations. In particular, the proposed eight-bar el-bow joint exoskeleton mechanism consists of a motorized Watt I six-bar linkage and a suitable RP dyad, which connects mechanically the external parts of the human arm with the corre-sponding forearm by hook and loop velcro and thus, helping their closing relative motion for lifting objects during repetitive and heavy operations. This relative motion is not a pure rotation and thus, the upper part of the exoskeleton is fastened to the arm, while the lower part is not rigidly connected to the forearm, but through a prismatic pair which allows both rotation and sliding along the forearm axis. Instead, the human arm is sketched by means of a crossed four-bar linkage, which coupler link is considered as attached to the glyph of the prismatic pair, that is fastened to the forearm. Therefore, the kinematic analysis of the whole ten-bar mecha-nism, which is obtained by joining the Watt I six-bar linkage and the RP dyad to the crossed four-bar linkage, is formulated to investigate the main kinematic performance and for design purposes. The proposed algorithm has given several numerical and graphical results. Finally, a double-parallelogram linkage, as particular case of the Watt I six-bar linkage, was considered in combination with the RP dyad and the crossed four-bar linkage, by giving a first mechanical de-sign and a 3D printed prototype.

Certain micronutrients exhibit immunomodulatory effects. However, no intervention has yet investigated the effect of an individualized supplementation on the severity of upper respiratory tract infections (URI). Therefore, we investigated whether a personalized supplementation moderates the incidence and severity of URI. Selenium, zinc, and vitamin D was measured from 59 healthy participants ) in dried blood spots. Accordingly, a personalized supplement was provided with or without the respective micronutrients. We used WURSS-21 questionnaires to assess the disease status. The blood values converged during the intervention and micronutrients no longer differed at the end of the intervention period between treated and untreated volunteers. The incidence and severity of the illness did not significantly differ between the groups. However, when analyzing the WURSS-21 score by the intention to treat, the initially randomized treatment arm revealed a significantly higher score than the placebo arm. Upon acute administration, individualized combination of selenium, zinc and vitamin D does not reduce the number or contribute to a milder course of URIs. Therefore, supplementation in acute infectious situations seems questionable. Further studies must address the habitual diet in more detail to better understand the impact of individual micronutrient status on the prevention of URI.

We performed urine cytology analysis of a pharmacologically induced diuresis for diagnostics of upper tract urothelial carcinoma. To evaluate the diagnostic value of cytology of pharmacologically forced diuresis, a first cohort of 77 consecutive patients with primary upper tract urothelial carcinoma treated with radical surgery was enrolled. To evaluate pharmacologically forced diuresis cytology as follow-up procedure, a second cohort of 1250 patients who underwent radical cystectomy for bladder cancer was selected. In the first cohort, sensitivity of cytology of pharmacologically forced diuresis in patients with invasive, high-grade, low-grade, and concomitant carcinoma in situ was 8%, 9%, 0% and 14%, respectively. In the second cohort, cytology of pharmacologically forced diuresis was positive in 30/689 (4.3%) of patients, in whom upper urinary tract recurrence was present in 21/30 (70%) and urethral recurrence in 8/30 (26%) of cases. As a follow-up tool, cytology of pharmacologically forced diuresis showed a sensitivity, specificity, and positive and negative predictive value of 60%, 99%, 70% and 98%, respectively. Summarized, as diagnostic tool, sensitivity of cytology of pharmacologically forced diuresis is slightly better in patients with invasive upper tract urothelial carcinoma and concomitant carcinoma in situ. As follow-up method, positive cytology of pharmacologically forced diuresis is strongly related to cancer recurrence and can reveal urethral recurrence. cytology of pharmacologically forced diuresis might be useful in patients with contraindications for imaging or with difficult endoscopic access to the upper urinary tract.

The Surgical Complexity Score (SCS) has been widely used to describe the surgical effort during advanced stage epithelial ovarian cancer (EOC) cytoreduction. Referring to a variety of multi-visceral resections, it best combines the numbers with the complexity of the sub-procedures. Nevertheless, not all potential surgical procedures are described by this score. Lately, the European Society for Gynaecological Oncology (ESGO) has established standard outcome quality indicators pertinent to achieving complete cytoreduction (CC0). There is a need to define what weight all these surgical sub-procedures comprising CC0 would be given. Explainable Artificial Intelligence (XAI) could explain the impact of real-time features on the CC0 prediction. We analyzed prospectively collected data from 560 consecutive patients with FIGO-stage III-IV who underwent cytoreductive surgery between Jan 2014 and Dec 2019 at a UK tertiary referral centre. Following adaptation of the structured ESGO ovarian cancer report template, we employed the eXtreme Gradient Boosting (XGBoost) algorithm to model an exhaustive list of surgical sub-procedures. We applied the Shapley Additive explanations (SHAP) framework to provide global (cohort) explainability. We used Cox regression for survival analysis and constructed Kaplan-Meier curves. The XGBoost model predicted CC0 with an acceptable accuracy (area under curve [AUC] = 0.70; 95% confidence interval [CI] = 0.63–0.76). Visual quantification of the feature importance for the prediction of CC0 identified upper abdominal peritonectomy (UAP) as the most important feature, followed by regional lymphadenectomies. The UAP best correlated with bladder peritonectomy and diaphragmatic stripping (Pearson’s correlations &gt; 0.5). Clear inflection points were shown by pelvic and para-aortic lymph node dissection and ileocecal resection/right hemicolectomy, which increased the probability for CC0. When UAP was solely added to a composite model comprising of engineered features, it substantially enhanced its predictive value (AUC = 0.80, CI = 0.75-0.84). The UAP was predictive of poorer progression-free survival (HR=1.76, CI 1.14- 2.70, P:0.01) but not overall survival (HR=1.06, CI 0.56-1.99, P:0.86). The SCS did not have significant survival impact. Machine Learning allows for operational feature selection by weighting the relative importance of those surgical sub-procedures that appear to be more predictive of CC0. Our study identifies UAP as the most important procedural predictor of CC0 in surgically cytoreduced advanced-stage EOC women. The classification model presented here can potentially be trained with a larger number of samples to generate a robust digital surgical reference in high output tertiary centres. The upper abdominal quadrants should be thoroughly inspected to ensure that CC0 is achievable.

Upper mesophilic temperature acclimation of halophilic, hydrogen-producing bacteria from salt fields was investigated in this study, along with the changes in microbial abundance during an-aerobic digestion (AD) process. Genomic approaches such as PCR-denaturing gradient gel elec-trophoresis (DGGE) and next-generation sequencing (NGS) were performed to profile the mi-crobial communities. During AD, there was a significant abundance of Halanaerobacter lacunarum at 48°C followed by the increase in hydrogen yield, signifying potential contribution from the halophile in the hydrogen production. A decrease in the dominance of H. lacunarum and Halan-aerobium fermentans at 42°C, likely due to an increase in other bacterial species, was noted but their dominance significantly increased at temperatures of 45°C and 48°C. This investigation provides valuable insights in highlighting the potential of Halanaerobium sp. and the other halo-philic bacteria to adapt under upper mesophilic temperature conditions and synthesizing hy-drogen. The findings in the present study also underscore the importance of optimizing temper-ature and pH conditions to maximize hydrogen yield during high-salt anaerobic digestion.

Disasters related to climate change on our water resources are on the rise in terms of scale and severity. Therefore, predicting groundwater levels (GWL) is a crucial means to aid adaptive capacity towards disasters related to climate change in our water resources. In this study Gradient Boosting (GB) regression modelling approach for GWL prediction as a function of rainfall and antecedent GWL is used. Firstly, we sought to demonstrate the effects of rainfall changes on our groundwater resources through a Mann-Kendall trend analysis. Secondly, we evaluated the relationship between the input and response variables and determined the optimal lag times between the variables using autocorrelations and cross-correlations. Lastly a predictive model was developed for eight groundwater stations in the Upper Crocodile. 50 % of the groundwater stations revealed declining trends, while 25% had no trends and the other 25% showed an increasing trend. Generally low cross-correlation maximum (CCmax) were obtained, with the highest CCmax being 0.299 at an optimal lag of 2-month. While the highest autocorrelation was 0.969 at a 1-month lag. The best groundwater predictive model had R2 and MSE of 0.66 and 0.06, respectively. The stations that generally performed better had both high autocorrelation and cross-correlation coefficients. GB model performed satisfactorily in predicting GWL for most of the stations in the study area. Therefore, GB can be used for GWL prediction in the Upper Crocodile.

Repetitive transcranial magnetic stimulation (rTMS) with intensive occupational therapy improves upper limb motor paralysis and activities of daily living after stroke; however, amount of improvement according to paralysis severity remains unverified. Target activities for daily living using patients’ upper limb functions can be established by predicting the amount of change after treatment for each severity level of upper limb motor paralysis and further aid practice planning. This study estimated post-treatment score changes for each severity level of motor paralysis (no, poor, limited, notable, and full) stratified according to Action Research Arm Test (ARAT) scores before combined rTMS and intensive occupational therapy. Severity of motor paralysis was the fixed factor for analysis of covariance, delta (post-pre) of the scores was the dependent variable. Ordinal logistic regression analysis was used to compare changes in ARAT subscores in patients, divided according to paralysis severity before treatment. A multicenter retrospective cohort dataset analyzed 907 patients with stroke hemiplegia. Largest treatment-related changes in scores were observed in the Limited recovery group for upper limb motor paralysis and Full recovery group for quality-of-life activities using paralyzed upper limb. These results will help predict treatment effects and determine exercises and goal movements for occupational therapy after rTMS.

Nowadays molecular research is essential for the better understanding of tumor cells pathophysiology. The increasing number of neoplasms is taken under ‘the molecular magnifying glass’ therefore it is possible to discover complex relationships between cytophysiology and tumor cells. Signal transducer and activator of transcription 3 (STAT3) belongs to the family of latent cytoplasmic transcription factors called STATs which comprises seven members: STAT1, STAT2, STAT3, STAT5A, STAT5B, STAT6. Those proteins play important role in cytokine-activated gene expression by transducing signals from the cell membrane to the nucleus. Abnormal prolonged activation results in tumorigenesis, metastasis, cell proliferation, invasion, migration and angiogenesis. Inhibition of this transcription factor inhibits previously mentioned effects in cancer cells whereas normal cells are not affected. Hence STAT3 might be a viable target for cancer therapy.

Background: Upper extremities’ function impairments (UEFI) and gait impairment are frequently reported even in the early stages of Multiple Sclerosis (MS) disease. These motor deficits can negatively affect the quality of life (QOL) in MS patient. Exercise has been repeatedly introduced as a beneficial adjuvant therapy for MS, attenuating a wide range of physical and psychological symptoms without any side effects or increased risks of relapse or exacerbation in disease symptoms.Aim: This paper investigates the effect of multi-function swing suspension training (MFSST) program on upper and lower extremities’ function (ULEF), and QOL in MS women according to expanded disability status scale (EDSS) score.Design: Experimental method with a pre-test and post-test design with control group. Setting: The department of Sports Injuries and Corrective Exercise at the Shahid Bahonar University of Kerman.Population: Forty-seven MS women.Methods: Eligible subjects who matched the selection criteria were randomly assigned into three groups as follow: i. Intervention group A (EDSS of 2 – 4), ii. Intervention group B (EDSS of 4.5 – 6.5), and iii. Control group (EDSS of 2 – 6.5). The intervention groups have been trained by the SET program for a duration of 8 weeks. At baseline and after the intervention, the upper extremities’ function (UEF) and the lower extremities’ function (LEF) were assessed by 9-hole peg test (9HPT) and the timed 25-foot walk (T25FW) test, respectively. Moreover, participants’ QOL was measured using the Short Form questionnaire (SF-36).Results: A significant difference was found between the pre-test and post-test variables of walking speed and upper extremity endurance in intervention groups, and between the intervention groups and control group (P < 0.05). Compared to control group, both intervention groups showed improvements in all subscales of QOL, except emotional role limitation score.Conclusions: In summary, these results show that the present protocol of MFSST could be effective in improving ULEF and QOL in MS patients, showing the improvements after 4^th week. Moreover, this protocol was more useful for patients with an EDSS score of more than 4.5. Therefore, it seems that exercise therapy should be considered as a beneficial clinical intervention approach to improve ULEF and QOL in MS patients.

Human coronaviruses cause both upper and lower respiratory tract infections in humans. In 2012 a sixth human coronavirus (hCoV) was isolated from a patient presenting with severe respiratory illness. The 60-year-old man died as a result of renal and respiratory failure after admission to a hospital in Jeddah, Saudi Arabia. The aetiological agent was eventually identified as a coronavirus and designated Middle East respiratory syndrome coronavirus (MERS-CoV). MERS-CoV has now been reported in more than 27 countries across the Middle East, Europe, North Africa and Asia. As of July 2017, 2040 MERS-CoV laboratory confirmed cases, resulting in 712 deaths, were reported globally, with a majority of these cases from the Arabian Peninsula. This review summarises the current understanding of MERS-CoV, with special reference to the (i) genome structure, (ii) clinical features, (iii) diagnosis of infection and (iv) treatment and vaccine development.

Background: Upper tract urothelial carcinoma (UTUC) presents significant challenges in prognostication due to its rarity and complex anatomy. This study introduces a novel approach integrating perirenal fat (PRF) radiomics with clinical factors to enhance prognostic accuracy in UTUC. Methods: The study retrospectively analysed 103 UTUC patients who underwent radical nephroureterectomy. PRF radiomics features were extracted from preoperative CT scans using a semi-automated segmentation method. Three prognostic models were developed: clinical, ra-diomics, and combined. Model performance was assessed using concordance index (C-index), time-dependent Area Under the Curve (AUC), and integrated Brier score. Results: The combined model demonstrated superior performance (C-index: 0.784, 95% CI: 0.707-0.861) compared to the radiomics (0.759, 95% CI: 0.678-0.840) and clinical (0.653, 95% CI: 0.547-0.759) models. Time-dependent AUC analysis revealed the radiomics model's particular strength in short-term prognosis (12-month AUC: 0.9281), while the combined model excelled in long-term predictions (60-month AUC: 0.8403). Key PRF radiomics features showed stronger prognostic value than traditional clinical factors. Conclusions: Integration of PRF radiomics with clinical data significantly improves prognostic accuracy in UTUC. This approach offers a more nuanced analysis of the tumour microenvironment, potentially capturing early signs of tumour invasion not visible through conventional imaging. The semi-automated PRF segmentation method presents advantages in reproducibility and ease of use, facilitating potential clinical implementation.

The implementation of a progressive rehabilitation training model to promote patients’ motivation efforts can greatly restore the damaged central nervous system function in patients. The patients’ active engagement can be effectively stimulated by assist-as-needed (AAN) robot rehabilitation training. However, its application in robotic therapy has been hindered by a simple determination method of robot assisted torque which focuses on the evaluation only of the affected limb's movement ability. Moreover, the expected effect of assistance depends on the designer, which deviates from the patient's expectations, and its applicability to different patients is deficient. In this study, we propose a control method with personalized treatment features based on the idea of estimating and mapping the stiffness of the patient’s healthy limbs. This control method comprises an interactive control module in the task-oriented space based on the quantitative evaluation of motion needs and an inner loop position control module for the pneumatic swing cylinder in the joint space. An upper limb endpoint stiffness estimation model is constructed and a parameter identification algorithm is designed. The upper limb endpoint stiffness which characterizes the patient's ability to complete training movements is obtained by collecting surface electromyographic (sEMG) signals and human-robot interaction forces during patient movement. Then the motor needs of the affected limb when completing the same movement are quantified based on the performance of the healthy limb. A stiffness mapping algorithm is designed to dynamically adjust the rehabilitation training trajectory and auxiliary force of the robot based on the actual movement ability of the affected limb, achieving AAN control. Experimental studies were conducted on a self-developed pneumatic upper limb rehabilitation robot, and the results showed that the proposed AAN control method can effectively estimate the patient's movement needs and achieve progressive rehabilitation training. The rehabilitation training robot that simulates the movement characteristics of the patient's healthy limbs drives the affected limb, making the intensity of the rehabilitation training task more in line with the patient's pre-morbid limb use habits, and also beneficial for the consistency of bilateral limb movements.

Delivery of drugs through the nasal route provides an alternative, yet highly efficacious modality for administering both large and small pharmaceutic molecules. This method proves particularly advantageous for drugs that are unstable during oral administration, as they undergo significant degradation in the gastrointestinal tract or metabolization through the first-pass effect in the liver. Nasal administration stands as a viable alternative to parenteral therapy and is also suitable for long-term medical management. The nasal mucosa, characterized by high vascularity and permeability, facilitates rapid pharmaceutical absorption, ensuring a swift onset of therapeutic action. Despite its noninvasive nature, the nasal delivery technique finds broad applicability for both local treatment and systemic therapy, as the drug directly enters systemic circulation. This article explores the feasibility of a novel spray delivery mechanism for intranasal drug deposition. The study aims to determine whether users can correctly follow the state-of-the-art application instructions for a nasal spray with an optimal nozzle placement angle (namely, 12-15°) at the nostril while maintaining sufficient safety and efficacy, and without engaging in preventable usage errors that could harm the user. Additionally, the study evaluates the effectiveness of device labeling, instructions for use, and a short video in supporting the correct application of the nasal spray at the optimal angle (12-15°) and assesses whether users can differentiate the product from others with similar appearances. We have also performed physical spray tests to experimentally evaluate drug penetration to the nasopharynx (a key target site for viral infections) for two different nozzle placements – one for current package instructions coming with over-the-counter spray products and the other for the optimal spray usage procedure to enhance targeted drug delivery. Human Factors (HF) validation studies were also conducted, instructing users to follow the application instructions of the nasal spray bottle with the nozzle placed at the optimal angle to target the nasopharynx. The experimental tests consistently confirmed improved penetration with the 12-15° nozzle placement, with visual cues proving effective when used in tandem with written instructions for guiding the study participants to adhere to the recommended usage procedures.

Retinal findings may change in patients with obstructive sleep apnea syndrome (OSAS). The present study aims to evaluate several retinal findings such as macula layer thickness, peripapillary retinal nerve fiber layer, and the optic nerve head in patients with OSAS using optical coherence tomography (OCT) and monitor the result of several types of treatment of OSAS with OCT. A prospective comparative study was designed. Patients were recruited at a Sleep Unit of a University Hospital and underwent comprehensive ophthalmological examinations. Following exclusion criteria, fifty-two patients with OSAS were finally included. Patients were examined by OCT twice: first, before treatment; secondly, after six months of treatment. In mild-moderate patients, where retinal swelling has been demonstrated, retinal thicknesses decreased [fovea (p=0.026), as well as inner ring macula (p=0.007), outer ring macula (p=0.015), and macular volume (p=0.015)]. In severe patients, where retinal atrophy had been observed, retinal thickness increased [fovea (p&lt;0.001)]. No statistically significant differences in efficacy between treatments were demonstrated. In conclusion, OCT can evaluate the retina in patients with OSAS and help monitor results after treatment. In severe OSAS, retinal thickness increased six months after treatment.

The current work reports the upper bound of the state variable of the of the Pointwise Steady Fluid Flow Approximation (PSFFA) model of non-stationary M/Ek/1 queueing system.

The composition and pattern of ecosystems are important factors determining the overall status and spatial differences of ecosystem service functions. However, under the background of differential land policies and ecological protection policies, research on the trend of ecological system pattern changes in the Fenhe River Basin is insufficient. Taking the upper and middle reaches of the Fenhe River Basin as the study area, based on long-term NDVI index and multi-period LUCC remote sensing images, this study used spatial statistics and time trend analysis methods to analyze the spatio-temporal dynamic changes of vegetation, land use, landscape pattern, and explored the impact of major driving factors on ecosystem changes. The results show that: (1) From 2010 to 2020, the vegetation cover in the upper and middle reaches of the Fenhe River Basin increased, with an annual NDVI increment of 0.003 (P<0.001). NDVI showed an increasing trend spatially, with significant statistics (P<0.001) and significant changes (P<0.05) in vegetation in high-altitude mountain areas, and the vegetation cover was mostly forests or grasslands. There was no significant change in vegetation cover in the low-lying urban agglomeration area. (2) From 2010 to 2020, the area of water bodies or wetlands in the study area significantly decreased, with 51.3% converted to arable land and 33.9% transferred to construction land, while only 2.2% remained as water bodies or wetlands. From 2015 to 2020, the trend of water body changes slowed down, with the proportions of conversion to arable land and construction land being 44.0% and 18.4% respectively, while the area of wetlands or water bodies remained at 16.3%. During the period of 2015-2020, the area of water bodies or wetlands converted to other land types increased by more than 14% compared to 2010-2015. This proportion reached more than 30% compared to the 13th Five-year Plan Period. (3) From 2010 to 2020, the spatial changes of landscape diversity (SHDI) and evenness (SHEI) of LUCC showed heterogeneous characteristics. In the high-altitude areas near the river basin boundary, the values of SHDI and SHEI were below 1.0. While in the low-altitude plain areas and urban areas with relatively frequent human activities, the values of SHDI and SHEI were above 1.0, and the values in urban areas could reach above 1.5. The evolution of ecosystem patterns in the upper and middle reaches of the Fenhe River Basin in the past decade has been clarified, providing a scientific basis for the construction and management of ecological environment governance and restoration projects in the Fenhe River Basin, and providing practical references for ecological protection and high-quality development practice in the Yellow River Basin.

This service improvement project was carried out at LEKMA Hospital, Ghana. Ghana has high levels of antimicrobial resistance (AMR). There is an urgent need to introduce models of care that optimize antibiotic prescribing. Methods Delayed / back-up prescribing is a strategy that could reduce antibiotic use in suspected upper respiratory tract infections. Four different models of delayed / back-up prescribing [no prescription; post-dated prescription (given to patient); post-dated prescription (forwarded to pharmacy); and follow-up appointment for reassessment after 3 days] were implemented in discussion between clinician and patient. Patients were contacted 10 days after their appointment to record compliance, check on their wellbeing, and rate their experience. Results Over a 3-month period (12/2019-02/2020), 142 patients were eligible for delayed / back-up prescribing. The most common clinical diagnoses were sore throat (102/140, 73%), common cold (22/140, 16%) and sinusitis (10/140, 7%). In total, 12 (9%) patients remained symptomatic at day 10, and only one individual in the entire cohort took antibiotics. Most patients (95%) rated their experience as good or very good. Conclusions Delayed / back-up prescribing models can lead to substantial reduction in antibiotic consumption amongst outpatient department patients with suspected upper respiratory tract infections. Delayed / back-up prescribing can be implemented safely in low and middle-income countries.

Technology-based approaches for upper limb (UL) motor rehabilitation after stroke are designed mostly for severely affected patients to increase their recovery chances. However, the available randomised controlled trials (RCTs) focused on efficacy of technology-based interventions often include patients with a wide range of motor impairment. This scoping review aims at overviewing the actual severity of stroke patients enrolled in RCTs which claim to specifically address UL severe motor impairment. The literature search was conducted on Scopus and PubMed databases and included articles from 2008 to May 2024, specifically RCTs investigating the impact of technology-based interventions on UL motor functional recovery after stroke. Forty-eight studies were selected. They showed that upon patients’ enrolment the values of the UL Fugl-Meyer Assessment and Action Research Arm Test covered the whole range of both scales, thus revealing the non-selective inclusion of severe impaired patients. Heterogeneity in terms of numerosity, characteristics of enrolled patients, trial design, implementation, and reporting were present across studies. No clear difference in the severity of the included patients according to the intervention type was found. Patient stratification upon enrolment is crucial to best direct resources to those patients who will benefit the most from a given technology-assisted approach (personalised rehabilitation).

Mood disorders are among the commonest mental disorders worldwide. Epidemiological and clinical evidence suggests that there are close links between infectious diseases and mood disorders, but the strength and direction of these association remain largely unknown. Theoretical models have attempted to explain this link based on evolutionary or immune-related factors, but these have not been empirically verified. The current study examined cross-sectional and longitudinal associations between the incidence of infectious diseases and mood disorders, while correcting for climate and economic factors, based on data from the Global Burden of Disease Studies, 1990-2019. It was found that major depressive disorder was positively associated with lower respiratory infections, while bipolar disorder was positively associated with upper respiratory infections and negatively associated with enteric and tropical infections, both cross-sectionally and over a period of thirty years. These results suggest that a complex, bidirectional relationship exists between these disorders. This relationship may be mediated through the immune system as well as through the gut-brain and lung-brain axes. Understanding the mechanisms that link these groups of disorders could lead to advances in the prevention and treatment of both.

The hydrochemical composition of the Upper Jurassic groundwaters in the South German Mo-lasse Basin (SGMB) indicates a heterogeneous and varying hydrogeochemical evolution, which contradicts previous flow model concepts. For this study, the data of 88 Tertiary, Cretaceous and Upper Jurassic groundwater samples were investigated for hydrochemical elements, 2H/18O-H2O isotopes, 87Sr/86Sr ratios as well as δ11B values. In addition, the geochemical composition, 87Sr/86Sr and δ11B values were analysed from depth-oriented Upper Jurassic rock samples to delineate water-rock interactions in the aquifer systems. Slightly elevated 87Sr/86Sr ratios of the carbonates compared to the typical signatures of marine Upper Jurassic carbonates indicate a synsedimentary radiogenic influence due to the erosion of the adjacent Bohemian Massif. However, these values cannot explain the significant higher Sr-isotope fingerprint of the groundwaters in the central SGMB. Different water types occur in the Upper Jurassic aquifer, primarily distinguished by the dominant cations, calcium or sodium with subclasses of the major anions. The calcium-dominated groundwaters occur mainly at the western and northern margins of the SGMB. The sodi-um-dominated ion exchange groundwaters instead dominate in the central and eastern SGMB. With increasing strontium content, the 87Sr/86Sr ratios of the Upper Jurassic groundwater samples either indicate a strontium uptake by carbonate of the host rocks, or a prevailing radiogenic sig-nature. This implies a basic interaction with terrestrial or marine Tertiary sediments. The results illustrate a downward transformational fluid flow systematic via the thick Tertiary sediment cover into the Upper Jurassic carbonate formation in the SGMB, highlighting a new understanding on the evolution of the Upper Jurassic groundwaters and a basin-wide recharge mechanism.

In this work the existence and nonexistence of stationary radial solutions to the elliptic partial differential equation arising in the molecular beam epitaxy are studied. Since we are interested in radial solutions we arrive at the following fourth-order differential equation

It is well understood that near midnight, the Harang Discontinuity separates the auroral duskside eastward electrojet (EEJ) and dawnside westward electrojet (WEJ) and associated plasma flows driven by enhanced magnetospheric convections via Magnetosphere-Ionosphere (M-I) coupling. There are conflicting reports regarding the significance of Region1 (R1) and R2 currents and the enhancement of Sub-Auroral Polarization Streams (SAPS) in the Harang region. We investigate the M-I conjugate Harang and SAPS phenomena using multipoint satellite observations. Results show the inner-magnetosphere (1) Harang region at midnight between the plasmapause and the closed/open field line boundary and (2) strong SAPS electric field (EX≈30 mV/m; in magnitude) in a fast-time voltage generator (VGFT) near the plasmapause, and the topside-ionosphere (3) Harang Discontinuity with R1 and R2 currents flown along, and (4) enhanced SAPS flow (~1,800 m/s) in the underlying VGFT system requiring no R2 currents. From these (1-4) findings we conclude (i) the significance of both R1 and R2 currents in the observed M-I conjugate Harang phenomenon’s development, (ii) the different development of the reversing EEJ-WEJ compared to the regular auroral EEJ and WEJ in the topside-ionosphere R1-R2 system, and (iii) the R2 currents’ absence in the enhanced SAPS flow newly formed in the VGFT system.

For over a decade, endoscopic hemostatic powders have been used to manage upper gastrointestinal bleeding (UGIB). Various preclinical benchtop and animal models have been developed to evaluate these devices. Multiple companies have released hemostatic powders to market, assessing their safety and efficacy using an established porcine gastric vessel bleed model. This model simulates an aggressive arterial bleed, allowing prototypes to be tested under challenging conditions. It requires a surgeon to insert an artery segment into the gastric lumen and puncture it to produce a bleed. In our study, we tested a control group not included in prior research. We aimed to evaluate the relationship between intragastric pressure and bleed severity by injecting gas used to deliver hemostatic powder to the bleed site, without administering hemostatic powder. Our results indicate that elevated intragastric pressures alone can cause bleed cessation. Additional findings suggest that other factors in the model can lead to false positive hemostasis. This study highlights flaws in the porcine gastric vessel bleed model and underscores the need to develop more robust models for testing hemostatic devices, as no valid endoscopic bleed model currently exists. These experiments stress the importance of vetting preclinical models before acquiring efficacy data.

Based on the nonlinear failure criterion and modified tangential technique, the upper bound solutions of supporting pressure on the deep tunnel face were obtained under pore water pressure conditions. The influence of parameters on the supporting pressure and collapse range was investigated according to the unlimited block failure mechanism. It is found that the upper bound solutions of supporting pressure increase with the growth of the nonlinear coefficient and pore water pressure coefficient. The collapse range of the tunnel face scales out with the increase of the nonlinear coefficient and shrinks when increasing the pore water pressure coefficient. Moreover, with the increase of the nonlinear coefficient, the impact strength on supporting pressure and collapse range declines gradually. According to the calculating results, it is manifest that both the pore water pressure and nonlinear criterion factors have negative impacts on the stability of the tunnel face. Thus, more attention should be paid to these parameters to ensure face stability in deep tunnel construction.

Mirror Therapy (MT) and Cognitive Therapeutic Exercise (CTE) are two neurorehabilitation techniques based on neuroplasticity and designed to enhance the functionality of the upper limb. Therefore, the aim is to assess the effectiveness of the combination of CTE and MT with task-oriented training (TOT) on fine and gross motor skills of the affected hand, as well as the functionality of the affected upper limb, autonomy, independence, and quality of life (QoL) in patients with acute stroke. This longitudinal and multicenter study involved a sample of 120 participants selected randomly and consecutively. Three groups were formed, including a control group (CG) and two treatment groups, one with MT and the other with CTE. The functionality of the upper limb, fine and gross motor skills, the quantity and quality of use of the affected upper limb, autonomy, and QoL were evaluated using various scales validated in the Spanish population at the baseline, after 20 treatment sessions, and at three months of follow-up. ANCOVA analysis was conducted, revealing statistically significant differences between assessments in the CG compared to the experimental groups (GEs), indicating a notable improvement in overall functionality, fine and gross motor skills, autonomy, and QoL in the latter. However, there were no significant differences between the GEs. Therefore, the application of either of these experimental combinations is crucial for the motor recovery, functionality, and improvement of the quality of life of individuals who have suffered a stroke.

The current study applied a new approach for the interpolation and regionalization of observed precipitation series to a smaller spatial scale (0.125° by 0.125° grid) across the Upper Indus Basin (UIB), with appropriate adjustments for the orographic effect and changes in glacier storage. The approach is evaluated and validated through reverse hydrology, guided by observed flows and available knowledge base. More specifically, the generated corrected precipitation data is validated by means of SWAT-modelled responses of the observed flows to the different input precipitation series (original and corrected ones). The results show that the SWAT- simulated flows using the corrected, regionalized precipitation series as input are much more in line with the observed flows than those using the uncorrected observed precipitation input for which significant underestimations are obtained.

So far, scientific studies on high frequency welding (HF) have observed the three main parameters: anode current, welding time and pressure of upper electrode. Some authors have also observed and studied the welding frequency, the power, and the values of the dielectric constants of the materials or the angle of dielectric losses. Due to the complex effects that the parameters have on the quality of the welded joint, it is necessary to extend the research and study the mutual relationships between a large numbers of process parameters on the welded joint in order to achieve satisfactory strength of the welded joint. In this research, the number of considered parameters is increased to 17, each of which is relevant to the processes of HF welding, and their mathematical equations are presented. The research is carried out on a HF welding machine improved with a linear pneumatic actuator for lowering the upper electrode and regulating the compressive force, and a measuring machine with the appropriate measuring method for determining the breaking forces with a tension gage and performing the „T“ test is made. Numerous researches were carried out on the functional changes of the process parameters of the percentage share of the values of the coupling capacitor, the anode current and the welding time on the values of the breaking forces of the welded joints. Based on the conducted research, it was concluded that the optimization of the process parameters of HF machine must be performed before the welding process, which is determined by a certain amount of energy that must be introduced into the material. These parameters are the capacity of the output capacitor, i.e., the value of the electric current flowing through the material and the time for the development of the operating power to produce welded joints with a certain strength and quality of welded joints for a specific material used in the process.

The challenging issues of Computer Network and Databases are not only the intrusion detection but also the reduction of false positive and increase of detection rate. In any intrusion detection system, anomaly detection mainly focuses on modeling the normal behavior of the users and detecting the deviations from normal behavior which are assumed to be potential intrusions or treat. Several techniques have already been successfully tried for this purpose. However, the normal and suspicious behavior are hard to predict as there is no precise boundary differentiat-ing one from another. Here rough set theory and fuzzy set theory come into the picture. In this article, a hybrid approach based on rough set theory and intuitionistic fuzzy set theory is pro-posed for the detection of anomaly. The proposed approach is a classification approach which takes the advantages of softness properties both rough and fuzzy set theory to deal with uncer-tainty in the dataset. The algorithm classifies the data instances in such a way that they can be expressed using natural language. The experimental results with a real world dataset and a syn-thetic dataset show that the proposed algorithm has normal true positive rates of 91.989% and 96.99% and attack true positive rates of 91.289% and 96.29% respectively