On April 17, 2019, a coach with tourists from Germany crashed in Madeira requiring repatriation by the German Air Force. The Advance Trauma Life Support (ATLS) concept was the central component of patient care. Data in Madeira were collected through a structured interview. The analysis of the Aeromedical Evacuation was based on intensive care transport records. In Germany all available were reviewed for data collection. Quality of life (HRQoL) was evaluated by the 12-item Short-Form Health Survey (SF-12). Twenty-eight prehospital patients were transported to the Level III Trauma Center in Funchal (Madeira). Five operative procedures were performed. Fifteen patients were eligible for Aeromedical Evacuation (AE). In the second hospital phase in Germany in total 82 radiological images and nine operations were performed. Hospital stay lasted 11 days (median, IQR 10–18). Median Follow-up (14 of 15 patients) was 16 months (IQR 16–21). 80% (8 out of 10) showed an increased risk for post-traumatic stress disorder (PTSD). Six key findings were identified in this study: divergent injury classification, impact of AE mission on health status, lack of communication, need of PTSD prophylaxis, patient identification, media coverage. Those findings may improve AE missions in the future e.g. required after armed conflicts.

Recent studies have demonstrated silk fibroin’s ability to extend the shelf life of foods by mitigating the hallmarks of spoilage, namely oxidation and dehydration. Due to the potential for this protein to become more widespread, its safety was evaluated comprehensively. First, a bacterial reverse mutation test (Ames test) was conducted in five bacterial strains. Second, an in vivo erythrocyte test was conducted with Sprague Dawley rats at doses up to 1,000mg/kg-bw/day. Third, a range-finder study was conducted with Sprague Dawley rats at the highest consumption amount given solubility and oral gavage volume constrains (500mg/kg-bw/day). Fourth, a 28-day study in Sprague Dawley rats was conducted at the 500mg/kg-bw/day amount. Fifth, an in vitro pepsin digestion assay was performed to assess the potential for protein allergenicity. Sixth, allergenic potential was further assessed using liquid chromatography-mass spectroscopy for detection of allergenic insect proteins. Seventh, the protein sequences were subjected to bioinformatic analyses. Together, these studies raise no mutagenic, carcinogenic, toxicological, or allergenic concerns with the oral consumption of silk fibroin.

The colpodellids consist of free-living predatory protists phylogenetically related to pathogenic Apicomplexan parasites such as Plasmodium species, Cryptosporidium sp. and Toxoplasma gondii. Among the colpodellids, Colpodella species prey on bodonids, algae, and ciliates. Voromonas pontica preys on Percolomonas species. In the past decade, Colpodella species have been reported to cause opportunistic infections in humans and animals, and having the potential for zoonotic infections in humans due to the presence of Colpodella species in ticks. In the reported cases, transmission and pathogenic stages of Col-podella were not identified by light microscopy. In the colpodellid V. pontica, cyst stages of both the pred-ator and its prey Percolomonas cosmopolitus have not been identified by light microscopy. In this study we evaluated the dye components used for Sam-Yellowe’s trichrome staining, from different major vendors to determine the consistency and reproducibility of the staining protocol to aid the use of the staining proto-col for diagnosis. We show that although slight variations in the color of the stained cells are obtained, life cycle stages of Colpodella ATCC 50594 could be clearly identified, regardless of the vendor used. For the first time, Sam-Yellowe’s trichrome staining series, could identify cysts of V. pontica and its prey, demonstrating that the staining protocol can identify life cycle stages of other colpodellids. Sam-Yellowe's trichrome staining will aid molecular diagnosis of infections caused by colpodellids in human and ani-mals, identify colpodellids in ticks and flies and from environmental samples, when used for staining.

The lexical analysis of seminal policy-to-diplomacy documents from the socio-environmental discourse of the last fifty year agendas allowed examining the evolution of five themes: resources/waste, pollution, social and economic development, justice, and health. Contextual affinities were strongest between resources, pollution, and health and are linked to societal trends and pressures. On those grounds, the central role of resource stewardship according to nature’s physical limits is highlighted, and dedicated concepts, analytical frameworks, and methodologies with different degrees of sustainability are analyzed. To reframe the identified social and economic problems, the work proposes criteria and choices that (1) allow to compare the dynamics of socioecological states across the planet, (2) help matching the pace of socioecological change by addressing path dependencies through participation and engagement of communities, and (3) enable stakeholders to make trade-offs and take decisions in specific social, economic, political, and cultural contexts. The prioritization of resource justice and responsibility becomes a societal project : from Wellfare State to commonfare communities.

(1) Background: Adolescent well-being is a multifaceted construct embedded in family, school, and peer socialization contexts. By adopting a social-psychological perspective we test the association between three sources of support (parents, teachers, peers) and specific components of subjective well-being (cognitive, affective, global-and-domain-specific) to determine whether there is a functional specialization of the role that these crucial socialization agents play for adolescents to attain well-being in specific life domains. (2) Methods: Cross-sectional Albanian data from Wave 3 of the Children’s Worlds International Survey (www.isciweb.org) were used, including 2,339 adolescents (age range 9-13; girls = 49.3%). A structural equation model (SEM) was employed to explore associations between supportive relationships with parents, teachers, and peers and adolescent well-being. (3) Results: Findings support a functional specialization hypothesis as parental support was significantly related to global cognitive and affective well-being; teacher support was significantly related with school satisfaction; and significant relations were found between peer support and almost all well-being variables (context-free, domain-based life satisfaction and affective subjective well-being). (4) Conclusions: Findings contribute to a more nuanced understanding of the role of supportive relationships with adults and peers in adolescents’ proximal socialization contexts (family, school, peer groups) and specific components of subjective well-being.

In the current industrial landscape, increasingly pervaded by technological innovations, the adoption of optimized strategies for asset management is becoming a critical key success factor. Among the various strategies available, the “Prognostics and Health Management” strategy is able to support maintenance management decisions more accurately, through continuous monitoring of equipment health and “Remaining Useful Life” forecasting. In the present study, Convolutional Neural Network-based Deep Neural Network techniques are investigated for the Remaining Useful Life prediction of a punch tool, whose degradation is caused by working surface deformations during the machining process. Surface deformation is determined using a 3D scanning sensor capable of returning point clouds with micrometric accuracy during the operation of the punching machine, avoiding both downtime and human intervention. The 3D point clouds thus obtained are transformed into bidimensional image-type maps, i.e., maps of depths and normal vectors, to fully exploit the potential of convolutional neural networks for extracting features. Such maps are then processed by comparing 15 genetically optimized architectures with the transfer learning of 19 pre-trained models, using a classic machine learning approach, i.e., Support Vector Regression, as a benchmark. The achieved results clearly show that, in this specific case, optimized architectures provide performance far superior (MAPE=0.058) to that of transfer learning which, instead, remains at a lower or slightly higher level (MAPE=0.416) than Support Vector Regression (MAPE=0.857).

Electric moped scooter sharing services have recently experienced strong growth rates, particularly in Europe. Due to their compactness, environmental-friendliness and convenience, shared e-mopeds are suitable modes of transport in urban mobility to help reduce the environmental impact. However, its traffic-related, economic and environmental effects are merely represented in academic research. We used passenger car traffic data in Berlin generated by the multi-agent transport simulation framework MATSim to develop a python-based simulation, resembling an e-moped sharing system. Based on the results, a total cost of ownership and a life cycle assessment for fleet sizes of 2,500, 10,000 and 50,000 vehicles were conducted. The results indicate that a substantial part of all passenger car trips in Berlin can be substituted. The larger the fleet, the more and longer trips are replaced. Simultaneously, the efficiency in terms of fleet utilization decreases. The scenario with 10,000 e-mopeds offers the lowest total distance-based costs for sharing operators, whereas a fleet consisting of 2,500 vehicles exhibits the lowest environmental emissions per kilometer driven over the expected lifespan of a shared e-moped. Based on the renewable energy potential for 2050 forecasted by the German Federal Environment Agency, a significant overall decline in environmental impacts can be achieved.

Ultraviolet light incident on organic material can initiate its spontaneous dissipative structuring into chromophores which can catalyze their own replication. This may have been the case for one of the most ancient of all chromophores dissipating the Archean UVC photon flux, the nucleic acids. Oligos of nucleic acids with affinity to particular amino acids which foment UVC photon dissipation would have been selected through non-equilibrium thermodynamic imperatives which favor entropy production. Indeed, we show here that those amino acids with characteristics most relevant to fomenting UVC photon dissipation are precisely those with greatest chemical affinity to their codons or anticodons. Entropy production could thus provide an explanation for the accumulation of information in nucleic acids relevant to the dissipation of the externally imposed thermodynamic potentials. The accumulation of information in this manner provides a link between evolution and entropy production.

The present paper reviews evidence for ecological evolution of Montiaceae. Montiaceae (Portulacineae) comprise a family of ca. 275 species and ca. 25 subspecific taxa of flowering plants distributed mainly in extreme western America, with additional endemism elsewhere, including other continents and islands. They have diversified repeatedly across steep ecological gradients. Based on narrative analysis, I argue that phylogenetic transitions from annual to perennial life history have been more frequent than suggested by computational phylogenetic reconstructions. I suggest that a reported phylogenetic correlation between the evolution of life history and temperature niche is coincidental and not causal. I demonstrate how statistical phylogenetic comparative analysis (PhCA) missed evidence for marked moisture niche diversification among Montiaceae. I discount PhCA evidence for the relation between Montiaceae genome duplication and ecological diversification. Based on the present analysis of Montiaceae evolution, I criticize the premise of the prevalent statistical approach to PhCA, which tests Darwinian deterministic hypotheses against stochastic evolutionary null models. I discuss theoretical/empirical evidence that evolution is neither stochastic, nor Darwinistically-determined, but idiosyncratic. Idiosyncraticity describes the outcome of a stochastically perturbed nonlinear chaos-like process. The Principle of Evolutionary Idiosyncraticity (PEI) is based on the evolutionary theory of Natural Drift, which maintains that determinism in evolution is a property of the organism and not, as maintained by the theory of Natural Selection, its traits or its milieu. This determinism is characteristic of chaotic functions, which are absolutely determinate, generate self-similarity, but remain absolutely unpredictable. PEI explains precisely observations that evolution proceeds not linearly, but chaotically, producing both quasi-linear fractal-like patterns and non-linear jumps. PEI has ramifications for all areas of macroevolutionary research. In particular, it demonstrates both the fallacy and futility of the statistical PhCA approach that interprets evolutionary causes in terms of evolutionary correlations. However, statistical methods of PhCA can be applied heuristically and fruitfully to reveal idiosyncraticity and discover evolutionary novelty. This, in turn, is demonstrated by the emergence of statistical anomalies in evolutionary analyses of Montiaceae.

All life on Earth uses three integrated molecular systems in which genetic information contained in DNA base sequences is transmitted to ribosomes by RNA and a genetic code, then translated into the amino acid sequences of structural and catalytic proteins. Therefore, the most important point for understanding the origin of life is to determine how such systems could emerge from random processes on the early Earth. In this review, two alternatives are compared: the RNA world hypothesis and the [GADV]-protein world hypothesis. [GADV] refers to four amino acids, Gly [G], Ala [A], Asp [D] and Val [V] that are conserved in the amino acid sequences of many common proteins. Here I will argue that the origins of the three primary processes required for life to begin can be better explained by the GADV hypothesis than the RNA world hypothesis. The GADV hypothesis also incorporates a conversion process by which random polymers can evolve into proteins with ordered sequences.

Background: Despite continuous improvements in revascularization techniques, refractory angina without potential revascularization options remains a relevant clinical issue with significant impact on patient’s quality of life. Recently, a novel device, the Coronary Sinus Reducer (CSR), has been introduced into clinical practice as a therapeutic option for patients with disabling angina pectoris. In this single-center, observational study, we evaluated the mid-term (3-month) safety and efficacy of the CSR in a real-world cohort. Methods: The study population consisted of 55 patients with refractory angina without potential revascularization options, predominantly men (87.3%) with a high cardiovascular risk factor burden and advanced angina (baseline CCS angina class 3.15 ± 0.6). In terms of procedure safety, all patients underwent successful device deployment with only one periprocedural complication. Results: At the 3-month follow-up we observed statistically significant improvement in angina control measured CCS class and SAQ-7 Total questionnaire along with increased abolition of physical limitation – 6-MWT (233.3 ± 107.1 vs 305.2 ± 126.8; p<0.0001). Additionally, we observed significant improvement in terms of quality of life measurements SF-36, the EQ-5D-5L questionnaire, and the EQ-VAS. Conclusions: Our real-world data suggest that CSR implantation is a relatively safe procedure and appears to be particularly effective in relieving angina symptoms and improving quality of life in subjects with refractory angina.

Abstract: Extensive research shows nurses’ work environment to be particularly stressful. This study develops, explores, and psychometrically tests a new profession specific ques-tionnaire identifying generalized and specific resistance resources, that make it possible to measure resources to manage work-related stress. An exploratory study design was em-ployed. The questionnaire was developed inspired by the MEASURE approach and the salutogenic theory of health. Building on the results from a literature review of nursing re-search and salutogenesis, supplemented by twelve interviews with hospital nurses, an item pool was generated. A first version was pilot tested in a group of nurses who were studying to become specialist nurses. A second version of the questionnaire was psycho-metrically tested on nurses in close patient care (n = 475), analysed using Principal Com-ponent Analysis as the extracting technique to identify the underlying structure of the questionnaire. The Principal Component Analysis revealed a four-component model of 19 items. “Manageability as a resource for handling the workload” was the strongest compo-nent, accounting for 21 % of the explained variance. “Contacts with patients as resources for nurses’ job satisfaction” (17.8 %). “Professional attitudes are labelled as resources to nursing” (15 %). “Colleagues are important resources for remaining in the nursing profes-sion” (11 %). The structure of the questionnaire indicates its usefulness in clinical practice for measuring resistance resources.

Quality of life (QOL) is based on their perception of their position in life in respect to their goals, expectations, standards, and concerns, as well as their culture and value systems, their workflow and workplace situations while it influences quality of services. In this study we aim to report on dental and nursing academians’ QOL and well-being at the end of the third year of the COVID-19 pandemic. The World Health Organization Quality of Life-BREF Scale (WHOQOL-BREF) tool, recording Physical, Psychological, Social and Environmental dimensions of QOL, was used. The WHOQOL-BREF was modified on a spiritual, coaching/mentoring approach in a two-step designing and validated procedure. The modified SHQOL-BREF (Spiritual Healthcare version) designed for this study, was uploaded, and filled in online during April-June 2023. Staff (N=120, 75% female) of both departments of Dentistry (44.2%) and Nursing (55.8%) of the National and Kapodistrian university of Athens, participated in anonymity. QOL in terms of physical health was reported at a higher level (M=72.2 points) compared to social relationships (M=69 points), psychological health (M=65 points) and environment (M=59 points) (scores reported in 0-100 score). Overall QOL was rated at 66 points while satisfaction from health at 72 points. Job satisfaction (M1=3.2) and spirituality (M2=3.0) were reported at a medium level in a 5-point scale, while personal beliefs and values were reported at a high level (M3=4.0). Participants age presented a significant, moderate to strong effect on physical health [F(3,97)=2.89, p<.05, η2p=.08] and on environment [F(3,97)=2.80, p<.05, η2p=.08] and marital status on social relationships [F(1,97)=9.66, p<.05, η2p=.09]. Married participants reported consistently higher levels of QOL compared to single participants, for all age groups. Department had a significant moderate effect on social relationships (F(1,97)=5.10, p<.05, η2p=.05) and education a significant moderate to strong effect on psychological health (F(2,97)=3.74, p<.05, η2p=.07). PhD level participants in both departments presented higher levels of psychological health compared to lower educational levels. Also, participants from the department of Dentistry reported higher levels of social relationships QOL in all educational groups, compared to the department of Nursing. Strategic planning on sustainability and QOL initiatives should be introduced after the COVID-19 pandemic for dental and nursing academic personnel to promote resilience and QOL scores.

Cognitive impairment in older adults is associated with poor gait performance, physical decline, falls and poor quality of life. This paper analyzes the feasibility and efficacy of a tango-based in-tervention in older people with cognitive impairment living in nursing homes. A multicenter study, with pre and post-test, was carried out. Intervention attendance, well-being, physical abilities (Short Physical Performance Battery), walking performance, functional capacities (Katz Index), and quality of life (Quality of Life in Alzheimer’s Disease) were assessed. Fifty-four participants (84.9 ± 6.7 years, Mini Mental State Examination 14.5 ± 7.4) completed the protocol. Intervention attendance was 92%, and the mean subjective well-being after each session was 4.5 ± 0.5 (on a five-point scale). Statistically significant improvement was found in the quality of life (p = 0.030). Non statistically significant changes were found in walking performance, physical abilities, or in functional capacities. The study shows feasibility and suggests evidence for the effects of Tango therapy on well-being and quality of life. Further studies are necessary to contrast these findings and to verify the role of Tango interventions as a holistic approach to prevent functional decline in older people with cognitive impairment.

Healthy aging among older adults requires the maintenance of good physical and cognitive activity. However, in the natural course of aging, older adults usually experience a decline in their physical and cognitive activity, causing an increasingly sedentary lifestyle. Some older adults may not have a choice but to become increasingly sedentary as they age due to injury or deteriorated physicality. As such they require a manner of assistive technologies to aid in their daily lives and activities to maintain healthy cognitive function. Social Robots are a newer form of assistive technology, specifically designed for social interactions and gameplay. As with other assistive technologies, compliance barriers to the acceptance and use of social robots and types of meaningful, seated activities among older adults are expected. To better explore this phenomenon, improve quality of life and understand what drives older adults to accept and use newer forms of technology like social robots, this research conjoins two conceptual frameworks: The Activity Theory of Aging (ATA) and the Unified Theory of Acceptance and Use of Technology (UTAUT). As social robots hold great promise for improving the quality of life for older adults, exploring what driving factors could enable their greater acceptance and use is essential to furthering this field of study within Australia.

Supermarkets in Port Harcourt (PH) city, Nigeria, predominantly rely on diesel electricity generation due to grid instability, leading to high cost of electricity prices. Although solar photovoltaic (PV) systems have been proposed as an alternative, these supermarkets have yet to adopt them, mainly due to high investment costs and a lack of awareness of the long-term financial and environmental benefits. This paper examines the technical and economic practicality of a PV system for these supermarkets using the PVsyst software and a spreadsheet model. Solar resources showed that PH has a daily average solar radiation and temperature of 4.21 kWh/m2/day and 25.73℃, respectively. Market Square, the supermarket with the highest peak power demand of 59.8 kW, and a 561 kWh/day load profile, was chosen as a case study. A proposed PV system with a power capacity of 232 kW, battery storage capacity of 34,021 Ah, a charge controller size of 100 A/560V, and an inverter with a power rating of 60V/75 kW has been designed to meet the load demand. The economic analysis showed a $266,936 life cycle cost, $0.12 per kWh levelized cost of electricity (LCOE), 4-year simple payback time, and a 20.5% internal rate of return (IRR). The PV system is feasible due to its positive net present value (NPV) of $165,322 and carbon savings of 582 tCO2/year.

The physiological response to a psychological stressor broadly impacts energy metabolism. In-versely, changes in energy availability affect the physiological response to the stressor in terms of hypothalamus, pituitary adrenal axis (HPA) and sympathetic nervous system activation. Glu-cocorticoids, the endpoint of the HPA axis, are critical checkpoints in endocrine control of ener-gy homeostasis and have been linked to metabolic diseases including obesity, insulin resistance and type 2 diabetes. Glucocorticoids, through the glucocorticoid receptor, activate transcription of genes associated with glucose and lipid regulatory pathways and thereby control both physi-ological and pathophysiological systemic energy homeostasis. Here, we summarize the current knowledge of glucocorticoid functions in energy metabolism and systemic metabolic dysfunc-tion, particularly focusing on glucose and lipid metabolism. There are elements in the external environment that induce lifelong changes in the HPA axis stress response and glucocorticoid levels, the most prominent are early-life adversity, or exposure to traumatic stress. We hypothe-sise that when the HPA axis is so disturbed after early-life adversity, it will fundamentally alter hepatic gluconeogenesis, inducing hyperglycaemia, and hence crystalise the significant lifelong risk of developing either the metabolic syndrome, or type 2 diabetes. This gives a “Jekyll and Hyde” role to gluconeogenesis, providing the necessary energy in situations of acute stress, but driving towards pathophysiological consequences when the HPA axis has been altered.

This paper presents a new methodology to derive and analyze strategies for a fully decarbonized urban transport system which combines conceptual vehicle design, a large-scale agent-based transport simulation, operational cost analysis, and life cycle assessment for a complete urban region. The holistic approach evaluates technical feasibility, system cost, energy demand, transportation time and sustainability-related impacts of various decarbonization strategies. In contrast to previous work, the consequences of a transformation to fully decarbonized transport system scenarios are quantified across all traffic segments, considering procurement, operation and disposal. The methodology can be applied to arbitrary regions and transport systems. Here, the metropolitan region of Berlin is chosen as a demonstration case. First results are shown for a complete conversion of all traffic segments from conventional propulsion technology to battery electric vehicles. The transition of private individual traffic is analyzed regarding technical feasibility, energy demand and environmental impact. Commercial goods, municipal traffic and public transport are analyzed with respect to system cost and environmental impacts. We can show a feasible transition path for all cases with substantially lower greenhouse gas emissions. Based on current technologies and today’s cost structures our simulation shows a moderate increase in total systems cost of 13-18%.

1) Background: Capturing patients’ medical histories significantly influences clinical decisions. Errors in this process lead to clinical errors, increase costs and dissatisfaction among physicians and patients. Physicians in developing countries are overloaded with patients and cannot always follow the proper history-taking procedure. The challenges are acknowledged; however, a comprehensive understanding of the status and the remedies remained unexplored. 2) Objective: This paper aims to investigate the workload, history-taking challenges, and the willingness of the physicians to accept digital solutions. 3) Methods: A cross-sectional online survey was conducted on 104 physicians across Bangladesh, featuring 22 questions regarding their professional environment, workload, digitization status of health records, challenges in history-taking, and attitudes toward adopting digital solutions for managing patient histories; 4) Results: 92.67% of the physicians face workloads, 88.46% struggle in medical history-taking, and only 4.81% use digital medical records. About 70% struggle to complete the necessary history-taking steps, emphasizing the urgent need for solutions. An AI-based Smart Health Gantt Chart (SHGC) system has been introduced for their instant feedback. 93.27% of physicians expressed their willingness to use such a system. 5) Conclusions: The proposed SHGC has the potential to enhance healthcare efficiency in developing nations, benefit physicians, and improve patient-centered care.

BACKGROUND: Over the past few years, there has been an increasing interest to view the diagnosis of Familial hypercholesterolemia (FH) through the lens of the biopsychosocial model. However, other than a few epidemiological surveys, there is a dearth of studies from emerging economies that have examined FH using the biological, psychological and socio-environmental facets of the aforementioned model. AIM. The three aims of the current study were as follows: (i) to examine the psychosocial status among patients with genetically confirmed FH, (ii) to compare the intellectual capacity and cognitive outcomes with a reference group, and (iii) to examine the relationship between health literacy and cognitive functioning. METHOD: Consecutive FH patients referred to the lipid clinic at a tertiary care center for an expert opinion were recruited into this study, conducted from September 2019 to March 2020. Information regarding psychosocial functioning, health literacy, quality of life, and affective ranges were surveyed. Indices of current reasoning ability (attention and concentration, memory, and executive functioning) were compared with an age-matched reference group. The current hypothesis also explored the impact of FH on health literacy and cognition. RESULT: A total of 70 participants out of 106 (response rate: 66.0%) initially agreed to participate. However, 18 out of 70 dropped out of the study, yielding a final total of 52 FH patients. With 27 (51.9%) males and 25 (48.1%) females, the mean participant age stood at 37.2 years (SD=9.2), ranging from 21 to 52 years of age. In the psychosocial data, thirty-two percent (n=17) of them had anxiety (HADS≥ 8), and twenty-five percent (n=13) had depressive symptoms (HADS≥ 8). The performance of the FH patients was significantly impaired compared to the control group on the indices of current reasoning ability and all domains of cognitive functioning. In univariate analysis conducted to compare cognitive functioning with health literacy status, only indices of attention and concentration emerged as being significant. CONCLUSION: To date, there are only a few studies employing the biopsychosocial paradigm to investigate the FH population. The current study indicates that the FH population is marked by an impediment in almost all of the core features that are characteristically assessed by the biopsychosocial approach.

The multidimensionality of chronic pain forces us to look beyond isolated pain assessment such as pain intensity, which does not consider multiple key parameters, particularly in patients suffering from post-operative Persistent Spinal Pain Syndrome (PSPS-T2). Our ambition was to provide a novel Multi-dimensional Clinical Response Index (MCRI), including not only pain intensity but also functional capacity, anxiety-depression, quality of life and objective quantitative pain mapping assessments, the objective being to capture patient condition instantaneously, using machine learning techniques. Two hundred PSPS-T2 patients were enrolled in a real-life observational prospective PREDIBACK study with 12-month follow-up and received various treatments. From a multitude of questionnaires/scores, specific items were combined using exploratory factor analyses to create an optimally accurate MCRI; as a single composite index, using pairwise correlations between measurements, it appeared to better represent all pain dimensions than any other classical score. It appeared to be the best compromise among all existing indexes, showing the highest sensitivity/specificity related to Patient Global Impression of Change (PGIC). Novel composite indexes could help to refine pain assessment by changing the physician’s perception of patient condition on the basis of objective and holistic metrics, and by providing new insights to therapy efficacy/patient outcome assessments, before ultimately being adapted to other pathologies.

Cisplatin (CDDP) is a platinum-based drug effective against various cancers, including lung, bladder, prostate, ovarian, esophageal, stomach, and cervical cancer and malignant lymphoma. It plays a central role as the first choice in current anticancer therapy. However, CDDP causes serious side effects, such as neurological disorders, myelosuppression, and renal damage, because it is a small molecule indiscriminately distributed in normal tissues. Therefore, it is very important to prevent or attenuate CDDP toxicity. We hypothesized that liposomalization of CDDP could alleviate serious side effects. Therefore, this study aimed to evaluate the safety and efficacy of CDDP liposomes. A patient with multiple recurrent liver metastases from metastatic nasal carcinoma was administered CDDP liposomes with consent. Magnetic resonance imaging showed that the patient remained stable-diseased; however, no apparent side effects were observed, and blood draw data showed no worsening of renal function. Patients undergoing partial pancreatectomy and jejunoileal biliary anastomosis for biliary tract cancer who consented to receive CDDP liposomes demonstrated a partial response on angiographic computed tomography; however, they showed slight fatigue. To our knowledge, the present study is the first in Japan to suggest that liposomalization of CDDP may have anticancer effects while alleviating renal damage and bone marrow suppression.

Remaining service life (RSL) of pavement, as a sign of future pavement performance, has always received growing attention from pavement engineers. The RSL describes the time from the moment of pavement inspection until such a time when a major repair or reconstruction is required. The conventional approach to determining RSL involves using non-destructive tests. These tests, in addition to being costly, interfere with traffic flow and compromise users' safety. In this paper, surface distresses of pavement have been used to estimate the pavement’s RSL in order to eliminate the aforementioned problems and challenges. To implement the proposed theory, 105 flexible pavement segments were taken from Shahrood-Damghan Highway (Highway 44) in Iran. For each pavement segment, the type, severity, and extent of surface damage and pavement condition index (PCI) were determined. The pavement RSL was then estimated using non-destructive tests include Falling Weight Deflectometer (FWD) and Ground Penetrating Radar (GPR). After completing the dataset, the modeling was conducted to predict RSL using three techniques include Support Vector Regression (SVR), Support Vector Regression Optimized by Fruit Fly Optimization Algorithm (SVR-FOA), and Gene Expression Programming (GEP). All three techniques estimated the RSL of the pavement by selecting the PCI as input. The Correlation Coefficient (CC), Nash-Sutcliffe efficiency (NSE), Scattered Index (SI), and Willmott’s Index of agreement (WI) criteria were used to examine the performance of the three techniques adopted in this study. In the end, it was found that GEP with values of 0.874, 0.598, 0.601, and 0.807 for CC, SI, NSE, and WI criteria, respectively, had the highest accuracy in predicting the RSL of pavement.

A revitalized practice of natural philosophy can help people to live a better life and promote a flourishing ecosystem. Such a philosophy is natural in two senses. First, it is natural by seeking to understand the whole of nature, including mental phenomena, In particular, a comprehensive natural philosophy should address the phenomena of sentience by embracing first- and second-person methods of investigation. Moreover, to expand our understanding of the world, natural philosophy should embrace a full panoply of explanations, similar to Aristotle’s four causes. Second, such a philosophy is natural by being grounded in human nature, taking full account of human capacities and limitations. Future natural philosophers should also make use of all human capacities, including emotion and intuition as well as reason and perception, to investigate nature. Finally, since the majority of our brain's activities are unconscious, natural philosophy should explore the unconscious mind with the aim of deepening our relation to the rest of nature and enhancing well-being.

The building sector has a big potential to reduce the material resource demand needed for building construction and therefore, greenhouse gas (GHG) emissions. Digitalisation can help to make use of this potential and improve sustainability throughout the entire building’s life cycle. One way to address this potential is through the integration of Life-Cycle Assessment (LCA) into the building process by employing Building Information Modelling (BIM). BIM can reduce the effort needed to carry out an LCA and therefore facilitate the integration into the building process. A review of current industry practice and scientific literature shows two main approaches to address BIM-LCA integration. Either the LCA is performed in a simplified way at the beginning of the building process, or it is done at the very end when all the needed information is available, but it is too late for decision-making. One reason for this is the lack of methods, workflows and tools to implement BIM-LCA integration over the entire building process. Therefore, the main objective of this study is to develop an integrated BIM-LCA workflow implemented into a method for the whole building process using an existing structure for cost estimation. A tool is created and used in a case study in Switzerland to test the developed approach. The results of this study show that LCA can be performed continuously in each building phase over the entire building process using existing BIM modelling techniques. The main benefit of this approach is that the re-work caused by the need for re-entering data and the usage of many different software tools that characterise most of the current LCA practices is minimised. Furthermore, decision-making, both at the element and building levels, is supported.

There are no theorems (proven theories) in the biological sciences. We propose that the 3 31 nt minihelix tRNA evolution theorem be universally accepted as one. The 3 31 nt minihelix theorem completely describes evolution of type I and type II tRNAs from ordered precursors (RNA repeats and inverted repeats). Despite diversification of tRNAome sequences, statistical tests overwhelmingly support the theorem. Furthermore, the theorem relates the dominant pathway for the origin of life on Earth, specifically, how tRNAomes and the genetic code may have coevolved. Alternate models for tRNA evolution (i.e., 2 minihelix, convergent and accretion models) are falsified. In the context of the pre-life world, tRNA was a molecule that via mutation could modify anticodon sequences and teach itself to code. We relate the clearest history to date of the chemical evolution of life on Earth. From analysis of tRNA evolution, ribozyme-mediated RNA ligation was a primary driving force in evolution of complexity during the pre-life to life transition on Earth.

We consider the financial planning problem of a retiree wishing to enter a retirement village at a future uncertain date. The date of entry is determined by the retiree's utility and bequest maximisation problem within the context of uncertain future health states. In addition, the retiree must choose optimal consumption, investment, bequest and purchase of insurance products prior to her full annuitisation on entry to the retirement village. A hyperbolic absolute risk-aversion (HARA) utility function is used to allow necessary consumption for basic living and medical costs. The retirement village will typically require an initial deposit upon entry. This threshold wealth requirement leads to exercising the replication of an American put option at the uncertain stopping time. From our numerical results, active insurance and annuity markets are shown to be a critical aspect in retirement planning.

Several studies have shown that physical activity (PA) is related to physical and mental health. Yet, there are few studies on the frequency of PA as it relates to health and a healthy lifestyle. The purpose of this study was to investigate the relationship between the frequency of practicing different types of physical activities (dependent variables), living a healthy lifestyle (BMI, smoking and alcohol consumption), physical health (sum of all doctor visits except psychiatrists) and mental health (a sum of visits to psychiatrists) at different ages (independent variables). We fo-cused on three types of PA: (1) medium to high-intensity aerobic exercises; (2) low to medium intensity relaxing and stretching exercises, (3) outdoor leisure PA. 9,617 participants (ages: 19 -81) were included in the study (with health registries over a period of 10 years prior to a cross-sectional survey). Descriptive statistics and multinomial logistic regression on frequencies of three types of PA and factors related to health and healthy lifestyles, as well as age and sex, were performed in this study. The results indicate that a higher frequency of practicing PA had a higher probability of association with the following factors: lower BMI, less or non-smoking behavior (types 1 & 3); higher education (types 1 & 2); higher age (types 2 & 3) and better physical health (type 1). Occasional (practicing sometimes) PA, type 2, was positively associated with poorer mental health (higher number of psychiatrist visits). Women were more likely to practice PA type 2, and men – PA types 3 & 1. Conclusion: In general, a higher frequency of PA is related with better health and healthy life styles; with the exception of PA type 2 that is related to poorer mental health.

Spinal Cord Stimulation (SCS) is an effective and validated treatment to address chronic refractory neuropathic pain in Persistent Spinal Pain Syndrome-Type 2 (PSPS-T2) patients. Surgical SCS lead placement is traditionally performed under general anesthesia due to its invasiveness. In parallel, recent works have suggested that Awake Anesthesia (AA), consisting in Target Controlled Intra-Veinous Anesthesia (TCIVA), could be an interesting tool to optimize lead anatomical placement using patient intra-operative feedback. We hypothesized that combining AA with Minimal Invasive Surgery (MIS) could improve SCS outcomes. The goal of this study was to evaluate SCS lead performance (defined by the area of pain adequately covered by paraesthesia generated via SCS), using an intraoperative objective quantitative mapping tool, and secondarily to assess pain relief, functional improvement and change in quality of life with a composite score. We analyzed data from a prospective multicenter study (ESTIMET) to compare the outcomes of 115 patients implanted with MIS under AA (MISAA group) or General Anesthesia (MISGA group), or by Laminectomy under General Anesthesia (LGA group). All in all, MISAA appears to show significantly better performance in terms of patient pain coverage, as well as improved secondary outcomes. One step further, our results suggest that MISAA combined with intra-operative hypnosis could potentialize patient intraoperative cooperation and could be proposed as a personalized package offered to PSPS-T2 patients eligible for SCS implantation in highly dedicated neuromodulation centers.

"Redesigning Education: A Transformative Approach" outlines comprehensive strategies for re-forming educational systems from primary to secondary levels to promote holistic student de-velopment. Traditional educational models fail to address diverse learning needs and cultivate critical thinking, creativity, and emotional intelligence. This study introduces innovative approaches such as personalized education through AI, wellness schools, professional skill development programs, and social and emotional learning (SEL) integration. The methodology includes an extensive literature review of contemporary educational books, peer-reviewed articles, and case studies from highly developed European countries, ensuring that the proposed strategies are grounded in credible and current research. Key reforms include continuous professional development for teachers, enhanced teacher training and support, comprehensive counseling services, and robust support systems for students. Strengthening school-family collaboration and promoting multiculturalism through inclusive policies and cultural events are emphasized. Additionally, upgrading school infrastructure to create safe and welcoming learning environments is essential for student prosperity. The proposed educational reforms aim to create an inclusive, innovative, and supportive learning environment, ensuring students thrive academically, emotionally, and socially. By integrating these comprehensive reforms, the study seeks to develop effective educational systems that foster student well-being and excellence, equipping future generations for success in a rapidly evolving world.

The Late Heavy Bombardment Period (4.1 to 3.8 billion years ago) of heightened impact cratering activity on young Earth is likely the driving force for the origin of life. During the Eoarchean, asteroids such as carbonaceous chondrites delivered the building blocks of life and water to early Earth. Asteroid collisions created innumerable hydrothermal crater lakes in the Eoarchean crust which inadvertently became the perfect cradle for prebiotic chemistry. These hydrothermal crater lakes were filled with cosmic water and the building blocks of life. forming a thick prebiotic soup. The unique combination of exogenous delivery of extraterrestrial building blocks of life, and the endogenous biosynthesis in hydrothermal impact crater lakes very likely gave rise to life. A new symbiotic model for the origin of life within the hydrothermal crater lakes is here proposed. In this scenario, life arose around four billion years ago through five hierarchical stages of increasing molecular complexity: cosmic, geologic, chemical, information, and biological. During the prebiotic synthesis, membranes first appeared in the hydrothermal crater lakes, followed by the simultaneous origin of RNA and protein molecules, creating the RNA/protein world. These proteins were noncoded protein enzymes that facilitated chemical reactions. RNA molecules formed in the hydrothermal crater basin by polymerization of the nucleotides on the montmorillonite mineral substrate. Similarly, the initial synthesis of abiotic protein enzymes was mediated by the condensation of amino acids on pyrite surfaces. The regular wet-dry cycles within the crater lakes assisted further concentration, condensation, and polymerization of the RNAs and proteins. Lipid membranes randomly encapsulated amino acids, RNA, and protein molecules from the prebiotic soup to initiate a molecular symbiosis inside the protocells, this led to the hierarchical emergence of several cell components. As the role of protein enzymes became essential for catalytic process in the RNA/protein world, Darwinian selection from noncoded to coded protein synthesis led to translation systems and the genetic code, heralding the information stage. In this stage, the biochemical pathways suggest the successive emergence of translation machineries such as tRNAs, aaRS, mRNAs, and of ribosomes for protein synthesis. The molecular attraction between tRNA and amino acid led to the emergence of translation machinery and the genetic code. tRNA is an ancient molecule that created mRNA for the purpose of storing amino acid information like a digital strip. Each mRNA strand became the storage device for genetic information that encoded the amino acid sequences in triplet nucleotides. As information became available in the digital languages of the codon within mRNA, biosynthesis became less random and more organized and directional. The original translation machinery was simpler before the emergence of the ribosome than that of today. We review three main concepts on the origin and evolution of the genetic code: the stereochemical theory, the coevolution theory, and adaptive theory. We believe that these three theories are not mutually exclusive, but are compatible with our coevolution model of translations machines and the genetic code. We suggest biosynthetic pathways as the origin of the translation machine that provided the framework for the origin of the genetic code. During translation, the genetic code developed in three stages coincident with the refinement of the translation machinery: GNC code with four codons and four amino acids during interactions of pre-tRNA/pre-aaRS /pre-mRNA, SNS code consisting of 16 codons and 10 amino acids appeared during the tRNA/aaRS/mRNA interaction, and finally the universal genetic code evolved with the emergence of the tRNA/aaRS/mRNA/ribosome machine. The universal code consists of 64 codons and 20 amino acids, with a redundancy that minimizes errors in translation. To address the question of the origin of the biological information system in the RNA/protein world, we converted letter codons into numerical codons in the Universal Genetic Code Table. We developed a software called CATI (Codon-Amino Acid-Translator-Imitator) to translate randomly chosen numerical codons into corresponding amino acids and vice versa, gaining insight into how translation might have worked in the RNA/protein world. We simulated the likely biochemical pathways for the origin of translation and the genetic code using the Model-View-Controller (MVC) software framework, and the translation machinery step-by-step. We used AnyLogic software to simulate and visualize the evolution of the translation machines and the genetic code. We conclude that the emergence of the information age from the RNA/protein world was a watershed event in the origin of life about four billion years ago.