: Intracellular tripeptide glutathione is an important agent of cell survival in hypoxia. Glutathione covalently binds to SH-groups of hemoglobin cysteine residues, protecting them from irreversible oxidation and changes its affinity to oxygen. Reduced glutathione (GSH) can also form a non-covalent complex with hemoglobin. Previously, we showed that hemoglobin tetramer has four noncovalent binding sites of glutathione GSH molecules inside, two of which are released during hemoglobin transition to deoxy form. In this study, we characterized the conserved cysteine residues and residues of non-covalent glutathione binding sites in the sequences of a number of hypoxia tolerant and hypoxia-sensitive mammals. The alpha subunit of all species considered was found to have no conserved cysteines, whereas the beta subunit contains Cys94 residue, which is conserved across species and whose glutathionylation changes the affinity of hemoglobin for oxygen 5-6-fold. In addition, the key residues of noncovalent glutathione binding sites in both alpha and beta subunits are absolutely conserved in all species considered, suggesting a common mechanism of hemoglobin redox regulation for both hypoxia-sensitive and hypoxia-tolerant mammals. The solvent accessibility of all HbA and HbB residues in oxy- and deoxy- forms was analyzed. The key residue betaCys94 is solvent accessible only in the deoxy form.

This paper presents the mathematical modeling for designing a 10[kW] DC-AC inverter system from 48 [V] DC to 120 V ACrms, considering its non-linear operation, allowing to obtain a detailed simulation to assess the proposed fuzzy PI control (with anti-windup action) and its optimal operation. The performance assessment of the converter was carried out with the discrete treatment of the voltage and current signals using spectral analysis, filtering considerations, and evaluation of limit cycle technique to determine the system's stability. The main results showed that THD at the filter output (transformer and capacitor) was around 0.0322% and 0.0632% at nominal load in open loop and closed loop, respectively. The inverter system presented more sensitivity in the current signal with a ripple at 120 [Hz] of 2.02% and at 5000 [Hz] of 10.62% (at nominal load). However, when the system operates in a closed loop, the current ripple at 120 [Hz] is 2.38% and at 5000 [Hz] is 10.62%.

(1) Background: It is crucial to provide safe and knowledgeable healthcare practices because no research has been done on the knowledge and usage patterns of NSAIDs among the Hail population. (2) Method: Structured questionnaires were utilized to gather data from 399 individuals in Hail, Saudi Arabia for the cross-sectional analysis. The study assessed participants' knowledge regarding NSAIDs, patterns of use, reasons for use, and awareness of potential side effects. (3) Results: In the study, the gender distribution indicated that 170 participants (42.61%) were male, while 229 (57.39%) were female. Gender, occupation, and marital status showed non-significant associations (p>0.01), except for menstrual cycle and joint pain, where marital status displayed significant associations. Age had significant associations with muscle pain, menstrual cycle, and joint pain (p<0.01). Education and monthly income exhibited non-significant associations for all the reasons. The regression analysis demonstrated that gender played a significant role, with females having higher odds of knowledge (AOR = 1.75, 95% CI 1.10-2.88) than males. Age also had a notable impact, with individuals aged 50-59 (AOR = 0.21, 95% CI 0.07-0.66) exhibiting lower odds of knowledge. Education holding a Ph.D (AOR = 3.50, 95% CI 0.54-22.51) and business as an occupation (AOR = 6.12, 95% CI 1.10-35.10) had significantly higher odds of knowledge while housewives (AOR = 0.76, 95% CI 0.25-2.27) had lower odds. Meanwhile, >50% of the participants had knowledge of adverse events related to the use of NSAIDs while 25% had no knowledge. Moreover, 59 (25.766%) participants reported discomfort with the use of NSAIDs. In addition, 50% and >75% of participants’ considered NSAIDs can cause peptic ulcers and damage kidneys, respectively (4) Conclusions: This study shed light on the knowledge and patterns of NSAIDs use in the population of Hail, Saudi Arabia. While NSAIDs are commonly utilized for pain management, there exists a need for improved public awareness regarding potential risks and safe usage practices. Healthcare providers and policymakers should consider these insights to develop targeted educational initiatives and healthcare interventions to promote safe and informed NSAID utilization in the region.

This study aimed to investigate the effects of jet-milling on lutein extraction contents of spinach powder (SP) and pulsed electric fields as a non-thermal pasteurization technology on spinach juice (SJ) to preserve lutein contents. SP particles were divided into SP-coarse (Dv50 = 315.2 μm), SP-fine (Dv50 = 125.20 μm), and SP-superfine (Dv50 = 5.59 μm) fractions and SP-superfine was added to SJ due to the highest contents of lutein extract. The PEF and thermal treatment were applied to evaluate the effects of preserving the lutein content of PEF during storage (25 days). The juice after being designated to untreated (no pasteurization), PEF1,2 (SJ treated with PEF 20 kV/cm 110 kJ/L, 150 kJ/L), Thermal1,2 (SJ treated with 90 ℃, 10 min and 121 ℃, 15 min). The sizes and surface shapes of superfine SP particles were more homogeneous and smoother than the other samples. SJ made with SP-superfine and treated by PEF had the highest lutein content and antioxidant activities among the group. Complex of jet-milling and PEF pasteurization could be great potential technologies to improve the lutein contents of lutein-enriched juice in the food industry.

There were designed and synthesized two new sulfone 2-aminobenzimidazole derivatives. Coordination compounds were obtained with nickel(II), copper(II), zinc(II), cadmium(II) and mercury(II) and these novel ligands. There were fully characterized by spectroscopic and analytical techniques. Single crystal X-ray structural analysis was performed on order to study the relevant intra and inter non-covalent interactions, mainly H...π, lone pair·...π, π...π, highlighting the difference between the ethyl and phenyl groups in such interactions. Dimeric and trimeric supramolecular syntons were found for some of these compounds. Their biological activity was investigated, being the copper(II) compounds with the sulfone phenyl derivative the most active.

Preterm infants often experience frequent intermittent hypoxia (IH) episodes which is associated with neuroinflammation. We tested the hypotheses that early caffeine and/or non-steroidal in-flammatory drugs (NSAIDs) confer superior therapeutic benefits for protection against IH-induced neuroinflammation than late treatment. Newborn rats were exposed to IH or hy-peroxia (50% O2) from birth (P0) to P14. For early treatment, the pups were administered: 1) dai-ly caffeine citrate (Cafcit, 20 mg/kg IP loading on P0, followed by 5 mg/kg from P1-P14); 2) ke-torolac topical ocular solution in both eyes from P0 to P14; 3) ibuprofen (Neoprofen, 10 mg/kg loading dose on P0 followed by 5 mg/kg/day on P1 and P2); 4) caffeine+ketorolac co-treatment; 5) caffeine+ibuprofen co-treatment; or 6) equivalent volume saline. On P14, animals were placed in room air (RA) with no further treatment. For late treatment, pups received similar treatments from P15-P21 (caffeine and/or ketorolac), or P15-P17 (ibuprofen). RA control were similarly treated. At P21, whole brains were assessed for histopathology, apoptosis, mye-lination, and biomarkers of inflammation. IH caused significant inflammation, reduced mye-lination, and apoptosis in preterm rat brains, an effect that was improved predominantly with combined caffeine/NSAID early treatment. Early caffeine/NSAID co-treatment confers syner-gistic neuroprotection against IH-induced damage.

Autoantibodies against specific lung cancer-associated antigens have been suggested for lung cancer diagnosis. This study aimed to evaluate the diagnostic performance of anti-gen-autoantibody immune complex (AIC) against its free antigens for CYFRA21-1, ProGRP, NGAL, and NSE in non-small cell lung cancer (NSCLC). In total, 85 patients with NSCLC and 120 healthy controls (HCs) were examined using a 9G DNA chip method. The ratios of AICs to their antigens and combinations of ratios consisting of two to four markers were calculated. The levels of AICs for CYFRA21-1, ProGRP, NGAL, and NSE were higher than their free antigens in all participants. The levels of each free antigen distinguished patients with NSCLC from HCs. The ratios of AIC to its antigen and seven combinations consisting of two to four ratios were significantly higher in patients with NSCLC than those in HCs. Excellent diagnostic performance was observed for all combination ratios (C4-1), with 85.9% sensitivity and 86.7% specificity at cutoff 3.51. Higher sensitivity was observed in the very early stages (0–I) and adenocarcinoma than in stages II–IV and other pathological types. The combination of all ratios of AICs and their antigens for all four markers is useful in the diagnosis of NSCLC.

The Coronavirus Disease 2019 (COVID-19) pandemic has had a major impact on the mental and physical health of hospitalized patients. In our study we focused on the onset of symptoms correlated with Post-traumatic stress disorder (PTSD), depression and physical disabilities in patients admitted to the Intensive Care Unit (ICU) because of a severe respiratory distress related to COVID-19 (COVID Group) compared with patients admitted to the same ICU for trauma and other medical conditions than COVID-19 (No-COVID Group). The physical symptoms and the level of disability were evaluated with the Glasgow Outcome Scale-Extended (GOS-E), the Quality of Life after Brain Injury (QOLIBRI) and the 3 levels version of EQ-5D (EQ-5D-3L) questionnaire; psychiatric symptoms were investigated using the Impact of Event Scale-Revised 22-item (IES-R), the Patient Health Questionnaire, 9-Item Version (PHQ-9) and the Generalized Anxiety Disorder Assessment, 7-items version (GAD-7). These questionnaires were administered 6 months after discharge. Patients in the No-COVID Group showed statistically significant more severe scores in all the physical assessments while similar relevant PTSD and depressive symptoms were reported in both groups. The results of the present study underline the psychopathological impact of being hospitalized in ICU because of COVID-19 even after 6 months from discharge ,suggesting the importance of assessing the psychiatric effects of COVID-19 in the long term in order to create supportive measures.

This paper presents an analysis of the sensitivity of controlling an autonomous surface object among a group of encountered objects to the inaccuracy of state control process data. For this purpose, a safe and optimal model of the control process was defined. An algorithm for determining the optimal and safe trajectory of an object, based on the multi-object game model, was developed; for comparative analysis, an algorithm for calculating only the optimal trajectory, not taking into account the maneuverability of other objects, was additionally developed. First, simulation-based studies of the algorithms enabled a comparative analysis of a number of different acceptable strategies for optimally shifting the trajectory of maneuvering objects from a single initial direction. Thereafter, the main goal of this paper was implemented: an analysis of the sensitivity characteristics of safe control, assessed with the risk of collision, both on the inaccuracy of navigation data and on the number of possible control strategies. Finally, final conclusions and a plan for further research on the subject of the paper were formulated.

Background. There are scant data about the effectiveness of high flow nasal cannula (HFNC) oxygen therapy in patients hospitalized with severe acute respiratory failure (ARF) in non-intensive medical wards, particularly regarding the effect on arterial oxygenation compared to conventional oxygen therapy (COT) and non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP). Methods. In a retrospective observational study, oxygenation parameters were measured before and immediately after HFNC initiation in 37 consecutive patients hospitalized in a geriatric ward in 2017. Results. HFNC was used as escalation therapy for untreatable hypoxia after failure of NIV/CPAP (n=18) or COT (n=19). Twenty-two patients died, 2 were transferred to the intensive care unit, while 13 were discharged alive. A “do not intubate” status was identified in 17 of the 22 deceased patients. Partial pressure of oxygen (pO2, p< 0.0001), oxygen saturation (SO2, p< 0.0001), pO2/fraction of inspired oxygen ratio (p=0.004) and peripheral SO2 measured by pulse oximetry (p< 0.0001) significantly increased soon after HFNC application. Oxygenation improvements were greater after escalation from NIV/CPAP and in patients discharged alive. Conclusion. HFNC significantly improved oxygenation in severe ARF after failure of COT or NIV/CPAP and may be particularly suitable for older patients hospitalized in non-intensive medical wards.

Mental Health Care Users (MHCUs) are admitted in general wards with medical and surgical conditions where non-psychiatric nurses are allocated to render services for medical and surgical conditions. Non-psychiatric nurses are expected to care for MHCUs in general wards regardless of their knowledge and skills which is against the Mental Health Care Act. The purpose of the study was to explore and describe the experiences of non-psychiatric nurses in car-ing for MHCUs admitted in general wards in Limpopo Province. Qualitative approach using explorative, descriptive, and contextual design was adopted for the study. Methodology included the setting, population, sampling, ethical con-siderations, and the measures to ensure trustworthiness. The study was conducted in four general hospitals of Limpopo Province, South Africa with mental health care wards, medical ward and surgical ward which were selected through simple random sampling. Semi structured Individual interviews were used to collect data from twenty professional nurses until data saturation. Data was analysed using Tesch’ s method. Ethical considerations were adhered to throughout the study. Themes that emerged after data analysis were: Managing MHCUs, Types of patient’s behaviour. The study concluded that professional nurses without psychiatry caring for MHCUs in general wards need training to provide holistic care.

SMARCA4-deficient non-small cell lung cancer (NSCLC) is a more recently recognized subset of NSCLC. We describe the 18F-fluorodeoxyglucose (FDG) PET/CT findings in a rare case of SMARCA4-deficient NSCLC and response to therapy. A 45-year-old male patient with a history of heavy smoking (10 years) underwent an 18F-fluorodeoxyglucose (FDG) PET/CT dynamic (chest) + static (whole-body) scan for diagnosis and pre-treatment staging. 18F-FDG PET/CT showed an FDG-avid mass in the upper lobe of the left lung (SUVmax of 22.4) and FDG-avid lymph nodes (LN) in the left pulmonary hilar region (SUVmax of 5.7). In addition, there are multiple metastases throughout the body, including distant LNs, adrenal glands, bone, and brain. Pathological findings confirmed SMARCA-4 deficient NSCLC. After 4 cycles of chemotherapy and immune checkpoint inhibitors（ICI）, the patient underwent again an 18F-FDG PET/CT scan (including dynamic scan) for efficacy evaluation. We report cases that deepen the understanding of the 18F-FDG PET/CT presentation of SMARCA4-deficient NSCLC as well as dynamic imaging features and parametric characteristics.

Poverty alleviation must be carried out in a planned and sustainable manner by the central government and regional governments, the private sector, and the entire community to achieve a prosperous society by getting special attention from the government. This study aims to analyze the impact of the non-cash food assistance program on poverty alleviation, stunting and economic problems using a public private partnership (PPP) approach that involves the role of the government, the private sector and the community. This study uses a qualitative-explorative research method to examine Indonesia's non-cash food assistance program as a national initiative to fight poverty in the form of food. Data were collected from interviews, field observations, and relevant literature, then Nvivo 12 Pro was used to analyze the results. The location of this research is in Indonesia, namely Takalar Regency. The results of the study show that the implementation of the non-cash basic food assistance program has been effective. The involvement of the government, the private sector, and the community shows this. The success factors for the basic food assistance program are alleviating poverty in Indonesia, reducing stunting rates, and increasing economic growth because people are given a place to be part of small businesses. From the results of this analysis it was concluded that the non-cash basic food assistance program is a special program that can overcome various social problems in society. So that poverty alleviation programs are expected to be sustainable and improved to provide benefits for people's welfare. The implementation of the food aid program also involved several cross-sectoral efforts to channel government assistance.

This lack of information is due to the primary role of HSTs in fungal pathogenesis, which often masks the functions of NSTs and CWDEs. So, the toxic effects of A. alternata metabolites due to NSTs and CWDEs have received minor attention than those reported for HSTs mycotoxins [11]. A wider study of the activity of isolated fungal metabolites can allow the identification of compounds directly related to the pathogenic activity of the fungus, making it possible to create chemo libraries that facilitate the linking of the structure of the compounds with the species that produce it and its effect on host and non-host crops, as well as with biosynthetic features [12]. In this context, our work reports a study focused on NSTs and CWDEs used by an A. alternata strain isolated from infected pears in Italy. To this aim, the characterization of hydrolytic enzyme activities of A. alternata and the identification of the metabolites produced in vitro were performed. Furthermore, the phytotoxic activity of the isolated compounds was evaluated on pear (host and non-host varieties) and lemon fruits [13]. Finally, the competition of A. alternata with other pathogens was evaluated to investigate the role of NSTs on co-infections.

Renewable active sludge is a smart material for wastewater treatment and the protection of surface water bodies. The generated pellets (dried and pelletised dehydrated anaerobically stabilised excess sludge) are produced in a quantity of 31.4 g ± 5.6 g dry matter (DM) per one Population equivalent (PE) calculated to COD (PE_COD) in one day. As pellets are combustible material, their energy utilisation must reach sustainable development goals (SDGs) - a bridge must be created between »treated sewage sludge as the tool to remove pollutants and nutrients from wastewater« and »preparation of the valuable material as a solid recovered fuel (SRF) that meets customer-specific requirements«. Technical Report CEN/TR 15508 and Technical Standard EN ISO 21640 set up methods for specifying and classifying pellets as an SRF. In the last eleven years (2010 – 2021), pellets' net calorific value (NCV) is 13.0 ± 0.7 MJ kg^-1 as received (ar). In 2021, the 80^th percentile of the Hg/NCV ratio was 0.079 mg Hg MJ^-1. In 2010 – 2021, the annual amount of Hg transferred to stakeholders reduced by 64.3 % m/m - from 10.1 kg to 3.67 kg. The halogen contents of the pellets do not threaten corrosion to the incineration facility. Stable pellets' energy potential and perspective ash composition for critical raw materials recovery qualify pellets as a specific waste stream and a renewable material for SRF production.

Recurrent bacterial vaginosis (RBV) after antibiotic treatments has a relapse rate of 35% within 3 months and 60% within 12 months. Products containing polycarbophil (PLGG), that inhibits bacterial growth and mucoadhesive property, can impair biofilm formation. Here are shown the results of the POLARIS (Polybactum® to assess Recurrent Bacterial Vaginosis) study. The first phase was an interventional, open-label, non-controlled, and multicentre trial enrolling 56 women in Italy and Romania. The second phase was an observational 10-month follow-up without treatment conducted only in Romania. After 3 cycles with PLGG, only 8 BV recurrences out of 54 evaluable patients were identified (rate 14.81%) and for 26 out of 39 patients (66.67%) was evidenced positive effect on Lactobacilli in the vaginal secretions. In the follow-up 35 patients were observed after PLGG stopping treatment; 1 RBV (2.86%) at the 4th month and an additional 6 cases (17.14%) were evidenced at the end of the follow-up period. Therefore, no recurrence was evidenced in 12 subjects (34.28%) at 10th ± 2 months after the end of the PLGGtreatment. The use of PLGG vaginal ovules in the treatment of BV reduces the rate of relapses and improves the microbiological parameters (positive effect on Lactobacilli in 66.7 % of cases).

Stem/progenitor cell transplantation is a potential novel therapeutic strategy to induce angiogenesis in ischemic tissue, which can prevent major amputation in patients with advanced peripheral artery disease (PAD). Thus, clinicians can use cell therapies worldwide to treat PAD. However, some cell therapy studies did not report beneficial outcomes. Clinical researchers suggested that classical risk factors and comorbidities may adversely affect the efficacy of cell therapy. Some studies have indicated that the response to stem cell therapy varies among patients even in those harboring limited risk factors. This suggested the role of undetermined risk factors, including genetic alterations, somatic mutations, and clonal hematopoiesis. Personalized stem cell-based therapy can be developed by analyzing individual risk factors. These approaches must consider several clinical biomarkers and perform studies (such as genome-wide association studies (GWAS)) on disease-related genetic traits and integrate the findings with those of transcriptome-wide association studies (TWAS) and whole-genome sequencing in PAD. Additional unbiased analyses with state-of-the-art computational methods, such as machine learning-based patient stratification, are suited for predictions in clinical investigations. The integration of these complex approaches into a unified analysis procedure for the identification of responders and non-responders before stem cell therapy, which can decrease treatment expenditure, is a major challenge to increase the efficacy of therapies.

Philip Phenix’s (1964) book Realms of meaning started the ever growing movement concerned with how school education might help young people in their search for meaning in times of rapid social change. Today, in globalised, digital, secularised, de-traditionalised culture, the importance and urgency of this role have never been greater. Cultural change has accelerated exponentially, and for many – including students in religious/Catholic schools – traditional religious sources of meaning are no longer prominent or plausible reference points. Catholic schools, whether independent or semi-state institutions because of government funding, can make a valuable contribution young people’s spiritual/moral education, no matter what their level of religious affiliation or practice. This article argues that such a contribution requires change to the discourse or narrative of Catholic school Religious Education, with corresponding adjustments to content and pedagogy. Its present trajectory, which is excessively concerned with promoting a Catholic identity in students, needs to be modified. Both the religious and non-religious students, especially in the senior classes, would derive greater spiritual and religious benefit from the inclusion of more life-relevant and issue-related content, together with a critical, research-oriented pedagogy. Such an approach proposes that the Catholic Church’s schools should offer unconditionally a meaningful spiritual/moral education that is relevant to all students, rather than a traditional one which seemed to presume that all students are, or should be practising Catholics. This does not minimise attention to the Catholic tradition, but it allows for a study of how people negotiate the task of constructing meaning and values in a complex culture. The article also looks at the ‘headwinds’ that hinder the implementation of this approach. The article is focused specifically on the Australian context where Catholic schools are semi-state institutions because they are funded by both state and federal governments. The issues are still likely to be pertinent to Catholic education in other countries, while taking into account significant contextual differences.

Evidence indicates that the long noncoding RNAs are involved in the metformin-mediated anti-cancer processes. However, the potential effects of the long noncoding RNAs in metformin-mediated anti-tumor processes in esophageal squamous cell carcinomas (ESCC) are still elusive. This study uncovered that metformin decreases the level of long noncoding RNAs CCAT1 and SPRY4-IT1 thereby contributing to the down-regulation of c-Myc and vimentin. Also, the RNA level test of human ESCC tissue confirmed the positive correlation between CCAT1 and c-Myc. These findings demonstrated that metformin facilitated anti-cancer effects by targeting the 2 long noncoding RNAs (CCAT1 and SPRY4-IT1) and their consequential targets c-Myc and vimentin. Therefore, the CCAT1 and SPRY4-IT1 might act as novel molecular targets that mediate the anti-tumor effects in esophageal squamous cell carcinoma. This helps in predicting the treatment response of metformin in patients diagnosed with esophageal squamous cell carcinoma.

The streptavidin and biotin interaction is one of the strongest non-covalent interactions in nature. As a result, this non-covalent interaction has been of great interest when it comes to biochemical assays, diagnosis of diseases, and cell-targeted drug delivery. Past research has proven that biotin-streptavidin is useful in biosensor development to improve the detection of a system when conjugated to nanoparticles. This study aims to prove that streptavidin-coated nanoparticles can be conjugated with biotinylated antibodies using the primary-secondary method to non-invasively detect adenocarcinoma in-vitro. While the use of nanoparticles is not uncommon to the diagnostics area of scientific research, the technique this research aims to investigate is a non-invasive one, utilizing the primary-secondary method. Specifically, the increased stability of fluorophores when bound to antibodies as opposed to nanoparticles directly can be indicative of the particles conjugated through the primary-secondary method’s ability to specifically bind to overexpressed transferrin receptors in the A549 cell line. In this paper, streptavidin-coated nanoparticles were conjugated with biotinylated anti-transferrin receptor antibodies and AlexaFluor-488 secondary antibodies were used to enable fluorescence-based detection. The efficiency of these particles were observed quantitatively through a plate reader and qualitatively through a fluorescence microscope. I demonstrated that these nanoparticles are able to specifically bind to the target proteins in this study. These findings contribute to the field of nanoparticle diagnostics and can be extended to different diseases caused by overexpression of proteins in the future. While this was conducted in-vitro, conjugates can be prepared to detect cancer in-vivo and can be tested with magnetic relaxometry in the future.

Background: Research continues to search for blood-based biomarkers sensitive to Alzheimer’s disease (AD) pathology during the initial stages when symptoms of cognitive decline are not yet apparent. A blood-based biomarker candidate is metalloprotein p53, the conformation of which was previously found to be altered in peripheral cells from individuals with mild cognitive impairment (MCI) and AD, presenting as an unfolded p53 (U-p53) conformational variant. Methods: Plasma samples from the well-characterized Australian Imaging, Biomarkers, and Lifestyle (AIBL) cohort were used to identify the clinically relevant AZ 284^® peptide, specifically present in samples from individuals with symptomatic AD. The AZ 284^® peptide, which is a marker of the U-p53 conformational variant (U-p53^AZ), was identified by immunoprecipitation (IP) with a novel U-p53 conformational variant-specific antibody followed by liquid chromatography (LC) tandem mass spectrometry (MS/MS) and protein sequencing. Using IP-LC surface-activated chemical ionization (SACI) MS/MS analysis, the prognostic and diagnostic performance of U-p53^AZ were examined in the longitudinal AIBL cohort, including 252 plasma samples derived from 214 elderly individuals. For the prognostic analyses, U-p53^AZ levels were assessed at 36, 72, and 90 months after baseline assessment. Results: The prognostic performance of U-p53^AZ to predict the progression to AD from preclinical or prodromal AD was high, with area under the receiver operating characteristic curve (AUC) values close to or above 0.90. Furthermore, U-p53^AZ predicted the progression to AD more than 6 years prior to symptom onset with positive and negative predictive values of about 90%. Additionally, the estimated prognostic performance of U-p53^AZ was superior to other main risk factors (i.e., age, sex, and either alone or in combination with amyloid status. Furthermore, U-p53^AZ had high diagnostic performance to differentiate cognitively normal individuals from those with AD (AUC values >0.88). Conclusion: These findings support the use of U-p53^AZ as a prognostic blood-based biomarker accurately predicting the progression to AD dementia during the preclinical and prodromal stages at least 6 years before receiving the clinical diagnosis of AD dementia.

The prevalence of overweight/obesity in the adult population in the Philippines has doubled in the past 20 years. Zumba exercise has recently been implemented throughout the Philippines. However, there is scarce information on the effects of Zumba on obesity and Zumba participants’ characteristics in the Philippines. This study described the current practice of Zumba in the Philippines, along with the practitioners’ characteristics, and identified factors associated with Zumba participation. In this observational, cross-sectional study, a structured questionnaire was used to survey 10 Zumba locations in September 2019. Anthropometric measurements of participants were assessed. Respondents included 171 women (88.6%) and 22 men (11.4%), with a mean (±SD) age of 44.1 (± 8.9) years. All respondents answered that Zumba was enjoyable, and some answered “very enjoyable.” Determinants of frequent participation were as follows: being older than the mean age of participants, starting Zumba to enjoy dancing, starting Zumba not to lose weight, shopping mall location, and participation fee required. “To enjoy dance” being a motivation for Zumba practice was identified as a determinant of frequent participation, rather than “to lose weight.” The element of “enjoyable” may strongly influence continuation and frequent participation of Zumba exercise in the Philippines.

Smoking is a major risk factor for non-communicable diseases and remains a significant public health challenge in many lower- and middle-income countries (LMIC) including Namibia. The purpose of the study was to estimate the prevalence of smoking and its associated risk factors among HCWs and non-HCWs in Zambezi region. An exploratory cross-sectional survey was conducted between March and October 2020 among residents of the eight (8) constituencies of Zambezi region. Four hundred and sixty-one (461) respondents who had been residents of the selected constituencies for over five years and aged between 17-60 years were selected for the study. The main outcome measure was current cigarette smoking status. Descriptive statistics were used to summarize the socio-demographic characteristics of the respondents. We stratified data analysis by individual being health workers or non-health workers. A bivariate Pearson Chi-square test was used to determine the association between socio-demographic characteristics and the smoking status. Statistically significant variables in the bivariate analysis were used as predictors in the univariate and multivariate models. The response rate of potential participants was 95% (n=434). The mean (±SD) age of participant’s was 32.5 (± 11.34 years). Significant relationships were observed between smoking status and area of residency (constituency), gender, age category, level of education, age of onset of smoking and the daily smoking frequency. The majority of smokers (n=108) were none-HCWs with males being the majority (n=62). Age (p=0.001), education levels (p=0.001) and area of residency (p=0.022) were highly associated with smoking among none-HCW while marital status was associated with smoking among HCWs (p=0.013). In the final multivariate model, the odds of smoking among female non-HCWs were significantly lower (OR: 0.386; 95% CI: 0.228 – 0.655). Furthermore, the odds of smoking among this same group were lower among those who had secondary level education (OR: 0.178; 95% CI: 0.0659 – 0.483), post-secondary (OR: 0.117, 95% CI: 0.0412 – 0.330) and first stage tertiary (OR: 0.306: 95% CI: 0.106 – 0.881) compared to those who had primary school education. In conclusion, smoking prevalence among none HCWs and HCWs working in Zambezi included in the study was similar to that of the general Namibian population but higher than other neighboring countries within SADC. The results showed a need for the establishment of specific smoking related strategies that target HCWs to address smoking use parallel to the running of none HCWs which would ultimately decrease the smoking prevalence and improve health.

Simulating the non-perturbative and non-Markovian dynamics of open quantum systems is a very challenging many body problem, due to the need to evolve both the system and its environments on an equal footing. Tensor network and matrix product states (MPS) have emerged as powerful tools for open system models, but the numerical resources required to treat finite temperature environments grow extremely rapidly and limit their applications. In this study we use time-dependent variational evolution of MPS to expore the striking theory of Tamescelli et al. that shows how finite temperture open dyanmics can be obtained from zero temperature, i.e. pure wave function, simulations. Using this approach, we produce a benchmark data set for the dynamics of the Ohmic spin-boson model across a wide range of coupling and temperatures, and also present detailed analysis of the numerical costs of simulating non-equilibrium steady states, such as those emerging from the non-perturbative coupling of a qubit to baths at different temperatures. Despite ever growing resource requirements, we find that converged non-perturbative results can be obtained, and we discuss a number of recent ideas and numerical techniques that should allow wide application of MPS to complex open quantum systems.

Pattern analysis of salivary metabolic profile has been proven accurate to discriminate generalized periodontitis (GP) patients from healthy individuals (HI) as disease modifies the salivary concentrations of specific metabolites. Due to the scarcity of data in the literature, the aim of this study was to determine whether non-surgical periodontal therapy (NST) could change salivary metabolomic profile in GP to one more similar to HI. Unstimulated whole saliva of 11 HI and 12 GP patients were obtained prior to and 3 months after NST. Metabolic profiling was performed using Nuclear Magnetic Resonance (NMR) spectroscopy, followed by supervised multivariate statistical approach on entire saliva spectra and partial least square (PLS) discriminant analysis. In GP group, periodontal treatment improved all clinical parameters, but not all the diseased sites were eradicated. PLS revealed an accuracy of 100% in discriminating the metabolomic profile of each GP patient before and after NST. OPLS was able to discriminate the 3 groups of subjects with an accuracy of 85.6%. However the post-NST metabolic profile of GP patients could not be completely assimilated to that of HS. Although NST may produce significant changes in the metabolic profile, GP patients maintained a distinctive fingerprint compared to HI.

Metallic glass matrix composites are unique new materials which have superior mechanical properties as compared to existing conventional materials. Owing to this, they are potential candidates for various future structural applications. However, they suffer from disadvantages of brittleness, poor ductility and little or no toughness and they manifest catastrophic failure on application of force. Their behavior is dubious and require extensive experimentation to draw conclusive results. In present study, which is continuation of previous study by author, an effort has been made to overcome this pitfall by simulation. A quantitative mathematical model based on KGT theory has been developed to describe nucleation and growth of crystalline phase dendrites in glassy matrix during solidification. It yields information about numerical parameters to understand the behavior of each individual element in a phase in multicomponent sluggish slurry and their effect on final microstructural evolution. Model is programmed and simulated in MATLAB®. Its validation is done by comparison with identical curves reported in literature previously for similar alloys. Results indicate that effect of incorporating all heat transfer coefficients at macroscopic level and diffusion coefficients at microscopic level play a vital role in refining the model and bringing it closer to actual experimental observations. Two types of hypoeutectic and eutectic systems namely Zr₆₅Cu₁₅Al₁₀Ni₁₀ and Zr_47.5Cu_45.5Al₅Co₂ respectively were studied. Simulation results were found to be in good agreement with prior simulated and experimental values

The outbreak of COVID-19, the disease caused by SARS-CoV-2, continues to affect millions of people around the world. The absence of a globally distributed effective treatment makes the exploration of new mechanisms of action a key step to address this situation. Stabilization of non-native Protein-Protein Interactions (PPIs) of the nucleocapsid protein of MERS-CoV has been reported as a valid strategy to inhibit viral replication. In this study, the applicability of this unexplored mechanism of action against SARS-CoV-2 is analyzed. During our research, we were able to find three inducible interfaces of SARS-CoV-2 N protein NTD, compare them to the previously reported MERS-CoV stabilized dimers, and identify those residues that are responsible for their formation. A drug discovery protocol implemented consisting of docking, molecular dynamics and MM-GBSA enabled us to find several compounds that might be able to exploit this mechanism of action. In addition, a common catechin skeleton was found among many of these molecules, which might be useful for further drug design. We consider that our findings could motivate future research in the fields of drug discovery and design towards the exploitation of this previously unexplored mechanism of action against COVID-19.

In the present paper, the effect of the non-linear thermal radiation on the neutral gas mixture in the unsteady state is investigated for the first time. The unsteady BGK technique of the Boltzmann kinetic equations for a neutral non-homogenous gas is solved. The solution of the unsteady case makes the problem more general significance than the stationary one. For this purpose, the moments' method, together with the traveling wave method, is applied. The temperature and concentration are calculated for each gas component and mixture for the first time.Furthermore, the study is held for aboard range of temperatures ratio parameter and a wide range of the molar fraction. The distribution functions are calculated for each gas component and the gas mixture. The significant non-equilibrium irreversible thermodynamic characteristics the entire system is acquired analytically. That technic allows us to investigate the consistency of Boltzmann's H-theorem, Le Chatelier principle, and thermodynamics laws. Moreover, the ratios among the different participation of the internal energy alteration are evaluated via the Gibbs formula of total energy. The final results are utilized to the argon-helium non-homogenous gas at different magnitudes of radiation force strength and molar fraction parameters. 3D-graphics are presented to predict the behavior of the calculated variables, and the obtained results are theoretically discussed.

Asians are known to more likely than Westerners develop fatty liver and lifestyle-related diseases despite their weight. However, the relationship between fat accumulation and lifestyle-related diseases in non-obese Asians is unknown. Therefore, this study aimed to analyze visceral fat and hepatic fat in participants with a normal body mass index (BMI) and examine their characteristics during a medical checkup. This cross-sectional study was conducted on 663 of 1,142 patients who underwent abdominal ultrasonography and who had an alcohol intake (converted to ethanol) of <30 g/day for males and <20 g/day for females and a BMI of <25 kg/m2 during a health checkup. Participants were classified into four groups: group A, visceral fat accumulation (VFA) (−) and fatty liver (FL) (−) (n = 549); group B, VFA (+) and FL(−) (n = 32); group C, VFA (−) and FL (+) (n = 58); and group D, VFA (+) and FL (+) (n = 24). The frequencies of lifestyle-related disease complications, liver function tests, and liver fibrosis were evaluated among the four groups. Compared with group A (control), groups B, C, and D had higher number of males; BMI; abdominal circumference, ALT, AST, γ-GTP, triglyceride, uric acid, fasting blood sugar levels; and incidence of hyperlipidemia. Groups C and D had higher ALT, HbA1c, cholinesterase, and triglyceride levels; FIB4 index; and number of patients with diabetes mellitus (DM) than groups A and B; however, there was no difference between groups A and B. FL is a risk factor of DM and liver fibrosis in non-obese Japanese individuals; however, VFA only is not a risk factor of DM and liver fibrosis.

Therapeutically effective treatments of cancer are limited. To calibrate the efficiency of the novel technique we recently discovered to modulate cancer cell viability using tuned electromagnetic fields; H1299 human lung cancer cells were irradiated in a sweeping regime of W-band (75-105 GHz) millimeter waves (MMW) at 0.2 mW/cm² (2 W/m²). Effects on cell morphology, cell death and senescence were examined and compared to that of non-tumorigenic MCF-10A human epithelial cells. MMW irradiation led to alterations of cell and nucleus morphology of H1299 cells, significantly increasing mortality and senescence over 14 days of observation. Extended irradiation of 10 minutes duration resulted in complete death of exposed H1299 cell population within two days, while healthy MCF-10A cells remained unaffected even after 16 minutes of irradiation under the same conditions. Irradiation effects were observed to be specific to MMW treated H1299 cells and absent in the control group of non-irradiated cells. MMW irradiation affected nuclear morphology of H1299 cells only and not of the immortalized MCF-10A cells. Irradiation with low intensity MMW shows an antitumor effect on H1299 lung cancer cells. This method provides a novel treatment modality enabling targeted specificity for various types of cancers.

Environmental DNA (eDNA) is an increasingly used non-invasive molecular tool for detecting species presence and monitoring populations. In this article, we review the current state of non-avian reptile eDNA work in aquatic systems, as well as present a field experiment on detecting the presence of painted turtle (Chrysemys picta) eDNA. Thus far, turtle and snake eDNA studies have been successful mostly in detecting the presence of these animals in field conditions. However, some instances of low detection rates and non-detection occur for these non-avian reptiles, especially for squamates. We explored this matter by sampling lentic ponds with different densities (0 kg/ha, 6 kg/ha, 9 kg/ha, and 13 kg/ha) of painted turtles over three months, attempting to detect differences in eDNA accumulation using a qPCR assay. Only one sample of the highest density pond readily amplified eDNA. Yet, estimates of eDNA concentration from pond eDNA were rank-order correlated with turtle density. We present a “shedding hypothesis”–the possibility that animals with hard, keratinized integument do not shed as much DNA as mucus-covered organisms–as a potential challenge for turtle eDNA studies. Despite challenges with eDNA inhibition and availability in water samples, we remain hopeful that eDNA can be used to detect freshwater turtles in the field. We provide key recommendations for biologists wishing to use eDNA methods for detecting non-avian reptiles.

Anticancer regimens for Hodgkin lymphoma (HL) patients include highly genotoxic drugs that have been very successful in killing tumor cells and providing a 90% disease-free survival at five years. However, these treatments do not have a specific cell target, damaging both cancerous and normal cells. Thus, HL survivors have a high risk of developing new primary cancers, both hematologic and solid tumors, that have been related to treatment. Several studies have shown that after-treatment, HL patients and survivors present persistent chromosomal instability, including non-clonal chromosomal aberrations. The frequency and type of chromosomal abnormalities appear to depend on the type of therapy and the cell type examined. For example, MOPP chemotherapy affects hematopoietic and germ stem cells leading to long-term genotoxic effects and azoospermia, while ABVD chemotherapy affects transiently sperm cells, with most of the patients showing recovery of spermatogenesis. Both regimens have long-term effects in somatic cells, presenting non-clonal chromosomal aberrations and genomic chaos in a fraction of non-cancerous cells. This is a source of karyotypic heterogeneity that could eventually generate a more stable population acquiring clonal chromosomal aberrations and leading towards the development of a new cancer.

This paper presents computational study of non-stoichiometric nickel oxide in a 32-cell NiO system to model and validate localized heating effects due to nanosecond laser irradiation. Variation in Bandgap of NiO is studied as a function of varying concentrations of native defects ranging from 0 to 25%. It is observed that there is a slight increase in the bandgap from 3.8 eV for stiochiometric NiO to 3.86 eV for Ni-rich NiO and to 3.95 eV for O-rich NiO. It is hence deduced that the experimental laser irradiation leads to simultaneous reduction of Ni²⁺ ions and oxidation of NiO as the number of laser pulses increase. As well, a detailed study on the effects of doping nickel family elements, i.e. palladium (Pd) and platinum (Pt) in stoichiometric NiO is presented. A bandgap decrease from 3.8 eV for pure NiO to 2.5 eV for Pd-doping and 2 eV for Pt-doping for varying doping concentrations ranging from 0–25% Pd, Pt respectively is observed.

This paper relies on accounting-based measures of country risk to investigate U.S. global banks' exposure to foreign country risk over the 2017 fiscal year as measured by the sum of cross-border risk, foreign office risk, and derivative risk claims. We achieve this using panel linear modeling methods with country level heterogeneity and time fixed effects, along with a constructed panel data of 284 observations on 71 countries distributed across 6 world regional blocks, and observed over 4 consecutive quarters starting from 4th quarter 2016 and ending with 3rd quarter 2017. The results show that on average, over the four quarters, a 1% increase in foreign banking sector's claims significantly increases U.S. global banks cross border risk exposure by 0.34%, while reducing derivative risk exposure by 0.22%, but have no significant impact on foreign office risk exposure. Similar results are observed with public sector claims which significantly increase banks' exposure to cross border risk by 0.21%, while reducing derivative risk exposure by 0.19%. Conversely however, non-bank financial sector claims are found to have no significant affect on cross-border risk exposure, but significantly reduce foreign office risk exposure by 0.09%, while increasing derivative risk exposure by 0.06%. These results indicate the presence of sectoral heterogeneities in U.S. banks' exposure to foreign counterparties' risk, and also that overall, over the course of 2017 the level of U.S. global banks' cross-border risk exposure increased, while their level of derivative risk exposure decreased, and the level of foreign office risk exposure remained relatively unchanged.

Abstract: Radiation-induced skin injury can be a serious cutaneous damage and have specific characteristics. Asymptomatic periods are classified as the latent stage. The skin barrier plays a critical role in the modulation of skin permeability and hydration and protects the body against a harsh external environment. However, an analysis on the skin barrier dysfunction against radiation exposure in the latent stage has not been conducted. Thus, we investigated whether skin barrier is impaired by irradiation in the latent stage and aimed to identify the molecules involved in skin barrier dysfunction. We analyzed skin barrier function and its components in SKH-1 mice that received 20 and 40 Gy local irradiation. Increased transepidermal water loss and skin pH were observed in the latent stage of the irradiated skin. Skin barrier components, such as structural proteins and lipid synthesis enzymes in keratinocyte, increased in the irradiated group. Interestingly, we noted sebaceous gland atrophy and increased serine protease and inflammatory cytokines in the irradiated skin during the latent period. This finding indicates that the main factor of skin barrier dysfunction in the latent stage of radiation-induced skin injury is sebaceous gland deficiency, which could be an intervention target for skin barrier impairment.

The Energy Performance of Buildings Directive 2010 calls for the Nearly Zero Energy Standard for new buildings from 2021 onwards: Buildings using “almost no energy” are powered by renewable sources or energy produced by the building itself. For residential buildings, this ambitious new standard has already been reached. But for other building types this goal is still far away. The potential of these buildings to meet a Nearly Zero Energy Standard was investigated by analyzing ten case studies representing non-residential buildings with different uses. The analysis shows that the primary characteristics common to critical building types are a dense building context with a very high degree of technical installation (such as hospital, research and laboratory buildings). The large primary energy demand of these types of buildings cannot be compensated by building and property-related energy generation including off-site renewables. If the future Nearly Zero Energy Standard were to be defined with lower requirements because of this, the state related properties of Bavaria suggest that the real potential energy savings available in at least 85% of all new buildings would be insufficiently exploited. Therefore, it would be useful to instead individualize the legal energy verification process for new buildings to distinguish critical building types such as laboratories and hospitals.

Lung cancer is the leading cause of cancer-related deaths globally, with non-small cell lung cancer (NSCLC) accounting for over 85% of cases and poor prognosis in advanced stages. This study explored shifts in circulating metabolite levels in NSCLC patients versus healthy controls and examined the effects of conventionally fractionated radiation therapy (CFRT) and stereotactic body radiation therapy (SBRT). We enrolled 91 NSCLC patients (38 CFRT and 53 SBRT) and 40 healthy controls. Plasma metabolite levels were assessed using semi-targeted metabolomics, revealing 32 elevated and 18 reduced metabolites in patients. Key discriminatory metabolites included ethylmalonic acid, maltose, 3-phosphoglyceric acid, taurine, glutamic acid, glycocolic acid, and d-arabinose, with a combined Receiver Operating Characteristics curve indicating perfect discrimination between patients and controls. CFRT and SBRT affected different metabolites, but both changes suggested a partial normalization of energy and amino acid metabolism pathways. In conclusion, metabolomics identified distinct metabolic signatures in NSCLC patients with potential as diagnostic biomarkers. The differing metabolic responses to CFRT and SBRT reflect their unique therapeutic impacts, underscoring the utility of this technique in enhancing NSCLC diagnosis and treatment monitoring.

Soil-borne Trichoderma spp. have been extensively studied for their biocontrol activities against pathogens and growth promotion ability with plants. However, the beneficial effect of Trichoderma on inducing resistance against insect herbivores has been considered only recently. Among diverse Trichoderma species, consistent with previous reports, we showed that root colonization by T. virens triggered induced systemic resistance (ISR) to leaf-infecting fungal pathogens. Whether T. virens induces ISR to insect pests has not been tested before. In this study, we investigated whether T. virens affects jasmonic acid (JA) biosynthesis and defense against fall armyworm (FAW) and western corn rootworm (WCR). Unexpectedly, the results showed that T. virens colonization of maize seedlings grown in autoclaved soil suppressed wound-induced production of JA, resulting in reduced resistance to FAW. Similarly, the bacterial endophyte Pseudomonas chlororaphis 30-84 suppressed systemic resistance to FAW due to reduced JA. Further comparative analyses of the systemic effects of these endophytes when applied into sterile or non-sterile field soil showed that both T. virens and P. chlororaphis 30-84 triggered ISR against hemibiotrophic fungal pathogen Colletotrichum graminicola in both soil conditions, but only suppressed resistance to FAW in sterile soil. In contrast to the effect on FAW defense, T. virens colonization of maize roots suppressed WCR larvae survival and weight gain. This is the first report suggesting the potential role of T. virens as a biocontrol agent against WCR.

Two polyurethanes (PUs) were similarly synthesized by reacting a cycloaliphatic isocyanate with 1,4 butanediol and two polyols of different nature (polyester, polycarbonate diol) with molecular weights of 1000 Da. The PU made with polycarbonate diol polyol (YCD) was the only showing intrinsic self-healing at 20 °C. For assessing the mechanism of intrinsic self-healing of YCD, a structural characterization by molecular weights determination, infrared and X-ray photoelectronic spectroscopies, differential scanning calorimetry, X-ray diffraction, thermal gravimetric analysis and dynamic mechanical thermal analysis was carried out. It was concluded that the self-healing at 20 °C of YCD was due to non-covalent dynamic exchange interactions among the carbonate groups of the soft segments. Therefore, the chemical nature of the polyol played a key role in developing PUs with intrinsic self-healing at 20 °C.

Aim: Child-to-parent offenders (CPOs) are commonly specialist offenders and with high rates of recidivism. Thus, a field study was designed to estimate the prevalence in the reference measures of recidivism i.e., dangerousness, risk factors and psychopathy, and compare CPOs with non-child-to-parent juvenile offenders. Method: 136 juvenile offenders (76.5% boys), 76 CPOs and 60 non-CPOs juvenile offenders, aged from 14 to 18 years old, were measured in dangerousness, risk of factors and psychopathic traits. Results: The results showed in CPOs a more than common prevalence (&gt; .50), 75.0%, 95% CI [.653, .847], of dangerousness (caseness); a significant prevalence (&gt; .05) of diagnostic of psychopathy, 25.0%, 95% CI [.150, .350]; and a common prevalence (= .50), 55.3%, 95% CI [.441, .665] of classification as high and very high risk by risk factors. Comparatively, no significant differences were observed between CPOs and non-CPOS juvenile offenders in mental health problems (dangerousness), meanwhile that CPOs exhibited significant more interpersonal and affective psychopathic traits and significant more risk in family circumstances, and personality and behaviour risk factors. Conclusions: The implications for prevention and intervention programs with CPOs are discussed

The fertility rate and litter size of female pigs are critically affected by the expression of estrus. The objective of this study was to elucidate the regulatory mechanisms of estrus expression by analyzing the differential expression of genes and long intergenic non-coding RNAs (lincRNA), as well as the utilization of alternative polyadenylation (APA) sites, in the vulva and vagina during the estrus and diestrus stages of Large White and indigenous Chinese Mi gilts. Our study revealed that the number of differentially expressed genes (DEG) in the vulva was less than that in the vagina, and the DEGs in the vulva were enriched in pathways such as “neural” pathways and steroid hormone responses, including the “Calcium signaling pathway” and “Oxytocin signaling pathway”. The DEGs in the vagina were enriched in the “Metabolic pathways” and “VEGF signaling pathway”. Furthermore, 27 and 21 differentially expressed lincRNAs (DEL), whose target genes were enriched in the “Endocrine resistance” pathway, were identified in the vulva and vagina, respectively. Additionally, we observed that 63 and 618 transcripts of the 3'-untranslated region (3'-UTR) were lengthened during estrus in the vulva and vagina, respectively. Interestingly, the genes undergoing APA events in the vulva exhibited species-specific enrichment in neural or steroid-related pathways, whereas those in the vagina were enriched in apoptosis or autophagy-related pathways. Further bioinformatic analysis of these lengthened 3'-UTRs revealed the presence of multiple miRNAs binding sites and cytoplasmic polyadenylation element (CPE) regulatory elements. In particular, we identified more than 10 CPEs in the validated lengthened 3'-UTRs of the NFIX, PCNX4, CEP162 and ABHD2 genes using RT-qPCR. These findings demonstrated the involvement of APA and lincRNAs in the regulation of estrus expression in female pigs, providing new insights into the molecular mechanisms underlying estrus expression in pigs.

Traditional methods of non-metallic materials joining for industrial uses are limited to lasers, or induction or conduction heating. The precision and efficiency for large-scale applications are difficult to be achieved at the same time. Here in this paper, we report a precise microwave welding method induced by localized surface plasmon of metallic macro-gaps under microwave excitation. The proposed method utilizes energy from well-developed commercial microwaver, and benefits from the precision of localized surface plasmon, an oscillating electron cloud excited by electromagnetic waves, which is currently under hot investigation only at micro- or nano-scales. The method is applied to the welding of polymers to solve the problems of complex processing equipment and high processing energy consumption in the traditional welding process, so as to cope with the growing energy and environmental crisis. Finite element numerical simulations are used to study the distribution characteristics of electric fields and temperature fields. The results show that the process is a high quality, efficient, low consumption and environmentally friendly green process compared to traditional polymer welding methods.

Gradual disability worsening in Multiple Sclerosis (MS) is indicative of confirmed progression that mostly involves progression independent of relapse activity (PIRA) and is associated with neurodegeneration. Insights from pathology reveal grey matter involvement (neocortex, hippocampus, spinal cord, and deep grey matter structures) and microglia activation in early stages of MS. Cortical lesions result in thinning and atrophy and are considered accurate predictors of disability progression and cognitive decline.Neuroimaging biomarkers, such as high-resolution 7T MR images and TSPO-PET, have been examined for the detection of cortical pathology linked to cognitive deficits and thus progression, but are limited in clinical practice due to availability, time constraints, and cost.Electroencephalography (EEG) emerges as a non-invasive, cost-effective tool that reflects cortical activity in MS. Its potential in monitoring cognitive impairment is explored by focusing on nonlinear EEG analysis. The MuST PREDICT^TM project aims to extract linear and nonlinear EEG features, investigating their role in predicting disease progression and optimizing treatment. The study employs retrospective, cross-sectional, and prospective designs, utilizing EEGs from various MS forms, cognitive assessments, serum/cerebrospinal fluid biomarkers and neuroimaging. The methodology involves time-based and spectral feature extraction, employing artificial intelligence classifiers and brain criticality-based approaches.The conceptual framework of an innovative modality is herein presented, that would EEG for early MS progression detection. Standardization of the methodology could lead to the creation of a digital tool for better prognostication and treatment strategy optimization.

The treatment of critically ill patients remains an evolving and controversial issue. Mechanical circulatory support through a percutaneous approach for the management of cardiogenic shock has taken place in recent years. The combined use of IABP and Impella 2.5 device may have a role to play for this group of patients. A simulation approach may help with a quantitative as-sessment of the achievable degree of assistance. In this paper, we analyse the interaction be-tween Impella 2.5 pump applied as LVAD and IABP using the numerical simulator of the cardi-ovascular system developed in our laboratory. Starting with pathological conditions reproduced using literature data, the simulations were performed setting different rotational speeds for the LVAD and driving the IABP in full mode (1:1) or partial mode (1:2, 1:3 and 1:4). The effects in-duced by drug administration during the assistance were simulated too. The haemodynamic pa-rameters under investigation were: mean aortic pressure, systolic and diastolic aortic pressure, mean pulmonary arterial pressure, mean left and right atrial pressure, cardiac output, cardiac index, left and right ventricular end-systolic volume, left ventricular end-diastolic volume and mean coronary blood flow. The energetic variables considered in the study were: left and right ventricular external work and left and right atrial pressure-volume area. The outcome of our simulations shows that the combined use of IABP and Impella 2.5 achieves adequate support in the acute phase of cardiogenic shock compared to each standalone device. This would allow fur-ther stabilisation and transfer to a transplant centre should escalation of treatment be required.

X-linked myotubular myopathy (XLMTM) is a rare congenital myopathy resulting from dysfunction of the protein myotubularin encoded by the MTM1 gene. XLMTM has a high neonatal and infantile mortality rate due to a severe myopathic phenotype and respiratory failure. However, in a minority of XLMTM cases, patients present with milder phenotypes and achieve ambulation and adulthood. Regarding wide phenotypic variability, we investigated the genotype-phenotype correlations in newly diagnosed XLMTM patients in a patients' cohort (previously published data plus three novel variants, n=414). We found a significant association between severe phenotype and truncating variants (p < 0.001), frameshift variants (p < 0.001), nonsense variants (p = 0.006), and in/del variants (p = 0.036). On the contrary, missense variants were significantly associated with the mild and moderate phenotype (p < 0.001). We found no significant association between phenotype and the MTM1-specific functional domain, contrasting with previously published data. Based on the significant facial gestalt difference between XLMTM patients and unaffected controls (p = 0.001), we consider the Face2Gene application as an effective diagnostic tool in XLMTM when using the correct algorithm. The Face2Gene application seems to be a practical, non-invasive diagnostic approach in XLMTM.

Aronia berries contain antioxidants that may have health promoting properties e.g., demonstrated positive effects on hypertension and dyslipidemia. There is a close link between cardiovascular diseases and hypertension and dyslipidemia, and cardiovascular events are the leading cause of death among subjects with T2D. Thus, we investigated the effect of 8 weeks supplementation with fermented aronia extract (FAE), non-fermented aronia extract (AE) and placebo on cardiovascular risk factors. The extracts were incorporated into snack bars containing 34 g (37%) aronia extract, or 17 g (21%) wheat bran for placebo, as well as raisins and coconut oil. The study was randomized and blinded with a triple-cross-over design. We examined the effects of aronia extracts on blood pressure, adiponectin and high-sensitive C-reactive protein and found no effects. After supplementation with placebo, there were significantly higher total-cholesterol, LDL-cholesterol, and HDL-cholesterol, with the placebo group showing significantly higher increases in total-cholesterol and LDL-cholesterol than the FAE group. Furthermore, we observed an increase in HDL-cholesterol in the AE group and an increase in triglyceride in the FAE group. Thus, we assume that raisins may have increased the participants’ cholesterol levels, however, with both AE and FAE having the potential to prevent this increase.

Non-ulcerated cutaneous leishmaniasis (NUCL) is an atypical and peculiar clinical form of the disease that was first described by Ponce et al. (1988) in Honduras (Central America), where iso-lated or disseminated popular and/or nodular skin lesions are commonly seen in adolescents and young adults. Leishmania (L.) chagasi was then incriminated as the causal agent of the disease, as well as of American visceral leishmaniasis (AVL), although NUCL has been shown to be more prevalent than AVL in the region. Considering, however, the dubious taxonomic character of the causal agent of NUCL, as there is no evidence of this form of disease associated with L. (L.) cha-gasi in South America, this study aimed to carry out a retrospective taxonomic analysis on a se-ries of studies on the diagnostic approach to the Honduran parasite in loco (El Tigre island, Amapala municipality, west coast of Honduras), where taxonomic characters of a biological (in vitro and in vivo), epidemiological (vector and canine reservoir), clinical-immunological (im-munopathological features of in situ skin lesion and systemic infection) and molecular (ge-nomic/phylogenetic analyses) nature were considered. The findings, particularly those of mo-lecular nature, such as: the Honduran parasite showed to be more ancestral (molecular clock analysis of the DNA polymerase alpha subunit gene) than all viscerotropic ones [L. (L.) chagasi, L. (L.) donovani and L. (L.) infantum], as well as presenting an absolutely unprecedented structural variation on chromosome 17 and the highest frequency of genomic SNPs (more than twice the number seen in the Brazilian parasite), in addition to representing a different phylogenetic lin-eage (mainly in the NJ - RNA Pol II tree) from those viscerotropic ones, have pointed to the characterization of a new leishmanine parasite, Leishmania (Leishmania) poncei n. sp. (Kinetoplas-tea: Trypanosomatidae), in honor of Professor Ponce, who was the first researcher to describe NUCL in Honduras.

A high prevalence of childhood obesity has been observed in the last years. Ultrasound of adi-pose tissue is technique validated in adults in order to detect risk of comorbidity as NAFLD and NASH, but no studies at pediatric population. The main objective is to assess measurement of preperitoneal fat by nutritional ultrasound as a screening method for non-alcoholic fatty liver disease (NAFLD) in obese children. Patients and methods: Prospective longitudinal study. A study of somatometry, bioelectrical impedancemetry and nutritional ultrasound has been car-ried out. Results : 102 patients were included, with a mean BMI (SDS) of 2.58. A linear and direct correlation was observed between the fat mass measured by bioelectrical impedancemetry and the total subcutaneous abdominal fat measured by nutritional ultrasound. We also observed a correlation between preperitoneal fat measured by nutritional ultrasound and NASH, with a cut-off point of 0.93 cm of preperitoneal fat (sensitivity 96% and specificity 94%).Conclusions: Measurement of preperitoneal fat by nutritional ultrasound is a good screening method for NASH in obese children.

Periodontal diseases and Thalassemia Major (TM), which are two chronic inflammatory diseases, are associated with increased levels of proinflammatory cytokines in bio-fluids. Interleukin (IL)-6 and IL-8 have been identified as potent proinflammatory biomarkers in periodontal diseases as well as in patients with β-thalassemia (TM-β). This suggests that patients with TM-β and gingival inflammation have two chronic inflammatory conditions, each of which may affect the other. The objective of this pioneer research was to evaluate the effect of oral hygiene maintenance and care on serum levels of IL-6 and IL-8. 31 participants selected after screening and were given Non-surgical periodontal therapy(NSPT). IL-6 and IL-8 were evaluated by enzyme linked immunohistochemistry assay (ELISA) at baseline and compared at 6 weeks after NSPT. Statistical analysis was done with SPSS v23. The comparison from the baseline to 6-weeks follow-up for both IL-6 and IL-8 was done using Wilcoxon Signed rank test. The descriptive statistics are represented as median and inter quartile range (IQR). Highly significant improvement (p-&lt;0.000) was found for IL-6 and IL-8 when compared at 6 weeks from baseline. Results provide a gateway to new modality in lowering systemic burden of the disease, thereby reducing morbidity, via local measures or oral care.

Intensive care nurses are highly prone to occupational stress and burnout, affecting their physical and mental health. The occurrence of the pandemic and related events increased nurses’ workload and exacerbated stress and burnout. We conducted a prospective longitudinal mixed-methods study with a cohort of nurses working in a medical ICU (COVID unit; n = 14) and cardiovascular ICU (non-COVID unit; n = 5). Each participant was followed for six 12-hour shifts. Validated questionnaires measured occupational stress and burnout prevalence. Wrist-worn wearable technologies recorded physiological indices of stress. Participants elaborated on the contributors to stress via post-study questionnaire. Data were analyzed using statistical and qualitative methods. Participants who cared for COVID patients at the COVID unit were 3.71 times more likely to experience stress (p &lt; .001) in comparison to non-COVID unit participants. No differences in stress levels were found when the same participants worked with COVID and non-COVID patients at different shifts at the COVID unit. The cohorts expressed similar contributors to stress including communication tasks, patient acuity, clinical procedures, admission processes, proning, labs, and assisting coworkers. Nurses in COVID units, irrespective of whether they care for a COVID patient, may experience high occupational stress and burnout.

Dormancy is a physiological state that confers winter hardiness to and orchestrates phenological phase progression in temperate perennial plants. Weather fluctuations caused by climate change increasingly disturb dormancy onset and release in many plant species including tree crops leading to aberrant growth, flowering, and fruiting. Currently, research in this field is impeded by the lack of affordable non-invasive methods for on-line monitoring of dormancy. We report on an automatic framework for low-cost, long-term, and scalable dormancy studies in deciduous plants. The proposed method is based on continuous near-field sensing of the photosynthetic activity of shoots via pulse-amplitude modulated chlorophyll fluorescence sensors connected remotely to a data processing system. The resulting high-resolution time series of JIP-test parameters indicative of the responsiveness of the photosynthetic apparatus to environmental stimuli are subjected to frequency-domain analysis. The proposed approach allows to overcome the variance coming from diurnal changes of insolation and to derive estimations on the depth of dormancy. Our approach was validated over three seasons in an experimental apple (Malus × domestica Borkh.) orchard by collating the non-invasive estimations with the results of traditional methods (growing of the cuttings obtained from the tress at different phases of dormancy) and the output of commonly used chilling requirement models. We discuss the advantages of the proposed monitoring framework such as prompt detection of freeze damages along with its potential limitations.

Most pivotal clinical trials in advanced non-small cell lung cancer (NSCLC) have excluded patients with poor performance status (PS), and data on the efficacy and safety of pharmacotherapy have not been fully accumulated. For NSCLC patients with PS 2 and without druggable genetic alterations, monotherapy with cytotoxic agents or carboplatin-based combination therapy is usually administered based on the results of several randomized trials. However, the evidence of cytotoxic chemotherapy for patients with PS 2 is insufficient, with limited efficacy and toxicity concerns. Immune checkpoint inhibitors (ICIs) are a promising treatment for patients with PS 2 because of lower incidence of severe toxicity compared to cytotoxic chemotherapy. Meanwhile, several reports suggest that anti-PD-1 antibodies monotherapy is less effective for patients with PS 2, especially for those with PS 2 caused by disease burden. Although the combination therapy of nivolumab and ipilimumab is a promising treatment option, there is a divergence in efficacy data between clinical trials. The standard of care for advanced NSCLC with PS 2 has not been established, and future therapeutic strategies should take into account the heterogeneity of the PS 2 population.

(1) Background: Reduced magnesium (Mg) levels may be associated with a faster de-cline in renal function. The aim of this study was to evaluate the association of serum and uri-nary Mg levels with body composition and inflammatory markers; (2) Methods: Lon-gitudinal study with patients with chronic kidney disease undergoing non-dialysis treatment in stages 3A, 3B and 4. Venous samples were collected after a 12-hour night fast. Body composition was evaluated by Double X-Ray Emission Absorptiometry and Air Displacement Plethysmog-raphy; (3) Results: The sample consisted of 134 patients. In the adjusted linear regression model, uric acid, percentage of lean mass and ali-mentar intake of Mg were positively associated with the sergic Mg. Triglyceride levels, WC and fat mass percentage were negatively associated with serum Mg. For the Mg urinal, in the adjusted model, the eGFR (estimated glomerular filtration rate), IL (interleukin 6), food intake of Mg and the percentage of lean mass showed a positive correlation.; (4) Conclusions: Serum Mg levels were positively associated with lean mass and negatively with total and central body fat and urinary Mg was positively associated with IL6 and lean mass.

The endothelium has multiple functions from maintaining vascular homeostasis, providing nutrition and oxygen to tissues, to evocating inflammation, under adverse conditions, and determining endo-thelial barrier disruption resulting in dysfunction. Endothelial dysfunction represents the typical condition associated with the pathogenesis of all the diseases of cardiovascular system, as well as of diseases of all the other human body’s systems, also including sepsis, acute respiratory distress syn-drome and COVID-19 respiratory distress. Such evidence is leading to identifying potential bi-omarkers and therapeutic targets for preserving, reverting, or restoring endothelium integrity and functionality by early treating its dysfunction. Here, it stresses some strategies for achieving these goals, even if diverse challenges exist and require a significant bench work associated with an in-creased number of clinical studies.

Background Due to the COVID-19 pandemic, teledermoscopy has been increasingly used in the remote diagnosis of skin cancers. In a study conducted in 2020, we demonstrated a potential role of an inexpensive device (NurugoTM Derma) as a first triage to select the skin lesions that require a face-to-face consultation with dermatologists. Herein, we report the results of a novel study that aims to better investigate the performance of NurugoTM. Objectives i) verify whether the NurugoTM can be a communication tool between the General Practitioner (GP) and dermatologist in the first assessment of skin lesions; ii) analyze the degree of diagnostic-therapeutic agreement between dermatologists; iii) estimate the number of potentially serious diagnostic errors. Methods One hundred forty-four images of skin lesions were collected at the Dermatology Outpatient Clinic in Novara using a conventional dermatoscope (instrument F), the NurugoTM (instrument N), and the latter with the interposition of a laboratory slide (instrument V). The images were evaluated in-blind by four dermatologists, and each was asked to make a diagnosis and to specify a possible treatment. Results: Our data show that F gave higher agreement values for all dermatologists, concerning the real clinical diagnosis. Nevertheless, a medium/moderate agreement value was obtained also for N and V instruments and that can be considered encouraging and indicate that all examined tools can potentially be used for the first screening of skin lesions. The total amount of misclassified lesions was limited (especially with the V tool), with up to nine malignant lesions wrongly classified as benign. Conclusions NurugoTM, with adequate training, can be used to build a specific support network between GP and dermatologist or between dermatologists. Furthermore, its use could be extended to the diagnosis and follow-up of other skin diseases, especially for frail patients in emergencies such as the current pandemic context.

Lung cancer is a common malignant tumor of the lung and the leading cause of cancer mortality worldwide. Non-small-cell lung cancer (NSCLC) accounts for 80%–85% of lung cancer, 40% of NSCLCs will have spread beyond the lungs by the time it is diagnosed. Long non-coding RNA (LncRNA) prostate androgen-regulated transcript 1 (PART-1) was reported that promote the development of several cancers. In the current study, we conducted experiments to investigate the role of PART-1 in the proliferation, invasion, and migration of NSCLC. The expression level of the PART-1 gene increased significantly in the NSCLC cell lines, including A549, H1229, H1650, H1975, and PC9. Knocking down of PART-1 inhibited the proliferation, invasion, and migration of A549 cells, moreover, decreased the tumor proliferation in nude mice. We confirmed that PART-1 targeted miR-204-3p directly, and miR-204-3p targeted the insulin-like growth factor binding protein 2 (IGFBP-2) directly. Furthermore, we discovered that PART-1 involved the NSCLC progression by regulating the miR-204-3p-targeted IGFBP-2 pathway. LncRNA PART-1 might be a target for treating NSCLC, and a warning sign of diagnosis of early lung cancer.

Several clusters and individual cases of acute —often severe— hepatitis have been reported in Europe —mainly in the United Kingdom (U.K.)—, the United States (U.S.) and recently in Asia since October 2021. Laboratory investigation of the common viral hepatitis agents (HAV, HBV, HCV, HDV and HEV) yielded negative results prompting the use of the term “acute non hepA–E hepatitis” to describe this condition. The cases were characterized by the manifestations of acute hepatitis (abdominal pain, vomiting, diarrhea, jaundice and very high levels of liver enzymes) affecting children with a median age of 3–4 years. The exact underlying etiology has not been revealed yet; however, a leading hypothesis is that an infectious agent is the culprit underlying cause or at least a risk factor for acute non hepA–E hepatitis occurrence. So far, laboratory testing has shown the presence of adenovirus serotype 41 (Ad–41) which is classified in group F of adenoviruses in about three-fourths of the reported cases. However, the definitive link between adenoviruses and acute non hepA–E hepatitis has not been fully elucidated, which necessitates further investigation of this possible correlation. As of the end of April 2022, more than 200 cases were reported worldwide, the majority of which were in Europe: the U.K. (n=114), Italy (n=17), Spain (n=13), Israel (n=12), the U.S. (n=9), Denmark (n=6), Netherlands and Ireland (n=4), Japan (n=3), Austria, Belgium, France, and Norway (n=2), Germany, Poland, and Romania (n=1). Possible cases are being evaluated in Illinois, Minnesota, North Carolina, Wisconsin states of the U.S., Canada, Singapore and Slovenia. Vigilant surveillance and epidemiologic investigation to identify further cases are warranted at the global level to delineate the features of this emergent public health issue. The possible role of environmental and toxic agents including foodborne toxins should not be overlooked as well. Specific guidelines for identification of further cases is necessary particularly in low-income settings where testing for adenoviruses is not considered routinely. Genetic analysis of Ad–41 isolates is recommended to assess the potential changes in virus genome with subsequent possible altered virus behavior. Immunopathogenesis is another possibility that should be examined as well considering the absence of virus detection in liver biopsies of the affected children in the U.S.

Abstract: COVID-19 Long Haulers, an estimated 3% to 12% of people infected globally with coronavirus having latter devasting symptoms 12 weeks after the initial infection is on the rise. We conducted a collaborative study with the long covid patient organization in Greece in order to estimate the prevalence, symptoms and problems that adult long haulers experience and then propose a management plan for these patients. Symptoms were obtained from 208 patients using unstructured qualitative free text entries in an anonymized online questionnaire. The majority of respondents (68.8%) were not hospitalized and had been diagnosed more than six months ago with lingering symptoms (66,8%). Eighteen different symptoms (fatigue, tachycardia, shortness of breath, parosmia etc) were mentioned in both hospitalized and community patients. Interestingly, patients with initial mild symptoms suffer from the same persistent symptoms as those who were hospitalized. Awareness of long covid sequelae seems to be low even among medical doctors. Treatment options incorporating targeted rehabilitation programs are either not available or still excluded from the management plan of long covid patients. Since long COVID is a multi-systemic entity, we propose a holistic interventional approach using a multidisciplinary medical team in order to securely and effectively diagnose and treat these specific patients. Academic and medical community must collaborate with long covid patients’ organizations so as to provide personalized medicine.

Solidification microstructure is formed under high cooling rates and temperature gradients in powder-based additive manufacturing. In this study, a non-equilibrium multi-phase field method (MPFM), which was based on a finite interface dissipation model proposed by Steinbach et. al., coupled with a CALPHAD database was developed for a multicomponent Ni alloy. A qua-si-equilibrium MPFM was also developed for comparison. Two-dimensional equiaxed micro-structural evolution for the Ni (Bal.)–Al–Co–Cr–Mo–Ta–Ti–W–C alloy was performed at various cooling rates. The temperature–γ fraction profiles obtained under 10^5 K/s using non- and qua-si-equilibrium MPFMs were in good agreement with each other. Over 10^6 K/s, the differences between non- and quasi-equilibrium methods grew as the cooling rate increased. The non-equilibrium solidification was strengthened over a cooling rate of 10^6 K/s. Colum-nar-solidification microstructural evolution was performed under cooling rates from 5×10^5 K/s to 1×10^7 K/s at various temperature gradient values under the constant interface velocity (0.1 m/s). The results showed that as the cooling rate increased, the cell space decreased in both methods, and the non-equilibrium MPFM agreed well with experimental measurements. Our results show that the non-equilibrium MPFM can simulate solidification microstructure in powder bed fusion additive manufacturing.

Objective: To study the changes in urine metabolism in female water polo players before and after high-intensity training by using ultra-high performance liquid chromatography-mass spectrometry, and to explore the biometabolic characteristics of urine after training and competition. Methods: Twelve young female water polo players (except goalkeepers) from Shanxi Province were selected. A 4-week formal training was started after one week of acclimatization according to experimental requirements. Urine samples (5 ml) were collected before formal training, early morning after 4 weeks of training, and immediately after 4 weeks of training matches, and labeled as T1, T2, and T3, respectively. The samples were tested by LC-MS after pre-treatment. XCMS, SIMCA-P 14.1, and SPSS16.0 were used to process the data and identify differential metabolites. Results: On comparing the immediate post-competition period with the pre-training period (T3 vs T1), 24 differential metabolites involved in 16 metabolic pathways were identified, among which niacin and niacinamide metabolism and purine metabolism were potential post-competition urinary metabolic pathways in the untrained state of the athletes. On comparing the immediate post-competition period with the post-training period (T3 vs T2), 10 metabolites involved in 3 metabolic pathways were identified, among which niacin and niacinamide metabolism was a potential target urinary metabolic pathway for the athletes after training. Niacinamide, 1-methylnicotinamide, 2-pyridone, L-Gln, AMP, and Hx were involved in two metabolic pathways before and after the training. Conclusion: Differential changes in urine after water polo games are due changes in the metabolic pathways of niacin and niacinamide.

Emotion recognition is becoming very relevant in educational scenarios, since previous research has proven the strong influence of emotions on the student's engagement and motivation. There is no standard method for stating student's affect, but physiological signals have been widely used in educational contexts. Physiological signals have been proved to offer high accuracy in detecting emotions because they reflect spontaneous affect-related information, and which is fresh and do not require an additional control or interpretation. However, most proposed works use measuring equipment that limit its applicability in real-world scenarios because of their high cost and their intrusiveness. Expensive material means an economic challenge for schools and reduce the scalability of the experiments. Intrusive equipment can be uncomfortable for the students which can lead to errors in the collected data. In this work, we analyse the feasibility of developing a low-cost non-intrusive device that integrates easy-to-capture signals that guarantee high detection accuracy. The advantage of the approach also lies in using user’s centred information sources (intra-subject) in real-world situations, which provide better detection accuracy, by offering models adapted to each subject. To this end, we present an experimental study that aims to explore the potential application of Hidden Markov Models (HMM) to predict the concentration state from 4 commonly used physiological signals, namely heart rate, breath rate, skin conductance and skin temperature. We study the multi-fusion of every possible combination of these four signals and analyse their potential use in an educational context in terms of intrusiveness, cost and accuracy. Results show that a high accuracy can be achieved with three of the signals when using HMM-based intra-subject models. However, inter-subject models, which are meant to obtain subject-independent approaches for affect detection, fail at the same task. This work concludes that the implementation of a low-cost wrist-worn device for recognising relevant emotions from each student is possible and open the way to a wide range of practical applications in the context of adaptive learning systems.

While many in-steam tidal energy resource studies have been carried out globally, very few studies have assessed the effect of seabed changes on tidal energy resources. For coastal regions in particular, where the seabed is generally more mobile than in deep waters, bathymetric evolution could have a significant effect on tidal energy production. Here two high-resolution models, one purely hydrodynamic and one morphodynamic, are used to analyse the potential effect of natural morphodynamic evolution on tidal energy resources at two macro-tidal sandy bays, Adaír Bay and San Jorge Bay, in the Upper Gulf of California, Mexico. The high-resolution models are validated using a low-resolution model and ADCP observations to assess the agreement between model predictions and observations of tides at three ADCP moorings within the domain of interest. The models’ skill is evaluated using several error statistics such as the mean relative error, the root mean square error (RMSE), and the correlation coefficient. It was found that the regions with the largest bed changes, and also the largest renewable energy resources, were near the shore. Moreover, the results indicated a good correlation between a) regions with the most significant depth changes, and b) the regions where the difference in annual energy production with and without depth change was largest. Finally, the morphodynamic model was run for two years, and the evolution of a zonal profile (in the west-east direction) off the coast at the southeastern corner of Adaír Bay was inspected. This profile evolved towards a featureless equilibrium profile, in good agreement with the morphological classification for macro-tidal sandy environments and with the model assumptions. But most importantly, this natural evolution would not be detrimental to tidal energy exploitation at the site.

This study presents a novel technique utilizing high frequency vibration to shorten treatment time and preserve alveolar bone in challenging orthodontic cases treated with Invisalign® clear aligners. Four non-growing orthodontic patients (age range 14-47 years old) with Class II skeletal patterns (convex profiles with retrognathic mandibles) who sought correction of their crowded teeth and non-surgical correction of their convex profiles were included in this study. These patients were treated using Invisalign clear aligners together with high frequency vibration (HFV) devices (120 Hz) (VPro5™) that were used by all patients for five minutes per day during active orthodontic treatment. Vertical control and forward rotation of the mandible for each patient was achieved through pre-programming the Invisalign to produce posterior teeth intrusion. Successful forward rotation of the mandibles achieved in all patients led to improvement of their facial convex profiles (ANB improved 2.1 + 0.5 degrees; FMA improved 1.2 +1.1 degrees). Dental decompensation was achieved by lingual tipping of the lower incisors and palatal root torque of upper incisors. The use of HFV together with Invisalign facilitated achieving these results within a 12+6 month period. In addition, more bone labial to the lower incisors after their lingual movement was noted. In conclusion, the use of HFV concurrent with SmartTrack Invisalign aligners allowed complex tooth movement and forward projection without surgery in non-growing patients with skeletal Class II relationships. The clinical impact and implications of this case series is that the use of HFV facilitates complex orthodontic tooth movement including posterior teeth intrusion and incisor decompensation in addition to increased bone formation labial to lower incisors that may minimize future gum recession due to their labial inclination.

The aim of this cross-sectional study was to assess the perceived medication-related burden among patients with multiple non-communicable diseases (NCDs), and to investigate the association between perceived burden and adherence to medication therapy. Medication-related burden was measured in three primary care clinics in Qatar using the Living with Medicines Questionnaire (LMQ) among adults with diabetes, with or without other comorbidities. Adherence was measured using the Adherence to Refills and Medications Scale (ARMS). Two hundred ninety-three eligible patients participated in the study. Majority of participants reported experiencing minimum (66.6%) to moderate (24.1%) medication-related burden. There was a significant positive correlation between the medication-related burden (measured by the LWQ) and medication adherence (measured by ARMS) (rs (253) = 0.317, p <0.0005). The duration of diabetes diagnosis, adherence score, marital status, employment status, and presence diagnosis of hypertension were significant predictors of medication burden. A considerable proportion of the patients in this study have reported experiencing medication-related burden. Healthcare providers should seek strategies to address this burden especially among patients with risk factors of cardiovascular diseases, non-adherent to their medication therapy, living alone, or non-employed.

Butanol extracts from leaves, twigs and fruits of Elaeagnus rhamnoides (L.) A. Nelson (sea buckthorn, SBT) were fractionated into phenolic and non-polar lipid components. Their chemical composition was analyzed using the Thermo Ultimate 3000RS chromatographic system, equipped with a diode array detector, a corona-charged aerosol detector, and coupled with a (Q-TOF) mass spectrometer. Assuming that an effect on natural microbiotaand host epithelial cells needs to be assessed, regardless of the purpose of using SBT formulations in vivo, the MIC/MBC/MFC of the fractions and reference phytocompounds were screened involving 17 species of Gram-positive and Gram-negative bacteria and Candida species. The impact of the fractions (subMIC) on the important in vivo persistence properties of S. aureus and C. albicans strains was evaluated. Tests for adhesion and biofilm formation on an abiotic surface and the surfaces conditioned with fibrinogen, collagen, plasma or artificial saliva showed the inhibitory activity of the fractions. The effects on FITC-labeled staphylococci adhesion to fibroblasts (HFF-1) and epithelial cells (Caco-2), and on fungal morphogenesis, indicated that SBT extracts have high anti-virulence potential. Cytotoxicity tests (MTT-reduction) on the standard fibroblast cell line showed variable biological safety of the fractions depending on their composition and concentration.

The aim of the present study was to predict the response of non-small cell lung cancer (NSCLC) patients to immune checkpoint inhibitors (ICIs) by leveraging computed tomography (CT) images using deep learning techniques. Retrospectively, 624 sequential CT images were gathered from 156 patients at Jiangsu Province Hospital, along with their clinical data. The dataset was subsequently partitioned into three groups: training (n=547), validation (n=64), and test (n=64). Moreover, an external validation cohort included 37 CT images from patients at Nanjing Pukou Peoples' Hospital, accompanied by comprehensive clinical data. An advanced Video Vision Transformer (ViViT) model incorporating global self-attention was utilized to analyse patients treated with ICIs and predict their response. The ViViT model's efficacy was evaluated using a confusion matrix and a receiver operating characteristic curve (ROC). Notably, the ViViT model demonstrated predictive prowess for ICIs response, yielding respective areas under the receiver operating characteristic curve (AUC) of 0.74 (95% CI: 0.69-0.78), 0.74 (95% CI: 0.61-0.86), 0.76 (95% CI: 0.62-0.88), and 0.69 (95% CI: 0.5-0.87) in the training, validation, test, and external validation cohorts. The present study illustrates how a deep learning model can provide a non-invasive means to predict clinical outcomes in NSCLC patients undergoing ICIs, potentially transforming personalized treatment approaches for individuals with NSCLC.

Background and objective: Analysis of inflammatory biomarkers, along with the neutrophil/lymphocyte ratio (NLR) or platelets/lymphocyte ratio (PLR), supports the connection between inflammation and carcinogenesis. Methods: We conducted a retrospective observational study at the Clinical County Hospital Mureș, including patients with lung cancer. The parameters analyzed included: histopathological type (NSCLC - squamous cell carcinoma or adenocarcinoma; SCLC), molecular mutations (EGFR, ALK, PD-L1), parameters from the complete blood count, inflammatory parameters and associated comorbidities. Results: 380 patients were included: 115 patients in the cancer group and 265 patients in the control group. Among patients in the lung cancer group, 88 were diagnosed with NSCLC (44 adenocarcinomas, 44 squamous cell carcinomas) and 27 with SCLC. Both NLR and PLR were significantly higher in cancer patients than in the control group (5,30 versus 2,60, p&lt;0,001; 217 versus 136, p&lt; 0.001, respectively). NLR and PLR differs between men and women (p = 0.005, respectively p=0.056). C-reactive protein was not correlated with either NLR (p-value: 0.0669) or PLR (p-value: 0.6733) in lung cancer patients. Conclusion: The NLR and PLR values ​​may serve as new predictive biomarkers for the diagnostic of disease in patients with lung cancer, especially those with NSCLC.

Cancer stem cell (CSC) has paved the way to many fundamental and translational studies. Recent studies have highlighted differentiated breast cancer cells (non-CSCs) switching phenotype to CSCs in response to various stimuli, depicting the existence of cancer stem cell plasticity. Although strategies to reduce the phenotypic plasticity of non-CSCs into CSCs are likely to prevent treatment-resilient cancer cells driving recurrence, most phenotypic plasticity mechanisms involve Notch, Wnt or MAPK signaling pathways. In this study, breast cancer cells were irradiated to identify soluble reprogramming factors. Using conditioned medias, protein arrays analyses, flow cytometry and in cellulo/in vivo functional assays, we demonstrated, for the first time, that radiation-induced chemokine expression, especially CXCL1 and CCL5 and their receptors CXCR2, CCR1 and CCR5, stimulates reprogramming of breast non-CSCs into CSCs. Treatment of non-CSCs with recombinant CXCL1 and CCL5 is sufficient to induce cell reprogramming, while their inhibition can be used to prevent reprogramming and sensitize tumor to radiation. Moreover, analysis of gene expression profiles from 38 public merged databases demonstrated that combined over-expression of CXCL1/CXCR2, CCL5/CCR1 or CCL5/CCR5 has a poorer prognosis in patients treated with radiotherapy, suggesting a promising way for patient stratification, where individuals with elevated cytokine levels could benefit from radiotherapy in conjunction with cytokine inhibitors. Taken together, our findings provide a rationale to consider these axes as potential targets and predictive biomarkers in breast cancer patients.

As brachycephalic dog breed ownership increases, there is a growing concern for the welfare of these breeds due to extreme brachycephalism. Understanding the motivations and behaviours of those choosing to own these breeds is important if we wish to address these concerns. The aim of this study was to investigate how owners of brachycephalic and non-brachycephalic dog breeds use social media dog breed groups to discuss common health issues. The purpose of Facebook posts in relation to common health issues, owner awareness of health issues, and the role of Facebook facilitated social support were explored between brachycephalic and non-brachycephalic dog owners. Twelve Facebook breed groups were selected (brachycephalic breed groups, n=6, non-brachycephalic breed groups, n=6). Using key word searches we extracted the first twenty posts from each group. Thematic analysis revealed three overarching themes: advice seeking, advice giving and community bonding mechanisms. Whilst the purpose of posting did not differ between groups, non-brachycephalic owners appeared to display greater awareness of breed-specific health issues, whilst social support played a more prominent role in brachycephalic groups. This research highlights that social media groups can act as platforms for knowledge exchange and emotional support. These could be utilised by owners, veterinarians and welfare organisations to more effectively enhance dog health and wellbeing.

Antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are multi-targeted and variable over time. Multiplex quantitative serological assays are needed to provide accurate and robust seropositivity data for establishment of serological signatures during vaccination and or infection. We describe here, validation and evaluation of an electro-chemiluminescence (ECL) based Mesoscale Discovery assays (MSD), for estimation of total and functional IgG to SARS-CoV-2 spike, nucleocapsid, and receptor binding (RBD) proteins in human serum samples to establish serological signatures of SARS-CoV-2 natural infection and breakthrough cases. The 9-PLEX assay was validated as per ICH, EMA and US FDA guidelines using a panel of sera samples including the NIBSC/WHO international reference panel (20/268). Assay demonstrated high specificity and selectivity in inhibition assays, wherein the homologous inhibition was more than 85% and heterologous inhibition was below 10 %. Assay also met predetermined acceptance criteria for precision (CV < 30 %), accuracy (70-130 %) and dilutional linearity. Method applicability to serological signatures was demonstrated using sera samples (N=45) representing vaccinated, infected and breakthrough cases. The method was able to establish distinct serological signatures and thus provide potential tool for seroprevalence of SARS-COV-2 during vaccination or infection.

In this observational study, we compared continuous physiological signals during an active stand test in adults aged 50 years and over, characterized as frail by three different criteria, using data from The Irish Longitudinal Study on Ageing (TILDA). Four independent groups were identified: those characterized as frail only by one of the frailty tools used (the physical Frailty Phenotype (FP), the 32-item Frailty Index (FI), or the Clinical Frailty Scale (CFS) classification tree), and a fourth group where participants were not characterized as frail by any of these tools. Continuous non-invasive physiological signals were collected during an active stand test: systolic (sBP) and diastolic (dBP) blood pressure, as well as heart rate (HR), using digital artery photoplethysmography. Additionally, frontal lobe cerebral oxygenation (Oxy), deoxygenation (Deoxy), and tissue saturation index (TSI) were also non-invasively measured using near-infrared spectroscopy (NIRS). The signals were visualized across frailty groups and statistically compared using one-dimensional statistical parametric mapping (SPM). A total of 1,124 participants (mean age 63.5 years, 50.2% women) were included: 23 were characterized as frail only by FP, 97 by FI, 38 by CFS, and 966 by none of these criteria. SPM analyses revealed that only the group characterized as frail by FI had significantly different signals (p<0.05) compared to the non-frail group. Specifically, they exhibited a lesser increase in HR between 5-15 seconds post-stand and larger deficits in sBP and dBP between 15-40 seconds post-stand, and possibly a lower Delta TSI at 20 seconds post-stand. In this comparison, the FI proved more adept at capturing distinct physiological responses to standing, likely due to its direct inclusion of cardiovascular morbidities in its definition.

The overexploitation of forest resources in the charcoal production basin of the city of Lubum-bashi (DR Congo) is reducing the resilience of miombo woodlands and threatening the survival of the riparian as well as urban human populations that depend on it. We assessed the socio-economic value and availability of plant-based non-timber forest products NTFPs in the rural area of Lubumbashi through ethnobotanical (100 respondents) and socio-economic (90 respondents) interviews, supplemented with floristic inventories, in two village areas selected on the basis of the level of forest degradation. The results show that 60 woody species, including 46 in the degraded forest (Maksem) and 53 in the intact forest (Mwawa), belonging to 22 families are used as sources of NTFPs in both villages. Among these species, 25 are considered priority species. NTFPs are collected for various purposes, including handcrafting, hut building, and traditional medicine. Moreover, the ethnobotanical lists reveal a similarity of almost 75%, indicating that both local communities surveyed use the same species for collecting plant-based NTFPs, despite differences in the level of degradation of the miombo woodlands in the two corresponding study areas. However, the plant-based NTFPs that are collected from miombo woodlands and traded in the urban markets have significant economic value, which ranges from 0.5 to 14.58 USD per kg depending on the species and uses. NTFPs used for handicraft purposes have a higher economic value than those used for other purposes. However, the sustainability of this activity is threatened due to unsustainable harvesting practices that include stem slashing, root digging, and bark peeling of woody species. Consequently, there is a low availability of plant-based NTFPs, particularly in the village area where forest degradation is more advanced. It is imperative that policies for monitoring and regulation of harvesting, and promoting sustainable management of communities’ plant-based NTFPs priority, be undertaken to maintain their resilience.

Cardiovascular disease (CVD) is one of the leading causes of death in Puerto Rico, where clopidogrel is commonly prescribed to prevent ischemic events. Genetic contributors to both a poor clopidogrel response and the severity of CVD have been identified mainly in Europeans. However, the non-random enrichment of single nucleotide polymorphisms (SNPs) associated with clopidogrel resistance within risk loci linked to underlying CVDs, and the role of admixture, has yet to be tested. This study aimed to assess possible interaction between genetic biomarkers linked to CVDs and those associated with clopidogrel resistance among admixed Caribbean Hispanics. We identified 50 SNPs significantly associated with CVDs in previous genome-wide association studies (GWAS). These SNPs were combined with another ten SNPs related to clopidogrel resistance in Caribbean Hispanics. We developed Python scripts to determine whether SNPs related to CVDs are in close proximity to those associated with clopidogrel response. Average and individual local ancestry (LAI) within each locus were inferred, and 60 random SNPs with their corresponding LAI were generated for enrichment estimation purposes. Our results showed no CVD-linked SNPs in close proximity to those associated with clopidogrel response among Caribbean Hispanics. Consequently, no genetic loci with a dual predictive role for risk of CVD severity and clopidogrel resistance were found in this population. Native American ancestry was the most enriched within risk loci linked to CVDs in this population. Non-random enrichment of disease susceptibility loci with drug response SNPs is a new frontier in Precision Medicine that needs further attention.

The term neuroinflammation defines the reactions of astrocytes and microglia to alterations in homeostasis in the diseased central nervous system (CNS), the exacerbation of which contributes to the neurodegenerative effects of Alzheimer's disease (AD). Local environmental conditions, such as the presence of proinflammatory molecules, mechanical properties of the extracellular matrix (ECM) and local cell-cell interactions, are determinants of glial cell phenotypes. In AD, the load of the cytotoxic/proinflammatory amyloid β peptide (Aβ) is a microenvironmental component increasingly growing in the CNS, imposing time-evolving challenges on resident cells. This study aimed at investigating the temporal and spatial variations of the effects produced by this process on astrocytes and microglia, either directly or by interfering in their interactions. Ex vivo confocal analyses of hippocampal sections from the mouse model TgCRND8 at different ages have shown that overproduction of Aβ peptide induced early and time persistent disassembly of functional astroglia syncytium and promoted a senile phenotype of reactive microglia, hindering Aβ clearance. In the late stages of disease, these patterns were altered in the presence of Aβ-plaques, surrounded by typically reactive astrocytes and microglia. Morphofunctional characterization of peri-plaque gliosis revealed a direct contribution of astrocytes in plaque buildup that might result in shielding Aβ-peptide cytotoxicity and, as a side effect, in exacerbating neuroinflammation.

The non-structural protein (NS) and nucleoprotein (NP) of the severe fever with thrombocytopenia syndrome virus (SFTSV) encoded by the S segment are crucial for viral pathogenesis. They reside in viroplasm-like structures (VLS), but their interaction and their significance in viral propagation remain unclear. Here, we investigated the significance of the association between NS and NP during viral infection through in-silico and in-vitro analyses. Through in-silico analysis, three possible binding sites were predicted, at NSs1-32, NSs56-82, and NSs207-237. Rationally, three mutant NSs were developed by site-directed mutagenesis and tested for NP interaction by co-immunoprecipitation. NSsW61Y failed to interact with the nucleoprotein, which was substantiated by the conformational changes observed in the structural analyses. Additionally, molecular docking analysis corroborated that the NSW61Y mutant protein does not interact well compared to wild-type NS. Over-expression of wild-type NS in HeLa cells increased the SFTSV replication by five folds, but NSsW61Y exhibited 1.9-folds less viral replication than wild-type. We demonstrated that the W61Y alteration was implicated in the reduction of NS-NP interaction and viral replication. Thus, the present study identified a critical NS site, which could be targeted for development of therapeutic regimens against SFTSV.

Urban planning in third-world development cannot only refer to its outward appearance. The lack of urban physiognomy caused many problems regarding ineffective planning policies. Palangka Raya is the only capital city in Indonesia where President Sukarno inaugurated it in 1957. Then Tjilik Riwut, the first governor of Central Kalimantan province, who was also a Dayak ethnic leader, proposed Palangka Raya to be the capital of Indonesia at a National Council meeting in 1958, replacing Jakarta. President Sukarno, who chaired the meeting, agreed to further research on the idea. However, the emergence of Palangka Raya in 1957 and the initiation of the Trans Kalimantan National Road project in the 1990s have changed the spatial patterns of ancient Dayak cities that believed in rivers. This qualitative research investigates vernacular settlement planning in Central Kalimantan, collecting data related to photographs, drawings, sketches, and documents from the Tjilik Riwut Museum. Through social construction, this study narrates the meanings that arise in social relations, both individuals and groups. So far, the study of urban analysis using physiognomy is still lacking in depth and limited to persona and gestures. This paper is about the non-existent planning policies, looking at shadow aspects and subjectivity.

We sought to evaluate the effects of non-surgical periodontal treatment (NSPT) on periodontal clinical parameters, systemic blood pressure (BP) and plasma levels of systemic inflammation markers in patients with combined refractory arterial hypertension (RAH) and stage III grade B periodontitis. Twenty-seven participants with RAH and periodontitis received NSPT. The analyzed clinical parameters were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). An assessment was performed for systemic BP, complete blood count, coagulogram, creatinine measurement, C-reactive protein (CRP), glycated hemoglobin, cholesterol, glutamic oxaloacetic transaminase, glutamate pyruvic transaminase, waist-hip ratio, and body mass index. In the follow-up period, twenty-two patients were evaluated at baseline and after 90 and 180 days. The data were submitted to statistical analysis (α=0.05%). As expected, the clinical results showed a significant improvement in the percentages of PI, BOP, PD and CAL, which were statistically significant at 90 and 180 days (p&lt;0.0001). Importantly, NSPT significantly reduced the blood level of CRP (p&lt;0.02). However, no significant reduction in BP parameters was noted in the evaluated follow-up periods. NSPT, despite the benefits in periodontal clinical parameters, reduced the plasma level of CRP but not the BP in patients with combined RAH and periodontitis.

Pneumonia kills over two million children under-age of five every year. Oral amoxicillin was recommended by WHO as the first drug of choice for treatment of non-severe pneumonia. The study aimed to determine the clinical failure rate of amoxycillin for the treatment of childhood non-severe pneumonia at Primary Health Care Centers (PHCCs). A randomized controlled multicenter-trial study was conducted in Sana’a. IMCI strategy was used to enrollments the cases where randomly allocated to receive amoxicillin or co-trimoxazole orally for five days. Multivariate logistic regression was used for identified risk factors associated with clinical failure. A total of 254 children were enrolled, of whom 128 cases were treated with amoxicillin while 126 with co-trimoxazole. The clinical failure for amoxicillin was significantly more than co-trimoxazole (30% vs 10%) p value > 0.001. the most risk factor which significantly associated to amoxicillin failure were pre-infection in the last 6 months, while abnormal CBC and literate mothers were associated with clinical failure of co-trimoxazole (p value > 0.05). The use of co-trimoxazole as an alternative to amoxicillin for the treatment of non-severe pneumonia in the PHCCs and conducting further studies to determine the appropriate antibiotic as the first line of defense are recommended.

Non-pneumatic tires have gained a lot of attention due to their advantages, including not having to worry about getting a flat tire. In this type of tire, metamaterial cells replace the pneumatic part of the tire. In general, metamaterials are formed by stacking cells together. These cells are obtained by various methods including topology optimization. Therefore, in this research, to achieve a metamaterial cell suitable for a non-pneumatic tire with the objective function of increasing compressive strength and bending fatigue life, optimization for three types of geometry including (1) square plane, (2) rectangular plane, and (3) entire circumference of tire and three types of material including polylactic acid (PLA), thermoplastic polyurethane (TPU) and void have been done. Optimization has been implemented by using MATLAB code in 2D mode. The cubic cell is obtained from extruding the optimized response of the square plane. From the optimized response of the rectangular plane, the cylindrical cell and from extruding the optimized response of the entire circumference of tire to the tire cross-section size, the main geometry of the tire has been calculated. Finally, to check the quality of 3D printing in producing cells and how they are connected, the optimal cell fabricated by the fused deposition modeling (FDM) method has been observed using a field-emission scanning electron microscopy (FE-SEM). The results show that in the optimization of the square plane, the sample with the minimum remaining weight constraint equal to 40% and in the optimization of the rectangular plane and the entire circumference of tire, the sample with the minimum remaining weight constraint equal to 60% was selected as the optimal sample. From checking the quality of 3D printing, it has been concluded that PLA and TPU materials are completely connected.

Enteroaggregative Escherichia coli (EAEC) are highly heterogeneous in virulence; we wanted to understand the pathogenic potential of EAEC isolated various clinical and non-clinical sources in an animal model. We infected male BALB/c mice in six mice/group with 50 EAEC isolates, isolated from clinical and non-clinical sources. We studied colonization, weight loss, stool shedding, inflammatory markers and its relationship with 21 virulence genes and phylogroups, EAEC organ burden and histopathological changes. We detected significantly more inflammatory changes and fecal lactoferrin and calprotectin levels in mice infected with EAEC isolated from symptomatic cases. In clinical EAEC isolates, the presence of chromosomal genes {(aap (46%), aaiC (23.3%), and SPATEs (pet (13.3%), sat (20%), sigA and pic (6.6%)}, adhesive variants {(agg4A (53.3%), aggA (53.3%), aafA (36.6%), agg3A (40%)} of EAEC, and master regulator gene aggR (66.6%) were associated with higher levels of lactoferrin and calprotectin. Also, 70% (9/13) of EAEC isolated from acute diarrheal cases bearing chuA (70%) in our study were assigned to group B2 (4 isolates) and D (5 isolates). Real-time PCR analysis revealed that colonization by EAEC strains from different clinical and non-clinical sources occurs up to 10-15 days of life. Even from non-diarrhoeal stools and non-clinical sources, had the potential to cause prolonged colonization, weight loss, and inflammation in the intestine though the degree varied. Moreover, better understanding of EAEC pathogenic pathways is desperately needed in different clinical scenarios.

According to this study, approximately half of Africa's forests are utilized primarily or partially for the production of wood and non-wood commodities. Aims to evaluate Africa's forestry and forest products, namely Wood Forest Products (WFPs) and Non-wood Forest Products (NWFPs) in the sixteen (16) West African countries. While adhering to the following guidelines: wood extraction and preparation, analyzing wood primarily used as an energy source in Africa, identifying non-wood forest products in Africa, the state of export, trade, and customs procedures in West Africa, and examining the role of forests and forest stakeholders in Africa's low-carbon economy transition. An exploratory literature review of selected wood forest products and non-wood forest products (plants and animals) in West Africa identifying the country, the natural land area with the natural habitat issues of the forest, the species most harvested and traded in the West African sub-region. The study reemphasized some government legislation, policies, and market trade failures and limitations while also stating that trees may help in the low-carbon revolution through interventions aimed at maintaining, improving, and restoring natural capital have demonstrated that high environmental requirements of sustainable forest management (SFM) may be met in both natural and planted forests. The study identified a systematic assessment of the most common forest products (wood and non-wood forest products) considering the available data on the national forest reserves of the selected countries in West Africa. The study also revealed the need for biodiversity conservation of the available forest reserves to help mitigate the impact of global warming targeting the United Nation’s Sustainable Development Goal 13- Climate Action. Which is focused on integrating climate change mitigation, adaptation, impact reduction, and early warning signs into the national policies, improving forest planning and management education, awareness-raising, and institutional capacity within the sub-region.

Globally, noncommunicable diseases (NCDs) were responsible for 41 million deaths in 2016, with the majority of these occurring in low and middle-income countries. These diseases were on the rise as a result of unhealthy, low-quality, and unbalanced diets, which resulted in overweight and obesity. The National School Nutrition Programme (NSNP) was created to regulate the foods sold to schoolchildren. To ascertain school management teams' perspectives on the relationship between the NSNP and the development of lifestyle diseases. A phenomenological qualitative study using Focus Group Discussions among 16 purposively selected members of the School Management Teams were conducted in Mt Frere, Eastern Cape in 2016. The narrative data was analyzed using Tesch's eight-phase thematic analysis approach. The data analysis revealed two themes (NSNP and the vendor system) and six sub-themes. The NSNP was viewed as making a significant contribution to children's food security, thereby improving academic output. However, reengineering of the NSNP was need through improved budgeting and inclusion of breakfast in the menu to control NCDs risk factors. The current implementation of the vendor system did not support reduction of NCDs risk factors. Improved implementation of the guide to vendor system is needed.

The three-armed cluster-randomized trial ARena (Sustainable reduction of antibiotic-induced antimicrobial resistance) aimed to foster appropriate antibiotic use and reduce overprescribing in German ambulatory care to counter antibiotic resistance. Multi-faceted interventions targeted primary care physicians, teams and patients. This study examined effectiveness of the implementation program. ARena was conducted in 14 primary care networks with 196 practices. All arms received data-based feedback on antibiotics prescribing and quality circles. Arms II and III received different add-on components each. Primary outcome examined is the prescribing rate for systemic antibiotics for cases with non-complicated acute infections (upper respiratory tract, bronchitis, sinusitis, tonsillitis, otitis media). Secondary outcomes refer to prescribing of quinolones and guideline-recommended antibiotics. Based on pseudonymized quarterly claims data, mixed logistic regression models examined pre-post intervention antibiotic prescribing rate changes and compared to matched standard care. A significant rate reduction (arm I 11.7%; arm II 9.9%; arm III 12.7%) and significantly lower prescribing rates were observed for all arms (20.1%, 18.9% and 23.6%) compared to matched standard care (29.4%). Fluoroquinolone prescribing was reduced in all intervention arms and rates for recommended substances generally increased. No significant post-interventional difference between intervention arms was detected. Findings indicate implementation program impact compared to standard care. Trial registration: ISRCTN, ISRCTN58150046

Nitrogen and phosphorous support the ecosystem by supplying nutrients to algae and aquatic plants. Having them in excess results in the eutrophication of waters creating quality problems. In the past, nitrogen has been widely investigated for wells in the context of groundwater flow. However, a national-scale nitrogen assessment in rivers and streams has not received enough attention. In this research, the Wilcoxon rank sum test, as a non-parametric hypothesis testing method, has been applied to nitrogen concentration in the form of nitrate-nitrogen and nitrite-nitrogen in rivers and streams of the Contiguous United States. This approach was particularly selected because of the non-normal and positively skewed nitrogen levels occurring in the surface flow. This method was able to identify the impaired body of waters as well as quantify the confidence, significance, and errors involved. The Northern Appalachians (NAP), Northern Plains (NPL), and Xeric (XER) ecoregions were worsening in the nitrogen-nitrate condition with NAP, and XER needed immediate actions. The nitrite-nitrogen condition did not pose an immediate threat, so mitigation plans should focus more on nitrate-nitrogen remediation. It was shown that the method was superior to the two-sample t-test by yielding lower type II errors.

Background: Health-related knowledge is among the essential factors to enable women to be aware of their rights to seek health services. However, little is known about knowledge of safe abortion care services among women of reproductive age in Ethiopia. The main purpose of the study was to assess knowledge of safe abortion care services and associated factors among women of reproductive age in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from April-June 2019 among 432 respondents. Bivariate statistics including correlation coefficients, student t-test, one-way analysis of variance, and linear regressions, and multiple linear regression analyses were used. A significant statistical test was determined at a 95% confidence interval and p-value <0.05. Results: About 65.5% had heard about safe abortion care services; media being the main source of information for 79.5%. The finding from an independent-sample t-test shows that the place where the respondents grew up (p< 0.006), history of past miscarriage, and previous information of abortion care service were significantly associated with the knowledge about safe abortion care services (p< 0.001). Conclusions: Women without prior health experiences and those with rural origin could be targeted for reproductive health information interventions including safe abortion care provision.

The extracts from the aerial parts of Helianthus salicifolius A. Dietr and Helianthus tuberosus L. collected in June were obtained using carbon dioxide supercritical fluid extraction with water as co-solvent. The antimicrobial activity in vitro of these extracts were determined against the reference species of Gram-positive and Gram-negative bacteria as well as fungi, representing by the yeast species of Candida spp. The following parameters were estimated: minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) or minimum fungicidal concentration (MFC). Both extracts were found to possess antimicrobial activity with MIC = 0.62-5 mg mL-1 for bacteria and MIC = 5-10 mg mL-1 for yeasts, showing bactericidal (MBC/MIC = 2-4) or fungicidal effect (MFC/MIC = 1-2 ). The highest activity was observed against S. aureus ATCC 29213 (MIC = 0.62 mg mL-1 for H. salicifolius extract; MIC = 2.5 mg mL-1 for H. tuberosus extract). Bactericidal effect of both extracts against S. aureus ATCC 29213 was confirmed by time-kill assay. Higher antioxidant activity was found for H. tuberosus extract (EC50 = 0.332 mg mL-1) as compared to that of H. salicifolius (EC50 = 0.609 mg mL-1). The total polyphenol content (TPC) expressed as gallic acid equivalents (GAE) was 13.75 ± 0.50 mg GAE (g of H. salicifolius extract)-1 and 33.06 ± 0.80 mg GAE (g of H. tuberosus extract)-1. There was a correlation between the antioxidant potential of both extracts and TPC but not between antistaphylococcal activity and TPC. The obtained data suggest potential application of these extracts as the natural preparations with the biocidal activity, including those with antistaphylococcal activity. Besides, both extracts may be regarded as potential natural conservants in cosmetics as well as natural preservatives in food.

Carotenoid and carotenoid esters profiles of peel, pulp and whole fruit tissues of astringent persimmon (Diospyrus kaki Thunb., var. Rojo Brillante) have been characterized in detail and quantified for the first time. Carotenoids were determined by HPLC-PDA-MS/MS (APCI+), using a reverse phase C30 column. A total of 38 carotenoids were identified and quantified, corresponding to 21 free carotenoids (13 xanthophylls and 8 hydrocarbon carotenes) and a total of 17 carotenoid esters. The qualitative profiles are very similar among tissues, differing only in the carotenoids concentration. The most important identified free xanthophylls were (all-E)-β-cryptoxanthin, (all-E)-antheraxanthin, (all-E)-lutein, (all-E)-zeaxanthin and (all-E)-violaxanthin . Hydrocarbon carotenoids found were (all-E)-β-carotene, (all-E)-α-carotene, (9Z)-β-carotene, (13Z)-β-carotene, (9Z)-α-carotene, and lycopene. The most abundant carotenoid esters were (all-E)-lutein-3-O-palmitate, (all-E)-zeaxanthin myristate, (all-E)-zeaxanthin palmitate and (all-E)-cryptoxanthin laurate. Processing by high pressures produced no regular effect on persimmon carotenoids and pasteurization affected negatively the content of all carotenoids from all studied persimmon tissues. This work will contribute to the development of scientific research about the bioaccessibity and bioavailabity of each individual free or esterified persimmon carotenoids in order to a better understanding of the carotenoid compounds impact in human health.

Exhaled breath condensate (EBC) sample analysis is an entirely non-invasive novel sample collection method that is fast, easy to perform, and effort-appeared independent. EBC samples can be very useful in identifying the biomarkers of many diseases. This review provides an updated overview of EBC pH disturbances in different disorders as well as physiological levels among healthy individuals since 2012. Our meta-analysis addresses some of the key questions related to sample processing before pH measurement and discusses various methods of condensate standardization that can be employed prior to conducting a pH assay. Given the recent widespread interest in research into the use of EBC to identify biomarkers, it is necessary to establish a pathway leading from analytical methods for biomarker evaluation using EBC pH to clinical applications of this technology. This review fills a gap in the literature and attempts to connect theory to practical analytical approaches to analyzing EBC samples and making critical treatment-related decisions next to the patient's bed.

This study aimed to analyse the relationship between environmental, social, and governance disclosure (ESG disclosure) and the performance of Saudi Arabian companies. Looking at the Saudi Arabian context, ESG disclosure guidelines were issued in 2018 to encourage Saudi companies to disclose their ESG practices. Grounded in the frameworks of agency and signalling theory, this study bears profound implications for stakeholders, decision makers, policymakers, and academics alike. Our findings underscore the paramount significance of ESG disclosure practices in enhancing corporate performance and creating long-term value for stakeholders within the Saudi Arabian context. The analysis is based on panel data spanning from 2017 to 2022. Rigorous econometric methods, including fixed effects (FEs), random effects (REs), the Hausman test, and the Generalised Method of Moments (GMM), were employed in the analysis. Furthermore, to evaluate corporate performance, we also used vital indicators, such as the return on assets (ROA), return on equity (ROE), and Tobin’s Q. To score companies’ sustainability practices, we created an ESG index that was obtained through a principal component analysis of individual environmental, social, and governance scores using a sample extracted from the annual reports of the top 100 non-financial listed companies in the Saudi Arabian stock exchange (Tadawul). The results of this study provide a strong confirmation of the significantly positive relationship between ESG disclosure and companies’ key performance variables. These results are consistent with stakeholder theory, which argues that companies that actively manage their stakeholders through comprehensive ESG practices have better financial performance; this is also in agreement with signalling theory, which argues that the positive relations found in this study can be a signal sent to policymakers and decision makers. This finding should instil confidence in the potential of ESG practices to drive companies’ success. Recommendations include strengthened regulatory frameworks, awareness-raising campaigns for ESG philosophies among investors and potential target companies, capability enhancement programs, arrangements for engagement with stakeholders, and effective reward/confirmation mechanisms in credit/debit plans, if possible, to encourage more companies to adopt ESG disclosure and to help stakeholders, decision makers, policymakers, and academics improve their awareness. These measures, if implemented, can significantly enhance the ESG landscape in Saudi Arabia, inspiring a more sustainable and responsible business environment. This research sheds light on the complex processes by which ESG considerations and corporate strategy remain integrated by using advanced econometric methodologies that suggest important policy implications. The findings of this study underscore the critical role of sustainable business practices in enhancing corporate performance, fostering societal development, and ensuring sustainability within the context of Saudi Arabian enterprises

In this study, the determination of static E50 and υ parameters of rock materials was investigated using P-S wave velocities and Shore hardness (SH), non-destructive measurement methods. We used multiple linear regression (MLR), multiple non-linear regression (MNLR) and artificial neural network (ANN) models to estimate and determine these parameters. When the models defined by MLR, MNLR, and ANN were compared to the R2 values, ANN models that estimate E50 and υ parameters of rock materials using non-destructive methods (Vp, Vs, Vp/Vs, d, and SH) could be determined with higher accuracy than MLR and MNLR models. The study’s originality is based on the fact that ores such as galena, chromite, and barite have been studied for the first time on rock mechanics, and in this respect, it offers an innovative perspective. In addition, the use of all non-destructive measurement methods, Vp, Vs, and Shore hardness tests, also increases the originality of the study.

The reservoir water level fluctuation zones (RWLFZs) and the natural riparian zones (NRZs) are two riparian ecosystems with the dramatically opposite hydrological rhythms which notably influence the plant guilds. However, little is known about the discrepancy of functional traits and niche characteristics of plant guilds in the RWLFZ and NRZ under different flooding rhythms. Here the RWLFZs (degraded riparian zones) and NRZs were chosen in the Xiangxi River Basin of the Three Gorges Reservoir (TGR) to investigate the variation in plant community structure, the spatial patterns of diversity, key functional traits and niche characteristics of dominant plant populations. The results showed that a total of 78 vascular plant species were identified in the riparian zones of Xiangxi River Basin. Most of the dominant species were annual herbs in the two riparian ecosystems and the percentage of annual dominant species increased from 65.79% in the NRZ to 67.34% in the RWLFZ. Compared with the NRZ, the specific leaf area, vegetation coverage and the aboveground biomass in the RWLFZ significantly increased by 74%, 27% and 19.6% respectively, while the water use efficiency of the RWLFZ decreased by 59.6% and there was no significant difference in the net photosynthetic rate between them, which showed that annuals in the RWLFZ adopt the R adaptation strategy with fast-growing, short lifespan and quickly acquiring and investing resources by altering leaf morphology such as expanding leaf area. The Simpson dominance index of RWLFZ was significantly higher than that of NRZ. Thus counter-seasonally hydrological alterations had the significant effects on functional traits of dominant species in the RWFLZ. Moreover, the highly adaptable and widely distributed species with larger niche breadths and high important values usually had a higher niche overlap value in the RWLFZ than in the NRZ, which showed that the competition in the plant community after experiencing anti-seasonal flooding was much more intraspecific than interspecific and would facilitate the expansion of species niches. And the distribution of the plant community was mainly driven by elevation (flooding depth), flooding duration and TK in the WLFZs. Our findings imply that the species with large niche breadths and high important values should be prioritized in ecological restoration efforts in the newly formed hydro-fluctuation zone of the TGR.

Background/aim: Insulin- and non-insulin treated diabetes (ITDM and NITDM) may have different prognostic impact in patients with ST-elevation myocardial infarction (STEMI) and /or heart failure. The aims of this study were to analyze the impact of ITDM and NTIDM on the incidence of all-cause mortality and major adverse cardiovascular events (MACE- cardiovascular death, non-fatal infarction, non-fatal stroke and tagert vessel revascularization) in the eight-year follow-up of STEMI patients with a reduced ejection fraction (EF). Method: we analysed 2,230 STEMI patients with EF <50%. Patients presenting with cardiogenic shock were excluded. Results: The incidence of DM was 20.7%; among the patients with DM, 103 (22.3%) had ITDM, and 358 (77.7%) patients had NITDM. Eight year mortality and MACE were higher in patients with ITDM than in patients without DM (19.8% vs. 37.8%, and 15.2% vas 40.8%, respectively, p<0.001); there was no difference in mortality and MACE between patients without DM and patients with NITDM. IDM was an independent predictor for 8-year mortality (HR 1.72, 95%CI 1.12-2.62, p=0.013) and MACE (HR 1.49, 95%CI 1.01-2.19, p=0.041). Conclusion: ITDM independently increased long-term mortality and MACE in patients with EF<50% after STEMI. NITDM had no significant influence on long-term mortality and MACE in analyzed patients.

Non-exhaust road transport emissions in cities contribute to poor air quality and create health impacts. This paper presents a new study of the emitted particles due to the tyres-road wear ‘TRWP’ in real driving and gives their emission factors EF. The most frequently observed particles were &lt;1 µm; followed by particles size between [1µm, 4µm] for urban, suburban and highway areas. These particle sizes are well-known to have a higher degree of toxicity. An overall analysis of all the measured pollutants gave EF equal to 30 10+12 #/km and 35 10+12 #/km, respectively for urban and sub-urban areas; and 5 10+12 #/km on highway. The analysis of the 19 most emitted pollutants, taken individually, showed that their EFs ranged from 0.003 to 18.142 10+12#/km. The obtained EF are above the value of the Euro standard for vehicles, but are below the values for vehicles unequipped with a particle filter. Significant test analysis confirmed that inertia of chemical pollutants is homogeneous. EF assessment of the PM10 and PM2.5 emitted is equal to 1.45 mg/km and 0.35 mg/km respectively. These results should contribute to the emergence of future regulations of non-exhaust emissions and should help to analyse the exposure-impact relationship to TRWP.

In children, the global burden of vaccines-preventable diseases (VPDs) and deaths can be averted by adopting timely immunization practices. Administering immunization to a child within 28 or 30 days of the designated immunization date is referred to as timely immunization. Delaying or missing vaccinations puts children, especially those in urban slums, at a higher risk of getting sick or dying from different diseases. This study was designed to examine the immunization practices and to measure the determinants of immunization non-compliance in children living in urban slums of Karachi, Pakistan. A community-based retrospective cohort was carried out from October-2018- to August-2019 in six different urban slums of Karachi. Immunization status of children aged less than 2 years was assessed by reviewing their vaccination card. Children from each slum were approached via 30x7 multistage stratified cluster sampling technique. Data of each child was analysed descriptively and inferentially using a statistical software, i.e., Jamovi version 1.2.25. The practice of timely immunization was observed in approximately half of children, i.e., 49.8%(n=457). The immunization rate at birth (first-visit) was 100%, of which 95.7% were timely immunized. Following the second immunization visit, a sharp decline in the immunization rate, including timely immunization rate was observed. Lack of knowledge, childhood illnesses, lack of interest, and vaccines unavailability were the main reasons of immunization non-compliance. However, an increase in paternal education was significantly associated to decrease the odds of immunization non-compliance. A decrease in the practice of timely immunization is replaced by either invalid and/or delayed and/or missed immunization practices. Thus, timely immunization is crucial for preventing the infectious diseases and promoting the health of a child.

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent world-wide. It progresses from simple steatosis to non-alcoholic steatohepatitis (NASH). Fibrosis is often present during NAFLD progression; however, factors determining which subjects develop NASH or fibrosis are unclear. Insulin-like growth factor binding proteins (IGFBP) is a family of secreted proteins involved in senescence and scarring mainly synthetized in the liver. Here we aimed to study the association of IGFBP and its induced senescence with the progression of NAFLD and liver fibrosis. Materials and Methods: 16 weeks old male C57BL/6 mice weighing 23 ± 3 g were fed either Methionine-Choline Deficient or control diet for 2, 8 or 12 weeks. Blood and liver samples were collected; histological assessment of NAFLD and fibrosis was performed. Fat contents were measured. Cellular senescence was evaluated in the liver. IGFBP levels were assessed in liver and serum. Data was expressed as Mean ± SD and analyzed by one-way ANOVA followed Tukey’s test. Lineal regression models were applied for NAFLD and fibrosis progression. p

The 2022-2023 Mpox multi-country outbreak, identified in over 110 WHO Member States, revealed a predominant impact on cisgender men, particularly those engaging in sex with men, while less frequently affecting women. This disparity prompted a focused investigation into the gender-specific characteristics of Mpox infections, particularly among women, to address a notable knowledge gap. This review systematically gathers and analyzes scientific literature and case reports concerning Mpox infections in women, covering a broad geographical spectrum including regions such as Buenos Aires, Brazil, Northern California, Colombia, Nigeria, Europe, Vietnam, Spain, Switzerland, and the United States. The analysis delves into various aspects of Mpox in women, including clinical features, epidemiology, psychological impacts, preparedness strategies, and case studies, with particular attention to pregnant women and those with underlying health conditions. Empirical data from multiple studies underscore the unique epidemiological and clinical patterns of Mpox in women. In the United States, a small percentage of Mpox cases were reported among cisgender women, with a notable portion involving non-Hispanic Black or African American, non-Hispanic White, and Hispanic or Latino ethnicities. The primary transmission route was identified as sexual or close intimate contact, with the virus predominantly manifesting on the legs, arms, and genital areas. Further, a study in Spain highlighted significant disparities in diagnosis delays, transmission modes, and clinical manifestations between genders, indicating a different risk profile and disease progression in women. Additionally, a case from Vietnam linked to a new Mpox sublineage in women emphasizes the role of women in the transmission dynamics and the importance of genomic monitoring. This review emphasizes the necessity for inclusive surveillance and research to fully understand Mpox dynamics across diverse population groups, including women. Highlighting gender and sexual orientation in public health responses is crucial for an effective approach to managing the spread and impact of the disease. The findings advocate for a gender-diverse assessment in health services and further research to explore the nuances of Mpox transmission, behavior, and progression among different groups, thereby enhancing the global response to Mpox and similar public health challenges.

The main objective of this this cross-sectional study was to analyze the influence of lifestyle fac-tors (diet, physical activity, sleep), which can affect the concentrations of fecal short-chain fatty acids (SCFAs) and SCFAs potential role in modulating cardiometabolic disease risk by interact-ing with biochemical and body composition parameters. The study comprised 77 healthy, non-obese individuals, aged 30-45 years who were assessed in the light of SCFAs concentration in stool, diet, physical activity level and sleep duration. Moreover, body composition measurement and patients’ biochemical parameters were included in the analysis. We have indicated a signifi-cant negative correlation between several SCFAs [especially acetic acid (AA), isobutyric acid (IBA), butyric acid (BA), isovaleric acid (IVA) and valeric acid (VA)] with BMI, VAT/SAT ratio (visceral to subcutaneous fat ratio) and percentage of fat mass in a group of females enrolled in the study as well as with waist circumference (WC) in case of both sexes included in the study. Moreover, the results of our study acknowledged the importance of a diet in shaping SCFAs pro-file - we noticed the significant negative associations between energy and fat intake and some SCFAs in males [IBA, IVA, VA, isocaproic acid (ICA)]. In terms of fiber intake, we noticed elevat-ed concentrations of vast majority of SCFAs and amount of SCFAs in total in case of both sexes included in the study. These strong correlations reflect the fact that diet shapes the composition of the gut microbiota and SCFAs (main microbial metabolites) are synthesized from dietary fiber. Furthermore, we noticed that in a group of women, the concentration of AA, propionic acid (PA) and ICA as well as the total concentration of SCFAs showed a significant positive association with their sleep duration. We concluded that SCFAs can have a potential role in modulating car-diometabolic disease risk by interacting with adiposity parameters and diet. In addition, this potential direct link between diet and SCFAs may at least partly contribute to sleep improvement.

The aim of this study is to compare different methods used for determination of the DS for sulfonated membranes before and after high dose irradiation. Commercial PEEK was homogenously sulfonated up to DS of 60-90% and the membranes were prepared using solvent casting method. Part of the samples were irradiated with 10 MeV electron beam up to 500 kGy dose to assess the ionising radiation induced effects. Both non-irradiated and irradiated membranes were characterized by Fourier Transformation infrared (FT-IR) spectrometry, thermogravimetric analysis (TGA), proton nuclear magnetic resonance (1H-NMR), electrochemical impedance analysis and for the first time for non-irradiated membranes by spectrophotometric analysis with Cr(III). Comparison of the above-mentioned methods for application for DS assessment was done. It was observed that irradiated membranes presented a higher value of DS. Appearance of different new signals in 1H-NMR and FT-IR spectra of irradiated membranes indicated the effects of radiation induced changes in the structure of SPEEK materials. It was determined that the novel method with Cr(III) is applicable for the determination of SPEEK DS under 80%.

Tissue programmed death ligand-1 (PD-L1) protein is the recognized predictive immune biomarker of immune checkpoint inhibitor (ICI) treatment benefit in metastatic non-small cell lung cancer (NSCLC). However, tissue PD-L1 protein testing can be limited by tumor heterogeneity and fraught with tissue acquisition difficulties. A plasma PD-L1 assay potentially overcomes these tissue limitations. Patients with metastatic NSCLC treated with first-line ICI-based treatment and available results of plasma cfRNA PD-L1 by real-time polymerase chain reaction (RT-PCR) and tissue PD-L1 protein PD-L1 with the Dako 22C3 monoclonal antibody were retrospectively assessed for median and landmark 3-year overall survival (OS). OS was identical whether positive plasma cfRNA PD-L1 expression or positive tissue PD-L1 protein expression (median OS 15 months; 3-year landmark OS 30%; hazard ratio (HR) 0.97; 95% CI, 0.44-2.10). Positive plasma cfRNA PD-L1 patients also demonstrated a numerically longer median and higher 3-year OS compared to patients lacking PD-L1 expression (median 15 months versus 8 months; 3-year landmark OS 30% versus 15%; HR 0.56; 95% CI, 0.27-1.17). Plasma cfRNA PD-L1 expression by RT-PCR was similarly predictive of ICI-based treatment benefit as tissue PD-L1 protein expression.

Background: The detection of the EGFR T790M (T790M) mutation in non-small cell lung cancer (NSCLC) patients who progressed under treatment with first- or second-generation EGFR-tyrosine kinase inhibitors (TKIs) is important to offer a subsequent therapy with a third-generation EGFR-TKI. Liquid biopsy is a powerful tool to determine the T790M mutation status. Several liquid biopsy platforms with varying degrees of accuracy are available to test for T790M mutations and sensitivities may differ among these methods. Methods: As no standard exists for the testing of T790M mutation in liquid biopsy, we performed a collaborative study to describe and compare the sensitivity of different in-house liquid biopsy platforms for the detection of the T790M mutation, EGFR exon 19 deletion (del19) and EGFR L858R mutation (L858R) across multiple participating laboratories in seven Central and Eastern European countries. Results: Of the 25 invited laboratories across Central and Eastern Europe, 21 centers participated and received 10 plasma samples spiked with cell-line DNA containing the T790M, del19, or L858R mutation in different concentrations. In-house PCR-based and NGS-based methods were used accordingly, and results reported as in routine clinical practice. Two laboratories, which used the AmoyDx® EGFR 29 Mutations Detection Kit (AmoyDx) with Cobas® cfDNA Sample Preparation Kit and QX200 Droplet Digital PCR (ddPCR) with the QIAamp Circulating Nucleic Acid Kit identified all ten samples correctly. Cobas® EGFR Mutation Test v2 (Cobas), the NGS methods, and the IdyllaTM detection method used in this study performed within the known sensitivity range of each detection method. Conclusions: If a negative result was obtained from methods with lower sensitivity (e.g. Cobas), repeated liquid biopsy testing and/or tissue biopsy analysis should be performed whenever possible, with the aim of identifying T790M-positive patients to allow them to receive the optimal second-line treatment with a third-generation EGFR TKI.