The increase in the frequency of droughts in Africa has increased the interest in crops with drought escape mechanisms like grain Amaranth (Amaranthus hypochondriacus). However, the white-seeded grain Amaranth is easily cross-pollinated by its black seeded wild relatives such as smooth pigweed (Amaranthus hybridus). A study to investigate a minimum isolation distance enough to prevent seed contamination study was carried out at three sites namely Gweru and Bindura (2020/2021 rainy season) and Shamva (2021/2022 rainy season). Smooth pigweed was planted at distances of 3 to 150 m from pure grain Amaranth. Close monitoring of phenology and measurement of meteorological conditions such as temperature, wind speed and direction were done during the anthesis period. Cross-pollination in grain Amaranth was influenced by distance from the pollen source. A maximum of 12.9 % contamination rate was measured within the 10 m radius from the pollen donor plot and a minimum outcrossing rate of 0.45 % was recorded at the widest distance of 150 m. It can be concluded that complete removal of wild relatives of grain Amaranth is important within the field at as far as 150 m from the crop.

Abstract: Colistin is a last-resort antimicrobial for treating multidrug-resistant Gram-negative bacteria. Phe-notypic colistin resistance is highly associated with plasmid-mediated mobile colistin resistance (mcr) genes. mcr-bearing Enterobacteriaceae have been detected in many countries, with the emergence of colistin-resistant pathogens a global concern. This study assessed the distribution of mcr-1, mcr-2, mcr-3, mcr-4, and mcr-5 genes with the phenotypic colistin resistance in isolates from diarrheal infants and children in Bangladesh. Bacteria were identified using the API-20E biochemical panel and 16s rDNA gene sequencing. Polymerase chain reac-tions detected mcr gene variants in the isolates. Their susceptibilities to colistin were determined by agar dilu-tion and E-test by minimal inhibitory concentration (MIC) measurements. Over 30.0% (69/225) of isolates showed colistin resistance by agar dilution assessment (MIC> 2.0 μg/mL). Overall, 15.5% of isolates carried mcr genes (7, mcr-1; 17, mcr-2; 13, mcr-3; and co-occurrence occurred in 2 isolates). Clinical breakout MIC val-ues (≥ 4 μg/mL) were associated with 91.3% of mcr-positive isolates. The mcr-positive pathogens include twenty Escherichia spp., five Shigella flexneri, five Citrobacter spp., two Klebsiella pneumoniae, and three Pseudo-monas parafulva. mcr-genes appeared to be significantly associated with phenotypic colistin resistance phe-nomena (p=0.000), with 100% colistin-resistant isolates showing MDR phenomena. Age and sex of patients showed no significant association with detected mcr variants. Overall, mcr-associated colistin-resistant bacte-ria have emerged in Bangladesh, which warrants further research to determine their spread and instigate ac-tivities to reduce resistance.

The population’s mobility in urban areas is a necessary variable in the modeling of risk scenarios caused by atmospheric contamination. The inclusion of this concept makes static models more dynamic while considering people within a city to be an entity with complex mobility processes. We propose a conceptual and methodological tool to make the representation of the social, economic and territorial components, as well as the patterns in the population´s mobility to delimitate risk areas for human health by exposure of contaminants. In the volatile organic compounds (VOC), benzene, ethylbenzene, toluene and xylene (BTEX) are amongst the most dominant substances in fugitive vapor emissions in gas stations (GS). In urban areas, the exposure to BTEX by residential proximity and proximity to other facilities, which cause intra-urban agglomeration, can impact and affect human health. This model seeks to facilitate the focalization, identification and prioritization of risk areas by BTEX environmental contamination. This article goes beyond de conceptual framework. It suggests methodological and instrumental aspects to be applied in other cities. The government agencies must consider these results when establishing rules, permissions and procedures to reduce environmental pollution for managing the risk in a complex urban environment.

ABSTRACT: Recurrent glioblastoma (rGBM) is a highly aggressive form of brain cancer that poses a significant challenge for treatment in neurooncology, and the survival status of patients after relapse usually means rapid deterioration, and also the leading cause of death among patients. In recent years, immunotherapy has emerged as a promising strategy for the treatment of recurrent glioblastoma by stimulate the body's immune system to recognize and attack cancer cells , which could be used as a in combination with other treatments such as surgery, radiation, and chemotherapy to improve outcomes for patients with recurrent glioblastoma, This therapy combines several key methods such as the use of monoclonal antibodies, chimeric antigen receptor T cell (CAR-T) therapy, checkpoint inhibitors, oncolytic viral therapy cancer vaccines, and combination strategies. In this review, we mainly document the latest immunotherapies for the treatment of glioblastoma and focus on the rGBM especially.

The present short communication aimed to determine the effects of vegetable cultivation on health. We conducted a qualitative study using responses to an open-ended question that was part of a survey on regional differences on vegetable intake. Participants in this study were residents of Gunma Prefecture, Japan, and were aged between 20–74 years. In the questionnaire, we asked: “Aside from increasing vegetable intake, how does vegetable cultivation affect your health?” We were able to categorize the answers into six subcategories related to physical health, mental health, and social well-being.

A B S T R A C T Genital herpes disease is caused mainly by herpes simplex virus type 2 (HSV-2), which is sexually transmitted with a high prevalence in both developed and developing countries. No vaccine is currently available against genital herpes. In this study, we introduced and expressed two genes encoding HSV-2 glycoprotein D (gD) and VP16 protein and a GFP marker gene (control) in tobacco seedlings. Positive plant infection was assessed through characteristic tobacco mosaic virus disease symptoms on leaves and by monitoring the fluorescence emitted by the expressed GFP protein. Expression of the HSV-gD2 and VP16 antigens was verified by RT-PCR, ELISA and Western blot. As a proof of concept, the immunogenicity and the protection ability of the plant produced gD antigen was tested in a mouse model of genital herpes and compared to gD antigen produced in a mammalian expression system. This showed that the plant-gD preparation, when used in combination with a CpG oligodeoxynucleotide as adjuvant, was highly immunogenic and capable of inducing complete immunity to lethal vaginal HSV-2 challenge in mice. Thus, the data presented here may have implications for the development of a production system for highly immunogenic plant-based HSV-2 vaccine antigens.

Background: With the rapid improvement of the healthcare technologies, security and privacy of the most sensitive data, health data is at risk. Protecting patient privacy has many components, even though the data are in electronic format. Although patient privacy is thoroughly discussed in the literature, there is no study presenting all components of patient privacy protection. Methods: In this study, a complete evaluation framework is presented, as an evaluation tool, an inventory is developed, reliability and validity of the inventory is examined. Study is conducted in three phases: Conceptual framework development, inventory development and an evaluation case study. In the evaluation, fuzzy conjoint analysis is employed to handle the subjectivity and am-biguity. As the result of the evaluation, the institution is given a patient privacy protection ma-turity grade, between 1 and 5, where 1 is the worst and 5 is the best grade. Results: In the case study, XXX’s biggest hospital, employing 800 nurses, is evaluated. Half of the nurses, 400, have partici-pated in the study. Literature tells healthcare institutions do not invest enough to protect patient privacy, and the study results support this finding. Institution’s maturity grade resulted as level 2, which is bad. Conclusion: The study measures he privacy maturity with many evaluation com-ponents. Result of the evaluation explains to the patients and the public if their data is safe or not. With this maturity grade, patients have an idea about which institution to choose, public can conclude the institutions’ reliability in terms of patient privacy.

This paper focuses on the highly radioactive, long-lasting nuclear waste produced by the currently operating fission reactors and on the way to deal with the sensitive issue of spent fuel reprocessing. The review includes a short description of the fission process and a detailed analysis of the more hazardous radioisotopes produced either by secondary reactions occurring in the nuclear installations or by decay of the fission fragments. Also outlined are the strategies presently adopted to minimize the harmfulness of the nuclear waste to be disposed and discussed advanced options and possible solutions proposed for the recycling of the used fuel and for the reusing of some technologicaly relevant radioisotopes.

Viruses are the most common congenital infections and an important cause of fetal malformations, morbidity, and mortality. The effects of these infections, which are transmitted in-utero (transplacentally), during childbirth or in the puerperium depend on the timing of the infections. These vary from miscarriages (usually with infections in very early pregnancy), congenital malformations (where the infections occur during organogenesis) and morbidity (with infections occurring late in pregnancy, during childbirth or after delivery). The most common of these viruses are cytomegalovirus, hepatitis, parvovirus B-19, rubella, varicella and zika. There are currently very few efficacious antiviral agents licensed for use in pregnancy and therefore for most of these infections, prevention by means of immunisation (where there is a vaccine), administration of immunoglobulins to those exposed to the virus to offer passive immunity or appropriate measures to avoid being infected would be options to minimise the infections and their consequences. In this review, we discuss the current understanding of some of the congenital infections and their consequences on both the mother and fetus and their management focusing mainly on prevention.

This paper explores the application of fisheries management theories to broader environmental issues, including climate change and biodiversity conservation. It underscores the inherent trade-off in fisheries between yield and resource conservation, identifying harvesting as a significant environmental burden. Early recognition of the sustainability concept aimed to address challenges like economic discounts and the tragedy of the commons, contributing to the issue of overfishing. These insights extend beyond fisries to other environmental concerns, particularly climate change. The development of adaptive management, initially tailored to address uncertainties and non-stationarity in fisheries, has found application in diverse environmental issues. Recognizing humans as integral parts of ecosystems highlights the impossibility of achieving zero environmental impact when utilizing natural resources. The paper advocates for passive restoration to prevent overfishing, leveraging nature's resilience. While goals like complete biodiversity restoration are inherent in fisheries, their relevance may not be immediately apparent to other environmentalists. Despite ongoing discussions on the sustainability of ecosystem services, legislation often tends to favor the long-term maximization of fisheries yield. The paper calls for mutual understanding of theories and experiences across various environmental fields, including fisheries, to enhance collaborative efforts in each field.

Introduction SARS-CoV-2 infection normally damages respiratory system but may likewise impair endocrine organs’ function. Thyroid dysfunction and hyperglycemia are common endocrine complications of SARS-CoV-2 infection. Onset of T1D and associated complications including DKA, hospitalization and death, are thought to be increased during the COVID-19 pandemic. The aim of this study is to review the available data about the incidence rate of T1D and accompanying complications since the beginning of the COVID-19 pandemic. Methods: A systematic review was conducted using electronic databases PubMed and Google Scholar. The keywords “T1D, T1DM, Type 1 DM or Type 1 Diabetes”, “Coronavirus, SARS-CoV-2 or COVID-19” were used to search these databases. Titles and abstracts were screened for selection, and then relevant studies were reviewed in full text. Result: we selected 21 manuscripts out of 296 identified studies. Data about the incidence rate of T1D, hospitalization and death are not consistent across countries, but DKA incidence and severity seem to be higher during the COVID-19 pandemic. Conclusion: Our data collection demonstrated that COVID-19 may or may not increase the incidence of type 1 diabetes. Nevertheless, it is associated with higher incidence and severity of DKA in T1D patients. Antivirals are not fully protective against endocrine complications of SARS-CoV-2 infection. Combining medications that reduce SARS-CoV-2 entry into the cells and modulate the immune response to infection is an alternative practical approach to treating COVID-19.

Gender Identity Dysphoria (GID) is a condition characterized by a strong and persistent identification with the opposite sex. These people consider themselves victims of a sort of biological accident: "a soul in a wrong body". There are numerous theories on the origin of transsexualism: genetic, hormonal and psychological causes have been hypothesized, but those currently most accredited are the neuroanatomical ones. The cornerstones of hormone conversion therapy (Gender Affirming Hormone Therapy, GAHT) are feminizing hormones for transgender women (MtFs) and virilizing for transgender males (FtMs). GID can be present among adolescents and older people. For adolescents is now accepted reversible treatment of puberty withdrawal with hormones that stops the progression of pubertal development in the biological direction not accepted; for elderly people is suggested GAHT in reduced doses. Physicians should consider and discuss with people with GID about fertility preservation, general and cancer risks. We present also data of 127 transsexual patients enrolled at the Garibaldi-Nesima Andrology Clinic in Catania (Italy) from 2003 to 2020. To optimize the conversion treatment with sex hormones, transsexuals require long-term follow-up. GAHT must be performed by a doctor who is familiar with these problems. Therefore, the “do-it-yourself” trend and the lack of medical and laboratory checks over time should be absolutely discouraged. Before proceeding with the surgical sex reassignment, it is recommended to refer to an endocrinologist and psychologist or psychiatrist for a period of 2-3 years. The transition surgical conclusion process must be practiced by a quality surgical team.

Temporomandibular disorders (TMD) is a group of orofacial pain conditions which is the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology and often cyclical nature of the disease, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.

Objective: This study aimed to explore potential interventions or preventive measures to reduce the incidence of falls among the elderly in the Madinah region, and to provide recommendations for healthcare professionals, policymakers, and community stakeholders to enhance fall prevention strategies and improve the overall well-being of the elderly population in this area. Methods: The study adopted a cross-sectional study design, and was carried out in the Madinah region using convenient physical assignment among of Saudi and non-Saudi local residents aged 65 years and over. Questionnaire surveys were circulated and demographic characteristics were collected, including participants’ fall experience and health status data over the past year, in order to assess the incidence of falls among the elderly population. This design allows for the collection of data at a single point in time, aiming to evaluate the prevalence, risk factors, and consequences of falls among the target population. Results: A total of 189 participants were recruited to the study, and the data indicated that the prevalence of falls among those aged 65 years and older in the past year was 41.5%. We found that 73% of the participants had experienced falls and post-fall injuries within the past 12 months. There were minimal differences in terms of physical handicapped cases found between those with and without a fall history. Logistic regression analysis revealed a significant link between fall experience and maximum bite force. Conclusion: There is a high prevalence of falls in the elderly population in the Madinah region. Our study reveals that 50.79% of our elderly participants had experienced more than one fall during the preceding year. Some preventable risk factors were identified in an analysis of their daily routines. The impacts of these risk factors have potential consequences for their healthy lives.

Secondary prevention after SCA (acute coronary syndrome) is of paramount importance to reduce the incidence of MACE and improve prognosis in follow-up. The control of avoidable risk factors, lifestyle modifications, but especially careful control of cholesterolemia (with a target of LDL-C

Vitamin D plays an important role in maintaining healthy mineralized skeleton. It is also consid-ered an immunomodulatory agent that regulate the innate and adaptive immune systems. Multi-ple observational studies have demonstrated the association between low level of serum 25-hydroxyvitamin D [25(OH)D] and presence and severity of several rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), spondyloarthropathies and oste-oarthritis (OA). Nevertheless, the specific benefits of vitamin D supplement for treatment and prevention of rheumatic diseases are less accepted as the results from randomized clinical trials are inconsistent, although some conceivable benefits of vitamin D for improvement of disease ac-tivity of RA, SLE and OA have been demonstrated in meta-analyses. It is also possible that some individuals might benefit from vitamin D differently from others since inter-individual difference in responsiveness to vitamin D supplementation has been observed in genomic studies. Although the optimal level of serum 25(OH)D is still debatable, it is advisable it is advisable that patients with rheumatic diseases should maintain serum 25(OH)D level at least 30 ng/mL (75 nmol/L) to prevent osteomalacia, secondary osteoporosis and fracture, and possibly 40 – 60 ng/mL (100 – 150 nmol/L) to achieve maximal benefit from vitamin D for immune health and overall health.

In May of 2022, millions of U.S. parents faced uncertainty in safely feeding their infants due to the infant formula shortage. Methods: An anonymous, electronic, cross-sectional, retrospective survey was used. Results: U.S. parents (n =187) whose infants were 10.2 weeks old during the short-age completed the survey. Eighty-one percent of parents switched formulas during the shortage, 87% switched because they could not find the formula they typically used, 34% switched 3-5 times, 29% of parents visited ≥ 4 stores/24 hours and 26% of parents traveled >20 miles/24 hours to purchase formula. Use of infant formula increased (p< 0.01); in infants requiring specialty for-mula, use of intact cow’s milk formula increased (p < 0.05) and use of premature infant formulas decreased (p < 0.05). Infants relying on specialty formulas experienced at least one undesirable outcome compared with non-specialty users. Parents used social media, relatives/friends, and healthcare providers for support during the shortage, but their helpfulness scores were suboptimal. Parents reported needs for greater infant formula availability, free prenatal lactation education and postpartum lactation support. Conclusions: Government, regulatory and healthcare policy oversight are needed to protect the infant feeding system, including more commercially available products, access to banked donor milk and lactation support.

This article combines the traditional definition of portfolio risk with minimum spanning tree based “interconnectedness risk" to improve the equal risk contribution portfolio performance. We use betweenness centrality to measure an asset’s importance in a market graph (network). After filtering the complete correlation network to a minimum spanning tree, we calculate the centrality score and convert it to a centrality heuristic. We develop an adjusted variance-covariance matrix using the centrality heuristic, to bias the model to assign peripheral assets in the minimum spanning tree higher weights. We test this methodology using the constituents of the S&amp;P 100 index. The results show that the centrality equal risk portfolio can improve upon the base equal risk portfolio returns, with a similar level of risk. We observe that during bear markets, the centrality-based portfolio can surpass the base equal risk portfolio risk.

For a long-only active equity manager (or investor), the ability to hedge the downside risk before a significant price correction is a valuable skill. The authors proposed constructing a signal that provides timing information for a manager to hedge the downside risk. This systematic signal can help a manager put on a hedge before the price corrections of the dot com bubble in 2000 and the global financial crisis in 2008. The signal is constructed for each GICS sector index in the S&P 500. When a sector’s PE indicates a high valuation and, at the same time, if the high valuation sector’s correlations with some other sectors are out of their historical norm, then these two conditions contribute a timing signal for the significant price swing of the index during the following six months. After observing the timing signal, managers can benefit significantly by hedging the downside risk. The signal can also be interpreted as the beginning of a high volatility regime for a sector.

Primary Biliary Cholangitis (PBC) is a chronic, cholestatic liver disease with a heterogeneous presentation, symptomatology, disease progression, and response to therapy. The current risk stratification assessment, aimed at identifying patients with a higher risk of disease progression, encompasses an in-depth analysis of demographic data, clinical and laboratory findings, antibody profiles, and the evaluation of liver fibrosis using both invasive and non-invasive techniques. Treatment response scores after one year of therapy remain to date a major factor influencing the prognosis of PBC patients. While the initial therapeutic approach with ursodeoxycholic acid (UDCA) is universally applied, new second-line treatment options have recently emerged, with many others under investigation. Consequently, the prevailing one-size-fits-all approach is poised to be supplanted by tailored strategies, ensuring high-risk patients receive the most appropriate treatment regimen from diagnosis. This will require the development of a risk prediction model to assess, at the time of diagnosis, the course, outcome, and response to first and additional treatments of PBC patients. This manuscript provides a comprehensive overview of the current and emerging tools used for risk stratification in PBC and speculates on how these developments might shape the disease landscape in the near future.

In this study was found that these cancers were attributable to risk factors such as cigarette smoking, second-hand smoke, alcohol intake, excess body weight, diet, and six cancer-associated infections. Several databases were reviewed including PUBMED, Google scholar, and Web of Science. The facts suggest that a number of individuals present risk factors for cancer, which can be modifiable.

Cervical cancer is the fourth common cancer amongst women worldwide. Environmental factors such as smoking and obesity, and recurrent infection by high-risk human papillomavirus subtypes are known to promote progression towards invasive cervical disease. Infection by high-risk HPV is necessary in most cases but not sufficient to develop invasive cervical cancer. Despite a predicted genetic heritability of between 27-36%, known genetic susceptibility loci that may be tumorigenic or influence host response to infection, only account for a small fraction of heritable risk factors so far. Various biobank-driven population based studies and meta-analyses have found corroborative evidence for several risk variants at the 6p21.3 locus (HLA), while many reports of variants outside the HLA region remain to be validated in other cohorts. Here, we review cervical cancer susceptibility variants arising from recent genome-wide association studies and meta-analysis in large cohorts and propose 2q14 (PAX8), 17q12 (GSDMB), and 5p15.33 (CLPTM1L) as consistently replicated non-HLA cervical cancer susceptibility loci. We further discuss the available evidence for these loci, knowledge gaps, future perspectives, and the potential impact of these findings on precision medicine strategies to combat cervical cancer.

Risk-based redispatch optimization is proposed as a methodology to support the Transmission System Operator (TSO) with preventive remedial actions obtained by extending the security constrained unit commitment/economic dispatch with constraints resulting from the risk assessed for the power system. Although being heuristic, the methodology is based on comprehensive dynamic security assessment as time-domain simulations are used, allowing to express the degree of all types of instabilities, e.g., caused by contingencies, in monetary terms. Therefore, the risk is assessed as the expected value of the cost incurred by the TSO. Such approach forms a new pathway to including risk in planning procedures already used by TSOs. Results obtained for the IEEE39 dynamic power system, with costs assigned to load shedding and generator tripping due to single transmission lines short-circuits, are shown as a reference case.

Throughout the world, disabilities people have worse health prospects, lower education levels, lower economic participation, and higher poverty rate in comparative terms to people without disabilities. For disabilities people achieve better, more long-lasting prospects, we must empower these people and remove barriers that restrict them from participating in the community have access to quality education, to find decent work and have their voices heard. In statistical terms, a very useful alternative that can provide support and monitoring of public policies in this area is proposing to be used continuously. A risk index called risk index disabled person who is to assess which factors are associated to this risk, as well as the intensity and direction of each of these factors, yielding a final score that can be sorted or classified according to the probability of people acquire a certain disability. In the Brazilian case, we propose the use of techniques such as binary and ordinal logistic regression to select the most significant factors using criteria such as AIC, BIC and DIC. Calculate the risk probability for different disabilities (see, hear, move and intellectual) and number of disabilities to the dataset Sample of respondents for Full Questionnaire at IBGE 2010 Census. In this work, by using stereotype ordinal logistic model with ordinal response, it was possible to improve the fit quality, to be compared with binary response logistic model. By using ordinal response merged the disability risk for different severity degree and amount of deficiencies. Mains conclusions were: i)the model required a smaller number of explanatory variables was intellectual or mental and greater number was disabilities; ii) the most sensitive adjust was using stereotype ordinal logistic; iii) different disabilities aren´t homogenous as the different predictor variables, and finally; iv) higher incidence of risks were noted visual disability, living in the northeast, female, age 80, yellow race, instruction level until incomplete fundamental, works production form their own consumption and high number of children.

Groundnut is an important cash crop and a diet component for rural households in sub-Saharan Africa. However, Aflatoxin contamination remains a barrier to promoting groundnut-based food products as food levels above maximum limit (ML) can adversely affect human health. Three objectives were set, namely, (i) to characterize the post-harvest operations and risk factors affecting aflatoxin contamination, (ii) to assess aflatoxin incidence in on-farm stores and, iii) to assess agronomic practices that can be integrated to improve yield and reduce aflatoxin contamination. The average aflatoxin levels in on-farm stores were 11.3-16.4μg/kg, in which the proportions of ML were 25.7% at 4μg/kg, 56.3% at 15μg/kg, and 80% at 20μg/kg (~5-7 months after harvest). The application of Aflasafe® resulted in safe or no aflatoxin contamination across the locations. Significant hazards identified during postharvest operations include intermittent rain at harvest and drying (6.5), insect pests attacks after harvest (6), prolonged harvest to stripping interval (6.6), drying on bare ground (6.2), storing on bare floor (6.9), use of poorly efficient shelling machines (6.5), and re-use of rejected nut (6.1). This study provides solutions to minimize aflatoxin risk if appropriate technologies (e.g. improved variety, fertilizer, rhizobia inoculant, and Aflasafe®) and policies are deployed.

1. Background: Cardiovascular diseases (CVDs) are India’s leading cause of mortality. This study aimed to recalibrate the original Framingham Risk Score (FRS) equations among adults in Kerala state. 2. Methods: Baseline survey data from the Kerala Diabetes Prevention Program were analyzed: 921 males and 567 females for lipid-based FRS scores and 1042 males and 646 females for BMI-based FRS scores. Recalibration of the original FRS scores was performed using local data on CVD risk factors and CVD mortality. 3. Results: Among males, the median 10-year CVD risk with the recalibrated lipid-based FRS score was 7.34 (IQR 4.33-12.42), compared with the original score of 8.88 (5.23-14.87) (p<0.001). For BMI-based FRS scores, the median 10-year CVD risk was 7.40 (4.27-11.83) with the recalibrated score, compared to 9.32 (5.40-14.80) for the original score (p<0.001). In females, the median 10-year CVD risk was 4.83 (2.90-8.36) with the recalibrated score, compared to 2.85 (IQR 1.71-4.98) with the original score (p<0.001). Similarly, the median 10-year CVD risk was 4.66 (2.74-8.81) with the recalibrated BMI-based FRS score, compared to 2.95 (1.72-5.61) with the original score (p<0.001). 4. Conclusions: Recalibrated FRS scores estimated a significantly lower 10-year CVD risk in males and a higher risk in females than the original FRS scores.

This narrative review aims to summarize evidence regarding the current utilization and future applications of neuromodulation in patients with headaches, with special attention paid to migraine and chronic cluster headache. We performed a narrative review of the literature to identify studies that detail the effectiveness of neuromodulation therapies in the treatment of headache syndromes. The literature was refined to predominantly focus on systematic reviews published in the last year that have the most robust reporting of research done on this topic. Patients with headache face several challenges, including medication overuse, cost burden, non-compliance to medications due to inability to tolerate side effects, or treatments that are ineffective. Neuromodulation is an emerging field that encompasses implantable and non-implantable technologies that intervene on the signaling and perception of pain. In recent years, this technology has been used as an analgesic, and has been shown to be effective for treatment-resistant headache, particularly when used in patients with migraine and chronic cluster headache.

Gastric perforations and leaks are significant complications that can arise from various gastrointestinal disorders and surgical interventions. Over the past decade, endoscopic techniques have emerged as effective method for managing these conditions. Furthermore, as endoscopic resection techniques have grown in popularity, the risk of acute and delayed perforations has also grown. This review aims to provide an in-depth analysis of the endoscopic management strategies employed in the management of gastric perforations and leaks. We will discuss the etiology, diagnostic modalities, and various endoscopic techniques utilized, and emerging trends in endoscopic management. Our attempt in writing this review paper is to educate and guide clinicians in making informed decisions when faced with gastric perforations and leaks.

Disabled children on the one hand have a wide range of impairments that translate into functional limitations but at the same time they possess various talents and capacities. These are manifested into the dynamics of society and the environment that they interact with. This article discusses disaster management with disabled children as a focus group. Disaster, disability and its management is discussed in the context of international practices in general and suited to India in particular. The research follows a review of the recommendations of the United States National Commission on Children and Disaster. In addition to this Disaster Medicine as one approach to Disaster Management concerning disabled children has been explored. The research concludes that the understanding of particular issues of Children with disabilities as one stakeholder, their capacity to engage and a shift in mindset and power relations in which they can contribute to disability inclusive disaster management are fundamental to disability-inclusive DRR.

Clearly policy makers should consider the impacts of any decisions they might make before making them. Science can provide estimates of various economic, ecologic, environmental, and even social impacts of alternative policies, impacts that determine how effective any particular policy will be. These impact estimates can be used to compare and evaluate alternative policies in the search for identifying the best one to implement. Among all scientists providing inputs to policy making processes are analysts who develop and apply models that provide these estimated impacts and, possibly, their probabilities of occurrence. But just producing them is not a guarantee that they will be considered by policy makers. This paper discusses ways scientists, including systems analysts, can effectively contribute to and inform those involved in making water management decisions. Brief descriptions of a variety of past and on-going water management policy making processes illustrate both some successes and failures of science informing policy.

Based on a large sample of publicly listed and non-listed US commercial banks from 1996 to 2011, we find robust evidence consistent with banks using realized available for sale (AFS) securities gains and losses to smooth earnings and increase low regulatory capital. We also find that (i) banks with positive earnings smooth earnings, and banks with negative earnings generally take big baths; (ii) regulatory capital constrains big baths; (iii) banks with more negative earnings and more unrealized beginning-of-quarter losses (gains) take big baths (smooth earnings); and (iv) banks with low regulatory capital and more unrealized gains realize more gains. Also, banks with negative earnings tak big baths (avoid or reduce the earnings loss) if their unrealized gains are insufficient (sufficient) to offset the negative earnings. Our inferences apply to listed and non-listed banks, which indicates that the earnings management incentives do not derive solely from public capital markets. Our findings reveal that the accounting for AFS securities gains and losses enables banks to manage regulatory capital and earnings in a variety of ways.

This paper formulates a new strategy for participatory forest management consisting of encouraging public participation as long as it increases empathy among participants. The strategy requires the homogeneous representation of the opinion of a participant (i.e. to determine how they assess a forest plan and identify the best one). Utility assessments are prepared for participants through pair-comparisons between meaningful points in the territory and from value functions based on forest indicators. The best plan is designed by applying combinatorial optimization algorithms to the utility of a participant. The calculating of empathy -of one participant relative to another - is based on the equivalence of their respective utilities when the current forest plan is modified. This involves calculating the opinions that are due to systematic changes in the collective plan for those participants that each participant supposes will affect the utility of the other participants. Calculating empathy also requires knowing the interactions among participants, which have been incorporated through agent-based simulation models. Application of the above methodology has confirmed the association between increases in empathy and convergence of opinions in different scenarios: well and medium-informed participants and with and without interaction among them, which verifies the proposed strategy. In addition, this strategy is easily integrated into available information systems and its outcomes show advantages over current participatory applications.

Dry periods and drought are inherent natural occurrences. However, due to the increasing pressures of global warming and climate change, these events become more frequent and severe on a global scale. These phenomena can be traced with various indicators and related indices proposed by various scholars. In general, drought risk assessment is done by modelling these indicators and determining the drought occurrence probabilities. The proposed adaptation introduces the "Kaplan-Meier Estimator," a non-parametric statistic traditionally used in medical contexts to estimate survival functions from lifetime data. The study aims to repurpose this methodology to assess drought risk by treating past droughts as "events" and evaluating the Standardized Precipitation Index (SPI) and Standardized Precipitation Evapotranspiration Index (SPEI) and map these results for a better understanding of the drought risks within larger spatial scales such as a river basin. The adapted method provides the probability of non-occurrence, with inverted results indicating the likelihood of drought occurrence. As a case study, the method is applied to SPI and SPEI values at different time steps (3, 6, and 12 months) across 27 meteorological stations in the Gediz River Basin, located in Western Turkey—a region anticipated to be profoundly affected by global climate change. The results are represented as the generated drought risk maps and curves, which indicate that (i) drought risks increase as the considered period extends, (ii) drought risks decrease as the utilized indicator timescales increase, (iii) locally plotted drought curves indicate higher drought risks as their initial slope get steeper. The method used enables the generation of historical evidence based spatially distributed drought risk maps which expose more vulnerable areas within the river basin.

Risk management for technological hazards mainly focuses on the consequences on human lives. Although technological risk analysis evaluates environmental vulnerability, it does not reflect the consequences on environmentally exposed elements, such as rivers, water springs, flora, and fauna. This paper's objective was to propose a conceptual framework and create a multidisciplinary evaluation model for environmental risk analysis in the oil and gas industry. Initially, the problem was approached from a global perspective to justify the necessity of a holistic environmental risk analysis methodology in the oil industry, using environmental risk factors as well as underlying factors, such as environmental fragility and lack of resilience. The holistic assessment was carried out based on probabilistic risk analysis methodologies to obtain a holistic environmental risk index, HERI. This methodology was applied to an oil and gas industry company in Colombia. This allowed greater disaggregation of the results to establish priorities for risk reduction actions and identify the company's weaknesses.

Lump sum contracts are specific contracts used in the construction industry to give owners financial certainty and decrease risk while incentivizing contractors to finish projects on schedule and within budget. This article discusses the usage of lump sum contracts in construction projects, covering the types of projects appropriate for lump sum contracts, critical considerations for entering a lump sum contract, and the tender and preliminary expenses involved. The article also covers lump sum contracts' benefits and drawbacks and how owners and contractors allocate risk. Finally, the difficulties of implementing lump sum contracts, such as potential disagreements over scope changes and quality issues, are investigated. In general, lump sum contracts can be a valuable tool for managing construction projects, but their execution necessitates careful planning and collaboration to ensure successful completion.

The famous Capital Asset Pricing Model (CAPM) takes into account only business risk. In practice, companies use debt financing and operate at non–zero levels of leverage. This means that it is necessary to take into account the financial risk associated with the use of debt financing along with business one. The purpose of this paper is to simultaneously take into account the business and financial risk. A new approach to CAPM has been developed that takes into account both business and financial risk. We combine the theory of CAPM and the Modigliani–Miller (MM) theory. The first is based on portfolio analysis and accounting for business risks in relation to the market (or industry). The second one (the Modigliani–Miller (MM) theory) describes a specific company and takes into account the financial risks associated with the use of debt financing. The combination of these two different approaches makes it possible to take into account both types of risks: business and financial ones. We combine these two approaches analytically, while Hamada did it phenomenologically. Using the Modigliani–Miller (MM) theory, it is shown that the Hamada’s model, first model, used for this purpose half a century ago, is incorrect. In addition to the renormalization of the beta–coefficient, obtained in the Hamada model, two additional terms are found: the renormalized risk–free return and the term dependent on the cost of debt kd. A critical analysis of the Hamada model was carried out. The vast majority of listing companies use debt financing and are levered, and the Hamada model is not applicable to them in contrast to a new approach applicable to leveraged companies. Implemented a new approach to specific companies. A comparison of the results of the new approach with the results of the conventional CAPM is shown. Two versions of CAPM (market or industry) are considered.

Children from rural areas face numerous possibilities for neurodevelopmental conditions that may compromise their well-being and optimal development. Neuropsychology and electroencephalography (EEG) have shown strong agreement in detecting correlations between these two variables and suggest an association with specific environmental and social risk factors. The present meta-analysis aims to integrate the qualitative and quantitative EEG findings, their relationship with cognitive impairment in children living in vulnerable or rural environments, and the main risk factors influencing EEG abnormalities. The method for this purpose was based on a systematic string-based review from Ebscohost and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Qualitative and quantitative analyses were conducted from the outcomes that complied with the selected criteria. A total of 92 records were identified; however, only 20 were eligible, considering 11 for qualitative and 9 for quantitative analysis. The findings highlight a significant amount of literature on EEG and its relation with cognitive impairment from studies in children with epilepsy and malnutrition. In general, there is evidence about the advantages of implementing EEG diagnosis and research techniques in children living under risk conditions. Further research is needed to better describe and integrate the state of the art regarding EEG features extraction.

Peyronie's disease (PD) is a benign condition caused by plaque formation on the tunica albuginea of the penis. It is associated with penile pain, curvature, and shortening, and contributes to erectile dysfunction, which worsens patient quality of life. In recent years, understanding of the detailed mechanisms and risk factors involved in development of PD has been increasing. In this review, the pathological mechanisms and several closely related signaling pathways, including TGF-β, WNT/β-catenin, Hedgehog, YAP/TAZ, MAPK, ROCK, and PI3K/AKT, are described. Findings regarding cross-talk among these pathways are then discussed to elucidate the complicated cascade behind tunica albuginea fibrosis. Finally, various risk factors including genetic involved in the development of PD are presented and their association with the disease summarized. The purpose of this review is to provide better understanding regarding involvement of risk factors in the molecular mechanisms associated with PD pathogenesis, as well as provide insight into disease prevention and novel therapeutic interventions.

Phytoplasma diseases pose a substantial threat to diverse crops of agricultural importance. Management measures are usually implemented only after the disease has already occurred. Early detection of such phytopathogens, prior to disease outbreak, has rarely been attempted but would be highly beneficial for phytosanitary risk assessment, disease prevention and mitigation. In this study we present the implementation of a recently proposed proactive disease management protocol (DAMA: Document, Assess, Monitor, Act) for a group of vector-borne phytopathogens. We used insect samples collected during a recent biomonitoring program in southern Germany to screen for the presence of phytoplasmas. Insects were collected with Malaise traps in different agricultural settings. DNA was extracted from these mass trap samples and subjected to PCR-based phytoplasma detection and COI sequence metabarcoding. In about 1% of the analyzed samples, phytoplasma DNA was detected. Phytoplasma group identification was performed by 16S rRNA gene sequence analysis and the detected phytoplasmas could be assigned to the 16SrI subgroups B and L. Insect species in the sample were identified by DNA metabarcoding. By using established databases, checklists, and archives, we documented historical associations and records of phytoplasmas and its hosts in the study region. For the assessment in the DAMA protocol, phylogenetic triage was performed in order to determine the risk for tri-trophic interactions (plant-insect-phytoplasma) and associated disease outbreaks in the study region. A phylogenetic heat map constitutes the basis for risk assessment and was used here to identify a minimum number of seven leafhopper species suggested to be monitored by stakeholders in this region. A proactive stance in monitoring changing patterns of association between hosts and pathogens can be a cornerstone in capabilities to prevent future phytoplasma disease outbreaks. To our knowledge, this is the first time that the DAMA protocol has been applied in the field of phytopathology and vector-borne plant diseases.

In its 8th Malaysia Plan (MP*), the Malaysian government has given nanotechnology development a high priority and has been made a Strategic Research (SR) programme. Consequently, an exhaustive and long-term approach is essential. Additionally, specific laws are required to provide an optimal health and safety environment for workers. Consequently, the current study intends to assist Malaysian policymakers in promoting improved safety, risk assessment, and management for nanotechnology workplaces, as well as drafting a comprehensive policy for the recently released DOSH guideline in 2018. Utilizing a unique methodology, this study evaluated the assessment and management of nanotechnology health and safety risks in Malaysia using the international risk governance council (IRGC) framework. In addition to document analysis, n = 20 semi-structured interviews were conducted with representatives of several nanotechnology platforms to collect data that was then analyzed thematically. The research evaluated current workplace safety regulations and laws. Consequently, we propose a future dynamic strategy for Malaysian nanotechnology with more favourable upgrades supported by increased concentrations in the following areas: I policy creation, ii) comprehensive management system, iii) knowledge transfer, and iv) infrastructure management. In addition, the findings highlight the need of cross-sectional communication in bridging existing gaps. This study laid the groundwork for a more systematic and comprehensive health and safety strategy.

The assessment of seismic risk in urban areas with high seismicity is certainly one of the most important problems that territorial managers have to face. A reliable evaluation of this risk is the basis for the design of both specific seismic improvement interventions and emergency management plans. Unappropriate seismic risk assessments may provide misleading results and induce bad decisions with relevant economic and social impact.The seismic risk in urban areas is mainly linked to three factors, namely, “hazard”, “exposure” and “vulnerability”. Hazard measures the potential of an earthquake to produce harm; exposure evaluates the amount of population exposed to harm; vulnerability represents the proneness of considered buildings to suffer damages in case of an earthquake. Estimates of such factors may not always coincide with the perceived risk of the resident population. The propensity to implement structural seismic improvement interventions aimed at reducing the vulnerability of buildings depends significantly on the perceived risk.This paper investigates on the difference between objective and perceived risk and highlights some critical issues. The aim of this study is to calibrate opportune policies, which allow addressing the most appropriate seismic risk mitigation options with reference to current levels of perceived risk. We propose the introduction of a Seismic Policy Prevention index (SPPi). This methodology is applied to a case-study focused on a densely populated district of the city of Catania (Italy).

Urban flood risk mapping is an important tool for the mitigation of flooding in view of human activities and climate change. Many developing countries, however, lack sufficiently detailed data to produce reliable risk maps with existing methods. Thus, improved methods are needed that can improve urban flood risk management in regions with scarce hydrological data. Given this, we estimated the flood risk map for Rasht City (Iran), applying a composition of decision-making and machine learning methods. Flood hazard maps were produced applying six state-of-the-art machine learning methods such as classification and regression trees (CART), random forest (RF), boosted regression trees (BRT), multivariate adaptive regression splines (MARS), multivariate discriminant analysis (MDA), and support vector machine (SVM). Flood conditioning parameters applied in modeling were elevation, slope angle, aspect, rainfall, distance to river (DTR), distance to streets (DTS), soil hydrological group (SHG), curve number (CN), distance to urban drainage (DTUD), urban drainage density (UDD), and land use. In total, 93 flood location points were collected from the regional water company of Gilan province combined with field surveys. We used the Analytic Hierarchy Process (AHP) decision-making tool for creating an urban flood vulnerability map, which is according to population density (PD), dwelling quality (DQ), household income (HI), distance to cultural heritage (DTCH), distance to medical centers and hospitals (DTMCH), and land use. Then, the urban flood risk map was derived according to flood vulnerability and flood hazard maps. Evaluation of models was performed using receiver-operator characteristic curve (ROC), accuracy, probability of detection (POD), false alarm ratio (FAR), and precision. The findings showed that the CART method is most accurate method (AUC = 0.947, accuracy = 0.892, POD = 0.867, FAR = 0.071, and precision = 0.929). The results also demonstrated that DTR, UDD, and DTUD played important roles in flood hazard modeling; whereas, the population density was the most significant parameter in vulnerability mapping. These findings indicated that machine learning methods can improve urban flood risk management significantly in regions with limited hydrological data.

Evidence points to a link between gluten-free diet or celiac disease and eating disorders, but not with orthorexia. This study is the first to examine adults with celiac disease in terms of the prevalence of risk of orthorexia. The study included 130 adults diagnosed with celiac disease. The standardized ORTHO-15 questionnaire was used to assess the risk of orthorexia. Cronbach's alpha test was used to determine the reliability of the ORTHO-15 questionnaire. Eating habits of the subjects were assessed using a questionnaire. The effect of celiac disease on diet was assessed on a 5-point scale. A risk of orthorexia was found in 69% of subjects with celiac disease. A statistically significant (p&lt;0.005) positive correlation was observed between age and ORTHO-15 test scores (rho=0.37). In the group with orthorexia risk, meals were more often self-prepared (93.3%) compared to those without orthorexia (80%) (p=0.023). For 80% of those at risk for orthorexia versus 20% without risk, mood was a factor influencing dietary choices (p=0.001). The study observed a strong association between celiac disease and the presence of orthorexia risk. The numerous risk factors for orthorexia suggest the need for holistic care, including nutritional and psychological support among individuals with celiac disease.

Self-perceived health is an important indicator of occupational health. This research explores the relationship between poor self-perceived health and exposure to psychosocial risk factors, taking into account potential socio-demographic, occupational and employment determinants. Using data from the First Survey of Occupational Safety and Health Conditions covering 1049 salaried workers in Guayaquil, Ecuador descriptive and stratified binary logistic regression analyses (Odds Ratios with corresponding 95% confidence intervals) were carried out. No significant relationship was found between exposure to psychosocial risk factors and the probability of presenting poor self-perceived health by socio-demographic, occupational and employment characteristics. Occupational exposure factors to psychosocial risks are predictors of self-perceived ill health and are related to the variables analyzed; the most frequently expressed factors among the respondents were Cognitive Demands (DGOG) and Job Insecurity (IL). The results have implications in terms of designing effective workplace interventions pursuant of ensuring the health and wellbeing of employee.

This study employed a deductive research approach and a survey strategy to assess risk perception and its influencing factors among construction workers in Malawi. Three specific construction hazards and their associated risks were selected. The hazards were ‘working at height (WAH) ‘manual handling of loads (MHL)’ and ‘heavy workload or intense pressure to be more productive (HWP)’. The study engaged multistage sampling of 376 subjects. Univariate analysis, factor analysis and multiple linear regressions were performed in order to determine the main influencing factors among the independent variables. The study established that workers were aware of risks posed by their work. They perceived the risk associated with WAH, MHL and HWP as very high (62.7%, = 8.80 ± 1.95); (48.5%, = 8.10 ± 2.38); (57.9%, = 8.49 ± 2.22) respectively. The study identified six factors as variables that showed significant effect on workers’ perception of risk (p < 0.05). These factors were “dreaded factor”, “avoidability and controllability”, “expert knowledge”, “personal knowledge”, education level and age. It is concluded that contractors in the Malawian construction industry should integrate analysis of behaviors and risk perception of the workers and other players to guide the identification of better health and safety interventions at their worksites.

The current discussion about a “risk culture” in financial services was triggered by the recent series of crisis (from the US subprime mortgage crisis to the lock-in trap of central banks in the aftermath of the sovereign debt crisis). The last decade saw a long list of hybris, misconduct and criminal activities by human beings on a single or even a collective basis in banks, in the industry or in the whole economy. As a counter-reaction, financial authorities called for a guidance by a “new” risk culture in financial institutions based on a set of abstract, formal and normative governance processes. In the humanities, culture is a paraphrase for the behaviour in collectives and dynamics of organization found in human societies. Therefore, a “risk culture” should be a link between those normative guidelines and the positive “real-world” decision-making in financial services. This paper will focus on “risk culture” from the perspective of human beings interacting in dynamical and intertemporal commercial relations. In this context, “risk” is perceived by economic agents ex-ante as the consequence of the time-lag between the present and the uncertain future development (compared to a probability distribution calculated by observers ex-post). For all those individual decisions – to be made under uncertainty – future “risk” includes the so-called “normal accidents”, i.e. failures that will happen at some uncertain point in time but inevitable, and it is only the questions, when failure will happen and how to maintain function in the first line of defence. Finally, the sum of all decisions with individual responsibility for things to come is the positive economical context of a “risk culture” in the sense of the (rational) behaviour of an honourable merchant in long-term and repeated commercial relations in a merchant community, as this is a heritage of European business culture.

1) Background: Studies have shown that there is a higher risk of burnout among employees in the healthcare sector. Therefore, this study focused on “Certified Nursing Aides” (CNAs) who have shown a high prevalence of burnout, and are therefore considered an especially vulnerable group. The objective of this study was to identify the relationships between some organizational, personal and sociodemographic factors and burnout; 2) Methods: The final study sample was made up of 278 working CNAs with a mean age of 40.88 (SD=9.41). To compile the data, an ad hoc questionnaire was used to collect sociodemographic information, and to collect professional and employment information, the Brief Emotional Intelligence Inventory for Adults, the Brief Questionnaire on Perceived Social Support, and The General Self-Efficacy Scale.; 3) Results: The results show that the Burnout Syndrome is significantly related negatively to all the emotional intelligence factors, self-efficacy and perceived social support. The risk of burnout is higher in younger persons and in permanently employed professionals. General self-efficacy and stress management act as protective factors against the likelihood of burnout.; and 4) Conclusions: This study suggests that organizations should urge coaching and transformational leadership training programs to promote the wellbeing and organizational commitment of workers.

In the wake of the 2008 financial crisis, the Financial Stability Board (FSB) and the Basel Committee on Banking Supervision (BCBS) created a list of Systemically Important Financial Institutions (SIFIs) with the intention of determining which financial institutions were important enough to the global market that their failure would result in systemic collapse. In this work we create a model that modifies the BCBS's five indicators of size, interconnectedness, cross-jurisdictional activities, complexity, and substitutability and applies these measures of systemic stress to governments. The original application of the model is to track the systemic interdependence of the Eurozone, with particular emphasis on the case of Greece. We anticipate this model can be used in regional fiscal situations beyond the Eurozone.

The present research focuses on the endogenous development theory and investigates the relationship between economic growth (dependent variable) and renewable energy consumption, technological innovation, and export diversification (independent variables) in seven emerging economies known as the E-7. Previous studies have examined these factors individually but have not explored their combined impact on the E-7 economies. Therefore, this study contributes to the existing literature on the effects of renewable energy consumption, technological advancement, and export diversification on economic development. The study analyses the dynamic connection among these variables in seven selected emerging countries: Brazil, China, Indonesia, India, Mexico, Russia, and Turkey. Panel data from 1990 to 2022 is utilized, and various methodologies, including panel cointegration, the PMG-ARDL estimator, and robustness tests such as FMOLS and DOLS, are employed. Empirical inferences are drawn using the Dumitrescu-Hurlin Panel Causality (DHC) test, and the long-run relationships among the variables are validated using the Westerlund residual cointegration tests. The results from the PMG-ARDL estimator show that renewable energy consumption, technological advancement, and export diversification have a significant and positive impact on economic expansion, confirming the validity of the endogenous growth model in the E-7 countries. The control variable of the financial sector has a positive but insignificant effect on economic growth, while trade openness has a negative and significant effect. The DHC test results indicate a neutral feedback effect of renewable energy consumption on economic growth. The findings also reveal a unidirectional causal relationship between technological innovation and economic growth. Overall, these findings provide valuable insights for economic policymakers in the E-7 countries. By removing barriers to renewable energy consumption, technological innovation, and export diversification, policymakers can promote sustainable economic development.

The Interdisciplinary Canadian Collaborative ME Research Network (ICanCME), established in 2019, aims to foster research in Canada and contribute to finding the causes and possible treatments for myalgic encephalomyelitis /chronic fatigue syndrome (ME/CFS), thereby reducing the impact of ME/CFS on the health of Canadians. The main objectives of this paper are to suggest standards for ME/CFS research for the collection of data from participants (Recommended Data Elements) and to consider other factors, such as design, language, cultural issues, equity, and diversity. Consensus of the relevant contents of this research guideline was reached during the ICanCME working group meetings and were based on existing guidelines. Members of the working group contributed to guideline development based on their respective expertise. The proposed research guidelines could improve research quality and advance knowledge in the field of ME/CFS, and ultimately benefit ME/CFS patients.

Accurate estimation of livestock carrying capacity (LCC) and implementing an appropriate actual stocking rate (ASR) is key to sustainable management of grazing adapted alpine grassland ecosystems. Reliable determination of aboveground biomass is fundamental to these determinations. Peak aboveground biomass (AGBP) captured from satellite data at the peak of the growing season (POS) is widely used as a proxy for annual aboveground biomass (AGBA) to estimate LCC of grasslands. Here we demonstrate limitations of this approach and highlight the ability of POS in the estimation of ASR. We develop and trail new approaches that incorporate remote sensing phenology timings of grassland response to grazing activity, considering relations between biomass growth and consumption dynamics, in efforts to support more accurate and reliable estimation of LCC and ASR. Results show that based on averaged values from large-scale studies of alpine grassland on the Qinghai-Tibet Plateau (QTP), differences between AGBP and AGBA underestimate LCC by about 31%. Findings from a smaller-scale study that incorporate phenology timings into estimation of annual aboveground biomass reveal that Haibei alpine meadows were overgrazed by 11.5% during the study period from 2000-2005. The methods proposed can be extended to map grassland grazing pressure by predicting LCC and tracking ASR, thereby improving sustainable resource use in alpine grasslands.

Abstract Background: Occipital neuralgia is a debilitating condition and traditional treatments often provide limited or temporary relief. Recently, ultrasound-guided hydrodissection of the greater occipital nerve (GON) has emerged as a promising minimally invasive approach. Objectives: To describe two novel ultrasound-guided hydrodissection with 5% dextrose for GON and discuss their advantages, disadvantages, and considerations. Methods: Two case reports are presented. Case 1 describes a lateral decubitus approach for hydrodissecting the GON between the semispinalis capitis (SSC) and obliquus capitis inferior (OCI) muscles. Case 2 details a cranial-to-caudal approach for hydrodissecting the GON within the SSC and upper trapezius (UT) muscles when the GON pass through these two muscles. Results: Both patients experienced significant and sustained pain relief with improvements in function and quality of life. Conclusions: Ultrasound-guided GON hydrodissection using 5% dextrose is a promising treatment for occipital neuralgia. The lateral decubitus and cranial to caudal approaches provide additional options to address patient-specific anatomical considerations and preferences.

A Challenging task in routine practice is finding distinction between benign and malignant paragangliomas and pheochromocytomas. The aim of this study is a comparative analysis of angiogenesis by assessing intratumoral microvascular density (MVD) with immunohistochemical (IHC) markers (CD31, CD34, CD105, ERG), and S100 immunoreactivity, Ki67 proliferative index, SDHB expressiveness, tumor size with one the most utilized score Pheochromocytoma of Adrenal Gland Scales Score (PASS), using tissue microarray (TMA) with 115 tumor samples, 61 benign (PASS&lt;4) and 54 potentially malignant (PASS ≥4). We found no notable difference between intratumoral MVD and potentially malignant behavior. Group of potentially malignant tumors are significantly larger in size, have lower intratumoral MVD, and decreased number of S100 labeled sustentacular cells. Both groups have low proliferative activity (mean Ki67 is 1,02 and 1,22 respectively). Most tumors maintains SDHB expression, only 6 cases (5,2%) showed a loss of expression (4 of them in PASS&lt;4 group and 2 in PASS≥4). PASS score is easy available for assessment, and complemented with markers of biological behavior completes risk stratification algorithm. Size is directly related with PASS score and malignancy. Intratumoral MVD is extensively developed but it is not crucial in evaluating the malignant potential.

The Internet-of-Things (IoT) enables enterprises to obtain profits from data but triggers data protection questions and new types of cyber risk. Cyber risk regulations for the IoT however do not exist. The IoT risk is not included in the cyber security assessment standards, hence, often not visible to cyber security experts. This is concerning, because companies integrating IoT devices and services need to perform a self-assessment of its IoT cyber security posture. The outcome of such self-assessment needs to define a current and target state, prior to creating a transformation roadmap outlining tasks to achieve the stated target state. In this article, a comparative empirical analysis is performed of multiple cyber risk assessment approaches, to define a high-level potential target state for company integrating IoT devices and/or services. Defining a high-level potential target state represent is followed by a high-level transformation roadmap, describing how company can achieve their target state, based on their current state. The transformation roadmap is used to adapt IoT risk impact assessment with a Goal-Oriented Approach and the Internet of Things Micro Mart model.

This study provides an evaluation of a web-based platform for game management and sales, developed using PHP, MySQL, and SASS. The development process utilized the SCRUM methodology, concentrating on essential modules such as user management, game catalog, payment processing, and technical support. The platform's performance was assessed using Google's Lighthouse tool, which evaluates four critical areas: performance, accessibility, best practices, and SEO. The results demonstrated exceptional performance with a score of 99/100 and perfect adherence to best practices with a score of 100/100, reflecting high efficiency and compliance with web development standards. Accessibility received a score of 83/100, indicating potential areas for improvement, while SEO achieved a score of 91/100, suggesting effective search engine optimization. The findings reveal that the platform exhibits high levels of optimization and operational efficiency. However, there remains an opportunity to enhance accessibility features. This study highlights the significance of rigorous web development practices and optimization efforts in achieving superior performance and user experience in web-based systems.

Studies on social media (SM) and disaster management (DM) have mainly focused on the adap-tation, application and use of SM in each stage of DM. With the widespread availability and use of SM, the effective utilisation of SM in DM is impeded by various challenges, but not yet com-prehensively researched. Therefore, this paper aims to identify the challenges, as well as the strategies to overcome the challenges and categorises them into a classified model. The study adopts a systematic literature review to present and analyse the challenges and strategies for us-ing SM in DM. Utilising prominent databases, 72 publications were carefully selected and ana-lysed qualitatively using content analysis. The findings revealed four key challenges to its users: spread of misinformation; insufficient human resources to manage SM use; lack of trust in infor-mation and authorities; and, poor information quality and content of messages. The study identi-fied several strategies to overcome challenges, which can be classified into three sectors of the SM community: individuals, organisations, and SM companies. These findings contribute to enhanc-ing the effective utilisation of SM in DM by community practitioners. Furthermore, this study provides insight into the current status of knowledge and identifies the research gaps around SM in DM for future research.

SUDEP is a sudden death in a person with epilepsy, without evidence of a seizure before death. While its cause is still unclear, various factors have been linked to seizure onset and cardiopulmonary function. Studies have shown that although 91.3% of epilepsy patients want information on premature death, only 31% of them receive it. The numbers emphasize the need for open and sensitive communication by medical professionals. It is important to choose the appropriate moment for the conversation, avoiding periods of stress and ensuring emotional stability in the patient, as well as clear, appropriate and easy to comprehend information about SUDEP. To facilitate this, knowing the patient's level of knowledge is essential. Education on the warning signs of seizures and SUDEP can help take precautions and can decrease the incidence of the phenomenon itself. Effective epilepsy care requires a comprehensive plan, including medication adherence and lifestyle changes. Regular communication and collaboration between the patient, caregiver and health professionals are essential for the effective management of epilepsy, so just as epilepsy has a fluid, changeable course of disease and follow-up appointments are very important, the topic of SUDEP is not a one-time conversation either.

The automobile industry is undergoing technological advancement, which includes breakthroughs such as hybrid cars, electric vehicles (EVs), and self-driving capabilities. However, despite these advances, issues remain, notably in recall management efficiency, security and risk of fraud. To solve these difficulties, the idea of Industry 4.0 has been adopted, which uses technologies such as sensors, IOT’s, and machine learning. Even this technology still has loopholes in the area of security which has been exploited negatively over time. In other to mitigate these loopholes we introduce Blockchain technology as a viable alternative, providing a safe and transparent environment. This study investigates and proposed the use of blockchain to create an enhanced Vehicle Tracking System (VTS) intended at enhancing recall management and reducing fraud in the automobile sector. The proposed solution was discussed in detail and a mock smart contract was also written, which was deployed on the Ethereum Virtual Machine (EVM).

This research delves into the epidemiology, clinical manifestations, and management of hyperprolactinemia, particularly focusing on prolactin-secreting pituitary adenomas, or prolactinomas, in Dolj County, a region historically underrepresented in medical literature. Hyperprolactinemia, a prevalent endocrine disorder, arises from excessive prolactin secretion by the pituitary gland's lactotrope cells and presents a diverse clinical picture. The most significant etiological contributors identified are prolactinomas, accounting for approximately 39% of all secretory pituitary tumors. In light of hyperprolactinemia's substantial morbidity and prevalence, this study underscores the necessity of comprehensive understanding of its regional epidemiology and clinical presentations. Our methodology incorporated collecting retrospective data across various medical facilities in Dolj, ensuing a meticulous analysis of clinical features, paraclinical investigation outcomes, and therapeutic responses among patients with prolactinomas. Emphasis was placed on discerning risk factors, demographic characteristics, and associated comorbidities to encapsulate the full spectrum of these tumors' impact within the community. Preliminary results suggest a nuanced incidence rate of prolactinomas within Dolj, with specific demographic and clinical trends potentially distinct from those reported in wider literature. These findings stress the critical role of localized studies in enhancing screening, diagnostic, and therapeutic protocols. Ultimately, this investigation offers critical insights into the epidemiology and symptomatology of prolactinomas in Dolj, significantly augmenting existing literature and informing regional medical practices.

: One of the challenges facing operations management is the design, choice and imple-mentation of action plans adapted to the magnitude of the deviations of the variables of an industrial process. Making conscious and quick decisions is crucial to achieving im-provements in productivity. This will be achieved if the organization's internal and external communication model is strategically designed, considering specific cultural factors and the symmetry or asymmetry required in the communication model. However, how do we organize ourselves and through what channels do we communicate within a production process to generate Big Data that combines data from technologies and the perception, comprehension and projection of experienced humans? Our purpose is to create an operations management model that facilitates the incorporation of technology, allows a prompt response to failures, and promotes the sustainability of processes, without losing sight of its alignment with the organizational strategy. The developed model was implemented in an operations management team, following the guidelines of an action researcher methodology. This resulted in the design of an operations management model and a detailed methodology for its implementation, achieving sig-nificant improvements in the metrics of the current process, making it a success story.

Gastroesophageal (GE) junction adenocarcinoma is an aggressive malignancy of growing incidence and is associated with public health issues such as obesity and GERD. Management has evolved over the last 2 decades to incorporate a multidisciplinary approach including endoscopic intervention, and neoadjuvant chemotherapy/ chemoradiation and minimally invasive or more limited surgical approaches. Surgical approaches include esophagectomy, total gastrectomy, and more recently proximal gastrectomy. This review analyzes the evidence for and applicability of these varied approaches in management as well areas of continued controversy and investigation.

Bronchiolitis is an acute viral infection of the lower respiratory tract that affects infants and young children. Respiratory syncytial virus (RSV) is the most common causative agent, however other viruses can be the reason of the disease. We retrospectively reviewed the clinical features of infants aged less than 12 months referred to our Pediatric Units of Chivasso, Cirié and Ivrea for acute bronchiolitis requiring hospitalization over two consecutive bronchiolitis seasons. Patient-, disease- and treatment related variables were analyzed in this retrospective study. We were able to show how with the high flow oxygen support (HFNC) only a very low number of children (8 out of 192) need to be trasferred to our HUB referral centers. The probability of success were 96% for all patients and 93% for RSV vs. 98% for non-RSV patients (P=NS). Factor associated to failure of treatment were age below 1 months and the failure of HFNC. The wide and increasing use of HFNC in pediatric inpatients improved management of bronchiolitis in Spoke hospitals, reducing transfer to a Hub hospital provided with Intensive Care Units.

Traumatic Brain Injury (TBI) remains a leading cause of morbidity and mortality among all ages; despite the advances, understanding pathophysiological responses after TBI is still complex, involving multiple mechanisms. Previous reviews have focused on potential targets; however, the research on potential targets has continuously grown in the last five years, bringing even more alternatives and elucidating previous mechanisms. Knowing the key and updated pathophysiology concepts is vital for adequate management and better outcomes. This article reviews the underlying molecular mechanisms, the latest updates, and future directions for pathophysiology-based TBI management.

Premature ventricular complexes (PVCs) are frequently encountered in clinical practice. The association of PVCs with adverse cardiovascular outcomes in the context of structural heart disease is well established, yet the association between PVCs and cardiovascular outcomes in the absence of structural heart disease is not fully elucidated. Cardiac magnetic resonance (CMR) seems to contribute prognostically in the latter subgroup. PVC- induced myocardial dysfunction refers to the impairment of ventricular function due to the PVCs and is mainly associated with a PVC burden greater than 10%. The surface 12- lead ECG is used to localize the anatomic site of origin and multiple algorithms have been developed to differentiate right ventricular and left ventricular outflow tract (RVOT and LVOT, respectively) origin. Novel algorithms include alternative ECG configurations and lately, sophisticated artificial intelligence methods have been utilized to distinguish the origins of outflow tract arrhythmias. The decision to therapeutically address PVCs should be taken upon the presence of symptoms or the development of PVC- induced myocardial dysfunction. The therapeutic modalities include pharmacological therapy, namely I-C antiarrhythmic drugs and beta blockers, as well as catheter ablation, which demonstrates superior efficacy and safety.

In the modern world, stress has become a pervasive concern that affects individuals' physical and mental well-being. To address this issue, many wearable devices have emerged as potential tools for stress detection and management, by measuring heart rate, heart rate variability (HRV), and various matrices related to it. This literature review aims to provide a comprehensive analysis of existing research on HRV tracking and Biofeedback using smartwatches and finger monitor/sensor pairing with reliable 3rd party mobile apps like Elite HRV, Welltory, and HRV4Training specifically designed for stress detection and management. we apply various algorithms and methodologies employed for HRV analysis and stress detection is discussed, including time-domain, frequency-domain, and non-linear analysis techniques. Prominent smartwatches, such as Apple Watch, Garmin, Fitbit, Polar, and Samsung Galaxy Watch, are evaluated based on their HRV measurement accuracy, data quality, sensor technology, and integration with stress management features. We describe the efficacy of smartwatches in providing real-time stress feedback, personalized stress management interventions, and promoting overall well-being. To assist researchers, doctors, and developers use smartwatch technology to address stress and promote holistic well-being, we discuss the data's advantages and limitations, future developments, and the significance of user-centered design and personalized interventions. Keywords: smartwatch; stress; wearable device; heart rate variability; comparative analysis

The article deals with human resource management and selected personnel indicators in 10 sustainable development. The main goal of this paper is to analyse and describe human resource 11 management focused on audit of workload, motivation of employees, the competence of staff, their 12 knowledge and experience. The article shows how the selected personnel indicators are examined 13 in selected establishments of multinational company in Slovakia, as an attractive employer inter-14 ested in growth of its employees, thus employer branding. For research methods, a case study meth-15 odology is used. Data collection was carried out through a questionnaire survey with employees in 16 the company as well as an interview with sale advisors and managers. The research aimed to point 17 out a case study of the investigation of selected personnel indicators in human resources manage-18 ment in a selected company and to examine the perception of the performance of employees in 19 connection with their financial evaluation and their satisfaction in the selected company with an 20 impact on employees´ performance. Furthermore, the research aimed to determine whether there 21 was a dependence between the subjectively perceived performance of the employees and selected 22 aspects. Further indicators were calculated, such as employment rate, proportion of wasted time 23 and labour productivity.

The article deals with human resource management and selected personnel indicators in sus-tainable development. The main goal of this paper is to analyse and describe human resource management focused on audit of workload, motivation of employees, the competence of staff, their knowledge and experience. The article shows how the selected personnel indicators are examined in selected establishments of multinational company in Slovakia, as an attractive em-ployer interested in growth of its employees, thus employer branding. For research methods, a case study methodology is used. Data collection was carried out through a questionnaire survey with employees in the company as well as an interview with sale advisors and managers. The research aimed to point out a case study of the investigation of selected personnel indicators in human resources management in a selected company and to examine the perception of the per-formance of employees in connection with their financial evaluation and their satisfaction in the selected company with an impact on employees´ performance. Furthermore, the research aimed to determine whether there was a dependence between the subjectively perceived performance of the employees and selected aspects. Further indicators were calculated, such as employment rate, proportion of wasted time and labour productivity.

According to the World Health Organization (WHO), dementia is the seventh leading reason of death among all illnesses and one of the leading causes of disability among the world’s elderly people. Day by day the number of Alzheimer’s patients is raising. Considering the increasing rate and the dangers, Alzheimer’s disease should be diagnosed carefully. Machine learning is a potential technique for Alzheimer’s diagnosis but general users do not trust machine learning models due to the black-box nature. Even, some of those models do not provide the best performance because of using only neuroimaging data. To solve these issues, this paper proposes a novel explainable Alzheimer’s disease prediction model using a multimodal dataset. This approach performs a data-level fusion using clinical data, Freesurfer MRI segmentation data, and psychological data. For Alzheimer’s disease vs cognitively normal prediction, the random forest classifier provides 100% accuracy. Furthermore, Alzheimer’s disease and non-Alzheimer’s dementia should be classified properly because their symptoms are similar. To the best of our knowledge, we are the first to present a three-class classification on Alzheimer’s disease vs cognitively normal vs non-Alzheimer’s dementia and achieved 99.86% accuracy using an ensemble model. Besides, a novel Alzheimer’s patient management architecture is also proposed in this work..

Gout is the most common form of inflammatory arthritis. Hyperuricaemia is the pre-requisite for gout and is influenced by variable modifiable and non-modifiable risk factors. Clinical features unique for gout are due to deposition of monosodium urate (MSU) crystal in articular and extra articular tissues. Among various treating agents, anti-inflammatory drugs and urate lowering therapies (ULT) are used widely and successfully, however, non-medicinal means are also effective in the disorder. In their updated guidelines, ACR (2012) and EULAR (2016) recommended both medicinal and non-medicinal approaches that could be used in treating gout, though some of the recommendations are based on lower level of evidence. Moreover, researchers’ continued effort in finding new gout managing agents appear promising, for example, role of Lesinurad in gout management (CLEAR1, CLEAR2). In this new synthesis the author is aimed to provide updated information on gout management based on a systematic review including published work within last ten years between 2008 and 2018 and for this purpose, using ‘clinical trials in gout management’ string, published worked searched in PubMed database from 1st September 2018 to 30 October 2018. Besides the recent ACR and EULAR evidence based management guidelines, the author reviewed another 91 (total 93) articles to make this new draft – 39 articles describe role of pharmacological agents and 54 describe different gout risks, pharmacokinetics/pharmacodynamics of ULT, association between raised sUA level and renal impairment, efficacy of non-pharmacological agents in reducing sUA. According to published work, anti-inflammatory agent is the most appropriate drug group in mitigating inflammatory symptoms of gout, though they often adversely affect over other vital 2 organs with impaired function. Besides ULT, uricase analogues are also found useful in non refractory gout. Since anti-inflammatory agents and ULT contraindicate in some clinical conditions, intra-articular steroid and or adrenocorticotropic hormone (ACTH) are appropriate alternatives instead. However, head-to-head comparison between different NSAIDs, NSAID and prednisolone, NSAID and colchicine are yet to perform. Use of combined anti-inflammatory preparations in gout is also based on lower level of evidence. Regarding effective maximum dose and long-standing impact of ULT on vital organs we are yet to reach a conclusion. Likewise, non-medicinal approaches are widely using in achieving target sUA level, though some of them are based on biased study outcomes and or study with inadequate power, requiring further analysis. Among non-pharmacological approaches, life-style modification, restriction of purine rich diets, avoidance of gout inciting agents are important, but inconclusive. Educating patients’ about diseases, risk factors, available treatment options and side effects from them are also important in terms of achieving sUA level, nevertheless too much counseling sometimes could be worthless.

We present an automated system for nutrient solution management. Prior arts usually measure only pH and EC of the nutrient solutions for maintenance. When EC drops, they just simply add concentrated nutrient to the horticulture bed. Such approach can maintain the density of nutrient solution but cannot maintain the rates of individual ion particles. To prevent nutrition related disorders, fertilization methods with ion selective electrodes are widely introduced. This trend measures individual ion concentration of nutrient solution to maintain appropriate nutrient composition by supplying only insufficient ions. Many researchers have suggested ISE based automated fertilization systems. However, they failed to control a chemical artifact called ion interference effect, which becomes greater at higher density. Our system measures individual concentration of multiple ions and add only deficient nutrients, while handling the ion interference effect issue. To ensure the performance of ion selective electrodes, the system also performs fully automated 3-point calibration 24 times a day. A machine learning algorithm is applied on the sensory parts to remove ion interference effect which make measurement of complex solution with ISE almost impossible. With automated calibration and signal processing technology, the system robustly and continuously maintains nutrient condition for plants. We suggest applying this system on closed hydroponic systems such as smart farms or plant factory, to reduce water consumption and to provide more appropriate environment for the crops.

The need to consider sustainability has substantially increased the complexity of implementing construction and infrastructure projects and new management practices have emerged during the past decade to tackle the global sustainability challenges, where the engagement and coordination of broader competences from stakeholders throughout the supply chain is required. This new project management paradigm has been accompanied by greater attention to the concept of collaborative business arrangements, often called partnering, that has emerged in construction and infrastructure projects to improve project deliveries. However, there are uncertainties about the optimal strategy to foster, integrate and maintain the required collaboration, particularly in sustainable management practices in infrastructure maintenance projects. This paper addresses these uncertainties, based on a single case study of an infrastructure maintenance contract involving an extensive collaborative business arrangement. The findings reveal that different collaborative practices affect diverse aspects of sustainable project management. Further, the extensive collaborative business arrangement has promoted sustainable deliveries based upon organizational learning and continuous improvements. Thus, this study offers an encouraging example of how extensive collaboration can be fostered and play a key role in sustainable project management practices.

Background: As noninvasive prenatal screening usage grows in the general obstetrics setting, proper patient education on the screen’s benefits and limitations is needed. Objective: Describe the use of a technology platform designed for large-scale dissemination of noninvasive prenatal screening information and results. Study Design: The technology platform functioned as follows: Patients were emailed a link to an noninvasive prenatal screening general-education video upon laboratory receipt of a test requisition. Providers were then notified upon availability of patients’ results. If noninvasive prenatal screening results were negative, the patient was sent an automated email with instructions to access results through a secure portal where she could watch tailored informational videos, request “on-demand” or scheduled genetic counseling, or decline any further services. If genetic counseling was elected, a summary of the session was sent to the ordering provider and patient upon completion. If noninvasive prenatal screening results were positive, either the ordering provider or a board-certified genetic counselor contacted the patient directly to communicate test results and provide counseling. The number and type of results issued through the platform, the number and type of genetic counseling consultations completed, and factors associated with requesting laboratory-delivered genetic counseling were tracked and analyzed for a 39-month period. Results: Over the study period, 67,122 noninvasive prenatal screening results were issued through the platform, and 4,673 patients elected genetic counseling consultations; 95.2% (n=4,450) of consultations were for patients receiving negative results. Over 70% (n= 3,370) of consultations were on-demand rather than scheduled. Median consultation time was 14 minutes for positive results and six minutes for negative results. A positive screen, advanced maternal age, family history, previous history of a pregnancy with a chromosomal abnormality, and other high-risk pregnancy were associated with the greatest odds of electing laboratory-delivered genetic counseling. Conclusions: By combining web education, automated notifications, and genetic counseling, we implemented a service that effectively facilitates results disclosure for ordering providers. These data demonstrate the capability to deliver noninvasive prenatal screening results, education, and counseling—congruent with management guidelines—to a large population, which is imperative to quality care as uptake increases.

Background: The study aimed to investigate the association between environmental tobacco smoke exposure and the risk of wheezing among rural and urban preschool children in Mpumalanga province, South Africa, an area associated with poor air quality. Methods: In this study, parents/caregivers of preschool children (n=3145) completed a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Data were analysed using multiple logistic regression models. Results: The overall prevalence of Wheeze ever was 15.14%, with a higher prevalence in urban pre-schoolers than rural pre-schoolers (20.71% vs 13.30 %, P<0.000). Moreover, the total prevalence of asthma ever was 2.34%. The prevalence was greater in urban pre-schoolers than in rural pre-schoolers (3.92% vs 1.81%, P<0.001). In the final adjusted model, both urban and rural area children who lived with one or more people who smoked in the same household (WE: OR 1.44, 95% CI 1.11-1.86) (CW: OR 2.09, 95% CI 1.38-3.16) and (AE: OR 2.49, 95% CI 1.12-5.54) were found to have an increased likelihood of having Wheeze Ever, Current Wheeze and Asthma Ever as compared to those who lived with non-smokers. Conclusions: The implementation of smoking limits and prohibition is crucial in areas that are frequented or utilized by children. Hence, it is imperative for healthcare providers to actively champion the rights of those who do not smoke within the society, while also endorsing legislative measures aimed at curtailing the extent of tobacco smoke exposure.

Abstract: Sustainable use of Native American heritage places is viewed in this analysis as serving to preserve their traditional purposes and sustain the cultural landscapes that give them heritage meaning. The research is about the potential impacts of heritage tourism to selected Native American places at Arches National Park, Canyonlands National Park, and Hovenweep National Monument. The impacts of tourists to a heritage place must be understood as having both potential effects on the place itself and on an integrated cultural landscape. Impacts to one place potentially change other places- functions in a Native American landscape and the integrity of the landscape itself. The analysis is based on 696 interviews with representatives from nine tribes and pueblos, who in addition to defining the cultural meaning of places, officially made 349 heritage management recommendations. The U.S. National Park Service interprets Natives American resources and then brings millions of tourists to these through museums, brochures, outdoor displays, and ranger-guided tours. Native American ethnographic study participants argued that tourist education and regulation can increase the sustainability of Native American places in a park and can help protect related places beyond the park.

Throughout its history Western science has tended to treat complexity as a problem to be avoided or solved. A philosophy of simplification achieved significant improvements in human life and prevails as a model for achieving societal good. However, misplaced efforts to control complexity worsen our sustainability challenges. Effective responses to modern day dilemmas such as floods and climate change require ways of thinking that are more congruent with the complexity of the world. Further, governmental programs to reduce flood risk depend on the support of an informed and engaged public. It has proven difficult to communicate risk in ways that align scientific and technical expertise based on an objective worldview, with communal and individual under-standings of risk based on subjective experiences and perspectives. I introduce Paul Cilliers’ philosophy of critical complexity as the basis of a new conceptual framework that values and balances complexity and simplicity. This paper shows how objective strategies that rely on analytic and probabilistic thinking can be integrated with subjective approaches that draw on the experiential and possibilistic. An example depicts how the problematic framing of the “100-year flood” can be replaced by a model of the data that covers a range of possibilities within an experiential time frame. Cilliers’ work opens an ethical dimension in which we make more intentional choices and acknowledge our limitations. Complexability – understanding how to live with complexity rather than aiming to simplify it – is a vital component of sustainability communication and education.

In Brazil, the production of corn and soybeans has been growing significantly in recent years. Considering that the strategies for investing in the production of these crops are conditioned by production costs and risk, the objective of this article is to propose a simulation model that indicates the trend of production costs for these commodities, considering the dispersion and correlation of selected key variable prices and corn and soybean production costs practiced between the years of 2018 and 2022. Fifty specialized companies in the state of Sao Paulo, Brazil, provided data for this study, and Monte Carlo simulations showed that the total cost of corn production/ha is between USD 600.00 and USD 1150.00, with a level of certainty of 84.7%, and soybeans are in the range of USD 260.00 to USD 420.00, with a level of certainty of 86.4%. The model evidenced a trend of decreasing production costs for the crops for the 2023/24 and 2024/25 harvests, as the input with the greatest impact (fertilizer) is showing a downward trend. On the other hand, costs related to labor, soybean seed, and fungicides are showing an upward trend, while dolomitic limestone corrective remains stable.

Abstract: Letter migrations between words in reading aloud (e.g., reading "cane love" as "lane love" or "lane cove") are known to result from a deficit in the visual-orthographic analysis and characterize attentional dyslexia. In spontaneous speech, individuals with impairment in the phonological output buffer may show migrations of phonemes between words. The purpose of this study was to examine whether migrations between words in reading aloud can also result from a deficit in the phonological output buffer, to explore the characteristics of migrations resulting from orthographic input and from phonological output deficits, and to examine methods to distinguish these two sources. Using tasks of reading aloud of 92-182 word pairs, we identified 18 adults and adolescents with developmental dyslexia who made between-word letter migrations in reading aloud, significantly more than age-matched controls (372 adults and 26 7th-graders). To distinguish between orthographic-input and phonological-output sources for these migrations, we administered a test assessing orthographic-input without spoken-output (written-semantic-decision on 140 migratable word pairs) and a test of repetition of 36 auditorily-presented migratable word pairs, assessing spoken output without orthographic-input (and word span tests). These tests indicated that the migrations of ten of the participants with dyslexia resulted from an orthographic-input deficit, and for the other eight participants, migrations resulted from a phonological-output deficit. We identified several differences between the two types of between-word errors: first, whereas the individuals with attentional dyslexia made omissions of a letter that appeared in the same position in the two words, the phonological output buffer group did not make such omissions. In addition, the groups differed in the origin of migration: orthographic input migrations involve letters that are orthographically adjacent, whereas phonological output migrations involve phonemes that have just been spoken or that are prepared together in the phonological buffer for production. This was manifested in that migrations from the line below and from two lines above occurred only in the orthographic input deficit group, and migrations occurred from a word vertically close to the target in the orthographic input group but from a word that has just been spoken (placed diagonally to the target) in the phonological output group. This study thus indicates that between-word migrations in reading-aloud can result not only from attentional dyslexia, but also from a phonological output buffer deficit, and offers ways to distinguish between the two.

Ocean big data is the scientific practice of using big data technology in the marine field. Data from satellites, manned spacecraft, space stations, airship, unmanned aerial vehicles, shore-based radar and observation stations, exploration platforms, buoys, underwater gliders, submersibles, and submarine observation networks are seamlessly combined into the ocean’s big data. Increasing numbers of scholars have tried to fully analyze the ocean’s big data. To explore the key research technology knowledge graphs related to ocean big data, articles between 1990 and 2020 were collected from the “Web of Science”. By comparing bibliometric software and using the visualization software Cite-Space, the pivotal literature related to ocean big data, as well as countries, institutions, categories, and keywords, were visualized and recognized. Journal co-citation analysis networks can help determine the national distribution of core journals. Co-citation analysis networks for documents show authors who are influential at key technical levels. Key co-occurrence analysis network keywords can determine research hot spots and research frontiers. The three supporting elements of marine big data research are shown in the co-citation network. These elements are author, institution, and country. By examining the co-occurrence of keywords, the key technology research directions for future marine big data were determined.

Background: Tumor microenvironment (TME) plays a crucial role in virtually every aspect of tumorigenesis of glioblastoma multiforme (GBM). The dysfunctional TME promotes drug resistance, disease recurrence and distant metastasis. Recent evidence indicates that exosomes released by stromal cells within TME may promote oncogenic phenotypes via transferring signaling molecules such as cytokines, proteins and microRNAs. Results: In this study, clinical GBM samples were collected and analyzed. We found that GBM-associated macrophages (GAMs) secreted exosomes which were enriched with oncomiR-21. Co-culture of GAMs (and GAM derived exosomes) and GBM cell lines resulted in the increased GBM cells’ resistance against temozolomide (TMZ) by upregulating pro-survival gene, PDCD4 and stemness markers Sox2, STAT3, Nestin and miR-21-5p and increased M2 cytokines, IL-6 and TGF-β1 secreted by GBM cells, promoting the M2 polarization of GAMs. Subsequently, pacritinib treatment suppressed GBM tumorigenesis and stemness; more importantly, pacritinib-treated GBM cells showed markedly reduced ability to secret M2 cytokines and reduced miR-21 enriched exosomes secreted by GAMs. Pacritinib-mediated effects were accompanied by a reduction of oncomiR miR-21-5p, by which tumor suppressor PDCD4 was targeted. We subsequently established a patient-derived xenograft models where mice bore patient GBM and GAMs. The treatment of pacritinib, and the combination of pacritinib/TMZ appeared to significantly reduce tumorigenesis of GBM/GAM PDX mice, overcome TMZ-resistance, and M2 polarization of GAMs. Conclusion: In summation, we showed that potential of pacritinib alone or in combination with TMZ for suppressing GBM tumorigenesis via modulating STAT3/miR-21/PDCD4 signaling. Further investigations are warranted for adopting pacritinib for the treatment of TMZ-resistant GBM in the clinical settings.

BACKGROUND AND AIMS: Cardiovascular disease and colorectal cancer (CRC) are significant health problems and share some risk factors. The aim of our study was to develop and validate a predictive score for advanced colorectal neoplasia (CRN) based on risk factors for cardiovascular disease and CRC. MATERIALS AND METHODS: A cross-sectional study comprising a derivation cohort and an external validation cohort of 1049 and 308 patients respectively. A prediction score for advanced CRN (CRNAS: Colorectal Neoplasia Advanced Score) was developed from a logistic regression model, comprising sex, age, first-degree family history for CRC, systolic and diastolic blood pressure, total cholesterol, HDL-cholesterol, body mass index, diabetes, smoking, and antihypertensive treatment. Other cardiovascular risk scores (Framingham-Wilson, REGICOR, SCORE and FRESCO) were also used to predict the risk of advanced CRN. The discriminatory capacity of each score was evaluated using the area under the curve (AUC). RESULTS: CRN were found in 379 subjects from the derivation cohort (36%) including 228 patients (22%) with an advanced CRN. Male sex, age, diabetes, and smoking were identified as independent risk factors for advanced CRN. The newly created score (CRNAS), showed an AUC of 0.68 (95% CI: 0.64-0.73) for advanced CRN, which was better than cardiovascular risk scores (p

This study examines the effects of working capital management strategies on firm’s financial performance of Indian cement companies using 11-year (2010-2020) financial data of 31 companies listed in Bombay Stock Exchange. It is intended to find out whether the strategies made by finance managers with respect to the components of working capital such as average receivable period, inventory conversion period, average payment period and cash conversion cycle, etc. affects the firm’s performances individually and in total. The results of Pearson’s correlation coefficient and random effect regression model shows that there exists a negative relationship between financial performance measured in terms of return on assets (ROA) and inventory turnover period (ITP) as well as accounts payable period (APP), whereas firm’s performance is not significantly affected by accounts receivable period (ARP) and cash conversion cycle (CCC). Similarly, it has been observed that the liquidity measures such as current ratio (CR) and quick ratio (QR) have a significant positive association with ROA. Moreover, the size of the firms and leverage are inversely related to ROA but the age of the firms is not significantly affecting their financial performances. Hence, it can be concluded that how an organisation designs its working capital strategy do have an impact on its performances.

Hidradenitis suppurativa and Langerhans cell histiocytosis are rare disorders that can reveal similar clinical manifestations, making differential diagnosis difficult. A definitive diagnosis requires biopsy and histological confirmation in suspicious cases. The complex pathophysiology of these diseases has still not been understood, therefore the treatment is still a challenge for physicians. It is seen with predilection in the intertriginous areas of the body, predominantly in the axillary region, rarely requiring a surgical procedure. However perineal, perianal, and gluteal HS usually necessitates some form of surgical treatment. Langerhans cell histiocytosis (histiocytosis X) is a very rare systemic disease manifested by clonal cell proliferation of histiocytic-dendritic nature, with pseudonodular manifestation that deeply infiltrates the hypodermis and ulcerates the epidermis on the surface. Langerhans cells are dendritic, antigen-presenting cells localized in the suprabasal regions of the squamous epithelium of the skin and mucous membranes, which help regulate the immune system. In this report, we present our experience with extensive gluteal, perineal, and perianal hidradenitis suppurativa and Langerhans cell histiocytosis cases, including our treatment methods and outcomes.

Understanding the subtle signs of carpal instability and other unique injury patterns in the wrist is a critical skill for radiologists. Proper patient management and outcomes are directly dependent on the accurate interpretation of wrist imaging studies. This review will provide a detailed overview of typical imaging features of carpal trauma and instability, management, and complications, using multimodality imaging and original medical illustrations. A detailed overview of the osseous, ligamentous, arterial anatomy of the wrist, arcs of Gilula, and zones of vulnerability will be provided. Carpal fractures, dislocations, special radiographic views, and imaging pearls will be discussed. Instability patterns and the myriad of associate abbreviations (CID, CIND, CIC, CIA, VISI, DISI, SLD, LTD, MCI, SLAC, SNAC) will be clarified. Expected outcomes, potential complications, and management will be reviewed.

The Kenya Forestry Service permits rental of low-density national forest areas for use as common farmland, but public access to such areas is restricted to prevent deforestation against a background of rising demand for fuel wood. This study was conducted to clarify characteristics relating to the production of indigenous bamboo (a useful wood resource) by the approximately 23% of locals who work on common farmland in central Kenya’s Kamae forest management area, with estimation to determine above-ground biomass. The results showed that bamboo still represents 60% of such biomass, indicating sustainability in the industry.

Tinnitus is a complex and heterogeneous psycho-physiological disorder responsible for causing a phantom ringing or buzzing sound albeit the absence of an external sound source. It has a direct influence on affecting the quality of life of its sufferers. Despite being around for a while, there hasn’t been a cure for tinnitus, and the usual course of action for its treatment involves use of tinnitus retaining and sound therapy, or Cognitive Behavioral Therapy (CBT). One positive aspect about these therapies is that they can be administered face-to-face as well as delivered via internet or smartphone. Smartphones are especially helpful as they are highly personalized devices, and offer a well-established ecosystem of apps, accessible via respective marketplaces of differing mobile platforms. Note that current therapeutic treatments such as CBT have shown to be effective in suppressing the tinnitus symptoms when administered face-to-face, their effectiveness when being delivered using smartphones is not known so far. A quick search on the prominent market places of popular mobile platforms (Android and iOS) yielded roughly 250 smartphone apps offering tinnitus-related therapies and tinnitus management. As this number is expected to steadily increase due to high interest in smartphone app development, a contemporary review of such apps is crucial. In this paper, we aim to review scientific studies validating the smartphone apps, particularly to test their effectiveness in tinnitus management and treatment. We use the PRISMA guidelines for systematic identification of studies on major scientific literature sources and delineate the outcomes of identified studies.

Subacute rumen acidosis (SARA) is a prevalent issue in intensive livestock farming, particularly associated with high-concentrate diets. This study investigates the prevalence and impact of SARA in Greek dairy sheep farming and explores the use of computerized rumen colorimetry as a management and diagnostic tool for SARA in dairy sheep farms. Forty-two dairy sheep flocks were monitored regularly for rumen pH, milk composition, and milk yield over an approximately 9-month milking period. Computerized Rumen Mucosal Colorimetry was applied to 280 culled, aged ewes from these farms, with rumen wall samples taken for histological examination. SARA cases were identified in 19 farms (45%, n=48). Farms with SARA cases had lower milk fat levels, although milk yield was higher in these farms, while milk protein levels did not differ based on the SARA status of the farms. In culled ewes, rumen color was significantly associated with the farm's SARA status. Additionally, ewes from farms with more SARA cases exhibited increased thickness in the ruminal epithelium layers, particularly in the non-keratinized and total epithelium layers. In conclusion, SARA is a common disorder in the Greek dairy sheep industry, lowering the fat content of milk. The study suggests that computerized rumen epithelium colorimetry in aged culled ewes shows promise as a diagnostic tool for SARA in dairy sheep farms.

In data-scarce regions, prudent planning and precise decision-making for sustainable development especially in agriculture remains a challenging task due to the lack of correct information. Remotely sensed satellite images provide a powerful source for assessing land use land cover (LULC) classes and crop identification. Applying Remote Sensing (RS) in conjunction with the Geographical Information System (GIS) and modern tools/ algorithms of artificial intelligence (AI) and deep learning has been proven effective for strategic planning and integrated resources management. The (this)study was conducted in the canal command area of the Lower Chenab Canal system in Punjab, Pakistan. Crop features/ classes were assessed using the Normalized Difference Vegetation Index (NDVI) algorithm. The MODIS (Moderate Resolution Imaging Spectroradiometer) 250 m and Landsat 5 TM (thematic mapper) images were deployed for NDVI time-series analysis with unsupervised classification technique to get LULC classes that helped to discern cropping pattern, crop rotation, and the area of specific crops, which were then used as a key input for agricultural mechanization planning and resources management. The accuracy of the LULC map was 78%, assessed by the error matrix approach. Limitations of high-resolution RS data availability and the accuracy of the results are the concerns observed in this study that could be managed by the availability of good quality local sources and advanced techniques of processing, which will make it more useful and applicable for regional agriculture and environmental management.

Objectives: The study aimed to develop a deep learning-based edge AI model deployed on electrocardiograph (ECG) devices for real-time detection of atrial fibrillation (AF)-risk during sinus rhythm (SR) using standard 10-second 12-lead electrocardiograms (ECGs). Methods: A novel approach was used to convert standard 12-lead ECGs into binary images for model input, and a lightweight convolutional neural network (CNN)-based model was trained using data collected by the Japan Agency for Medical and Research Development (AMED) between 2019 and 2022. Patients over 40 years old with digital, SR ECGs were retrospectively enrolled and divided into AF and non-AF groups. Data labeling was supervised by cardiologists. The dataset was randomly allocated into training, validation, and internal testing datasets. External testing was conducted on data collected from other hospitals.　Results: The best-trained model achieved an AUC of 0.82 and 0.80, sensitivity of 79.5% and 72.3%, specificity of 77.8% and 77.7%, precision of 78.2% and 76.4%, and overall accuracy of 78.6% and 75.0% in the internal and external testing datasets, respectively. The deployed model and app package utilized 2.5MB and 40MB of the available ROM and RAM capacity on the edge ECG device, correspondingly. Processing time for AF-risk detection was approximately 2 seconds.　Conclusion: The model maintains comparable performance and improves its suitability for deployment on resource-constrained ECG devices, thereby expanding its potential impact to a wide range of healthcare settings. Its successful deployment enables real-time AF-risk detection during SR, allowing for timely intervention to prevent AF-related serious consequences like stroke and premature death.

Background: Modulator therapies improve weight and body mass index (BMI) in cystic fibrosis (CF) patients. We aimed to compare the nutritional risk index (NRI) in adult CF patients receiving modulator (MT) or only non-modulator (conventional) therapies (non-MT). Methods: A single-center prospective cohort study was conducted between June-December 2023. The NRI based on weight gain and albumin was calculated at beginning and end of a 12 weeks period in both groups. This design was pragmatic, since based on individual patient access to MT for 12 weeks. Results: 107 patients were included [mean (SD) age: 23.85 (4.98) years, 54.7% male, 46.7% MT]. In the MT group, mean (SD) weight (kg) and albumin (g/dL) increased significantly [changes: +3.09 (2.74) and +0.17 (0.37); p

Climate simulations in West Africa have been attributed with large uncertainties. Global climate projections are not consistent with changes in observations at the regional or local level of the Niger basin, making management of hydrological projects in the basin uncertain. This study evaluates the potential of using the quantile mapping bias correction to improve the Coupled Model Intercomparison Project (CMIP5) outputs for use in hydrology impact studies. Rainfall and temperature projections from 8 CMIP5 Global Climate Models (GCM) were bias corrected using the quantile mapping approach. Impacts of climate change was evaluated with bias corrected rainfall, temperature and potential evapotranspiration (PET). The IHACRES hydrological model was adapted to the Niger basin and used to simulate impacts of climate change on discharge under present and future conditions. Bias correction significantly improved the accuracy of rainfall and temperature simulations compared to observations. Nash coefficient (NSE) for monthly rainfall comparisons of 8 GCMs to the observed was improved by bias correction from 0.69 to 0.84. The standard deviations among the 8 GCM rainfall data were significantly reduced from 0.13 to 0.03. Increasing rainfall, temperature, PET and river discharge were projected for all GCMs used in this study under the RCP8.5 scenario. These results will help improving projections and contribute to the development of sustainable climate change adaptation strategies.

Colorectal cancer is the second leading cause of cancer-related mortality worldwide. Numerous pathophysiological mechanisms, such as abnormal cell proliferation, cell differentiation, resistance to apoptosis, invasion of structures adjacent to colorectal tumor cells, and distant metastasis, are involved in colorectal carcinogenesis. These processes are initiated by the complex interaction of a number of genetic and environmental factors, including sedentary lifestyle, obesity, alcohol consumption, smoking or gut microbiota. Despite the significant progress achieved in the diagnostic and therapeutic management of patients with colorectal cancer, there has been recently a noteworthy increase in the incidence of colorectal cancer in individuals below the age of 50 years. Early-onset colorectal cancer has a different frequency of oncogenic mutations, a higher prevalence of mucinous histology, a distinct deoxyribonucleic acid (DNA) methylation profile, a more distal location, and lower survival rates. A significant improvement in the prognosis of these patients can be achieved through the detection and removal of modifiable risk factors, along with the implementation of personalized screening strategies for individuals at high risk for this malignancy. Furthermore, gaining comprehension of the pathophysiological mechanisms by which these risk factors contribute to the process of oncogenesis may facilitate the discovery of novel therapeutic targets.

As a result of identity prejudice, certain individuals are at higher risk for conflict and violence when they are in the field. At-risk individuals include minority identities of the following: race/ethnicity, sexual orientation, disability, gender identity, and/or religion. Everyone deserves to conduct fieldwork as safely as possible; therefore, it is paramount for anyone conducting fieldwork to be informed of the increased risk certain populations face when conducting field research and to define informed strategies. Research groups should adhere to best practices to minimize risk for all individuals who go into the field. Here we provide strategies that 1) acknowledge that some individuals encounter dangerous situations in the field due to their identity(ies), and 2) minimize the chance of conflict between and among researchers and other communities present at field sites. The inclusion of this document as a key resource in a research lab, a university department, or any active research or work environment sends a positive signal to at-risk individuals that their professional community acknowledges their risk and is willing to implement actions to ensure their safety. We suggest that this document be made freely available to anyone who is directly or indirectly involved in fieldwork. Supervisors who support the information in this document should publicly commit to promote a diverse and inclusive environment in order to maintain the safety of their researchers.

Portfolio weights solely based on risk avoid estimation error from the sample mean, but they are still affected from the misspecification in the sample covariance matrix. To solve this problem, we shrink the covariance matrix towards the Identity, the Variance Identity, the Single-index model, the Common Covariance, the Constant Correlation and the Exponential Weighted Moving Average target matrices. By an extensive Monte Carlo simulation, we offer a comparative study of these target estimators, testing their ability in reproducing the true portfolio weights. We control for the dataset dimensionality and the shrinkage intensity in the Minimum Variance, Inverse Volatility, Equal-risk-contribution and Maximum Diversification portfolios. We find out that the Identity and Variance Identity have very good statistical properties, being well-conditioned also in high-dimensional dataset. In addition, the these two models are the best target towards to shrink: they minimise the misspecification in risk-based portfolio weights, generating estimates very close to the population values. Overall, shrinking the sample covariance matrix helps reducing weights misspecification, especially in the Minimum Variance and the Maximum Diversification portfolios. The Inverse Volatility and the Equal-Risk-Contribution portfolios are less sensitive to covariance misspecification, hence they benefit less from shrinkage.

We propose a methodology for the quantification of model risk in the context of credit derivatives pricing and CVA, where the uncertain or unmodelled parameter is often the correlation between rates and credit. We take the rates model to be Hull-White (normal) and the credit model to be Black-Karasinski (lognormal). We show how highly accurate analytic pricing formulae, hitherto unpublished, can be derived for CDS and extended to address instruments with defaultable Libor flows which may in addition be capped and/or floored. We also consider the pricing of a contingent CDS with an interest rate swap underlying. We derive explicit expressions showing how to good accuracy the dependence of model prices on the uncertain parameter(s) can be captured in analytic formulae which are readily amenable to computation without recourse to Monte Carlo or lattice-based computation. In so doing, we take into account the impact on model calibration of the uncertain (or unmodelled) parameter.

Authorities and governmental bodies strongly emphasize the importance of residents preparing for natural disasters, particularly underscoring the significance of readiness for geophysical hazards like earthquakes. In this study, which represents comparative quantitative research, the levels and predictors of the impact on preparedness for earthquake-induced disasters in South-Eastern Europe countries such as Montenegro, North Macedonia, and Serbia are examined. Using the snowball sampling technique (online questionnaire), a survey of 1245 respondents (Montenegro (n = 400), North Macedonia (n = 345), and Serbia (n = 500) was conducted from February 2023 to February 2024. The paper is based on the central hypothesis that the most significant predictor of earthquake preparedness in Montenegro, North Macedonia, and Serbia is age, followed by gender and education. Multivariate regression analysis was used to determine the extent to which five scores of the subscales (household preparedness, community preparedness, disaster preparation, earthquake risk awareness, reinforced house) were associated with seventh demographic and socio-economic variables. In addition to the mentioned analysis, other statistical analyses such as T-test, one-way ANOVA analysis, and Pearson correlation were also utilized. The results indicate that age emerges as a predictor in various aspects of earthquake-induced disaster preparedness and awareness in most models, followed by education. These findings confirm the significance of respondents' age in determining levels of preparedness and earthquake awareness. Overall, in North Macedonia, respondents recorded the highest ratings (M = 3.52) for household preparedness for earthquakes, compared to Montenegro (M = 2.98) and Serbia (M = 3.26), where the lowest ratings were recorded. Research findings, taking into account cultural characteristics, can serve as a basis for the development of targeted interventions, strategies, policies, and programs aimed at improving the level of societal preparedness for earthquake-induced disasters.

To ensure sustainability of the future power grid, the rate of expansion of distributed renewable energy resources (DRER) has introduced operational challenges. These includes managing transmission constraints with DRER power injection, dispatching DRER efficiently, managing system frequency and ensuring sufficient reactive power for voltage support. Coupled with the intensification of wildfires, power infrastructure across the United States faces challenges to minimize the impact to maintain system reliability and resiliency. This research embarks on a comprehensive evaluation, beginning with an in-depth historical analysis to delineate regions most susceptible to wildfires. Utilizing a multidimensional approach, the study assesses wildfire-induced risks to power grids, by integrating historical wildfire occurrences, real-time wildfire proximities, Moderate Resolution Imaging Spectroradiometer (MODIS) derived vegetation metrics, and system parameters, by employing Principal Component Analysis (PCA) based optimal weights, leading to the formulation of a novel risk factor model. This risk factor has the potential to be the key to ensuring the resilience of a renewable-rich smart grid when faced with a severe weather event. Our model’s applicability was further verified through an empirical assessment, selecting representative networks from diverse regions, providing insights into the geographical variability of risk factors. Ultimately, this study offers stakeholders and policymakers a comprehensive tool-set, empowering decisions regarding infrastructure investments, grid reinforcements, and strategic power rerouting to ensure consistent energy delivery using risk assessment against wildfire.

This paper proposes a model that combines multi-criteria and multi-faceted risk assessment. Using two data sources, a fuzzy Technique for Order of Preference by Similarity to Ideal Solution FTOPSIS method combined with FMEA assessment. The FMEA method presented in this paper combines the technique of prioritising preferences according to FTOPSIS similarity to the ideal solution and conviction structure to overcome the defects of traditional FMEA indicators. The paper describes the exact process and tool selection, and the results obtained in the study verified accurate data. Finally, a numerical case study was presented on hospital reorganization services and case adaptation to prioritize surgical abandonment in Poland. The problem considered in the publication is the priority of patients’ operations in hospitals. The selection of relevant criteria, their importance and patient preferences are presented. The results obtained from the method provide a viable action plan for the proposed research problem. The proposed method is multi-faceted and can be part of an information system supporting reorganization, restructuring, and modification of the operational process.

Emerging infectious diseases (EIDs) continue to be a problem all across the world, but in certain areas the threat is greater than in others. The detection of new diseases will aid in the focus of surveillance efforts. Specifically, identifying a "patient zero" is critical step to help limit further transmission. In fact, several factors have been found to contribute to emerging infectious diseases emergence and transmission. Antigenic drift is an important factor that affects vaccine effectiveness and it is important for scientists and healthcare providers alike to understand how this process works in order to ensure that people receive effective vaccinations against infectious diseases. However, recent advances in biotechnology, immunology and artificial intelligence have enabled us to make progress in diagnosis, treatment, prevention and control of infectious diseases. The fight against infectious diseases will always be ongoing, but the advancement of bioscience offers a promising outlook for the near future. In the last two decades, several high impact zoonotic disease outbreaks have been linked to bat-borne viruses. These include SARS coronavirus, Hendra virus and Nipah virus. In addition, it has been suspected that ebolaviruses and MERS coronavirus are also linked to bats. It is being increasingly accepted that bats are potential reservoirs of a large number of known and unknown viruses, many of which could spillover into animal and human populations. In this article, we discuss the potential risk factors that contribute in emerging infectious diseases. Also, we discuss the management of disease prevention and control.

Introduction. Congenital muscular torticollis (CMT) is an asymmetrical head positioning resulting from structural changes in the sternocleidomastoid muscle (SCM) that occurs early in a child’s development period or due to perinatal trauma. Children with CMT exhibit a marked imbalance in tension between the SCMs. When the clinical picture is typical, an ultrasound scan is performed to reveal characteristic lesions, such as tissue fibrosis or post-traumatic changes. Early diagnosis of CMT in newborns and implementation of treatment offer the chance of a complete cure. Torticollis treatment aims to rebuild the SCM's normal function by restoring its anatomical length, normal cervical spine mobility and muscle flexibility to enable regular head movements. Surgical treatment is performed when conservative methods fail to improve the patient’s condition. Indications for surgery include marked shortening of the SCM, persistent fibrosis in the muscle, constant head and facial asymmetry, and rotation or lateral flexion in the cervical spine restricted by > 15°. After hip dislocations and foot deformities, pediatric orthopedics addresses torticollis as the third most common congenital anomaly. Aim. This study was a retrospective analysis of 111 children diagnosed and treated due to CMT. Methods. The following were determined: the relationship between the side of CMT location and the type of delivery (cc vs. natural), between the body weight at birth and the side of CMT location, between the extent of SCM thickening and the type of delivery, and the incidence of CMT depending on the order of delivery. Results and conclusions. The analysis showed that CMT was more common in boys 61(54%) than in girls 51(46%), which may be related to the greater birth weight in boys. Of the pediatric patients with CMT, 76% were primiparous. More often, children born via natural delivery had left-sided torticollis with a more significant broadening of the SCM on ultrasound scans than right-sided torticollis. Theories of torticollis development pathophysiology should be deepened, systematized, and further researched.

Background: Helicobacter pylori infection is a global health concern, contributing to gastritis, peptic ulcer disease, and gastric cancer. However, knowledge about H. pylori epidemiology in Somalia is limited. This scoping review aims to synthesize evidence on H. pylori prevalence in Somalia and associated factors. Methods: We systematically retrieved six scholarly investigations on H. pylori prevalence in Somalia published until 2023 from academic databases. We extracted data on prevalence, demographics, and covariate factors. Results: H. pylori infection varied (32.4% to 56.5%) across studies, with higher rates in adults and outpatient settings. Temporal variability was observed. Gastritis symptoms and female gender showed an association with H. pylori infection, while age, family history, diet, lifestyle, and comorbidities had inconclusive associations. Conclusions: Somalia faces a substantial H. pylori burden, reaching 56.5% in symptomatic adults seeking outpatient care. Temporal prevalence fluctuations require further investigation. These findings inform research and clinical management. Population-based studies are essential to establish a national prevalence profile. This research addresses a critical knowledge gap in Somalia's H. pylori epidemiology, guiding public health strategies. Journals in gastroenterology, infectious diseases, and public health may consider this for publication.