The notion that ‘Stock-G’ humpback whales off western South America are primarily deep oceanic migrators is poorly supported. We documented 66 land-based sightings from Pucusana, Lima Sur: 18 incidental (2002–2023) and 48 dedicated sightings during the northbound winter migration (June-July 2023), covering respectively 38 and 105 individual whales, despite a mean daily observer effort of only 58.7 min. Estimated distances from shore ranged 20–7,000 m (mean= 2,729 m) at depths 25–99 m, while 50% migrated at < 2,500 m (median) from shore. Several groups skirted the coastline from headland to headland. Of five southbound migrating groups, four included an adult with neonate; no northbound groups enclosed a neonate. Two cases of single juvenile/subadult whales moving multidirectionally and closely associated with large seabird feeding frenzies, were considered foraging also. In 2023, 94% of all northbound nearshore sightings occurred from 14 June-11 July, signalling the maximum threat period for interactions with coastal fisheries off metropolitan Lima. If migration is temporally and spatially predictable, effective mitigating measures should be feasible.

This study investigates the influence of the porous structure, on the density and the mechanical behaviour of new foam concretes incorporating hemp shives. A total of eight batches of foam concretes were manufactured and tested, made with a protein-based foam agent, containing cement, ground granulated blast furnace slag and Metakaolin as binder and hemp shives as natural aggregate. The effect of several parameters is studied, elaboration method (direct and preformed), amount of pozzolanic additions (0% and 30%) and incorporation of hemp shives (5 and 15 vol%) on the resulting physical properties, microstructure, porous structure and mechanical behaviour of the concretes. Hemp shives incorporation results in increased concrete porosity and air bubble radius, decreased uniformity and mechanical strength, and lower cohesion with the cement matrix compared to standard concretes.

This work aimed to develop an easy-to-use smartphone-based electrochemical biosensor to quickly assess coffee blend's total polyphenol (Phs) content at industrial and individual level. The device is based on a commercial carbon-based screen-printed electrode (SPE) modified with multi-walled carbon nanotubes (CNTs) and gold nanoparticles (GNPs). At the same time, the biotransducer, Laccase from Trametes versicolor, TvLac, was immobilized on the sensor surface by using glutaraldehyde (GA) as cross-linking agent. The platform was electrochemically characterized to ascertain the influence of the SPE surface modification on its performance. The working electrode (WE) surface morphology characterization was obtained by scanning electron microscopy (SEM) and Fourier-transform infrared (FT-IR) imaging. All the measurements were carried out with a micro-potentiostat Sensit Smart by PalmSens connected to a smartphone. The developed biosensor provided a sensitivity of 0.12 μA/μM, a linear response ranging from 5 to 70 μM, and a lower detection limit (LOD) of 2.99 μM. Afterwards, the biosensor was tested for quantifying the total Phs content in coffee blends, evaluating the influence of both the variety and the roasting degree. The smartphone-based electrochemical biosensor performance has been validated though the Folin-Ciocâlteu standard method.

Cells are influenced by several biomechanical aspects of their microenvironment, such as substrate geometry. According to the literature, substrate geometry influences the behavior of muscle cells; in particular, the curvature feature improves cell proliferation. However, the effect of the substrate geometry on the myogenic differentiation process is not clear and needs to be further investigated. Here, we show that the 3D co-printing technique allows the realization of substrates. To test the influence of the co-printing technique on cellular behavior we realized linear polycaprolactone substrates with channels in which a fibrinogen-based hydrogel loaded with C2C12 cells was deposited. Cell viability and differentiation were investigated up to 21 days in culture. The results suggest that this technology significantly improves the differentiation at 14 days. Therefore, we investigate the substrate geometry influence by comparing three different co-printed geometries – linear, circular, and hybrid structures (linear and circular features combined). Based on our results, all structures exhibit optimal cell viability (&gt; 94%) but the linear pattern allows to increase the in-vitro cell differentiation, in particular after 14 days of culture. This study proposes an endorsed approach for creating artificial muscles for future skeletal muscle tissue engineering applications.

All solar thermal systems, due to their thermal nature, can be hybridised or operated with both fossil fuel and solar energy. By enhancing availability and dispatch ability, hybridization has the potential to boost the value of concentrating solar thermal technology. Hybrid photovoltaic thermal systems (PV/T) offer a solution to improve on the limited capacity growth seen with standard solar panels. The analysis focuses on the creation of alternative structural and design so-lutions that may be used to boost lacking efficiency that was previously hampered by limited spectrum absorption of sun light. As a result, the spectrum is separated into two spectrum ranges, one that directly matches the bandgap of PV materials and the other that is absorbed for thermal absorption outputs. Most two channel systems are used to capture or reflect sunlight, with the layer specifically located right above the PV cell. Another layer of nanofluid is employed to evacuate heat from the PV cell, acting as the second channel, to specifically eliminate overheating difficulties. To address concerns that have arisen as a result of years of observation, the most recent study involves nano-particle-based fluids employed in PV/T, which uses a cooling medium to provide an alternate heat transfer option. Aside from nanofluids, there are phase change materials, channel alterations that result in a higher flow rate and hence improve overall performance.

Evidence-based data for endometriosis management are limited. Experiments are excluded without adequate animal models. Data are limited to symptomatic women and occasional observations. Hormonal medical therapy cannot be blinded if recognised by the patient. Randomised controlled trials are not realistic for surgery since a variable disease with low numbers. Each diagnosis and treatment is an experiment with an outcome and experience is Bayesian updating from the past. If the experience of many is similar, this has more value than an opinion. The combined experience of a group of endometriosis surgeons was used to discuss problems in the management of endometriosis. Considering endometriosis as several genetically/epigenetically different diseases is important for medical therapy. Imaging cannot exclude endometriosis and diagnostic accuracy is limited for superficial lesions, deep lesions, and cystic corpora lutea. Surgery should not be avoided for emotional reasons. Shifting infertility treatment to IVF without considering fertility surgery is questionable. The concept of complete excision should be reconsidered. Surgeons should introduce quality control and teaching should move to explain why it is done. The perception of information has a personal bias. These are the major problems in the management of endometriosis identified by the combined experience of endometriosis surgeons.

There is an international concern for reducing energy consumption and protecting the environment in the construction industry. The energy efficiency of a building depends on the thermal resistance of concrete, and utilizing concrete products with elevated thermal resistance can enhance this aspect. This study analyzes the impact of perlite, as an addition, on the physico-mechanical properties of concrete, with the aim of identifying perlite concrete products that will respond to the improvement of the heat transfer resistance of the building envelope. The study examines the effect of replacing different amounts of concrete aggregates with perlite in percentages of 10%, 20%, 30%, and 100%. The results show that substituting sand with perlite improves the thermal performance of concrete, but its mechanical properties are negatively affected. The research carried out highlighted that perlite can be successfully introduced in the production of concrete blocks used for external non-bearing wall panels, the outstanding feature being the reduction of energy consumption in buildings. Overall, the paper identifies an efficient and environmentally friendly way of using perlite in the construction industry, enhancing the energy efficiency of buildings while minimizing the environmental footprint caused by the construction industry.

Animal welfare assessment protocols are important for identifying welfare problems in conservation programs. This study aimed to develop a baseline welfare protocol for the assessment of welfare in huemul (Hippocamelus bisulcus) in conservation centers. This protocol is based on the Welfare Quality® (WQ) framework for cattle, considering the available literature on the behaviours, ecology, conservation plans, captive management of this species, and welfare assessment protocols for other ungulate species. As a result, the protocol was specifically developed for huemuls and included four principles, 12 criteria, and 23 animal- and resource-based indicators. The 12 criteria of the WQ protocol were reduced to nine, and three new criteria were added because they were both feasible and essential for welfare assessment in captive huemuls. This protocol is mainly intended to identify welfare problems in endangered species in the context of conservation centers (reproduction, rescue, rehabilitation, or treatment centers). Thus, aggregation of different measures to obtain a global score has not been proposed. However, a scoring system that assigns a value on a 0-2 scale (0= No welfare concern; 1= welfare concern; 2= urgent welfare concern) is proposed for each category. Although further research is still needed to fully validate the protocol, this is the first development of a completed protocol for huemul welfare assessment.

High-precision ground point cloud data has a wide range of applications in various fields, and the separation of ground points from non-ground points is a crucial preprocessing step. Therefore, designing an efficient, accurate, and stable ground extraction algorithm is of great significance for improving the processing efficiency and analysis accuracy of point cloud data. The study area in this article was a Park in Guilin, Guangxi, China. The point cloud was obtained by utilizing the UAV platform. In order to improve the stability and accuracy of the Filter algorithm, this article proposed a triangular grid filter based on Slope Filter, found violation points by the spatial position relationship within each point in the triangulation network, improved KD-Tree-Based Euclidean Clustering, and applied it to the non-ground points extraction, this method has good accuracy, stability and achieves good results in separating ground points from non-ground points. At first, using Slope Filter to remove some non-ground points, to reduce the error of taking ground points as non-ground points; Secondly, established a triangular grid based on the triangular relationship between each point, the violation-triangle can determin through the grid, and then the corresponding violation points were found in the violation-triangle; Thirdly, according to the three-point collinear method to extract the regular points, used these points to extract the regular landmarks by KD-Tree-Based Euclidean Clustering and Convex Hull Algorithm; Finally, removed disperse points and irregular landmarks by Clustering Algorithm. In order to confirm the superiority of this algorithm, this article compared the filter effects of various algorithms on the study area and filtered the 15 sample data provided by ISPRS, and obtained an average error of 3. 46%. The results showed that the algorithm in this article have a high processing efficiency and accuracy, which can greatly improve the processing efficiency of point cloud data in practical applications.

Nanotechnology and polymer engineering are steering towards a new development to invade deleterious mysteries. In the last few decades, polymer engineering has grabbed researchers’ attention and similarly, polymeric network-engineered structures have been vastly studied. Prior to therapeutic application, early and quick detection analyses are critical. Therefore, developing nanoscale sensors to manage the acute expression of feeble states and malignancies to draw therapeutic lines demands advanced nanoengineering. In spite of nano-therapeutics have emerged as an alternative approach to tackling strenuous diseases. Also, studies have shown highly biocompatible biomedical engineering has emerged with sheer progression. Moreover, hydrogels have emerged as a three-dimensional (3D) polymeric network that consists of hydrophilic natural or synthetic polymers. The resemblance of hydrogels with tissue structure makes it more unique to study inquisitively. Preceding studies have shown a vast spectrum of synthetic and natural polymer deployment in the field of biotechnology and molecular diagnostics. This review explores recent studies on synthetic and natural polymer engineered hydrogel-based biosensors and their applications in multipurpose diagnostics and therapeutics. We reviewed the latest studies on hydrogel-engineered biosensors, exclusively DNA-based and DNA hydrogels fabricated biosensors.

: Consumption of plant-based milk replacers has increased in recent years due to health benefits, benefits attributed mainly to the content of phenolic compounds, fatty acids, or bioactive compounds with antioxidant activity. In this context, we proposed to obtain two types of less studied plant-based beverages, namely lupine and chickpea beverages, as well as the possibility of getting these beverages using germinated seeds and even obtaining probiotic drinks through fermentation with Lactobacillus plantarum 299v. To evaluate the quality of the obtained products, we determined their content of proteins, fatty acids, organic acids, volatile compounds, and phenolic compounds. We evaluated the antioxidant activity of the obtained herbal drinks, and a load of probiotic microorganisms present after the fermentation process. Both lupine and chickpea drinks have the desired properties, high content of fatty acids and phenolic compounds, that bring probiotic benefits.

Polymeric wet-strength agents are important additives used in the paper industry to improve the mechanical properties of paper products, especially when they come in contact with water. These agents play a crucial role in enhancing the durability, strength, and dimensional stability of paper products. The aim of this review is to provide an overview of the different types of wet-strength agents available and their mechanisms of action. We will also discuss the challenges associated with the use of wet-strength agents and the recent advances in the development of more sustainable and environmentally friendly agents. As the demand for more sustainable and durable paper products continues to grow, the use of wet strength agents is expected to increase in the coming years.

3D point cloud classification tasks have been a hot topic in recent years. Most existing point cloud processing frameworks lack context-aware features due to the deficiency of sufficient local feature extraction information. Therefore, we design an augmented sampling and grouping (ASG) module to efficiently obtain fine-grained features from the original point cloud. In particular, this method strengthens the domain near each centroid and makes reasonable use of the local mean and global standard deviation to mine point cloud’s local and global features. In addition to this, inspired by the transformer structure UFO-ViT in 2D vision tasks, we first try to use a linearly-normalized attention mechanism in point cloud processing tasks, investigating a novel transformer-based point cloud classification architecture UFO-Net. An effective local feature learning module is adopted as a bridging technique to connect different feature extraction modules. Importantly, UFO-Net employs multiple stacked blocks to better capture feature representation of the point cloud. Extensive ablation experiments on public datasets show that our method outperforms other state-of-the-art methods. For instance, our network performed with 93.7% overall accuracy on the ModelNet40 dataset, which was 0.5% higher than PCT. Our network also archived 83.8% overall accuracy on the ScanObjectNN dataset, which is 3.8% better than PCT.

A growing number of health conscious consumers are looking for animal protein alternatives with similar texture, appearance, and flavor. There has been a lot of interest in meat analogs as potential meat substitutes. However, research and development still needs to find any alternative non-meat materials. The objective of the current research was to develop fungi minced meat alternative (FMMA) from edible mushrooms. Pleurotus Sajor-caju (SC) was used as the starting material. SC mushroom was selected for starting materials based on high protein content (41.99%.) and sensory attributes. Chickpea flour was used to improve the textural properties by mixing with SC mushroom at a ratio of 0:50, 12.5:37.5, 25:25, 37.5:12.5, and 50:0 (w/w). Textural and sensory attributes suggest that SC mushroom to chickpea at a ratio of 37.5:12.5, shows higher acceptability of FMMA with the protein content up to 47%. Beetroot extract 0.2% (w/w), and 5% (w/w) canola oil showed the most acceptable color parameters and consumer acceptability. This research suggested that SC mushroom with 12.5% chickpea flour, 0.2% beetroot extract and 5% canola oil could be suitable ingredients for the mushroom-based FMMA.

Topological indices are invariant numerical fields of a graph that give facts about the structure of graphs and are found to be very helpful in predicting the physical properties of aluminophosphates. The characteristics of the aluminophosphates are similar to those of zeolites. Two examples of current applications are natural gas dehydration and humidity sensor. New frameworks are being synthesised by researchers in chemistry and materials science. There are many layers and holes in these substances. In this study, Vertex version of distance-based topological indices, the entropy of topological indices and their numerical analysis are explained.

CD39 is involved in adenosine metabolism through conversion of extracellular ATP to adenosine. Because extracellular adenosine plays a critical role in the immune suppression of tumor microenvironment, the inhibition of CD39 activity by monoclonal antibodies (mAbs) is one of the important strategies for tumor therapy. In this study, we developed specific and sensitive mAbs for mouse CD39 (mCD39) using the Cell-Based Immunization and Screening (CBIS) method. The established anti-mCD39 mAbs, which were established by the CBIS method including C₃₉Mab-1 (rat IgG_2a, kappa) and C₃₉Mab-2 (rat IgG_2a, lambda), reacted with not only mCD39-overexpressed Chinese hamster ovary-K1 (CHO/mCD39) but also endogenously mCD39-expressed cell lines, such as L1210 (mouse lymphocytic leukemia) and J774-1 (mouse macrophage-like) cell lines through flow cytometry. Kinetic analyses using flow cytometry indicated that the dissociation constant (K_D) of C₃₉Mab-1 and C₃₉Mab-2 for CHO/mCD39 was 7.3 × 10⁻⁹ M and 5.5 × 10⁻⁹ M, respectively. K_D of C₃₉Mab-1 and C₃₉Mab-2 for L1210 was 3.3 × 10⁻⁹ M and 3.6 × 10⁻¹⁰ M, respectively. Furthermore, C₃₉Mab-1 could detect the lysate of CHO/mCD39 by western blot analysis. These results indicate that C₃₉Mab-1 and C₃₉Mab-2 are useful for the detection of mCD39 in many functional studies.

Residents’ perceptions on ecosystem services (ESs) provided by urban green spaces (UGSs) are vital for developing sustainable cities. However, there has been limited research on this issue in Malaysia. The aim of this paper is to assess Malaysians’ perceptions on ESs provided UGSs and how their perceptions are influenced by different socio-demographic factors. We used a structured online questionnaire and obtained 645 responses on 16 ESs from regulatory, cultural, and supporting ES categories. Descriptive statistics and binary logistic regressions were used for data analysis. In general, city dwellers have high positive perceptions on ESs provided by UGSs. Their perceptions for global climate regulation, noise buffering, pest regulation, spiritual, and research and education services would likely to significantly increase as they grow older. Households with moderate income have significantly greater perceptions of microclimate regulation, air filtration and aesthetic services. Having non-tertiary level education would significantly lower their perceptions of global climate and microclimate regulation, spiritual, aesthetics, and recreational services. Tertiary educated residents with non-environmental degrees also showed similar associations. Infrequent visits to UGSs would likely to significantly reduce the perception of global climate regulation, noise buffering, runoff reduction, erosion control, spiritual, and aesthetics services. People living far (>5km) from the UGSs also have significantly lower perceptions of microclimate regulation, air filtration services. Suggestions are made to incorporate ESs related content in pre-university curriculum and establishing small parks in neighborhoods to improve knowledge and uses of UGSs. These findings would assist urban planners designing environmentally sound urban policies and thereby improving human wellbeing in the cities.

Altered expression of microRNAs (miRNAs) after spinal cord injury (SCI) has been described as being responsible for the main secondary responses, such as apoptosis. X-linked inhibitor apoptosis protein (XIAP) is a key apoptotic component involved in the progression of apoptotic programmed cell death. Several regulators have been described to modulate the XIAP's function, including the post-transcriptional regulator's miRNAs. The main aim of the present work is to identify miRNAs with altered expression after SCI which can regulate XIAP expression. Our bioinformatic analyses identified several candidate miRNAs that may regulate XIAP, among which miR-199a-5p may be involved in the downregulation of XIAP after SCI. Gene reporter assays and in vitro analyses in the neural C6 cell line confirmed the targeting of miR-199a-5p on the 3-UTR of the rat XIAP and its post-transcriptional regulation of XIAP protein level, but not at mRNA level. Analyses in a rat model of SCI revealed a trend towards increased expression of miR-199a-5p and a decrease in XIAP protein level at 3 days after injury. Finally, using a specific fluorescent in situ hybridization (FISH) probe for miR-199a-5p, we characterized the expression pattern of miR-199a-5p in cells of uninjured and rat-contused spinal cords. These findings provide new insights into apoptotic miRNA-mediated mechanisms after SCI, which will help us develop therapeutic strategies based on miRNAs for treating SCI.

Measuring pulmonary nodules accurately can help with early diagnosis of lung cancer, which can improve a patient’s chances of survival. Many methods for segmenting nodules have been developed, but they all rely on input from radiologists in the form of a 3D volume of interest (VOI) or use a constant region of interest (ROI) and only consider the presence of nodule within the given VOI. These approaches limit the networks’ ability to detect nodules outside the given VOI and can also include unnecessary structures in the VOI, leading to potentially inaccurate segmentation. In this work, we propose a novel approach for 3D lung nodule segmentation by using 2D region of interest (ROI) inputted from radiologist or computer-aided detection (CADe) system. Particularly, we design a dual-encoder-based hard attention network (DEHA-Net) which incorporates the full slice of thoracic computed tomography scan along with the ROI mask to produce an accurate segmentation mask of lung nodule in the given slice. The proposed architecture exploits the adaptive region of interest (A-ROI) algorithm to automatically investigates the penetration of lung nodule into surrounding slices while eliminating the need to drawing separate ROIs in each slice. Further, the framework performs the multi-view analysis, i.e., in sagittal and coronal views, to improve the segmentation performance. The proposed scheme has been rigorously evaluated on the lung image database consortium and image database resource initiative (LIDC/IDRI) dataset and an extensive analysis of results have been performed. The quantitative analysis shows that the proposed method not only improves the existing state-of-the-art in term of dice score but also, significantly robust against the different types, shape and dimensions of lung nodules.

COVID-19 is a well-known respiratory disease spreading worldwide since January 2020, causing many deaths and massive pressure on health systems. This pandemic’s appearance compromised the health services’ sustainability and quality as many procedures were postponed or even canceled out, with an expected increase of adverse events like nosocomial infections, in-hospital deaths, and the worsening of the patients’ clinical status. Therefore, assessing whether the healthcare providers’ performance has changed is paramount. In this case, we evaluated the public hospitals in Portugal as the leading secondary health care providers in the country, which in turn has been highly affected by the pandemic. To this end, we developed a network Data Envelopment Analysis model serially relating efficiency and effectiveness. Using 2,795 observations from public hospitals and 18 variables, we observed consistent drops in efficiency when the pandemic started, followed by a recovery to levels above the pre-pandemic ones. Regarding effectiveness, we observed a positive trend during the evaluated period. In short, these results allow us to conclude that, apart from the great resilience of public healthcare providers, the Portuguese State was not prepared for a pandemic like COVID-19, but still the actions taken (including massive vaccination) were beneficial.

Background: It is necessary to apply a behavior-based safety (BBS) program to prevent at-risk behavior. An effective BBS program requires the implementation of not only behavioral definitions and a customized critical behavior checklist (CBC) but also observations of behavior, coupled with customized interventions at power plants. Method: In this study, a customized CBC and behavioral definition were developed through a review of five different sites that previously used a CBC. The rules of observation, flow, and target were established to initiate the observations. Customized interventions were selected to increase safe behaviors. CBC scoring was used to evaluate observed safe behaviors for three years. Recognized safe behaviors were evaluated with a questionnaire that included four items each for conformity and participation behaviors and were then analyzed through a factor analysis and a t-test. The questionnaires were conducted three months before and after the implementation of the BBS program. Results: The customized CBC, behavioral definition, and interventions were effective, such that observed safe behaviors and the levels of workers’ recognized safe behaviors increased. Conclusion: The application of the BBS program was found to increase the observed and recognized safe behaviors. Therefore, the program applied to this site can help increase safe behaviors at other identical or similar sites, as well as prevent an accident, which also corresponds with the results of prior studies.

We report an agent-based model to compare the effectiveness of simple and complex mobile dating application interfaces in generating matches for virtual users. We define the relative complexity of dating applications as the number of available features and dub this variable, the multiplicity. We replicate some of the most popular mobile dating applications through the generation of a synthetic population endowed with attributes, preferences, and behaviors drawn from literature. We treat our data as a network dataset and use a robust statistical procedure (MRQAP) to issue a valid and reliable comparison between simulated applications. We show how the quadratic assignment procedure can be used to compare network simulations rigorously. As a result, we observe a direct relationship between multiplicity and agent-level experiences and expectations in match generation. We also observe the emergence of divergent matching systems with minor rule changes as well as several expected properties of online dating systems. This work serves as a proof-of-concept in the integration of classical social network analysis methods with agent-based modeling to compare virtual designs and to enhance the policy-generation process of online social networks.

An adaptor signature can be viewed as a signature concealed with a secret value and, by design, any two of the trio yield the other. In a multiparty setting, an initial adaptor signature allows each party create additional adaptor signatures without the original secret. Adaptor signatures help address scalability and interoperabity issues in blockchain. They can also bring some important advantages to cryptocurrencies, such as low on-chain cost, improved transaction fungibility, and less limitations of a blockchain’s scripting language. In this paper, we propose a new two-party adaptor signature scheme that relies on quantum-safe hard problems in coding theory. The proposed scheme uses a hash-and-sign code-based signature scheme introduced by Debris-Alazard et al. and a code-based hard relation defined from the well-known syndrome decoding problem. To achieve all the basic properties of adaptor signatures formalized by Aumayr et al., we introduce further modifications to the aforementioned signature scheme. We also give a security analysis of our scheme and its application to the atomic swap. After providing a set of parameters for our scheme, we show that it has the smallest pre-signature size compared to existing post-quantum adaptor signatures.

The aim of this study was to determine the extent to which the Tyme Wear smart shirt is as reliable and valid in detecting personalized ventilatory thresholds when compared to the Parvo Medics TrueOne 2400. In this validation study, 19 subjects were recruited to conduct two graded exercise test (GXT) trials. Each GXT trial was separated by seven to ten days of rest. During the GXT, gas exchange and heart rate data were collected by the TrueOne 2400 (TRUE) in addition to the ventilation data collected by the Tyme Wear smart shirt (S-PRED). Gas exchange data from TRUE was used to detect VT1 and VT2. TRUE and S-PRED VT1 and VT2 were compared to determine the reliability and validity of the smart shirt. Of the 19 subjects, data from 15 subjects were used during analysis. S-PRED exhibited excellent (ICC &gt; 0.90) reliability for detection of VT1 and VT2 utilizing time point and workload and moderate (0.90 &gt; ICC &gt; 0.75 ) reliability utilizing heart rate. TRUE exhibited excellent reliability for detection of VT1 and VT2 utilizing time point, workload, and heart rate. When compared to TRUE, S-PRED appears to underestimate the VT1 workload (p &gt; 0.05) across both trials and heart rate (p &lt; 0.05) for trial 1. However, S-PRED appears to underestimate VT2 workload (p &lt; 0.05) and heart rate (p &lt; 0.05) across both trials. The result from this study suggests that the Tyme Wear smart shirt is less valid but is comparable in reliability when compared to the gold standard. Moreover, despite the underestimation of S-PRED VT1 and VT2, the S-PRED detected personalized ventilatory thresholds will provide an adequate training workload for most individuals. In conclusion, the Tyme Wear smart shirt provides easily accessible testing to establish threshold-guided training zones but does not devalue the long-standing laboratory equivalent.

Tephra plumes can cause a significant hazard for surrounding towns, infrastructure, and air traffic. The current work presents the use of a small and compact X-band Multi-Parameter (X-MP) radar for the remote tephra detection and tracking of two eruptive events at Merapi Volcano, Indonesia, in May and June 2018. Tephra detection was done by analysing the multiple parameters of radar: copolar correlation and reflectivity intensity. These parameters were used to cancel unwanted clutter and retrieve tephra properties, which are grain size and concentration. Real-time spatial and temporal forecasting of tephra dispersal was performed by applying an advection scheme (nowcasting) in the manner of Ensemble Prediction System (EPS). Cross-validation was done using field-survey data, radar observations, and Himawari-8 imagery. The nowcasting model computed both the displacement and growth and decaying rate of the plume based on the temporal changes in two-dimensional movement and tephra concentration, respectively. Our results with ground-based data, where the radar-based estimated grain size distribution fell within the range of in-situ data. The uncertainty of real-time forecasted tephra plume depends on the initial condition, which affects the growth-and decaying rate estimation. The EPS improves the predictability rate by reducing the number of missed and false forecasted events. Our findings and the method presented here are suitable for early warning of tephra fall hazard at the local scale.

The unavoidable progression of EGFR-mutated NSCLC on EGFR-TKIs forces us to discover solutions for further therapies. Herein, we discuss the necessity of accurate genomic mapping of progressive disease illustrated by a patient case. Tumor rebiopsies at progression are strongly needed to characterize acquired resistance to EGFR-TKI. The necessary data, however, may be reliably obtained only by deep targeted next generation sequencing (NGS) of both DNA and RNA. The reported case is a patient with EGFR-mutant NSCLC, who progressed during second line Osimertinib with subsequent targeted treatment determined by the detection of an acquired intergenic ANK3-RET-fusion with concomitant PTEN-mutation and MDM2-amplification. These three acquired gene alterations represent potential mechanisms of TKI-resistance, not previously reported on second line Osimertinib. Yet, while PTEN-mutations and MDM2-amplification are currently undruggable, the ANK3-RET fusion allowed further personalized treatment by combining continuation of Osimertinib with the RET-TKI Pralsetinib, which resulted in objective partial response, so far for 7 months, and significant clinical improvement. Hence, complementary DNA- and RNA-based targeted NGS may be of importance in clinical routine to better reveal the current molecular state of the disease and contribute to the identification of further targeted therapy strategies. Indeed, further cases with acquired RET-fusions, including ANK3-RET, should be investigated to fully determine the effectiveness of RET-TKI-Osimertinib combinations.

This document presents the design and manufacture of a reflectarray (RA) antenna for the Ku-band, based on a fully-metallic 3D architecture. The reflectarray unit cell is formed by a square-shaped waveguide section ended in a short circuit, that is the reflectarray back ground plane. Each cell has the ability of configuring the phase of its own reflected field by means of resonators perforated on the walls of the cell waveguide section. The resonator-based waveguide cell introduces the 3D character to the design. The geometry of the resonators and its size variation introduces the phase behaviour of each cell, conforming the radiation pattern of the reflectarray. This design explores the potential of phase value truncation (6 states and 2 states), and demonstrates that proper pattern results can be obtained with this phase truncation.

Traditional refractory materials such as nickel-based superalloys have been gradually unable to meet the performance requirements of advanced materials. The Mo-Si-based alloy, as a new type of high temperature structural material, has entered the vision of researchers due to its charming high temperature performance characteristics. However, its easy oxidation and even "pesting oxidation" at medium temperatures limit its further applications. In order to solve this problem, researchers have conducted large numbers of experiments and made breakthrough achievements. Based on these research results, the effects of rare earth elements like La, Hf, Ce and Y on the microstructure and oxidation behavior of Mo-Si-based alloys were systematically reviewed in the current work. Meanwhile, this paper also provided an analysis about the strengthening mechanism of rare earth elements on the oxidation behavior for Mo-Si-based alloys after discussing the oxidation process. Furthermore, the research focus about the oxidation protection of Mo-Si-based alloys in the future was prospected to expand the application field.

The task of unsupervised anomalous sound detection (ASD) is challenging for detecting anomalous sounds from a large audio database without any annotated anomalous training data. Many unsupervised methods were proposed, but previous works have confirmed that the classification-based models far exceeds the unsupervised models in ASD. In this paper, we adopt two classification-based anomaly detection models: (1) Outlier classifier is to distinguish anomalous sounds or outliers from the normal; (2) ID classifier identifies anomalies using both the confidence of classification and the similarity of hidden embeddings. We conduct experiments in task 2 of DCASE 2020 challenge, and our ensemble method achieves an averaged area under the curve (AUC) of 95.82% and averaged partial AUC (pAUC) of 92.32%, which outperforms the state-of-the-art models.

Nickel-based superalloys are attractive to many industrial sectors (automotive, military, energy, aerospace etc.). However, their physical properties make them difficult to machining using traditional tools. Therefore, the new materials for the machining of Ni-based alloys are required. Ceramic-based composites could act as a tool to replace the current materials. The incentives for this paper are to provide an overview of existing ceramic composites and draw some conclusions that will help in solving the problem of choosing materials for processing of Ni-based superalloys. Despite the diversity of ceramic composites in this work the focus was on the SiAlON ceramic.

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

Predictive maintenance (PM) algorithms are widely applied for detecting operational anomalies on industrial processes to trigger maintenance before a possible breakdown; however, much less focus has been devoted to the use of such PM predictions as feedback in automated process control mechanisms. They usually integrate preventive solutions to protect the machines, usually causing downtimes. The premise of this study is to develop a holistic adaptive process scheduling mechanism that incorporates PM analysis as a safety component to optimize the operation mode of an industrial process toward preventing breakdowns while maintaining its availability and operational state, thereby reducing downtimes. As PM is largely a data-driven approach; hence, relies on the setup, we first compare different PM approaches and identify a one-class support vector machine (OCSVM) as the best performing option for the anomaly detection on our setup. Then, we propose a novel pipeline to integrate maintenance predictions into a real-time adaptive process scheduling mechanism. It schedules for the most suitable operation, i.e., optimizing for machine health and process efficiency, according to the abnormal readings. To demonstrate the pipeline on action, we implement our approach on a small-scale conveyor belt system utilizing our Internet of Things (IoT) framework. The results show that our PM-based adaptive process control provides an efficient process with less or no downtime. We also conclude that a PM approach does not provide sufficient efficiency without its integration into an autonomous planning process.

Cryptography has been used from time immemorial for preserving the confidentiality of data/information in storage or in transit. Thus, cryptography research has also been evolving from the classical Caesar cipher to the modern cryptosystems based on modular arithmetic to the contemporary cryptosystems based on quantum computing. The emergence of quantum computing imposes a major threat on the modern cryptosystems based on modular arithmetic whereby, even the computationally hard problems which constitute for the strength of the modular arithmetic ciphers could be solved in deterministic time. This threat triggered post-quantum cryptography research in order to design and develop post-quantum algorithms that can withstand quantum computing attacks. This paper provides a review of the various post-quantum cryptography and, in specific, code-based cryptography research dimensions. The research directions that are yet to be explored in code-based cryptography research is another key contribution of this paper.

The use of vitamin D (VitD) supplements has become widespread in the last decade due not only to the dissociation between the blood levels recommended as "optimal" and those shown by the healthy population, but also to its presumed beneficial effects on multiple disorders. This work evaluated the levels of 25-hydroxyvitamin D [25(OH)D] in a healthy population of European origin living in a region with high solar irradiation. In serum samples from a population-based study conducted in the Canary Islands, levels of 25(OH)D were analyzed. In 876 individuals who had no history of kidney or malabsorption disorders and who had not been treated with calcium and/or VitD supplementation, the median 25(OH)D level was 26.3 (5th;95th percentile, 14.3;45.8)ng/mL. Notably, 65.4% of the population had 25(OH)D blood levels below 30ng/mL, 23.4% below 20ng/mL and 6.4% below 15ng/mL. Based on the lack of evidence supporting causality between 25(OH)D levels below what is recommended as optimal (≥20ng/mL, or even ≥30ng/mL) and major skeletal and non-skeletal diseases, and in light of the distribution of the concentration of this vitamin in healthy adults living under optimal conditions of solar irradiation, it seems reasonable to consider 25(OH)D levels below 20ng/mL and close to 15ng/mL as adequate for the general population.

Purpose: Now traditional lecture-based teaching and learning have been affected by the COVID-19. The objectives of this article are to design the novel educational technique called ‘dynamic-based learning’ (DBL) that provides the combination of online teaching-learning methods and student’s creativity, to evaluate primary dynamic-based learning function, and to propose dynamic-based learning for higher education. Methods: DBL composes of four steps, including, preparation, homework, classroom, and evaluation, which was designed, and taught in medical and dental schools. Online support materials included mobile phone, email, Facebook Messenger, Line Messenger, Cisco Webex, and Zoom Meetings applications were recruited for this novel method. Results: A total of 32 third-year medical students and 26 sixth-year dental students was treated by DBL similarly. three subjects, including, Innovation in Dentistry, Basic Medical Research, and Principles of Pathology and Forensic Medicine were selected in this article. The results showed students could create their knowledge, ideas, and creativity during the online classes.Conclusion: DBL can be used as an alternative learning mode during the COVID-19 crisis. The benefits of DBL also include high flexibility, dynamic process, active learning, and high creativity. DBL should be tested with other disciplines such as engineering school, laws school, health sciences school, and should be compared with other traditional teaching and learning modes in the future. This method may support the global higher education systems to move forward the COVID-19 pandemic to set a novel standard of a future normal.

Significant efforts in the past decades to teach evidence-based practice (EBP) implementation has emphasized increasing knowledge of EBP and developing interventions to support adoption to practice. These efforts have resulted in only limited sustained improvements in the daily use of evidence-based interventions in clinical practice in most health professions. Many new interven-tions with limited evidence of effectiveness are readily adopted each year - indicating openness to change is not the problem. The selection of an intervention is the outcome of an elaborate and complex cognitive process which is shaped by how they represent the problem in their mind and is mostly invisible processes to others. Therefore, the complex thinking process which support appropriate adoption of interventions should be taught more explicitly. Making the process visible to clinicians increases the acquisition of the skills required to judiciously select one in-tervention over others. The purpose of this paper is to provide a review of the selection process and the critical analysis that is required to appropriately decide to trial or not trial new intervention strategies with patients.

Therapeutic options for the highly pathogenic human Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) causing the current pandemic Coronavirus disease (COVID-19) are urgently needed. COVID-19 is associated with viral pneumonia and acute respiratory distress syndrome causing significant morbidity and mortality. The proposed treatments for COVID-19, such as hydroxychloroquine, remdesivir and lopinavir/ritonavir, have shown little or no effect in the clinic. Additionally, bacterial and fungal pathogens contribute to the SARS-CoV-2 mediated pneumonia disease complex. The antibiotic resistance in pneumonia treatment is increasing at an alarming rate. Therefore, carbon-based nanomaterials (CBNs), such as fullerene, carbon dots, graphene, and their derivatives constitute a promising alternative due to their wide-spectrum antimicrobial activity, biocompatibility, biodegradability and capacity to induce tissue regeneration. Furthermore, the antimicrobial mode of action is mainly physical (e.g. membrane distortion), which is characterized by a low risk of antimicrobial resistance. In this review, we evaluated the literature on the antiviral activity and broad-spectrum antimicrobial properties of CBNs. CBNs had antiviral activity against 12 enveloped positive-sense single-stranded RNA viruses similar to SARS-CoV-2. CBNs with low or no toxicity to the humans are promising therapeutics against COVID-19 pneumonia complex with other viruses, bacteria and fungi, including those that are multidrug-resistant.

Background: This year has seen the emergence of two major crises, a significant increase in frequency and severity of hurricanes and the COVID-19 pandemic. However, little is known as to how each of these two events have impacted the other. A rapid qualitative assessment was conducted to determine the impact of the pandemic on preparedness and response to natural disasters and the impact of past experiences with natural disasters in responding to the pandemic. Methods: Semi-structured interviews were conducted with 26 representatives of 24 different community-based programs in southern Louisiana. Data were analyzed using procedures embedded in the Rapid Assessment Procedure – Informed Community Ethnography methodology, using techniques of immersion and crystallization and focused thematic analysis. Results: The pandemic has impacted the form and function of disaster preparedness, making it harder to plan for evacuations in event of a hurricane. Specific concerns included being able to see people in-person, providing food and other resources to residents who shelter in place, finding volunteers to assist in food distribution and other forms of disaster response, competing for funds to support disaster-related activities, developing new support infrastructures, and focusing on equity in disaster preparedness. However, several strengths based on disaster preparedness experience and capabilities were identified, including providing a framework for how to respond and adapt to COVID and integration of COVID response with their normal disaster preparedness activities. Conclusions: Although prior experience has enabled community-based organizations to respond to the pandemic, the pandemic is also creating new challenges to preparing for and responding to natural disasters.

Considering the significant advancements in autonomous vehicle technology, research in this field is of interest to researchers. To automatic parking, controlling steer angle, gas hatch, and brakes need to be learned. Due to the increase in the number of cars and road traffic, car parking space has decreased. Its main reason is information error. Because the driver does not receive the necessary information or receives it too late, he cannot take appropriate action against it. This paper uses two phases: the first phase, for goal coordination, was used genetic algorithms and the Cuckoo search algorithm was used to increase driver information from the surroundings. Using the Cuckoo search algorithm and considering the limitations, it increases the driver’s level of information from the environment. Also, by exchanging information through the application, it enables the information to reach the driver much more quickly and the driver reacts appropriately at the right time. The suggested protocol is called the MODM-based solution. Here, the technique is assessed through extensive simulations performed in the NS-3 environment. Based on the simulation outcomes, it is indicated that the parking system performance metrics are enhanced based on the detection rate, false-negative rate, and false-positive rate.

Cluster-based routing in Mobile Ad-Hoc Networks is considered one of the convenient methods of routing. The existence of Cluster Head (CH) in a group of nodes for data forwarding improves the performance of routing in terms of routing overhead and power consumption. In this paper, a clustering algorithm using hierarchical routing for mobile ad hoc networks is proposed. In the proposed method, first, clusters are formed by the FLOC clustering method with low overlapping. Then, according to the most important network criteria, including hop count, noise ratio, distance, remaining energy, and link expiration time, head clusters are selected based on the weighting algorithm. To transfer data in the proposed method, two types of communication are used, e.g., inter-cluster communication and intra-cluster communication in which the shortest path to the target cluster is selected. The proposed P-METHOD technique is based on hierarchy and clustering as well as using a weighted algorithm that reduces delay in data transmission on the network. Moreover, P-METHOD is evaluated here via extensive simulations carried out in NS-2. The simulation results indicate that the MANET network performance metrics are improved in terms of average throughput, Packet Delivery Ratio (PDR), delay, residual energy, and lifetime.

The aim of this paper is to contribute to the body of knowledge about Project-Based Learning (PBL) methodology in higher education by describing and analysing interrelations between competencies, and their contribution to knowledge transfer (KT) and students’ rating of the project. The sample consisted of 464 students from the Universities of Huelva (N=347; 74.8%) and Murcia (N= 117; 25.2%), enrolled in the second year of a degree in either Infant or Primary Education. Data was collected through a self-administered questionnaire comprising a total of 53 items measuring General, Specific and Transversal competencies, as well as students’ rating of the project. Competencies were selected from the course programmes for the degrees in Infant and Primary Education. Preliminary results showed that competencies were moderately to highly acquired after PBL, and that students reported notable KT as well as a positive assessment of the project. KT showed a high degree of association with students’ ratings and was established as a key factor in learning and learner satisfaction in higher education.

Nickel based superalloys finds extensive usage in manufacturing of intricate part shapes in gas turbine, aircraft, submarine, and chemical industries owing their excellent mechanical property and heat resistant abilities. However, machining of such difficult-to-machine alloys up to the desired accuracy and preciseness is a complex task owing to a rapid tool wear and failure. In view of this, present work proposes an experimental investigation and optimization of process parameters of the cryogenic assisted turning process during machining of Nimonic C-263 super alloy with a multilayer CVD insert. Taguchi’s L-27 orthogonal array is used plan the experiments. Effect of input parameters viz. cutting speed (N), cutting feed (f), depth of cut (d) are studied on responses viz. surface roughness (SR), nose wear (NW) and cutting forces (F) under hybrid cryogenic (direct+indirect) machining environment. A scanning electron microscope (SEM) analysis is carried out to explore the post-machining outcomes on the performance measures. The multiple responses are converted in to single response and ranked according to Taguchi based gray relational grade (TGRG). Feed rate (f) is found to be the most influential parameter from the analysis of variance of GRG. The means of GRG for each level of process parameters are used to improve the optimal process parameters further. Finally, the confirmative experiment is performed with these optimal set of process parameters which showed an improvement of 9.34% in the value of GRG. The proposed work can be beneficial to choose ideal process conditions to enhance the performance of turning operation.

Drug design is used for different applications of bioinformatics tools analyze DNA, genome, and sequence target region of a small organic molecule in order to understand the molecules of disease. Bioinformatics tools are identified a newly wide research field and minimize future risks through web servers and data mining. Clinical sample test performed with the bioinformatics tools as the biomedical detective. A particular structure and configuration of protein obliging in Drug design concluded Bioinformatics. This review bioinformatics tools and webserver will discuss functions of small organic molecules according to clinical pharmacology.

While the knowledge about the development of understanding positive integers is rapidly growing, the development of understanding zero is not well-known. Here we tested several components of preschoolers’ understanding zero: whether they can use empty sets in numerical tasks, whether they can use empty sets soon after they understand the cardinality principle, whether they know what the word “zero” refers to, and whether they categorize zero as a number. The results show that preschoolers can handle empty sets in numerical tasks as soon as they understand the cardinality principle or even earlier, and some of them know that these sets are labeled as “zero.” However, they are unsure whether zero is a number. These results identify three components of knowledge about zero: operational knowledge, linguistic knowledge, and meta knowledge. To account for these results we propose that preschoolers might understand numbers as the properties of items or objects in a set. In this view, zero cannot be a number, because an empty set does not include any items, and the missing items cannot have any property, excluding also the number property. This model might explain why zero is handled correctly in numerical tasks, while it is not regarded to be a number.

In this study, the thermal behavior of a PCM-based heat sink in the presence of horizontal fins was numerically investigated. These types of heat sink can be effective in electronic cooling applications. Independent variables included aspect ratio (AR), number of horizontal fins (n) and their length (LR), while the objective function was defined to maximize the safe operation time (tmax). The incorporation of horizontal fins has a positive effect (thermal conductivity enhancement) as well as a negative effect (latent heat reduction). Based on the results, the optimal number of horizontal fins was five. As the number of fins rises up to five, the incremental effect of thermal conductivity improvement (positive effect) was superior to the decremental effect of the latent heat reduction (negative effect), hence the objective function (tmax) improved. However, with a further increase in the number of fins upon five, the negative effect prevailed over the positive effect and therefore the safe operation time diminished.

Since the outbreak of the novel coronavirus disease (COVID-19) at the end of 2019, the clinical presentation of the disease showed a great heterogeneity with a diverse impact between different subpopulations. Emerging evidence from different parts of the world showed significantly poor outcome among males compared to female patients. A better understanding of the molecular mechanisms behind this difference might be a fundamental step for a more effective and targeted response to the outbreak. For that reason, here we try to investigate the molecular basis of the gender variations in mortality rates related to COVID-19 infection. To achieve this, we used our in-house pipeline to process publicly available lung transcriptomic data from 141 females compared to 286 males. After excluding Y specific genes, our results showed a shortlist of 73 genes that are differentially expressed between the two groups. Our results showed downregulation of a group of genes that are involved in the regulation of hydrolase activity including (AGTR1, CHM, DDX3X, FGFR3, SFRP2, and NLRP2), which is also believed to be essential for lung immune response and antimicrobial activity in the lung tissues in males compared to females. In contrast, our results showed an upregulation of angiotensin II receptor type 1 (AGTR1), a member of the renin-angiotensin system (RAS) that plays a role in angiotensin-converting enzyme 2 (ACE2) activity modulation. Interestingly, recent reports and experimental animal models highlight an important role of this receptor in SARS-Coronavirus lung damage as well as pulmonary edema, suggesting a possible role of its blockers like losartan and olmesartan as potential therapeutic options for COVID-19 infection. Finally, our results also showed a differential expression of different genes that are involved in the immune response including the NLRP2 and PTGDR2, further supporting the notion of the sex-based immunological differences. Taken together, our results provide an initial evidence of the molecular mechanisms that might be involved in the differential outcomes observed between both genders during the COVID-19 outbreak. This might be essential for the discovery of new targets and more precise therapeutic options to treat COVID-19 patients from different clinical and epidemiological characteristics with the aim of improving their outcome.

Background: Three drug-combinations, ipilimumab-nivolumab (Ipi-Nivo), pembrolizumab-axitinib (Pembro-Axi) and avelumab-axitinib (Ave-Axi), have received regulatory approvals in USA and Europe for the treatment of metastatic renal cell carcinoma with clear cell component (mRCC). However, no head-to-head comparison data are available to identify the best option. Therefore, we aimed to compare these new treatments in the first-line setting. Methods: We conducted a systematic search in Pubmed, the Cochrane library and clinicaltri-al.gov website from January 2015 to October 2019, for any randomized controlled trials of treatment-naïve patients with mRCC. The process was performed according to PRISMA guide-lines. We performed a Bayesian network meta-analysis with two different approaches. The out-comes for analysis were overall survival, progression-free survival, and objective response rate. Results: Our search identified 3 published phase 3 randomized clinical trials (2835 patients). In the contrast-based model, Ave-Axi (SUCRA: 83%) and Pembro-Axi (SUCRA: 80%) exhibited the best ranking probabilities for PFS. For OS, Pembro-Axi (SUCRA: 96%) was the most pref-erable option against Ave-Axi and Ipi-Nivo. Objective response rate analysis showed Ave-Axi as the best (SUCRA= 94%) and Pembro-Axi as second best option. In the parametric models, risk of progression was comparable for Ave-Axi and Ipi-Nivo, whereas Pembro-Axi exhibited a lower risk during the first 6 months of treatment and a higher risk afterward. Furthermore, Pembro-Axi exhibited a net advantage in terms of OS over the two other regimens, while Ave-Axi was the least preferable option. Conclusions: Overall evidences suggested pembrolizumab plus axitinib may be the best option.

In this manuscript, an automated framework dedicated to design space exploration and design optimization studies is presented. The framework integrates a set of numerical simulation, computer-aided design, numerical optimization, and data analytics tools using scripting capabilities. The tools used are open-source and freeware, and can be deployed on any platform. The main feature of the proposed methodology is the use of a cloud-based parametrical computer-aided design application, which allows the user to change any parametric variable defined in the solid model. We demonstrate the capabilities and flexibility of the framework using computational fluid dynamics applications; however, the same workflow can be used with any numerical simulation tool (e.g., a structural solver or a spread-sheet) that is able to interact via a command line interface or using scripting languages. We conduct design space exploration and design optimization studies using quantitative and qualitative metrics, and to reduce the high computing times and computational resources intrinsic to these kinds of studies, concurrent simulations and surrogate-based optimization are used.

A systematic review of the potential of implementing augmented reality (AR) in inquiry-based learning was conducted. We considered the purposes, potential advantages, application characteristics and the effects of using AR in inquiry-based learning. The findings reveal that AR, in the context of inquiry-based learning, is mostly implemented successfully to achieve cognitive and, less often, motivational and emotional learning goals. The AR solutions have mainly been applied in the Conceptualization and less in the Investigation phase. The affordances of AR in the Orientation, Conclusion and Discussion phase need to be applied in further studies.

The Ni-Co-Cr-W-Mo system is critical for the design of nickel-based super-alloys. This system stabilizes different topologically close packed (TCP) phases in many of the commercially super-alloys with high W and Mo contents. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), and thermodynamic calculations are applied to investigate the thermodynamics of the precipitates in two different W content Ni-Co-Cr-W-Mo super-alloys. Computational thermodynamics verified experimental observation of the f u phase formation as a function of temperature and alloy chemistry, but the kinetics for the precipitation of M6C phase do not agree with the experimental findings. The major precipitates of alloy 1 at temperatures 700 and 750 °C during long time exposure are M23C6, γ′ phase, and MC, and alloy 2 are M23C6, γ′ phase, MC, M6C and u phase. The W addition is found to promote the precipitation of M6C and u phase during exposure. The M6C has higher W and lower Ni content than that of u phase, meanwhile, M6C is an unstable phase would transform into M12C after 5000 h exposure at 750 °C. A great quantity of needle-like u phases precipitated after exposure at 750 °C for 5000h, which have no effect on the impact property of alloy 2.

Ecosystems are not merely vulnerable to climate change but, if sustainably restored and protected, are a major source of human resilience. Not only is the evidence-base for the importance of these “Nature-based Solutions” (NbS) growing rapidly, but NbS are featuring with increasing prominence in global climate change policy. Here we report on the prominence of NbS in the 141 adaptation components of the 167 Nationally Determined Contributions (NDCs) that were submitted to UNFCCC by all signatories of the Paris Agreement. In total, 103 nations include NbS in the adaptation component of their NDC, 76 nations include them in both their adaptation and mitigation component, and an additional 27 include them as part of their mitigation plans only. In other words, 130 nations—or 66% of all signatories to the Paris Agreement—have articulated intentions of working with ecosystems, in one form or another, to address the causes and consequences of climate change. However, commitments rarely translate into robust science-based targets. As climate pledges are revised in 2020, we urge the ecosystem science community to work closely with policymakers to identify meaningful adaptation targets that benefit both people and the ecosystems on which they depend.

Grain production and storage are major components in food security. In the ancient times, food security was achieved through gathering of fruits, grains, herbs, tubers, and roots from the forests by individual households. Advancements in human civilization led to domestication of crops and a need to save food for not only a household, but the nation. This extended need for food security led to establishment of national reservoirs for major produces and this practice varies greatly in different states. Each of the applied food production, handling and storage approaches has got its benefits and challenges. In sub-Saharan Africa, several countries have a public funded budget to subsidize production costs, to buy grains from farmers and to store the produce for a specific period and/or until the next harvests. During the times of famine, the stored grains are later given free to the citizens. If there is no famine, the grain is sold to retailers and/or processors (e.g., millers) who later sell it to the consumers. This approach works well if the produce (mainly grain) is stored under conditions that do not favor growth of molds, as some of these could contaminate the grain with toxic and carcinogenic metabolites called mycotoxins. Conditions that alleviate contamination of grains are required during production, handling and storage. Most of the grain is produced by smallholder farmers under sub-optimal conditions, which make vulnerable to colonization and contamination by toxigenic fungi. Further, the grain is stored in silos at large masses, where it is hard to monitor the conditions at different points of these facilities, and hence it becomes vulnerable to additional contamination. Production and storage of grain under conditions that favor mycotoxins poses major food health and safety risks to humans and livestock who consume the grain. This concept paper focuses on how establishment of local grain production and banking system (LGPBS) could enhance food security and safety in East Africa. The concept of LGPBS provides an extension of advisory and finance support within warehouse receipting system to enhance grain production under optimal conditions. The major practices at the LGPBS, and how each could contribute to food security and safety are discussed. While the concept paper gives more strength on maize production and safety, similar practices could be applied to enhance safety of other grains in the same LGPBS.

Performance appraisal is a fundamental indicator in public accountability to achieve the good governance principles. Hence, this study aims to analyze the performance measurement that can improve performance on government agencies in South Sulawesi, Indonesia. The study was conducted in qualitative approach. The research found that non-integrated models of performance measurement in South Sulawesi are inefficient and ineffective. Inefficiency happens because it uses time and cost resources separately, while being ineffective is because both models focuses on each goal instead on performance goals and the process is not supported by the actual management.

Location-Based Services (LBS) have been widely deployed for the connected vehicle (CV) applications such as vehicle navigation,vehicle tracking and location-based augmented reality. The current LBS deployments have limitations in supporting time-critical CV use cases, including vehicle to vehicle (V2V), vehicle to infrastructure (V2I) and vehicle-to-people (V2P) safety applications. The paper presents the new LBS framework based on the publish-subscribe communication paradigm, to enable device-to-device (D2D) connections through use of selected application protocols in the application layer of the TCP/IP layered protocol model. Two publish-subscribe application protocols, Distributed Data Service (DDS) real-time publish and subscribe (DDS-RTPS) and Message Queue Telemetry Transport (MQTT), are introduced to support the LBS D2D applications. A number of test scenarios with Mosquitto MQTT and OpenDDS under 4G-mobile broadband (MBB) services are designed to assess the transmit/receive round-trip time (RTT) and packet-loss rate (PLR) with settings of a publisher to multiple subscribers, to simulate the connections to multiple vehicles. The transmission frequency is set for 10 Hz and the message sizes vary from 100 to 2000 Bytes. The PLRs are defined as the percentages of the delayed messages beyond a delay limit. Static test results with OpenDDS show that for the RTT delay beyond the limit of 100 ms, the total PLRs range between 5.25% and 8.76% for the message size of 50 to 2000 Bytes. Vehicle testing results with Mosquitto show that PLRs for the RTT delays between 200 ms and 1000 ms are 0.63%, 3.58% and 5.77%, for connections with 1, 4 and 10 vehicles, respectively. The results demonstrate the potential of the D2D LBS framework for medium-demanding CV safety applications such as V2P and V2I use cases, taking advantages of the 4G-MBB services and 5G extreme mobile broadband (eMBB) services and mobile devices generally available with all road users.

One control challenge in prosthetic legs is seamless transition from one gait mode to another. User intent recognition (UIR) is a high-level controller that tells a low-level controller to switch to the identified activity mode, depending on the user’s intent and environment. We propose a new framework to design an optimal UIR system with simultaneous maximum performance and parsimony for gait mode recognition. We use multi-objective optimization (MOO) to find an optimal feature subset that creates a trade-off between these two conflicting objectives. The main contribution of this paper is two-fold: (1) a new gradient-based multi-objective feature selection (GMOFS) method for optimal UIR design; and (2) the application of advanced evolutionary MOO methods for UIR. GMOFS is an embedded method that simultaneously performs feature selection and classification by incorporating an elastic net in multilayer perceptron neural network training. Experimental data are collected from six subjects, including three able-bodied subjects and three transfemoral amputees. We implement GMOFS and four variants of multi-objective biogeography-based optimization (MOBBO) for optimal feature subset selection, and we compare their performances using normalized hypervolume and relative coverage. GMOFS demonstrates competitive performance compared to the four MOBBO methods. We achieve a mean classification accuracy of 97.14% ± 1.51% and 98.45% ± 1.22% with the optimal selected subset for able-bodied and amputee subjects, respectively, while using only 23% of the available features. Results thus indicate the potential of advanced optimization methods to simultaneously achieve accurate, reliable, and compact UIR for locomotion mode detection of lower-limb amputees with prostheses.

Since smart cities aim at becoming self-monitoring and self-response systems, their deployment relies on close resource monitoring through large-scale urban sensing. The subsequent gathering of massive amounts of data makes essential the development of event filtering mechanisms that enable the selection of what is relevant and trustworthy. Due to the rise of mobile event producers, location information has become a valuable filtering criterion as it not only offers extra information on the event described but also enhances trust on the producer. Implementing mechanisms that validate the quality of location information becomes then imperative. The lack of such strategies in cloud architectures compels the adoption of new communication schemes for IoT-based urban services. To serve the demand for location verification in urban event-based systems (DEBS), we have designed three different fog architectures that combine proximity and cloud communication. Moreover, we have successfully assessed their performance using network simulations with realistic urban traces.

The impact of instructional guidance on learning outcomes in higher biomedical education is subject of intense debate. There is the teacher-centered or traditional way of teaching (TT) and, on the other side, the notion that students learn best under minimal guidance (problem-based learning, PBL). Although the benefits of PBL are well-known, there are aspects susceptible to improvement. Hence, a format merging TT and PBL (hybrid-PBL, h-PBL) may advance education in biomedical sciences. Here, we systematically reviewed studies that employed h-PBL in higher biomedical education compared to TT and/or pure PBL. We found that h-PBL resulted in better overall students’ performance and perception than TT or pure PBL. These findings encourage more research on investigating the pedagogical benefits of h-PBL and posit an eclectic system in which the pedagogical tools from TT and PBL are used cooperatively in the best interest of the education and satisfaction of the students.

Hydrogen peroxide is an important chemical of increasing demand in today’s world. Currently, the anthraquinone autoxidation process dominates the industrial production of hydrogen peroxide. Herein, hydrogen and oxygen are reacted indirectly in the presence of quinones to yield hydrogen peroxide. Owing to the complexity and multi-step nature of the process, it is advantageous to replace the process with an easier and straightforward one. The direct synthesis of hydrogen peroxide from its constituent reagents is an effective and clean route to achieve this goal. Factors such as water formation due to thermodynamics, explosion risk, and the stability of the hydrogen peroxide produced hinder the applicability of this process at an industrial level. Currently, the catalysis for the direct synthesis reaction is palladium based and the research into finding an effective and active catalyst has been ongoing for more than a century now. Palladium in its pure form, or alloyed with certain metals are some of the new generation of catalysts that are extensively researched. Additionally, to prevent the decomposition of hydrogen peroxide to water, the process is stabilised by adding certain promoters such as mineral acids and halides. A major part of today’s research in this field focusses on the reactor and the mode of operation required for synthesising hydrogen peroxide. The emergence of microreactor technology has helped in setting up this synthesis in a continuous mode, which could possibly replace the anthraquinone process in the near future. This review will focus on the recent findings of the scientific community in terms of reaction engineering, catalyst and reactor design in the direct synthesis of hydrogen peroxide.

In this paper we present the numerical and experimental results of a design optimization of electromagnetic cantilevers. In particular, a cost-effective technique of evolutionary computing enabling the simultaneous minimization of multiple criteria is applied. A set of optimal solutions are subsequently fabricated and measured. The designed structures are fabricated in arrays, which makes the comparison and measurements of the sensor properties reliable. The microfabrication process, based on the silicon on insulator (SOI) technology, is proposed in order to minimize parasitic phenomena and enable efficient electromagnetic actuation. Measurements on the fabricated prototypes assessed the proposed methodological approach.

In this paper, the Fourier-based synchrosqueezing transform (FSST) method is introduced into the power system to realize low frequency oscillation identification. Firstly, the modal components of low frequency oscillation signal are separated by FSST, and calculating the instantaneous parameters including magnitude, frequency and phase of every mode component with Hilbert transform. Then , calculating the damping ration of every modal component based on above parameters and derived the formulas. Thus, it realized effective identification of of modal parameters of low frequency oscillation signal. The experimental results of simulated data and 16-generator system demonstrate the validity and correctness of the FSST method. Comparing with the classical Prony method shows that the FSST method is better in the identification accuracy when the low frequency oscillation signal is polluted by noise. Finally, the effectiveness of the FSST in Actual power grid is verified based on the real data from Sichuan power grid.

Developments in technology have enabled envisioning the derivation of materials and products from renewable biomass, as an alternative to finite fossil-based resource consumption. Therefore, bioeconomy is regarded as an opportunity for sustainable economic growth. Countries are formulating strategies in accordance with their goals to attain from bioeconomy. Proper measurement, monitoring and reporting of the outcomes of these strategies is crucial for long-term success. This study aims to critically evaluate the national methods used for the measurement, monitoring and reporting of bioeconomy contribution to the total economy. For this purpose, research and surveys have been conducted on selected countries (Argentina, Germany, Malaysia, the Netherlands, South Africa and the United States). The results reveal that the bioeconomy targets set up in the strategies often reflect country’s priorities and comparative advantages. However, comprehensive approaches to measure and monitor bioeconomy progress are frequently lacking. Most countries only measure the contribution to gross domestic product (GDP), turnover and employment of the sectors included in their bioeconomy definition, which may provide an incomplete picture. In addition, this study identifies the mismatch between the targets and measurement methods, as the environmental and social impacts of bioeconomy are often foreseen, but not measured. It is concluded that existing global efforts towards a sustainable bioeconomy monitoring can be strengthened and leveraged to measure progress towards sustainable goals.

Wetlands are among the most bio-diverse and highest productivity ecosystems on earth, making their monitoring a high priority to conservation, protection and management interests. Although visual interpretation of satellite images is generally precise for monitoring wetlands, recent works have emphasized computerized classification methods because of the reduction in analyst time. However, it is difficult to automatically identify wetland solely based on spectral characteristics due to the complexity of wetland ecosystems. The ability to extract wetland information rapidly and accurately is the basis and the key to wetland mapping at a large scale. Here we propose an operational method to map China wetlands based on Landsat TM data and ancillary data. On the basis of theoretical analysis of wetland automatic classification, we developed a revised multi-layer wetland classification scheme and a rule-based classification model. In the latter, supervised classification (SVM and decision tree) and unsupervised classification (ISODATA) methods were tested. Four Landsat TM images, representing various wetland eco-regions in China (i.e. the Sanjiang Plain in the northeast China, the North China Plain, the Zoige Plateau in the southwest China and the Pearl River Estuary in southeast China), were automatically classified. The overall classification accuracies were 86.57%, 96.00%, 84.51% and 88.30%, respectively, which we considered to be satisfactory accuracy. Our results indicate that issues such as the resolution of geographic data and the understanding of wetland samples should be carefully addressed in the future.

The present investigation has been conducted on one hundred tissue fragments of breast cancer, collected and immediately cryopreserved following the surgical resection. The fragments were selected from patients with invasive ductal carcinoma of the breast, the most common and potentially aggressive type of mammary cancer, with the objective to increase the knowledge of breast cancer molecular markers, useful for diagnostic and prognostic categorization of patients, in assessing post-surgical therapeutic regimes. The proteomic screening, by 2D-IPG and mass spectrometry, allowed us to identify two main classes of protein clusters: proteins expressed ubiquitously at high levels in all patients, and proteins expressed sporadically among the same patients. Within the group of ubiquitous proteins, glycolytic enzymes and proteins with anti-apoptotic activity were predominant. Among the sporadic ones, proteins involved in cell motility, molecular chaperones and proteins involved in the detoxification appeared prevalent. The data of the present study indicates that the primary tumor growth is generally supported by two concurrent pathways: the inhibition of apoptosis and the stimulation of cellular proliferation. The second phase of the evolution of the tumor can be prematurely scheduled by the occasional presence of proteins involved in cell motility and in the defenses of the oxidative stress. To our knowledge this report on large-scales proteomics of breast cancer is currently a unique approach in the literature that offers the opportunity to evaluate the presence and recurrence of proteins to be used as prognostic indicators and susceptibility to metastasis in patients operated on for invasive ductal carcinoma of the breast.

The systematic sampling is used as a method to get the quantitative results from the tissues and the radiological images. Systematic sampling on real line (R) is a very attractive method within which the biomedical imaging is consulted by the practitioners. For the systematic sampling on R, the measurement function (MF) is occurred by slicing the three-dimensional object equidistant systematically. The currently used covariogram model in variance approximation proposed by [28,29] is tested for the different measurement functions in a class to see the performance on the variance estimation of systematically sampled R. This study is an extension of [17], and an exact calculation method is proposed to calculate the constant λ(q,N) of confidence interval in the systematic sampling. The exact value of constant λ(q,N) is examined for the different measurement functions as well. As a result, it is observed from the simulation that the proposed MF should be used to check the performances of the variance approximation and the constant λ(q,N). Synthetic data can support the results of real data.

The Work Ability Index (WAI) is the most widely used questionnaire for the self-assessment of working ability. Because of its different applications, shorter versions, and widespread use in healthcare activities, it is worthwhile assessing its characteristics. The WAI was distributed online among the workers of a healthcare company; the results were compared with data contained in the workers' personal health records and with absence registers. 340 out of 575 workers (59.1%) participated; 6.5% of them reported poor work ability. Exploratory factor analysis indicated that the one-factor version best described the characteristics of the WAI. The scores of the complete WAI, the shorter form without the list of diseases, and the minimal one-item version (WAS) had equal distribution and were significantly correlated. The WAI score was inversely related to age and significantly lower in women than in men, but it was higher in night workers than in colleagues due to the probable effect of selective factors. The WAI score was also correlated with absenteeism, but no differences were found between males and females in the average number of absences, suggesting that cultural or emotional factors influence the self-rating of the WAI. Workers tended to overreport illnesses in the online survey compared to data collected during occupational health checks. Musculoskeletal disorders were the most frequently reported illnesses (53%). Psychiatric illnesses affected 21% of workers and had the greatest impact on work ability. Multilevel ergonomic and human factor intervention seems to be needed to recover the working capacity of healthcare workers.

The study of coordination practices in health policy and, especially in emergency situations is a central aspect. The COVID-19 pandemic has highlighted the need for further research on such practices, especially those that are deployed in complex and unforeseen situations to respond quickly while minimising errors. These dialogic coordination practices (DP) have been identified through case studies but have not been validated. The purpose of this study is to develop and validate a DP questionnaire for healthcare teams. The development of the items was based on a literature review and the content validation was carried out by means of a Delphi study. A total of 10 experts assessed the clarity and appropriateness of the items and their corresponding measurement scales. Consensus was reached after the second round, with a percentage of agreement greater than or equal to 90% for all items. The validation of these items constitutes a methodological innovation that responds to the call in the literature to open up new avenues for comparative studies, the possibility of generalising the findings obtained and the possibility of bringing together different approaches to the problem of coordination, key in health policy.

Wearable devices have become ubiquitous, collecting rich temporal data that offers valuable insights into human activities, health monitoring, and behavior analysis. Leveraging this data, researchers have developed innovative approaches to classify and predict time-based patterns and events in human life. Time-based techniques allow the capture of intricate temporal dependencies, which is the nature of the data coming from wearable devices. This paper focuses on predicting well-being factors, such as stress, anxiety, positive and negative affect, on the Tesserae dataset collected from office workers. We examine the performance of different methodologies, including deep learning architectures, LSTM, ensemble techniques, Random Forest (RF) and XGBoost and compare their performances for time-based and non-time-based versions. In time-based versions, we investigate the effect of previous records of well-being factors on the upcoming ones. The overall results show that time-based LSTM performs the best among conventional (non-time-based) RF, XGBoost, and LSTM. The performance even increases when we consider a more extended previous period, in this case, 3 past-days rather than 1 past-day to predict the next day. Furthermore, we explore the corresponding biomarkers for each well-being factor using feature ranking. The obtained rankings are compatible with the psychological literature. In this work, we validated them based on device measurements rather than subjective survey responses.

Cyber diplomacy is critical in dealing with evolving cybersecurity dangers and possibilities in the digital era. This article investigates the impact of Artificial Intelligence (AI), the Internet of Things (IoT), Blockchains, and Quantum Computing on cyber diplomacy. AI holds the potential for proactive threat identification and response, while IoT enables international information sharing. Blockchains enable secure data sharing and document verification, but they also pose new threats, such as AI-driven cyber-attacks, IoT privacy breaches, blockchain vulnerabilities, and the potential for quantum computing to break encryption. This article conducts case study reviews, in combination with secondary data analysis, and emphasises the value of international cooperation in developing global norms and frameworks to control responsible technology adoption. Cyber diplomacy can promote cybersecurity, protect national interests, and foster mutual trust among nations in the digital sphere by capitalising on possibilities and reducing threats.

Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in 5 Spanish NHs. UI (measured with Minimum Data Set 3.0.), sociodemographic and health-related variables were collected. Chi- square (or Fisher’s) or Student’s t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6–77.2) and was significantly associated with frailty (PR 1.84; 95%CI 0.96–3.53), faecal incontinence (FI) (PR 1.65; 95%CI 1.02–2.65), anxiety (PR 1.64; 95%CI 1.01–2.66), physical performance (PR 1.77; 95%CI 1.00–3.11) and cognitive state (PR 1.95; 95%CI 1.05–3.60). Statistically significant differences between incontinent-continent groups were found for activities of daily living (ADL) limitations, mobility, quality of life, sedentary behaviour (SB) and handgrip strength. It can be concluded that 2/3 of the residents experienced UI, and its significant associated factors were mainly physical (SB, frailty, physical performance, ADL limitations, mobility, FI and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety and quality of life).

Avocado (Persea americana Mill.) plant fruits are well-known for their high nutritional value, unique test, and healthy oil. It has a history of about 10,000 years. Avocado fruit offers many health benefits, and its production is rapidly increasing. The Food and Agriculture Organization (FAO)’s recent data suggest that the Avocados produced in the world in 2019 was twice that of 2010 (3778010 tons). Avocado’s global Gross Production Value was about 5.812 billion USD in 2018, and it is likely to increase rapidly because of the increasing demand for Avocado fruits. Avocado oil is also used in the cosmetic industry because of its therapeutic properties, and it boosts the economic value of the Avocado industry. Avocado fruits have a rough green-gold skin; however, fruits are called ‘the green gold’ because of their massive global demand in the worldwide market and a lucrative business. The cultivation of Avocado has tremendous potential in increasing the rural economy, rural agriculture-based employment and reducing the poverty rate of growers. On the other hand, the Avocado industry is highly criticised because of deforestation, massive water utilisation, polluting water bodies with insecticides and fertilisers, posing a threat to other plant species, and environmental pollution. However, it doesn’t preclude the importance of Avocado. Cameroon’s average temperature is about 23 °C, which is considered optimal for Avocado propagation and commercial cultivation. Cameroon Association of Active Youths (CAMAAY) want to explore the possibilities of engaging Cameroon youths in Avocado cultivation. This review is aimed to provide an overview of Avocado. The review also highlights Avocado cultivation related issues from one health and sustainability perspective in line with the global goals.

Orthodontic appliances may cause discomfort for patients. It could influence person‘s psychological well–being. The aim was to examine psychological health of patients wearing orthodontic appliances. It is important to analyze well-being of patients during orthodontic treatment because it is started in a young age and it may affect one’s psychological health. Therefore, for doctors and patients it is important to understand and take every aspect of the treatment into consideration when deciding when to start the treatment and what appliance to choose. 339 patients answered anonymous questionnaire. They were divided into four groups according to their age and type of appliance. Main reasons to seek treatment were crooked teeth and bad bite. Statistically signifi-cant difference was between women and men as women seeked treatment because of crooked teeth, meanwhile men indicated bad bite as main reason. 48.7% of subjects noted that they were feeling good during treatment, however, 4% of all patients noted that they were feeling bad. 45% of subjects stated that they felt unhappy at least sometimes. 43% of subjects felt stress. Even though patients indicated various negative aspects on their well-being during treatment, for the majority of the subjects end results significantly increased their psychological well-being.

The incidence of infections due to carbapenemase-producing Enterobacteriaceae (CPE) is rising worldwide. We present the case of a 48-year-old female patient, diabetic, with previous episodes of urinary tract infections that was admitted due to pyelonephritis, later identified to be caused by KPC and ESBL-producing Klebsiella pneumoniae. Both the patient and her family had no strong epidemiological link with the healthcare system, and for this reason, this case stands out in regional literature since similar reports are scarce and therefore constitutes a reason for alert in health institutions. Further studies are needed in order to ascertain the real incidence of these infections in community settings in Latin America and the Caribbean.

Cardiovascular diseases (CVDs) and associated risk factors are a growing concern in Cameroon. Physiotherapists (PTs) can play a crucial role in prevention and management. However, the extent of Cameroonian PT involvement in health promotion (HP) activities remains unclear. This study assessed Cameroonian physiotherapists’ current HP practices for people at risk of developing or living with CVDs (pwCVDs). A cross-sectional survey was administered online to PTs practising in Cameroon. Out of 181 PT responses, 95% reported providing a variety of HP activities, including weight management (74%), dietary advice (73%), physical activity (69%), smoking cessation (69%), stress management (61%), and sleep promotion (48%). While PTs were confident in lifestyle assessments, they felt less confident about sleep interventions. Strong beliefs, confidence, team support, and time allocation enhanced HP practice. However, preference for passive modalities, patient adherence issues, organisational challenges within healthcare services, role ambiguity among healthcare providers, inadequate training opportunities, and the absence of established guidelines for CVD prevention negatively affect HP practice. These findings highlight the challenges and opportunities for enhancing HP delivery within the physiotherapy profession in Cameroon. Strategic investments and concerted efforts are necessary to address barriers and leverage facilitators effectively for scaling up HP initiatives, given the significant burden of CVDs in the country.

The following article analyses the relationship between the mental health index and the variables of the Environment, Social and Governance-ESG model in the Italian regions between 2004 and 2023. First of all, a static analysis is proposed aimed at identifying trends relating to mental health in the Italian regions with indication of the regional gaps. Subsequently, a clustering with k-Means algorithm is proposed. Below is a comparison of 11 machine learning algorithms for predicting the performance of the mental health index. Finally, the article offers some economic policy suggestions. The results are critically discussed in light of the scientific literature.

The following article analyses the relationship between the mental health index and the variables of the Environment, Social and Governance-ESG model in the Italian regions between 2004 and 2023. The econometric analysis is aimed at investigating in detail the relationships between the mental health index and the individual components of the ESG model. The results are critically discussed

The application of antimicrobials in aquaculture primarily aims to prevent and treat bacterial infections in fish. Inappropriate use of antimicrobials in fish farming may result in the emergence of zoonotic antibiotic-resistant bacteria and subsequent transmission of resistant strains to humans via food consumption. From recently, AMR emerged as a significant public health concern in the aquaculture ecosystem and fisheries. The aquatic environment serves as a potential reservoir for resistant bacteria, with aquaculture practices providing an ideal breeding ground for AMR due to the excessive use of antimicrobials to prevent and treat diseases. The mutual inter-connection of intensive fish farming systems with terrestrial environments, food processing industry and human population creates pathways for the transmission of resistant bacteria, exacerbating the problem further. One Health concept, which recognizes the interconnectedness of human, animal and environmental health, enables a holistic approach to address the challenges posed by AMR. By understanding the evolution of such approach, the future of aquaculture, being the important source of a global animal protein supply, can be safeguarded. Risk mitigation strategies for AMR should be based on One Health concept to contribute to sustainable aquaculture practices that protect human and animal health, ensure food safety and protection of environment.

Mobile applications, websites and social media networks are nowadays widely used communication tools. With the emergence of communication-related technologies in our lives and, consequently, the rise of social networks and mobile applications, health-related applications, generically encompassed under the term digital health, have become popular among the population. Smartphones and artificial intelligence have become very useful tools for health-related interventions. Because they are very accessible and cost-effective. They are also able to serve a larger number of communities than traditional interventions. Nutrition is not a field that has remained on the sidelines, and numerous mobile applications and technological tools have emerged that are intended to help and support diets or in the process of recovering from disease. However, many of these applications have limitations that are important to consider. For this reason, the aim of this review was to analyze the most widely used tools currently in use, discuss their advantages and disadvantages, and propose hypotheses for improvement.

Background: This longitudinal study aimed to investigate the relationship between self-reported chewing status and increases in waist circumference (WC) after 1 year in 10,870 Japanese adults who had received health checkups. Subsequently, 8,068 participants were included in the final analysis at follow-up. Methods: Chewing status was evaluated using a self-reported questionnaire at baseline; 1,080 (13%) respondents were diagnosed as having poor chewing status. We defined an increase in WC of ≥ 5 cm after 1 year as an unhealthy increase; in total, 613 (7.5%) respondents met this criterion. Results: After adjusting for age, gender, WC, body mass index (BMI), and chewing status, an increase in WC ≥ 5 cm was found to be positively associated with gender (females: odds ratios [ORs]: 1.206; 95% confidence intervals [CIs]: 1.008–1.443), WC (ORs: 0.967; 95% CIs: 0.954–0.981), BMI (≥ 25 kg/m2; ORs: 2.194; 95% CIs: 1.715–2.808), and chewing status (poor; ORs: 1.356; 95% CIs: 1.084–1.697). Conclusions: These findings suggest that self-reported poor chewing status is associated with increases in WC after 1 year in Japanese adults.

Background: Snus consumption is increasingly popular, mainly among the youth, due to the promotion of the tobacco industry and the lack of knowledge regarding its adverse effects. Even though some of its systemic complications are common knowledge, the oral consequences are rarely known. Aim: Therefore, the objective of this study is to evaluate the oral health effects of snus consumption among a highly exposed group of adolescent athletes. Design: Participants received an interactive presentation, followed by interviews and dental screenings by young doctors to establish trust. They were categorized into groups based on the frequency of snus usage. The oral hygiene habits and status, snus consumption habits and awareness about its adverse effects were evaluated. Results: Statistically significantly (p

Health care operations in many hospitals are experiencing increasing demand which is however hindered by the limited resources available. The imbalance between the demand and service provision capacity within the hospitals have resulted in long waiting times for service delivery due to overcrowding, high costs of treatment as well as low levels of patient’s satisfaction. The above problems are attributed to the development of hospital management information system. This dissertation is focused on investigating some of the causes of the increased cost and time consumption as well as low levels of patient’s satisfaction in the application of hospital management information system. The study used comparative design to make a comparison of the respondents from two different hospital facilities where 400 health workers were drawn for research. The questionnaire was used as a survey tool for the study that involved both qualitative and quantitative analysis. The results of the study indicate various playing factors that arise due to the development of the hospital management information system. These factors include the large functionality of the system, the need for training of the end users, the increasing ageing population, and delays. The identified factors play a significant role in the way the information system impacts the time taken, the cost involved, and patient satisfaction. Keywords: health, hospital, doctors, technology, information system, time, and cost.

Adenomyosis, a benign gynecological condition characterized by the infiltration of endometrial tissue into the myometrium, poses significant challenges to women's reproductive health. Recently, the landscape of adenomyosis diagnosis transformed significantly, thanks to advancements in imaging technologies such as transvaginal ultrasound and magnetic resonance imaging. This lead to a noticeable shift in the demographic profile of patients diagnosed with adenomyosis, including younger women of reproductive age who frequently present with a diverse array of symptoms. Approximately 20% of women are affected by adenomyosis. Adenomyosis manifests with various subtypes, distinct epidemiological profiles, symptomatology, and treatment responses, necessitating tailored approaches for optimal management. Despite its clinical significance, adenomyosis remains understudied, resulting in a significant disparity in research and literature compared to other gynecological conditions. The severity of adenomyosis is compounded when coexisting with endometriosis, particularly deep infiltrating endometriosis (DIE), leading to exacerbated fertility issues and severe symptomatology. The wide range of symptoms, including adverse pregnancy outcomes such as pre-eclampsia, highlights its wider impact and emphasizes the need for increased awareness of the condition. Furthermore, Adenomyosis is frequently associated with treatment failure in endometriosis, contributing to dienogest resistance, elevated discontinuation rates, and persistent pain post endometriosis surgery. Additionally, the lack of specific treatments tailored to adenomyosis poses a considerable challenge in clinical management.

Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has indicated that hydrotherapy can alleviate pain, but comparative studies between therapeutic showers and bathtubs are scarce. Objective: This study aims to compare the effects of therapeutic showers and bathtubs on pain perception, labor duration, use of epi-dural analgesia, and maternal and neonatal outcomes during labor. Methods: A total of 124 pregnant women were included in this study. Participants were divided into two groups: those who used a thera-peutic shower and those who used a bathtub during labor. Pain levels were measured using a visual analog scale (VAS). Labor duration, use of epidural analgesia, types of delivery, maternal outcomes (postpartum hemorrhage, perineal status, maternal hypotension, fever, and breastfeeding), and neonatal outcomes (APGAR scores, fetal heart rate, complications, and neonatal unit admissions) were recorded and analyzed. Results: Both the therapeutic shower and the bathtub effectively reduced pain perception, with the bathtub showing a greater reduction in VAS scores. The therapeutic shower group experienced a signifi-cantly shorter labor duration compared to the bathtub group. The majority of participants in both groups did not require epidural analgesia, with no significant differences between the groups. There were no sig-nificant differences in the types of delivery. Maternal outcomes indicated a lower incidence of perineal tears and episiotomies in the therapeutic shower group. Neonatal outcomes, including APGAR scores and fetal heart rate, were similar between the groups, with no significant differences in complications or neo-natal unit admissions. Conclusions: Both therapeutic showers and bathtubs are effective for pain relief during labor, with the bathtub showing a higher reduction in pain intensity. The therapeutic shower is as-sociated with a shorter labor duration and a lower incidence of perineal tears and episiotomies. Both meth-ods are safe for neonatal well-being, making hydrotherapy a viable non-pharmacological option for pain management in labor. However, the therapeutic shower may offer additional benefits in terms of labor du-ration and maternal outcomes.

Abstract: Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguis-tically and culturally for the Italian context. Methods: Following Beaton et al.’s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates good internal consistency and stability, making it suita-ble for assessing nursing students during clinical internships and practicing nurses. Availability of Italian tools promotes research in healthcare, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

This case report utilized the primary data gathered from the extension program of the LORMA College of Medical Laboratory Science at the institution’s adopted locale. Arosip is a secluded, difficult-to-reach mountainous barangay in the municipality of Bacnotan, in the province of La Union, Philippines. The study subjects were forty-one (41) kindergarten to grade three students of Arosip Elementary School. Modified Kato-Katz technique was performed to the submitted stool samples. Among 41 participants, nine were screened positive for the helminthic ova of Ascaris lumbricoides, and Trichuris trichiura – yielding a total of 21.95% prevalence rate. Among those 9 participants, 6 (66.67%) were positive for Ascaris lumbricoides ova, and 3 (33.33%) were co-infected with both Ascaris lumbricoides and Trichuris trichiura ova. The findings were relayed and reported to the local government unit. The team recommends for a more comprehensive screening and monitoring of STH cases in the locale, a continuous stewardship of health programs including mass-deworming for the school children and awareness campaigns, and provision of health resources. Ultimately, interagency collaboration between the Department of Health, Department Education, and Local Government Unit remains highly warranted to satisfy the health inequities experienced by this disadvantaged remote community.

Background: Individuals living in rural areas often face challenges in accessing healthcare, increasing their risk of poor health outcomes. Farmers, a sub-population in rural areas, are particularly vulnerable to mental health issues and suicide, yet exhibit low rates of help-seeking behavior. The aim of our study was to develop an in-depth understanding of the issues influencing mental help-seeking among farmers living in rural areas from the perspectives of healthcare providers, as well as to explore the strategies providers use to navigate through these issues to effectively engage with this vulnerable population. Methods: We used a descriptive phenomenological approach to understand healthcare providers’ perspectives, experiences, and approaches to providing mental healthcare to farmer clients in rural areas. Semi-structured interviews were conducted with 21 participants between March and May 2023. Results: Our analysis yielded five thematic areas: (1) ensuring accessibility, (2) establishing relatability, (3) addressing stoicism and stigma, (4) navigating dual roles, and (5) understanding community trauma. Conclusions: Healthcare service delivery for farmers is multifaceted. This study fills a gap in knowledge by translating these the data to inform an evidence-based model and a list of recommendations for implementing agriculturally-informed practices in rural areas.

The human voice has the potential to serve as a valuable biomarker for the early detection, diagnosis, and monitoring of pediatric conditions. This scoping review synthesizes the current knowledge on the application of Artificial Intelligence (AI) in analyzing pediatric voice as a biomarker for health. The included studies featured voice recordings from pediatric populations aged 0-17 years, utilized feature extraction methods, and analyzed pathological biomarkers using AI models. Data from 62 studies were extracted, encompassing study and participant characteristics, recording sources, feature extraction methods, and AI models. The review showed a global representation of pediatric voice studies, with a focus on developmental, respiratory, speech, and language conditions. The most frequently studied conditions were Autism Spectrum Disorder, intellectual disabilities, asphyxia, and asthma. Mel-Frequency Cepstral Coefficients were the most utilized feature extraction method, while Support Vector Machines were the predominant AI model. The analysis of pediatric voice using AI demonstrates promise as a non-invasive, cost-effective biomarker for a broad spectrum of pediatric conditions. However, further research and development are crucial to enhance the accuracy and applicability of these tools in clinical settings.

People experiencing homelessness are at risk from a number of co-morbidities including traumatic brain injury, mental health disorders and various infections. Little is known about the rehabilitation needs of this population. This study took advantage of unique access to a specialist ‘Access’ GP practice for people experiencing homelessness and a local inclusion health initiative to explore the five year period prevalence of these conditions in a population of people experiencing homelessness, through electronic case record searches; and identify barriers and facilitators to healthcare provision for this population in the context of an interdisciplinary and multi specialist inclusion health team, through semi structured interviews with 12 staff working in primary and secondary care who interact with this population. The five year period prevalence of TBI, infections and mental health disorders was 9.5%, 4% and 22.8% respectively. Of those who had suffered a brain injury only 3, had accessed rehabilitation services. Themes from thematic analysis of interviews included: lack of resource, stigmatisation, under recognised multi-morbidity (including from brain injury) as barriers, trauma-informed, person-centred, adaptable, &amp; integrated and collaborative models of care as facilitators. The combination of quantitative and qualitative data suggests a potential role for rehabilitation medicine in inclusion health initiatives.

Rationale - From the year 1 anno Domini until 1855 with the third Plague, major pandemics occurred on average every 348 years. Since then, they have occurred on average every 33 years, with Coronavirus disease 2019 (COVID-19) now underway.Even though current technologies have greatly improved the way of life of human beings, COVID-19, with more than 700 000 000 cases and 6 950 000 deaths worldwide by the end of 2023, reminds us that much remains to be done. Objective - Given the frequency and duration of recent pandemics, it might be wise to start thinking about preventative methods to minimize the impact of future pandemics. This report looks back at 18 months of COVID-19, from March 2020 to August 2021, with the aim of highlighting potential solutions that could prove practical, or even essential, for the future. Material - COVID-19 data, including case and death reports, were extracted daily from the Worldometer platform to build a database for macroscopic analysis of the spread of the virus around the world. Demographic data were integrated into the COVID-19 database for a better understanding of the spatial spread of the SARS-CoV-2 virus in cities/municipalities. Method - Without loss of generality, we only analyzed data from the top 30 (out of 200 and above) countries ranked by total number of COVID-19 cases. Statistics (regression, t-test (p < 0.05), correlation, mean ± std, etc.) were carried out with Excel software. Spectral analysis, using Matlab software, was also used to try to better understand the temporal spread of COVID-19. Results - A good linear correlation was observed between the number of cases and the respective number of deaths depending on the country, i.e. y = 0.0121x + 19559 with R² = 0.8042. The analysis then focused mainly on the number of cases.This study showed that COVID-19 mainly affects G20 countries. The most interesting result is that cities/municipalities with high population density are a powerful activator of the spread of the virus. The current demographic context seems to be becoming a societal problem that must be addressed adequately.Spectral analysis highlighted that the very first months of spread of COVID-19 were the most notable with a strong expansion of the SARS-CoV-2 virus. On the other hand, the following six months showed a certain stability due mainly to multiple preventive measures such as confinement, closure of non-essential services, wearing of masks, distancing of 2 meters, etc. Discussion - Analysis of case and death data showed that COVID-19 mainly affects G20 countries. Nevertheless, the most interesting result of this study is that cities and municipal areas with population densities of several thousand inhabitants per square kilometer largely favored the spread of the SARS-CoV-2 virus. It is believed that such a demographic context is becoming a societal problem that developed countries around the world will sooner or later face and therefore needs to be adequately addressed. Conclusion - COVID-19 has made us understand that it is time to act both preventatively and curatively. Phenomenological insights suggest that the next pandemic could occur in less than 50 years. It may be time to launch new societal projects aimed at relieving congestion in densely populated regions.

Retiring coal power plants can reduce air pollution and health damages. However, the spatial distribution of those impacts remains unclear due to complex power system adjustments and pollution chemistry and transport. Focusing on coal retirements in Pennsylvania (PA), we analyze six counterfactual scenarios for 2019 that differ in retirement targets (e.g., reducing 50% of coal-based installed capacity vs. generation) and priorities (e.g., closing plants with higher cost, closer to Environmental Justice Areas, or with higher CO₂ emissions). Using a power system model of the PJM Interconnection, we find that coal retirements in PA shift power generation across PA and the Rest of PJM region leading to scenario-varying changes in the plant-level release of several air pollutants. Due to air pollution chemistry and transport and socio-demographics, these changes in turn give rise to a reduction of 10 to 182 PM_2.5-attributable deaths in PJM across the six scenarios, with most reductions occurring in PA. Scenarios that reduce more coal power generation yield greater aggregate health benefits due to air quality improvements in PA and adjacent downwind regions. In addition, vulnerable populations—in both PA and Rest of PJM—benefit most in scenarios that prioritize plant closures in PA near Environmental Justice Areas. These results demonstrate the importance of considering cross-regional linkages and socio-demographics in designing equitable retirement strategies.

Being forced to live in an area following a catastrophic landslide may adversely impact people's mental well-being. Unprivileged communities such as Adivasis, Dalits, plantation workers, and people with low incomes in Kerala's hilly districts are forced to live in landslide-affected areas despite their fear. This paper examines the fears and concerns of landslide survivors from the marginalized sections of society from a broader framework of the political economy of mental health. This approach aligns with the assertion made by the World Health Organisation that individual factors do not solely determine mental health but are intricately linked to broader social, political, and economic circumstances. Data were collected through in-depth interviews with fatal landslide survivors and key informants [ ]. The study employed thematic data analysis from in-depth interviews of various fatal landslide survivors since 2018. The three major themes unveiled in the analysis are: 1. post-disaster fears, 2. The factors that triggered fear and concern and 3. Socio-economic marginality and mental health. The study asserts that individuals who are poor and unprivileged are highly susceptible to mental health issues associated with landslides.

A new trend in cow's milk has emerged in the market called type A1 and A2 milk. These products have piqued the interest of both consumers and researchers. Recent studies suggest that A2 milk may have potential health benefits, which is why researchers are investigating this product further. It is interesting to note that the A1 and A2 milk types have area-specific characteristics compared to breed-specific characteristics. Extensive research has focused on milk derivatives obtained from cow’s milk, primarily through in vitro and animal studies. However, few clinical studies have been conducted in humans, and the results have been unsatisfactory. New molecular techniques for identifying A1 and A2 milk may help researchers to develop new studies that can clarify certain controversies surrounding A1 milk. It is essential to exercise extreme caution when interpreting the updated literature. It has the potential to spread panic worldwide and have negative economic implications. Therefore, this study aims to investigate the new aspects of A1 and A2 milk in different research areas and clarify some aspects regarding these two types of milk.

It is concerning that Cameroon's urban centers are experiencing an alarming rise in air pollution as a result of urbanization, population growth, industrial activity, and transportation emissions. We examined the causes, health impacts, research methodology, case studies, and government measures to address the urgent issue of air pollution in Cameroon's urban regions. We have emphasized how Cameroon's air pollution levels have significantly increased as a result of causes like population expansion, urbanization, industrial emissions, and automobile exhaust A thorough discussion of the negative health impacts of extended exposure to air pollution is included, with special attention to the sensitivity of the old and young. These effects include respiratory disorders, cardiovascular ailments, and early mortality. We emphasized the pressing need for all-encompassing strategies to address air pollution, such as increased public awareness campaigns, stronger emissions regulations, the development of renewable energy sources, and better waste management. The techniques employed in studies on air pollution, like as epidemiological research and air quality monitoring, are also explained to provide light on the unique health dangers that Cameroonian urban dwellers must contend with. We emphasized in our conclusion the significance of joint efforts by legislators, medical professionals, and the general people to reduce air pollution and protect public health in Cameroon in order to create a cleaner and healthier future. In order to protect public health in the future, it is imperative that Cameroon's air pollution be addressed.

Machine Learning is increasingly and ubiquitously being used in the medical domain. Evaluation metrics like accuracy, precision, and recall may indicate the performance of the models but not necessarily the reliability of their outcomes. This paper assesses the effectiveness of a number of machine learning algorithms applied to an important dataset in the medical domain, specifically, mental health, by employing explainability methodologies. Using multiple machine learning algorithms and model explainability techniques, the project provides insights into the model workings to help determine the reliability of the machine learning algorithm predictions. The results are not intuitive. It was found that the models were focusing significantly on less relevant features and at times, unsound ranking of the features to make the predictions. The paper therefore argues that it is important for research in applied machine learning to provide insights into explainability of the models in addition to other performance metrics like accuracy. This is particularly important for applications in critical domains such as healthcare. A future direction is to investigate methods to quantify the effectiveness of the machine learning models in terms of the insights from their explainability.

Aims: The study aims to take the COVID-19 pandemic as an example to provide a scientific reference for diabetic patients’ self-health management and nurses’ work for these patients when facing future pandemics. Review Methods: It conducted a comprehensive literature search and analysed relevant texts. This article reviews the daily health management of diabetic patients in the context of the COVID-19 pandemic and the role that nurses should play in this process. Results: Diabetic patients face challenges in self-health management during the pandemic, including disruptions in healthcare access, increased mental problems, and unhealthy lifestyles. Nurses serve as the front-line interface between these patients and the healthcare system. Adopting telehealth and remote consultation has effectively bridged the gap created by social distancing measures. Conclusion: Daily self-health management can significantly improve glycemic control and reduce the risk of diabetes-related complications, which is vital during the pandemic when patients may be experiencing disruptions to their routine care. Moreover, empowering patients through educational initiatives led by nurses can bring better self-monitoring, medication adherence, and lifestyle modifications, all of which are crucial in mitigating the effects of diabetes on the body’s immune response, thus reducing the severity of COVID-19 if contracted.

The primary sources of particulate matter are linked to human activity. Certain particulate emissions, particularly those of a finer nature, can significantly impact human health, making them one of the most concerning pollutants. Ultrafine particles (UFP), which have a diameter of less than 100 nm, are of particular concern due to their impact on human health and the difficulty in controlling them. The concentration of ultrafine particles (UFP) in the workplace is a growing concern and is classified as an emerging risk. Workers may be exposed to UFP through inhalation, skin absorption, ingestion, or a combination of these routes. This study aims to determine the levels of UFP exposure among workers in environments with varying direct particle emission patterns. Measurements were conducted to compare the results with the levels recommended by the WHO. The study monitored industrial workplaces with direct particulate matter emissions, such as a carpentry and a bakery, as well as social sector sites without or almost without direct particle emissions, such as a school and a health clinic. One conclusion drawn from this study is that all tasks and occupations are susceptible to high levels of UFP, exceeding WHO recommended values in virtually all monitored environments. Therefore, monitoring and controlling UFP is crucial. Further in-depth studies on this subject are also necessary..

AbstractCurrently, public health researchers are investigating several complex and multi-faced health problems that require mixed-method approaches (MMA) to clearly understand problems and design proper intervention approaches and policy formulation. Besides, a comprehensive comprehension of the complex operation of society is vital. The MMA helps in having a broader understanding of the functioning and structure of the community at large. MMA deliberately integrates qualitative and quantitative approaches carefully to build on the merits of each other and confirm that the findings of research are closer to the truth. Therefore, public health scholars must have an excellent comprehension of the MMA and its philosophical foundations for discovering the complex conditions that challenge public health nowadays. However, public health researchers do not clearly understand the theoretical underpinnings and practical application of MMA, despite its popularity in developing countries. Therefore, this article aimed to provide comprehensive evidence on the theoretical underpinnings and practical application of MMA.

Background and objectives: Effective management for chronic diseases, hereditary and rare diseases and Thalassaemia in particular constitutes an important indicator for the quality of healthcare systems. We aimed at assessing healthcare services in different countries by using publicly available health indicators and by surveying Thalassaemia patients and their caregivers. Materials and Methods: We reviewed official worldwide databases from the WHO, World Bank, and scientific resources and also used a structured patient tailored self-completed questionnaire to survey Thalassaemia patients and their caregivers in 2023. Results: A total of 2,082 participants were surveyed (mean age 27 years, males 42%). About 1 in 4 respondents had less than high school education, while 24% had a bachelor degree. About a third of respondents were married and had either full- or part-time employment. The vast majority (~80%) had initiated transfusion therapy between 1 – 4 years of age. Only 42% reported no delays in receiving blood transfusion, while 47% reported occasional delays and 8% serious delays. About half of patients reported being very satisfied (11%) or satisfied (38%) with the quality of provided services, while 1 in 3 patients reported being unsatisfied or very unsatisfied, and their access to treatment was difficult or very difficult due to traveling expenses and high cost of treatment. Conclusion: Important improvements in the care of Thalassaemia patients have been documented during the past decades. Nevertheless, our recent survey reveals many unmet needs where additional focus is required through national healthcare systems in order to address them effectively and achieve satisfactory patient outcomes.

Recent evidence suggests that the lower gut microbiome of ruminants presents roles in their health and environment, including the development of the mucosal immune system, milk production efficiency and quality and subsequent methane emissions. However, there are proportionately fewer studies on this complex microbial community in cattle and region-focus studies are non- existent. Herein, we present the research protocol of the GUTBIOME CY project pertaining to determine the composition of the lower gut microbiome in dairy cows situated in 37 farms across five districts of the island of Cyprus. Detailed questionnaires on animal husbandry and farming practices will be gathered from each farm. Faecal, milk (individual and bulk) and water samples will also be collected from cows and their offspring. Samples will be analysed using a combination of molecular biology and bioinformatics pipelines to define microbiome profiles and antimicrobial resistance (AMR). Information collected from the questionnaires will be use to test for associations between animal husbandry or farming practices and microbiome components and AMR. Collected samples will establish the first dairy cattle biobank in the country for contributing substantially towards scientific advancements in microbiome research and providing insights to all stakeholders, tailored to the unique agricultural context of Cyprus.

A temporary monitoring system was installed on the 175-years-old historical Széchenyi chain bridge under its reconstruction process. The bridge is in the downtown area of the capital city of Hungary and plays a significant role in city life of Budapest. Six-month-long measurements were conducted during the reconstruction process of the bridge, yielding crucial insights into the structural behaviour of the historical structure. Measurement results were evaluated; the findings encompass the rotation capacity of pins between chain elements, and structural response to temperature changes. This information helped the decision-making of designers and construction company during the reconstruction made between 2021 and 2023. For instance, daily temperature fluctuations result in increased bending moments in the chain elements, rising up to 158% compared to the values observed during a proof load test in 2018. Furthermore, the measurements reveal an approximate 42% increase in normal forces compared to the proof load test, which highlights the high sensitivity of chain bridges to temperature fluctuations, where geometric stiffness plays a crucial role. Reconstruction, reducing self-weight, notably intensifies the impact on normal forces and bending moments. These outcomes strongly emphasize the dominance of dead load and self-weight in the case of chain bridges.

Numerous studies have shown that pesticide exposure is linked to adverse health outcomes. Nevertheless, in Bolivia, where there is an increasing use of pesticides, including those restricted or banned in industrialized nations, the literature is spare. To address knowledge gaps and guide future research in Bolivia, we conducted a scoping review crossing 22 years (January 2000 to December 2022). Our search identified 37 peer-reviewed articles and 27 reports/documents on Bolivian regulations. Most studies focused on farmers and revealed high pesticide exposure levels, assessed through biomarkers of exposure, susceptibility, and effect. Literature explored a range of health effects due to pesticide exposure, spanning acute to chronic conditions. Many studies highlighted the correlation between pesticide exposure and genotoxic damage, measured by DNA strand breaks and/or micronuclei formation, particularly in farmers without personal protection equipment (PPE), which increases the risk of developing chronic diseases, including cancer. Recent findings also showed the alarming use of banned or restricted pesticides in Bolivian crops. Despite existing Bolivian regulations, the uncontrolled use of pesticides persists, evidencing the harmful health effects on the population and increasing land and water pollution. These findings underscore the need for stringent enforcement of regulations and provide a scientific foundation for decision-making by relevant authorities.