Chromosomal instability (CIN), defined by variations in the number or structure of chromosomes from cell to cell, is recognized as a distinctive characteristic of cancer, associated with the ability of tumors to adapt to challenging environments. CIN has been recognized as a source of genetic variation that leads to clonal heterogeneity (CH). Recent findings suggest a potential association between CIN and CH with the prognosis of BC patients, particularly in tumors expressing the epidermal growth factor receptor 2 (HER2+). In fact, information on the role of CIN in other BC subtypes, including luminal B BC, is limited. Additionally, it remains unknown whether CIN in luminal B BC tumors, above a specific threshold, could have a detrimental effect on the growth of human tumors, or if low or intermediate CIN levels could be linked to a more favorable BC patient prognosis when contrasted with elevated levels. Clarifying these relationships could have a substantial impact on risk stratification and the development of future therapeutic strategies aimed at targeting CIN in BC. This study aimed to assess CIN and CH in tumor tissue samples from ten patients with luminal B BC, and compared them with established clinicopathological parameters. The results of our study show that luminal B BC patients exhibit intermediate CIN and stable aneuploidy, both of which correlated with lymphovascular invasion. These findings suggest that evaluating CIN, CH and aneuploidy could improve risk stratification, the prediction of clinical outcomes and future therapeutic approaches in luminal B BC patients.

Smoker’s paradox usually refers to the common observation of a favourable outcome of smoker patients in acute myocardial infarction. The interpretation of this phenomenon is still controversial and not fully explained. We aimed at assessing whether smoking could be associated with mortality in a large cohort of prospectively enrolled patients with ST segment elevation myocardial infarction (STEMI) referred to primary percutaneous coronary intervention (pPCI). From April 2006 to December 2018 a population of 2456 STEMI patients treated with primary PCI were prospectively enrolled in the MATRIX registry. Ischemic time, clinical, demographics, angiographic data and 1-year follow-up were collected. Among 2546 patients admitted with STEMI 1007 (41%) were current smokers. Smokers were 10 years younger and had lower crude in-hospital and 1-year mortality (1.5% vs 6%, p<0.0001 and 5% vs 11%, p<0.0001), shorter ischemic time (203 [147-299] vs 220 [154-334] minutes, p=0.002) and shorter decision time (60 [30-135] vs 70 [36-170] minutes, p=0.0063). After propensity-matching, age, cardiogenic shock and low TIMI score were associated with in-hospital mortality, while smoking habit was still associated with reduced mortality. Smoking was also associated with reduced death rate at 1-year follow-up (HR 0.54, 95% CI [0.37 - 0.78]; p<0.001). Our data show a protective link between smoking status and mortality in patients with STEMI, the so called “smoker’s paradox”. This could be explained not only by the shorter ischemic time and younger age of the smoking population but also by a specific pathogenetic effect of smoking underlying the onset of STEMI and response to therapies.

Aim: Utilizing the subjective experience of nurse executives who have supervised nurses during a major disaster in a hospital setting, this study aims to describe the subjective experience of nurse executives (NE) who have supervised nurses’ response to major disaster. This paper will focus on strategies to support nursing response to disaster, specifically to strengthen resiliency and the ability to maintain function despite the shock of disaster, including those caused by climate changes. Methods: Semi-structured interviews were conducted with 11 hospital-based nurse executives who supervised nurses during some of the worst natural and human-made disasters in different regions of the United States. A phenomenological approach was used to analyze and describe emerging themes from qualitative data. Results: Three Nurse Executives demonstrated theme saturation for mitigation steps to augment traditional disaster readiness activities: 1.) Assessment of Human Infrastructure: Daily Skills Needed During Disaster Response, 2.) Identification and Study of Failure Points & Metrics, 3.) Strengthening Human Infrastructure: Rectifying Deficiencies), and 4.) Monitoring Metrics & Making Corrections During Conventional Periods. Conclusion: Mitigation steps may improve outcomes in hospital function during conventional times; therefore, may improve resiliency and the ability to maintain functions during major disasters, including climate change.

Background: School meals represent a significant supply of nutrients for children in Brazil, especially those in conditions of social vulnerability. Objectives: This study aimed to assess the levels of arsenic (As), cadmium (Cd), and lead (Pb) in meals served in public elementary schools in four municipalities in the state of Bahia, Brazil, and assess the risk posed to children's health. Methods: Ninety-six samples were collected from 16 schools, freeze-dried, and subjected to microwave-assisted digestion. The As, Cd, and Pb levels were determined by graphite furnace atomic absorption spectrometry. The risk assessment was based on calculating each element's hazard quotient (HQ). Results: None of the samples reached or exceeded the tolerable levels for the elements analyzed. Pb was the metal that obtained the most significant result, reaching maximum levels of 39-157 µg.kg-¹. Conclusions: No element exceeded the PTWI proposed by JECFA; thus, the toxic metal content in school meals poses a negligible risk to children´s health.

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

Cardiovascular comorbidity is a common companion of psoriasis and psoriatic arthritis (PsA). Recently, a significant link has been found between the HLA-Cw6 allele and a better cardiometabolic profile in these patients. We aimed to check this finding in our setting. Cross-sectional observational study (n: 572 psoriasis patients, 30% with PsA). Different study variables were collected in detail, as well as classic cardiometabolic risk factors. The distribution of the HLA-Cw6 allele and the IFIH1/MDA5 gene variants previously linked to disease risk was determined in the study cohort and stratified according to the cardiometabolic comorbidity. Linear and logistic regression models were constructed to analyze these associations. The study cohort included 309 men and 263 women, mean age 46.7 years (SD 14.5), mean disease duration 19.4 years (SD 14.8). We confirmed the known association between HLA-Cw6 and type I psoriasis (familial, severe, early onset). Psoriasis severity (OR: 2.14), female sex (OR: 1.63), and the IFIH1/MDA5 rs1990760 TT genotype (OR: 1.62) were significantly related to PsA, while HLA-Cw6 resulted protective (OR: 0.65). HLA-Cw6 carriers showed lower waist perimeter, lower BMI, and lower risk of both hypertension (OR: 0.52, p<0.001) and diabetes (OR: 0.36, p<0.001), but these findings were no longer apparent upon adjusted regression models. No IFIH1/MDA5 gene variant was associated with any cardiometabolic risk factor. The influence of HLA-Cw6 on the cardiometabolic risk profile of psoriatic patients seems to be explained by other factors (age, sex, duration of the disease or arthritis) and not by this biomarker itself.

Intermediate CAG expansions in the gene ataxin-2 (ATXN2) are a known risk factor for ALS, but little is known about their role in FTD risk. Moreover, their contribution to the risk and phenotype of patients might vary in populations with different genetic background. The aim of this study was to assess the relationship of intermediate CAG expansions in ATXN2 with the risk and phenotype of ALS and FTD in the Spanish population. Repeat-Primed PCR was performed in 620 ALS and 137 FTD patients in three referral centers of Spain to determine the exact number of CAG repeats. In our cohort, ≥27 CAG repeats in ATXN2 was associated with a higher risk of developing ALS (odds ratio [OR] = 2.666 [1.471-4.882]; p = 0.0013), but not FTD (odds ratio [OR] = 1.446 [0.558-3.574]; p = 0.44). Moreover, ALS patients with ≥27 CAG repeats in ATXN2 showed shorter survival rate compared to those with &lt;27 repeats (hazard ratio [HR] 1.74 [1.18, 2.56], p = 0.005), more frequent limb onset (odds ratio [OR] = 2.34 [1.093-4.936]; p = 0.028), as well as family history of ALS (odds ratio [OR] = 2.538 [1.375-4.634]; p = 0.002). Intermediate CAG expansions of ≥27 repeats in ATXN2 are associated with ALS risk, but not with FTD, in the Spanish population. ALS patients carrying an intermediate expansion in ATXN2 show more frequent limb onset, but worse prognosis than those without expansions. In patients carrying C9orf72 expansions, the intermediate ATXN2 expansion might increase the penetrance and modify the phenotype.

The present work provides continuity with studies where currently the industrial market is characterized by a highly variable demand in terms of quantities and flexibility of manufacturing or mass customization, which translates into a more demanding production context in terms of the continuous changes required to the production systems, the effect of which results in an increase in the fatigue subjected to the machines that make up the production systems. On the other hand, current production systems tend to use highly communicative and sensorized cyber-physical systems; these characteristics can be used to integrate them into decision-assisted systems in order to improve the availability of the industrial plant. The assisted system developed focuses on collecting and taking advantage of historical knowledge of industrial plant failures and breakdowns. By ideally integrating the Reliability Centered Maintenance (RCM) methodology and Case-Based Reasoning (CBR) algorithms implemented in a Java application, it is possible to design maintenance plans adjusted to a real and changing operational context of any industrial plant. As a result, faster and more accurate decisions are made, as they are based on data. This article focuses on improving certain aspects of the developed assisted system by adding more value to it by incorporating Fuzzy Logic (FL) techniques. The aim is to improve the way of entering information about risk factors and their relative importance, by incorporating natural language, instead of a numerical score, resulting in increased precision in the calculation of the Risk Priority Number (RPN) of the new cases incorporated into the assisted system.

Background: Approximately 75% of all head and neck cancer patients are treated with radiotherapy (RT). RT to the oral cavity results in acute and late adverse events which can be severe and detrimental to a patient’s quality of life and function. The purpose of this study was to explore associations between RT dose to a defined oral cavity organ at risk (OAR) avoidance structure, provider and patient reported outcomes (PROs), opioid use, and hospitalization. Methods: This was a retrospective analysis of prospectively obtained outcomes using multivariable modeling. The study included 196 patients treated with RT involving the oral cavity for a head and neck tumor. A defined oral cavity OAR avoidance structure was used in all patients for RT treatment planning. Validated PROs were collected prospectively. Opioid use and hospitalization were abstracted electronically from medical records. Results: Multivariable modeling revealed the mean dose to the oral cavity OAR was significantly associated with opioid use (p=0.0082) and hospitalization (p=0.0356) during and within 30 days of completing RT. Conclusion: The findings of this study may be valuable in RT treatment planning for patients with tumors of the head and neck region to reduce the need for opioid use and hospitalization during treatment.

Having as objective to reach a circular economy, it is important to maximize the Physical Asset’s Life Cycle. The evaluation of Physical Assets Life Cycle may have several approaches which may provide different results. These differences may not be very significant, but must be taken into consideration, because they have consequences in the manager decision. This permits to have a wider time interval to decide when to withdrawal the Physical Asset or to renewal it, and or if this ought to continue functioning because the profits are higher than the expenses, what allows to diminish waste and increase sustainability. These are some aspects that are discussed in this paper, which presents several models to evaluate the Physical Assets Life Cycle, considering the market value, devaluations methods and a more generalized way of Fisher’s Equation, which can include the Risk tax, among others. The results are discussed supported in data for simulation, which are used for each Econometric Model aiming to evaluate the differences among them. In all Models they are considered not only the expenses, namely of Investment and Functioning, but also the Profits, which permit to evaluate the Physical Asset Life Cycle in a holistic way. The models are very versatile, allowing to evaluate quantitatively the changing in the maintenance policies, the energy prices variations, the risk evaluation, the variation of profits according to the real market, and so on. The results demonstrated the robustness of the approach described and that maximize the Physical Assets Life Cycle allowing to minimize the consumption of world resources and, by consequence, it contributes for a more sustainable world.

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and the risk of a major cardiovascular event is highest among those with established disease. Ongoing management of these patients relies on the accurate assessment of their response to any prescribed therapy, and their residual risk, in order to optimize treatment. Recent international guidelines and position statements concur that the plasma concentration of apolipoprotein B (apoB) is the most accurate measure of lipoprotein associated ASCVD risk. This is especially true for the growing number of individuals with diabetes, obesity or the metabolic syndrome, and those on statin therapy. Most guidelines, however, continue to promote LDL-C as the primary risk marker due to uncertainty as to whether the greater accuracy of apoB is sufficient to warrant a paradigm shift. Recommendations regarding apoB measurement vary, and the information provided on how to interpret apoB results is sometimes insufficient, particularly for the non-lipid specialist. Misinformation regarding the reliability of the assays is also frequently repeated despite its equivalent or better standardization than many other diagnostic assays. Thus, demand for apoB testing is relatively low, which means there is little incentive to increase its availability or reduce its cost. In this review, we examine the results of recent clinical outcomes studies and meta-analyses on the relative values of apoB, LDL-C and non-HDL-C as markers of ASCVD risk. Although there is seemingly minimal difference among these markers when only population-based metrics are considered, it is evident from our analysis that, from a personalized or precision medicine standpoint, a great many individuals would benefit, at a negligible total cost, if apoB measurement were better integrated into the diagnosis and treatment of ASCVD.

To quantitatively estimate the risk of power system operation under extreme rainfall, a multi-scenario stochastic risk assessment method is proposed. First, a scenario generation scheme considering waterlogged faults of power facilities is constructed based on the storm water management model (SWMM) and the extreme learning machine method. These scenarios will be merged to several typical scenario sets for further processing. The outage of power facilities will induce power flow transfer which may consequently lead to transmission lines’ thermal limit violation. Semi-invariant and Gram-Charlier level expansion methods are adopted to analytically depict the probability density function and cumulative probability function of each line’s power flow. The optimal solution is performed by a particle swarm algorithm to obtain proper load curtailment at each bus, and consequently the violation probability of line thermal violations can be controlled within an allowable range. The volume of load curtailment as well as their importance are considered to quantitatively access the risk of power supply security under extreme precipitation scenarios. The effectiveness of the proposed method is verified in case studies based on the IEEE 24-bus system.

Historically, Physalis physalis massive stranding events have been infrequent and poorly documented. However, their occurrence can have significant impacts on human health and the stability of coastal ecosystems. In this study we analyze the largest P. physalis stranding event historically recorded affected Cuba’s northwestern coast in December 2022. We counted all colonies during the massive event along ~ 3 km coast, within a 5 m stripe. Density, dimorphic form (left/right-handed), and colony size were quantified using 0.25 m2 quadrat placed every 50 m, 10 m from shoreline. Eighty-five people were stung, with 38 having strong allergic reactions, resulting in a health risk. Over ten thousand colonies were recorded, with the highest mean colony density (29.3 per m2) ever reported. The massive stranding coincided with the lowest Arctic Oscillation index (-2.59) in the past 11 years during December, likely linked to climate change. This led to the emergence of northeasterly winds reaching speeds of up to 24 km/h. Wind direction and speed, coupled with the dominance of left-handed colonies (71.4%), suggest the Sargasso Sea as the possible source of the bloom. The high prevalence of juvenile P. physalis colonies (68 %) likely aligns with the autumn breeding season in the northern hemisphere. The potential causes of P. physalis blooms are still poorly understood. Systematic monitoring of the distribution and abundance of this species should be a research priority considering the potential risk to human health and that the blooms could become more frequent and affect other areas in the Atlantic, given climate change and increasing eutrophication of the oceans.

The current study explores the problem of illiquidity in the corporate bond market and examines a broad set of liquidity proxies through empirical investigation. Purpose: The purpose of this paper is to give solution to the global issue of illiquidity in the corporate bond market. The problem is identified by many researchers and this paper attempts to find out the viable solution of the "fungibility route" as an alternative to the "liquidity route". Design/ Methodology: An Analysis of a sample size of 2,34,772 trade data of corporate bonds and a sample size of 2,00,607 trade data of G-securities is done to identify the problem. Findings / Solution proposed: A mathematical model based on credit risk differential and sensitivity differential is proposed to find out the fair value at which an illiquid bond can be swapped by a liquid bond. To arrive at the fair value of the illiquid bond, we have calculated risk adjusted discount rate using modified duration and credit risk differential. With our solution, it is possible to enhance the liquidity of the bond not directly but through fungibility route. Originality: the research is first of its kind in which solution is given to the global problem of corporate bond illiquidity. To execute the trade in the fungibility route, proposed parties involved are the Fungibility platform, the initiator, and the bidder. The derived fair value would facilitate trade and serve as an exit strategy for illiquid bond holders worldwide.

Decomposed fuzzy sets are the resent extension of intuitionistic fuzzy sets by incorporating functional and dysfunctional points of views to the definition of membership functions. This paper extends the Technique of Order Preference Similarity to the Ideal Solution (TOPSIS) method to the Decomposed Fuzzy TOPSIS (DF TOPSIS) method and applies it to a multi-criteria risk-based supplier selection problem under fuzziness. DF TOPSIS involves finding a positive ideal solution and a negative ideal solution and measuring the distance of each alternative to these solutions. The final ranking is obtained based on the proportion of distances to the positive and negative ideal solutions. The developed DF TOPSIS method incorporates the accuracy and consistency of expert judgments, enhancing the decision-making process. A sensitivity analysis is also presented in order to show the robustness of the obtained rankings by DF TOPSIS.

Since 2017 Cartagena UNESCO World Heritage has threatened to be categorized as "in Danger" by UNESCO. This research analyzes two main critical aspects, Governance and Current state of the Site. Regarding Governance, the study aims to identify strengths, weaknesses, opportunities and treats in the UNESCO Site. Exemplary heritage management systems are studied to propose an adaptable management approach specifically for Cartagena. On the other hand, a comprehensive analysis is conducted utilizing a photographic report that highlights the major issues arising from inadequate heritage management. Hyperspectral images obtained from a previous study are employed to identify vegetation and asbestos-cement roofs within the cultural heritage Site. The study reveals that the ambiguity surrounding decision-making authority for heritage management, distributed between the Mayor's Office and the Ministry of Culture, is a primary challenge. This fragmentation has resulted in duplicated efforts and a lack of coordinated action, significantly compromising the conservation and protection of the cultural heritage Site. Moreover, twelve current shortcomings of cultural heritage in Cartagena are identified through authors' five-year on-site regular visits, photographic reports and observation. To address the prevailing concerns, a new line of command for cultural heritage management is proposed as the most effective means of tackling these challenges. Additionally, general recommendations are presented to mitigate the existing problems and prevent the classification of Cartagena's heritage as "at risk" by UNESCO in the near future. This research provides a scientific perspective, drawing upon years of experience studying heritage and residing in the city, devoid of political influences or conflicts of interest.

As in many parts of the world, rural-urban, forest-urban interface areas surrounding urban regions expose the natural areas they interact with to a threat of fire risk that can reach various sizes. This risk has been assessed for various regions of the world using many different methods and numerical models so far. Among these, it is seen that machine learning models have successful applications in risk assessment and risk prediction studies. For the fire risk prediction of Istanbul's yet unurbanized regions, but where the city is anticipated to potentially shift, data was collected using the opportunities provided by Geographic Information Systems and Remote Sensing technologies based on fires that occurred between 2000-2021, and the region was examined. Machine learning methods' Random Forest (RF), Extreme Gradient Boosting (XGB), and Light Gradient Boosting (LGB) models were applied for the classification of factors effective in fire. The best result was given by the RF model with 0.93 accuracy, 0.062 F1 score, and 0.753 Area Under Curve (AUC) value. In the classification of factors in the RF model, the grouping between fire-initiating factors and factors effective in spreading is evident, while this distinction is partially noticeable in the other two models.

Introdução: Os fatores de risco vasculares são decisivos na evolução da doença aterosclerótica e a ecografia Doppler carotídea e vertebral permite acompanhar o seu aparecimento e evolução. A medida do espessamento da parede arterial permite o diagnóstico precoce da doença potencializando seu tratamento e controle dos fatores de risco vasculares. Objetivo: Analisar a presença de doença ateromatosa em indivíduos com idade > 65 anos e compreender sua transformação com fatores de risco vascular. Materiais e Métodos: Estudo observacional transversal, em indivíduos com idade > 65 anos manifestados ao ecoDoppler carotídeo entre 1º de janeiro de 2012 e 31 de dezembro de 2021. Foi calculado o índice médio-intimal, a presença de placas ateromatosas, sua repercussão hemodinâmica e fatores de risco vascular foram registrados. Resultados: Obteve-se uma amostra de 5885 indivíduos, sendo 41,8% do sexo feminino e 58,2% do sexo masculino. A média de idade foi de 76,59 anos, variando entre 65 e 98 anos (+6,69). A hipertensão arterial foi a mais prevalente 81,3%. Houve relação positiva significativa entre índice médio-intimal, idade e história pessoal de doenças cardiovasculares e cerebrovasculares (p=0,001). Na presença de placas, sexo masculino, hipertensão arterial, diabetes, dislipidemia, tabagismo e história pessoal de doenças cardiovasculares e cerebrovasculares apresentadas de forma positiva. Conclusões: Nesta amostra, fatores de risco vascular não modificáveis ​​parecem ser determinantes na presença de aumento da espessura da parede arterial. Na presença de sinais de um estágio mais avançado da doença aterosclerótica, os fatores de risco vascular modificáveis ​​​​são decisivos,

Lifestyle physical activity (PA) and nutrition are known to be effective interventions in preventing and managing obesity related comorbidities is adult populations, but less so in children and adolescents. We examined the effectiveness of lifestyle interventions in children from minority ethnic populations in western high-income countries. Our systematic review included 53 studies involving 26045 children from minority ethnic populations within western countries, who followed lifestyle intervention programs lasting between 8 weeks and 5 years with an aim to prevent and/or manage childhood obesity and associated comorbidities, including adiposity and cardiometabolic risks. Studies were heterogenous in terms of lifestyle intervention components (nutrition, PA, behavioural counselling) and settings (community vs. schools and after schools). Our meta-analysis included 31 eligible studies and showed no significant effects of lifestyle interventions when they focused on body weight and body mass index (BMI) outcomes [pooled BMI mean change = -0.09 (95% CI -0.19, 0.01), p=0.09]. This was irrespective of the intervention program duration (< 6 months vs. ≥ 6 months), type (PA vs nutrition/combined intervention) and weight status (overweight or obese vs no normal weight), all showed no significant effects in the sensitivity analysis. Nonetheless, 19 of the 53 studies reported reduction in BMI, BMI z scores and body fat percentage. However, majority of lifestyle interventions adopting a quasi-design with a combined primary and secondary obesity measures (11 out of 15 studies), were effective in reducing obesity comorbidities of cardiometabolic risks including metabolic syndrome, insulin sensitivity, and blood pressure in children with overweight and obesity. Preventing childhood obesity and associated comorbidities in children from high-risk ethnic minority groups is best achieved using a combined PA and nutrition intervention approach, which jointly target preventing obesity and cardiometabolic disease primary and secondary outcomes, especially measures of diabetes, hypertension, and cardiovascular disease.

China's gradually increasing assertiveness at the international level marked the beginning of several influential geopolitical projects. The biggest of these is the Belt and Road Initiative, which will be the subject of this post. The Chinese government initiated the BRI in 2013 to revive the historic Silk Road. The name of the new initiative was chosen based on well-known historical parallels, emphasizing the ideological component of China's current position. At the same time, neo-mercantilism prevails in China, and we can say that all roads lead to China, which means that the current nature of Chinese strategic planning corresponds to the increasingly important role of the state in international relations and strengthens its position in the world economy. The aim of the paper is to use the methods of analysis, synthesis, deduction, induction, comparison, and explanation to analyse Chinese investments that flow into various sectors worldwide, but especially into the countries participating in the Belt and Road Initiative from 2013 to the present. The largest such sector is the energy sector, which we will look at in more detail in the post. Finally, the contribution will be focused on predicting the development of further investments based on the available information as well as our own suggestions and recommendations to make them more efficient.

Identifying productive, profitable and less risky cropping systems is important for sustaining farm-based livelihoods in the context of climatic uncertainties and market volatility in many developing nations. Reductionist field crop research identifies the best-bet solutions based on treatment replicates at a single point in time, which may not account for price instability under climatic uncertainties and volatile markets. Keeping this in mind, we estimated productivity, profitability and weather-related risk from eleven different rice-based cropping systems (eight existing and three potential systems) in the coastal region of West Bengal, India. Information on the crop management practices, yield and prices of the component crops of these eleven cropping systems, under ’best,’ ’normal’ and ‘worst’ situations (scenario), were collected through a ques-tionnaire survey on50 farms of Gosaba Block, West Bengal, India. Irrespective of the scenarios, the rice-lathyrus systems, followed by rice-onion and rice-lentil systems recorded the lowest rice-equivalent yields and system yields. However, the highest rice-equivalent yields and system yields were recorded for rice-chilli systems, followed by rice-tomato and rice-potato-green gram systems. Per hectare total paid-out cost (TPC) of rice-tomato systems was higher, followed by rice-chilli, rice-potato-green gram and rice-potato systems. However, irrespective of seasonal conditions (best, normal and worst), rice-chilli systems gave a higher net return followed by rice-tomato and rice-potato-green gram systems. The rice-fallow system recorded the lowest value for both parameters. Under the worst seasonal conditions, the rice-onion system gave a negative net return. Under all the scenarios, the highest B:C ratio was observed for rice-chilli, rice-tomato, rice-potato-green gram and rice-potato systems. The cumulative probability distribution of the rice-tomato system showed first-degree stochastic dominance over other systems and the rice-chilli system showed second-degree stochastic dominance over the rest of the systems. Only the rice-onion system had a small chance (< 1%) of a negative net return, while the rest of the cropping systems were highly likely to get a positive net return. Taking productivity, economics, and risk assessment of different rice-based systems into account, rice-vegetable systems, especially rice-tomato and rice-chilli among the existing systems and rice-potato-green gram system among the potential systems, can be recommended for sustainable intensification in these coastal saline tracts of the region. We also discuss additional socio-economic factors explored by in-depth in-terviews with the farmers, which might influence the adoption and upscaling of these cropping systems in the region.

INTRODUCTION There have been several advances in the treatment of hepatitis C virus (HCV) infection which have resulted in major reductions in the morbidity and mortality from liver-associated disease. These are not widely available in the Caribbean, due in part, to lack of knowledge of the epidemiology of infections with HCV. As efforts are made to eliminate HCV from the region, these and other existing barriers such as lack of an established database on HCV must be addressed. This review seeks to identify gaps in the knowledge of HCV in the Caribbean with respect to seroprevalence, genotype distribution and general epidemiologic characteristics. MATERIALS AND METHODS The literature for the period January 1, 2005, to October 2022, was reviewed to gather country specific data on HCV across the Caribbean. References were identified through indexed journals accessed through established databases. The usage pattern of HCV drugs was determined from data obtained from Pharmacists and Infectious Diseases Specialists across the region. RESULTS The prevalence of HCV in the Caribbean was 1.5%; the region should therefore be considered an area of moderate prevalence. Notably, data from specific countries were limited. The prevalence of HCV among intravenous drug users (21.9-58.8%); persons living with HIV/AIDS (0.8 to 58.5%); prisoners (32.8-64%) and men who have sex with men (MSM) (0.8-6.9%) was generally higher than in the general population (0.8-2.3%). Genotype 1 (83% was most prevalent followed by genotypes 2 (7.2%) and 3(2.1%), respectively. Drugs currently being used for treatment of HCV infections across the Caribbean include Epclusa (Sofosbuvir/velpatasvir), and Harvoni (Ledipasvir/sofosbuvir). Some of these drugs, are only available in the private sector and are sourced externally whenever needed. CONCLUSION There is a paucity of current data on the seroprevalence of HCV in the Caribbean and well-designed prospective studies are indicated to drive the implementation of treatment and control programs for HCV in the region. Barriers which need to be first overcome include unavailability and high cost of drugs used to treat HCV infections, injecting drug use and limited access to medical care and laboratory testing.

Background: Irish dance is growing in popularity, evolving to a more athletic and demanding dance style. Aims: To conduct a systematic review, previously registered with PROSPERO, to identify prevalence, incidence, and injury pattern among Irish dancers and analyse associated risk factors. Methods: Six online databases, plus two dance-specific science publications were searched systematically. Studies were included if the pattern of injuries among Irish dancers were evaluated or the factors associated with injury were analysed, published in English or Portuguese, in peer-reviewed scientific journals. Four reviewers assessed the quality and level of evidence using the Downs and Black criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Results: Eleven articles were included, 8 level 3c (cross-sectional) and 3 level 3b (prospective). Mean DB percentage score was 63% ± 7,2%. Prevalence ranged from 72,2% to 92,6%, affecting mostly the foot/ankle complex. Only 2 articles reported incidence, which ranged from 3,4–10,6 injuries/1000 hours danced depending on injury definition. Psychological factors, elite level, and insufficient/poor sleep were associated with musculoskeletal injury. Conclusions: Injury prevalence and incidence is high in Irish dancers, with the foot and ankle more affected. Due to heterogeneity in injury definitions, methods, and populations, along with the need for improvement in studies quality, recommendations were made for future research.

Background: Pathologic complete response (pCR) of breast cancer after neoadjuvant chemotherapy (NAC) is highly related to molecular subtypes. Patients who achieved tumor pCR after NAC have a better prognosis. However, despite of better prognosis, pCR patients have a potential for recurrence. There is little evidence of risk factors of recurrence in patients with pCR. We aim to analyze factors associated with tumor recurrence in patients who achieved pCR. Methods: This study retrospectively reviewed the data of patients diagnosed with breast cancer who achieved pCR after receiving NAC between January 2009 and December 2018 in Samsung Medical Center. pCR was defined as no residual invasive cancer in the breast and axillary nodes even if there is residual ductal carcinoma in situ (ypT0 or ypTis with ypN0). Breast cancers are classified into 4 subtypes based on hormone receptors (HR) and human epithelial growth factor receptor 2 (HER2) status. Patients who had bilateral breast cancer, inflammatory breast cancer, distant metastasis, unknown subtype, and histologically unique case were excluded from the study. Results: In total 483 patients were included in this study except for patients who corresponded to the exclusion criteria. The median follow-up duration was 59.0 months (range, 0.5-153.3 months). Breast cancer recurred in 4.1% of patients (20 of 483). There was a significant difference in clinical T (p = .004) and clinical N (p = .034) stage in the Kaplan-Meier curve for disease-free survival. Molecular subtypes (p = .573), Ki67 (p = 1.000), and breast surgery type (p = .574) were not associated with tumor recurrence in patients who achieved pCR after NAC. In the clinical T stage and clinical N stage, there was a significant difference between recurrence and no-recurrence groups (clinical T stage; p = .045, clinical N stage; p = .002). Univariable Cox regression revealed statistical significance in the clinical T stage (p = .049) and clinical N stage (p = .010), while multivariable Cox regression demonstrated non-significance in the clinical T stage (p = .320) and clinical N stage (p = .073). Conclusion: Results in this study showed that clinical T, clinical N stage, and molecular subtypes were not statistically significant predictors of recurrence in patients who achieved pCR after NAC. It is hypothesized that a multicenter-based study would lead to the identification of factors as predictors of recurrence after achieving pCR.

The COVID-19 pandemic has presented an unprecedented challenge to the healthcare system. Identifying the genomics and clinical biomarkers for effective patient stratification and management is critical to controlling the spread of the disease. Omics datasets provide a wealth of information that can aid in understanding the underlying molecular mechanisms of COVID-19 and identifying potential biomarkers for patient stratification. Artificial intelligence (AI) and machine learning (ML) algorithms have been increasingly used to analyze large-scale omics and clinical datasets for patient stratification. In this manuscript, we demonstrate the recent advances and predictive accuracies in AI and ML-based patient stratification modeling linking omics and clinical biomarker datasets, focusing on COVID-19 patients. Our ML model not only demonstrates that clinical features are enough an indicator of COVID-19 severity and survival but also infers what clinical features are more impactful, which makes our approach a useful guide for clinicians for prioritization of best-fit therapeutics for a given cohort of patients. Moreover, with weighted gene network analysis, we are able to provide insights into gene networks that have a significant association with COVID-19 severity and clinical features. Finally, we have demonstrated the importance of clinical biomarkers in identifying high-risk patients and predicting disease progression.

In this paper, we introduce the application of Type-I fuzzy inference systems (FIS) as an alternative to improve the prioritization in the FMECA analysis applied in cyber-power grids. Classical FMECA assesses the risk level through the Risk Priority Number (RPN). The multiplication between three integer numbers computes this, called risk factors, representing the severity, occurrence, and detectability of each failure mode and are defined by a team of experts. The RPN does not consider any relative importance between the risk factors and may not necessarily represent the real risk perception of the FMECA team members, usually expressed by natural language; this is the main FMECA shortcoming criticized in the literature. Our approach considers fuzzy variables defined by FMECA experts to represent the uncertainty associated with the human language and a rule base consisting of 125 fuzzy rules to represent the risk perception of the experts. To test our approach, we select a cyber-power grid previously analyzed by the authors using the classical FMECA. The results reveal our proposed fuzzy approach as promissory to represent the uncertainty associated with expert knowledge and to perform an accurate prioritization of failure modes in the context of electrical power systems.

The ability to identify and rank risk is essential for efficient and effective supervision of financial service firms, such as banks and insurers. Risk ranking ensures limited resources are allocated where they are most needed. Today, automatic risk identification within insurance supervision primarily relies on quantitative metrics based on numerical data (e.g. returns). The purpose of this work is to assess whether Natural Language Processing (NLP) and cognitive networks can achieve similar automated risk ranking and identification by analysing textual data, i.e. NIDT=829 investor transcripts from Bloomberg. To this aim, this work explores and tunes 3 NLP techniques: (1) keyword extraction enhanced by cognitive network analysis; (2) valence/sentiment analysis; and (3) topic modelling. Results highlight that keyword analysis, enriched by term frequency-inverse document frequency scores and semantic framing through cognitive networks, could detect events of relevance for the insurance system like cyber-attacks or the COVID-19 pandemic. Cognitive networks were found to highlight events that related to specific financial transitions: The semantic frame of "climate" grew in size by +538% between 2018 and 2020 and outlined an increased awareness that agents and insurers expressed towards climate change. A lexicon-based sentiment analysis achieved a Pearson’s correlation of ρ=0.16 (p&lt;0.001,N=829) between sentiment levels and daily share prices. Although relatively weak, this finding indicates that insurance jargon is insightful to support risk supervision. Topic modelling is considered less amenable to support supervision, because of a lack of results’ stability and an intrinsic difficulty to interpret risk patterns. We discuss how these automatic methods could complement existing supervisory tools in automated risk ranking.

Background: Two years after the first cases, critical gaps remain in identifying prognostic factors in multisystem inflammatory syndrome in children (MIS-C). Methods: This retrospective study included 99 patients with MIS-C hospitalized between August 2020 and March 2022 in a pediatric tertiary center. The patients were divided into two groups according to clinical severity (low and high-risk). Prognostic values of baseline clinical and laboratory characteristics were evaluated with advanced statistical analysis, including machine learning. Results: Sixty-three patients were male, and the median age was 83 (3–205) months. Fifty-nine patients (%59.6) were low-risk cases. Patients aged six years and over tended to be at higher risk. Involvement of aortic or tricuspid valve or &gt;1 valve was more frequent in the high-risk group. Mortality in previously healthy children was 3.2%. Intensive care unit admission and mortality rate in the high-risk group were 37.5% and 7.5%, respectively. At admission, high-risk patients were more likely to have reduced lymphocyte count and total protein level and increased brain natriuretic peptide (BNP), ferritin, D-dimer, and troponin concentrations. The multiple logistic regression model showed that BNP, total protein, and troponin were associated with higher risk. When the laboratory parameters were used together, BNP, total protein, ferritin, and D-dimer provided the highest contribution to the discrimination of the risk groups (100%, 89.6%, 85.6%, and 55.8%, respectively). Conclusions: Our study widely evaluates and points to some clinical and laboratory parameters that, at admission, may indicate a more severe course. Modeling studies with larger sample groups are strongly needed.

Anemonia viridis is an abundant and widely-distributed temperate sea anemone that can form dense congregations of individuals. Despite the potential severity of its sting, few detailed cases have been reported. We report a case of a severe toxic reaction following an A. viridis sting in a 35-year-old oceanographer. She developed severe pain, itching, redness and burning sensation, which worsened one week after treatment with anti-inflammatories, antihistamines and corticosteroids. Prompted by this event, and due to the insufficient risk prevention, lack of training for marine-environment users and lack of research into sting-specific first-aid protocols, we evaluated the cnidocyst response to five different compounds commonly recommended as rinse solutions in first-aid protocols (seawater, vinegar, ammonia, baking soda and freshwater) by means of the Tentacle Solution Assay. Vinegar and ammonia triggered an immediate and massive cnidocyst discharge after their application and were classified as activator solutions. Baking soda and freshwater were also classified as activator solutions, although with a lower intensity of discharge. Only seawater was classified as a neutral solution and therefore recommended as a rinse solution after A. viridis sting, at least until an inhibitory solution is discovered.

Abstract: The aim of the present study was to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals with a TV time &gt; 3 h/day (prevalence = 25.2%) and PA &gt; 150 min/week (prevalence = 35%). Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants &gt; 30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, married individuals are less likely to spend more than 3 hours a day watching TV than single individuals. Single men and women were more likely to do more than 150 min of PA/week at younger age groups and married women older than 40 years were more likely to do 150 min of PA/week than single women.

We aimed to compare prognostic factors for overall survival (OS) following percutaneous radiofrequency ablation (PRFA) with or without chemolipiodolization (CL) for early-stage hepatocellular carcinoma (HCC) using propensity score-matched analysis. We enrolled 221 patients with early-stage HCC who received PRFA with (n = 76) or without (n = 145) CL in Saga Central Hospital between April 2004 and December 2020. No significant difference was observed in OS between PRFA with and without CL cohorts (median survival time [MST]: 5.4 vs. 4.5 years; p = 0.0806). To reduce confounding effects, 108 patients were selected using propensity score-matched analysis (n = 54 for each treatment). No significant difference was observed in OS between the cohorts (MST: 3.6 vs. 4.0 years; p = 0.5474). After stratification according to tumor size, no significant difference was observed in OS for patients with tumor size ≥20 mm between PRFA with and without CL cohorts (MST: 3.4 vs. 3.5 years; p = 0.8236). PRFA with CL was not a significant prognostic factor in both univariate and multivariate analyses (p = 0.5477 and 0.9600, respectively). Our findings suggest that PRFA with CL does not demonstrate longer prognostic effects than PRFA without CL in early-stage HCC, regardless of tumor size.

Since the exploitation of mineral resources results in the release of radionuclides, and consuming radionuclides affects public health in the short and long term. A case study of the environmental radiation impact from coal mining and germanium processing was carried out in southwest China. The coal mines contain germanium and uranium and have been exploited for more than 40 years. The farmlands around the site of coal mining and germanium processing have been contaminated by the solid waste and mine water in some extend since then. Samples of crops have been collected from contaminated farmlands in research area. The research area covers a radius of 5 km, in which there are 2 coal mines located. 210Pb and 210Po have been analyzed as the key radionuclides during monitoring program. The average activity concentrations of 210Pb and 210Po in the crops were 1.38 and 1.32 Bq/kg in cereals, 4.07 and 2.19 Bq/kg in leafy vegetables and 1.63 and 1.32 Bq/kg in root vegetables. The annual effective doses due to the ingestion of 210Pb and 210Po in consumed crops have been estimated for adult residents living in research area. The average annual effective dose was 0.336mSv/a, while the minimum was 0.171 mSv/a and the maximum was 0.948 mSv/a. The results show that crops grown on contaminated farmland contained an enhanced level of radioactivity concentration. Ingestion doses of local residents in research area were significantly higher than the China average level of 0.112 mSv/a, and the world average level of 0.042 mSv/a through 210Pb and 210Po in crops intake respectively.

In the context of seismic risk, studying the characteristics of urban soils and of the built environment means adopting a holistic vision of the city taking a step forward compared to the current microzonation approach. Based on this principle, CLARA WebGIS aims to collect, organise, and disseminate the available information on soils and buildings in the urban area of Matera. The geodatabase is populated with i) 488 downloadable geological, geotechnical, geophysical, surveys; ii) geological, geomorphological, and seismic homogeneous microzones maps and iii) a new Digital Surface Model. The CLARA WebGIS (https://smartcities-matera-clara.imaa.cnr.it/) is the first publicly available database reporting for the whole urban area the spatial distribution of the fundamental frequencies for soils and the overlying 4043 buildings, along with probability levels of soil-building resonance. The WebGIS is addressed to a broad target of end users (local government, engineers, and geologists, etc.) as a support to the implementation of seismic risk mitigation strategies in terms of urban planning, seismic retrofitting, and management of post-earthquake crises. We recommend that the database be managed by local administrators, who would also have the task of deciding on future developments and continuous updating as new data becomes available.

Both academic literature and global organizations have emphasized the need for responsible water consumption, as stated in the Sustainable Development Goal 12. However, individuals’ water-saving behaviors in their current state are not enough. This situation entails a resistance to change (RC) in consumer habits and a lack of perceived risk of scarcity. The novelty of this study lies in examining the influence of RC (through its emotional, cognitive, and confidence components) and perceived risk on water-saving intention. Interviews (n = 384) were conducted in the southeast Mediterranean area of Spain by interviewers using a paper-and-pencil questionnaire. The results of the structural equation modeling show that the perceived risk and the components of cognitive rigidity and negative emotions exert a direct influence on water-saving habits and an indirect influence on water-saving intention. None of the components of RC directly influence intention, and a lack of confidence in the outcomes of water saving does not influence water-saving habits or water-saving intention. In addition to the results obtained, the novelty of the work lies in the idea that in order to influence the perception of the risk of water scarcity through awareness campaigns, it is better to use an emotional message rather than showing facts or information, because this does not drive water saving behavior.

This study aimed to quantify the extent of heavy metal, non-metal and metalloid level of Campomanesia adamantium pulp obtained from area crossed by road of the high large vehicle traffic and intensive agriculture modern farm, and for monitoring the health risks associated with pulp human consumption. For this purpose, three spots located between this area, ripe fruits were collected in roadside, bush and margin-farm. Pulp samples were digested by microwave-assisted equipment, and mineral elements were quantified by ICP OES. The mineral elements average demonstrated no statistical difference observed between this pulp (p > 0.05). The heavy metals and metalloid concentrations that exceeded FAO/WHO standards are ordered Pb > As > Mo > Co > Ni > Mn > Cr. Therefore, among these metalloid and heavy metals, As, Pb and Cr were found higher in farm-margin > roadside > bush (1.5 × 10^-3, 1.1 × 10^-3 and 6.2 × 10^-4) respectively. Therefore, As is the most important metalloid with higher levels in farm-margin, roadside and bush (1.5 × 10^-3, 1.1 × 10^-3 and 6.2 × 10^-4 > 10^-6–10^-4 and 3.33, 2.30 and 1.34 > 1) respectively, to total cancer risk and hazard quotient, if 100 g daily of pulp are consumed.

The novel coronavirus SARS-CoV-2 likely emerged from a wildlife source with transmission to humans followed by rapid geographic spread throughout the globe and severe impacts on both human health and the global economy. Since the onset of the pandemic, there have been many instances of human-to-animal transmission involving companion, farmed and zoo animals, and limited evidence for spread into free-living wildlife. The establishment of reservoirs of infection in wild animals would create significant challenges to infection control in humans and could pose a threat to the welfare and conservation status of wildlife. We discuss the potential for exposure, onward transmission and persistence of SARS-CoV-2 in an initial selection of wild mammals (bats, canids, felids, mustelids, great apes, rodents and cervids). Dynamic risk assessment and targeted surveillance are important tools for the early detection of infection in wildlife, and here we describe a framework for collating and synthesising emerging information to inform targeted surveillance for SARS-CoV-2 in wildlife. Surveillance efforts should be integrated with information from public and veterinary health initiatives to provide insights into the potential role of wild mammals in the epidemiology of SARS-CoV-2.

Background/Purpose: In recent times, Sub-Sahara Africa (SSA) had been rated by the World Health Organization, (WHO), as the most malaria endemic region in the world. Evidence synthesis of the risk factors associated with malaria among children aged under-five in SSA is urgently needed. This would help to inform decisions that policy makers and executors in the region need to make for the effective distribution of scare palliative resources to curb the spread of the illness. This scoping review is aimed to identify studies that have used multivariate classical regression analysis to determine risk factors associated with malaria among children under-five years old in SSA. Methods/Design: The search terms followed PICOTS, (Population, Intervention, Comparator, Outcome, Timing, Setting), and were used in searching through the following databases: PubMed, MEDLINE, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, and MeasureDHS. The databases were searched for published articles from January 1990 to December 2020. Results: Among the 1154 studies identified, only thirteen (13) studies met the study’s inclusion/exclusion criteria. Narrative syntheses were performed on the selected papers to synchronise the various risk factors identified. Factors ranging from child-related, (age, birth order and use of bed net), parental/household-related, (maternal age and education status, household wealth index) and community-related variables, (community wealth status, free bed net distribution), were some of the identified significant risk factors. Conclusion: It is timely to have a synthesis of risk factors that influence the malaria status of children under-five in SSA. The outcome of the review will increase the knowledge of the epidemiology of morbidity that will form the basis for designing efficient and cost-effective distribution of palliatives and controls of malaria in SSA.

Background and objectives: Induction of labor (IOL) is an event that occurs in up to one-quarter of pregnancies; less is known about the outcomes and safety of IOL in obese pregnant woman; no data is available on misoprostol vaginal insert (MVI) IOL in high-risk pregnancy obese women. Objectives: (1) to evaluate the rate of successful IOL with 200 μg MVI in obese (Body Mass Index - BMI over 30 kg/m2) high-risk pregnant women: late-term pregnancy, hypertension or diabetes, compared to obese non-high-risk ones; (2) to evaluate the safety profile of MVI in high-risk pregnancy obese patients. Study design: We conducted a cross-sectional study in "Filantropia" Clinical Hospital, Bucharest, Romania, from June 2017 to September 2019 (28 months). From a total of 11,096 registered live births, IOL was performed in 206 obese patients; 74 obese high-risk pregnant patients matched the inclusion criteria; of these, 33.8% pregnancies (n=25) were late-term (41 – 41+6 weeks), 43.2% (n=32) had associated pathologies (hypertension and diabetes); labor induction was guided using a standardized protocol. We evaluated the maternal and gestational age, parity, fetal tachysystole, hyper-stimulation, initial cervical status, time from induction to delivery, drug side effects, mode of delivery, and neonatal outcomes. Results: (a) The overall successful labor induction rate, evaluated by the vaginal delivery rate, was 71.6% (n=53), spontaneously or instrumentally assisted; 28.4% (n=21) births were unsuccessful MVI IOL, converted into caesareans. (b) No significant differences were found regarding the maternal outcomes; in terms of perinatal outcomes of safety, four cases of high-risk pregnancies vaginally delivered were associated with neonatal intensive care unit (NICU) admissions and a one-minute Apgar score under seven (5.4%). Most cases with adverse effects of misoprostol have been managed conservatively, except for three emergency C-section cases. Conclusions: Misoprostol vaginal insert is a safe choice in IOL in obese high-risk pregnancies with good maternal and perinatal outcomes.

Background: Dental professions are at high risk of contracting novel corona virus (COVID-19) infections during the dental procedure due to the droplets and aerosols generated during various dental procedures on infected patients. To prevent and avoid the cross-infection of the infection to dental professionals or the patients attending the dental clinic, good knowledge of the infection and its prevention mechanisms is mandatory among the professionals. Until to date, there is no pooled estimate on the knowledge,attitude and practice (KAP) of dental professionals to COVID-19 in the globe. Hence, this study aimed to determine the pooled estimate of KAP of dental professionals in this pandemic disease. Methods: Article search was done electronically using Medline, Scopus, Web of Science, EMBASE, SciELO and Google Scholar from June 1, 2020 to August 20, 2020. All studies that assessed the KAP of dental professionals to COVID-19 were searched and included in this review after passing the inclusion criteria. The pooled analysis of their knowledge (sign and symptom, mode of transmission and prevention mechanisms), attitude (their concern, intention to treat suspected patients) and practice (face mask usage, hand washing and alcohol based hand rub usage, handshaking practice, deferred procedures and checkup of patients temperature) was computed using RevMan 5.3 and random effect model was used. The presence of publication bias was assessed using the funnel plot. Results: Twelve articles with a total of 5,362 study participants were included in this study. The pooled estimate revealed that 59.91% of the dental professionals had good knowledge of the signs and symptoms of COVID-19. Two-third of dental professionals know the prevention mechanisms of the infection, and 70.13% had enough knowledge of the transmission modalities of the infection. The professional attitude revealed that only 36.43% of the participants had intention to treat a patient with cough or suspected COVID-19 (36.43%, 95%CI: 8.57, 64.29). Moreover, 47.85% of the dentists were concerned about their life, and the fate of their profession due to this pandemic disease (47.85%, 95%CI: 26.74, 68.97). The pooled analysis showed only 50.86% (95%CI: 18.64, 83.09) of the study participants worn face mask and 52.63% (95%CI: 10.54, 94.71) had avoided handshaking practice during this pandemic period. Non-emergency dental procedures were canceled by 83.98%. Conclusion: The dental professional KAP is not optimal. Thus, dental professionals should be aware of the recently updated knowledge about COVID-19 and practice according to the standards of treatment guidelines, and the recommended infection control measures in dental settings. Moreover, as saliva and droplets are the major sources of infection, dentists should follow essential protocols to regulate droplet and aerosol contamination in the dental practice

Among others, road traffic, industrial emissions, commercial activities, smoking and cooking are considered as major contributing factors for the increasing levels of pollutants in atmosphere. High levels of potentially toxic metals and microbes in atmosphere, especially in indoor air, may pose serious threat to human health. Therefore, concentration and associated health risks of potentially toxic trace metals (Cd, Cr, Cu, Fe, Mn, Pb, and Zn) and their risk to human health, and microbial load in indoor air was assessed using air condition (AC) filter dust samples collected from 5 locations representing residential, agricultural and industrial settings of Eastern Province, Kingdom of Saudi Arabia. The levels of trace metals varied considerably among sampling areas, with the highest levels of Cr and Cd recorded in the Industrial-area sites followed by the Agricultural and Urban-Residential sites. The highest levels of Pb and Fe were found in the Agricultural area sites followed by the Industrial and Urban-Residential area sites. The metals in dust sample, especially Cd, Cr and Pb, showed a considerable health risk through dermal pathway. Among the sites, the highest hazard quotient for these metals was found for Al-Qatif-Industrial areas sites and among the metals it was the highest for Cd. The cancer risk from the metals contained in AC filter dust was negligible. Samples collected from Agricultural and Industrial area sites were substantially contaminated with bacteria and fungi, respectively. Bacterial contaminants were mostly Gram Negative, with considerable antibiotic resistance and haemolytic activity. Thus, indoor air quality as assessed by AC filter dust depicted that a considerable health risk could be posed by the trace heavy metals and microorganisms for a long-term exposure. Furthermore, this study demonstrated that AC filters dust could be a unique and reliable test sample for the assessment of indoor environment.

World statistics demonstrate that around 970 million people around the globe suffer from mental health problems (Ritchie & Roser, 2019), a major proportion of which comprised of adolescents and young adults (UNODC, 2018). Also, because of increased mental health issues the problems like substance use, suicide, depression, anxiety, and stress are also increasing (Armstrong, 2019; Bandelow & Michaelis, 2015; Ritchie & Roser, 2018; United Nations Office on Drugs and Crime [UNODC], 2019). It is thus a dire need to address the issue. The present coneptual paper proposed the role of transpersonal gratitude, emotional intelligence, and life contentment for reducing mental health risk among the adolescents and young adults.

Total Hip Arthroplasty is one of the most successful surgery. However, due to the worldwide growing population life expectancy and the related incidence of age-dependent bone diseases, a growing number of cases of intra-operative fractures lead to revision surgery with high rates of morbidity and mortality. Surgeons choose the type of the implant, either cemented or cementless prosthesis, on the basis of the age, the quality of the bone and the general medical conditions of the patients. Generally, no quantitative measures are available to assess the intra-operative fracture risk. Consequently, the decision-making process is mainly based on medical operators’ expertise and qualitative information obtained by imaging. Motivated by this scenario, we here propose a mechanical-supported strategy to assist surgeons in their decisions, by giving intelligible maps of the risk fracture which take into account the interplay between actual strength distribution inside the bone tissue and its response to the forces exerted by the implant. To this end, we produce charts and patient-specific synthetic “traffic-light” indicators of fracture risk, by making use of ad hoc analytical solutions to predict the stress levels in the bone by means of CT-based mechanical and geometrical parameters of the patient. We felt that, if implemented in a friendly software or proposed as an app, the strategy could constitute a practical tool to help the medical decision-making process, in particular with respect to the choice of adopting cemented or cementless implant

The recent detection of SARS-CoV-2 RNA in feces has led to speculation that it can be transmitted via the fecal-oral/ocular route. This review aims to critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in feces and urine, and whether these pose an infection risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. rivers, lakes and marine waters). Overall, severe GI dysfunction is only evident in a small number of COVID-19 cases, with 11 ± 2% exhibiting diarrhea and 12 ± 3% exhibiting vomiting and nausea. In addition to these cases, SARS-CoV-2 RNA can be detected in feces from some asymptomatic, mildly- and pre-symptomatic individuals. Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. SARS-CoV-2 RNA is occasionally detected in urine, but reports in fecal samples are more frequent. The abundance of the virus genetic material in both urine (ca. 10²-10⁵ gc/ml) and feces (ca. 10²-10⁷ gc/ml) is much lower than in nasopharyngeal fluids (ca. 10⁵-10¹¹ gc/ml). There is strong evidence of multiplication of SARS-CoV-2 in the GI tract and infectious virus has occasionally been recovered from both urine and stool samples. The level and infectious capability of SARS-CoV-2 in vomit remain unknown. In comparison to enteric viruses transmitted via the fecal-oral route (e.g. norovirus, adenovirus), the likelihood of SARS-CoV-2 being transmitted via feces or urine appears lower due to the lower relative amounts of virus present in feces/urine. The biggest risk of transmission will occur in clinical and care home settings where secondary handling of people and urine/fecal matter occurs. In addition, while SARS-CoV-2 RNA genetic material can be detected by in wastewater, this signal is greatly reduced by conventional treatment. Our analysis also suggests the likelihood of infection due to contact with sewage-contaminated water (e.g. swimming, surfing, angling) or food (e.g. salads, shellfish) is extremely low or negligible based on very low predicted abundances and limited environmental survival of SARS-CoV-2. These conclusions are corroborated by the fact that over eight million global cases of COVID-19 have occurred, but exposure to feces or wastewater has never been implicated as a transmission vector.

Since the beginning of the year 2020, the global healthcare system has been challenged by the threat of the SARS-COV 2 virus. Molecular, antigen, and antibody testing are the mainstay to identify infected patients and fight the virus. Molecular and antigen tests that detect the presence of the virus are relevant in the acute phase only. Serological assays detect antibodies to the Sars-CoV-2 virus in the recovering and recovered phase. Each testing methodology has its advantages and disadvantages. To evaluate the test methods, sensitivity (percent positive agreement - PPA) and specificity (percent negative agreement – PNA) are the most common metrics utilized, followed by the positive and negative predictive value (PPV and NPV), the probability that a positive or negative test result represents a true positive or negative patient. In this paper, we illustrate how patient risk and clinical costs are driven by false-positive and false-negative results. We demonstrate the value of reporting PFP (probability of false positive results), PFN (probability of false negative results), and costs to patients and healthcare. These risk metrics can be calculated from the risk drivers of PPA and PNA combined with estimates of prevalence, cost, and Reff number (people infected by one positive SARS COV-2).

Cardiovascular diseases (CVDs) constitute the first cause of death among the population of developing and developed countries. Atherosclerosis, which is a disorder with multifactorial etiopathogenesis, underlies most CVDs. The available literature includes ample research studies on the influence of classic cardiovascular (CV) risk factors. However, environmental exposure to heavy metals, among other substances, is still an unappreciated risk factor of CVDs. This study aimed to assess the concentration of some heavy metals (copper (Cu), zinc (Zn), manganese (Mn), cobalt (Co), and iron (Fe)) in the blood serum of postmyocardial infarction (post-MI) patients and patients free from myocardial infarction (MI) as well as estimate the relationship between the occurrence of MI and increased concentration of heavy metals. The concentration of heavy metals (Cu, Zn, Mn, Co, and Fe) was assessed using the inductively coupled plasma mass spectrometry technique in a group of 146 respondents divided into two groups: post-MI group (study group (SG), n = 74) and group without cardiovascular event (CVE) having a low CV risk (control group (CG), n = 72). The concentration of the analyzed heavy metals was higher in SG. All the heavy metals showed a significant diagnostic value (p < 0.001). The highest value of area under the curve (AUC) was observed for manganese (Mn) (0.955; 95% confidence interval (CI) = 0.922–0.988), while the lowest value was found for zinc (Zn) (0.691; 95% CI = 0.599–0.782). In one-dimensional models, high concentrations of each of the analyzed heavy metals significantly increased the chances of having MI from 7-fold (Cu) to 128-fold (Mn). All the models containing a particular metal showed a significant and high discrimination value for MI occurrence (AUC 0.72–0.92). Higher concentrations of Cu, Zn, Mn, Co, and Fe were found to considerably increase the chances of having MI. Considering the increasingly higher environmental exposure to heavy metals in recent times, their concentrations can be distinguished as a potential risk factor of CVDs.

This purpose was to compare the ability of body shape index (ABSI) and body roundness index (BRI) with waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body adiposity index (BAI) to predict metabolic risk. The cross-sectional study was conducted in 17,360 Chinese subjects (were aged 18-95 years old) who escaped cardiovascular disease (CVD) or diabetes. Biochemical and anthropometric variables were measured by trained staff. Receiver operating characteristic curve (ROC) and optimal cutoff values of obesity indices were recruited to compare the predictive ability for metabolic risk factors. The mean age of subjects was 53.7(13.1) years, 41.6 % were males. Within young group (<60 years), the areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to similarly predict high metabolic risk in males (0.74 vs. 0.74 vs. 0.73 vs. 0.73 vs. 0.73) and in females (0.73 vs. 0.73 vs. 0.71 vs. 0.73 vs. 0.73), while the approximate predictive ability were only acquired in males (0.73 vs. 0.73 vs. 0.70 vs. 0.73 vs. 0.73) within elder group (≥60 years). The optimal cut-off values of BRI for high metabolic risk were calculated in males (<60 y: 3.49 vs. ≥60 y: 3.46) and females (<60 y: 3.47 vs. ≥60 y: 3.60). Meanwhile, BRI displayed a strong prediction to elevated BP and elevated TG in males (AUC = 0.64; AUC = 0.70) and to elevated BP, elevated TG and elevated SUA in females (AUC = 0.67; AUC = 0.69; AUC =0.70). BRI was able to similarly predict high metabolic risk compared to WC, BMI, WHR, WHtR and BAI, while ABSI was not. Moreover, BRI revealed specific predictive ability for elevated BP, elevated TG and elevated SUA.

Objectives: COVID-19, a respiratory disease caused by SARS-COV2 and transmitted from person-to-person through viral droplets remains a global pandemic. There is a need to understand the transmission modes, populations at risk, and how to mitigate the spread and case fatality in the United States (US) and globally. The current study aimed to assess the global COVID-19 transmission and case fatality, examine similar parameters by countries and determine evidence-based practice in extreme epidemiology response in epidemic curve flattening and case fatality reduction. Methods: A cross-sectional ecologic design was used to assess the preexisting data on confirmed COVID-19 cases and mortality in March 2020 from the CDC, WHO, Worldodomter, and STATISTA. A rapid assessment between March 23^rd and 31^st, 2020, was utilized for the extreme epidemiology response. The case fatality, termed fatality proportion, was examined using mortality in relation to confirmed cases involving the world, United States of America (USA), United Kingdom (UK), Italy, France, Spain, China, Germany, India and South Korea. Results: The COVID-19 is a global pandemic, with the US as the epicenter for transmission, representing 20.9% of all confirmed cases worldwide, while Italy is the epicenter for case fatality, 30.6% of mortality as at 03/31/ 2020. The fatality proportion (FP) in Italy was 11.4%, Spain (8.8%), France (6.8%) and UK (6.4%). Despite the increased number of confirmed cases, the lowest FP was observed in Germany (0.96%) and South Korea (1.66%). There is increasing linear tends in transmission in the US, R²=0.97 as well as positive daily percentage change, ranging from 1.27% to 20.5%. Conclusions: The USA remains the epicenter for COVID-19 transmission, while Italy is the epicenter for case fatality. The observed relatively low case fatality in Germany and South Korea is due to an “extreme epidemiology” response through the application of Wuhan, China’s early data on COVID-19 transmission control measures and optimized patient care. These data are suggestive of relaxing the clinical guidelines in the United States in COVID-19 testing, application of contact tracing and testing, case isolation and most importantly enhancing resources for case management and social and physical distancing globally, hence epidemic curve flattening and case fatality reduction.

When discussing the concepts of risk, safety, and security, people have an intuitive understanding of what these concepts mean, and, to a certain level, this understanding is universal. However, when delving into the real meaning of these concepts, one is likely to fall into semantic debates and ontological discussions. In industrial parks, it is important that (risk) managers from dierent companies, belonging to one and the same park, have the same understanding of the concepts of risk, safety, and security. It is even important that all companies in all industrial parks share a common understanding regarding these issues. As such, this paper explores the similarities and dierences behind the perceptions of these concepts, to come to a fundamental understanding of risk, safety, and security, proposing a semantic and ontological ground for safety and security science, based on an etymological and etiological study of the concepts of risk and safety. The foundation has been induced by the semantics used in the ISO 31000 risk management guidance standard. Hence, this article proposes a coherent, standardized set of concepts and definitions with a focus on the notion “objectives” that can be used as an ontological foundation for safety and security science, linking “objectives” with the concepts of safety, security, risk, performance and also failure and success, theoretically allowing for an increasingly more precise understanding and measurement of (un)safety across the whole range of individuals, sectors and organizations, or even society as a whole.

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

Land use and land cover change (LULCC) is a critical factor for enhancing the soil erosion risk and land degradation process in the Wabi Shebelle Basin. Up-to-date spatial and statistical data on basin-wide erosion rates can provide an important basis for planning and conservation of soil and water ecosystems. The objectives of this study were to examine the magnitude of LULCC and consequent changes in the spatial extent of soil erosion risk, and identify priority areas for Soil and Water Conservation (SWC) in the Erer Sub-Basin, Wabi Shebelle Basin, Ethiopia. The soil loss rates were estimated using an empirical prediction model of the Revised Universal Soil Loss Equation (RUSLE) outlined in the ArcGIS environment. The estimated total annual actual soil loss at the sub-basin level was 1.01 million tons in 2000 and 1.52 million tons in 2018 with a mean erosion rate of 75.85 t ha^–1 y^–1 and 107.07 t ha^–1 y^–1, respectively. The most extensive soil loss rates were estimated in croplands and bare land cover, with a mean soil loss rate of 37.60 t ha^–1 y^–1 and 15.78 t ha⁻¹ y⁻¹, respectively. The soil erosion risk has increased by 18.28% of the total area, and decreased by 15.93%, showing that the overall soil erosion situation is worsening in the study area. We determined SWC priority areas using the Multi-Criteria Decision Rule (MCDR) approach, indicates that the top three levels identified for intense SWC account for about 2.50%, 2.38%, and 2.14%, respectively. These priority levels are typically situated along the steep slopes in Babile, Fedis, Fik, Gursum, Gola Oda, Haramaya, Jarso, and Kombolcha districts that need emergency SWC measures.

This retrospective study aimed to investigate the effect of known risk factors on nonsurgical periodontal treatment (NSPT) response using a pocket depth fine-tuning multilevel linear model (MLM). Thirty-seven patients (24 males and 13 females) with moderate to severe chronic periodontitis were treated with nonsurgical periodontal therapy. Follow-up visits at 3, 6, and 12 months included measurement of several clinical periodontal parameters. Data were extracted from a database system. Probing depth (PD) and Clinical Attachment Loss (CAL) reductions after NSPT in an overall of 1416 initially affected sites (baseline PD ≥ 4 mm), distributed on 536 teeth, were analyzed against known risk factors at three hierarchical levels (patient, tooth and site). The variance component models fitted to assess the three-level variance of PD and CAL decrease for each post-treatment follow-up showed that all levels contributed significantly to the overall variance (P < 0.001). Patients that underwent NSPT and were continually monitored had very curative results. All three hierarchical levels included risk factors who had impact on the to influence the magnitude of PD and CAL reduction. Specifically, the tooth’s type, surfaces involved and teeth mobility site-level risk factors showed the highest influence on these reductions, being highly relevant factors for the NSPT success.

In 2014, the International Union for Conservation of Nature adopted the Red List of Ecosystems (IUCN RLE) criteria as the global standard for assessing risks to terrestrial, marine, and freshwater ecosystems. Identifying and quantifying the impacts of biodiversity assessments on the status of nature is key to justifying continued investment in assessments and enabling strategic planning to maximize future impact. In this policy perspective, we use an established impact evaluation framework to identify the impacts of the IUCN RLE since its inception. To date, 1,397 ecosystem units in 100 countries have been assessed following the IUCN RLE protocol. Systematic assessments are complete or underway in more than 25 countries and two continental regions (the Americas and Europe). Countries with established ecosystem red lists have already used them to inform legislation, land-use planning, protected area expansion, monitoring and reporting, and ecosystem management. IUCN RLE indices based on systematic assessments have high potential to inform global biodiversity reporting for the Aichi Targets and the United Nations Sustainable Development Goals. Expanding the coverage of IUCN RLE assessments, building capacity to undertake them, and establishing stronger policy instruments to manage red-listed ecosystems will be key to maximizing conservation impacts over the coming decades.

Purpose: Expanded carrier screening (ECS) informs couples of their risk of having offspring affected by certain genetic conditions. Limited data exists assessing the actions and reproductive outcomes of at-risk couples (ARCs). We describe the impact of ECS on planned and actual pregnancy management in the largest sample of ARCs studied to date. Methods: Couples who elected ECS and were found to be at high risk of having a pregnancy affected by at least one of 176 genetic conditions were invited to complete a survey about their actions and pregnancy management. Results: Three hundred ninety-one ARCs completed the survey. Among those screened before becoming pregnant, 77% planned or pursued actions to avoid having affected offspring. Among those screened during pregnancy, 37% elected prenatal diagnostic testing (PNDx) for that pregnancy. In subsequent pregnancies that occurred in both the preconception and prenatal screening groups, PNDx was pursued in 29%. The decision to decline PNDx was most frequently based on the fear of procedure-related miscarriage, as well as the belief that termination would not be pursued in the event of a positive diagnosis. Conclusions: ECS results impacted couples’ reproductive decision-making and led to altered pregnancy management that effectively eliminates the risk of having affected offspring.

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

This research investigates the relationship among human knowledge, behavior, and risk as they relate to urban chicken husbandry in the U.S. Concern over zoonotic diseases has been on the rise, especially with increasing contact. In particular, avian influenza, or bird flu, Salmonella enterica (salmonella), and Escherichia coli (E. coli), can all cross species lines between people and poultry. This study analyzed knowledge and practices in urban chicken husbandry to assess how they relate to risk of disease acquisition, hypothesizing that certain practices associated with a lessened knowledge base may heighten the risk. This study used social surveys to examine the self-reported knowledge base of individuals involved in chicken husbandry as they relate to beliefs and behaviors associated with the care of these animals. These results identify key factors that may heighten the risk of disease transmission, and demonstrate that an increased knowledge base could act to lessen this risk.

Persistent cervical infection with high-risk Human papillomaviruses (hrHPVs) is a necessary, but not sufficient, condition for the development of cervical cancer. Therefore, there are other co-factors facilitating the hrHPV carcinogenic process, one of which is smoking. In order to assess the effect of smoking on high-risk (hr) HPV DNA positivity and on the expression of HPV E7 oncoprotein, as a surrogate of persistent hrHPV infection, we used data from women recruited for the PIPAVIR project, which examined the role of E7 protein detection in cervical cancer screening. Women were tested for hrHPV DNA, using Multiplex Genotyping and E7 protein, using a novel sandwich ELISA method, and gave information on their smoking habits. Among 1473 women, hrHPV prevalence was 19.1%. The odds ratio (OR) for hrHPV positivity of smokers compared to non-smokers was 1.785 (95%CI: 1.365-2.332, p<0.001). The ORs for E7 positivity, concerning hrHPV positive women, ranged from 0.720 to 1.360 depending on the E7 detection assay used, but this was not statistically significant. Smoking increases the probability of hrHPV infection, and smoking intensity is positively associated to this increase. Smoking is not related to an increased probability of E7 protein positivity for hrHPV positive women.

A reliability-based criterion to estimate strength amplification factors for buildings with asymmetric yielding located within a seismic region presenting different soil conditions is proposed and applied. The approach involves the calculation of the mean annual rate of exceedance of structural demands of systems with different levels of asymmetric yielding. Two simplified mathematical expressions are developed considering different soil conditions of the valley of Mexico. The mathematical expressions depend on the ductility of the structural systems, their level of asymmetric yielding, their fundamental vibration period and the dominant period of the soil. In addition, the proposed expressions are compared with that recommended by the current Mexico City Building Code (MCBC). Since the expressions are developed with the help of simplified structural systems, the validity of such expressions is corroborated by comparing the expected ductility demand of multi-degree of freedom (MDOF) structural systems with respect to that of their equivalent simplified systems. Both structural representations are associated with a given annual rate of exceedance value of an engineering demand parameter. The expressions proposed in this study will be incorporated in the new version of the MCBC.

The paper presents the results of the theoretical and practical research on developing the infrastructure for assessment of overall risk (explosion / occupational / terrorist attack) associated with unwanted events such as major accidents that can occur at explosive storehouses for civilian use. The scientific research outlined in this article was carried out within the Nucleu Project PN 16 43 02 15 - “Research on increasing safety levels at technical facilities for storage of explosives for civil use”.

Understanding the vulnerability of areas and the likelihood of specific disasters, particularly earthquakes, is one of the most important issues in Iran. One of the major concerns in Iran is the resilience of rural communities. The present study is devoted to spatial analysis of risk in rural areas and the evaluation of preparedness in the rural districts of the city of Abhar. In particular, this study evaluates the resilience to earthquakes. The research was conducted in two parts in which the first part has used the VIKOR Multiple criteria decision making model as well as the employment of this model in the ArcGis. The second part of the study used field studies, in the form of questionnaires, to evaluate the readiness of the local population against the risks of earthquakes. Four indicators, individual, physical, economic abilities and access, were assessed. The population included rural districts, where statistical samples were villagers. Results of the spatial analysis indicated that 15 villages are in the high-risk areas, 24 villages were in the medium-risk areas and all other villages were in low-risk areas. In terms of readiness of the locals, the results indicated a lack of planning with regards to the four mentioned indicators.

Georgia is ranked fifth highest among states for rates of HIV diagnosis. About 4% of persons living with HIV infection in the United States reside in Georgia, and almost 19% of these people do not know their HIV status. The present study examined the trends and associated factors of HIV testing among adults in Georgia between 2010 and 2014 by analyzing data of the Behavioral Risk Factor Surveillance System (BRFSS). A total of 30,791 persons aged ≥18 years were identified who responded to the question “Have you ever been tested for HIV?” Overall, there were 11,543 respondents who had been tested for HIV, with a decrease in percentage from 49.4% in 2010 to 43.7% in 2014 (p<0.001). Factors associated with HIV testing were being black (p<0.001), being younger than 55 years (p<0.001), single (p=0.02), attaining education level above high school (P<0.001), engaging in HIV high-risk behaviors (p<0.001), and not having healthcare coverage (p=0.03). Overall in Georgia, there has been a decline in the temporal trend of HIV testing, and more than half of adults have never been tested for HIV. For reducing HIV transmission in Georgia, enhancing access and utilization of HIV testing should be a public health priority.

Human papillomavirus (HPV), a DNA virus, causes one the most common sexually transmitted infections (STI), spreading through direct sexual contact to the anogenital and oropharyngeal regions. Although most infected individuals may be asymptomatic and naturally undergo viral clearance, in some individuals HPV causes carcinogenesis of the infected epithelia. HPV now accounts for over 70% of oropharyngeal carcinomas (OPC). More than 90% of these OPC are associated with HPV 16, one of the 14 high-risk subtypes. In recent years, HPV positive (HPV+) OPC has been one of the most rapidly rising cancers, by new cancer incidence rates, especially among men. The HPV driven OPCs present some unique infection driven cellular and molecular features, constituting distinct preventive, therapeutic and prognostic strategies, in contrast to HPV negative (HPV-) OPC. In this manuscript, we drive through the role of HPV, from a sexually transmitted infection to malignancy transformation landscape, while parsing through the significant immune response environment. In this comprehensive review we collate key literature around transmission and epidemiology of HPV, while addressing the current state of clinical management, diagnosis, prevention and screening strategies, that can help shed light on this critical area.

In computer vision, human action recognition is a hot topic, popularized by the development of deep learning. Current models have achieved high accuracy results on public datasets. Despite this success, they require significant computational resources for training. Given that transfer learning based techniques allow reusing what other models have already learned and training models with less computational resources, in this work we propose using a transfer learning based approach for action recognition in videos. We describe a methodology for human action recognition using transfer learning techniques in a custom dataset. The proposed method consists of four stages: 1) human detection and tracking, 2) video preprocessing, 3) feature extraction (using pretrained models with ImageNet), and 4) action recognition using a two-stream model consisting of TCNs, LSTMs, and CNNs layers. The custom dataset is imbalanced with 189, 390, 490, 854, and 890 videos per class, respectively. For feature extraction, we analyzed the performance of seven pretrained models: Inception-v3, MobileNet-v2, MobileNet-v3-L, VGG-16, VGG-19, Xception, and ConvNeXt-L. We show that the best results were obtained with the last one. Finally, using pretrained models for feature extraction allowed training in a PC with a single GPU with an accuracy of 94.9%.

Hormone changes across women's menstrual cycle may lead to changes in perception of chemical signals and hormonal responses to these cues. The aim of the present study was to determine the role of menstrual cycle phase on the effects of extracts of male axillary secretions (EMAS) in women. We tested healthy reproductive age and premenopausal women (n=29). EMAS/control solution was applied once in two hours either in the follicular or luteal phase, while collecting saliva samples for LH and cortisol monitoring. LH and cortisol concentrations were analyzed using EIA technique. PANAS and VAS were used to assess the mood. We observed a significant increase in the number of LH peaks (p=0.0447) and their amplitude (p=0.0469) when EMAS was applied in the follicular phase. The same application in the luteal phase lowered the amplitude of LH peaks (p=0.0382). EMAS application increases salivary cortisol level in reproductive age women relative to premenopausal women (p=0.0032). PANAS revealed changes in positive and negative affect after EMAS application. Our data indicate the significance of the menstrual cycle phase for EMAS effects on LH secretion, mood, but not on cortisol secretion in women.

To elucidate mesenchymal stromal cells (MSC)-tumor intricate and ambiguous interactions, the reliable cell labeling and tracking techniques are imperative. Traditional methods of cell labelling have limitations mostly relevant to need for genetic modification what demands the exploration for alternative strategies. Here, we propose using fluorescent photoconvertible microcapsules containing Rhodamine B (RhB) to study mMSC migration in brain tumors. These 3 μm sized microcapsules are readily internalised by cells and undergo photoconversion under 561 nm laser exposure with fluorescence blue shift on demand. Optimal photoconversion was achieved with a laser irradiation duration of 0.4 ms, which provide a maximal brightness of photoconverted label without an excessive laser exposure on cells. Capsules modified with polyallylamine hydrochloride demonstrated the best potential for intracellular uptake without significantly affecting cell viability, motility, or proliferation. The optimal ratio of 20 capsules per mMSC was determined for labeling. Moreover, migration of individual mMSCs within 2D and 3D glioblastoma cell (EPNT-5) colonies over 2 days and in vivo tumor settings over 7 days was tracked. Our study unveils a robust platform for investigating MSC-tumor dynamics, offering insights into therapeutic strategies. Photoconvertible microcapsules could also become an indispensable tool for studying complex fundamental processes of cell-cell interactions for a wide range of problems in biology and medicine.

Maternal diet plays a significant role in the fatty acid composition of breast milk. Natural trans fatty acids (TFAs) are generated through the biohydrogenation of unsaturated fatty acids (FAs) in the rumen of animals by bacterial isomerases and are consequently found in milk, dairy products, and meat from ruminant animals. Dietary products such as milk and meat are the primary sources of natural TFAs for humans, derived from rumen fermentations. These peculiar fatty acids hold nutritional significance as they not only lack the detrimental effects on endothelium characteristic of industrially produced trans fat, but also exhibit anti-inflammatory properties. The relationship between the presence in breast milk of eight fatty acids (including natural TFAs trans-vaccenic and conjugated linoleic acid) and maternal diet has been explored, and their abundance has been compared to that of infant formulas. Two cohorts of lactating women participated in this study, originating from a Spanish region adhered to the Southern European Atlantic Diet or Atlantic Diet. While the consumption of conventional meat or dairy products does not seem to increase the abundance of trans fatty acids in breast milk, trans-vaccenic and oleic acid are among the most distinctive features of breast milk fat in mothers consuming naturally improved dairy products, with an improved fatty acid profile. The most significant differences between natural breastfeeding and formula feeding lie in natural trans fatty acids, since formula are notably deficient, while overfortified in alpha-linolenic acid in comparison to breast milk.

The cyber physical systems of smart cities are facing increasingly severe attack situations, and traditional separate protection methods are difficult to effectively respond to. It is urgent to coordinate public security and network security protection. However, the integration of the two faces many challenges and is a very promising research field. The aim of this study is to investigate technical approaches for the synergy between public safety and cyber security. This paper proposes a smart city safety protection model inspired by the human immune mechanism. It was found that through a three line defense architecture similar to the human immune mechanism, and with the help of certain algorithms and functional middleware modules, public security and network security protection components can be dynamically combined to achieve collaboration. This work has verified through experiments a promising path to effectively resist complicated attack threats intertwined with public safety and cyber security factors.

We report the case of a 28-year-old male with uncontrolled human immunodeficiency virus (HIV) infection who presented with extensive ulcerated lesions with dark lamellated crusting on his face, torso, and limbs. The patient had an RPR of 1:512. A skin biopsy revealed granulomata surrounded by lymphocytes, histiocytes, and plasma cells, with spirochetes visible on immunohistochemical staining. This severe form of secondary syphilis has been termed malignant syphilis, lues maligna, ulceronodular syphilis, and rupioid syphilis, among other names. The patient’s rash resolved with hyperpigmented scarring after treatment with penicillin and doxycycline. First, we propose a single descriptive name for this entity, ulceronodular-rupioid syphilis. In 1967, Fisher and coworkers proposed criteria for malignant syphilis based on lesion appearance, RPR values, histopathologic findings, the occurrence of the Jarisch-Herxheimer reaction, and response to treatment. However, the Fisher criteria were found to be imprecise. Thus, we examined the features of an additional 74 cases from the medical literature and propose new diagnostic criteria based on rash appearance, histopathologic characteristics, non-treponemal and treponemal test positivity, and response to therapy. We also found that uncontrolled viremia and not a low CD4 count is a major risk factor for this severe manifestation of secondary syphilis in the HIV population.

In an era where dietary habits significantly impact health, technological interventions can offer personalized and accessible food choices. This paper introduces Chef Dalle, a recipe recommen-dation system that leverages multimodal human-computer interaction (HCI) techniques to pro-vide personalized cooking guidance. The application integrates voice-to-text conversion via Whisper, ingredient image recognition through GPT-Vision, and employs TF-IDF vectorization alongside cosine similarity for personalized recipe recommendations. These methods enable users to interact with the system using voice, text, or images, accommodating various dietary re-strictions and preferences. Furthermore, the utilization of DALL-E 3 for generating recipe images enhances user engagement. User feedback mechanisms allow for the refinement of future rec-ommendations, demonstrating the system's adaptability. Chef Dalle showcases potential appli-cations ranging from home kitchens to grocery stores and restaurant menu customization, ad-dresses accessibility, promoting healthier eating habits. This paper underscores the significance of multimodal HCI in enhancing culinary experiences, setting a precedent for future developments in the field.

Contamination in coastal regions attributed to fluoride and nitrate cannot be disregarded, given the substantial environmental and public health issues they present worldwide. Maintaining water quality is crucial for environmental well-being. This comprehensive study was performed to assess the spatial as well as indexical water quality, identify contamination sources, and evaluate associated health risks pertaining to nitrate and flouride in AlHassa region, KSA. The physiochemical results revealed a pervasive pollution of the overall groundwater. The dominant water type was Na-Cl, indicating saltwater intrusion and reverse ion exchange impact. Spatiotemporal variations in physicochemical properties suggest diverse hydrochemical mechanisms, with geogenic factors primarily influencing groundwater chemistry. The groundwater pollution index varied between 0.8426 and 4.7172, classifying samples as moderately to very highly polluted. Similarly, the synthetic pollution index (in the range of 0.5021-4.0715) revealed that none of the samples had excellent water quality, with various degrees of pollution categories. Nitrate Health Quotient (HQ) values indicated chronic human health risks ranging from low to severe, with newborns being the most vulnerable. Household use of nitrate-rich groundwater for showering and cleaning did not pose significant health risks. Fluoride HQ decreased with age, and children faced the highest risk of fluorosis. The Hazard Index (HI) yielded moderate to high-risk values. Nitrate risks were 1.21 times higher than fluoride risks, as per average HI assessment. All samples fell into the vulnerable category based on the Total Hazard Index (THI), with 88.89% classified as very high risk. This research provides valuable insights into groundwater quality, guiding water authorities, inhabitants, and researchers in identifying safe water sources and vulnerable human populations. The results highlight the need for appropriate treatment techniques and long-term coastal groundwater management plans.

We develop new theory from a broad case-study approach to explore a better understanding of what constitutes knowledge and its value as identifiable to human-machine teams. From past research, this trail of exploration will lead to these initial questions: What is the value of debate in the furtherance of knowledge? Will machines with AI be able to contribute to a debate if we humans cannot define it or determine its value sufficiently for a machine’s understanding, contribution, exploration and identification? Like humans, as teammates, machines must be able to determine with AI what constitutes the usable knowledge that contributes to a team’s success in the field (e.g., testing "knowledge" in the field, identifying new knowledge, using knowledge to develop innovation) or its failure (viz., trouble shooting; identifying weaknesses; discovering vulnerabilities, hiding by deception). It matters not whether a debate is public, private or unexpressed by an individual human or machine agent alone; we speculate in this exploration that the process advances the science of autonomous human-machine teams and assists in interpretable machine learning. We conclude with questions and a speculation: How does a human become aware or express its awareness of knowledge? Can a machine be as expressive as its human teammates? And how does a human-machine teammate become aware that its teammates possess sufficient knowledge to perform a task? We speculate that the structure of “knowledge," once found, is resistant to alternatives (i.e., it is ordered); that its functional utility is generalizable; and that its applications are multifaceted (akin to maximum entropy production). The complexity of the team is taken into consideration in our search for knowledge, which can also be used as an information metric.

To better understand anogenital warts (AGW) natural history and dynamic of HPV6/11 infection in regional hairs, 32 newly diagnosed AGW male patients and 32 age-matched healthy controls were closely followed. During enrollment and six follow-up visits (every 2.6 months) 43 AGW tissue and 1,232 anogenital and eyebrow hair samples were collected. This represents the closest longitudinal monitoring of AGW patients to date. Patients were treated according to standard-of-care. HPV6/11 prevalence was 19.9% in patients’ hair samples (HPV6 B1 in 87.5%) and 0% in controls. The highest HPV6/11 prevalence was found in pubic hairs (29.0%) and lowest in eyebrows (7.1%). Odds for HPV6/11-positive hairs increased with smoking, shaving anogenital region and age. A close association between HPV6/11 presence in hairs and clinically visible AGW was observed. The proportion of patients with visible AGW and HPV6/11-positive hairs declined during follow-up with similar trends. No particular HPV6/11 variant was linked with increased AGW recurrence, but sublineage HPV6 B1 showed significantly higher clearance from hairs. Despite treatment, 78.1% and 62.5% of AGW patients experienced one and two/more post-initial AGW episodes, respectively. Patients having HPV6/11-positive hairs or visible AGW at preceding visit demonstrated substantially higher odds for presenting with visible AGW in subsequent visit.

(1) Background/Objectives: Accurate determination of chronological age is crucial in legal dental identification. This study aimed to compare the effectiveness of different formulas in estimating the age of a Brazilian subpopulation by analyzing the pulp/tooth ratio of the maxillary canine and mandibular second premolar in panoramic and periapical radiographs. (2) Methods: The sample consisted of panoramic and periapical radiographs of 247 individuals. The file of each radiograph was opened in the Adobe Photoshop CS4® program to outline and obtain values in pixels for calculating the pulp/tooth ratio. Statistical analysis was conducted using the SPSS program, with a significance level set at 5%. (3) Results: The interclass correlation coefficient demonstrated excellent intra-observer agreement (0.990 – 0.999). The determination coefficients (R2) suggested that only 30-35% of the actual age results could be explained by the pulp/tooth ratio. Smallest differences were observed with Cameriere's formula for the mandibular second premolar on panoramic radiographs (+4.1 years). The greatest differences were found with the formulas for the mandibular second premolar in panoramic radiographs of the Korean (+12.5 years) and Portuguese (-12.1 years) populations. (4) Conclusions: The equations employed allowed for estimating the age of a Brazilian subpopulation and showed little agreement between the actual age and the estimated age.

This article delves into the complex tension between national self-rule and international involvement, in the context of global politics, examining the inherent challenges of upholding both principles when confronted with human rights abuses and the pursuit of global peace. The introduction presents the fundamental dilemma: self-governance versus moral obligations. The problem statement calls for a nuanced approach to address the intricate complexities of sovereignty and intervention, acknowledging the potential misuse by oppressive regimes and the ongoing challenges of determining when and how intervention is warranted. The article advocates for a more responsible and effective approach to global conflicts and human rights violations, balancing national sovereignty with judicious intervention when required. The methodology employs both literature review and case analysis to construct a framework for objectively assessing when international intervention is justified in instances of human rights abuses. The conclusion stresses the criticality of objective intervention criteria, transcending cultural, political, and economic biases, and advocates for a globally accepted approach that celebrates diversity while promoting global stability.

Heavy metal pollution poses a significant threat to global populations, particularly impacting human health. Developing countries, characterized by chemical engineering and mining industrial activities, often contribute to diverse heavy metal contaminants. Consumption of water contaminated with heavy metals, prevalent in such regions, can lead to severe health risks, including gastric cancer. Addressing the urgent issue of heavy metal pollution, this paper employs a bibliographic approach to explore the latest literature on heavy metal pollution. The study discusses recent research findings and potential methods for the treatment and mitigation of heavy metal pollution, emphasizing the pressing need for effective solutions to safeguard public health.

Climate change is one of the widely acknowledged challenges faced by international communities in the 21^st century. It poses challenges to fundamental elements of our understanding of appropriate goals for socioeconomic policies, such as the connection of prosperity, growth, equity and sustainable development. Human activities-induced climatic changes have been widely perceived as threatening criteria for the long-term resilience of societies and communities throughout the world. The United Nations Intergovernmental Panel on Climate Change (UNIPCC) reported that greenhouse gas (GHG) emissions due to human activities, such as the burning of fossil fuels for energy generation, is changing the climate of Earth. Despite contributing less towards the causes, poor citizens of developing countries bear a lot of its impacts. In particular, women and girls face a major impact and finally, they migrate due to the social gender division and scarcity of food. Studies on gender and climate change-induced migration are scarce. This study provides an overview of the induced impact of climate change on the livelihood, health and migration of women and girls. The aim of this study would significantly advance our understanding of the current inter-linkages between migration, displacement patterns and climate change impacts.

Abstruct Green Human Resource Management (GHRM) has emerged as an essential strategy for achieving environmental sustainability within organizations. However, there remains a significant gap in understanding its direct impact on sustainable performance. This study seeks to address these gaps by investigating the relationship between GHRM and sustainable performance, with a focus on the mediating role of green innovation and the moderating influence of transformational leadership. A cross-sectional study was conducted among Malaysian small and medium-sized enterprises (SMEs) to explore the interrelationships between Green HRM, green process and product innovation, sustainability, and the role of sustainable leadership. The study's findings reveal a positive and significant relationship between green HRM practices and sustainability, encompassing environmental, economic, and social aspects. The findings suggest that management support for environmental initiatives is a critical factor in enhancing the effectiveness and spread of green innovations, emphasizing the importance of GHM in the broader context of organizational change and sustainability. In addition, the study underscores the critical role of transformative leadership in fostering sustainable practices, particularly the significant moderator role of responsible leadership in driving sustainable business practices. In summary, this study provides a roadmap for businesses, particularly SMEs, to leverage HGRM as a strategic tool in their pursuit of sustainability.

The principal barrier to an HIV-1 cure is the persistence of infected cells harboring replication-competent proviruses despite antiretroviral therapy (ART). HIV-1 transcriptional suppression, referred to as viral latency, is foremost among persistence determinants, as it allows infected cells to evade the cytopathic effects of virion production and killing by cytotoxic T lymphocytes (CTL) and other immune factors. HIV-1 persistence is also governed by cellular proliferation, an innate and essential capacity of CD4+ T cells that both sustains cell populations over time and enables a robust directed response to immunological threats. Yet when HIV-1 infects CD4+ T cells, this capacity for proliferation can counterproductively enable surreptitious HIV-1 propagation without the deleterious effects of viral gene expression in latently infected cells. Over time on ART, the HIV1 reservoir is shaped by both persistence determinants, with selective forces most often favoring clonally expanded infected cell populations harboring transcriptionally quiescent proviruses. Moreover, if HIV latency is incomplete or sporadically reversed in clonal infected cell populations that are replenished faster than they are depleted, such populations could both persist indefinitely and contribute to low-level persistent viremia during ART and viremic rebound if treatment is withdrawn. In this review, select genetic, epigenetic, cellular, and immunological determinants of viral transcriptional suppression and clonal expansion of HIV-1 reservoir T cells, interdependencies among these determinants, and implications for HIV-1 persistence will be presented and discussed.

Considering bitemark evidence, forensic dentists must give testimony that could have catastrophic consequences. A bitemark is often the only physical evidence on a body, and odontologists' testimony should be powerful and simple to understand. Given that perpetrators may be executed or imprisoned for life, a defective bitemark analysis is comparable to dentists' most crucial clinical decisions regarding diagnosis. Bias affects human bitemark analysis, and forensic dentists must examine its invisible impacts to avoid making mistakes. The aim of this study was to explore the potential of different types of bias in bitemark analysis and methods during analysis by conducting a scoping review. The majority of the 14 articles that were taken into consideration were published in 2019. USA, UK, Australia, New Zealand, and the Netherlands published the most articles. 36% of the publications addressed contextual bias, while 57% acknowledged cognitive bias. Preventive measures have been recommended to address bias in bitemark analysis. These consist of limiting the availability of unrelated data during the research, employing several comparison samples for a more impartial assessment, and repeating the analysis while being blind to past findings. These preventative measures reduce cognitive and contextual bias and improve bitemark analysis in forensic investigations.

Herpesvirus is a prevalent pathogen that primarily infects human epithelial cells and has the ability to reside in neurons. In the field of otolaryngology, herpesvirus infection primarily leads to hearing loss and vestibular neuritis, and is considered the primary hypothesis regarding the pathogenesis of vestibular neuritis. In this review, we provide a summary of the effects of herpes virus on cellular processes in both host cells and immune cells, with a focus on HSV-1 as illus-trative examples.

Despite great strides in diagnosis and treatment, cardiac diseases remain the number one cause of mortality in the developed world, with rates catching up at an alarming rate in the developing world. Targeted delivery of therapeutics, specifically to cardiomyocytes, would open up new frontiers. Our prior work using a combinatorial in vitro and in vivo phage display methodology identified a 12-amino acid long peptide that targets cardiomyocytes selectively after an intravenous injection in as little as 5 mins, and hence was termed cardiac targeting peptide (CTP: APHLSSQYSRT). CTP has been used to deliver imaging agents, small drug molecules, photosensitizing nanoparticles, exosomes, and even miRNA to cardiomyocytes. As a natural extension for development of CTP as a clinically viable cardiac vector, we now present toxicity studies performed on the peptide. In vitro viability studies were performed in a human left ventricular myocyte cell line with 10µM of Cyanine-5.5 labeled CTP (CTP-Cy5.5). In vitro ion channel profiles were completed for CTP followed by more extensive studies performed by Eurofins in stably transfected cell lines for an extensive list of GPCR-coupled receptors. Positive data for GPCR-coupled receptors was interrogated further with RT-qPCRs performed on mouse heart tissue. In vivo studies consisted of pre- and post-blood pressure monitoring acutely after a single CTP (10 mg/Kg) injection. Further in vivo toxicity studies consisted of injecting 60, 6-week-old, wild-type CD1, male/female mice (1:1) injected with CTP (150 µg/Kg) intravenously. Mice were weighed immediately before injections and daily thereafter. Cohorts of mice were euthanized on day 0, 1, 2, 7 and 14 with inhalational CO2, followed by opening of the chest cavity, collection of blood via cardiac puncture, complete blood count analysis, metabolic profiling, and finally, liver, renal and thyroid studies. Lastly, mouse cardiac MRI was performed immediately before and after injections of CTP (150 µg/Kg) to assess changes in cardiac size or function. Human left ventricular cardiomyocytes showed no decrease in viability after a 30 min incubation with CTP-Cy5.5. In the Eurofins Cardiac Profiler Qube, no significant activation or inhibition of any of seventy-eight protein channels was observed other than OPRM1 and COX2 at the highest tested concentration, neither of which were expressed in mouse heart tissue as assessed by RT-qPCR. There was no change in blood pressures before and after injections with CTP at 10 mg/Kg. Blood counts and chemistries showed no evidence of significant hematological, hepatic or renal toxicities. Lastly, there was no significant difference in cardiac function, size or mass before and after CTP injections. Our studies with CTP showed no activation or inhibition of GPCR-associated receptors in vitro. We found no signals indicative of toxicity in vivo. Most importantly, cardiac functions remained unchanged acutely in response to CTP uptake. Further studies, in good laboratory practices fashion, are needed with more prolonged, chronic administration of CTP conjugated to a specific cargo of choice before human studies can be contemplated.

Human serum albumin (HSA) is multifunctional protein, known to be a natural carrier for a number of endogenous and exogenous compounds, including drugs. Formulating anticancer drugs with HSA is a clinically validated approach to improve the pharmacological properties and provide targeted delivery (passive and active) of cytotoxic payload to the tumor (such as in Abraxane). A number of receptors facilitating HSA uptake from systemic circulation have been characterized. What is interesting, such uptake may differ depending on the nature and quantity of ligands bound to HSA. Based on this, one might like to modify the HSA in a way that its distribution is more favorable for certain therapeutic purposes, thus ensuring more efficient delivery of the therapeutic cargo to disease site. E.g. Levofloxacin (LV), broad spectrum antibiotic drug, could benefit from extended systemic exposure, and stronger interaction with plasma proteins could be useful for this purpose. We have engrafted monomeric or polymeric CDs on the surface of HSA molecules to strengthen the LV adsorption (CD-LV dissociation constant is three orders of magnitude lower than that for HSA-LF). We have found that (HSA-HPolS)conj+LV exhibited the highest activity against E. coli, whereas (HSA-HPCD)conj+LV was the most effective against B. subtilis; and both HSA conjugates were more potent than LV alone or LV with HSA. Further fine-tuning of HSA could yield an improvement in biodistribution, and thus a more favorable risk/benefit ratio.

Hepatocellular carcinoma (HCC) is a non-AIDS-defining cancer closely tied to the chronic HIV infection and associated with the release of inflammatory cytokines, immune system dysfunction, and genetic alterations within mitochondria. However, our understanding of how these factors contribute to HCC risk in PLWH is limited. The objective of the study was to ascertain the differential secretion of cytokines and mitochondria DNA (mtDNA) deletion in PLWH, and individuals diagnosed with HCC without HIV. A cross-sectional study was conducted with PLWH and HCC participants from the Korle-Bu Teaching Hospital. Plasma and peripheral blood mononuclear cells (PBMCs) were isolated from whole blood. The plasma samples were used to measure cytokines using ELISA and Luminex techniques. We determined mtDNA deletions from PBMCs. We found that the secretion of the cytokines TGF-β, FGF-2, IL-8, TNF-α, VEGF, and RANTES implicated in the pre-cancer, initiation, and early stages of HCC were similar in PLWH compared to HCC participants without HIV. PBMCs of PLWH exhibited high mtDNA deletion (60%) comparable to HCC participants without HIV (64%). These findings underscore the underlying risks associated with HCC development in PLWH. There is a need for HCC surveillance among PLWH and these cytokines could be used as biomarkers.

Human activity recognition (HAR) using wearable sensors is gaining popularity in the healthcare domain, enabling continuous monitoring and timely interventions. The conventional HAR systems are centralised and need data sharing with a server for processing and model training. However, this data sharing leads to various challenges, such as privacy concerns, increased communication and storage costs, inefficient computational algorithms, data scarcity due to unwillingness to share, and difficulty achieving high accuracy and personalised models simultaneously. To overcome these challenges, this paper introduces a privacy and energy-aware federated learning (FL) framework for model training without data sharing. The proposed scheme incorporates spiking neural networks (SNNs), which are particularly suited for resource-constrained devices due to their event-driven information processing. The key idea is to synergise the strengths of SNNs and long short-term memory (LSTM) to create a hybrid model for robust HAR. The proposed hybrid spiking LSTM (S-LSTM) model uses the LSTM as an input layer to capture temporal dependencies efficiently, followed by spiking layers that replace the typical activation using leaky integrate-and-fire neurons. We employ the combination of surrogate gradient learning and backpropagation through time (BPTT) to update the weights of SNN layers in a supervised manner. The performance of the proposed model is evaluated using two publicly available datasets for both indoor and outdoor scenarios. The results show that the proposed S-LSTM performs much better than spike convolutional neural networks (S-CNN) and simple CNN, achieving the accuracy of 97% and 87% for indoor and outdoor datasets, respectively. Personalisation, also known as fine-tuning the global model using local data, is crucial in HAR. It allows the model to adapt to individual behaviour and preferences, making predictions more accurate. The results also show that personalisation improves the performance of participants up to 9% on average. Additionally, analysis with 50% random client participation reduces communication costs by 50% with minimal impact on accuracy.

Cancer researchers are fascinated by the chemistry of diverse natural products which show exciting potential as anticancer agents. In this study, we aimed to investigate the anticancer properties of watermelon rind extract (WRE) by examining its effects on cell proliferation, apoptosis, senescence, and global gene expression in human renal cell adenocarcinoma cells (HRAC-769-P) in vitro. Our metabolome data analysis of WRE exhibited untargeted phyto-constituents and targeted citrulline (22.29 µg/mg). HRAC-769-P cells were cultured in RPMI-1640 media and treated with 22.4, 44.8, 67.2, 88.6, 112, 134.4, and 156.8 mg mL-1 for 24, 48, and 72 hrs. At 24 hrs after treatment, (88.6 mg ml-1 of WRE) cell proliferation significantly reduced, more than 34% compared to the control. Cell viability decreased 48 and 72 hours after treatment to 45% and 37%, respectively. We also examined poly caspase, SA-beta-galactosidase (SA-beta-gal), and wound healing activities using WRE. All treatments induced an early poly caspase response and a significant reduction in cell migration. Further, we analyzed the transcript profile of the cells grown at 44.8 mg ml-1 of WRE after 6 hours using RNA sequencing (RNAseq) analysis. We identified 186 differentially expressed genes (DEGs), including 149 upregulated genes and 37 downregulated genes, in cells treated with WRE compared to the control. The differentially expressed genes were associated with NF-Kappa B signaling and TNF pathways. Crucial apoptosis-related genes such as BMF, NPTX1, NFKBIA, NFKBIE, and NFKBID might induce intrinsic and extrinsic apoptosis. Another possible mechanism is a high quantity of citrulline may lead to induction of apoptosis by the production of increased nitric oxide. Hence, our study suggests the potential anticancer properties of WRE and provides insights into its effects on cellular processes and gene expression in HRAC-769-P cells.

Aspergillus fumigatus is a ubiquitous, critical priority human fungal pathogen. Despite its clinical importance, there is limited knowledge regarding the variations of the genome within mitochondria, the powerhouse organelle within eukaryotic cells. In this study, we leveraged publicly available raw, whole genome sequence data from 1939 isolates to investigate the variations in the mitochondrial genomes of A. fumigatus. These isolates were isolated from 22 countries on six continents, as well as from outer space and from within the International Space Station. In total, our analysis revealed 39 mitochondrial single nucleotide polymorphisms (mtSNPs) within this global sample and together, these 39 mtSNPs grouped the 1939 isolates into 79 mitochondrial multilocus genotypes (MLGs). Among the 79 MLGs, 39 were each distributed in at least two countries and 30 were each shared by at least two continents. The two most frequent MLGs were also broadly distributed: MLG11 represented 420 isolates from 11 countries and four continents and while MLG79 represented 418 isolates from 18 countries and five continents, consistent with long-distance dispersals of mitogenomes. Our population genetic analyses of the mtSNPs revealed limited differentiation among continental populations but highly variable genetic differences among national populations, largely due to localized clonal expansions of different MLGs. Phylogenetic analysis and Discriminant Analysis of Principal Components of mtSNPs suggested the presence of at least three mitogenome clusters. Linkage disequilibrium, Index of Association, and phylogenetic incompatibility analyses collectively suggested evidence for mitogenome recombination in natural populations of A. fumigatus. In addition, sequence read depth analyses revealed an average ratio of ~20 mitogenomes per nuclear genome in this global population but the ratios varied among strains within and between certain geographic populations. Together, our results suggest evidence for organelle dynamics, genetic differentiation, recombination, and both widespread and localized clonal expansion of the mitogenomes in the global A. fumigatus population.

This investigation delves into the profound interplay between the e-commerce environment and the agricultural system, while scrutinizing the intricate human-land coupling dynamics engen-dered by transformations within the agricultural domain. Focusing on the expansion of orchards in Pinghe County, a pivotal epicenter for Chinese sweet pomelo production, this study eluci-dates the reverberations of Rural E-commerce Environment Development on Orchard Expansion through the lens of Tele-coupling. In doing so, it unveils the nuanced tapestry of the human-land coupling associations latent within the evolutionary trajectory of the agricultural system amidst the blossoming information society. The findings underscore a symbiotic relationship between the augmentation of orchard acreage and the burgeoning rural e-commerce landscape, effec-tively propelling the economic prosperity of the agricultural system. Moreover, a tele-coupling phenomenon has emerged, underscoring the intricate web of interconnections binding the mat-uration of the rural e-commerce ecosystem with the proliferation of orchards. The research illu-minates that the transformation of land utilization, imbricated within the agricultural system, manifests as a distinctive form of tele-coupling intricately woven into the fabric of urbanization and information technology advancements. Consequently, adopting a comprehensive theoreti-cal perspective, amalgamating disparate domains across distinct geographic realms, becomes imperative for discerning the intricate nuances of the human-land coupling nexus within these multifaceted, open systems.

In a rapidly evolving global landscape characterized by increased international travel, migration, and ecological shifts, this study sheds light on the emergence of protozoal and helminthic infections targeting the central nervous system (CNS) within Europe. Despite being traditionally associated with tropical regions, these infections are progressively becoming more prevalent in non-endemic areas. By scrutinizing the inherent risks, potential outcomes, and attendant challenges, this study underscores the intricate interplay between diagnostic limitations, susceptibility of specific population subsets, and the profound influence of climate fluctuations. The contemporary interconnectedness of societies serves as a conduit for the introduction and establishment of these infections, warranting comprehensive assessment. This study emphasizes the pivotal role of heightened clinician vigilance, judicious public health interventions, and synergistic research collaborations to mitigate the potential consequences of these infections. Though rare, their profound impact on morbidity and mortality underscores the collective urgency required to safeguard the neurological well-being of the European populace. Through this multifaceted approach, Europe can effectively navigate the complex terrain posed by these emergent infections.

Enzymatic hydrolysis of bovine and human hemoglobin yields a diversity of bioactive peptides, some of which are recognized for their antimicrobial properties. Certain small antimicrobial and anticancer peptides target protein synthesis inhibition. This study aims to produce bioactive peptides through enzymatic hemoglobin hydrolysis and evaluate their effects on cell growth inhibition, potentially serving as candidates for biological anticancer drugs. Rapid screening of candidate anticancer peptides derived from enzymatic hydrolysis of bovine and human hemoglobin was conducted using the Lepidium sativum radicle growth technique. The results demonstrate that: 1) the degree of hydrolysis (DH) significantly influences the production of bioactive peptides. DH levels of 3-10% yield considerably stronger radicle growth inhibition compared to DH 0 (native hemoglobin form), exhibiting three to four times greater intensity. 2) Certain peptide fractions from bovine hemoglobin exhibit higher activity than those from human hemoglobin. 3) The structural characteristics of peptides play a crucial role in the observed biological effects. 4) The α137-141 peptide is the most active among the fractions obtained from bovine (IC₅₀ = 29 ± 1 µg/mL) and human hemoglobin (IC₅₀ = 48 ± 2 µg/mL), standing out 10 to 15 times more potent than other hemoglobin fractions. In conclusion, these findings affirm the bioactivity of peptide fractions obtained from bovine and human hemoglobin. The study highlights how enzymatic hydrolysis of bovine and human hemoglobin can yield peptides that inhibit protein synthesis. Ultimately, these results suggest the feasibility of obtaining candidate peptides for biological anticancer drugs from both human and bovine hemoglobin sources. These scientific advances show new hope in the fight against cancer which affects a large number of people around the world.

This paper proposes a reconceptualization of the hierarchical understanding of the human organism, challenging the conventional idea of the supremacy of the nervous system. We argue that symbiotic coexistence and functional interdependence among all systems provide the human body with remarkable resistance to the universal tendency of entropy. We first examine the basis of cellular life, referring to ATP and DNA, essential substances that resist the entropic tendency through complex energy mechanisms. Next, we analyze the collaboration between the body's systems, highlighting the critical role of erythrocytes, which constitute 83.9% of the total cells (24.9 trillion), in the context of energy maintenance and homeostasis. We challenge the conventional view that the nervous system, composed of neurons and glial cells, which together make up 0.6% of the total cells (0.17 trillion), occupies the apex of a biological hierarchy, arguing that the nervous system is merely a component of a broader, interdependent mechanism. Finally, we provide a detailed description of human cellular composition, emphasizing the importance of each cell type in the functional context, thus contributing to the totality of the organism. With this, we present a vigorous appeal for the realization of critical reassessments of fundamental premises in human biology.

The rapid ageing of populations around the World is creating complex challenges for national governments. The establishment of sustainable and equitable long-term care systems for old and dependent people is one of the main issues of social policy in developed countries. The aim of this work is to define a cost model for residential and day care centres for dependent persons in Cantabria (Spain). The cost model will make it possible to establish the theoretical cost of attending to the needs of the different types of dependent persons in the different types of care centres, and the methodology used could be extrapolated to other regions. The daily cost per user for elderly residential care is €53.72. The cost per user in elderly day centres (5 days) is 32.56 euros. In residential centres for people with disabilities, the values range between €47.41 and €75.25 depending on the category of the centre. In three categories of centres the public price is not enough to cover the cost (physical disability, intellectual disability, mental illness – low care), and therefore the administration should reconsider their public prices for these kind of centres if they want to really contribute to the sustainability of these residential care centres. This research will have important implications for policy-makers in a context of fulfilment of SDGs and where better support for old and disabled people and their carers, as well as fair and efficient financing of social care services, are essential to address the current and future challenges of dependency.

It is known that during the process of aging there is a significant decrease in the number of melanosomes in the retinal pigment epithelium (RPE) cells of the human eye. We have previously shown that the interaction of melanin melanosomes with superoxide radicals results in its oxidative degradation with the formation of water-soluble fluorescent products. In the present study, we show using fluorescence analysis, HPLC, and mass spectrometry, that visible light irradiation of melanolipofuscin granules isolated from RPE cells of the human eye results in the formation of water-soluble fluorescent products of oxidative degradation of melanin, in contrast to lipofuscin granules and melanosomes irradiation. The formation of these products occurs as a result of oxidative degradation of melanin by superoxide radicals, which are generated by the lipofuscin part of the melanolipofuscin granule. We identified these products both in the composition of melanolipofuscin granules irradiated with visible light, and in composition of non-irradiated but oxidized by superoxide radicals, melanosomes. In melanolipofuscin granules irradiated with visible light, ions that could be associated to melanin oxidative degradation products were identified by applying principal component analysis of time-of-flight secondary ion mass spectrometry (ToF-SIMS) data. Degradation of the intact melanosomes by visible light is also possible; however, this requires significantly higher irradiation intensities than for melanolipofuscin granules. It is concluded that the decrease in the concentration of melanin in RPE cells of the human eye with age is due to its oxidative degradation by reactive oxygen species generated by lipofuscin as part of melanolipofuscin granules under the action of light.

Global climate change and associated environmental extremes present a pressing need to understand and predict social-environmental impacts while identifying opportunities for mitigation and adaptation. In support of informing a more resilient future, emerging data analytics technologies can leverage the growing availability of Earth observations from diverse data sources ranging from satellites to sensors to social media. Yet, there remains a need to transition from research for knowledge gain to sustained operational deployment. In this paper, we use the Wisdom-Knowledge-Information-Data (WKID) Innovation framework to inform solutions-oriented science in an integrated Research to Commercialization (R2C) model that explores market viability for value-added analytics. We conduct a case study using this R2C model to address the wicked wildfire problem. By integrating WKID and human centered design (HCD), through an industry-university partnership called the Climate Innovation Collaboratory between the University of Colorado Boulder and Deloitte Consulting, we systematically evaluated 39 different user stories across 8 user personas and identified common gaps, how to define information technologies that add value, and how to develop a marketable product. This R2C model could enable transition of knowledge to operational implementation informing policy and decision makers, tasked with addressing some of our most challenging environmental problems.

The concept of intellectual capital is increasingly recognized as one of the most important strategic assets of organizations. The significance of intellectual resources, which are now critical for every business unit, is underlined in this paper. Thus, this research aims to identify the effectiveness of intellectual capital and its components on the organizational innovation at Sulaimani Polytechnic University in Sulaymaniyah Governorate, from the point of view of the faculty members (academic and administrative staff). The study developed both theoretical and empirical sections. The descriptive approach was used to determine the effectiveness of intellectual capital and the quantities of research methodologies was used to measure this effectiveness. The study aims at investigating the correlations and causal effect between intellectual capital and organizational innovation. Moreover, the study investigates the correlations and causal effect between human capital, structural capital and relational capital on radical and incremental innovation in the organization. To achieve this, the 392 total sample were collected and analyzed by SPSS 22 software. The findings provide evidence that intellectual capital and its components have a positive and statistically significant effect on the organizational innovation and its components.

In this review, our goal is to design and test quantum-like algorithms for Artificial Intelligence (AI) in open systems to structure a human-machine team to be able to reach its maximum performance. Unlike the laboratory, in open systems, teams face complexity, uncertainty and conflict. All task domains have complexity levels, some have low, and others high levels. Complexity in this new domain is affected by the environment and the task, which are both affected by uncertainty and conflict. We contrast the individual and interdependence approaches to teams. The traditional and individual approach focuses on building teams and systems by aggregating the best available information for individuals, their thoughts, behaviors and skills. Its concepts are characterized chiefly by one-to-one relations between mind and body, a summation of disembodied individual mental and physical attributes, and degrees of freedom corresponding to the number of members in a team; however, this approach is characterized by the many researchers who have invested in it for almost a century with few effects that can be generalized to human-machine interactions; by the replication crisis of today (e.g., the invalid scales for self-esteem, implicit racism, and honesty); and by its many disembodied concepts. In contrast, our approach is based on the quantum-like nature of interdependence. It allows us to theorize about the bistability of mind and body, but it proposes a measurement problem and a non-factorable nature. Bistability addresses team structure and performance; the measurement problem solves the replication crisis; and the non-factorable aspect of teams reduces the degrees of freedom and the information derivable from teammates to match findings by the National Academies of Science. We begin with a review of the science of teams and a focus on human-machine team research in the laboratory versus the open; justifications for rejecting traditional social science while supporting our approach; a full understand of the complexity of the domain, tasks in the domain, and how teams address both; the mathematics involved; a review of results from our model versus the open field; a discussion of the results; conclusions; and the path forward to successfully advance the science of interdependence and autonomy.

Human pose estimation is a complex detection task in which the network needs to capture the rich information contained in the images. In this paper, we propose MSTPose (Multi-Scale Transformer for human Pose estimation). Specifically, MSTPose leverages a high-resolution Convolution neural network (CNN) to extract texture information from images. For the feature maps from three different scales produced by the backbone network, each branch performs the coordinate attention operations. The feature maps are then spatially and channel-wise flattened, combined with keypoint tokens generated through random initialization, and fed into a parallel Transformer structure to learn spatial dependencies between features. As the Transformer outputs one-dimensional sequential features, the mainstream two-dimensional heatmap method is abandoned in favor of one-dimensional coordinate vector regression. The experiments show that MSTPose outperforms other CNN-based pose estimation models and demonstrates clear advantages over CNN + Transformer networks of similar types.

Based on the eventual destruction of the solar system and the critical need for human continuation, this article suggests sending synthetic biology- and AI-created plant-like astronauts to the closest habitable exoplanet, Teegarden's Star b. Here we show that these astronauts will have green skin, blue blood, and the ability to perform photosynthesis. They could withstand cosmic radiation and extremely low temperatures in space while generating energy through photosynthesis. This groundbreaking interdisciplinary approach may provide a solution to the survival challenges faced by humans on their eternal interstellar journey. As long as plant-like astronauts possess human consciousness, it does not matter whether they are even a hybrid of carbon-based and silicon-based life. They will be a continuation of humanity on exoplanets. Human faces two options for survival. The first is the Mars migration program led by Elon Reeve Musk, which remains within the solar system and may not protect against the Sun's future scorching all life on the solar system during its red giant phase. The second option involves a more daring approach: the frantic escape of plant-like astronauts from the solar system. Should we consider both options simultaneously, much like how humans use their two legs to walk?

Fungi constitute a diverse group with highly positive and negative impacts in different envi-ronments, having several natural roles and beneficial applications in human life, but also caus-ing several concerns. Fungi can affect human health directly, but also indirectly by being detri-mental for animal and plant health influencing food safety and security. Climate changes are al-so affecting fungal distribution, prevalence, and their impact on different settings. Searching for sustainable solutions to deal with these issues is challenging due to the complexity of the inter-actions among fungi and agriculture, animal production, environment, and human health. In this way, the “One Health” approach may be useful to get some answers since it recognizes that human health is closely connected to animal and plant health, as well as to the shared environ-ment. This review aims to explore and correlate each of those factors influencing human health in this “One Health” perspective.

Humans’ performance varies due to the mental resources that are available to successfully pursue a task. To monitor users’ current cognitive resources in naturalistic scenarios, it is essential to not only measure demands induced by the task itself but also consider situational and environmental influences. We conducted a multimodal study with 18 participants (nine female, M = 25.9 with SD = 3.8 years). In this study, we recorded, respiratory, ocular, cardiac, and brain activity using functional near-infrared spectroscopy (fNIRS) while participants performed an adapted version of the warship commander task with concurrent emotional speech distraction. We tested the feasibility of decoding the experienced mental effort with a multimodal machine learning architecture. The architecture comprised feature engineering, model optimisation, and model selection to combine multimodal measurements in a cross-subject classification. Our approach reduces possible overfitting and reliably distinguishes two different levels of mental effort. These findings contribute to the prediction of different states of mental effort and pave the way toward generalised state monitoring across individuals in realistic applications.

The levels of informatization, automation, and intelligence are continuously improving; however, the risks due to the increased design and operational complexity of ship systems are increasing. Large-scale ship accidents occur for various reasons. Existing accident analysis methods that examine marine accidents from the perspective of causal one-to-one correspondence have limitations in systematically analyzing complex marine risks when identifying their causes for the prevention of similar accidents. This study focuses on a systematic causality analysis of the factors related to human errors in marine accidents that may occur during the arrival and departure of mega container ships. In particular, a representative case of the Milano Bridge crane contact accident at Busan New Port is considered. To explore the complex organizational–technical, human–technical, and organizational–human relationships relevant to this case, human factors (seafarer, pilot, etc) that are closely related to the linked causes were analyzed using the functional resonance analysis method. This study aims to reduce human error and prevent marine accidents including pilotage.

The German Constitutional Court’s climate verdict provides a re-interpretation of liberal- democratic core concepts and is highly relevant for liberal constitutional law in general – including EU and international law. The verdict accepts human rights as intertemporal and globally applicable; it applies the precautionary principle to these rights and frees them from the misleading causality debate. However, the court fails to address the most important violations of human rights, and it categorised climate policy as a greater threat to freedom than climate change. And the court does not make it clear that the Paris 1.5-degree limit implies a radically smaller carbon budget. Furthermore, little attention has so far been paid to the fact that the ruling implies an obligation for more EU climate protection, especially since most emissions are regulated supranationally. To be effective, the EU emissions trading system demands a reform, which should go well beyond the existing EU proposals to enable societal transformation to sustainability.