The preparation of gold nanoparticles (AuNPs) involves a variety of chemical and physical methods. These methods use toxic and environmentally harmful chemicals. Consequently, the synthesis of AuNPs using green chemistry has been under investigation to develop eco-friendly nanoparticles. One method to achieve this is the use of plant-derived phytochemicals capable of reducing gold ions to produce AuNPs. The aim of this study was to implement a facile microtitre-plate method to screen a large number of aqueous plant extracts to determine the optimum concentration (OC) to bio-synthesize the AuNPs. Several AuNPs of different sizes and shapes were successfully synthesized and characterized from seventeen South African plants. The characterization was done using Ultra Violet-Visible Spectroscopy, Dynamic Light Scattering, High Resolution Transmission Electron Microscopy and Energy-Dispersive X-ray Spectroscopy. We also studied the effects of temperature on the synthesis of the nanoparticles and measured its effect on the particle size of the synthesized AuNPs and the data showed that changes in temperatures affect the size and dispersity of the generated AuNPs. Further, some of the synthesized AuNPs were stable upon incubation with different biological solutions in vitro.

Melioidosis is an endemic infectious disease caused by Burkholderia pseudomallei bacteria, which contaminates soil and water. To better understand the environmental changes that have contributed to melioidosis outbreaks, this study used spatiotemporal analyses to clarify the distribution pattern of melioidosis and the relationship between melioidosis morbidity rate and local environmental indicators (land surface temperature, normalised difference vegetation index, normalised difference water index) and rainfall. A retrospective study was conducted from January 2013 to December 2022, covering data from 219 sub-districts, with each exhibiting varying morbidity rate of melioidosis on a monthly basis. Spatial autocorrelation was determined using local Moran’s I, and the relationship between melioidosis morbidity rate and the environmental indicators was evaluated using geographically weighted Poisson regression. The results revealed clustered spatiotemporal patterns of melioidosis morbidity rate across sub-districts, with hotspots predominantly observed in the northern region. Furthermore, we observed a range of coefficients for the environmental indicators, varying from negative to positive, which provided insights into their relative contributions to melioidosis in each local area and month. These findings highlight the presence of spatial heterogeneity driven by environmental indicators and underscore the importance of public health offices implementing targeted monitoring and surveillance strategies for melioidosis in different locations.

In the contemporary accelerated pace of life, emphasizing the importance of sleep quality is essential for enhancing overall well-being and health. This study investigates the link between poor sleep quality and key factors affecting wellness, such as mental health and eating disorders. Through a cross-sectional analysis involving 407 participants, utilizing established measures including the Depression Anxiety Stress Scale (DASS-21), the Eating Disorder Examination Questionnaire Short (EDE-QS), and the single-item Sleep Quality Scale (SQS), data was collected and analyzed using SPSS v28 and R-Statistics. The findings reveal a significant correlation (p<0.05) between DASS-21, EDE-QS, and SQS, indicating that individuals experiencing poor sleep quality exhibit higher levels of depression, anxiety, and stress. Furthermore, multinomial logistic regression analysis highlights low sleep quality as a risk factor for both mental health (OR: 1.071, 95% CI: 1.042, 1.102, p<0.05, low vs. high sleep quality), and eating disorders (OR: 1.047, 95% CI: 1.004, 1.092, p<0.05, low vs. high sleep quality). Overall, these results underscore the critical role of sleep quality in mental health and suggest insomnia as a predictive factor for both poor mental well-being and disordered eating habits. Further research through randomized controlled trials is warranted to validate the findings of this cross-sectional study.

Organisational performance is a major concern for any company wishing to remain competitive in today's market. This is why many companies have begun to integrate digital technologies into their management systems. The aim of this article is to determine the contribution of digitisation to organisational performance management, through observations and analysis of a single case study of a company that has adopted a digital transformation project. It emerged that digital transformation makes a significant contribution to organisational performance management. However, this transformation requires significant support and adaptation of skills and organisational structures.

This study explores the role of inflammation and oxidative stress, hallmarks of COVID-19, in accelerating cellular biological aging. We investigated early molecular markers—DNA methylation age (DNAmAge) and telomere length (TL)—in blood leukocytes, nasal cells (NC), and induced sputum (IS) one-year post-infection in pauci- and asymptomatic healthcare workers (HCWs) infected during the first pandemic wave (February-May 2020), compared to COPD patients, model for "aged lung". Data by questionnaires, Work Ability Index (WAI), blood analyses, autonomic cardiac balance assessments, heart rate variability (HRV), and pulmonary function tests were collected. Elevated leukocyte DNAmAge significantly correlated with advancing age, male gender, daytime work, and an aged phenotype characterized by chronic diseases, elevated LDL and glycemia levels, medications affecting HRV, and declines in lung function, WAI, lymphocyte count, hemoglobin levels, and HRV (p<0.05). Increasing age, LDL levels, job positions involving intensive patient contact, and higher leukocyte counts collectively contributed to shortened leukocyte TL (p<0.05). Notably, HCWs exhibited accelerated biological aging in IS cells compared to both blood leukocytes (p≤0.05) and NC (p<0.001), and were biologically older than COPD patients (p<0.05). These findings suggest the need for monitoring aging in pauci- and asymptomatic COVID-19 survivors, who represent the majority of the general population.

In many parts of the Asia, particularly in the arid regions of the middle east the date palm i.e. Phoneix dactylifera L. is considered a significant plant both culturally and economically. Over the past decade numerous biotechnological tools have been applied to revolutionize the date palm research and its cultivation process. In this comprehensive review ,we provided the in depth overview of the cutting edge developments in the date palm biotechnology, mentioning the important areas such as genomics, genetic engineering, in vitro propagation, omics technologies, and the integration of the artificial intelligence and machine learning (AI-ML).Due to these advancements ,in the date palm production how the date palm production lead the production of superior date palm cultivars with the improved yield ,fruit quality and resilience to biotic and abiotic stresses. Also it explores the application of the biotech tools in the enhancing pest and disease management strategies, increasing date palm productivity and developing the date palm based bio-factories for the production of high value compounds. This review highlights the current challenges faced by the date palm industries ,including the limited water resources ,genetic erosion , pests and disease and the need for improved postharvest handling and processing. It examines how these tools coupled with AI-based approaches can be leveraged to address these challenges and ensure the long term sustainability of date palm cultivation.

Background: The infant mortality rate (IMR) is an important reflection of the well-being of infants and the overall health of the population. This study aims to examine the macroeconomic (ME), sociodemographic (SD), and health status and resources (HSR) effects on IMR, as well as how they may interact with each other. Methods: A retrospective time-series study using yearly data for Oman from 1980 to 2022. Partial Least Squares-Structural Equation Modelling (PLS-SEM) was utilized to develop the exploratory model of the determinants of IMR. Results: The model indicates that HSR determinants directly but negatively affect IMR (= -0.617, p<0.001). SD directly and positively affects IMR (= 0.447, p<0.001). ME only indirectly affects IMR (=-0.854, p<0.001). ME determinants also exert some direct influences on both HSR (= 0.722, p<0.001) and SD (= -0.916, p<0.001) determinants. Conclusions: These findings indicate that an integrated policy that addresses socioeconomic and health-related factors and the overall ME environment is necessary for the health and well-being of the children and the population overall in Oman.

Background—In 2011, Miller and Goldman published a study in Human and Experimental Toxicology that found a counterintuitive, positive correlation, r = 0.70 (r² = 0.49, p < .0001), demonstrating that as nations require more vaccine doses for their infants, infant mortality rates (IMRs) tend to increase (worsen). The dataset (n = 30) included the United States, a nation that required the most vaccines for their infants, and all nations with better IMRs than the United States. Dr. E. Bailey, a professor at BYU, and her students, recently read the Miller-Goldman study and found it "troublesome that this manuscript is in the top 5% of all research outputs" and falsely claimed that its findings were due to "inappropriate data exclusion," i.e., failure to analyze the "full dataset" of all 185 nations. The "Bailey reanalysis," titled Infant vaccination does not predict increased infant mortality rate: correcting past misinformation, was posted to the medRxiv preprint server on September 10, 2021 (version 1) and October 5, 2021 (version 3) and Europe PMC preprint server on September 10, 2021. Objective—This present study examines the various claims postulated by the Bailey reanalysis and assesses the robustness of their methodology, analyses, and reported results and conclusions. Methods—Data discussed in this paper are based on the previously mentioned study by Miller and Goldman and the Bailey reanalysis. Results—Linear regression analysis of IMR and the number of vaccine doses for each country yield a statistically significant positive correlation of r = 0.70 (p < .0001) for the top nations (n = 30) chosen by Miller-Goldman and r = 0.16 (p < .04) for the "entire dataset" chosen by Bailey et al (n = 185). Bailey also conducted linear regression analyses (for the year 2019) of IMRs as a function of vaccination rates for each of eight different vaccines and reported statistically significant inverse correlations for 7 of 8 vaccines over the entire range of vaccination rates. However, Miller and Goldman reanalyzed the Bailey analyses for nations with vaccination rates below 60% and found no statistically significant correlation for six vaccines (DPT, Hib, hepatitis B, polio, rotavirus, and measles) and statistically significant positive correlations for tuberculosis (r = 0.8, p < .005) and pneumococcal (r = 0.6 p < .023) vaccines. Conclusions—Bailey’s reanalysis corroborates a statistically significant positive correlation originally reported by Miller and Goldman. However, Bailey’s reported correlation (r = +0.16, p < .04) is small, likely due to poor methodology (failing to account for covariates, i.e., disparities among numerous socioeconomic factors that add uncertainty to their conclusion). The r-value reported by the Bailey reanalysis demonstrates an effect size that is about one-fourth (0.16/0.70) that reported by Miller-Goldman—underscoring how critically important it is for Bailey's reanalysis to eliminate confounding variables. Moreover, Bailey’s linear regression analyses of IMR as a function of vaccination rates for each of eight different vaccines demonstrate that some countries with low vaccination rates have low IMRs, while other countries with high vaccination rates have high IMRs. Rather than supporting a strong inverse correlation, the Bailey reanalysis demonstrates high vaccination rates are neither necessary nor sufficient to cause low IMR.

The different sociocultural context and lifestyle may influence oral health. To evaluate the interference of these factors, we conducted a quantitative-qualitative cross-sectional study. The research was carried out in a private dental office, in an urban area, and in the Family Health Unit (USF), in a rural area. Fifty patients of each location participated on the research. A semi-structured questionnaire covering sociocultural profile, oral hygiene habits, drug consumption, use of medicinal plants, and antibiotics usage was applied. Also, laboratory tests to evaluate the tendency to have dental decay and Streptococcus sp colony counting was performed. There was no significant difference between patients in the two groups regarding gender, race, marital status, type of residence, number of residents in the same household, and type of employment. Private clinic participants were more prone to consuming alcohol and/or cigarettes and reported to brush the teeth more often. There was no association between salivary acidity and higher biofilm bacterial density. The usage of medicinal plants was more evident in the public service. Data presented here revealed that social inequality between private and public dental assistance are greater from the point of view of investment in public health for the population with difficult access and not from cultural or educational level diversity.

(1) Background: There is a need to assess the availability of essential antimicrobials as the availability of an antimicrobial is a critical element of its rational use. We aimed to assess the availability of antimicrobials listed in National List of Essential Medicines 2015, India (primary list) and a selected (secondary) list comprising of agents indicated for commonly encountered infectious illnesses in various healthcare settings and to identify the reasons for their non-availability. (2) Methods: A cross-sectional survey of 25 public, private, and other sector pharmacies was carried out in Rohtak, a district of North Indian state of Haryana, from April to June 2022. (3) Results: Most of the antimicrobials surveyed were optimally available in various sector pharmacies with the exception of benzathine benzyl penicillin, benzyl penicillin, cloxacillin, cefazolin, cefuroxime, cefadroxil, amphotericin B and antimalarials. Most frequent reasons for limited availability were low demand, no prescriptions and non-listing of drugs in state essential medicine list. (4) Conclusions: Enough evidence needs to be generated with respect to status of availability of essential antimicrobials from different regions of India as well as other lower-middle income countries to devise measures for ascertaining better availability of these agents especially antibiotics at regional, national and global scales.

While it is not new that Nigeria is challenged by a huge infrastructure deficit, the COVID-19 pandemic has exposed the country’s comatose healthcare system. Given the country’s dwindling revenue, massive debt profile and the inability of the public-sector to efficiently manage public facilities in the country, this paper examines how the public-private partnership model of infrastructure procurement can be deployed as a solution for Nigeria’s healthcare crisis. In addition to the above, this paper takes a look at how a partnership with the private sector can aid Nigeria’s quest towards achieving healthcare-related Sustainable Development Goals. The paper also considers two healthcare-based projects as case studies to serve as lessons for future projects in the country. Among others, the paper recommends a holistic long-term solution for the country’s healthcare needs.

Parental labour migration, either one or both parents, has been associated with various challenges among left-behind children (LBC). However, there is a limited understanding of the LBC’s own views and experiences of social and mental wellbeing and how the new daily life circumstances they encounter following their parents’ migration impact them. This study aimed to understand the influence of parental migration and its aftermath on the social and mental wellbeing of children and adolescents (referred to as LBC) in two rural districts in Indonesia. Employing a qualitative design, data were collected through individual in-depth interviews with LBC (n=24) aged 14 to 18 years, recruited using the snowball sampling technique. Data were thematically analysed, guided by a qualitative data analysis framework. The findings showed that parental migration negatively impacted the social wellbeing of LBC. This impact was reflected in negative labelling from friends and changes in familial roles which influenced their social interactions and activities with peers. Parental migration also caused challenges to the mental wellbeing of LBC. These manifested in the LBC experiencing fractured emotional bonds, leading to negative emotions, including stress, anxiety, sadness, depression, frustration, loss of motivation, and self-imposed isolation, which were associated with their parents’ migration and abrupt disruptions in parent-child communication. The transition to new life situations with caregivers after parental migration and the dynamics within the caregivers’ households were additional factors that detrimentally affected their mental well-being. Unmet basic needs and educational needs due to financial hardships faced by mothers and caregivers, further exacerbated mental health challenges for the children. The findings indicate the importance and improvement of policies and interventions in Indonesia (e.g., counselling services, non-cash food assistance, family hope program, direct cash assistance) that cover and address the diverse needs of mothers or caregivers and the LBC.

Healthcare personnel must face two problems of growing importance: violence in the workplace and the loss of work ability due to ageing of the workforce. Studying the relationship between these two phenomena can help to prepare effective prevention measures. In a public health company, we asked nurses to self-assess their work ability using the Work Ability Index (WAI) and we analysed the relationship between this indicator and the violence experienced in the previous and following years. 321 out of 344 nurses (99.3%) participated. In a logistic regression model, the WAI score was a significant protective factor for violence experienced in the previous year (OR=0.94 CI95%=0.90; 0.98 p&lt;0.01) and in the following year (OR=0.88 CI95%=0.84; 0.92 p&lt;0.01). In a hierarchical logistic regression model, social support acted as a protective factor (OR = 0.87 CI95% = 0.79; 0.95 for violence experienced in the previous year), while occupational stress was a significant determinant of the risk of aggression (OR=3.65 CI95%=1.90; 7.03 in the previous year, OR=3.54 CI95%=1.801; 6.947 in the following year). The difficulties that nurses encounter in carrying out their growing work demands in an environment that is not promptly adapted to their changing physical and mental conditions can lead to an increased risk of violence. Prevention of workplace violence should include organizational and ergonomic measures that reduce stress and increase staff support and work ability.

Understanding the dynamics of teamwork and communication among healthcare professionals is crucial in the face of evolving healthcare challenges. This study assessed relational coordination among healthcare professionals in the South Tyrolean healthcare system in Italy, focusing on communication and teamwork dynamics in a cross-sectional survey. Using the validated Relational Coordination Survey (RCS) instrument and 525 completed online responses, the questionnaire aimed to understand the implications of different levels of relational coordination ratings by general practitioners, hospital physicians, nurses, and administrative personnel (response rate 26%). The demographics of the participants revealed a predominance of female professionals (64%), with an average age of 50 and 18 years of service. The resulting RCS scores varied significantly across professional groups, with nurses reporting the highest within-group scores, indicating moderate coordination, and administrators reporting the lowest scores, reflecting areas of weak coordination. Between-group relational coordination was generally perceived as weak across professional groups, with the least weakness observed between general practitioners and nurses. German or Italian language and health district affiliation emerged as significant factors influencing relational coordination ratings, highlighting the need for differentiated understanding and strategies in multilingual and diverse regional settings. Assessments of interdisciplinary feedback and referral practices highlight the variation in teamwork and communication weaknesses and underscore the need for targeted interventions to improve relational coordination. This study provides insights into the complexity of relational dynamics in health care settings. It suggests that improving relational coordination through tailored strategies could significantly improve team effectiveness, quality of patient care, and overall system efficiency.

We assessed the impact of social determinants of health (SDOH) and psychosocial factors on screening behavior in a nationally representative sample of women in the US. A retrospective population-level cross-sectional sample was extracted from the 2022 Health Information National Trends Survey. Descriptive statistics were conducted for demographic characteristics and covariates. Population-based estimates with 95% confidence intervals (95% CI) were produced for Pap testing behaviors across study years. We used logistic regression models to assess Pap testing differences based on SDOH and psychosocial factors, adjusting for covariates, with a significance level of 0.05 for hypothesis testing. Women (n=2,224) with a mean age of 46.96 participated in the study. Our study found that 90% of women were interested in cervical cancer screening, with an 80% actual screening rate. Screening rates differed by age group and rurality. SDOH and psychosocial factors were associated with participants’ interest in screening and in actual screening behavior. The impacts of SDOH and psychosocial factors on screening behavior were 3% and 1%, respectively. The SDOH and psychosocial factors are associated with the uptake of cervical cancer screening among women in the United States. Policies must be directed at bridging the gap created by these SDOHs.

Introduction: It has long been accepted that trauma is one of the most important and frequent predisposing factors for onychomycoses . However, the role of direct trauma in the pathogenesis of fungal nail infections was only recently been elucidated in a series of 32 cases of post-traumatic single-digit onychomycosis. The importance of repeated trauma due to foot and toe abnormalities was rarely investigated.Aim of the study: This is a multicenter single-author observational study over a period of 6 years performed at a specialized nail clinic in three countries. All patient photographs taken by the author during this period were screened for toenail alterations and all toe onychomycosis cases were checked whether they contained enough information to evaluate potential foot and toe abnormalities. Particular attention was paid to the presence of hallux valgus, hallux valgus interphalangeus, hallux erectus, inward rotation of the big toe and outward rotation of the little toe, as well as splay foot. Only cases with unequivocal proof of fungal nail infection by either histopathology, mycologic culture or polymerase chain reaction (PCR) were accepted.Results: Of 1653 cases, 185 were onychomycoses proven by mycologic culture, PCR or histopathology. Of these, 179 involved at least one big toenail, 6 affected one or more lesser toenails. Three patients consulted us for another toenail disease and the onychomycosis was diagnosed as a second disease. Eight patients had a pronounced tinea pedum. Relatively few patients had a normal big toe position (n = 9). Most of the cases had a mild to marked hallux valgus (HV) (105) and a hallux valgus interphalangeus (HVI) (143), hallux erectus was observed in 43 patients, the combination of HV and HVI was observed 83 times. Discussion: The very high percentage of foot and toe deformations was surprising. It may be hypothesized that this is not only a pathogenetically important factor but may also play an important role for the localization of the fungal infection as no marked hallux deviation was noted in onychomycoses that affected the lesser toes only. As the management of onychomycoses is a complex procedure involving the exact diagnosis with determination of the pathogenic fungus, the nail growth rate, the type of onychomycosis, its duration and predisposing factors, anomalies of the toe position may be important. Among the most commonly mentioned predisposing factors are peripheral circulatory insufficiency, venous stasis, peripheral neuropathy, immune deficiency and iatrogenic immunosuppression whereas foot problems are not given enough attention. Unfortunately, many of these predisposing and aggravating factors are difficult to treat or to correct. Generally, when explaining the treatment of onychomycoses to the patients, the importance of these orthopedic alterations is not or only insufficiently discussed. In view of the problems encountered with the treatment of toenail mycoses, this attitude should be changed in order to make the patient understand why there is such a low cure rate despite excellent minimal inhibitory drug concentrations in the laboratory.

The main contribution of this paper is to develop a graphical tool to evaluate the suitability of a candidate parametric model to fit a data set. The practical motivation is to check the adequacy of the so called SAINT model proposed in Jarner and Kryger (2011). This model has been implemented in practice by an important European pension fund concerned with setting annuity reserves for all current or former employees of Denmark. So, one particular relevant question is whether this mortality model is actually fitting old-age. Our graphical test can be described as follows. First we transform the data by means of the parametric model which is being evaluated. Should the model be correct, the transformed data will be in accordance with an Exponential distribution with rate 1. Then we construct a family of local linear hazard estimates based on the data on the transformed scale. Finally we use the statistical tool SiZer to assess the goodness-of-fit of the Exponential distribution to the data on the transformed scale. If the model is correct the SiZer map should not reveal any significant feature in the family of kernel estimates. Our method allow us to establish a diagnostic regarding the validity of the SAINT model when describing mortality patterns in four different countries.

(1) Background: in the context of sustainable development goals (SDGs), this work explores the repair direction of future cultivated land protection policies based on the Smith policy implementation model from the historical evolution to ensure that the cultivated land protection policy does not deviate during the implementation process. (2) Methods: this paper uses literature research and inductive deduction methods to sort out the evolution process of Chinese cultivated land protection policy, summarize the successful experience of transferring the focus of cultivated land protection in chronological order, and conclude the repair direction of Chinese cultivated land protection. (3) Results: although the Chinese cultivated land protection policy in the historical evolution has through three significant phases, there are still certain issues in the development trend of Chinese cultivated land protection policy based on regional division of labor for grain transportation and sales. (4) Conclusion: directly utilizing feedback from farmers as stakeholders will contribute to the maturity and improvement of cultivated land protection policies in the specific implementation of cultivated land protection policies.

Achieving the dual development of rural revitalization and urbanization is an important strategic goal of China’s current modernization. Rural population and settlements are the main components of the countryside in traditional agricultural areas, and play an important role in the development of the countryside itself in terms of urban and rural land use and in the formation of urban and rural development patterns. This study analyzes the spatial and temporal changes in rural populations and settlements at the township level, as well as the degree and type of coupled development. A framework for urban–rural development relationships based on different types of coupled development is proposed, and a model of urban–rural forces is constructed to derive the spatial pattern of urban–rural development at the township level that may be formed in the future. Our study shows that the rural population and settlements in the study area are characterized by significant spatial and temporal dynamics, indicating that traditional rural areas are in a process of rapid development and change. The results of the township-level coupling measurements present four types of development in terms of the spatial pattern of urban–rural development: A-type is most likely to produce new cities or satellite towns in the Jixi–Harbin–Qiqihar area in the future; B-type is the fastest dying area in the future, located in the Harbin and Qitaihe clusters, with a tendency to merge into Harbin; C-type is the area to be focused on in the future to attract population and strictly control the growth of the rural settlement area to avoid it turning into B-type; D-type may develop regional township centers in the future in the combined area of Jiamusi City, Suihua City and Mudanjiang City. The results of the study provide experience in realizing rural revitalization according to local conditions. The new spatial pattern of urban–rural development provides an important reference for formulating land use policies, optimizing urban–rural land allocation and realizing integrated urban–rural development strategies.

Private Set Intersection (PSI) is a cryptographic method in secure multi-party computation that allows entities to identify common elements in their datasets without revealing their private data. Traditional approaches assume similar-sized datasets and equal computational power, overlooking practical imbalances. In real-world applications, dataset sizes and computational capacities often vary, particularly in the Internet of Things and mobile scenarios where device limitations restrict computational types. Traditional PSI protocols are inefficient here, as computational and communication complexities correlate with the size of larger datasets. Thus, adapting PSI protocols to these imbalances is crucial. This paper explores unbalanced PSI scenarios where one party (the receiver) has a relatively small dataset and limited computational power, while the other party (the sender) has a large amount of data and strong computational capabilities. It introduces three innovative solutions for unbalanced PSI: unbalanced PSI protocol based on Cuckoo filters, unbalanced PSI protocol based on single cloud assistance, and unbalanced PSI protocol based on dual cloud assistance, each addressing the shortcomings of the previous solution. These protocols primarily optimize database computational load, storage capacity, protocol execution time, and security. Depending on performance and security needs, different protocols can be employed for applications such as private contact discovery.

There is evidence that kidney involvement is frequently observed in COVID-19 patients, and can manifest as mild proteinuria to advancing acute kidney injury (AKI). One of the mechanisms is microvascular and macrovascular thrombosis caused by the hypercoagulation phase of the disease. Thromboelastography (TEG) is a valuable examination to detect significant hemostatic abnormalities, including the hypercoagulable state. This study analyzed the coagulation profiles, including TEG parameters, in COVID-19 patients who developed AKI compared to those who did not during their intensive care unit (ICU) stay, to identify predictors of AKI. Our single-center cohort retrospective study involved adult patients of COVID-19 in the ICU of Sardjito Hospital in Yogyakarta, Indonesia between May and September 2021. Patients were divided into two groups of AKI and non-AKI based on 2012 KDIGO definition and the elaboration by Indonesian Society of Nephrology. Variables showing a significant difference in the two groups were then analyzed using univariate and multivariate binary logistic regression. A total of 60 COVID-19 patients were included in the study, and 35% of them developed AKI. Compared to non-AKI patients, those with AKI exhibited a greater prevalence of diabetes mellitus (66.7% versus 35.9%, P = 0.023), higher D-Dimer levels (970 versus 685 ng/mL, P = 0.045), and higher values in TEG parameters of maximum amplitude/MA (74.6 versus 65.9 mm, P = 0.001) and coagulation index/CI (2.3 versus 1.0, P = 0.033). TEG parameter of MA emerged as the sole significant predictor for the development of AKI (OR, 6.33; 95% CI, 1.56 to 25.64). Our study validated the kidney involvement of COVID-19 infection, and showed that diabetes mellitus, high D-Dimer levels, and hypercoagulability serve as prominent risk factors in the development of AKI. Furthermore, TEG parameter of MA exceeding 70 mm is the single independent significant predictor of AKI.

Background Lower respiratory tract infections (LRTIs), particularly pneumonia, are a leading cause of morbidity and mortality among children worldwide, especially in low-resource settings. The World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) guidelines currently recommend antibiotic treatment for all case of with pneumonia based on clinical signs along, which can lead to over-prescription of antibiotics and contribute to antimicrobial resistance (AMR). Point of care Lung Ultrasound (LUS) has emerged as a promising diagnostic tool in this context and has demonstrated potential in distinguishing between bacterial and viral pneumonia, thus enabling more targeted antibiotic use. This study aims to explore whether integrating LUS into the IMCI-based management of clinical pneumonia will better identify those who would benefit from antibiotic treatment, reducing antibiotic overuse without compromising health outcomes. Methods An open label randomized controlled trial will enrol 3500 children aged 60 days to 12 years presenting with IMCI-defined pneumonia. Participants will be enrolled in Senegal, Tanzania, and South Africa. Participants will be randomly assigned in a ratio of 1:1, stratified by site and age group (<5years, 5-12years) to either an intervention group, where LUS will guide antibiotic prescriptions utilising a predefined interpretation framework, or a control group receiving routine IMCI-based care. The co-primary outcomes of this study are the reduction in antibiotic use on the day of enrolment (Day 1) and rate of clinical failure by Day 8, using an acceptable clinical difference of 1.5x as a non-inferiority margin (delta of 2.5%). Secondary outcomes will include adverse drug reactions, cure rates, hospital admissions including in-patient duration, and cost-effectiveness. Data will be collected at baseline (Day 1), Day 8, and Day 29 post-enrolment. Discussion This study seeks to provide evidence on the clinical and public health benefits of using LUS to improve the diagnosis and management of paediatric pneumonia in low-resource settings. If this intervention proves effective it could contribute significantly toward reducing unnecessary antibiotic prescriptions, thereby addressing AMR. The potential for LUS to be integrated into routine clinical practice could revolutionize pneumonia management, especially in areas with limited access to advanced diagnostic tools. Trial Registration This trial will be registered on ClinicalTrials.gov and The South African National Clinical Trials Register (SANCTR) prior to participant enrolment.

This study aimed at characterizing the composition and performing chemical speciation modelling to determine species that are abundant in the coal fly ash (CFA) and soil samples sourced from Hendrina Power station located in Mpumalanga Province. All CFA samples were alkaline in nature with pH values ranging between 8.11 ± 0.07 and 8.60 ± 0.03 with an electrical conductivity (EC) ranging between 301.70 and 1515.00 µS/cm while EC of control soil was 103.10 µS/cm. The control soil pH was found to be 6.24 ± 0.13 and total organic carbon values ranged between 2.68 and 85.82 mg/kg and some percentage organic carbon values of CFAs were found to be greater than 8%, which is above the permissible limits of hazardous waste dumping. Oxidation-reduction potential values were negative in all CFA samples and positive in soil. The speciation modelling showed that the potential for a trace metal to have hazardous effects in soil systems depends on its concentration, specific form and interactions with other constituents in CFA. The slow release of metals from CFA to soil was assessed by looking at how a given metal is distributed throughout its several possible chemical forms. The presence of divalent cations (Pb2+, Cu2+, Zn2+, etc.) in CFAs might pose a threat to soil quality. In the competition for binding sites on ferric hydroxides, dissolved metal ions faced off against other metals. Protons (H+) were seen to be in competition with Pb, Cu and Zn for the ability to bind to hydroxyl (OH-) groups and this is due to chemical precipitation and surface complexation.

Preventive Maintenance (PM) is a periodic maintenance strategy, which has great results for devices in extending their life, increasing productivity, and most importantly, help avoid unexpected breakdowns and their costly consequence. A preventive maintenance scheduling (PMS) is determining the time for carrying out PM, and it represents a sensitive issue in terms of impact on production if the time for the PM process is not optimally distributed. In this study, hybrid heuristic methods were used to solve the PMS problem, as genetic algorithm and Tabu research were adopted. The optimal solution was reached in a short time compared to previous studies in which optimal methods were used, integer programming and nonlinear integer programming. Also, sensitivity analysis was applied to measure the robustness and strength of the method used, where an optimal solution was obtained for all experiments and in record time. This method can be used for power plants in privet or public sectors, to generate an optimal PMS, to save money, and to avoid water or electricity cuts.

Debates regarding human capital disclosure (HCD) emphasise the usefulness of people-related information in stimulating investor confidence and building stakeholder trust. Despite this, human capital (HC) information is interwoven in most international sustainability reporting standards such as the global reporting initiative (GRI), thereby concealing the impact of human resource (HR) practices in shareholder value creation. The aim of this study is to develop a taxonomy to assess HCD in the sustainability reports to capture the true value of HC distinctively. A content analysis-based study with a deductive approach was followed by utilising the GRI standards to isolate and classify people-related information into an HCD sustainability taxonomy. 40% HC metrics were extracted from the GRI standards and subsequently classified into 7 dimensions, namely, human capital allocation, human capital wellbeing, human capital investment, human capital network, human capital governance, human capital risk and human capital earnings. Furthermore, 40 GRI content indexes of the companies listed in the Johannesburg Stock Exchange (JSE) revealed that most disclosures are covered in the human capital governance and human capital earnings categories. HCD sustainability provides investors and HR professionals with a useful tool to assess people-related information from the sustainability reports for isolating the true value of HC.

Abstract: Lipodystrophies (LDs) are rare, complex disorders of the adipose tissue characterized by selective fat loss, altered adipokines profile and metabolic impairment. Sirtuins (SIRTs) are class III NAD+-dependent histone-deacetylases linked to fat metabolism. SIRT1 plays a critical role in metabolic health by deacetylating target proteins in tissues including liver, muscle and adipose tissue. Circulating SIRT1 levels have been found to be reduced in obesity while increased in anorexia nervosa and in patients experiencing weight loss. We evaluated circulating SIRT1 levels in relation to fat amount in 32 lipodystrophic patients affected by congenital or acquired LDs compared to non-LD subjects (24 with anorexia nervosa, 22 normal weight and 24 with obe-sity). SIRT1 serum levels were higher in LDs as compared with normal weight subjects (mean ± SEM: 4.17 ± 0.48 vs. 2.59 ± 0.20 ng/mL) or subjects with obesity (1.7 ± 0.39 ng/mL), whereas they were close to those measured in anorexia nervosa (3.44 ± 0.46 ng/mL). Our findings show that within the LD group there was no relationship between SIRT1 levels and the amount of body fat. The mechanisms responsible for secretion and regulation of SIRT1 in LD deserve further investi-gation.

Text book ought to be viewed as one of the numerous sources educators can attract after making a powerful exercise and may offer a system of direction and introduction. The analysis of textbook forms a necessary part in academics so as to devise the most appropriate content. The present study made a comparative account of textbooks for Grade 5 Social studies taught in public (i.e., Punjab textbook) and private sector (Oxford textbook) of Pakistan. The comparison was made on key features and on themes suggested by National Curriculum Council (2017) as a standard for textbook publishers. The findings demonstrated that both books contain activities and are clearly written, however, PTB is cheaper, possess low paper quality than OTB and was revised in 2018 whereas OTB has not revised since 2010. It is also suggested that both textbooks do not contain enough information as per NCC’s standard. It is suggested that government should take notice about it and publishers should be bound to deliver only that material in education sector that is according to the devised set of standards.

A 2-month incubation study was carried out using two soil types to determine nitrogen mineralization of different inorganic-organic amendments. The following seven treatments (T) were established; T1 = control, T2 = 5 g of dry algae per kg of soil (100%DA), T3 = 136g of agri-mat per kg of soil (100%GA), T4 = 61 g of ground grass per kg of soil (100%GG), T5 = 2.5 g of dry algae + 2.5 g of nitrogen fertilizer (NF) per kg of soil (50%DA50NF), T6 = 50%GA50NF, T7 = 50%GG50NF. Three samples per treatment were drawn at 0, 3, 7, 15, 30, 45, and 60 days for mineral-N determination. A 2-month glasshouse experiment was established afterwards with the following five treatments: T1 = Control, T2 = 50%DA, T3 = 50%GA, T4 = 50%GG, and T5 = 100NF. The results indicated that nitrogen mineralization was significantly higher in organic-inorganic amendments compared to sole organic amendments. The percentage differences ranged from 157% to 195%. The 50%DA treatment increased spinach yield by 20.6% in sandy loam and 36.5% in loam soil. It is difficult to fully recommend the 50%DA treatment without field-scale evaluation, but it is a promising option to be considered.

(1) Introduction: Every two hours, a Romanian woman is diagnosed with cervical cancer [1] as the country ranks second in Europe in terms of mortality and incidence rate [2]. This paper aims to identify the main reasons that have led to this situation, focusing on the measures taken by the Romanian Ministry of Health for the prevention of this type of cancer national - programs for cervical cancer screening and HPV vaccination. (2) Materials and methods: We performed a study based on available secondary data from the National Statistics Institute, World Health Organization and Bucharest Institute of Oncology in order to assess the burden associated with cervical cancer and placing it in the context of known global and European incidence and mortality rates, thus evaluating the importance of this health issue in Romania. The second component of our study was a cross-sectional study, using a 14 questions questionnaire, applied to the women participating in the National Screening Program for Cervical Cancer, aimed to evaluate the women’s level of knowledge about screening and HPV vaccination and their access cervical cancer specific health-care services. (3) Results: The results of the research shows that a high percentage of women postpone the routine checks due to lack of time and financial resources and indicate that low level of knowledge about the disease and the specific preventive methods determines low participation screening and HPV vaccination programs implemented in Romania contributing to the country’s situation of cervical cancer. (4) Conclusions: The national programs have complicated procedures, are underfunded, and do not motivate enough health care workers. This combined with the lack of information adds up to an extremely low number of women screened and vaccinated. Our conclusion is that the Romanian Ministry of Health must take immediate action by conducting major awareness campaigns, implementing measures to make the programs functional and ensuring coherent funding.

Few studies have examined the dietary protein intake and sources in combination with the longitudinal changes in brain structure markers. Our study aimed to examine the association between dietary protein intake and different sources of dietary protein with the longitudinal rate of change in brain structural markers. A total of 2723 and 2679 participants from the UK Biobank were included in the analysis. The relative and absolute amounts of dietary protein intake were calculated through a 24-hour dietary recall questionnaire. The longitudinal change rates of brain structural biomarkers were computed using two waves of brain imaging data. We utilized multiple linear regression to examine the association between dietary protein and different sources and the longitudinal changes in brain structural biomarkers. Restrictive cubic splines were used to explore nonlinear relationships, and stratified and sensitivity analyses were conducted. Increasing the proportion of animal protein in dietary protein intake is associated with a slower reduction in the total hippocampus volume (THV, β: -0.02524, P&lt;0.05), left hippocampus volume (LHV, β: -0.02435, P&lt;0.01) and right hippocampus volume (RHV, β: -0.02544, P&lt;0.05).Higher intake of animal protein relative to plant protein is linked to a lower atrophy rate in THV (β: -0.01249, P&lt;0.05) and LHV (β: -0.01173, P&lt;0.05) and RHV (β: -0.01193, P&lt;0.05). Individuals with higher intake of seafood exhibit lower longitudinal rate of change in HV compared to those with no consume (THV, β: -0.004514; P&lt;0.05; RHV, β: -0.005527, P&lt;0.05). In subgroup and sensitivity analyses, there was not a significantly alteration. A moderate increase in the intake and proportion of animal protein in the diet, especially from seafood, is associated with a lower longitudinal change rate in hippocampus volume.

Aim: Ovarian cancer is the leading cause of gynecological cancer deaths worldwide. Treatment methods are listed as surgery, chemotherapy and radiotherapy depending on the stage of the cancer, but developing resistance to chemotherapy increases the need for alternative agents that act on the same pathways. In this study, the effects of rosmarinic acid (RA) and doxorubicin (DX) on the activation of FOXP3, an important tumor suppressor gene, in OVCAR3 cells were examined. Material Method: In the study, human ovarian adenocarcinoma cell line was used. MTT test was applied to determine the effect of rosmarinic acid and doxorubicin on the proliferation of OVCAR3 cells. Expression levels of FOXP3 for cell proliferation and Capase-3 for Apoptosis were determined by qRT-PCR and Western blot analysis. Wound healing model was applied to determine metastasis. The results were evaluated with one-way ANOVA in SPSS 20.0 program as p≤0.05. Results: It was determined that rosmarinic acid alone and in combination with doxorubicin inhibited the proliferation of OVCAR3 cells in a time- and dose-dependent manner for 24, 48 and 72 hours, and caused the cells to die by causing them to undergo apoptosis. It was observed that Caspase-3 expression increased approximately tenfold in OVCAR3 cells, while FOXP3 expression increased only in RA treatment and was downregulated in DX and RA+DX treatments. Coclusion According to the results of our study, it was observed that many steps of the signaling pathways related to proliferation, migration and apoptosis were affected by the combination of RA and DX in OVCAR3 cells. This shows that RA will gain an important place in cancer treatment with more comprehensive studies.

Aim: Ovarian cancer is one of the most frequently diagnosed cancers in women in the world. Recognition of the differences between tumors in cancers and resistance to treatment in patients have made the treatment potential of chemotherapy, radiotherapy and immunotherapy controversial. Especially against drug resistance, laboratories have implemented the drug diversion system by putting old drugs into new forms. In this study, the cytotoxic and apoptotic effects of the combination of doxorubicin (DX) and thymoquinone (TQ) on ovarian adenocarcinoma cells (OVCAR3) were investigated. Material Method: OVCAR3 cell line was cultured in RPMI medium containing 10% FBS, 1% penicillin/streptomycin. Cell viability and cell growth rate were determined by MTT viability test by combining doxorubicin and thymoquinone. Nucblue immunofluorescent staining was used to determine the mechanism of cell death at different doses of doxorubicin and thymoquinone compounds, qRT-PCR to determine the pathways underlying the apoptotic mechanism, and western blot methods to show protein levels. Result: We found that the combination of DX and TQ reduced the viability of OVCAR3 cells (MTT assay), induced apoptosis (RAF, RAS, Bcl2, Bax by qRT-PCR) and increased RAF, RAS protein levels in TQ and DX-treated cells by western blot analysis. Conclusion: The results obtained revealed for the first time that combining DX and TQ also had cytotoxic/apoptotic and anti-proliferative effects against ovarian adenocarcinoma cells.

To assess the community health workers’ (CHWs) knowledge, attitude, and practices (KAP) in type-2 diabetes (T2D) and hypertension (HTN) management. We thus also sought to assess the potential health system barriers for incorporating CHWs in T2D and HTN management. Mixed-method study comprised (1) a survey among 153 active CHWs to assess their KAP of T2D and HTN, and (2) semi-structured interviews with key informants to understand challenges of the health system and proposed solutions in incorporating CHWs in T2D and HTN management. The majority of CHWs correctly answered general knowledge questions on NCDs, risk factors, and prevention; however, only one-quarter correctly answered questions on smoking, family history, or tobacco use as risk factors. Most respondents appeared to have positive attitudes and have been practicing some activities related to T2D and HTN. Both financial and non-financial resource constraints were cited as challenges of the health system; therefore, re-structuring the role definition of CHWs and task of responsibilities, and assessment the need and workload have been proposed as ways forwards to effectively incorporate CHWs in T2D and HTN care. CHWs in Cambodia have shown their potential in T2D and HTN management; however, a well-designed strategy including technical training, clearly defined roles and responsibilities, and strong supporting structure are important to maximize their potential in the health system.

Yeasts are gaining increasing attention for their potential health benefits as probiotics in recent years. Researchers are actively searching for new yeast strains with probiotic properties (i.e, Debaryomyces hansenii; Kluyveromyces marxianus; Yarrowia lipolytica; Pichia hudriavzevii; Torulaspora delbrueckii) from various sources, including traditional fermented foods, the human gut, and the environment. This exploration is expanding the pool of potential probiotic yeasts beyond the well-studied Saccharomyces boulardii. Research suggests that specific yeast strains possess properties that could be beneficial for managing conditions like inflammatory bowel disease, irritable bowel syndrome, skin disorders and allergy. Additionally, probiotic yeasts may compete with pathogenic bacteria for adhesion sites and nutrients, thereby inhibiting their growth and colonization. They might also produce antimicrobial compounds that di-rectly eliminate harmful bacteria. To achieve these goals, the approach that uses probiotics for human health is changing. Next-generation yeast probiotics are emerging as a powerful new approach in the field of live biotherapeutics. By using genetic engineering, scientists are able to give these tools specialized capabilities. However, most research on these probiotic yeasts is still in its early stages, and more clinical trials are needed to confirm their efficacy and safety for various health condi-tions. This review could provide a brief overview of the situation in this field.

China's implementation of public-private partnerships projects has been quite effective, involving infrastructure and other livelihood projects, a total of 19 industries, and an investment of nearly 1.5 trillion yuan. The characteristics of PPP projects such as long construction period and large investment amount determine the risks of PPP projects are also great, and the PPP projects of comprehensive environmental governance are also the same. The government and social capital use the PPP model to cooperate, and use the principal component analysis method to assess the risks of the entire life cycle of the comprehensive environmental governance PPP project. Therefore, it plays an important role in ensuring the smooth implementation of projects and reducing the losses caused by risks. According to the risk factors of the whole life cycle of the comprehensive environmental governance PPP project, an indicator system of 5 first-level indicators, 18 second-level indicators, and 43 third-level indicators has been established. Principal component analysis is used to analyze the influence weight of risk factors at each stage. The analysis shows that among the four stages, environmental pollution risk, project approval delay risk, completion risk, interest rate and financial fluctuation risk, and franchise life risk are the most influential risks in the implementation of PPP projects. Therefore, suggestions are made through the risk factors of each stage in the comprehensive environmental governance PPP project. For example, strengthen the response to the external environment risks of the comprehensive environmental governance PPP project, standardize the bidding and procurement of the comprehensive environmental governance PPP project, and strengthen the subsequent management of the transfer of the comprehensive environmental governance PPP project. In this way, the ability to resist risks of comprehensive environmental governance PPP projects is improved; the smooth implementation of the project is guaranteed, and the long-term development of comprehensive environmental governance PPP projects is promoted.

Nutrient profiling (NP) models that assess nutrient density of foods can help remedy micronutrient deficiencies. We used NP methods to identify the most nutrient-rich foods in the 2019 FAO/INFOODS Western Africa Food Composition Table (WAFCT). The WAFCT had complete data for 909 foods. Three versions of the well-established Nutrient Rich Food (NRF) model were used: 1) the original NRF9.3; 2) a new NRF6.3 based on 6 priority micronutrients (iron, zinc, calcium, folate, vitamin A, vitamin B12); and 3) NRF 15.3, based on 15 nutrients to encourage (NRF6.3 nutrients + vitamin D, vitamin E, vitamin C, vitamin B1, vitamin B2, vitamin B3, vitamin B6, copper, and magnesium). Data analyses used one-way ANOVAs and independent t-tests, with significance at α=0.05. Animal-source foods were rated higher by NRF6.3 priority micronutrient and NRF15.3 NP models than by the NRF9.3 model. African indigenous vegetables had higher protein content and higher nutrient density compared to non-indigenous vegetables. African indigenous grains had higher nutrient density compared to non-indigenous grains. Though animal-source foods received some of the highest scores, NP models adapted to the West African context showed that African indigenous vegetables and grains were also nutrient rich. Indigenous foods could be important sources of priority micronutrients for the region.

Social biases may concentrate attention of researchers on a small number of well-known molecules/mechanisms leaving others underexplored. In accordance with this view, central to mechanistic toxicology is a narrow range of molecular pathways that are assumed to be involved in significant part of responses to toxicity. It is unclear, however, if there are other molecular mechanisms which play important role in toxicity events but are overlooked by toxicology. To identify overlooked genes sensitive to chemical exposures we used publicly available databases. First, we used data on published chemical-gene interactions for 17,338 genes to estimate their sensitivity to chemical exposures. Next, we extracted data on publication numbers per gene for 19,243 human genes from Find My Understudied Genes database. Threshold were applied to both datasets using our algorithm to identify chemically sensitive and chemically insensitive genes and well-studied and underexplored genes. 1,110 underexplored genes highly sensitive to chemical exposures were used in GSEA and Shiny GO analyses to identify enriched biological categories. Metabolism of fatty acids, amino acids, and glucose were identified as underexplored molecular mechanisms sensitive to chemical exposures. These findings suggest that future effort is needed to uncover the role of xenobiotics in the current epidemics of metabolic diseases.

This research aimed to study and compare prevalence of work-related musculoskeletal (MSK) problem and perceived discomfort among port crane operators consisting of quay and rubber tyred gantry (RTG) cranes working in the Laem Chabang Deep-sea Port, Thailand. Direct interviews for a cross-sectional analysis was selected for this unique job with a small amount of sample size. A standardized modified version of the Nordic Musculoskeletal Questionnaire (NMQ) was lunched for 26 male participants, consisting of 11 quay and 15 RTG, where a priori power analysis using G*Power suggested the minimum as 24 for the hypothesis test. Socio-demographic characteristics showed no significant difference among them. The NMQ revealed lower back as the highest prevalent body part (76.9%) followed by neck, shoulders and upper back at the same percentage (23.1%) for all port crane group, with up to 96.2% reporting MSK problem over the past 12 months. And Borg scale rating, assessing the perceived discomfort, revealed lower back with the highest score (2.38) followed by upper back (0.65), shoulders (0.54) and neck (0.5). Remarkably, the comparation between the quey and RTG crane operators on the MSK prevalence (χ2 test) and perceived discomfort levels (Kruskal-Wallis test), regarding different 9 body parts, revealed a significant difference between the two on upper back with quay crane having more problem than the RTG at p &lt; 0.05. while the rest of them were mainly in the same direction. MSK contributors such as: working awkward posture, mental stress, height, trolley distance and vibration are considerably the main causes of this. However, the larger in scale of exposure to those for the quey crane compared to the RTG might have led to the distinguishing MSK problem found in this study which require thoroughly deliberation for the particular solutions.

SARS-CoV-2 is the Coronavirus responsible for the COVID-19 pandemic. Even though we are no more in a pandemic situation, people are getting infected some of them needing hospitalization, and a few of them die. Methods: We did a retrospective study including 445 patients who accessed the Emergency Section of Policlinico Umberto I, Rome, Italy, where they had routine blood exams. In this study, we concentrated on the complete blood count, creatinine, and azotemia. The data was analyzed using ANOVA, Spearman correlation, and ROC analysis. They were divided into four groups based on their outcome: (1) the emergency group (patients with mild forms who were quickly discharged); (2) the hospital ward group (patients who after admission to the emergency section were hospitalized in a COVID-19 ward); (3) the intensive care unit (ICU) group (patients that after the admission in the emergency section required intensive assistance); (4) the deceased group (patients that after the admission in the emergency section had a fatal outcome). Results: We found significant changes for creatinine, azotemia, hematocrit, mean corpuscular hemoglobin concentration, basophils, monocytes, red blood cell distribution width, hemoglobin, hematocrit, and red blood cell numbers by ANOVA according to their outcomes, particularly for the deceased group. Also, we found outcome correlations for eosinophils, hemoglobin, hematocrit, mean corpuscular hemoglobin concentration, lymphocyte, neutrophil, platelet, and red blood cell number and red blood cell distribution width. Conclusions: This study discloses an association between “classical” routine blood biomarkers and the severity of outcomes in Omicron patients.

Exogenous melatonin, a nutraceutical for maintaining a healthy sleep-wake cycle and managing sleep disorders, requires large, repeated doses due to low bioavailability and short half-life. This necessitates the development of a sustained-release formulation with a longer half-life and sustained plasma concentration. Therefore, exogenous novel 5 mg sustained-release melatonin capsules (Melatonin-SR, test product) were formulated. This open-label cross-over study compared the pharmacokinetics (maximum concentration [Cmax], time to reach Cmax [Tmax], area under the curve [AUC] and elimination half-life [t1/2]) and safety of Melatonin-SR with 5 mg immediate-release melatonin capsules (Melatonin-IR, reference product) after single-dose oral administration in healthy fasting adults. Sixteen participants (aged 18-45 years) were randomized (1:1) to receive either Melatonin-SR or Melatonin-IR in two periods with a 7-day washout period. Melatonin-SR reported lower Cmax (11446.87 pg/mL) compared to Melatonin-IR (22786.30 pg/mL). The mean Tmax of Melatonin-SR and Melatonin-IR was 1.26 h and 0.87 h, respectively. The mean t1/2 of Melatonin-SR (5.10 h) was prolonged by five-fold compared to Melatonin-IR (1.01 h). One adverse event (vomiting) was reported following administration of the Melatonin-IR. Melatonin-SR resulted in higher and sustained plasma melatonin concentrations for an extended period and was well-tolerated. Hence, Melatonin-SR may be a promising nutraceutical for maintaining healthy sleep.

Recently Candida auris has emerged as a multi-resistant fungal pathogen, with a significant clinical impact, and has become a critical issue in WHO fungal priority list, due to its unique ability to persist for long time on human skin and hospital environments. It is therefore fundamental to reinforce hospital surveillance protocols to limit nosocomial outbreaks. The study purpose was the Fourier-Transform Infrared Spectroscopy (FT-IR) application to investigate the phylogenetic relationships between isolated strains within the C. auris outbreak at the university Intensive Care Unit of a Tertiary University hospital in Turin (Italy). In order to calculate a clustering cut-off, intra- and inter-isolates distance values were analysed. Data showed the presence of a major cluster Alfa and a minor cluster Beta with a defined C. auris clustering cut-off. The results were validated by an external C. auris strain and Principal Component and Linear Discriminant Analysis. The application of FT-IR technology had allowed to obtain important information about the phylogenetic relationships between the analysed strains, defining for the first time a “not WGS-based” clustering cut-off with a statistical-mathematical approach. FT-IR could represent a valid alternative to molecular methods for rapid and cost saving typing of C. auris strains with important clinical implications.

Objective: The private healthcare providers (PHCP) are believed to improve access to healthcare services in Public-Private Mix (PPM) projects, as they are considered first point of contact for healthcare. The purpose of this study was to know the satisfaction level of TB patients. Design: A questionnaire-based, cross-sectional study was carried out during November and December 2017 for 572 under-treatment patients registered with PHCPs in the PPM project. Lot quality assurance sampling technique was used to randomly select 19 districts from sample frame of 75 districts. In each selected district, data collector retrieved TB register of 8 months (Jan – Aug 2017) and systematically selected patients by fixed periodic interval. SPSS (version 24.0) was used to analyze the data. Results: Study included 53% (n=301) of males and 47% (n=271) of females, with mean age of 38 years (SD, ±18). Almost half of the participants were illiterate (51%, n=289) and 64% (n=365) were non-earning members of the family. In practice, most of the participants visit private providers (71%, n=407), including private hospital/clinic (44%) and traditional practitioners (27%; n=153). 55% of participants visited the current doctor because of clinic’s proximity to residence. 82% of the participants (n=469) were satisfied with the TB care services and 85% (n=488) said that they would recommend this clinic to others. Conclusion: PHCPs are preferred providers for individuals, which is consistent with findings of other studies. Though they are satisfied with TB care and services, interventions should be introduced to reduce the financial burden on the patient. Partnering PHCP is a way forward to ensure universal health coverage, health system strengthening and better health outcomes of the population.

Schistosomiasis, acquired by skin-penetrating cercariae of dioecious digenean schistosomes during freshwater contact, afflicts nearly 260 and 440 million people with active infections and residual morbidity, respectively; about 10 million women at reproductive age contract schistosomiasis during gestation every year. Acute schistosomiasis is characterized by pre-patent pro-inflammatory CD4+ T-helper 1 or CD4+ Th1/T-helper 17 reactivity against immature schistosomulae. Chronic schistosomiasis is dominated by post-patent anti-inflammatory CD4+ T-helper 2 reactivity against ova epitopes; flukes co-exist in immunocompetent definitive hosts as they are capable of evading their defense mechanisms. Preventive measures should be complemented by vaccination, inducing long-term protection against transmission, infection, and disease recurrence, given the latest advancements in schistosomal vaccines. Transmission models incorporating vaccination available in PubMed, Embase and Web of Science up to December 31, 2023 are presented. Besides conceptual model differences, predictions meant to guide decision- and policymaking reveal continued worm harboring facilitating transmission besides residual infections, and increased susceptibility to re-infection and rebound morbidity, both shifted to later life stages following the intervention. Consequently, a vaccination schedule is pivotal considering the optimal age for initial immunization, i.e., pre-schoolchildren or schoolchildren, in a cohort-based or population-based manner while incorporating potential non-adherers promoting ongoing transmission; longevity over magnitude of vaccine protection to antigenic schistosomal moieties is crucial including accounting for existing pre-acquired immunity from natural exposure, in utero priming besides herd immunity, and induced by chemotherapy. Combining as one multi-component approach long-term effects of vaccination with short-term effects of chemotherapy as regular repeated vaccine-linked therapy in contrast to a single-component intervention seems most promising for achieving WHO’s endpoints of transmission elimination and morbidity control.

The effect of land use on sandy soils of southern Botswana was carried out by comparing the composition and properties of soil organic matter. Virgin and disturbed soils were sampled from savanna ecosystems (Central District and Kweneng District). The biodegradability of organic matter was evaluated by incubation in the laboratory. Humic fractions were quantified and humic acids were analyzed by visible and infrared spectroscopy. The results indicate that continued disturbance, whether due to grazing or subsistence farming, has resulted in small significant changes in the concentration of available nutrients and organic matter in the soil. Nevertheless, substantial changes could be established in soil C/N ratio, humic acid/fulvic acid ratio and in the biodegradability of soil organic matter and the structural characteristics of humic acids. The increased aromaticity of humic acid (visible and IR spectroscopies) following disturbance, suggests increased biogeochemical activity and/or the impact of abiotic processes (such as periodic fires) selectively removing aliphatic constituents. The overall results indicate a low potential soil fertility, the sustainable preservation of which depending more on features related to quality than to the total amount of the soil organic matter, which shows considerable aromatization parallel to its degree of association with the mineral fraction.

In today's intricate media landscape, the resilience and relevance of public service media (PSM) depend on their capacity to align with the diverse and evolving expectations of the public. However, the audience perspective is often overlooked, resulting in a limited understanding of public expectations. This study employs a bottom-up approach that allows for a re-evaluation of the expectations from the audience's viewpoint. It investigates the public's expectations for PSM, drawing on data from 10 focus group discussions (with 60 participants) conducted in the Czech Republic. The findings indicate that expectations can be categorized into four primary dimensions: (1) the expected roles and functions of PSM; (2) the general characteristics of the PSM content (defining the desired nature of PSM content); (3) the principles governing the functioning of PSM (outlining how PSM should operate); and (4) specific requirements concerning PSM news and non-news content. In the latter dimension, objectivity emerged as one of the most critical expectations and a major source of dissatisfaction. While participants collectively value objectivity, they disagree on its definition. A deeper examination revealed that certain public expectations may be unattainable due to the simplistic view of objectivity held by some.

The detection, characterization, and monitoring of SARS-CoV-2 recombinant variants is a challenge to public health authorities worldwide. Recombinant variants, composed of two or more SARS-CoV-2 lineages, often have unknown impacts on transmission, immune escape, and virulence in the early stages of emergence. We examined 4,213 SARS-CoV-2 recombinant SARS-CoV-2 genomes collected between 2020 and 2022 from California to describe regional and statewide trends in prevalence. Many of these recombinant genomes, such as those belonging to the XZ lineage, or novel recombinant lineages, likely originated within the state of California. We discuss the challenges and limitations surrounding Pango lineage assignments, the use of publicly available sequence data, and adequate sample sizes for epidemiologic analyses. Although these challenges will continue as SARS-CoV-2 sequencing volumes decrease globally, this study enhances our understanding of SARS-CoV-2 recombinant genomes to date while providing a foundation for future insights into emerging recombinant lineages.

Severe early childhood caries remains the most common chronic disease affecting children. Its multifactorial etiology has established a controversy about which risk factors were more significant to its development. Therefore our study aimed through meticulous statistical analysis to arrange the “well agreed upon” common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program for this affected age group. The study reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to 3 or more, night feeding, child self-employed brushing, mother caries experience, 2 siblings, on demand feeding, once/day sugary food, sharing utensils, 1 Sibling, male gender, father’s education, late first child dental visit, brushing time, mother’s education, no dental visit, decreased brushing frequency & no night brushing.

Simple Summary: The distribution of typical bacterial redox enzymes such as pyruvate-ferredoxin oxidoreductase (PFOR) in protozoa remains interestingly puzzling. Previous studies have demonstrated diverse cellular localizations of PFOR in some amitochondriate anaerobic protozoa. PFOR is of particular pharmacological importance because it catalyzes the reductive bio-activation of nitro-based prodrugs to cytotoxic radical metabolites. Metronidazole was developed primarily as an antiprotozoal agent against infections caused by Trichomonas vaginalis. However, its antimicrobial spectrum was subsequently expanded to cover anaerobic bacterial infections. It has been shown that mutations in the genes encoding PFOR result in inherent resistance of PFOR-possessing anaerobic protozoa and bacteria to nitro-based prodrugs. Deciphering the evolutionary history of PFOR is crucial in deepening our understanding of the evolution of anaerobic pathogens and unfold new approaches for drug discovery and targeting in pathogen chemotherapy. Abstract: The present frontrunners in the chemotherapy of infections caused by protozoa are nitro-based prodrugs that are selectively activated by PFOR-mediated redox reactions. This study seeks to analyze the distribution of PFOR in selected protozoa and bacteria by applying comparative bioinformatics approaches to test the hypothesis that PFOR was most likely acquired through horizontal gene transfer (HGT) from bacteria. Furthermore, to identify other genes that were putatively acquired using proteome-wide and gene expression analyses. A plausible explanation for the patchy occurrence of PFOR in protozoa is based on the hypothesis that bacteria are potential sources of genes that enhance optimal adaptation of protozoa in hostile environments. The exclusively expressed proteins obtained from Entamoeba histolytica and the putative gene donor, Desulfovibrio vulgaris, showed an over-expression of eleven genes involved in intermediary metabolism. If these results can be reproduced in other PFOR-possessing protozoa, it would provide a more validated evidence to support the horizontal transfer of pfor from bacteria.

We conducted a study to determine if antenatally collected maternal urine cotinine (a me- 13 tabolite of nicotine) measurements can be used to assess the neonatal impact of nicotine exposure 14 during pregnancy. This was a prospective longitudinal cohort of mother-infant dyads. Only term 15 singleton pregnancies were included. The primary outcome measure was the correlation between 16 maternal urine cotinine and infant birth weight. We analysed data from 238 mother-neonates' dy- 17 ads. Urine cotinine was detected in 50.4 % (120/238) women from the whole cohort, but only 16% 18 (38/238) self-reported as smokers (chi-square 39.7, p<0.0001), and these women had significantly 19 smaller babies (p=0.010). There was a significant negative correlation between maternal urine co- 20 tinine and birth weight (Spearman's coefficient = -0.0226, p=0.013). Female babies born to women 21 with nicotine in the urine were significantly smaller (p= 0.001). The number of women exposed to 22 nicotine during late pregnancy (measured in urine) was markedly higher than self-reported and 23 National smoking percentages, suggesting an urgent need for improvement of medical record re- 24 porting on smoking habits to better assess neonatal outcomes.

Brazil has ideal conditions for the large-scale use of cabotage cargo transportation: a vast coastline with almost 7,400 km, approximately 70% of the population resident in a coastal range of up to 200 km from the coast and a strong concentration of activities economic along the coast. However, there is an absolute domain of road modal for the transportation of goods, and cabotage is underused. The purpose of the study was to raise the main barriers that negatively impact the performance of Brazilian cabotage. To this end, it was used to bibliographic and documentary research, based on studies already published in journals, doctoral theses, master's dissertations, congress annals, technical reports and research on government-related government agencies sites, navigation companies and entities related to cabotage. The main barriers that contribute to the low use of cabotage in Brazil were identified and analyzed, as well as possible alternatives of solution for sustainable development of this mode of transport. Such a study will certainly serve as subsidies for the definition of public policies aimed at better use of Brazilian cabotage, as well as to encourage navigation companies to invest more in the transport of goods by cabotage, in order to contribute to the reduction of trucks on highways Brazilian and for environmental preservation.

Objectives: To determine the effects of caffeine consumption on the sleep habits and lifestyle of medical students. Methods: A cross-sectional study was conducted at Jinnah Sindh Medical University (JSMU) and Hamdard College of Medicine. On 422 undergraduate students aged 18-25 years, through random sampling. The duration of the study was from January 2019 to June 2019. The data was collected through self-administered questionnaire which included data regarding sleep habits and lifestyle of medical students. Results: Majority (81.6%) of the students consumed caffeine while only (18.4%) did not. One third of the participants (31.8%) reported caffeine consumption increased their academic performance and (57.3%) reported that it does not. More than half of the participants (63.3%) who consumed caffeine slept during class, whereas (47.2%) never had difficulty in falling asleep during the night. Conclusion: This research concluded that caffeine does have some role on sleep habits of medical students as they tend to have less sleep hours, experience day time dysfunction, average quality of sleep, and falling asleep during class. It has been concluded that caffeine has no effect on eating habits of medical students however, it does increase the screening time, keeping them active.

Interferon-gamma (IFN-γ) is an important cytokine in host defense against tuberculosis infection. In some cases, administration of IFN-γ during tuberculosis infection can promote faster cure. In the present work, we have shown that in a mouse model, human interferon-gamma, exhibits some anti-tuberculosis activity, especially in combination with isoniazid.

Plantar flexors (PF) spasticity is known to poorly correlate with active dorsiflexion (DF) impairment throughout the swing phase of hemiparetic gait. Spastic Cocontraction, instead, stemming from descending pathways, potentially misdirect antagonist PF activity opposing DF during swing. Electromyographic (EMG) recordings, while unable to differentiate between reflex-based and descending origins, may offer valuable insights into this distinction by exploring PF EMG activity after tibial nerve neurotomy (which eliminates PF spasticity). Eleven subjects with hemiparesis walking at comfortable velocity and 11 controls walking at comfortable and slow velocity, underwent kinematic and PF/DF EMG analysis. Five of the hemiparetic subjects underwent tibial neurotomy &gt;1 year prior. We evaluated spasticity at rest (Tardieu scale), maximal ankle dorsiflexion, tibialis anterior agonist recruitment and gastrocnemius medialis and soleus cocontraction coefficients during swing. At slow velocity, controls (0.80±0.12 m/s) moved at a similar pace as hemiparetic subjects (0.73±0.37 m/s, NS). Hemiparetic subjects showed: (i) reduced ankle DF across swing (ii) increased PF cocontraction, including before any DF (iii) higher cocontraction despite absent spasticity in tibial neurotomy subjects (iv) higher tibialis anterior recruitment. Increased PF cocontraction occurs in the absence of spasticity or ankle DF despite higher agonist recruitment. Spastic cocontraction is a major factor limiting active DF at swing, unlike spasticity.

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

The research investigated the relationship between burnout syndrome and the variables of mental resilience and quality and enjoyment of life, in Greek private and public sector workers (N=112), with demographic differences. Data were collected through a structured questionnaire which was distributed in the form of an electronic Microsoft forms. The questionnaire contained demographic questions, the psychometric tool Burnout Assessment Tool version 2.0 (Schaufeli et al., 2019), the psychometric tool Brief Resilience Scale (BRS) (Smith et al., 2008), and the psychometric tool Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) (Endicott et al., 1993) which were used to measure the three variables examined by the research. For statistical analysis, Pearson and Spearman correlation coefficients were used to test the relationship between two quantitative variables, while linear regression analysis was used to find independent factors. The main research hypothesis was verified, finding a negative correlation between burnout and the variables of mental resilience and quality of life, while it was identified that employees experienced greater exhaustion and spiritual withdrawal compared to freelancers. Hypotheses regarding age, educational level, and public-private job data were not verified as there were no statistically significant differences in demographic results.

Background: Although Tuberculosis (TB) is one of the oldest diseases known to mankind, many practitioners are still unaware of various aspects of management of TB including drug resistant TB. To be able to make an impact on the disease burden we need to understand the knowledge, attitude and practices (KAP) of practitioners, both in government and private sector, towards TB case management. Methodology: A random cross-sectional survey of 99 respondents to assess the KAP towards TB case management using a digital semi-structured questionnaire which was pre-tested and administered to allopathic practitioners from across States in North and Central India. Results: 77% responders were government doctors and 23% were private practitioners. Chest physicians accounted for 61% of the responders. 26% of government and 78% of private doctors relied on sources which are difficult to validate for their knowledge on drug resistant TB management. There were large variations seen in knowledge on modes of transmission, standard precautions, extent of drug resistant TB, diagnostics as well as treatment regimen for drug resistant TB. Conclusion: The knowledge of both sector doctors especially amongst private practitioners with respect to the awareness of extent, diagnosis, and treatment and infection control measures for drug resistant TB is suboptimal which translates to poor diagnostic, therapeutic and infection control choices amongst private practitioners. If India has to achieve the targets for TB Elimination by 2025, serious work needs to be done to upgrade the knowledge of the private sector doctors on drug resistant tuberculosis. The Ministry of Health and Family Welfare, GoI needs to have regular educational programs for the private practitioners coupled with awareness campaigns and frequent surveys to assess the knowledge, attitude and practices being followed in the private sector for TB management including drug resistant TB.

The double burden of malnutrition (DBM) is escalating in low- and middle-income countries (LMICs), including in Rwanda, most notably in urbanizing areas. The 2019-2020 Rwanda Demographic Health Survey (DHS) revealed 33% of children under 5 are stunted while 42% of women in urban areas are overweight or obese. This coexistence has contributed to a surge in non-communicable diseases (NCDs), particularly in secondary cities. Using the World Health Organization’s (WHOs) “double-duty action” (DDA) concept, this study aims to identify and evaluate interventions with double-duty potential in Rwanda, focusing on the districts of Rusizi and Rubavu. Guided by Hawkes et al.’s conceptual framework for identifying DDA entry points, a desk review of national policies pinpointed 4 programs with DDA potential: early childhood development (ECD) centers, the school feeding program, farmer field schools (FFS), and the provision of nutrition-sensitive direct support. In-person interviews with key stakeholders assessed their implementation and a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis informed context-specific recommendations for their improvement. Recommendations include targeting beliefs surrounding nutrition, improving trainings for community educators, enhancing parent – particularly father – involvement, and close follow-up. These findings offer actionable strategies for governments and nutrition stakeholders and may benefit similar interventions in other rapidly urbanizing LMICs.

The direct detection of dark matter constituents, in particular the weakly interacting massive particles (WIMPs), is central to particle physics and cosmology. In this paper we develop the formalism for WIMP-Nucleus induced transitions from isomeric nuclear states. We specialize it in the case of the experimentally interesting target 180 Ta

Hard tissue apposition along the root canal walls is a slow, normally occurring physiological aging process. In response to tooth wear, local deposition of hard tissue may also occur in the pulp at a slow pace. Sometimes, the rate of hard tissue deposition acceleration may seem to be uncontrolled after dental trauma, autotransplantation, and orthodontic therapy, leading to rapid partial or total obliteration of the root canal space. This situation is called calcific metamorphosis (CM) or pulp canal obliteration (PCO). Although the incidence of pulpal necrosis in these teeth is believed to be infrequent, conventional endodontic therapy in severely calcified canals poses extreme difficulties and a higher risk for procedural accidents. This article aims to review the available approaches for the predictable negotiation of calcified canals and to introduce the buckling resistance activation test (BRAT) technique.

The economic, social and environmental benefits generated by the use of urban public transportation infrastructure constitute a complex dynamic urban public transportation infrastructure utilization benefit system. This paper evaluates the coupling coordination among these three benefits taking four Chinese autonomous municipalities as an example. These four cities have large-scale urban public transportation infrastructures but their utilization has many serious problems. The basic function of urban public transportation infrastructure has not been fully played in these cities. Whether the different benefits of urban public transportation infrastructure have been developed in harmony or not is unclear. We analyzed the coordinated development among three benefits by constructing coupling coordination degree model and used Gini coefficient to study the difference of coordinated development among three benefits of four cities. The result shows that the levels of coordinated development among three benefits of urban public transportation infrastructure were lower in these four cities and have positive correlation with it of urban public transportation infrastructure utilization benefit. Raising the level of urban public transportation infrastructure utilization benefit is the most crucial solution of promoting the coordinated development among three benefits.

Following the transfer of hospital services to provincial government oversight, it is essential to understand how such changes impact service quality and efficiency. This study aims to identify the factors affecting hospital service quality post-transfer and evaluate the role of professional nurses in maintaining service standards under new governance.We conducted the study at sub-district health-promoting hospitals using a mixed-methods design based on the Global Fund-HSS framework (2012), which categorizes factors into accessibility, processes, productivity, and outcomes. We collected data from 340 nurses and 400 patients using structured questionnaires. We divided the questionnaires into seven sections, which captured a range of metrics such as the personal data of nurses, hospital service activities, and leadership qualities. We employed a Likert scale to gauge perceptions and expectations of service quality. We used paired t-tests to compare performance metrics before and after the administrative transfer, one-way ANOVA to assess variability among different service units, and binary logistic regression to identify key determinants of service quality in our statistical analysis. The analysis revealed a significant correlation between the attitudes and competencies of healthcare teams and the levels of service quality. Notably, service units transferred less than 50% exhibited minimal changes, indicating that the degree of transfer significantly impacts service outcomes. Despite these variations, the fundamental mission of promoting health remained consistent. The study emphasizes the critical role of nurses and recommends further research to identify additional factors that could improve service quality in transferred healthcare facilities. This could contribute to improved healthcare delivery across restructured health systems.

Following the transfer of hospital services to provincial government oversight, it is essential to understand how such changes impact service quality and efficiency. This study, conducted from 1 March 2023 to 31 March 2024 at sub-district health-promoting hospitals in Thailand, aims to identify the factors affecting hospital service quality post-transfer and evaluate the role of profes-sional nurses in maintaining service standards under new governance. Utilizing a mixed-methods design based on the Global Fund-HSS framework (2012), which categorizes factors into accessibility, processes, productivity, and outcomes, we collected data from 340 nurses and 400 patients through structured questionnaires. These questionnaires were divided into seven sec-tions, capturing metrics such as the personal data of nurses, hospital service activities, and lead-ership qualities. We employed a Likert scale to gauge perceptions and expectations of service quality and conducted paired t-tests to compare performance metrics before and after the admin-istrative transfer. One-way ANOVA was used to assess variability among different service units, and binary logistic regression helped identify key determinants of service quality. The analysis revealed a significant correlation between the attitudes and competencies of healthcare teams and the levels of service quality. Notably, service units transferred less than 50% exhibited mini-mal changes, indicating that the degree of transfer significantly impacts service outcomes. Despite these variations, the fundamental mission of promoting health remained consistent. The study emphasizes the critical role of nurses and recommends further research to identify additional factors that could improve service quality in transferred healthcare facilities, potentially contributing to enhanced healthcare delivery across restructured health systems.

Abstract: Dispersal strategies of a species can affect its invasion success. Investigation into the dispersal strategies of invasive species in relation to different factors helps our understanding of the invasion mechanisms and provides knowledge for population management and invasion evaluation. Tetranychus ludeni Zacher (Acari: Tetranychidae) is an invasive species, which is native to Europe but now cosmopolitan. Here, we examined the effects of age and density on dispersal in mated females. Our results show that older females with more eggs were more likely to disperse and moved longer distances than younger ones with fewer eggs. Older females spread most of their eggs out of the natal habitats and over longer distances, which reduced competition and increased offspring fitness. Females significantly increased dispersal probability and distance with the increase of population density to avoid crowding. The synchronization of dispersal and reproduction, along with the positive density-dependent dispersal strategy, may facilitate habitat colonization and invasion speed of T. ludeni.

Abstract: Experiments conducted to date to verify the relativistic gravitational time dilation have limited scientific significance because the basic postulate of Einstein’s relativistic GR that the same time (t0) is measured in all non-inertial frames of reference, because all non-inertial frames of reference must be equal, has not yet been verified by time measurements. According to Einstein's relativistic GR, a correlation between time and different gravitational potentials must be the result of a relative relation between non-inertial frames of reference and must not the result of any other physical influence. An experiment that can differentiate between a causal correlation (relative relation) and an apparent correlation (relativistic relation) between time and gravitational potentials is still outstanding. The expressions "relative" and "relativistic" are often used as synonyms. However, Einstein's GR is a relativistic theory. In the case of general relativity, relativistic means that time depends only on the relative relation between non-inertial frames of reference and not on other physical factors. The author proposes an easy-to-realize experiment that is able to distinguish between a causal correlation (relative relation) and an apparent correlation (relativistic relation) between time and gravitational potentials, which can confirm or falsify Einstein's relativistic GR. .

The emergence of mRNA vaccines for SARS-CoV-2 has opened a new page in vaccine development; nevertheless, concerns of the experts have been expressed about unintentional side effects on the gut microbiota (GM). Previous studies showed that this virus acts as a bacteriophage, which infects and destroys specific bacterial strains in the GM. The present manuscript hypothesizes that the synthetic spike protein could create changes in the composition and the functioning of the GM by entering the intestinal cells after vaccination and impairing the symbiotic relationship between intestinal cells and the GM. An experimental protocol to test the hypothesis is suggested.

Abstract: This article reports the results of an ecological study of cancer incidence rates by state in the US for the period 2016-2020. The goals of this study were to determine the extent to which solar UVB doses still reduced cancer risk compared to findings reported in 2006 for cancer mortality rates for the periods 1950–1969 and 1970-1794 as well as cancer incidence rates for the period 1998–2002 and to determine which factors were recently associated with cancer risk. The cancer data for non-Hispanic white (European American) men and women were obtained from the Centers for Disease Control and Prevention. Indices were obtained for solar UVB at the surface for July 1992, and alcohol consumption, and diabetes and obesity prevalence near the 2016–2020 period. Lung cancer incidence rates were also used in the analyses as a surrogate for smoking, diet, and air pollution. The cancers for which solar UVB is significantly associated with reduced incidence are bladder, brain (males), breast, corpus uteri, esophageal, gastric, non-Hodgkin’s lymphoma, pancreatic, and renal cancer. Lung cancer was significantly associated with colorectal, laryngeal, and renal cancer. Diabetes was also significantly associated with breast, liver, and lung cancer. Obesity prevalence was significantly associated with breast, colorectal and renal cancer. Alcohol consumption was associated with bladder and esophageal cancer. Thus diet has become a very important driver of cancer incidence rates. The role of solar UVB in reducing risk of cancer has been reduced due to people spending less time outdoors, wearing sunscreen that blocks UVB but not UVA radiation, and population increases in overweight and obesity, which lowers 25-hydroxyvitamin D concentrations and generates systemic inflammation, a risk factor for cancer. The dietary approach that would reduce the risk of diabetes, obesity, lung cancer, and, therefore cancer, would be one based mostly on whole-plants and restrictions on red and processed meats and ultraprocessed foods. Solar UVB exposure for a few minutes before applying sunscreen and taking vitamin D supplements would also help reduce risk of cancer.Keywords: alcohol consumption; cancer incidence;

Empowering women and promoting gender equality is crucial for accelerating sustainable development in fragile countries, including the Democratic Republic of Congo (DRC). However, there is scarce existing knowledge or understanding of the factors determining women’s empowerment in these contexts. We aimed to assess women's empowerment and determine its associated factors in Kinshasa, DRC. We analyzed data from the 2021 Performance Monitoring Assessment (PMA) survey. A sample of 1,365 women of childbearing age was retained for this study. Twenty empowerment items related to household decision-making, contraception use, and husband/partner influence were considered. We calculated the average women’s empowerment index (aWEI), identified the women empowerment variables using principal component analysis (PCA), and determined the associated factors for the first three principal components through the performance of multivariate binary logistic regression. In Kinshasa, the overall aWEI was estimated at 0.65. It was low for household decision-making (0.34) and high for husband/partner influence domains (0.93), respectively. Three principal components were identified and named, including the absence of threats, control of sexuality, and participation in decision-making. The factors associated with these components were having internet access, being in free union with a partner, being aged 40-49 years, and residing in a non-slum area. Increasing access to information would enable women in Kinshasa to make strategic decisions about their lives, benefiting themselves and others.

During the COVID-19 pandemic, the high prevalence of comorbidities in Mexico, as well as the disparities between public and private health subsystems, substantially contributed to the severe impact it had in the country. The objective of this study was to evaluate and compare risk factors present at admission for mortality of hospitalized patients with COVID-19. A 2-year retrospective cohort study of hospitalized adult patients with COVID-19 was conducted at a private tertiary care center. The study population consisted of 1,258 patients with a median age of 56 ± 16.5 years, of whom 1,093 recovered (86.8%) and 165 died (13.1%). In the univariate analysis, older age (p &lt;0.001), comorbidities such as hypertension (p &lt;0.001) and diabetes (p &lt;0.001), signs and symptoms of respiratory distress, and markers of acute inflammatory response were significantly more frequent in non-survivors. The multivariate analysis showed that older age (p &lt;0.001), the presence of cyanosis (p 0.005) and previous myocardial infarction (p 0.032) were independent predictors for mortality. In the studied cohort, risk factors present at admission associated with an increased risk of death were older age, cyanosis and a previous myocardial infarction, which can be used as valuable predictors for patients’ outcomes. To our knowledge, this is the first study analyzing predictors of mortality in COVID-19 patients attended on a private tertiary hospital in Mexico.

In recent years, technical processes for the sequestration of CO2 through industrial waste mineral carbonation have been explored and developed. There is a large portfolio of Carbon Capture, Uti-lisation and Storage (CCUS) techniques that have been employed on a laboratory and at pilot scale. These include geological storage, ocean storage and mineralisation by carbonate ores. In view of this, the main purpose of this research was to investigate and explore chemical variables, particularly ammonium salts as lixiviants for calcium mineral extraction from iron making slag. The slag in use was acquired from a Steel Mill in the Vaal Triangle Region in Gauteng, South Af-rica. The experimental test work was conducted using different ammonium lixiviants, namely, NH4NO3, NH4Cl and CH3COONH4 to understand the influence of anion type as well as possible differences in mechanisms of interactions. Lixiviant concentration as well as the reaction time were varied in this research study. The three selected ammonium based lixiviants showed different extents of calcium extraction owing to differences in the anion groups. NH4NO3, NH4Cl and CH3COONH4 were found capable of dissolving 50% to 80% of calcium from the selected slag for different molar concentrations. Anion type and leaching time also had significant influences on the leaching of calcium from the slag. Rapid pH degradation resulted in better calcium extraction ca-pabilities. This work has shown that the selected ammonium salts have a potential as lixiviants for calcium dissolution from iron making blast furnace slags. These lixiviants would therefore be important to consider during calcium mineral carbonation for CO2 sequestration.

The COVID-19 pandemic halted progress in global vaccine coverage and disrupted routine childhood vaccination practices worldwide. While there is ample evidence of vaccination declines experienced during the pandemic, it is less clear how low-income countries were affected. We executed a systematic review to synthesize the current literature on impacts to routine childhood vaccinations in low-income countries from January 1, 2020 to February 8, 2023. We collected data using an extraction form on Covidence and assessed the quality of studies included in the review using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Effect estimates for changes in vaccination during the pandemic were reported and summarized. Factors that influenced changes were grouped into descriptive themes. Thirteen studies, encompassing 18 low-income countries and evaluating 15 vaccines at varying doses, were included in the final review. We found that routine childhood vaccinations during the COVID-19 pandemic varied considerably by vaccine type, location, and phase of the pandemic. Nine different themes were identified as factors that influenced changes in vaccination. Documenting past experiences and lessons learned is crucial for informing preparedness efforts in anticipation of future public health emergencies. Failure to effectively address these things in the next public health emergency could result in a recurrence of declining routine childhood vaccinations.

Two conundrums have puzzled COVID-19 investigators: 1) morbidity and mortality is rare among Infants and young children and 2) rates of morbidity and mortality exhibit very large variances across nations, locals and even within cities. These differences correlate with rates of Haemophilus influenzae type B (Hib) and pneumococcal vaccination, which are almost universal among infants and vary widely by geography among adults and the elderly. The higher the rate of vaccination, the lower the COVID-19 morbidity and mortality. Vaccination rates with other vaccines, including BCG and poliovirus, do not correlate with COVID-19 risks. Notably, both Hib and pneumoccoci are common co-infections with influenza and coronaviruses and are associated with more severe disease and risk of death. Whether the vaccines simply protect against COVID-19 complications, directly protect against COVID-19 infection by inducing cross-reactive immunity, or are markers for some other types of protection such as availability of better healthcare, is not yet known. What is known is that improving coverage rates of Hib and pneumococcal vaccination has significantly lowered severe morbidity and mortality in influenza epidemics and might have similar efficacy for mitigating coronavirus outbreaks. If infants and children are valid indicators, the beneficial effects might be very significant. The possibility that anti-viral proteins in milk (e.g., lactoferrin) protect against COVID-19 is also explored.

Background: To examine the association between income levels and mortality rates in patients with chronic kidney disease. Methods: We analyzed data obtained from 3,172 patients with chronic kidney disease obtained from the Korean National Health Insurance claims database (2003–2009). Each patient was monitored until December 2010 or until death, whichever came first. Individual income was estimated from the national health insurance premium. Information on mortality was obtained from the Korean National Statistical Office. Cox proportional hazard models were used to compare mortality rates between different income groups after adjusting for possible confounding risk factors. Results: A low income was significantly associated with a high mortality rate after adjusting for covariates (adjusted HR 1.298 [1.082–1.556]). In addition, dialysis patients who had low incomes were more likely to have higher mortality rates compared to those in dialysis patients who had high incomes (adjusted HR 1.528 [1.122–2.082]). Conclusion: The findings of this study indicate that chronic kidney disease patients with low incomes have the highest mortality risk. Promotion of targeted policies and priority health services for patients with low incomes may help reduce the mortality rate in this vulnerable group.

Ammonium sulfate has been utilized in agriculture; however, there is a dearth of research on its application in maize cultivation subsequent to the implementation of nitrification inhibitors or coating. This study aims to analyze the impacts of various combinations of ammonium sulfate fertilizers on soil nutrients, plant nutrient uptake, yield, and fertilizer utilization efficiency in maize cultivation to ascertain the optimal and stabilized disposal method for ammonium sulfate. A completely randomized design was employed with five treatments (AU, the control using urea; AS, treatment using ammonium sulfate; ASN, treatment using ammonium sulfate with a nitrification inhibitor; ASG, treatment using oil-coated ammonium sulfate; ASD, treatment using oil-humic acid-coated ammonium sulfate). Results showed that: (1) Compared with AU and AS, ASN, ASG and ASD decreased the leaching rates of TN, NH4+-N and NO3-N to the 10-20 cm soil layer, and more residual N was obtained in 0-10 cm soil layer. The first-order kinetic equation Nt=N0(1-e-kt) can better fit the process of nitrogen accumulation and release, and the N release rate constant is AU>CK>AS>ASH>ASN>ASD; (2) Compared with AU and AS treatments, the plant dry weight, grain dry weight, spike width, spike length, and yields of maize increased by 8.85-11.08%, 12.98-14.15%, 2.95-3.52%, 5.50-5.65%, and 43.21-51.10% under ASG treatment respectively. The impact of effective spike number on maize yield was found to be significant, as demonstrated by the path analysis conducted in this study. Furthermore, the accumulation levels of nitrogen, phosphorus, and potassium within above-ground plants significantly increased under the ASG treatment compared to the AU and AS treatments. The partial productivity of nitrogen, phosphorus, and potassium increased by 1.43-1.51-fold under ASG treatment, while grain nitrogen balance, grain phosphorus balance, and grain potassium balance increased by 1.41-1.58-fold, 1.51-1.95-fold, and 1.15-l.96-fold respectively. The oil-coated ammonium sulfate, therefore, exhibited the optimal slow-release effect of nutrients, thereby achieving superior performance in enhancing maize production and efficiency.

Marijuana is the most used illicit drug among youths in the United States. The objectives of the study were to identify the association between marijuana use and other risk behaviors including suicidality among high school students. The 2021 Mississippi Youth Risk Behavior Survey data sets were combined for this study. Crude odds ratio (OR) and adjusted odds ratio (AOR) with a 95% confidence interval were generated using the survey packages in R to account for weights and the complex sampling design of YRBS data. Tobacco products and alcohol use were significantly associated with marijuana use. Students who responded “Yes” to questions “currently used an electronic vapor product?”, “currently smoked cigarettes or cigars?” or “currently drank alcohol?” were more likely to use marijuana compared to students who responded “No”, after adjusting for other risk factors. Marijuana use is also significantly associated with students who had sex, compared to those who never had sex. The adjusted odds ratio is nearly doubled in those who had sex with the same sex or both sexes, compared to those who had heterosexual sex only. After adjusting for other health risk factors, the association between current marijuana use and attempted suicide was not statistically significant. The impact of students’ not sleeping in their parent's or guardian's home on current marijuana use was not significant after adjusting for other risk factors. Marijuana use is evenly burdened between males and females and between all race categories among Mississippi high school students. The identified associations seem to indicate that electronic vapor, tobacco products, and alcohol use could be the forerunners for drug use and should be treated accordingly in drug use prevention programs.

Background: Assessing the impact of bone health clinical management in breast cancer (BC) patients receiving adjuvant endocrine therapy and designing a personalized clinical pathway to reduce bone loss, in an Italian research hospital. Methods: The primary endpoint was to assess (through the process improvement organizational method) the clinical pathway that post-surgical BC patients prescribed with endocrine therapy undergo to prevent bone loss. The secondary endpoint was to design a personalized clinical pathway for a prompt implementation of guidelines, to assess and possibly prescribe antiresorptive therapy. Results: During the first year of the new diagnostic therapeutic assistance pathway execution, an 60% increase in Dual-Energy X-ray Absorptiometry evaluations within 30 days and a 39.5% increase in antiresorptive therapy prescription within 90 days (since prescription of endocrine therapy) were shown, thus increasing patients’ compliance. Conclusion: Case managers and bone health specialists in this context can improve patients’ adherence to therapies and bone health, helping physicians to expand their collaboration.

This paper provides a new discovery that adds to the contemporary theory of modelling of non-stationary queues, by capturing analytically the behavior of the root parameter, for the G1/M/1 PSFFA model of non-stationary Ek/M/1 queue. Additionally, it has been also revealed that the resulting root parameter reduces to the PSFFA model of non-stationary queue. Potential applications of PSFFA to Computer engineering are provided. Some challenging open problems are addressed combined with closing remarks and future research directions.

Crop production in Afghanistan suffers from limited phosphorus (P) availability, which severely hinders national agriculture sustainability. This present study hypothesized that deep fertilizer placement could significantly enhance uptake of immobile P and thus tissue P accumulation and crop yield. A two-year pot experiment growing two maize (Zea mays) hybrid cultivars (Xida-789 and Xida-211) was therefore conducted to test these hypotheses under three contrasting fertilizer placement methods (broadcast, side band, and deep band). In doing so, P concentrations in both maize tissues and soils were compared at 45, 60, and 115 days after sowing (DAS) under nine combinations of nitrogen (N) and P fertilizer rates (kg ha-1: N112P45, N112P60, N112P75, N150P45, N150P60, N150P75, N187P45, N187P60, N187P75). Results have shown that deep band placement significantly increased P uptake efficiency, leading to greater P concentration and accumulation in maize tissues compared to other two fertilization methods. This improved P uptake was attributed to several factors associated with deep placement, including reduced P fixation, enhanced root access to P, and moisture availability for P uptake. Additionally, deep band placement combined with higher N application rates (N187 and N150) further enhanced plant P uptake by promoting P availability and utilization mechanisms. Deep band placement also resulted in significantly higher total soil P, Olsen-P, and P use efficiency than broadcast and side band methods, indicating a more efficient P fertilization strategy for maize that can improve growth and yield. This present study also found positive correlations between P concentration in plant organs and soil Olsen-P, highlighting the importance of adequate soil P levels for optimal plant growth. Overall, our results have showed that deep band fertilizer placement emerged as a superior strategy for enhancing P uptake efficiency, utilization, and maize productivity compared to broadcast and side band placement. This approach can potentially optimize P fertilizer utilization, improve maize growth and yield, while minimizing environmental P losses associated with broadcast applications.

This study presents a comprehensive comparative analysis of retrofitting techniques aimed at enhancing the seismic resilience of seismically vulnerable historical buildings. Recognizing the dual objectives of structural safety and architectural preservation, this research evaluates and compares several advanced retrofitting methods, including base isolation, strengthening of masonry, steel bracing systems, Fiber-Reinforced Polymer (FRP) wrapping, and damping devices. Each technique is critically assessed based on its effectiveness in mitigating seismic risks, its compatibility with historical architectural features, and its applicability to various building types. Base isolation is highlighted for its ability to decouple buildings from ground motion, thereby significantly reducing seismic forces and protecting architectural integrity. Strengthening of masonry through the use of fiber-reinforced polymers and steel elements enhances the ductility and strength of masonry walls, making them more resilient to seismic forces. Steel bracing systems are shown to provide essential lateral support, particularly in timber-framed structures, improving overall stability and reducing deformation during earthquakes. FRP wrapping is identified as a versatile technique that strengthens structural elements without compromising aesthetic value, making it suitable for reinforcing concrete and masonry components. Damping devices, including viscous dampers and tuned mass dampers, are discussed for their ability to dissipate seismic energy and control structural vibrations, offering a minimally invasive solution that preserves historical aesthetics. The study also addresses several challenges and research gaps associated with these retrofitting techniques, such as ensuring architectural compatibility, assessing long-term material performance, optimizing cost-effectiveness, and navigating complex regulatory frameworks. By advancing knowledge in these areas, the research aims to foster interdisciplinary collaboration and innovation in the development of retrofitting solutions. Ultimately, this study contributes to the ongoing efforts to safeguard historical buildings against seismic hazards. By leveraging cutting-edge technologies and best practices in structural engineering and architectural conservation, stakeholders can develop sustainable, cost-effective, and culturally sensitive retrofitting strategies that protect valuable cultural heritage for future generations.

Background: The purpose of this review is to clarify the natural course of Benign Paroxysmal Torticollis (BPT) and to update the relationship of this disorder with migraine. BPT belongs to a group of “episodic syndromes that may be associated with migraine” and is diagnosed when according to diagnostic criteria of the International Classification of Headache Disorders, 3rd edition. It is present in infants and young children and it is an underdiagnosed manifestation, because it is not well recognized and in most cases with a benign evolution, but requires careful differential diagnosis. It was first described by Snyder in 1969 as a movement disorder, a cervical dystonia consequent to labyrinthic disorder.Materials and methods: The PubMed and Web of Science databases were consulted from 1968 to 2024, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines ,2020.( PRISMA)Results: 113 articles were identified, 86 selected and 20 considered for the purpose of this review. The clinical studies were considered in relation to evolution, cognitive and motor development, to genetic and not genetic etiology, to the relationship with migraine with and without aura, vestibular migraine, hemiplegic migraine, and paroxysmal vertigo.

Gene regulation is vital for cellular function and homeostasis, involving diverse mechanisms controlling specific gene products and contributing to tissue-specific gene expression. Dysregulation leads to diseases, emphasizing the need for understanding these mechanisms. Non-coding regions, notably enhancers and super-enhancers (SEs), act as crucial gene regulators, orchestrating transcriptional activity via transcription factors (TFs). SEs, with high activity, are pivotal in cell identity and disease progression. Current computational approaches focus on individual regulators like TFs and miRNAs, neglecting SE interactions. We emphasize incorporating SEs into models to enhance understanding. Experimental studies have recently linked miRNAs and TFs to SEs. Chromatin immunoprecipitation followed by sequencing (ChIP-Seq) provides valuable SE information. In this review, we categorize computational methods leveraging TF and miRNA data into three areas and explore challenges integrating enhancers/SEs. These include unraveling indirect regulatory networks, identifying network motifs, and enriching pathway identification by dissecting gene regulators, including SEs. We hypothesize that addressing these challenges will enhance our understanding of gene regulation, aiding in identifying therapeutic targets and disease biomarkers. We believe that understanding the role of ChIP-Seq data in predicting the effect of miRNA on gene regulation is crucial to construct statistical/computational model that would tackle these challenges.

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to under-stand how these elements continue to affect young populations in the post-pandemic era. Methods: In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7–19 years, to ensure age and gender representation. The survey included par-ent ratings and adolescent (11–19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Results: Of the 4,525 valid responses, 1,831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-report tended to underestimate them. Conclusions: Persistent mental health problems and gender disparities high-light the need for a public health approach. This should include accessible support services, resili-ence building, targeted support for vulnerable families and gender-specific interventions.

The paper presents the findings of research on companies in the early stage of development based on the concept of ensuring their sustainability. The starting point is attributes shaping a sustainable model of start-ups. A solution has been proposed and examined that identifies the factors dynamising a business model, which give the company the ability to make fast changes in the configuration of the business model, and that applies stabilizing factors based on the concept of the Triple Bottom Line. The research problem is a response to the phenomena of the bankruptcy of many start-ups that cannot find a way to survive in the long term. The business models of companies in the early stage of development should be designed taking into account the possibility of their dynamic and iterative changes when the earlier assumptions do not work when implemented in practice. A cognitive gap has been observed as the relevant literature does not propose a systemic solution to the problem of instability of the startups viewed from the perspective of the business model concept. The research problem, therefore, is to identify potential new methods to ensure the sustainability of young companies trying to combine aspects dynamising changes in business models, taking into account economic, environmental and social aspects. The findings of research on companies in the early stage of development show that when the methods of increasing the flexibility of the business model are applied and attention is drawn to environmental and social activities and a strong emphasis is put on financial performance, reflecting the expectations of shareholders, the concept of ensuring the sustainability of young companies from the point of view of sustainable business model attributes emerges.

Background Although the management of the majority of patients with IBS is dealt with by General Practitioners, randomized clinical trials and treatment guidelines are developed mostly in academic settings. Probiotics are one of the most investigated treatment modality for this condition. Scarce information is available as regards GPs attitude in this regard. Methods A literature search was performed to identify papers specifically dealing with probiotic treatment of IBS in the general practice setting. Moreover, the preliminary results of a survey on this topic conducted by the authors among general practitioners in a province in northern Italy are reported. Results Five papers specifically addressing probiotic treatment of IBS in general practice were found. The response rate varied from 4 to 100%. The prescription rate of probiotics by GPs in IBS varied from <10 to 46%, regardless of the patients’ bowel habits. Physicians’ satisfaction with this treatment varied from 20 to 93%. The variability of these results probably depends on factors such as differences in the interpretation of the available data on probiotics use in IBS and traditional/ cultural differences. Moreover, compliance with patient satisfaction, may play a role. Conclusions The reported data on the treatment of IBS with probiotics in general practice is scarce and inhomogeneous, thus it does not allow firm conclusions. It is suggested that the involvement in research on the use of probiotics in IBS of physicians working in general practice would be useful in order to pursue more reliable and useful results, since the majority of the IBS population is followed in general practice and may differ from the one represented in academic clinical trials.

Poultry farming in Slovakia has a tradition and an irreplaceable position to ensure rational nutrition for the population. In terms of a nutritional value, poultrymeat (Galliformes) contains a high amount of proteins, essential amino acids, essential unsaturated fatty acids, minerals, vitamins and a low fat content. Poultrymeat production has a relatively short reproductive cycle and thus allows regulating the demand and supply. The poultry market also influences the development of domestic consumption. According to the Statistical Office of the Slovak Republic, the consumption of meat has witnessed a persistent increase over the last 10 years. [1] According to the 2023 AVEC (The Voice of European Meat Sector) annual report, the consumption of poultrymeat in Slovakia was 20.0 kg per person per year. The average consumption in the EU-27 (2021) was 23.4 kg, with the countries with the highest consumption being Portugal (37.8 kg), Ireland (36.0 kg), Hungary (33.5 kg) and Spain (29.9 kg). On the other hand, the countries with the lowest consumption of poultrymeat, apart from Slovakia, also include Austria and Greece with a consumption of 21.5, resp. 21.0 kg [2]. The breeding of broiler chickens, as well as the production and placing on the market of poultrymeat must comply with the requirements laid down by legislation, while the compliance is regularly checked by the competent authorities.

The study assessed the trapping efficacy of locally-modified 1) Gravid Aedes Trap(GAT) lined with insecticide-treated net (ITN) as a killing agent, 2) Autocidal Gravid Ovitrap(AGO) with sticky board in the semi-field system (SFS) and field setting. Fully-balanced Latin square experiments were conducted to compare GAT lined with ITN vs AGO, both with either yeast or grass infusion. Biogents-Sentinel (BGS) with BG-Lure and no CO2 was used as standard trap for Aedes mosquitoes. In the SFS, GAT outperformed AGO in collecting both nulliparous (65% vs 49%,OR=2.22,[95%CI:1.89-2.60],p

Dengue infection is caused by the Dengue virus (DENV) and is transmitted to humans by infected female Aedes aegypti and Aedes albopictus mosquitoes. There are nearly 100 million new dengue cases yearly in more than 120 countries with a five-fold increase in incidence over the past four decades. While many patients experience a mild illness, a subset suffer from severe disease which can be fatal. Dysregulated immune responses are central to the pathogenesis of dengue, and haematologic manifestations are a prominent feature of severe disease. While thrombocytopaenia and coagulopathy are major causes of bleeding in severe dengue, leucocyte abnormities are emerging as important markers of prognosis. In this review, we provide our perspective on the clinical aspects and pathophysiology of haematologic manifestations in dengue. We also discuss the key gaps in our current practice and areas to be addressed by future research.

Weathering and erosion transport minerals and organics toward the sea or lake bottoms over geologic time. The finest solids are deposited in lower, less turbulent areas, such as lake bottoms and continental shelves. They sometimes stack up to thicknesses of kilometers, and begin compacting. These sediment sections are called shales, and as initially deposited in water, shales can have porosities up to 50-80{\%} water, As they are buried, many alteration products from oil to slate are produced due to overburden and temperature increasess, making them important to study. A preceeding paper \cite{1} showed that pressure solution is the primary mechanism for porosity reduction, with possible mechanical compaction at shallow depths. Without naming the mineral(s) involved, it postulated that the greater the product of the water and pore interfaces, the faster the reaction would proceed. This term is $ \varphi^{4m/3}(1-\varphi)^{4n/3}$ , where $\varphi$ is porosity and m and n are numbers close to unity. The large exponents, {\em 4/3}, recognize that the reaction occurs at the molecular scale at which the surfaces are rough. A second term, $\exp^{(-E/RT)}$ , indicates that the reaction is impeded by a quantum energy barrier, E, with diminished impeding power as increased available thermal energy, represented by the absolute temperature, T, becomes available at greater depths in the Earth. These two factors combine to allow porosity $\varphi$ to reduce with time, or equivalently for the fraction of solids, $(1-\varphi)$, to increase with time,$\left. \frac{\partial(ln(1-\varphi) ) }{\partial t } \right |_{\sigma} = (\varphi )^{4m/3}( 1-\varphi )^{4n/3}Ae^{-E/(RT)}$. { \em Here it is shown that this equation can cover quantitatively any actual deposition rates which may have been experienced by the six sections studied, the actual deposition rates being unknown for these cases. Hence a time-depth depositional history for any new shale section, known in detail, would allow determination of the parameters m, n, E and a lumped proportionality constant A. This was accomplished by showing that, for a wide range of depositional rates, r, the range of E for any of the studied sections is small compared to laboratory measurements of quartz solution\cite{2}, 24+-15kJ/mol. Results were obtained over this range of r's using the previously determined m and n, and porosity and temperature profiles. The presently existing porosity profiles necessarily incorporate any overpressure or underpressure conditions that may have existed in the past or currently, as the net difference between overburden and pore pressure is a primary driving force for pressure solution. $SiO_2$ usually comprises 20-50{\%} of shales. In conclusion, pressure solution of quartz can account for vertical compaction of shales quantitatively in the studied examples. Separately, a quasi-eqivalent method for discussing reduced porosities in Macron 2 versus Macron 1 as increased vertical stress, rather than additional horizontal stress, is illustrated. Experiments are suggested to clarify the pressure solution mechanism. The role of horizontal forces is discussed. From a global point of view, shale compaction by pressure solution is a quantified step in the cycling of continental rocks, beginning with rifting.

Background and Objective: Patients with spinal muscular atrophy (SMA) treated with a dis-ease-modifying therapy (DMT) are often classified as responders or non-responders based on at-tainment of a specific improvement threshold on validated functional scales. This categorization may significantly impact treatment reimbursement in some countries. The aim of this research is to evaluate the perception of treatment benefit by patients considered as responder or non-responder. Methods: In this non-commercial multicenter study, 99 post-symptomatically treated SMA type I-III patients with a median age of 11.2 (0.39-57.4) years at treatment initiation were stratified into three groups based on their treatment outcomes, i.e. those exhibiting clinically significant improvement (N=41), those with non-clinically significant improvement (N=18), or those show-ing no improvement (N=40). Fifteen months after treatment initiation patients or patients’ care-givers were assessed using a patient-rated scoring system based on the Patient Global Impression of Change (PGIC) scale, comprising 22 questions targeting important aspects and tasks in the daily life of patients with SMA. Results: We found no statistical difference in patient perception of treatment benefit in 17 out of 22 domains across patient groups. Conclusion: Our results suggest that functional motor scales do not recapitulate patients and pa-tients’ caregivers experience about the effect of nusinersen treatment in SMA.

The authors argue that despite significant numbers of foreign workers present in the Russian labor market Russia remains unattractive for highly skilled foreign workers. The economic crisis the country has faced since 2014 has resulted in a further outflow of foreign nationals from OECD countries. So Russia has to look for employees among newcomers from the former Soviet states, the majority of whom come from Central Asia. Russian politics with regard to immigration is characterized by the collision between “geopolitical” and domestic policy rationales. On one hand, seeking to maximize its influence in the post-Soviet space Russia provides preferential conditions of employment for citizens of partner countries in the framework of the Eurasian Economic Union. On the other hand, the Kremlin is afraid to liberalize its approach to immigration and the integration of immigrants through fear of losing popularity among the electorate. The second substantial feature of Russian immigration politics is an extreme level of securitization of migration issues. The government considers these issues primarily through a policing lens. One cannot claim that the Russian state does not take any steps to liberalize “migratory regulation”; however, the effect of these measures is being vastly reduced by new restrictions. In addition, liberally designed laws do not bring the expected results due to the corrupt practices that pervade the whole of migration regulation.

Coal fly ash (CFA) generated from coal-fired power plants (C-FPPs) is continuing to be an environmental health concern due to its potential to contaminate groundwater, surface water, air, and soil, leading to the degradation of land. This study investigated the effectiveness of Helichrysum splendidum Less. for phytoremediation of CFA-polluted sites by conducting pot trials experiments in 14 weeks. Plants of the same age were transplanted into CFA collected from Hendrina Power station to assess their potential in assimilating metallic pollutants (As, Cd, Co, Cu, Mn, Ni, Pb, and Zn) into their tissues and untreated plants were used as controls. Inductively coupled plasma-mass spectrometry was used to quantify the amount of trace elements in samples and the translocation factor (TF) and bioconcentration factor (BCF) were determined to evaluate the phytoremediation potential of Helichrysum splendidum. The results revealed that higher concentrations of As, Ni and Zn were accumulated in the aerial parts as indicated by the TF values greater than 1. In contrast, higher amounts of Cu, As and Zn were found in the roots for CFA grown plants, as demonstrated by their BCF values 1.22, 1.19 and 1.03, respectively. Although CFA medium had restricted growth of some plants as compared to the controls, the results showed an interesting removal efficiency ranging between 18.0 to 56.7% with highest reported for Cu and Zn. Gas exchange analysis revealed that photosynthetic parameters were almost similar in the CFA and control soil pots. The study can confirm that Helichrysum splendidum has phytoextraction and phytostabilization potentials and can be effectively employed for restoration of CFA dams.

Six bacterial strains with differing abilities to produce varying concentrations of Indole Acetic Acid were tested individually and in consortia for plant growth promoting and fitness related traits of Cicer arietinum. In all experiments the presence of the nitrogen fixer Mesorhizobium ciceri resulted in increased biomass production. In the absence of this strain, IAA Psedomonas putida and Bacillus megaterium hinder plant growth and fitness related traits. The application of mixes of the three strains always resulted in better plant performance when M. ciceri was present. Whereas P. putida has a noticeable plant growth-promoting effect B. megaterium resulted less effective. The low levels of IAA produced by the selected strains had a significantly greater positive effect on plant biomass accumulation, flower, pods and seed production as well as on total plant nitrogen and nitrogen concentration in seed than high IAA producer strains.

Generating electricity from coal combustion is highly associated with ongoing pollution problems that negatively impact the environment. Coal fly ash (CFA) is a predominant waste by-product of coal combustion which is disposed of in exposed ash dams constructed in the vicinity of power stations. Its disposal requires a large piece of land and therefore more land is converted to unproductive disposal sites, degrading the ecosystem. This waste material is classified as a hazardous substance in South Africa due to unacceptable levels of inorganic and persistent organic pollutants and its potential for dust creation. CFA is recycled and sold to the building and construction sectors, but the rate of its utilization is far less than the production rate resulting to high volumes that is stockpiled in disposal sites. More than 500 million tons CFA is produced yearly and over 200 million tons yearly remain unused globally and more CFA will continue to be produced due to high consumer energy demands, especially in countries with heavy reliance on coal for power generation. In this context, the paper discusses production of CFA, pollution problems due to its disposal, examines existing gaps within the scope of ash dam restoration processes and presents opportunities offered by phytoremediation (a low-cost and environmentally friendly technology that utilizes plants to restore the degraded environments). Ecological restoration through the use of socio-economically valuable plants (aromatic plants, legumes and grasses) has potential in addressing societal challenges and consequently impacting positively the livelihood of communities.

Satellite-based rainfall estimation products provide a vital alternative source of rainfall data in areas where conventional precipitation measurement is not readily available. In order to facilitate the use of these products there is the need to evaluate their accuracies. This study evaluated the accuracy of three satellite rainfall products; TMPA 3B42RT, TMPA 3B42 and CMORPH in the Pra basin (23,330 km²) of Ghana. The evaluation was through the point-to-pixel method by comparing 0.25°x 0.25° satellite grids to gauged rainfall based on gauge locations and analyzed statistically using correlation coefficient (r), bias and percent bias (pBias) as the performance verification methods. Seven (7) gauge stations with no missing data for the period of 2003-2008 was used in the evaluation. The analysis was based on daily, monthly, annual and seasonal timescales. Our results showed a good correlation between the TMPA products and the gauged data on all timescales considered. The CMORPH on the other hand showed huge overestimation at all gauge locations. The TMPA 3B42 was seen to be the best amongst the three products. The overall rainfall in the basin was well depicted by the TMPA 3B42 and 3B42RT. Although there wasn’t a perfect match between the 3B42RT and 3B42 products and the gauged rainfall, these products can be used to supplement gauged rainfall measurements in the basin and in estimation of rainfall in ungauged basins with similar characteristics.

The study aimed to estimate the prevalence of respiratory symptoms and to assess respiratory health risks associated with Particulate Matter (PM) exposure among the residents of Windhoek, Namibia. Objectives: To measure particulate pollution concentration in Windhoek through monitoring of particulate matter concentration and to identify any associations between particulate pollution, individual location and respiratory health among the Windhoek resident’s. Methods: an adapted standardized self-administered questionnaire was used to collect respiratory health related data as well as previous exposure, while PM monitoring was done using ASTM D1739 reference method. Results: A high prevalence was observed for cough (43%), breathlessness (25%), and Asthma (11.2%). PM was found to be a significant risk factor for episode of cough and phlegm, while high PM exposure category had increased odds ratio for episode of phlegm and cough (OR: 2.5, 95% CI: 0.8-8.0). No association was observed between location and respiratory health outcomes. Conclusion: The study found high levels of PM concentration across all Windhoek suburbs which were above the German, American and EPA. Enactment of legislation relating to the control and monitoring of PM related emissions at point of generation is required at country and city level.

Background: Condoms have proven to be an effective contraceptive barrier method of family planning and have played a vital role in preventing sexually transmitted diseases including HIV. However, existing evidence shows that utilization of condoms still remains low, especially among youth and adolescents. We aimed to determine the prevalence of condom use and associated factors among the students of Gulu university in Uganda. Methods: A cross-sectional study was conducted among undergraduate students of Gulu University between June and December 2023. The students were accessed from their respective faculties and chosen using a simple random sampling method. Data were collected using a pretested self-administered structured questionnaire. Condom use was defined as use of either male or female condom in the last sexual encounter in the previous six months. Results: A total of 404 participants, with a median age of 23 years (interquartile range (21.5-24) years) were enrolled in the study, 54.2%(n=219) of whom were male. Overall, 81.4%(n=329) of the participants were in senior classes (year 2,3,4, and 5) and 18.6%(n=75) were in their first year of study. The prevalence of condom use was 53.7%(n=217). Prevalence of condom use was 50.2%(n=109) among male and 49.8%(n=108) among female students. Year of study (senior class)(aPR = 1.4, 95% CI = 1.59, 3.54), having a sexual partner (aPR = 2.4, 95% CI = 1.89, 2.94), having a sexual partner within campus (aPR = 2.0, 95% CI = 1.69, 2.45), experience of condom bursting (aPR = 1.3, 95% CI = 1.08, 1.61), having sex in absence of condoms (aPR = 0.6, 95% CI = 0.44, 0.70), alcohol use (aPR = 1.2, 95% CI = 1.01, 1.45) were independently associated with condom use. Conclusion: Just over half of undergraduate students of Gulu university used condoms during sexual encounters. There should be heighten campaigns on condom use to prevent unintended pregnancies and sexually transmitted infections.

Abstract: NFinFET transistors with fin channel length 90nm and a planar MOSFET transistor with channel length 180nm and 90nm are presented with characteristic curves at various gate biases. A finalized algorithm with kink effects is effectively responsible for addressing the field effect transistors. The algorithm includes the modified conventional current-voltage formula and a nonlinear heat-associated kink solution which is simplified as a Gaussian form. Three parameters in modified model includes kN (related with channel width, channel length, and gate oxide capacitor, and proportional to the mobility of carriers)Vth(Threshold Voltage), and (the inverse of Early Voltage). Those parameters are determined to minimize the discrepancies between the measured data and the fitting values, but leave kinks located at around (VGS－Vth), which are deliberately eliminated by the Gaussian form because of the agitation of thermal kink effects. The whole fitting is made to be as close as the as-measured IDS-VDS. In the mean time, those determined parameters are physically meaningful after the analysis has been done.

In this paper, we identify several relative ordering properties of the modified proportional hazard rate and modified proportional reversed hazard rate models. For this purpose, we use two well-known relative orderings, namely the relative hazard rate ordering and the relative reversed hazard rate ordering. The investigation is to see how a relative ordering between two possible base distributions for the response distributions in these models is preserved when the parameters of the underlying models are changed. We will give some examples to illustrate the results and the conditions under which they are obtained.

Given the many approaches to and definitions of gender responsive monitoring and evaluation (M&E) for health programs and interventions there is a lack of clarity on how to operationalize it including what to measure and how to measure it. We conducted a scoping review to understand what makes M&E gender responsive. We included 31 studies and conducted two rounds of extraction to delineate ways in which gender was integrated into M&E. Twelve articles described the use of theory to guide M&E though most were not related to gender. Twelve articles employed a gender score in data collection, most of which measured Likert scale responses related to gender equity. Even though most studies did not use a specific gender framework, most incorporated gender domains in their analysis. Seven studies used participatory methods in the design and implementation of M&E. Most studies conducted M&E on programs or interventions that were designed to be gender intentional and related to gender issues. Gender responsive M&E intentionally integrates gender into the M&E process, regardless of how gender-intentional the program or intervention is. Gender dimensions can be identified through gender theories, models, scores, and frameworks to inform tool development, data collection, analysis, and stakeholder engagement processes.

Introduction: intraocular pressure (IOP) measurement is an essential part glaucoma’s diagnosis and follow-up. Goldmann applanation tonometry (GAT) is the gold standard for IOP measurement but it’s affected by many factors like central corneal thickness (CCT). Racial differences in CCT are reported but the Syrian population was never studied. Research design and methods: 57 subjects with 114 eyes visiting Damascus hospital were examined and 100 eyes were included. IOP was measured using GAT and CCT was measured using OCULUS Pentacam AXL Corneal Topography, demographic data and history of ocular surgery, systemic co-morbidities and history of medications were collected. IOP values were corrected for CCT. Results: 56% were males, the mean age was 48.1. 24% of subjects had hypertension. Males had higher CCT with 557.23± 25.33 compared with 531.34 ± 41.88 for females. There was a moderately positive correlation between CCT and IOP (r=0.232, p-0.02), CCT and IOP values were linearly correlated (ANOVA, p=0.02). Conclusions: This study showed that the correlation between CCT and IOP is present in the Syrian population. Males had a slightly thicker corneas than females and CCT didn’t significantly change with age.

We evaluated the dentofacial characteristics and temporomandibular disorder (TMD) symptomatology of patients with orthopedic instability before and after deprogramming with a stabilization splint. Sixty patients with the signs and symptoms of TMD were assessed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and underwent stabilization splint therapy to place the condyles in a more stable musculoskeletal position. The amount of condylar displacement was evaluated using the condylar position indicator (CPI). Six-teen angular and linear hard tissue landmarks were traced and compared from lateral cephalo-grams taken in the maximum intercuspation (MI) position before and in the centric relation (CR) position after the splint therapy. Following the splint therapy, the signs and symptoms of TMD were significantly reduced or completely eliminated in more than 90% of the patients. Compared with the values registered before the splint therapy, a significant reduction in the mean values of condylar displacement was observed on both sides of the vertical, horizontal, and transverse planes of space after the splint therapy. A comparison of pre- and post-splint lateral cephalograms revealed that, following the splint therapy, the mandible moved more posteriorly and rotated more in a clockwise direction. In patients with orthopedic instability and signs and symptoms of TMD, deprogramming of the neuromuscular system with a stabilization splint is highly recommended to provide a correct orthodontic diagnosis and improve the health of temporomandibular joint structures.