Immunology is a branch of medicine that studies the immune system and its pathology. There are known scientific informations, that in medical immunology specific tests performed in the laboratory for diagnosis. In addition good to mention that allergies include medical diagnostic methods such as blood tests. Also there are used for detection the presence and the levels of IgE antibodies. These antibodies are produced by the human immune system in contact with certain allergens. Examples of allergens include for example pollen, house dust, some herbs or molds, some animals and certain foods. If a person has an allergy, their immune system overreacts to an allergen by producing antibodies, called Immunoglobulin E (IgE). Currently within the present describtion aim to discuss some aspects reffering to fungal allergen and mold allergy diagnosis, in a briefly following steps of our purposed shortly review.

The patellofemoral joint (PFJ) is a complex articulation between the patella and the femur, in-volved in the extensor mechanism of the knee. Patellofemoral disorders can be classified into ob-jective patellar instability, potential patellar instability, and patellofemoral pain syndrome. An-atomical factors such as trochlear dysplasia, patella alta, and tibial tuberosity-trochlear groove (TT-TG) distance contribute to instability. Patellofemoral instability can result in various types of dislocations, and the frequency of dislocation can be categorized as recurrent, habitual, or per-manent. Primary patellar dislocation requires diagnostic framing, including physical examina-tion and imaging. Magnetic resonance imaging (MRI) is essential for assessing the extent of damage, such as bone bruises, osteochondral fractures, and medial patellofemoral ligament (MPFL) rupture. Treatment options for primary dislocation include urgent surgery for oste-ochondral fragments or conservative treatment for cases without lesions. Follow-up after treat-ment involves imaging screening and assessing principal and secondary factors of instability. Detecting and addressing these factors is crucial for preventing recurrent dislocations and opti-mizing patient outcomes.

Objective: to create a set of eligibility criteria for the use of MHT in non-gynecological cancer patients. Methods: We searched all articles published in peer-reviewed journals up to March 2021. The PICOS standards were used and the selection criteria as follows: menopausal women of any age with non-gynecological and non-breast cancer receiving HMT, any MHT preparation (oestrogens alone or combined with a progestogen, tibolone or tissue selective oestrogen complex) or any route of administration (oral, transdermal, vaginal or intra-nasal), recurrence and mortality, randomized controlled trials, and related extension studies or follow-up reports. Results: Women colorectal cancer survivors who use MHT have a lower risk of death from any cause than those survivors who do not use MHT. Women Skin Melanoma Survivors Using MHT Have Longer Survival than Non-MHT Survivors. There is no evidence that women lung cancer survivors who use MHT have a different survival rates than those survivors who do not use MHT. Conclusion: MHT is safe in women who have suffered from colorectal, lung or skin melanoma cancers The study was registered at www.prospero.org (CRD42020166658)

Today, enterococci (mainly Enterococcus faecalis) are one of the main causes of infective endocarditis in the world, generally affecting an elderly and fragile population, with a high mortality rate. enterococci are intrinsically resistant to many commonly used antimicrobial agents. All enterococci exhibit decreased susceptibility to penicillin and ampicillin, as well as high-level resistance to most cephalosporins and all semi-synthetic penicillins, as the result of expression of low-affinity penicillin-binding proteins, that precludes an unacceptable number of therapeutic failures with monotherapy with these drugs. For years, the synergistic combination of penicillins and aminoglycosides was the cornerstone of treatment, but the emergence of strains with high resistance to aminoglycosides led to the search for new alternatives, such as dual beta-lactam therapy. The development of multi-drug resistant strains of Enterococcus faecium is a matter of considerable concern due to its probable spread to E. faecalis and have forced the search of new alternatives with the combination of daptomycin, fosfomycin or tigecycline. Some of them have scarce clinical experience and others are still under investigation and will be analyzed in this review. In addition, the need for prolonged treatment (6-8 weeks) to avoid relapses has led to the consideration of viable options such as outpatient parenteral therapies or long-acting administrations with the new lipoglycopeptides (dalbavancin or oritavancin), and sequential oral treatments, which will also be discussed.

Monkeypox virus was named so because of its detection in monkeys in 1958. It belongs to the same family as smallpox and chickenpox viruses. There had been numerous outbreaks of this malady initially in the African continent and other parts of the world. The simultaneous spread in nineteen countries in 2022 has raised some serious concerns.Monkeypox is no more a rare disease and has the potential for bioweapon use. We discuss the various ways to prevent its spread, treatment options available, diagnosis, and differentiation from other closely related diseases. We also discuss if the present outbreak could be a bioattack or if this disease is here to stay.The literature suggests that we can effectively manage Monkeypox because of the availability of drugs and vaccination against smallpox. There is also a need for active surveillance against the new resistant recombinant viral strains. The possibility of this outbreak being a bioattack seems remote, although there are questions about the transmission which still need to be answered.

In this work, we demonstrate that cutting diamond crystals with a laser (532 nm wavelength, 0.5 mJ energy, 200 ns pulse duration at 15 kHz) produces a ≲20nm thick surface layer with magnetic order at room temperature. We have measured the magnetic moment with a SQUID magnetometer of six natural and six CVD diamond crystals of different size, nitrogen content and surface orientations. A robust ferromagnetic response at 300 K is observed only for crystals that were cut with the laser along the (100) surface orientation. The magnetic signals are much weaker for the (110) and negligible for the (111) orientations. We attribute the magnetic order to the disordered graphite layer produced by the laser at the diamond surface. The ferromagnetic signal vanished after chemical etching or after moderate temperature annealing. The obtained results indicate that laser treatment of diamond may pave the way to create ferromagnetic spots at its surface.

Polyacrylamide gel electrophoresis (PAGE) is widely used for studying proteins and protein-containing objects. However, it is employed most frequently as a qualitative method rather than a quantitative one. In this paper, we show the feasibility of routine digital image acquisition and mathematical processing of electrophoregrams for protein quantification. Both the well-studied model protein molecules (bovine serum albumin) and more complex real-world protein-based products (casein-containing isolate for sports nutrition), which were subjected to mechanical activation in a planetary ball mill to obtain samples characterized by different protein denaturation degrees, were used as study objects. Protein quantification in the mechanically activated samples was carried out. The degree of destruction of individual protein was shown to be higher compared to that of protein-containing mixture after mechanical treatment for an identical amount of time. The methodological approach used in this study can serve as guidance for other researchers who would like to use electrophoresis for protein quantification both in individual form and in protein mixtures. The findings prove that photographic imaging of gels followed by mathematical data processing can be applied for analyzing the electrophoretic data.

One of the biggest threats we face globally is the emergence of antimicrobial resistant (AMR) bacteria, which runs in parallel with a lack in the development of new antimicrobials. Among these AMR bacteria, pathogens belonging to the ESKAPE group can be highlighted (Enterococcus spp, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp) due to their profile of drug resistance and virulence. Therefore, innovative lines of treatment must be developed for these bacteria. In this review, we summarize the different strategies for the treatment and study of molecular mechanisms of AMR in the ESKAPE pathogens based on the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and CRISPR-associated (Cas) proteins' technologies: loss of plasmid or cellular viability, random mutation or gene deletion as well directed mutations that lead to a gene's loss of function.

Bacterial resistance to antibiotics is a growing global concern, threatening human and environ-mental health, particularly among urban populations. Wastewater treatment plants (WWTPs) are thought to be “hotspots” for antibiotic resistance dissemination. The conditions of WWTPs, in conjunction with the persistence of commonly used antibiotics, may favor the selection and trans-fer of resistance genes among bacterial populations. WWTPs provide an important ecological niche to examine the spread of antibiotic resistance. We used heterotrophic plate count methods to identify phenotypically resistant cultivable portions of these bacterial communities and charac-terized the composition of the culturable subset of these populations. Resistant taxa were more abundant in raw sewage and wastewater before the biological aeration treatment stage. While some antibiotic resistant bacteria (ARB) were detectable downstream of treated wastewater re-lease, these organisms are not enriched relative to effluent-free upstream water, indicating effi-cient removal during treatment. Combined culture-dependent and culture-independent analyses revealed a stark difference in community composition between culturable fractions and the envi-ronmental source material, irrespective of culturing conditions. Higher proportions of the envi-ronmental populations were recovered than predicted by the widely accepted 1% culturability paradigm. These results represent baseline abundance and compositional data for ARB commu-nities for reference in future studies addressing the dissemination of antibiotic resistance associ-ated with urban wastewater treatment ecosystems.

Application of native PGPR as bio inoculant is an alternative sustainable agricultural practice to enhance crop productivity, grain quality, and soil fertility. In this view, a study was to examine the effect of either individual or consortium PGPR inoculation on growth, yield, and grain nutrient uptake of two teff varieties. The pot experiment was carried out in (CRD) three replication and 10 treatments. The PGPR inoculants used in this study were Pseudomonas fluorescens biotype G, Enterobacter cloacae ss disolvens, and Serratia marcescens ss marcescen and their consortium. Dukem and Magna varieties were used in this study. The results of the analysis of variance showed significant differences (P ≤ 0.001) among the treatment and most of the agronomic traits except number of fertile tillers and also significant different (P ≤ 0.01) for grain P and N uptake. The variety was significantly affected grain Mg, Zn and Fe uptake at 5 % probability level and did not significantly influence all agronomic traits of the two varieties. Furthermore, interaction effects of two factors (TM*VT) were significant differences (P ≤ 0.05) for plant height and panicle length. Individual treatments mean comparison results showed that inoculation of native PGPR consortium significantly affected most of the PGP traits at (P ≤ 0.05). The maximum traits like plant height (189cm), panicle length (66.7cm), shoot dry biomass (9.98g), root dry biomass (2.90g) and grain yield per plant (4.55g) were observed from Dz-01-196. It could be concluded that the consortium of native PGPR inoculants for plant growth, yield and grain nutrient uptake improvement performed better than their individual strain.

Gastrointestinal stromal tumors are the mostly seen mesenchymal tumors of the gastrointestinal system. This rare tumor in duodenum is seen 5%. The diagnosis and treatment is hard because of its rarity and location. Case: A 63-year-old man with a solid mass at the third part of the duodenum, and local segmental resection of the tumor was performed. The histopathology was reported as gastrointestinal stromal tumor of the duodenum with negative surgical margins. Discussion: Gastrointestinal stromal tumors at the duodenum are seen rarely. They can be asymptomatic or may involve symptoms of upper GI bleeding and abdominal pain at presentation. Because of the misleading clinical presentation the differential diagnosis may be difficult. Tumors less than 2 cm can be followed by endoscopic ultrasound. Local segmental resection with 1cm clear margin is the treatment choice.

Introduction In sacubitril-valsartan (sacub/v), the effects of an angiotensin II receptor blocker (ARB) exerted by valsartan are strengthened by the addition of sacubitril, an inhibitor of neutral endopeptidases. PARADIGM - HF study proved this association to be superior to enalapril in reducing both all-cause death and cardiovascular mortality, as well as heart failure (HF) hospitalizations in patients with cardiac insufficiency and reduced left ventricular ejection fraction( HFREF) belonging to NYHA class II-IV. To test whether even in our experience sacub/v is associated with favorable outcomes concerning mortality and morbidity, an outpatient small population of HFREF patients was retrospectively studied, of whom one third was treated with sacub/v instead of conventional therapy with ACE -inhibitors or ARBs. Methods A retrospective cohort study was carried out to assess the effects of sacub/v in addition to beta-blocker and mineral receptor antagonist (MRA) in a group of HFREF patients in NYHA classes II-III compared with conventional therapy (comprising ACE inhibitor or ARB added to beta-blocker plus a MRA) administered in a second group of HFREF patients with comparable clinical features retrospectively enrolled as controls. In the two groups, the therapeutic regimen was established in accordance with the preferences of the treating physician. Additionally, in both groups, evidence-based drug therapy was supplemented by the adjunct of a loop diuretic, usually furosemide, at variable doses. The primary outcomes of interest were all-cause death and HF hospitalizations. Safety outcomes were symptomatic hypotension, angioedema, hyperkalemia and worsening renal function. Results Mortality at six months was 6.8% in patients under therapy with sacub/v versus 34% in those treated with conventional therapy (odds ratio[OR] = 0.14; 95% CI: 0.04-0.49). Moreover, HF hospitalizations in the observation period considered were 4.5% in sacub/v group versus 59% in the conventional therapy group (OR = 0.03; 95% CI: 0.01–0.14). Safety outcomes included in our study (angioedema, hyperkalemia, hypotension and worsening renal function) showed a comparable profile in the two groups, with evidence of good tolerability of sacub/v , except for the side - effect " hypotension" (PAS < 100 mm Hg) , found in 15.9% of patients under sacub/v versus 5.7% reported in controls (OR = 3.14; 95% CI: 0.94–10.55). Conclusions In our experience, sacub/v has yielded a strong protection against both all-cause death and HF hospitalizations at six months , in the absence of significant noxious side effects. Nevertheless, considering the retrospective character of the study and the relatively exiguous sample size, further post marketing observational studies would be desirable . In particular, studies aiming at exploring safety of the new pharmacologic principle, namely mainly focusing on hypotension and angioedema, are warranted, in order to validate further this very efficacious molecule for therapy of chronic HF, especially stable HFREF in NYHA classes II-III.

Thin film transistors (TFTs) using In-Ga-Zn Oxide (IGZO) as active layer and the gate insulator was treated with NH3 plasma and N2O plasma, respectively, which is fabricated on flexible PI substrate in this work. The performance of IGZO TFTs with different plasma species and treatment time are investigated and compared. The experiment results show that the plasma species and treatment time play an important role in the threshold voltage, field-effect mobility, Ion/Ioff ratio, sub-threshold swing (SS) and bias stress stability of the devices. The TFT with a 10 seconds NH3 plasma treatment shows the best performance; specifically, threshold voltage of 0.34 V, field-effect mobility of 15.97 cm2/Vs, Ion/Ioff ratio of 6.33×107, and sub-threshold swing of 0.36 V/dec. The proposed flexible IGZO-TFTs in this paper can be used as driving devices in the next-generation flexible displays.

Although suicide is a major public health issue worldwide, we understand little of the onset and development of suicidal behavior. Suicidal behavior is argued to be the end result of the complex interaction between psychological, social and biological factors. Epidemiological studies resulted in a range of risk factors for suicidal behavior, but we do not yet understand how their interaction increases the risk for suicidal behavior. A new approach called network analysis can help us better understand this process as it allows to visualize and quantify complex association between many different symptoms or risk factors. A network analysis of data contain information on suicidal patients can help us understand how risk factors interact and how their interaction is related to suicidal thoughts and behaviour. A network perspective has been successfully applied to the field of depression and psychosis, but not yet to the field of suicidology. In this theoretical article, I will introduce the concept of network analysis to the field of suicide prevention, and offer directions for future applications and studies.

Only languages with abundant resources are given the opportunity to build speech recognition systems, whereas low resource languages are disregarded. This project attempts to create a system that can normally convert speech to text in the Myanmar (Burmese) language, a language part of low resource languages. The Burmese language is extremely intricate and is made up of vowels, consonants, tones, and stress. There are 10 numbers, 12 vowels, and 33 letters in the Myanmar alphabet. Deep learning allows for the evolution of numerous algorithms while eradicating ignorance and even low-resource languages may be turned into speech-to-text systems with a small quantity of data. The procedures required to construct a successful speech recognition system that can assist both the corporate sector and society will be covered in this project, including data collecting, preprocessing, modeling, prototyping, assessment, and ultimately deployment.

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.

Neuropsychiatric manifestations of COVID-19 include delirium, general malaise, headache, and psychiatric symptoms. These manifestations are related to the neuroinflammatory response to viral antigens and proinflammatory mediators/immune cells. Tetracyclines, such as minocycline, have antibacterial and anti-inflammatory properties. Saiko-keishi-to, a traditional Japanese Kampo medicine, also has anti-inflammatory properties. Given the anti-inflammatory properties of minocycline and Saiko-keishi-to, we describe two cases of COVID-19 with prolonged headaches and general malaise successfully treated with these medications.

This study aims to describe the commitment to national heritage, patriotism, nationalism of elementary school students in the border areas between Indonesia and Timor Leste. This research was conducted in three elementary schools, they are SD Inpres Moto Ain, SD Inpres Class Jau Halimuti, SD Kristen Nanaeklot, and SD Negeri Motabenar from June to August 2018. The subjects of this study were elementary students in the Indonesia-Timor Leste border areas precisely around Motaain City, Belu Regency, East Nusa Tenggara. The research questionnaire was adapted from Karazawa and analyzed with descripriptive statistics. The results of this study showed that the commitment to national heritage, patriotism, and nationalism of elementary students on the Indonesian border areas with Timor Leste is in the very high level.

Lyme disease is a highly prevalent tick-borne infection caused by Borrelia burgdorferi spirochetes in North America and Eurasia. Diagnosis of the early disease remains difficult with the currently approved serological tests in the absence of noticeable tick bite or erythema migrans due to presentation of non-specific symptoms and the absence of antibodies early in infection. Furthermore, it is difficult to distinguish persistence of disease and reinfection in the endemic regions. If not treated early, infection spreads throughout the body and affects most organs with disease manifestations including arthritis, musculoskeletal pain, neuroborreliosis and acrodermatitis chronicum atrophicans. Although most patients recover after antibiotic treatment, ~10-12% of show recurrence of symptoms known as post-treatment Lyme disease syndrome (PTLDS). Various causes of PTLDS are not well-defined; however, the spirochete persisters, antigenic debris, dysregulation of immunological response in individuals or a combination of these factors are proposed to result in continuation of Lyme disease manifestations. Based on these considerations, this review highlights currently employed treatment approaches with antimicrobials and vaccines being tried for prevention of B. burgdorferi infection. We also summarize combinatorial approaches that could be employed to alleviate symptoms to improve the quality of life of the individuals suffering from long Lyme disease.

Solid spent nuclear fuel from nuclear power plants has 3.4% fission products (80-160amu), contributing to over 99.8% radioactivity. On the other hand, liquid high-level radioactive waste (HLRW) from spent fuel reprocessing has 98.9% bulk elements (0-60amu) with 0.1% radioactivity. A separation mechanism on the mass categories as groups presents unique opportunities in managing HLRW for the long term with a considerable cost reduction. This paper proposes a thermal plasma-based separation system incorporating atmospheric pressure plasma torches for HLRW mass separation into low-resolution mass groups. Several engineering issues, such as waste preparation, waste injection into the plasma and waste collecting after mass separation, need to be addressed. Using COMSOL Multiphysics simulation, the generic system can be studied using noble gas mass separation and further analyze the mass filter capabilities. This paper provides the history of plasma-based mass separation. Functional modelling of a thermal plasma mass separation system is proposed under atmospheric pressure. Finally, aspects of mass separation simulation using noble gas Argon and Helium inside the plasma mass separation system were studied in COMSOL Multiphysics.

Aim: To investigate inflammation indices and erythropoietin (EPO) levels for their potential role in distinguishing polycythemia vera (PV) from secondary polycythemia (SP), and to compare different parameter combinations in terms of diagnostic accuracy. Methods: This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. PV diagnosis was made according to the 2016 WHO criteria (n=145). Those who did not fulfill the criteria were defined as having SP (n=84). Results: NLR, PLR and SII were significantly higher in the PV group (p

The study comprehensively evaluated the prognostic roles of PLR, NLR, MLR, BLR, and ELR in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD). 619 patients with AECOPD and 300 healthy volunteers were retrospectively included into the study. The clinical characteristics containing laboratory findings of the AECOPD patients and the blood cell counts (CBCs) of the healthy volunteers were collected. Compared with the healthy volunteers, PLR, NLR, and MLR were elevated in COPD patients in stable condition, and were further ele-vated during exacerbation. ELR showed the opposite trend. PLR, NLR, and MLR were all posi-tively correlated with hospital LOS as well as CRP. In contrast, ELR was negatively correlated with hospital LOS as well as CRP. Elevated PLR, NLR, and MLR were all associated with more serious airflow limitation in AECOPD. Elevated PLR, NLR, and MLR were all associated with increased in-hospital mortality while Elevated ELR was associated with decreased in-hospital mortality in AECOPD. A nomogram was construct to predict in-hospital mortality in AECOPD. The nomo-gram had a C-index of 0.850 (95% CI: 0.799 – 0.901) with good predictive value and clinical ap-plicability. In summary, PLR, NLR, MLR, and ELR served as predictors for clinical outcomes in patients with AECOPD.

Physicists have employed various approaches to solve the “paradox” and offered a consistent conclusion that the traveller twin is younger than the homebody twin. However, some authors attribute the cause of differential aging to acceleration, while others believe that acceleration should not be regarded as the source of differential aging, but frame switch is. So far there is no agreement on this issue. Actually, acceleration and frame switch should not be regarded as the source of differential aging. The author will introduce a thought experiment in which two very long spacecraft are moving in opposite directions at a speed close to the speed of light to discuss the real cause of differential aging. The author found that the real cause of differential aging in the twin “paradox” is because of the asymmetry of destination choice. People always choose their destinations in the universe rather than in spacecraft. The destinations are always stationary relative to the homebody twin and moving relative to the traveller twin. Once we choose a destination in a reference frame, the distance is the proper length in this reference frame, but the distance will contract in another moving reference frame, thus the recording time will be shorter.

This addendum contains clarifications and a sharpening of some of the results on the VIT transform framework developed in [1]. The focus is on the right-coefficient and left- coefficient forms of the transform, the extraction of a first-order term from a left polynomial fraction, and the application to linear time-varying systems.

We have introduced a sign operator of energy, analogous to the operator helicity, but in the direction of what we call energy vector. However, this energy vector needs a time vector. To give physical senses to the components of such a time vector, we try to explain the time dilation in special relativity and try to relate the components of the time vector to the tunneling times when an electron crosses a potential barrier.

Climate change such as sea level rise, change in temperature, precipitation, and storminess are expected to impact significantly coastal lagoons. The nature and magnitude of these impacts are uncertain. The objective of the research is to determine the climate change impacts on mixing and circulation at Songkhla lagoon, Thailand. Songkhla lagoon is the largest lagoonal water resource in Thailand and Southeast Asia. The lagoon is a combined freshwater and estuarine complex of high productivity which represents an extraordinary combination of environmental resources believed to be unique in the region. This work is part of a Climate Change impact assessment framework. It is the validation phase (step 5) of the framework applying a case study. Delft 3D was used to simulate CC scenarios in the climate downscaling models, part of the previous framework steps. These results were compared to the current conditions to determine the main changes in mixing and circulation in the coastal lagoon. Three indicators were applied to quantify the impacts: flushing time, salinity intrusion and stratification. The results suggest an increase in water velocities at the inlet in future scenarios and a decrease of flushing time. Salinity and stratification showed more complex changes in futures scenarios.

A number of experimental tests of time orientability are described as well as clear experimental signatures from non time orientability (time reversal). Some tests are well known, while others are based on more recent theoretical work. Surprisingly, the results all suggest that time is not orientable at a microscopic level; even definitive tests are positive. At a microscopic level the direction of time can reverse and a consistent forward time direction cannot be defined. That is the conclusion supported by a range of well-known experiments. The conflict between quantum theory and local realism; electrodynamics with electric charges; and spin half transformation properties of fermions; can all be interpreted as evidence of time reversal. While particle-antiparticle annihilation provides a definitive test. It offers both a new view of space-time and an novel interpretation of quantum theory with the potential to unify classical and quantum theories.

This study explores the properties and behavior of bi-close-to-convex functions, introducing new subclasses defined by their relationship with fractional differential operator and bi-univalent functions. Using the Faber polynomial technique, we derive upper bounds for the n^{th} coefficient of functions in these classes. We also investigate the erratic behavior of initial coefficients in bi-close-to-convex functions, as characterized by the (λ,q)-fractional differintegral operator. Furthermore, we address Fekete-Szegö problems and present notable findings from our investigation, contributing to the continued growth and refinement of geometric function theory, yielding new insights and practical uses.

Background. IgA nephropathy (IgAN) is associated with chronic inflammation. Platelet-related parameters, such as platelet (PLT) count, platelet-to-albumin ratio (PAR) and platelet-to-lymphocyte ratio (PLR), were examined as potential prognostic indicators for renal and cardiovascular (CV) outcomes in IgAN. Methods. 150 IgAN patients were devided into two groups based on the cut-off value of PAR. All-cause mortality, major CV events and end-stage renal disease were the primary combined endpoints. Secondary endpoints, such as CV or renal endpoints, were also analyzed separately. Results. The patient’s mean age was 43.7 ± 13.5 years, and the follow-up time was 124 ± 67 months. The K-M curve showed that PLR, PAR and PLT were strongly associated with primary combined (p = 0.002, p = 0.004, p = 0.001) and renal outcomes (p < 0.001, p < 0.001, p < 0.001), but not with CV outcomes in IgAN. However, when combined with left ventricular hypertrophy (LVH) or metabolic syndrome (MetS) PAR was found to be a significant predictor of both primary (p < 0.001, p < 0.001) and secondary outcomes (p = 0.001 and p = 0.038; p = 0.001 and p = 0.015). Additionally, PLR correlated with microalbuminuria (r = -0.165, p = 0.033) and LVH (r = -0.178, p = 0.025), while PLT correlated with eGFR (r = 0.158, p = 0.040). Conclusion. Elevated PAR and PLR may predict progression to end-stage kidney disease, but in combination with LVH and MetS, they showed CV events also in IgAN. The determination of PAR and PLR can be useful and cost-effective parameters for assessing both cardiovascular and renal risks in CKD.

Background: The aim of this study has been to investigate if inflammatory biomarkers such as the systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have any correlation with the recurrence of pleomorphic adenomas (PA) in patients afflicted by this disease. Methods: A retrospective multicentre study involving two Italian centres, the Maxillofacial Sur-gery at the Policlinico Federico II in Naples and the ENT and Maxillofacial Surgery at the IRCCS G. Pascale National Cancer Institute in Naples, has been performed. The study, involving 608 pa-tients who had received a diagnosis of PA, was conducted between January 2000 and January 2020. A Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cut-off values for the SII, PLR and NLR. A linear regression model (LRM) and a non-linear logistic re-gression model (NLRM) were realized with respect to the NLR, PLR and SII. Results: The highest performance was achieved by the NLR (cut-off 2.960) with the AUC = 0.91, with an accuracy of 96.1%, sensitivity of 78.4% and specificity of 97.2%, PPV = 64.4% and NPV = 98.6%. The LRM and NLRM including all the haematological parameters did not increase the per-formance in terms of recurrence detection. Conclusion: The NLR is an excellent support tool in predicting the recurrence of PA with a cut-off of 2.960. It can be a good reference point for surgical decision-making and follow-up in clinical practice.

Can physical objects be in time-symmetry? Physical objects can only exist in a medium that has physical attributes, which means this medium is a type of energy. Is time energy? This article will show that time is not energy and there is no possibility that physical objects could be in time-symmetry. Physical objects only can be in symmetry in the time-invariant space in which they exist. In this perspective time measured with clocks is the result of the observer’s measurement in the time-invariant space. The time-symmetry model is flawed.

Capacity Expansion Models (CEMs) are optimization models used for long-term energy planning on national to continental scale. They are typically computationally demanding, thus in need of simplification, where one such simplification is to reduce the temporal representation. This paper investigates how using representative periods to reduce the temporal representation in CEMs distorts results compared to a benchmark model of a full chronological year. The test model is a generic CEM applied to Europe, equipped with a novel formulation for storage in model versions with reduced temporal representation. We test the performance of reduced models at penetration levels of wind and solar of 90%. Three measures for accuracy are used: (i) system cost, (ii) total capacity mix and (iii) regional capacity. We find that: (i) the system cost is well represented (~5% deviation from benchmark) with as few as ten representative days, (ii) the capacity mix is in general fairly well (~20% deviation) represented with 50 or more representative days, and (iii) the regional capacity mix displays large deviations (>50%) from benchmark for as many as 250 representative days. We conclude that modelers should be aware of the error margins when presenting results on these three aspects.

Today, due to recent developments in technology, children devote plenty of time for screen viewing. However, its harmful effects are not yet clear. The purpose of present study was to examine the associations among screen viewing and sleep duration, and body mass index (BMI) in under-five years old children. This cross-sectional study was conducted with 322 under-five healthy children that were selected using multistage stratified cluster sampling method in 2017. The data that were gathered by time-use diary method were analyzed using Kolmogorov-Smirnov test, Spearman correlation tests, multiple linear regression analysis, one-way ANCOVA, two-way ANCOVA. There was a negative correlation between screen time and sleep duration (rs = -0.42, p = 0.00), positive correlation between screen time and BMI (rs = 0.38, p = 0.00) and sleep duration negatively correlated with BMI (rs = -0.22, p = 0.00). screen viewing was a predictive factor for both sleep duration (β = -0.26, p = 0.00) and BMI (β = -0.26, p = 0.00). screen viewing had a significant impact on sleep duration (4, 314) = 5.02, P = 0.001) and BMI (F (4, 314) = 1.16, P=0.298). Results of this study indicated that screen viewing is related to sleep duration and BMI in under-five children. furthermore, screen time has an impact on sleep duration and BMI scores of children. findings of our study suggest that sleep duration negatively is associated with BMI in under-five-year-old children.

Background: Tuberculosis (TB) continues to be a serious public health threat that affects the most vulnerable population. Patients who are LTFU after TB diagnosis still represent one of the biggest challenges to TB control. Method: In this prospective observational study, we aimed to identify and analyse the risk factors associated with LTFU among TB patients who started first-line TB treatment in the Sanatorium Hospital in Luanda. Result: A total of 113 patients with TB were included between August 2018 and September 2019. Seventy-six (67.3%) patients were cured, 27 (23.9%) were LTFU, 5 (4.4%) died, 4 (3.5%) were transferred and 1 (0.9%) presented a treatment failure. After excluding those dead, transferred or who failed to treatment, we observed that severe TB at the time of diagnosis (OR 9.24, 95% CI 2.18-39.04) and food insecurity were significantly associated with LTFU (OR 5.96, 95% CI 1.66-21.41). Conclusion: The findings of our study are of enormous value to understand the reasons for the LTFU of patients with TB and can guide polices and facilitate designing measures to allow better adherence, and therefore, greater treatment success

Breast cancer (BC) affects millions of women; it is the leading cause of death by neoplasia in wom-en worldwide, with at least 500 thousand deaths each year, 70% of which occur in developing countries. Elastography evaluates tissue stiffness, making this a promising non-invasive real-time technique. BI-RADS is recognized as a standard and helpful technique for establishing BC risk. This study aimed to determine, by strain elastography (SE), the fat-to-lesion index (F/L index), sen-sitivity, specificity, and optimal cut-off to diagnose BC. This prospective study included 216 wom-en who underwent SE, ultrasound, mammography, and breast biopsy; according to mammogra-phy, we recruited BI-RADS category 2 (n= 5), category 3 (n=29), category 4 (n= 94), category 5 (n= 71) and category 6 (n=17); after biopsy, 108 women were classified as negative, and 108 were pos-itive for BC. Three expert BC radiologists performed all imaging interpretations and biopsies. Our results show mean values of the F/L index for negative biopsies of 3.70±2.57 and positive biopsies of 18.10±17.01; we developed two models for the prediction of BC, a logistic regression model with an AUC of 0.893 and a neural network with an AUC of 0.902. The Youden index yielded a F/L index cut-off >5.76, with a sensitivity and specificity of 84.26%. Positive Spearman's Rho cor-relation coefficient was observed between the F/L index and BI-RADS, r=.073 (p< 0.001). ANOVA test showed a difference between F/L index vs. molecular subtypes (p=0.002). SE is helpful as a di-agnostic complement to mammography, or in cases where the latter is contraindicated, elas-tography has an adequate predictive capacity and is a fast and minimally invasive procedure.

It has been proposed that upregulation of the noradrenergic (NA) system through exposure to novelty might be one of the key components for building cognitive reserve and resilience to neurodegeneration. A personality trait that promotes greater interest in novel experiences is Openness to Experience (OE). Individuals who are high in OE exhibit strong curiosity towards novelty and are more likely to be exposed to novel stimuli throughout the lifespan.Performing voxel-based morphometry analyses, we examined whether OE in 135 healthy young adults was associated with Locus Coeruleus (LC) - the main core of the noradrenergic system. We also investigated whether LC mediates the relationship between OE and a key measure of reserve, I.Q. In comparison with other neuromodulators’ seeds (Dorsal and Median Raphe [DR-MR] -5-HT, Ventral Tegmental Area [VTA] -DA- and Nucleus Basalis of Meynert [NBM] -Ach-), results show that greater LC integrity was related to greater OE and IQ. Additionally, mediation analyses revealed that only LC mediated the relationship between OE and IQ. Furthermore, a Bayesian multiple regression was conducted to model the contribution of both isolated and combined neuromodulator seeds to OE trait express. This approach found that the LC + VTA could account for more variance in OE expression compared to the LC alone. Other weaker but significant associations were observed between DR and OE, between LC + NBM and Conscientiousness and between DR + NBM and Extraversion. These results are together suggestive that OE is primarily underpinned by monoaminergic functioning, and that the LC-NA system plays a central role mediating the interdependence between OE expression and cognition (IQ level). While offering further understanding of the neurobiology of human personality, these findings indicate a pivotal role of LC-NA system integrity in novelty seeking in daily life. This provides a psychobiological account for how OE expression may be beneficial for maintaining the noradrenergic system to facilitate cognitive reserve and resilience to neurodegenerative conditions.

This paper compares the performance of three text-to-speech (TTS) models released from June 2021 to January 2022 in order to establish a baseline for Brazilian Portuguese. Those models were trained using dataset for Brazilian Portuguese. The experimental setup considers tts-portuguese dataset to fine-tune the following TTS models: VITS end-to-end model; glowtts and gradtts acoustic models both using hifi-gan vocoder. Performance metrics are arranged into objective and subjective metrics. As subjective metrics, the naturalness and intelligibility are measured based on the mean opinion score (MOS). Results shows that gradtts+hifigan model achieved naturalness of 4.07 MOS, close to performance of current commercial models.

Background: Vaccinating children against COVID-19 is an essential public health strategy in order to reach herd immunity and prevent illness among children and adults. Parents are facing tremendous stress in relation to the COVID-19 pandemic and the effectiveness of the COVID-19 vaccination program for children. In this study, we aimed to investigate parents’ willingness to vaccinate their children against COVID-19 in North Kivu province (DRC). Methods: A cross-sectional survey between December 01, 2021 to January 20, 2022 in 6 health zones (Goma, Karisimbi, Butembo, Beni, Kamango and Katwa) was conducted in the province of North Kivu. In each health zone, we selected 5 clusters (Health area) using the method of probabilistic selection proportional to population size. In total, 522 parents participated in our study. Results: Overall, 32.8% of parents intended to vaccinate their children. In the multivariate analysis, younger age of parents (aOR : 2.40, CI : [1.50-3.83]), higher level of fear that “a member of my family” could contract COVID-19 (aOR : 2.35, CI : [1.38-4.02]), higher level of perceived vulnerability to COVID-19 within the family (aOR : 1.70, CI : [1.005-2.2881]), higher level of perceived susceptibility to COVID-19 within the family (aOR : 3.07, CI : [1.80-5.23]), and history of vaccination against COVID-19 among parents (aOR : 16.47, CI : [8.39-32.33]), were significantly associated with the intention to have their children or adolescents vaccinated. Conclusion: Willingness of parents to vaccinate their children against the COVID-19 vaccination was low in North Kivu. There is undeniably in this region a need to reinsure the populations about vaccine safety for both children and adults. Public health authorities should also address widespread misinformation about vaccines in a timely manner.

With the COVID-19 pandemic continuing and the resulting economic burden increasingly apparent, the Indonesian government began to prepare a "new normal" phase and make peace with COVID-19. From this new decision arises the question of the readiness of businesses and the industrial sector to resume operations amid COVID-19. This article aims to provide concise and precise information about the preparations that can be made by businesses to operate safely amid COVID-19 based on existing scientific studies and literatures. From the literature visits it can be concluded that transmission and danger of a COVID-19 pandemic can be prevented through: creation of infectious disease prevention and response plan, implementing basic infection prevention measures, policies and procedures for proper identification and isolation of sick people, applying flexibilities in policies, and protections in the workplace.

Here we review and describe a set of research priorities to meet present and future challenges posed to farmed animal production that build on progress, successes and resources from the Functional Annotation of ANimal Genomes (FAANG) project.

South America has become the new epicenter of the coronavirus, especially in Brazil where the disease continues to spread exponentially across the country. This text aims to analyze the psychosocial factors of Covid-19 on back to school strategies in Brazil from a bioecological perspective. At the microsystem level, the population is experiencing different levels of stress and fear; at the mesosystem level, changes in routines, separation from family and friends, and closure of schools; and at the macrosystem level, national guidelines to control the pandemic, institutional standards on a national and international scale. Therefore, the main focus for the success of school return must be in the prevention of contagion and with physical and psychological health, and should not only consider the demands of curricula, financial or administrative management. For this reason, it is paramount that greater female representativeness is increased in decision-making levels of the meso and macrosystem, regarding the resumption of school and academic activities in the pandemic period, since the number of female leaders in decision-making, is still insufficient.

The COVID-19 pandemic has presented the world with increased challenges. The response to this pandemic has led to a sudden disruption of routine medical and elective surgical care. Most hospitals across the globe have had to change the way outpatient clinics are carried out and postpone non-urgent elective surgical procedures. NHS England ceased all elective general surgeries to train and re-deploy their staff to support the increased pressures from COVID-19 in an intensive care setting. However, with a decline of reported cases and deaths, the return to undertaking non-urgent elective services is imminent. In May 2020, Radha and Afzal published the first evidence-based guidelines for the resumption of elective orthopaedic services titled “Evidence based suggestions for the return to elective orthopaedic surgery following the COVID-19 Pandemic”. The pathway presented is adapted from the “Evidence based suggestions for the return to elective orthopaedic surgery following the COVID-19 Pandemic” and could potentially be used as a model for other surgical specialities. We present a three-phased return back to urological services. Safe resumption of elective care is possible but needs to be carefully planned.

Most large fibers in central nervous system of vertebrates are decussated. The cause or the evolutionary force of this phenomenon is not convincingly described. Here we show a pattern for this nervous system property that simultaneously is found to a more basic rule in evolution.The idea here is the "function to anatomy" theorem. We claim that functions of physical, biochemical, enzymatic, etc., in lower scale of living organisms "emerge" to anatomy in larger scales. And reversely, the anatomy we see in multicelular organisms are/were functions in microscopic scales.We propose descriptions, predictions, and a probable road map to what this can implicate in biological and medical issues.

An understanding of the cultural conditions that determine the factors affecting nurses’ intention to leave is important for countries suffering from nurse shortage. Aim: to examine factors influencing intention to leave among female hospital nurses in a large Japanese sample, classified into four generations by age considering economic conditions. Methods: a cross-sectional survey with convenience sampling was conducted. Anonymous self-administered questionnaires were distributed to all nurses in 30 hospitals. To assess intention to leave, basic attributes, life conditions, work characteristics, and factors of psychosocial work environment were addressed. After classifying data into four generations based on age cohorts, we conducted multivariate logistic regression analysis using the completed data (N = 5,074, mean age = 36.24). Results: regardless of generational characteristics influenced by economic conditions, effort and monetary reward were generation-common factors. Over-commitment, social support, and the presence of a role model were generation-common factors in three generations. While having children increased intention to leave in the generation born 1965–1979, having family members in need of caregiving other than children decreased the risk in the generation born in the 1980s. Conclusion: generational countermeasures considering factors of psychosocial work environment and life conditions are needed to avert female nurse turnover.

Microaggressions are subtle verbal and non-verbal slights based on group membership, and they are ubiquitous in the lives of racial minorities, women, and LGBTQ individuals (Sue, 2010). The goal of the current paper is to introduce a role-playing based exercise on effective responses to microaggressions. The workshop draws on the prejudice responding workshops of Plous (2000) and Lawson, et al. (2010) but integrates research-based strategies. The activity was tested in two groups of undergraduate students, and the findings suggested that both groups felt more prepared to deal with microaggressions after participating.

Monochromatic documents claim for much less computer bandwidth for network transmission and storage space than their color or even grayscale equivalent. The binarization of historical documents is far more complex than recent ones as paper aging, color, texture, translucidity, stains, back-to-front interference, kind and color of ink used in handwritting, printing process, digitalization process, etc. are some of the factors that affect binarization. This article presents a new binarization algorithm for historical documents. The new global filter proposed is performed in four steps: filtering the image using a bilateral filter, splitting image into the RGB components, decision-making for each RGB channel based on an adaptive binarization method inspired by Otsu's method with a choice of the threshold level, and classification of the binarized images to decide which of the RGB components best preserved the document information in the foreground. The quantitative and qualitative assessment made with 21 binarization algorithms in three sets of “real world” documents showed very good results.

HER2/neu positive breast tumors predict a high mortality and comprise 25-30% of breast cancer. We have shown that Flavokawain A (FKA) preferentially reduces the viabilities of HER2 overexpressing breast cancer cell lines (i.e. SKBR3 and MCF7/HER2) versus those with less HER2 expression (i.e. MCF7 and MDA-MB-468). FKA at cytotoxic concentrations to breast cancer cell lines also has minimal effect on the growth of non-malignant breast epithelial MCF10 cells. FKA induces G2M arrest in cell cycle progression of HER2 overexpressing breast cancer cell lines through inhibition of Cdc2 and Cdc25C phosphorylation and down-regulation of Myt1 and Wee1expression leading to increased Cdc2 kinase activities. In addition, FKA induces apoptosis in SKBR3 cells by increasing the protein expression of Bim and BAX and decreasing expression of Bcl₂, Bcl_x/L , XIAP and survivin. FKA also down-regulates the protein expression of HER-2 and inhibits AKT phosphorylation. Herceptin plus FKA treatment leads to enhanced growth inhibitory effect on HER-2 overexpressing breast cancer cell lines through down-regulation of Myt1, Wee1, Skp2, Survivin and XIAP. Our results suggest the promise of FKA as a novel apoptosis inducer and G2 checkpoint abrogating agent in combination with Herceptin for treatment of HER2 overexpressing breast cancer.

Background: Despite advances in the treatment of hepatocellular carcinoma (HCC) over the last few decades, treatment opportunities for patients with HCC remain limited. HCC is the most common form of liver cancer, accounting for approximately 90% of all cases worldwide. Moreover, apart from the current pharmacological interventions, hepatic resection and liver transplantation are the mainstay curative approaches for patients with HCC. Methods: This systematic review included phase I, II, III, and IV clinical trials (CTs) and randomized controlled trials (RCTs) on current treatments for patients with HCC in an Asian population (2013–2023). A total of 427 articles were screened, and 184 non-duplicate publications were identified. After screening titles and abstracts, 96 publications were excluded, and another 28 were excluded after full-text screening. The remaining 60 eligible RCTs/CTs were finally included. Results: Sixty clinical trials fulfilled our inclusion criteria and screened 36 drugs as monotherapy or combination therapy for HCC. Most studies used sorafenib alone or in combination with any of the treatment regimens. Lenvatinib or atezolizumab with bevacizumab was used for HCC after initial sorafenib treatment. Eighteen studies compared the efficacy of sorafenib with that of other drugs, including lenvatinib, cabozantinib, tepotinib, tigatuzumab, linifanib, erlotinib, resminostat, brivanib, tislelizumab, selumetinib, and refametinib. Conclusion: This study provides comprehensive insights into effective treatment interventions for HCC in Asian populations. The overall assessment indicated that sorafenib alone or in combination with atezolizumab and bevacizumab has been the first treatment choice in the past decade to achieve better outcomes in patients with HCC in an Asian population

The only solution to avoid pollution due to sewage is to treat the effluent and reuse water and sludge at the wastewater production site. This makes it necessary to install treatment plants distributed along the sewer system to prevent the movement of effluents with the consequent losses to the aquifer. This new management is called decentralized wastewater treatment. To make this change possible, it is necessary to develop treatment plants that do not represent a health hazard for citizens, eliminating the nuisance caused by traditional plants. These plants need to be robust, operate autonomously, have reduced maintenance and exhaustive control of each process, where each cubic meter of effluent is perfectly controlled, avoiding losses to the aquifer or discharges that may occur due to deficiencies in their purification capacity; constantly producing water and sludge, which are directly reusable with all the health and environmental guarantees regardless of variations in inlet effluent or environmental conditions. This article presents a paradigmatic case of a decentralized solution with conditions of maximum complexity that has been solved efficiently, saving around 98% of the initial investment, completely avoiding wastewater discharges into the environment and reusing 100% of the treated water, in 14 years of operation.

Hip fractures are the most frequently treated fractures in the world. Of these, intertrochanteric fractures (ITFs) account for almost 50%. After surgical fixation of ITFs, nonunion is rare. Nonunions are commonly produced from mal-reduction (in varus) and/or inadequate stability of the bone-implant construct and/or fatigue failure of the implants. Other causes of nonunion include posteromedial comminution and osteoporosis. The published incidence of ITF nonunion is 1%-2%. Mechanical complications of ITFs include cut-out, excessive shortening of the proximal femur, delayed union, nonunion, early implant fracture, nail toggle and cut through/medial migration. That is why a fundamental goal in the treatment of ITFs is to achieve stable fixation in osteoporotic bone, allowing early weight bearing. Intraoperative determination of fracture stability is essential. The American Academy of Orthopedic Surgeons (AAOS) clinical practice guidelines for the management of intertrochanteric fractures (ITF) in patients older than 55 years are the following: 1) In patients with stable ITF, the use of either a sliding hip screw (SHS) or a cephalomedullary nail (CMN) is advised (strong strength of evidence). 2) In patients with reverse obliquity fractures, a CMN is recommended (strong strength of evidence). 3) Patients with unstable ITF should be treated with a CMN (strong strength of evidence). 4) In patients with ITF, a short or long CMN may be considered (limited strength of evidence).

Crystalline silver thin layers were obtained by high-energy pulsed laser ablation without heating of the deposition substrate. The fluid Plateau-Rayleigh (PRI), Rayleigh – Taylor (RTI) and Richtmyer – Meshkov (RMI) instabilities, as well as crown splash induced during pulsed laser deposition (PLD) in high energy regime, resulting in ring and pearl shaped structures, offer the benefit of increased sorption surface. These morphological structures obtained for the silver thin layers make them of interest for catalytic applications. The study presented with this work addresses both the fundamental and applied issues on the morphological structures obtained for the silver thin layer and their catalytic function in organic processes. In this sense, the catalytic action of the thin silver layer was highlighted by modifications of the Reactive Blue 21 dye (C.I.) in aqueous solution with sodium bicarbonate. Specific investigations and analyzes were carried out by electron microscopy and elemental analysis (SEM-EDX), atomic force microscopy (AFM) and profilometry, mass spectrometry, ablation plasma diagnosis, diffractograms (XRD), as well as IR spectroscopy (FTIR). In addition to the experimental investigation and analyzes, simulation of the ionization energy threshold was conducted in COMSOL for complementary evaluation on the involved processes and phenomena.

A drug repositioning effort supported the possible use of the anti-HIV drug etravirine as a treatment for Friedreich Ataxia (FRDA). Etravirine increases frataxin protein and corrects the biochemical defects in cells derived from FRDA patients. Because of these findings, and since etravirine displays a favorable safety profile, we conducted this pilot open-label phase 2 clinical trial assessing the safety and potential efficacy of etravirine in FRDA patients. Thirty-five patients were stratified into 3 severity groups and randomized to etravirine 200 mg/day or 400 mg/day. They were treated for 4 months. Efficacy endpoints were represented by changes in peak oxygen uptake and workload as measured by incremental exercise test, SARA score, cardiac measures, measures of QoL and disability. Data were collected 4 months before the start of the treatment (T-4), at the start (T0), at the end (T4) and 4 months after the termination of the treatment (T+4). Etravirine was well tolerated. Etravirine completely stopped the progression of the SARA score during the 4-months treatment period, compared to the 4 months pre and post treatment. It increased peak workload, while the improvement of peak oxygen uptake was not statistically significant. No changes in the cardiac measures were observed. Health and QoL measures showed a worsening at the suspension of the drug. In this open trial etravirine significantly improved neurological function and was generally safe and reasonably tolerated. This suggests that etravirine represents a potential therapeutic agent in FRDA deserving testing in a randomized placebo controlled clinical trial.

Osteoporotic vertebral fracture is the most common fracture from osteoporosis, and are largely undiagnosed due to the mostly asymptomatic nature of the condition. It increases the risk of subsequent fractures and contributes to societal burden. Risk factors for osteoporotic fractures are found in the WHO fracture risk assessment model and used as a tool for monitoring bone health. Vertebral fractures are diagnosed from anteroposterior and lateral spine radiographs and are confirmed with an approximate loss of 20% vertebral height as compared to adjacent vertebrae. One of the most used grading for vertebral fractures is the SQ grading. Mild vertebral fractures could easily be misdiagnosed due to some peculiarities of the vertebral column. CT scan is useful for planning surgical intervention while an MRI scan can provide information about the recency of the fracture and rule out cancer-related fractures. Management depends on the severity of the fracture which could range from conservative management to surgical vertebral augmentation and decompression. Bisphosphonates are used to treat osteoporosis in acute and long-term management of fractures. Osteoimmunological therapies such as denosumab and romosozumab are new therapeutic interventions for osteoporosis while there are many other potential treatment options. Precision medicine provides an individualized treatment approach while regenerative medicine utilizes mesenchymal stem cells for fracture repair.

The consumption of foods with fiber and phenolic compounds can be part of treating obesity through interaction with the gastrointestinal tract. Treatment with common bean leaves (BL) for obesity was evaluated in mice on a high-fat, high-fructose diet (HFFD). The proximal and phytochemical characterization of BL was determined. Obesity was induced with a HFFD for 14 weeks. Immediately after, the animals were supplemented with BL (10%) or standard diet (SD) as a strategy to seem a healthy diet (12 additional weeks). Changes in body composi-tion, lipid profile, and intestinal integrity were analyzed. BL contained 27.2% dietary fiber, total phenolics (475.04 mg/100 g), and saponins (2.2 mg/100 g). The VAT consumption of the BL group decreased by 52% compared to the HFFD group. Additionally, triglyceride concentrations were 23% lower in the BL consumption group compared to the HFFD group. The improvement in lipid profile was attributed to the (1.77-fold) higher fecal lipid excretion in the BL consumption group compared to the HFFD group. Likewise, pancreatic lipase decreased by 29%. Furthermore, BL supplementation reduced the level of IL-6 (4.4-fold) and FITC-dextran in serum by 50% compared with that in the HFFD group. Metabolic endotoxemia was inhibited after BL supplementation (-33%) compared to the HFFD group. BL consumption as a treatment in obese mice reduces adipose tissue accumulation and improves the lipid profile. Furthermore, we report for the first time that BL consumption improves intestinal integrity.

This research investigates the difference on the products obtained through two hydrothermal carbonization treatments. Our aim is to synthesize metal-free, carbon-based catalysts for the Oxygen Reduction Reaction (ORR) to serve as efficient and cost-effective alternatives to plati-num-based catalysts. Catalysts synthesized using the traditional hydrothermal approach exhibit a higher electrocatalytic activity for ORR in alkaline media, despite a more energy-intensive pro-duction process. The superior performance is attributed to differences in particle morphology and to the chemical composition of the particle surfaces. The presence of functional groups on the surfaces of catalysts obtained via traditional approach significantly enhances ORR activity by fa-cilitating deprotonation reactions in an alkaline environment. Our research aims to be a reference for future investigations, shifting the focus to the fine-tuning of surface chemical compositions and morphologies of metal-free catalysts to enhance ORR activity.

Microbial community succession in raw milk determines its quality and storage period. In this study, carbon dioxide (CO2) at 2000 ppm was used to treat raw milk to investigate the mechanism of extending the shelf life of raw milk by CO2 treatment from the viewpoint of microbial colonies and metabolites. The results showed that the shelf life of CO2-treated raw milk was extended to 16 days at 4 ℃, while that of the control raw milk was only 6 days. Microbiomics analysis identified 221 Amplicon Sequence Variants (ASVs) in raw milk, and the alpha diversity of microbial communities increased (P < 0.05) with the extension of storage time. Among them, Pseudomonas, Actinobacteria and Serratia were the major microbial genus responsible for the deterioration of raw milk, with a percentage of 85.7%. A combined metagenomics and metabolomics analysis revealed that microorganisms altered the levels of metabolites, such as pyruvic acid, glutamic acid, 5'- cmp, arginine, 2-propenoic acid, and phenylalanine in the raw milk through metabolic activities, such as ABC transporters, pyrimidine metabolism, arginine and proline metabolism and phenylalanine metabolism, and reduced the shelf life of the raw milk. CO2 treatment prolonged the shelf life of the raw milk by inhibiting the abundance of Gram-negative aerobic bacteria, such as Acinetobacter guillouiae, Pseudomonas fluorescens, Serratia liquefaciens and Pseudomonas simiae.

Background The evolution of treatment patterns in neovascular age-related macular degeneration (nAMD) warrants investigation into the impact of patients’ adherence to anti-vascular endothelial growth factor (VEGF) treatment on visual outcomes. This retrospective, non-randomized, non-comparative study aimed to investigate real-world adherence to anti-VEGF treatment. Methods Patients (eyes) (≥ 50 years) with a diagnosis of nAMD who had a first injection of aflibercept or ranibizumab between January 2016 and December 2018 and 12 months of follow-up were included. Visual acuity (VA; logarithm of the minimum angle of resolution letters) and duration of injection intervals were recorded. Adherence was defined as < 20% of visits deviating from the schedule by ≥ 14 days. Results Overall, 133 patient eyes were included: 129 adherent, 4 non-adherent. Mean (± standard deviation) baseline VA was 57.0 (± 23.6) and 53.8 (± 35.3) letters in adherent and non-adherent patient eyes, respectively. Mean change in VA by month 12 was higher in adherent (6.3 letters) than non-adherent patient eyes (−11 letters). In non-adherent patient eyes, no improvement in VA was recorded following completion of the loading period (month 3). Compared with the previous visit, adherent visits were associated with a mean increase in VA of 0.67 letters and non-adherent visits with a decrease of 2.30 letters. Conclusions These results emphasize the importance of adherence to appropriate dosing regimens to optimize visual outcomes in patients with nAMD.

InGaN-based red micro light-emitting diodes (µLEDs) of different sizes prepared in this work. The red GaN epilayers were grown on a 4-inch sapphire substrate through metal organic chemical vapor deposition (MOCVD). Etching, sidewall treatment, and p- and n- contact deposition was involved in the fabrication process. Initially, the etching process would cause undesirable damages to the GaN sidewalls, which leads to an increase in leakage current. Hence, we employed KOH wet treatment to rectify the defects on the sidewalls and conducted a comparative and systematic analysis on electrical as well as optical properties. We observed that the µLEDs with a size of 5µm exhibited substantial leakage current, which was effectively mitigated by the application of KOH wet treatment. In terms of optical performance, the arrays with KOH demonstrated improved Light Output Power (LOP). Additionally, while photoelectric performance exhibited a decline with increasing current density, the devices treated with KOH consistently outperformed their counterparts in terms of optoelectronic efficiency. It is noteworthy that the optimized devices displayed enhanced photoelectric characteristics without significantly altering their original peak wavelength and FWHM. Our findings point to the elimination of surface non-radiative recombination by KOH wet treatment, thereby enhancing the performance of small-sized red µLEDs which has significant potential in realizing full-color micro-displays in near-eye projection applications.

Few clinical factors can help predict spontaneous culture conversion (SCC) in patients with Mycobacterium avium complex-pulmonary disease (MAC-PD). We retrospectively classified 373 MPD patients who had undergone watchful waiting without antibiotics according to the so-called ‘body mass index (BMI), age, cavity, erythrocyte sedimentation rate (ESR), and sex (BACES)’ severity. We evaluated whether lower severity is associated with a higher rate of SCC. Of 373 patients, 153 (41%) achieved SCC without antibiotics during a median follow-up of 48.1 months. There was a trend toward a higher SCC rate in patients with lower BACES severity: 48% (87/183), 37% (58/157), and 24% (8/33) in the mild, moderate, and severe BACES groups, respectively. In addition, a favorable outcome, defined as maintaining SCC or having two consecutive negative sputum cultures until the last follow-up date, was also more common in patients with lower BACES severity with 53% (97/183), 34% (54/157), and 18% (6/33) in the mild, moderate, and severe BACES groups, respectively. In multivariate analysis, moderate (hazard ratio [HR]=0.63; 95% confidence interval [CI] 0.44 – 0.91; p = 0.013) and severe BACES (HR 0.37; 95% CI 0.16 – 0.90; p = 0.028) had a significantly negative impact on favorable outcomes compared to mild BACES. Lower BACES severity may be associated with SCC in MAC-PD patients.

Serum carbohydrate antigen 19-9 (CA19-9) levels can increase in nontuberculous mycobacteria pulmonary disease (NTM-PD) and the levels correlate with disease activity. We compared the clinical characteristics of NTM-PD patients with and without elevated CA19-9 levels and evaluated its association with the antibiotic response in a retrospective study of NTM-PD patients diagnosed between January 1994 and December 2020. We analyzed 1,112 patients who had serum CA19-9 measured: 322 with elevated CA19-9 and 790 with normal CA19-9. The erythrocyte sedimentation rate and C-reactive protein levels were significantly higher in the elevated CA19-9 group (p < 0.001 and p = 0.029, respectively). The 1-year culture conversion rate after antibiotics did not differ between the elevated (n = 206) and normal (n = 377) CA19-9 groups (80% vs. 72%, p = 0.055). Analysis of a subset of 434 patients revealed that current smoking, bronchiectasis, acid-fast bacilli smear positivity, and the M. abscessus strain significantly reduced microbiological cure rates. Serum CA 19-9 levels did not have a significant association with microbiological cure in a multivariate analysis. These findings suggest that the role of serum CA19-9 in predicting antibiotic treatment outcomes is limited, and that elevated CA19-9 does not necessarily indicate a poor outcome.

Many of the current strategies for removing pollutants from water are based on nanomaterials and 18nanotechnology. Lower values of Biological Oxygen Demand (BOD5) and Chemical Oxygen De- 19 mand (COD) in water results in reduction in the amount of oxidizable pollutants. We present a study 20 on the reduction of COD and BOD5in water from Wadi El Bey River (Tunisia), using magnetite na- 21 noparticles (MNPs) and magnetic fields. The COD and BOD5 removal reached values higher than 22 50% after 60 min, with optimum efficiency at pH values of ≈8 and for MNPs concentrations of 1 g/L. 23 The use of a permanent magnetic field (0.33 T) showed an increase of COD and BOD5 removal from 2461% to 76% and from 63% to 78%, respectively. This enhancement is discussed in terms of the MNPs 25coagulation induced by the magnetic field and the adsorption of ionic species onto the MNPs sur- 26face due to Fe3O4 affinity.

Algologists and neurologists play a significant role in management of headache. The study aimed to compare the headache management approaches of algologist and neurologists and evaluate the impact of telehealth education on their practices. A questionnaire was developed and sent to algologists and neurologists through social media and email. Demographic information, diagnostic and treatment approaches to a headache case, and the impact of telehealth education were evaluated 82 algologists and 97 neurologists completed the survey. There was no significant difference between diagnosis. However, the examination methods differed, with the neurologists relying on history and the algologists suggesting further investigations. Both groups agreed on the application of prophylaxis treatment, with botulinum toxin administration and classical prophylactic agents being accepted in both groups. The newest preventive treatment method was used more frequently in the Neurologists. Participants reported that online meetings had a positive impact on their daily practices, with 48% stating that they were reflected in their practice. Those who attended online meetings marked more up- to-date treatment options such as CGRP antagonists and Botulinum toxin. The study showed that algologists and neurologists had similar approaches to headache management, with differences in examination methods and the use of newer preventive treatment methods. Telehealth education had a positive impact on the participants, improving their knowledge of up-to-date treatment options.

Treatment of the ADHD types (hyperactive-impulsive, inattentive, and combined) in children has rarely been studied separately, although their prognostic courses differ widely. In addition, data show that improvements in hyperactivity/impulsivity are hard to achieve. Thus, we focused on treatments tailored for hyperactivity/impulsivity. We examined meta-analyses and systematic reviews within the inter- and intra-individual treatments and found that psychoeducation and training for parents, school-based interventions, reinforcement strategies, and neurofeedback consistently showed small to moderate effect sizes in reducing hyperactivity/impulsivity in children. Conversely, emotional self-regulation, social skills, and cognitive trainings showed unsatisfactory results. In summary, we found that the quality of usual care can be surpassed when the designated interventions are purposefully combined into a multimodal treatment program.

Since first described by Dr. Tomisaku Kawasaki in 1967, the clinical diagnosis of Kawasaki disease (KD) has remained relatively unchanged. However, studies since then have suggested that diagnoses using only that original clinical criteria may lead to underdiagnosis. In this review, updated KD diagnostic methods, diagnostic methods for “atypical” KD, diagnostic pitfalls, and other differential diagnoses are discussed. Peripheral blood eosinophil showed important in distinguishing KD from febrile children. We review herein the current literature regarding new biomarkers, scoring systems, and microRNA panels that may aid in the diagnosis of KD, the importance of eosinophil and treatment updates.

Hereditary angioedema (HAE) is a very rare and potentially life-threatening genetic disease characterized by low levels of C1-INH inhibitor esterase and involving recurrent attacks of non-pruritic angioedema that do not leave subcutaneous or mucosal wells without the presence of hives. It occurs worldwide in 1 in 50,000 to 150,000 individuals and accounts for approximately 2% of clinical angioedema. It affects both sexes equally and can affect all races without ethnic differences. Methods: We conducted a review in Pubmed regarding this disease using keywords such as: hereditary angioedema, guideline, treatment, prophylaxis, management. Results: We analysed 195 articles and we focused our study on 17 reviews about type I of HAE published in English in the last 10 years. Conclusions: Screening among the family members of affected individuals (even if symptoms are absent) is mandatory, since it is a life-threatening condition. Moreover, advances in diagnosis and management have significantly improved the outcomes and quality of life of patients with hereditary angioedema.

Microbial communities inhabiting the human body play a crucial role in protecting the host against pathogens and inflammation. Disruptions to the microbial composition can lead to various health issues. Microbial transfer therapy (MTT) has emerged as a potential treatment option to address such issues. Fecal microbiota transplantation (FMT) is the most widely used form of MTT and has been successful in treating several diseases. Another form of MTT is vaginal microbiota transplantation (VMT), which involves transferring vaginal microbiota from a healthy female donor to a diseased patient's vaginal cavity with the goal of restoring normal vaginal microbial composition. However, VMT has not been extensively studied due to safety concerns and a lack of research. This paper explores the therapeutic mechanisms of VMT and discusses future perspectives. Further research is necessary to advance the clinical applications and techniques of VMT.

The human body is inhabited by unique microbial communities that protect and regulate the host against pathogens and inflammation. To address issues related to disrupted microbial composition, microbial transfer therapy (MTT) has emerged as a potential treatment option. The most popular form of MTT is fecal microbiota transplantation (FMT), which has been successful in treating various diseases. Another emerging form of MTT is vaginal microbiota transplantation (VMT), transferring of the vaginal microbiota from a healthy female donor to a diseased patient's vaginal cavity, which aims to restore normal vaginal microbial composition. However, VMT is vastly unexplored due to safety concerns and lack of research. This paper explores the mechanisms involved in VMT's therapeutic effect and discusses future perspectives. Further research is needed to advance VMT's clinical applications and techniques.

Background: Gingival enlargement is defined as an abnormal overgrowth of gingival tissues. A case of a 34–year–old female presenting with maxillary chronic inflammatory gingival enlargement associated with a nickel wire allergy is reported here. Replacement of the wire, good oral hygiene therapy and surgical therapy was carried out to provide a good aesthetic outcome. Histopathological evaluation was done of the excised specimen. There is only one similar case reported in literature to the best of our knowledge and ours is the second case. Result: A Histopathological diagnosis of inflammatory fibrous hyperplasia was established. No recurrence was reported at the end of 1 year. Conclusion: The patient should be made aware of the allergy at the initial visit and oral hygiene instructions should be reinforced at every visit. The significance of patient compliance during and following therapy as an important factor in the success of treatment.

Despite the relative scarcity of studies focusing on pharmacotherapy in aphasia, there is evidence in the literature indicating that remediation of language disorders via pharmaceutical agents could be a promising aphasia treatment option. Among the various agents used to treat chronic aphasic deficits, cholinergic drugs have provided interesting results. In the current review, we focused on published reports investigating the impact of acetylcholine on language and further cognitive disturbances. It has been suggested that acetylcholine plays an important role in neuroplasticity and is related to several aspects of cognition, such as memory and attention. Moreover, cholinergic input is diffused to a wide network of cortical areas, which have been associated with language sub-processes. This could be a possible explanation for the positive reported outcomes of cholinergic drugs in aphasia recovery, and specifically in distinct language processes, such as naming and comprehension, as well as overall communication competence. However, evidence with regard to functional alterations in specific brain areas after pharmacotherapy is rather limited. Finally, despite the positive results derived from the relevant studies, cholinergic pharmacotherapy treatment in post-stroke aphasia has not been widely implemented. The present review aims to provide an overview of the existing literature in cholinergic pharmacotherapy interventions in post-stroke aphasia, following an integrated approach by converging evidence from neuroanatomy, neurophysiology, and neuropsychology.

Fecal microbiota transplantation (FMT) is an emerging therapeutic option for a variety of diseases, which is characterized as transferring fecal microorganisms from a healthy donor into the intestinal tract of a diseased receipt. In human clinics, FMT has been used for treating diseases for decades with promising results. In recent years, veterinary specialists adapted FMT in canine patients, however, compared to humans, canine FMT is more inclined to research purposes than practical applications in most cases due to safety concerns. Therefore, in order to facilitate the application of fecal transplant therapy in dogs, in this paper, we aimed to review recent application of FMT in canine clinical treatments as well as possible mechanisms that are involved in the process of therapeutic effect of FMT.

Male breast cancers are uncommon, as men account for less than 1 percent of all breast carcinomas. Among the predisposing risk factors for male breast cancer, the following appear to be significant: a) breast/chest radiation exposure, b) estrogen use, diseases associated with hyper-estrogenism, such as cirrhosis or Klinefelter syndrome, and c) family health history. Furthermore, there are clear familial tendencies, with a higher incidence among men who have a large number of female relatives with breast cancer and d) major inheritance susceptibility. Moreover, in families with BRCA mutations, there is an increased risk of male breast cancer, although the risk appears to be greater with inherited BRCA2 mutations than with inherited BRCA1 mutations. Due to diagnostic delays, male breast cancer is more likely to present at an advanced stage. A core biopsy or a fine needle aspiration must be performed to confirm suspicious findings. Infiltrating ductal cancer is the most prevalent form of male breast cancer, while invasive lobular carcinoma is extremely uncommon. Male breast cancer is almost always positive for hormone receptors. A worse prognosis is associated with a more advanced stage at diagnosis for men with breast cancer. And randomized controlled trials which recruit both female and male patients should be developed in order to gain more consistent data on the optimal clinical approach.

Salivarian trypanosomes are extracellular parasites causing anthroponotic and zoonotic infections. Anti-parasite vaccination in considered the only sustainable method for global trypanosomosis control. Unfortunately, not a single field applicable vaccine solution has been successful so far. Active destruction of the host’s adaptive immune system by trypanosomes is believed to contribute to this problem. Here we show Trypanosome brucei brucei infection results in the lasting obliteration of immunological memory, including vaccine-induced memory against non-related pathogens. Using the well-established DTPa vaccine model in combination with a T. b. brucei infection and diminazene diaceturate anti-parasite treatment scheme, our result demonstrate that while the latter ensured the full recovery from the T. b. brucei infection, it failed to restore an efficacious anti-pertussis vaccine recall response. DTPa vaccine failure coincided with a shift in the IgG1/IgG2a anti-pertussis antibody ratio in favor of the latter, and a striking impact on all spleen immune cell populations. Interestingly, an increased plasma IFNy level in DTPa vaccinated trypanosome infected mice did result in a temporary antibody-independent improvement of early-stage trypanosomosis control. In conclusion, our results are the first to show that trypanosome inflicted immune damage is permanent, and is not restored by successful anti-parasite treatment.

Randomized clinical trials represent the gold standard in therapeutic research. Nevertheless, observational cohorts of patients treated for multidrug-resistant (MDR) or rifampin-resistant (RR) tuberculosis (TB) also play an important role in generating evidence to guide MDR/RR TB Generally, summary exposure classifications (e.g., ‘ever versus never’, ‘exposed at baseline’) have been used to characterize drug exposure, in the absence of detailed longitudinal data on MDR-TB regimen These summary classifications, along with an absence of data on covariates that change throughout the course of treatment, constrain researchers’ ability to answer the most relevant questions while accounting for known This paper highlights the importance of regimen changes in improving inference from observational studies of longer MDR-TB treatment regimens and offers an overview of the data and analytic strategies required to do

BACKGROUND: From March to April 2020, Spain was the center of the SARS-CoV-2 pandemic, particularly Madrid with approximately 30% of the cases in Spain. The aim of this study is to report the suspected serious adverse drug reactions (SADRs) in COVID-19 patients versus non-COVID-19 patients detected by the prospective pharmacovigilance program based on automatic laboratory signals (ALSs) in the hospital (PPLSH) during that period. We also compared the results with the suspected SADRs detected during the same period for 2019. METHODS: All ALSs that reflected potential SADRs (including neutropenia, pancytopenia, thrombocytopenia, anemia, eosinophilia, leukocytes in cerebrospinal fluid, hepatitis, pancreatitis, acute kidney injury, rhabdomyolysis and hyponatremia were prospectively monitored in hospitalized patients during the study periods. We analyzed the incidence and the distribution of causative drugs for the COVID-19 patients. RESULTS: The incidence rate of SADRs detected in the COVID-19 patients was 760.63 (95% CI 707.89–816.01) per 10,000 patients, 4.75-fold higher than the SADR rate for non-COVID-19 patients (160.15 per 10,000 patients,95% CI 137.09–186.80), and 5.84-fold higher than the SADR rate detected for the same period in 2019 (130.19 per 10,000 patients, 95% CI 109.53–154.36). The most frequently related drugs were tocilizumab (59.84%), dexketoprofen (13.93%), azithromycin (8.43%), lopinavir-ritonavir (7.35%), dexamethasone (7.62%), and chloroquine/hydroxychloroquine (6.91%). CONCLUSIONS: The incidence rate of SADRs detected by the PPSLH in patients with COVID-19 was 4.75-fold higher than that of the non-COVID-19 patients. Caution is recommended when using medications for COVID-19 patients, especially drugs that are hepatotoxic, myotoxic, and those that induce thromboembolic events.

This preprint is focused in the presence of plastics and microplastics in food. We will discuss how many we eat, and how they arrive to the food, and why. We will treat many other things, such as the waste treatment in Europe and in Spain, with updated data; how much plastic waste is generated; what are microplastics and how they are analyzed, I will tell about the experience we have at the University of Alicante (UA); how they can be removed and we will estimate how many we eat over the course of a year.

According to current literature and preliminary data, hydroxychloroquine (HCQ) seems potentially effective in the treatment of patients with Covid-19 pneumonia. The concentrations of HCQ in lungs might be well above that of plasma. Most likely, this property of HCQ provides effective drug concentrations in lungs. HCQ has a gradual onset of action in the treatment of rheumatic diseases. This could be valid for the treatment of Covid-19 pneumonia. It was suggested that regular HCQ administration in animals for a certain time might result in gradual accumulation of HCQ in tissues. Reduced perfusion, somewhat distorted architecture of lung tissue, edema and, suggested gradual accumulation of HCQ in lung tissue might cause reduced HCQ concentrations in pneumonic areas of the lungs in Covid-19 pneumonia. Patients with Covid-19 pneumonia and extensive lung involvement might have less HCQ concentrations in their lungs than patients having limited lung involvement. Furthermore, patients with Covid-19 pneumonia and extensive lung involvement might have more viral load than patients having limited lung involvement. That’s why treatment of patients with advanced Covid-19 pneumonia using HCQ might result in treatment failure, however HCQ might be effective in the treatment of patients with mild and moderate Covid-19 pneumonia. Using HCQ in Covid-19 pneumonia prophylaxis seems logical since providing enough accumulation of HCQ in the healthy lungs, before the arrival of the SARS-CoV-2 virus, might prevent Covid-19 pneumonia. However, the purpose of this paper is not to recommend using or not using HCQ for the treatment or for the prophylaxis of Covid-19 pneumonia. The purpose of this paper is only to try to bring a new perspective on the role of HCQ in the treatment or in the prophylaxis of Covid-19 pneumonia. This paper proposes only hypotheses, which need further researches to be confirmed.

Background and Objective: China has managed to control the coronavirus disease (COVID-19) with confinement measurements and treatment strategies, while other countries are struggling to contain the spread. This study discusses the guidelines related to COVID-19 in China in order to provide important references for other countries in the fight against COVID-19. Methods: Chinese guidelines relevant to COVID-19 were systematically searched via the China National Knowledge Infrastructure database, YiMaiTong database, and World Health Organization (WHO) COVID-19 database on March 20^th, 2020. Guideline information was extracted, including date of publication, source, objectives and the target population. Guidelines specific to the pharmacological treatment of COVID-19 were further investigated to identify the types of antivirus drugs recommended and to report on how treatment recommendations for COVID-19 have evolved overtime. Results: A total of 114 guidelines were identified, of which 87 were national guidelines and 27 were regional guidelines. The scope of included guidelines consisted of: the diagnosis and treatment of COVID-19, the management of hospital departments and specific diseases during the outbreak of COVID-19. Sixty-four of the included guidelines targeted all COVID-19 patients, while the remaining guidelines concentrated on special patient populations (i.e., geriatric population, pediatric population, and pregnant population) or patients with coexisting diseases. Twenty-three guidelines focused on the pharmacological treatments for all COVID-19 patients. Interferon, Lopinavir/Ritonavir, Ribavirin, Chloroquine, and Umifenovir represented the most recommended antivirus drugs. With the emergence of encouraging results from preclinical and preliminary clinical studies, Chloroquine Phosphate was recommended in the national Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (6^th version) on February 19^th, 2020. Thereafter, more detailed guidelines regarding the adjustment of dosage regimens and the monitoring of adverse events of Chloroquine Phosphate were published. To date, 8 Chinese guidelines have recommended Chloroquine Phosphate or Hydroxychloroquine as mainstream antivirus drug for the treatment of COVID-19. Conclusions: China has generated a plethora of guidelines covering almost all aspects of COVID-19. Chloroquine, as one widely affordable treatment, holds great potential to become the gold standard choice as more clinical evidence is shared by researchers from China as well as other countries.

Background: Activation of the immune-inflammatory response system (IRS) and the compensatory immune-regulatory system (CIRS) play a key role in SCZ and treatment resistant SCZ. There are only few data on immune and endogenous opioid system (EOS) interactions in SCZ and treatment resistant SCZ.Aim of the study: We examined serum β-endorphin, endomorphin-2 (EM2), mu-opioid (MOR) and kappa-opioid (KOR) receptors, and interleukin (IL)-6 and IL-10 in 60 non responders to treatment (NRTT), 55 partial RTT (PRTT) and 43 normal controls.Results: Serum EM2, KOR, MOR, IL-6 and IL-10 were significantly increased in SCZ as compared with controls. β-endorphin, EM2, MOR and IL-6 were significantly higher in NRTT than in PRTT. There were significant correlations between IL-6, on the one hand, and β-endorphin, EM2, KOR, and MOR, on the other, while IL-10 was significantly correlated with MOR only. A large part of the variance in negative symptoms, psychosis, hostility, excitation, mannerism, psychomotor retardation and formal thought disorders was explained by the combined effects of EM2 and MOR with or without IL-6 while increased KOR was significantly associated with all symptom dimensions. Increased MOR, KOR, EM2 and IL-6 were also associated with neurocognitive impairments including in episodic, semantic and working memory and executive functions.Conclusion: The EOS contributes to SCZ symptomatology, neurocognitive impairments and a non-response to treatment. In SCZ, EOS peptides/receptors may exert CIRS functions, whereas increased KOR levels may contribute to the pathophysiology of SCZ and EM2 and KOR to a non-response to treatment.

Implementation of waterflood is with injected pressured water to reservoir to escalation oil production. Produced water is the dominated result from oil and gas mechanism in this world meanwhile 65% of water is injected back to the well for pressure maintenance, 30% for discharge aquifier condition and surface. For shaly sand, produced water usually bring coarse and suspended sand to the surface. Therefore, this sand level is needed to declining to avoid plugging in injection well until certain economic condition.

Acute pancreatitis (AP) is an inflammatory condition of the pancreas and is one of the most common ailments of the gastrointestinal system that results in significant morbidity and mortality. The main etiologic causes of AP are alcohol consumption, gallstones, hypertriglyceridemia, and biliary stones. The clinical signs and symptoms, and diagnostic criteria of AP are well established in the literature and multiple studies. Multiple scoring systems have been used to predict the severity, prognosis, and mortality associated with AP. The present review of the literature brings to light the significant and recent contributions in the etiology, risk factors, epidemiology, diagnosis, complications, prognosis and newest modalities in treatment that could be beneficial in the management of AP.

Gastrointestinal stromal tumors are the mostly seen mesenchymal tumors of the gastrointestinal system and mostly seen at the stomach. We report a case of giant gastrointestinal stromal tumor of the stomach in a 71-year-old woman. The physical examination and radiological findings revealed that a giant mass occupied most of the abdominal cavity. The patient underwent an en-block resection of this giant mass with partial resection of the distal stomach and transverse colon and, reconstruction with gastro-jejunostomy and end-to end colo-colic anatomoses. The histopathologic diagnosis was revealed as gastrointestinal stromal tumor of the stomach. We suggest that complete surgical resection is the only effective radical treatment approach for giant gastrointestinal stromal tumors of the stomach.

Microbial Fuel Cells (MFCs) representing a promising technology for the extract of energy and resources through wastewater and it also offer an economic solution to the problem of environment effluent and energy crisis in near future. The advance device is rather appealing, due its potential benefits, its practical application is, however hindered by several drawbacks, such an internally competing microbial reaction, and low power generation. This report is an endeavor to address various design connected to the MFCs application to wastewater treatment, in particular cost effective bioelectricity from waste water are reviewed and discussed with a multidisciplinary approach. The conclusions drawn herein can be of practical interest to all new researchers dealing with effluent wastewater treatment using MFCs.

Gonorrhea is a sexually transmitted disease with a high morbidity burden. Incidence of this disease is rising due to the increasing number of antibiotic-resistant strains. Neisseria gonorrhoeae has shown an extraordinary ability to develop resistance to all antimicrobials introduced for its treatment. In fact, it was recently classified as a “Priority 2” microorganism in the WHO Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery and Development of New Antibiotics. Seeing as there is no gonococcal vaccine, control of the disease relies entirely on prevention, diagnosis and, especially, antibiotic treatment. Different health organizations worldwide have established treatment guidelines against gonorrhea, mostly consisting in dual therapy with a single oral or intramuscular dose. However, gonococci continue to develop resistances to all antibiotics introduced for treatment. In fact, the first strain of super-resistant N. gonorrhoeae was recently detected in the United Kingdom, which was resistant to ceftriaxone and azithromycin. This increasing detection of resistant gonococcal strains may lead to a situation where gonorrhea becomes untreatable. Seeing as drug resistance appears to be unstoppable, new treatment options are necessary in order to control the disease. Three approaches are currently being followed for the development of new therapies against drug-resistant gonococci: (1) novel combinations of already existing antibiotics, (2) development of new antibiotics and (3) development of alternative therapies which might slow down the appearance of resistances. N. gonorrhoeae is a public health threat due to the increasing number of antibiotic-resistant strains. Current treatment guidelines are already being challenged by this Superbug. This has lead the scientific community to develop new antibiotics and alternative therapies in order to control this disease.

In this study, we evaluated the cold drawing workability of two kinds of modified 9Cr-2W steel containing different contents of boron and nitrogen, depending on the temperature and time of normalizing and tempering treatments. Using ring compression tests at room temperature, the effect of intermediate heat treatment condition on workability was investigated. It was found that the prior austenite grain size can be changed by the austenite transformation, and the grain size increases with increasing temperature during normalizing heat treatment. Alloy B and Alloy N showed different patterns after normalizing heat treatment. Alloy N had higher stress than Alloy B, and the reduction in alloy N increased, while the reduction in alloy B decreased. Alloy B showed a larger number of initially formed cracks and a larger average crack length than Alloy N. Crack length and number increased proportionally in Alloy B as the stress increased. Alloy B had lower crack resistance than Alloy N due to boron segregation.

In the clinical electrophysiologic practice, the reading and comparing electroencephalographic (EEG) recordings some times is insufficient and take to much time. That is why in the last years it has begun to introduce new methods of EEG analysis, that give a better and faster understanding of the EEG dynamics and allow a rapid intervention in the patient's treatment. Tools coming from the information theory or nonlinear system as an entropy and complexity have been shown to be a very good alternative to address this problem. In this work we introduce a novel method -the permutation Lempel-ziv complexity vs permutation entropy map. This method was applied to EEG of two patients with specific diagnosed pathologies during respective follow up processes of pharmacological changes in order to detect changes that are not evident with the usual inspection method. Our results show that the proposed method are useful for observing an evolutionary retrospective clinical effects of pharmacological interventions in both patients, and from these, to follow the clinical response to the proposed treatment.

Neutrophil to lymphocyte ratio (NLR) is a promising predictive and prognostic factor in breast cancer. We investigated its ability to predict disease-free survival (DFS) and overall survival (OS) in patients with luminal A or luminal B-HER2-negative breast cancer who received neoadjuvant chemotherapy (NACT). Pre-treatment complete blood cell counts from 168 consecutive patients with luminal breast cancer were evaluated to assess NLR. The study population was stratified into NLRlow or NLRhigh according to a cut-off value established by receiving operator curve (ROC) analysis. Data on additional pre- and post-treatment clinical-pathological characteristics were also collected. Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models were used for statistical analyses. Patients with pre-treatment NLRlow showed a significantly shorter DFS (HR 6.97, 95% CI 1.65-10.55, p= 0.002) and OS (HR 7.79, 95% CI 1.25-15.07, p= 0.021) compared to those with NLRhigh. Non-ductal histology, luminal B subtype, and post-treatment Ki67≥ 14% were also associated with worse DFS (p= 0.016, p= 0.002, and p= 0.001, respectively). In multivariate analysis, luminal B subtype, post-treatment Ki67≥ 14%, and NLRlow remained independent prognostic factors for DFS, while only post-treatment Ki67≥ 14% and NLRlow affected OS. The present study provides evidence that pre-treatment NLRlow helps identify women at higher risk of recurrence and death among patients affected by luminal breast cancer treated with NACT.

Aluminium bronzes possess a unique combination of high strength and wear and corrosion resistance in aggressive environments; thus, these alloys find wide application in marine, shipbuilding, aviation, railway, offshore platform applications and other fields. Iron-aluminium bronzes (IABs) are the cheapest and most widely used. When the aluminium content is above 9.4 wt%, IAB is biphasic (i.e. it undergoes -transformation) and can be subjected to all heat-treatment types depending on the desired operating behaviour of the bronze component. This article presents correlations (mathematical models) between the primary mechanical characteristics (yield limit, tensile strength, elongation, hardness and impact toughness) and the ageing temperature and time of quench at 920°C in water Cu-11Al-6Fe bronze, obtained using the centrifugal casting method. The microstructure evolution was evaluated depending on the ageing temperature and time changes. Overall, the research was conducted in three successive inter-related stages: a one-factor-at-a-time study, planned experiment, and optimisations. Four optimisation tasks, which have the greatest importance for practice, were formulated and solved. The defined multiobjective optimisation tasks were solved by searching for the Pareto-optimal solution approach. The decisions were made through a nondominated sorting genetic algorithm (NSGA-II) using QstatLab. The optimisation results were verified experimentally. Additional samples were made for this purpose, quenched at 920°C in water and subjected to subsequent ageing with the optimal values of the governing factors (ageing temperature and time) for the corresponding optimisation task. The comparison of the results for the mechanical characteristics with the theoretical optimisation results presents good agreement.

High-strength wastewaters from a variety of sources, including the food industry, domestic septage and landfill leachate, are often hauled to municipal wastewater treatment plants (WWTPs) for co-treatment. Due to their high organic loadings, these wastewaters can cause process upsets in both the WWTP’s liquid and solids treatment trains and consume organic treatment capacity, leaving less capacity available to service customers in the catchment area. A novel pre-treatment method, the Waste Activated Sludge-High Rate (WASHR) process, is proposed to optimize the co-treatment of high-strength wastewaters. The WASHR process combines the contact stabilization and sequencing batch reactor processes. It utilizes waste activated sludge from the municipal WWTP as its biomass source, allowing rapid start-up. Bench scale treatment trials of winery wastewater confirm the WASHR process can reduce loadings on the downstream WWTP’s liquid treatment and solids treatment trains. A case study approach is used to confirm the economic viability and environmental sustainability of the WASHR process compared to direct co-treatment using life cycle cost analyses and greenhouse gas emissions estimates.

Time estimation was investigated in 24 healthy adults, 12 women and 12 men, before and after an exhaustive exercise. We compared the capability of estimating time intervals in the range from 1 to 5 s using tasks requiring mental count and tasks that did not allow the mental count. Time estimation and blood lactate levels were evaluated before and at the end of the exercise. We found that the perception of time intervals between 1 and 5 s was affected at the end of the exercise. The observed effects, associated with a significant increase in blood lactate levels, were different in the two types of time estimation used in the present study. In experimental conditions in which participants had to evaluate duration of the time interval by mental counting, at the end of exercise a significant reduction in the overestimation of time made at rest was observed. On the other hand, when participants had to assess the difference in duration between two events without the possibility to mentally count, at the end of the exercise a significant deterioration in performance was observed. In both cases, no gender differences were seen.

The current work reveals the fine tuning between stability zones and randomness of Pointwise Stationary Fluid Flow Approximation (PSFFA) model of the non-stationary queueing D/M/1 system. More specifically, this clearly provides more insights into developing a contemporary PSFFA theory that unifies non-stationary queueing theory with chaos theory and fields in both theoretical physics and chaotic systems. This opens new grounds for stability analysis of non-stationary queueing systems.

In this paper, the concept of absolute airspace is further elaborated, and the time transform effect, the frequency transform relation of clock timing, and the principle of Doppler effect of special relativistic light are analyzed and demonstrated. Based on the concept of absolute airspace, a new and accurate Doppler effect relation of light (electromagnetic wave) is proposed. It is proved that there is a synchronous relationship between the time shift effect and the frequency change of the timing inside the clock. When the light (electromagnetic wave) source is in motion, the Doppler effect includes two physical mechanisms: the frequency change caused by time transformation effect and the frequency change caused by relative motion. When the light source is in motion, the Doppler effect of the light there are some differences in different directions due to the rotation of the earth. The relation of Doppler effect of special relativistic light is only a highly approximate relation, and its theoretical basis, special relativity, is flawed in principle.

Effects and interactions of incubation time and chick preplacement holding time on mortality at placement, utilization of yolk sac, crop filling rate, early feeding–drinking behavior and broiler live performance were investigated. Ross 308 broiler hatching eggs from a 39-week-old flock were set in two identical setters in a commercial hatchery,with setting time 12 hours earlier in one machine. At the end of incubation, chicks were removed from the hatchers at the same time. Thus, incubation times were either 504 h (normal incubation time (NIT) treatment) or 516 h (longer incubation time (LIT) treatment). After pull time, chicks from each incubation time group were subjected to either 6, 24, 48, 60 or 72 h preplacement holding times. At placement, chicks were given access to feed and water. In total, 19,200 chicks were randomly assigned to a total of 10 subtreatment groups (2 incubation times × 5 preplacement holding times). Therefore, a total of 1,920 chicks were used in each subtreatment group for the grow-out period in a commercial broiler house. An interaction was found between incubation time and preplacement holding time for residual yolk sac (RYS) weight (g, %) (p &lt; 0.001). RYS weight was greater at pull time and at 6 and 24 h of preplacement holding time in the NIT treatment compared to the LIT treatment, while differences were no longer evident at 48–72 h. The lowest percentage of chicks with full crops and eating activity was observed in the shortest preplacement holding time (6 h) group at 3 h after placement. As expected, the initial BW at placement clearly decreased with increasing duration after the pull time (p &lt; 0.05) with the highest and lowest weights were found in the 6 and 72 h holding time treatments respectively. This BW difference was still evident at 35 d after placement and chicks held for the longest period after the pull time (72 h) showed the lowest BW (p &lt; 0.001). However, there was no significant difference between the 6 and 60 h preplacement holding times. Mortality during the first 7 d after placement increased only when the preplacement holding time was extended to 72 h (p = 0.031). Similar to the 7 d results, chicks held for 72 h exhibited higher 0-35 day mortality compared to those held for 6 or 24 h (p = 0.028). Neither BW nor mortality was affected by incubation time treatment at 35 d after placement (p &gt; 0.05). It can be concluded that there were no significant differences in average BW and mortality, up to and including a 60-h holding time under thermal comfort conditions, but a 72-h preplacement holding time resulted in final BW and mortality being negatively affected. In addition, LIT tended to have a beneficial effect on BW and mortality compared to NIT when the preplacement holding time was shorter (6–24 h) but had a negative effect for extended holding times (48–72 h).

On the basis of the findings of this paper, the theories of quantum mechanics and general relativity can be expressed in a comprehensive theory. The events were surveyed length of the time, in the Euclidean six-dimensional space-time (R6=x1+x2+x3+t1+t2+t3). Previous studies have not studied the relationship between the origin of matter's inherent properties, fundamental constants, and quantum mechanics phenomenon with space-time geometry. This theory prediction the with certainty obtained probabilistic results of quantum mechanics. This prediction is on the basis of metric resulting from the Eccentricity of the Ellipse due to the object density, in the length of time. The cause and nature of dark matter and dark energy are the findings of this article.

Noise model selection criteria has a significant impact on identifying the stochastic noise proper-ties of any GNSS daily coordinate time series. The low-frequency random walk noise existing in these time series could lead to overestimation of the tectonic rate, so it is of great significance to accurately detect the random walk component. This study focuses on noise model estimation cri-terion (BIC_tp) derived from the AIC and the BIC by introducing 2π factors. It is more sensitive to abnormal steps (random jumps). Using observation data from 72 GNSS stations from 1992 to 2022 and simulated data, four combined noise models are used to explore the impacts of time se-ries lengths (ranging from2 to 24 years) and data loss (between 2% and 30%) on noise models and velocity estimation. The results show that as the time length increased, the selected optimal noise model, and the estimated uncertainty of the tectonic trend with different data gap, gradually con-verge. When the time length is short (less than 8 years), it could lead to the FNRWWN, FNWN, and PLWN models being mistakenly estimated as GGMWN models, thereby affecting the accura-cy of determining the station velocity parameters. When the time length is 12 years, the RW noise component is more probably detected, As the time length increases, the impact of RW on velocity uncertainty is weakened. Finally, we conclude that for a time series with a minimum time length of 12 years, both the selection of the optimal stochastic noise model and the estimation of the ve-locity parameters are reliable.

The gelation time tg necessary for a solution of functional (associating) molecules to reach its gel point after a temperature jump, or a sudden concentration change, is theoretically calculated as a function of the concentration and temperature for the molecules carrying the number f of functional groups. Quite generally, tg is given by the product of the relaxation time tR and a thermodynamic factor Q. For pairwise cross-linking, and cross-linking with a fixed multiplicity k, precise values of tg are derived. For cross-linking with variable multiplicity, kinetic equation of stepwise association is derived for the reactivity pk of the functional groups, on the basis of which tg and tR are estimated. The thermodynamic factor Q is shown to generate a singularity of logarithmic divergence as the temperature (concentration) approaches the equilibrium gel point, while the relaxation time tR changes continuously across it. The retardation effect on the gelation time due to the reversibility of the cross-linking is explicitly calculated for some specific models of cross-linking. For a micellar cross-linking covering a wide range of the multiplicity, as seen in hydrophobically-modified water-soluble polymers, tR is shown to obey a formula similar to the Aniansson-Wall law.

We are using the book “Towards Quantum Gravity with an article by Claus Kiefer as to a quantum gravity interpretation of the density matrix in the early universe. The density matrix we are using is a one loop approximation, with inflaton value and potential terms, like V(phi) using the Padmanabhan values one can expect if the scale factor is a ~ a(Initial) times t ^ gamma , from early times . In doing so, we isolate out presuming a very small initial time step candidates initial time values which are from a polynomial for time values due to the Kiefer Density value.

In this paper, we study the Parisian time of a reflected Brownian motion with drift on a finite collection of rays. We derive the Laplace transform of the Parisian time using a recursive method, and provide an exact simulation algorithm to sample from the distribution of the Parisian time. The paper is motivated by the settlement delay in the real-time gross settlement (RTGS) system. Both the central bank and the participating banks in the system are concerned about the liquidity risk, and are interested in the first time that the duration of settlement delay exceeds a predefined limit, we reduce this problem to the calculation of the Parisian time. The Parisian time is also crucial in the pricing of Parisian type options; to this end, we will compare our results with the existing literature.

Future cyber-physical systems may extend over broad geographical areas, like cities or regions, thus requiring the deployment of large real-time networks. A strategy to guarantee predictable communication over such networks is to synthesize an offline time-triggered communication schedule. However, this synthesis problem is computationally hard (NP-complete), and existing approaches do not scale satisfactorily to the required network sizes. This article presents a segmented offline synthesis method which substantially reduces this limitation, being able to generate time-triggered schedules for large hybrid (wired and wireless) networks. We also present a series of algorithms and optimizations that increase the performance and compactness of the obtained schedules while solving some of the problems inherent to segmented approaches. We evaluate our approach on a set of realistic large-size multi-hop networks, significantly larger than those considered in the existing literature. The results show that our segmentation reduces the synthesis time up to two orders of magnitude.

In Newtonian mechanics, time as well as space are perceived as absolute entities. In 2 Einstein’s special relativity, time is frame dependent. Time is also affected by gravitational field 3 and as the field varies in space, time also varies throughout space. In the present article, a 4 thermodynamic-based time is investigated. The entity is called "irreversibility", which is generated 5 when availability (also known as exergy) is destroyed. Since each thermodynamic system may 6 generate different amount of irreversibility, this quantity is system dependent. The time’s arrow is 7 automatically satisfied, since irreversibility generation always proceeds in one direction (toward 8 future). We have demonstrated that, like common time, irreversibility is frame dependent, and 9 affected by gravity in the similar manner as the common time. For this reason, we propose to 10 assign the entity irreversibility of the system as thermodynamic time. A possible application of the 11 thermodynamic time is an interpretation and managing of the aging of biological systems. The 12 metabolic efficiency is related to the irreversibility of the chemical processes and affect the aging of 13 the system. Our sensation of time-flow may be attributed to the flow of availability and destruction 14 of it through the living system. It is shown by other authors that entropy generation (equivalent to 15 irreversibility) is a parameter for the human life span. Since the thermodynamic time is based on a 16 concept of thermodynamics that is universal, further applications to other subjects, such as biological 17 clock, telomere, and cosmology are possible.

With the great development of intelligent transportation systems (ITS), travel time prediction has attracted the attentions of many researchers and a large number of prediction methods have been developed. However, as an unavoidable topic, the predictability of travel time series is the basic premise for travel time prediction has received less attention than the methodology. Based on the analysis of the complexity of travel time series, this paper defines travel time predictability to express the probability of correct travel time prediction and proposes an entropy-based method to measure the upper bound of travel time predictability. Multiscale entropy is employed to quantify the complexity of travel time series, and the relationships between entropy and the upper bound of travel time predictability are presented. Empirical studies are made with vehicle trajectory data in an express road section. The effectiveness of time scales, tolerance, and series length to entropy and travel time predictability are analysis, and some valuable suggestions about the accuracy of travel time predictability are discussed. Finally, the comparisons between travel time predictability and actual prediction results from two prediction models, ARIMA and BPNN, are conducted. Experimental results demonstrate the validity and reliability of the proposed travel time predictability.