The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cog-nitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. 155 over-weight adults (BMI: Kg/m2= 43.8[6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demo-graphical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were ad-ministered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation ef-fects for gender and eating disorders (ED) have been considered. From baseline to dis-charge no significant differences between interventions were found, with the only ex-ception of an improvement in the CORE-OM total score and in the CORE-OM subjective well-being subscale for those in the CBT condition. From discharge to follow-up ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II’s wellbeing, symptoms, and psy-chological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM’ subscale reporting the risk for self-harm or harm others. The pres-ence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-Om’ symptoms and psychological problems sub-scales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.

: This study focused on assessing whether the inclusion of probiotics (B. subtilis) as feed additives during the preweaning stage can enhance the body weight and metabolic condition of neonatal calves. A total of 50 Holstein calves, all born on the same farm, were randomly divided into two homogeneous treatment groups after birth. The probiotic was administered 24 hours post-birth, signifying the start of the experimental period. The Control Group (CG), consisting of 25 calves, was fed with a milk replacer, while the Treatment Group (TG), also with 25 calves, received milk replacer supplemented with 7.5 mL/calf/day of B. subtilis probiotic, in accordance with the manufacturer's guidelines. It took one month to collect the animals. Body weight was measured at birth for all animals. A local veterinarian, working on the farm, conducted daily health checks of the calves, recording health parameters and any antibiotic treatments. Blood samples were collected from each calf at birth and again after 30 days by puncturing the jugular vein, using 10 mL evacuated serum tubes before morning feeding. Significant differences in body weight were observed at 30 days of age (p < 0.05). The CG's average body weight (BW) was 52.71 kg (±10.68), compared to 58.49 kg (±14.21) in the TG, a difference of 5.78 kg or an increase of 9.88%. Additionally, the TG exhibited significantly lower aspartate transaminase (AST) activity at 30 days of age (p < 0.001), with an average of 51.02 IU/L (±5.16) compared to 72.00 IU/L (±12.68) in the CG, a 41.12% decrease. The TG also had a significantly higher average phosphorus (P) concentration (p < 0.001) of 3.27 mmol/L (±0.22), a 9.36% increase over the CG's 2.99 mmol/L (±0.27). A significant increase in gamma-glutamyl transferase activity was observed in the TG compared to the CG (p < 0.001), with a 64.48% (or 26.29 IU/L) increase. The TG's average GGT activity was 40.64 IU/L (±22.43), while in the CG it was 14.35 IU/L (±3.45). Additionally, there was a significant 17.7% decrease (or 10.02 g/L) in total protein (TP) concentration in the TG compared to the CG, with the TG averaging 46.32 g/L (±17.43) and the CG 56.34 g/L (±9.81). Overall, dairy calves who were given conventional milk replacer along with a daily dose of 7.5 mL of B. subtilis probiotic experienced enhanced growth performance and a more favorable metabolic profile. Their body weight exhibited a 9.88% growth, but the activity of AST decreased by 41.12%, suggesting a decreased likelihood of liver damage. Additionally, their protein digestibility was 17.7% greater compared to the control group. In addition, B. subtilis had a positive impact on the overall concentration of phosphorus.

To assess if SARS-CoV-2 infection induces changes in the urinary volatilomic fingerprint able to be used in the non-invasive COVID-19 diagnosis and management, urine samples of SARS-CoV-2 infected patients (62), recovered COVID-19 patients (30), and non-infected individuals (41) were analysed using solid-phase microextraction technique in headspace mode, combined with gas chromatography hyphenated with mass spectrometry (HS-SPME/GC-MS). In total, 101 volatile organic metabolites (VOMs) from 13 chemical families were identified, being terpenes, phenolic compounds, norisoprenoids, and ketones the most represented groups. Overall, a decrease in the levels of terpenes and phenolic compounds was observed in the control group, whereas norisoprenoids and ketones showed a significant increase. In turn, a remarkable increase was noticed in norisoprenoids and ketones and a milder increase in alcohols, furanic, and sulfur compounds in the recovery group than in the COVID-19 group. Multivariate statistical analysis identified sets of VOMs with the potential to constitute volatile signatures for COVID-19 development and progression. These signatures are composed of D-carvone, 3-methoxy-5-(trifluoromethyl)aniline (MTA), 1,1,6-trimethyl-dihydronaphthalene (TDN), 2-heptanone, and 2,5,5,8a-tetramethyl-1,2,3,5,6,7,8,8-octahydro-1-naphthalenyl ester acetate (TONEA) for COVID-19 infection and nonanoic acid, α-terpinene, β-damascenone, α-isophorone, and trans-furan linalool for patients recovering from the disease. This study provides evidence that changes in the urinary volatilomic profile triggered by SARS-CoV-2 infection constitute a promising and valuable screening and/or diagnostic and management tool for COVID-19 in clinical environment.

Disruptive behaviour disorders (DBDs) in childhood, such as conduct disorder (CD) and oppositional defiant disorder (ODD) are characterized by high levels of irritability and aggression. Though psychological management is considered the first-line approach for these disorders, many children and adolescents require adjunctive pharmacotherapy for the control of specific symptoms. Several prior systematic reviews have examined the evidence for the use of antipsychotics in the symptomatic management of DBDs, but have concluded that their efficacy is marginal and limited by significant adverse effects. This paper updates existing reviews of this field by reviewing clinical trials of antipsychotics in children and adolescents with DBDs published in the period 2-1-2017 to 2-10-2022. The PubMed, Scopus and ScienceDirect databases were searched for relevant citations. Six relevant trials were identified during this period. These trials were critically evaluated in terms of outcome measures, efficacy and safety. Overall, the data from these trials suggests that certain atypical antipsychotics, such as risperidone and clozapine, are effective in the short-term management of aggression in DBDs. They have no apparent effect on cognition, but are associated with significant metabolic adverse effects. The results of these trials, and of the earlier systematic reviews, are discussed in the light of global trends towards increasing off-label prescription of antipsychotic medication in children and adolescents, and of recent literature on the neuropharmacology of aggression in this patient population. The need for rational, short-term use of these drugs is highlighted, as well as the importance of post-marketing surveillance for long-term or severe adverse events.

Delayed diagnosis and a lack of adequate care for people with autism spectrum disorder (ASD) are related to worse outcomes and quality of life. This study aimed to identify the profile of service use, barriers to access care, and factors related to those barriers in Brazilian families with children with ASD. A total of 927 families with ASD children (3-17 years) from five Brazilian regions completed an online version of the Caregivers Needs Survey. Results showed that the most used services were behavioral interventions and pharmacotherapy, while the most used professionals were neurologists, nutritionists, speech therapists, psychiatrists, psychologists, and pediatricians. The main barriers included waiting lists, costs, and the absence of services or treatment. Service use varied according to age, the region of residence, the type of health care system used, and the parents/caregivers' education. Access to behavioral interventions was more frequent among users of the private system/health insurance and families whose caregivers had higher education. The absence of specialized services/treatments was less frequent among residents of state capitals and families whose caregivers had higher levels of education. This study highlights how families with children/adolescents with ASD in Brazil face significant barriers to access care related to sociodemographic factors.

Peritoneal fluid is an ovarian exudate from the growing follicle or corpus luteum. Therefore, the free concentrations of estrogens and progesterone are always much higher than in plasma, especially after ovulation. The peritoneum is not vascularised, and peritoneal implants and the superficial portion of deep endometriosis are likely influenced mainly by peritoneal fluid. Follicular phase progesterone concentrations are as high as during the luteal phase in plasma. This explains that most peritoneal implants are rarely proliferative and out of phase with the endometrium. From some 5 mm of depth onwards, endometriosis is rather influenced by plasma hormone concentra-tions, and the deeper parts can be proliferative as the endometrium. Because of these progesterone concentrations, progesterone resistance has to be postulated, permitting endometriosis lesions to initiate and develop. This opens the discussion of whether endometriosis is similar to the basal endometrium. These peritoneal fluid concentrations are important to understand the natural history and medical therapy of endometriosis. Most medical therapies decrease ovarian function and affect peritoneal fluid steroid hormone concentrations. It is suggested that the efficacy of medical therapy for endometriosis-associated pain is a consequence of the decreased estrogen concentrations in the peritoneal cavity and that the local effect of progestins may not be determinant for pain relief. If this is true, a history of endometriosis should not be considered a contraindication for hormone re-placement therapy.

Glaucoma, a group of diseases characterized by progressive retinal ganglion cell loss, cupping of the optic disc and by a typical pattern of visual field defects, is a leading cause of severe visual impairment and blindness worldwide. Elevated intraocular pressure (IOP) is the leading risk factor for glaucoma development. However, glaucoma can also develop at normal pressure levels. An increased susceptibility of retinal ganglion cells to IOP, systemic vascular dysregulation, endothelial dysfunction and autoimmune imbalances have been suggested to play a role in the pathophysiology of normal tension glaucoma. Since inflammation and oxidative stress play a role in all forms of glaucoma, the goal of this review article is to resent an overview on the inflammatory and prooxidant mechanisms in the pathophysiology of glaucoma and to discuss immunomodulatory and antioxidant treatment approaches.

Peri-implant diseases are defined as pathological inflammatory reactions in the tissue surrounding the osseointegrated implants. They are classified into two categories: mucositis - defined as peri-implant soft tissue inflammation and peri-implantitis - bone loss in the peri-implant region. A clinical case of a 61-years-old woman with an implant in the 46 anatomical position and a 5-year follow-up is presented. A probe depth of 5mm and a bone defect length of 35% was observed. The Implacure® Protocol was applied, with the main objective of eliminating the biofilm present on the exposed implant surface. There are multiple approaches to treat peri-implant diseases. While non-surgical treatment is essential for mucositis control, the treatment of peri-implantitis surgical treatment should be considered. Regenerative bone reconstruction promotes bone repair in the defect area and reduces bleeding during probing. To achieve that, autologous fibrin combined with Cerasorb M® was used. The proposed approach in the exposed clinical case involves the application of Implacure® Protocol, whose combination of the physical decontamination technique, together with the use of chlorhexidine and orthophosphoric acid, added with the combination Piperacillin + Tazobactam together with hyaluronic acid, provide a base that allows to regenerate bone using platelet-rich fibrin with Cerasorb M® and increase the survival time of the implant.

This study explores the complementary or synergistic effects of medicinal cannabis constituents, particularly terpenes, concerning their therapeutic potential, known as the entourage effect. A systematic review of the literature on cannabis entourage effects was conducted using the PRISMA model. Two research questions conducted the review: (1) What are the Physiological Effects of Terpenes and Terpenoids found in Cannabis? (2) What are the proven Entourage Effects of Terpenes in Cannabis? The initial approach involved an exploratory search in electronic databases using predefined keywords and Boolean phrases across PubMed/MEDLINE, Web of Science, and EBSCO databases, using Medical Subject Headings (MeSH). Analysis of published studies shows no evidence of neuroprotective or anti-aggregatory effects of α-pinene and β-pinene against β-amyloid-mediated toxicity, however, modest lipid peroxidation inhibition by α-pinene, β pinene, and terpinolene may contribute to the multifaceted neuroprotection properties of these C. sativa-prevalent monoterpenes and their triterpene friedelin. Myrcene demonstrated anti-inflammatory proprieties topically, however, in combination with CBD did not show significant additional differences. Exploratory evidence suggests various therapeutic benefits of terpenes, such as myrcene for relaxing; linalool as sleep aid, exhaustion relief and mental stress; D-limonene as an analgesic; caryophyllene for cold tolerance and analgesia; valencene for cartilage protection, borneol for antinociceptive and anticonvulsant potential; and eucalyptol for muscle pain. While exploratory research suggests terpenes as influencers in the therapeutic benefits of cannabinoids, the potential for synergistic or additive enhancement of cannabinoid efficacy by terpenes remains unproven. Further clinical trials are needed to confirm these constituents' individual and combined effects.

Introduction: Inflammation is a significant contributor to cardiovascular disease (CVD) in people with HIV (PWH), who face twice the risk of CVD compared to the general population. The presence of co-existing rheumatic disease (RD) may further exacerbate inflammation and increase the incidence of CVD events in this population. Methods: We conducted a retrospective study using electronic health record (EHR) data from the Veterans Affairs Medical Center in Atlanta, covering the period from 2000 to 2019. The study included 3,930 veterans with HIV, and assessed the impact of rheumatic disease therapies (RDT) on CVD outcomes. The primary outcome was the first occurrence of a CVD event. Results: Rheumatic disease was significantly associated with an increased risk of CVD events (OR = 2.67; p < 0.001). Additionally, exposure to multiple RDTs (aHR = 2.121, p = 0.047), NSAIDs (aHR = 1.694, p = 0.003), glucocorticoids (aHR = 2.332, p < 0.0001), and hypouricemic agents and colchicine (aHR = 3.445, p < 0.0001) were all significantly associated with increased CVD events. Conclusion: The co-existence of HIV infection and rheumatic disease, along with the use of RDTs, may amplify the risk of CVD events in PWH. These findings underscore the need for further investigation into the relationship between RD, RDTs, and CVD risk in larger, controlled studies, given the potential implications for treatment decisions in this patient population.

Immune disorders, characterized by dysregulation at cellular and inflammatory levels, result from a complex interplay of genetics and environmental factors that lead to an abnormal immune response against autoantigens, triggering tissue damage. Recent research highlights reactive antibodies as key players in autoimmune diseases and graft rejection, but the complexity of their determination limits their use in clinic. Hence, we studied the specific binding profile of serological antibodies against a panel of cellular membranes in order to determine whether this antigenic panel could be used to diagnose specific immune disorders in humans. For this purpose, cell membrane microarrays of spleen, liver, and kidney tissues of monkey, rat, and human were developed, and human sera were analyzed, including healthy controls, patients with autoimmune disorders, and kidney transplant patients. A significant increase in antibody reactivity against specific monkey kidney and spleen membranes was observed in the serum of patients with lupus nephritis, while kidney transplant patients showed a significant enhancement against human tissues and Human embryonic kidney 293 cells. These results show the potential importance for clinical and basic research purposes of studying the presence of specific IgG against membrane antigens in the serum of patients as potential biomarkers of immune disorders.

Sleep disorders are a frequent problem in pediatrics. The prevalence is variable (from 15 to 50%) although the majority of papers coincide in that 1 every 3 kids can experiment some kind of sleep disorder. Underlying medical problems usually manifest by difficulty to fall asleep or stay asleep. The diagnosis and resolution of the medical problems with the specific treatment should be the prime concern, before starting with the treatment of the sleep behavioral problem

The Vitamin D Receptor (VDR) mediates the actions of vitamin D, which has important roles in bone homeostasis, growth/differentiation of cells, immune functions and reduction of inflammation. Emerging evidences suggest that epigenetic modifications of the VDR gene, particularly DNA methylation, may contribute to the onset and progression of many human disorders. This review aims to summarize the available information on the role of VDR methylation signatures in different pathological contexts, including autoimmune diseases, infectious diseases, cancer and others. The reversible nature of DNA methylation could enable the development of therapeutic strategies, offering new avenues for the management of these worldwide diseases.

Background. In a changing European agricultural context, diversification of dairy farms is gaining attention. This study seeks to (1) assess musculoskeletal pain prevalence associated with tasks such as butter, yogurt, and cheese production; and (2) analyze associated risks. Methods. Observing 31 mostly female workers, it utilized the ERGOROM questionnaire, a methodology adapted from the Institut National de Recherche et de Sécurité, and Key Indicator Method forms. Results. Findings revealed that tasks like load carrying (42% of workers), manual work (17%), and awkward postures (14%) resulted in musculoskeletal pain, predominantly in the lower back (65%), neck (39%), and dominant upper limb areas (shoulder: 61%, elbow: 26%, and wrist: 65%). While psychosocial risks remained low, concerns arose from workload, hygiene standards, and resource unpredictability. Conclusions. As dairy farming evolves from artisanal to semi-industrial, the study emphasizes the importance of ergonomic adaptations to protect farmer health and prevent musculoskeletal disorders during diversification.

Pancreatic alterations like inflammation and insulin resistance accompany hypothyroidism. Molecular iodine (I2) exerts antioxidant and differentiation actions in several tissues, and the pancreas is an iodine-uptake tissue. We analyzed the effect of two oral I2 doses on pancreatic disorders in a model of hypothyroidism for 30 days. Adult female rabbits were divided into the following groups: control, moderate oral dose of I2 (0.2 mg/kg, M-I2), high oral dose of I2 (2.0 mg/kg, H-I2), oral dose of methimazole (MMI; 10 mg/kg), MMI+M-I2, and MMI+H-I2. Moderate or high I2 supplementation did not modify circulating metabolites or pancreatic morphology. The MMI group showed circulating reductions of thyroxine (T4) and triiodo-thyronine (T3), moderate glucose increments, and significant increases in cholesterol and low-density lipoproteins. Acinar fibrosis, high insulin content, lipoperoxidation, and over-expression of GLUT4 were observed in the pancreas of this group. M-I2 supplementation normalized the T4 and cholesterol, but T3 remained low. Pancreatic alterations were prevented, nuclear factor erythroid-2-related factor-2 (Nrf2), antioxidant enzymes, and peroxisome proliferator-activated receptor gamma (PPARG) maintained their basal values. In MMI+H-I2, hypothyroidism was avoided, but pancreatic alterations and low PPARG expression remained. In conclusion, M-I2 supplementation reestablishes thyronine synthesis and diminishes pancreatic alterations, possibly related to Nrf2 and PPARG activation.

With an increasing aging population worldwide, the concept of multimorbidity has attracted growing interest over recent years, especially in frailty, which leads to progressive multisystem decline and increased adverse clinical outcomes. The relative contribution of multiple disorders to overall frailty index in older populations has not been established so far. This study aimed to assess the association between the Vulnerable Elders Survey-13 (VES-13) score, which is acknowledged to be one of the most widely used measures of frailty, and the most common ac-companying diseases among hospitalized adults aged 60 years old and more. 2860 participants with an average age of 83 years were included in this study. Multiple logistic regression with adjustment for age and nutritional status was used to assess the independent impact of every particular disease on vulnerability. Diabetes mellitus type 2, coronary artery disease, atrial fibrillation, heart failure, chronic kidney disease, osteoarthritis, fractures, eyes disorders, depression, dementia, pres-sure ulcers, and urinary incontinence were associated with higher scores of VES-13. Hospital admission of older subjects with those conditions should primarily draw attention to the risk of functional decline and while qualifying older patients for further treatment, particularly in surgery and oncology. At the same time, lipid disorders, gastrointestinal diseases, higher body mass index and albumins level were related to lower risk of being vulnerable, what may be attributed to younger age and better nu-tritional status of those patients.

Chikungunya virus is a re-emerging mosquito-borne alphavirus. Outbreaks are unpredictable and explosive in nature. Fever, arthralgia, and rash are common symptoms during the acute phase. Diagnostic tests are required to differentiate chikungunya virus from other co-circulating arboviruses, as symptoms can overlap, causing a dilemma for clinicians. Arthritis is observed during the sub-acute and chronic phases, which can flare up, resulting in increased morbidity that adversely affects activities of daily living. During the 2019 chikungunya epidemic in Thailand, cases surged in Bangkok in the last quarter of the year. Here, we demonstrate the chronic sequelae of post-chikungunya arthritis in one of our patients 1 year after the initial infection. An inflammatory process involving edema, erythema, and tenderness to palpation of her fingers' flexor surfaces was observed, with positive chikungunya IgG and negative IgM tests and antigen. The condition produced stiffness in the patient’s fingers and limited their range of motion, adversely affecting daily living activities. Resolution of symptoms was observed with a short course of an anti-inflammatory agent. More research is required to determine whether sanctuaries enable chikungunya virus to evade the host immune response and remain latent, flaring up months later and triggering an inflammatory response that causes post-chikungunya arthritis.

A growing body of evidence indicates that aging of the brain is strictly related to the decline of energy metabolism. In particular, in older adults, the neuronal metabolism of glucose declines steadily resulting in a growing deficit of ATP production. The decline is evoked by deficient NAD recovery in the salvage pathway and subsequent impairment of the Krebs cycle. NAD deficit impairs also the activity of NAD-dependent enzymes. All these open vicious circles of neurodegeneration and neuronal death. Some brain structures are particularly prone to aging and neurodegeneration. These are pathological foci of neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease. This review article summarizes the impacts and mutual relationships between metabolic processes both on neuronal and brain levels. It also provides directions on how to reduce the risk of neurodegeneration and protect the elderly against neurodegenerative diseases.

Maternal and child nutrition has been a critical component of health, sustainable development, and progress in low- and middle-income countries (LMIC). While a decrement in maternal mortality is an important indicator, simply surviving pregnancy and childbirth does not imply better maternal health. One of the fundamental obligations of nations under international human rights law is to enable mothers and teenage girls to endure pregnancy and delivery as an aspect of their enjoyment of reproductive and sexual health and rights and live a dignified life. The aim of this study was to discover the correlation between the Maternal Observation and Motivation (MOM) program and m-Health support for maternal and newborn health. A Comparative study was done among 109 pregnant mothers (study group-94; control group-102 mothers) with not less than 20 weeks of gestation. Maternal outcomes such as Hb, weight gain and newborn results like birth weight and crown- heel length was obtained on the baseline, 28 and 36 weeks of gestation. Other secondary data collected were abortion, stillbirth, low birth weight, major congenital malformations, twin or triplet pregnancies, physical activity and maternal wellbeing. The MOM intervention included initial face to face education, three in-person visits and eight virtual health coaching by WhatsApp. The baseline data on Hb of the mothers show that 31(32.98%) vs 27(28.72%) of the study and control group had anaemia, which improved to 27.66% and 14.98% among study group mothers at 28 and 36 weeks of gestation (p<0.001). The weight gain (p< 0.001), level of physical activity (p< 0.001), and maternal wellbeing (p< 0.01) also had significant differences after the Intervention. Even after controlling for potentially confounding variables, the maternal food practices regression model revealed that birth weight was directly correlated with consumption of milk (p 0.001), fruits (p 0.01), and green vegetables (p 0.05).As per the physical activity and maternal wellbeing regression model, the birth weight and crown heel length were strongly related with the physical activity and maternal wellbeing of mothers at 36 weeks of gestation (p <0.05). Combining the MOM intervention with standard antenatal care is a safe and effective way to improve maternal welfare while upholding pregnant mothers' human rights.

The aims of the study were to analyze the relationship between the Mediterranean diet (MD) and arterial stiffness and metabolic syndrome (MetS) and its components in individuals aged over 65, overall and by sex. Subjects were people over 65 years of age with a full record of all variables analyzed from the EVA, MARK and EVIDENT studies. Data from 1,280 subjects with a mean age of 69.52±3.58 years (57.5% men) were analyzed. MD was recorded with the validated 14-item MEDAS questionnaire used in the PREDIMED study. MetS was defined following the guidelines of the joint scientific statement from the Programa Nacional de Educación sobre el Colesterol III. Arterial stiffness was assessed with the VaSera VS-1500® device by measuring the cardio-ankle vascular index (CAVI) and the brachial-ankle pulse wave velocity (baPWV). Results: The mean MEDAS score was 6.00 ± 1.90, (5.92 ± 1.92 in men, 6.11 ± 1.88 in women; p = 0.036). The mean CAVI value was 9.30 ± 1.11 (9.49 ± 1.05 men, 9.03 ± 1.13 women; p = &lt;0.001). The mean baPWV value was 15.82 ± 2.56 (15.75 ± 2.46 men, 15.92 ± 2.68 women; p = &lt;0.001). MetS was found in 51% (49% men, 54% women; p = 0.036). Subjects with MetS had lower MD adherence and higher arterial stiffness values than subjects without MetS. Overall, we found a negative association of MD score with the number of MetS components (β = -0.168), with glycemia (β = -0.007), triglycerides (β = -0.003), waist circumference (β = -0.018), CAVI (β = -0.196) and baPWV (β = -0.065), and a positive association with HDL cholesterol (β = 0.013). By sex, associations followed the same direction but without reaching statistical significance with blood glucose and triglycerides in women and with HDL cholesterol and waist circumference in men. Conclusion: Results indicate that greater adherence to the Mediterranean diet decreases arterial stiffness and the percentage of subjects with MetS, although results differed in the association with MetS components by sex.

Ferritin is an indirect marker for total body iron stores. Comparison of the ferritin concentrations in the meconium with the concentrations of proteins regulating iron metabolism could aid better understanding of principles behind the adjustment between the fetal iron pool and newborn body size. Ferritin, transferrin, haptoglobin, ceruloplasmin, lactoferrin, myeloperoxidase, neutrophil gelatinase-associated lipocalin (NGAL) and calprotectin concentrations were measured by ELISA in meconium samples from 122 neonates. The neonates were classified according to the meconium ferritin tertiles and the values were collated with the meconium concentrations of other proteins and newborn body weight and length measurements. Increasing ferritin concentrations in meconium in consecutive tertiles (p < 0.05) were parallel to increased NGAL concentrations (p < 0.05). The interrelationships between the meconium concentrations of transferrin, haptoglobin and NGAL as well as between myeloperoxidase, calprotectin and lactoferrin are maintained in all subsequent tertiles of ferritin concentrations, (p < 0.05). In contrast to ferritin, increasing meconium NGAL concentrations in consecutive tertiles were linked to increased concentrations of transferrin, haptoglobin, lactoferrin and myeloperoxidase (p < 0.05) and of calprotectin, ferritin and ceruloplasmin (p < 0.1). Meconium ceruloplasmin concentrations correlate exclusively with neutrophil granule proteins, i.e. myeloperoxidase, NGAL, lactoferrin and calprotectin (p < 0.05). Meconium ferritin concentrations negatively correlates with birth weight (r= -0.20) and length (r= -0.31) of neonates, whereas NGAL concentrations just with birth length (r= -0.26). The remaining proteins did not show such relationships with the size of the newborn. High meconium concentrations of both ferritin and NGAL may specifically characterize neonates of smaller size. High meconium concentrations of both ferritin and NGAL may specifically characterize neonates with lower body measurements. Correlations between meconium transferrin, haptoglobin and NGAL may confirm the interrelationships of these proteins for proper iron control and transport in the intrauterine environment. Meconium ceruloplasmin concentrations may reflect the control of neutrophil activity in utero.

Certain micronutrients exhibit immunomodulatory effects. However, no intervention has yet investigated the effect of an individualized supplementation on the severity of upper respiratory tract infections (URI). Therefore, we investigated whether a personalized supplementation moderates the incidence and severity of URI. Selenium, zinc, and vitamin D was measured from 59 healthy participants ) in dried blood spots. Accordingly, a personalized supplement was provided with or without the respective micronutrients. We used WURSS-21 questionnaires to assess the disease status. The blood values converged during the intervention and micronutrients no longer differed at the end of the intervention period between treated and untreated volunteers. The incidence and severity of the illness did not significantly differ between the groups. However, when analyzing the WURSS-21 score by the intention to treat, the initially randomized treatment arm revealed a significantly higher score than the placebo arm. Upon acute administration, individualized combination of selenium, zinc and vitamin D does not reduce the number or contribute to a milder course of URIs. Therefore, supplementation in acute infectious situations seems questionable. Further studies must address the habitual diet in more detail to better understand the impact of individual micronutrient status on the prevention of URI.

We estimated the risk of blood clots after COVID-19 vaccination accounting for the roles of vaccination in reducing the infection rate, and indirectly lowering the risk of blood clots caused by infection. A self-controlled case series method was used to examine the association between blood clots and COVID-19 vaccination. To deal with the bias due to under-reported infection among non-hospitalized subjects, a case-control study was used to compare the risk of blood clots in infected subjects to control subjects who were hospitalized due to physical injury. We found increased risks of blood clots after vaccination (incidence rate ratio is 1.13, 95% confidence interval (CI): [1.03, 1.24] after the first dose and 1.23, 95% CI: [1.13,1.34] after the second dose). Furthermore, vaccination attenuated the increased risk of blood clots associated with infection (odds ratio (OR) = 2.16, 95% CI: [1.93, 2.42] in unvaccinated versus OR=1.46, 95% CI: [1.25, 1.70] in vaccinated). A causal model was used to explain and weigh up possible risk factors for blood clots after COVID-19 vaccination. After accounting for vaccine efficacy against infection and the protection against infection-associated blood clots, receiving the COVID-19 vaccines decreases the risk of blood clots, especially during high infection rate period.

Alzheimer's disease (AD) is a neurodegenerative olfactory disorder affecting millions of people worldwide. Alterations in the hexosamine or glucose-related pathways have been described through AD progression. Specifically, an alteration in glucosamine 6 phosphate isomerase 2 (GNPDA2) protein levels has been observed in olfactory areas from AD subjects. However, the biological role of GNPDA2 in neurodegeneration remains unknown. Using mass-spectrometry, multiple GNPDA2 interactors were identified in human nasal epithelial cells (NECs) mainly involved in intraciliary transport. Moreover, GNPDA2 overexpression induced an increment in NEC proliferation rates, accompanied by transcriptomic alterations in Type II interferon signalling or cellular stress responses. In contrast, the presence of beta-amyloid or mutated Tau-P301L in GNPDA2-overexpressing NECs induced a slow-down in the proliferative capacity in parallel with a disruption in protein processing. The proteomic characterization of Tau-P301L transgenic zebrafish embryos demonstrated that GNPDA2 overexpression interfered with collagen biosynthesis and RNA/protein processing, without inducing additional changes in axonal outgrowth defects nor neuronal cell death. In humans, a significant increase in serum GNPDA2 levels was observed across multiple neurological proteinopathies (AD, Lewy body dementia, progressive supranuclear palsy, mixed-dementia, and amyotrophic lateral sclerosis) (n=187). These data shed new light on GNPDA2-dependent mechanisms associated to the neurodegenerative process beyond the hexosamine route.

The objective of this study was to evaluate the efficacy of fungal treatment (Pleurotus ostreatus) of urea-treated rice stubble on growth performance in slow-growing goats. Eighteen crossbred Thai native x Anglo-Nubian male goats (average body weight: 20.4 ± 2.0 kg) were randomly assigned to three experimental total mixed rations containing 35% rice stubble (RS) that was either untreated (URS), urea treated (UTRS) or treated with urea and fungi (UFTRS). URS and UTRS were cultivated and harvested from aseptically fungal spawn, incubated at 25-30 °C for 25 days. Indicators of growth performance were monitored and faeces were collected quantitatively to assess nutrient digestibility, during a 12-week feeding trial. All goats remained healthy throughout experiment. The goats fed UFTRS had a lower feed conversion ratio (kg feed/kg growth) compared to goats fed URS or UTRS. Compared to URS, dietary UFTRS increased nutrient digestibility of slow-growing goats, such as OM (+8.5%), CP (+5.5%), NDF (+39.2%), and ADF (+27.4%). Likewise, dietary UFTRS tended to increase rumen ammonia concentrations but rumen pH and volatile fatty acids were not affected by UFTRS. In conclusion, the present study indicates that the fungal treatment of RS is an effective tool to improve the growth performance of slow-growing goats.

The immune system’s evolution is crucial for its role in fighting pathogens and involvement in autoimmune and neurodegenerative diseases. The GFI1 gene family controls the function of immune cells, including neutrophils in the innate immune system and CD4+ T cells in the adaptive immune system. GFI1 consists of two members, GFI1A and GFI1B. GFI1A is vital for myeloid and lymphoid differentiation, while GFI1B is crucial for generating red blood cells and platelets. Both genes share a repressor SNAG protein and C2H2 zinc finger domains, though the peptide sequences between these domains remain uncharacterized. Using a comprehensive phylogenetic approach, we traced the evolutionary history of the GFI1 gene family, revealing its early presence in invertebrates. Two rounds of genome duplication led to GFI1A and GFI1B. Despite positive selection, the family retained structural conservation. We identified new motifs in the less-characterized middle regions, such as the SPOP-binding motif in GFI1A, potentially regulating cytokine production, and the FEDFW motif, possibly involved in neutrophil recruitment. These motifs are unique to GFI1A in higher vertebrates. In GFI1B, we discovered a unique EPLRP motif, a Separase cleavage site linked to sister chromatid separation. Our results indicate that GFI1 has evolved new functions to adapt to the complexity of the vertebrate immune system. This highlights the evolutionary significance of GFI1 in immune responses and suggests potential therapeutic applications, especially in diseases related to immune function.

Brucellosis is a zoonoses caused by bacteria of the genus Brucella, which causes economic losses in livestock and threatens public health. A cross-sectional study was conducted to determine the prevalence of Brucella species and risk factors in smallholder dairy cattle in six regions of Tanzania from July 2019 to October 2020. Dairy cattle (n=2048) were sampled from 1371 farms. DNA ex-tracted from blood and vaginal swabs was tested for Brucella using qPCR targeting the IS711 gene and positives were tested for the alkB marker for B. abortus and BMEI1172 marker for B. melitensis. The molecular prevalence was 3.5% (95% CI: 2.8-4.4) with the highest prevalence 8.1% (95%CI: 4.6-13.0) in Njombe region. B. melitensis was the predominant species detected (66.2%). Logistic regression revealed PCR positivity in dairy cattle was higher in the animals with a history of abortion (OR: 3.17, 95%CI: 1.05-9.62) and farms without dogs around (OR: 2.68, 95%CI: 1.12-5.90). Further studies are recommended to understand the source of B. melitensis and the implications to veterinary public health. Livestock keepers should be informed of the risks and biosecurity practices to reduce introduction and control Brucella. Cattle and small ruminant vaccination pro-grams could be implemented to control brucellosis in high-risk populations in the country.

Background: clubfoot is a common congenital deformity. The Ponseti technique, involving early corrective manipulations followed by the application of long leg casts and Achilles tenotomy, is widely accepted as the preferred treatment. Rapid healing of the tendon after surgery has been documented, but the aspect regarding tendon structure and properties is not known. Three cases of Achilles tendon rupture in adolescent previously treated for clubfoot have been described in the literature. Since rupture is a rare event in this age group a possible correlation with previous surgery has been hypothesized. The primary aim of the study was to compare the ultrasound findings of the Achilles tendon, in patients treated for clubfoot, between patients treated with casting alone and the ones who underwent surgery (percutaneous tenotomy or Z-plasty lengthening). Methods: 22 asymptomatic patients, (34 feet) median age 12 years, previously treated for clubfoot, were recruited for this study; the patients underwent an Achilles tendon ultrasound examination during a follow-up outpatient visit. Results: a greater thickness and structural alterations with presence of hypoechoic areas of the operated tendons compared to those treated with plaster alone were observed (p value: 0.0498 and

The increased cultivation of high THC-containing Cannabis sativa L. (cannabis), particularly in greenhouses, has resulted in a greater incidence of diseases and molds that can negatively affect the growth and quality of the crop. Among them, the most important diseases are root rots (Fusarium and Pythium spp.), Botrytis bud rot (Botrytis cinerea), powdery mildew (Golovinomyces ambrosiae), cannabis stunt disease (caused by Hop latent viroid), and a range of microbes that reduce post-harvest quality. An integrated management approach to reduce the impact of these diseases/microbes requires combining different approaches that target the reproduction, spread and survival of the associated pathogens, many of which can occur on the same plant simultaneously. These approaches will be discussed in the context of developing an integrated plan to manage the important pathogens of greenhouse-grown cannabis at different stages of plant development. These stages include maintenance of stock plants, propagation through cuttings, vegetative growth of plants, and flowering. The cultivation of cannabis genotypes with tolerance or resistance to various pathogens is a very important approach, followed by the maintenance of pathogen-free stock plants. When combined with cultural approaches (sanitation, management of irrigation, and monitoring for diseases) and environmental approaches (greenhouse climate modification), a significant reduction in pathogen development and spread can be achieved. The use of preventive applications of microbial biological control agents and reduced risk biorational products can also reduce disease development at all stages of production in jurisdictions where they are registered for use. The combined use of promising strategies for integrated disease management on cannabis plants during greenhouse production will be reviewed. Future areas for research are identified.

The evaluation of tourism sustainability has become of paramount importance for researchers and decision-makers to better protect tourist destinations, especially with the continuous increase in the number of tourists and visitors that alter the natural components of the environment and degrade ecosystems. Therefore, the use of geographical data is of great significance, particularly in environmental monitoring and land management, due to its ease of use and availability. However, calculating composite indices for sustainability involves several steps and requires a basic understanding of existing models. This article describes the development and design of a package of plugins in QGIS that serves as an easy-to-use tool for processing and automatically calculating economic, environmental, social indices, and the overall index of tourist sustainability. These plugins have been built in Python and designed as QGIS software plugins.

Rice is an essential crop for national food security in Egypt. Increasing the population calls for regular increases in rice production. At the same time, cultivated rice crop areas should be decreased because of the gradual scarcity of irrigation water. This means more rice production should be gained from less rice area. This situation calls for the annual accurate system for rice monitoring and yield estimation. Therefore, it is necessary to apply a remotely sensed based system for rice cultivation assessment using satellite imagery parallel with field measurements of some biophysical parameters. Multi-temporal normalized difference vegetation index (NDVI) extracted from twelve sentinel-2 imagery cover the whole summer season with variance and maximum value assessed by ground control points (GCPs), were used to isolate uncultivated areas, then to isolate rice areas and other vegetation covers. object-based classification methods with kappa co-efficient 0.9261 and overall accuracy 94.92% was generated to discriminate rice crop area and other summer crops on the study area. Leaf area index (LAI) for the experiment the l site was calculated using the surface energy balance algorithm for Land (SEBAL) model and then tested versus measured (LAI). NDVI and LAI were used to generate an empirical ran rice yield prediction model. Then, this model was used to produce rice to yield a map. The study was carried out in an experimental site in Kafr Elsheikh governorate with a total area of 5040 Hectare. Produced cultivated land use map showed 95% overall accuracy. High similarity was observed between measured and calculated (LAI) with high accuracy of R2 = 0.94. of Rice, yield map showed expected to yield more to than a month before harvest. The generated yield map was tested using a correlation coefficient between actual yield and estimated yield with high accuracy R2 = 0.9. This method is applicable to estimate the acreage and productivity of rice in the northern Nile delta in adequate time before harvest.

The exploration and identification of targets and pathways for Atopic dermatitis (AD) treatment and diagnosis are critical for AD control. The conventional target exploration approach such as the literature review is not satisfying in terms of efficiency and accuracy. Recently, the bioinformatic approach is drawing attention for its unique advantage of high-volume data analysis for target and pathway exploration; Open Targets Platform is the targets source for this study to extract top 200 high-rank proteins from 3122 AD associated proteins. STRING, Cytoscape, CytoHubba, ClueGo, and CluePedia function had been applied for data analysis. The KEGG Mapper search & colour pathway was the pathway map resource for identified pathways; 23 key hub genes (VDR, KIT, BCL2L11, NFKBIA, KRAS, IL13, JAK2, STAT3, IL21, IL4R, REL, PDGFRB, FOXP3, RARA, RELB, EGFR, IL21R, MYC, CREBBP, NR3C1, IL2, JAK1, and KITLG). Additionally, 8 correlated pathways and the biological process had been identified; Through this study, a viable approach for target and pathway exploration had been presented. The identified AD targets and pathways will be tested for upcoming research for traditional Chinese medicinal herb interactions

A bacterium known as Akkermansia muciniphila (AkkermansiaA. muciniphila) was detected in human feces in 2004. It is defined as a gram-negative, anaerobic, and mucin-degrading microbe belonging to the Verrucomicrobia species. Although the majority of A. muciniphila is found in the human intestinal tract playing a role in the gut microbiome, there are also smaller levels detected in breast milk and oral cavities as well as in the pancreas and appendix.Evidence suggests that having A. muciniphila present in the gut microbiome has positive effects on human health. As a result, A. muciniphila has been shown to have health benefits when taken as a dietary supplementation where it is considered a promising next-generation probiotic. However, the large-scale production of A. muciniphila remains a challenge due to its need for a stable environment. While culturing A. muciniphila in a mucin-based medium is one option, other strategies that use plate-based mediums have also been explored. Currently, both live and pasteurized forms of A. muciniphila are available on the market and shown to have promising outcomes in animal models. Additionally, researchers are investigating various prebiotics to increase the abundance of A. muciniphila in the human gut. This article presents a detailed summary of the phenotypic characteristics of A. muciniphila and its associations with various human health condition illnesses. Finally, the paper explores A. muciniphila's potential as an effective next-generation probiotic.

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

Outbreaks of avian pathogens such as Newcastle disease virus, avian influenza virus and Salmonella have a major impact on economies and food security worldwide. Some pathogens also pose a significant zoonotic potential, especially avian influenza viruses. Vaccination plays a key role in controlling many poultry diseases and there are many vaccines licenced in the United Kingdom for diseases of poultry caused by viruses, bacteria, and parasites. However, these vaccines often do not provide complete protection and can cause unwanted side effects. Several factors affect the potency of poultry vaccines including the type of vaccination used, the mechanism of delivery and the use of adjuvants. Advancements in technology have led to the study and development of novel vaccines and vaccine adjuvants for use in poultry. These induce stronger immune responses compared to current vaccine technology and have the potential to protect against multiple poultry diseases. This review aims to discuss existing poultry vaccine technology, the effect of delivery mechanisms of vaccine efficacy, the use of current and novel adjuvants, the ability to target antigen to antigen presenting cells, the use of probiotics, multivalent vaccines, and nanotechnology to enhance the potency of poultry vaccines.

Every individual at some point encounters the progressive biological process of aging which is considered one of the major risk factors for common diseases. The main drivers of aging are oxi-dative stress, senescence, and Reactive oxygen species (ROS). The renin-angiotensin-aldosterone system (RAAS) includes several systematic processes for the regulation of blood pressure which is caused by an imbalance of electrolytes. During activation of RAAS, binding of angiotensin II (ANG II) to angiotensin II type I receptor (AGTR1) activates intracellular NADPH oxidase to generate superoxide anions and promote uncoupling of endothelial NO synthase, which in turn decreases NO availability and increases ROS production. Promoting oxidative stress and DNA damage mediated by ANG II is tightly regulated. Individuals with sodium deficiency-associated diseases such as Gitelman syndrome (GS) and Bartter syndrome (BS) show down-regulation of inflammation-related processes and have reduced oxidative stress and ROS. Additionally, the histone deacetylase-Sirtuin-1(SIRT1) has a significant impact on the aging process with reduced activity with age. However, GS/BS patients generally sustain higher levels of SIRT1 activity than aged-matched healthy individuals. In this review, we highlight the importance of the hallmarks of aging, inflammation, and the RAAS system in GS/BS patients and how this might impact healthy aging. We further propose fu-ture research directions for studying the etiology of GS/BS at the molecular level using pa-tient-derived renal stem cells and induced pluripotent stem cells.

Total-body PET/CT scanners provide increased sensitivity, enabling the adjustment of imaging parameters by reducing injected activity or shortening acquisition time. This study aimed to evaluate the limitations of reduced [18F]FDG activity doses on image quality, lesion detectabil-ity, and quantification of lesion uptake in the Biograph Vision Quadra, as well as to assess the benefits of the recently introduced ultra-high sensitivity mode in a clinical setting. A number of 26 patients who underwent [18F]FDG-PET/CT (3.0 MBq/kg, 5 min. scan time) were included in this analysis. PET raw data was rebinned for shorter frame durations to simulate 5 min. scans with lower activities in high sensitivity (HS) and ultra-high sensitivity (UHS) modes. Image quality, noise, and lesion detectability (n=82) were assessed using a 5-point Likert scale. The co-efficient of variation (CoV), signal-to-noise ratio (SNR), tumor-to-background ratio (TBR), and standardized uptake values (SUV) including SUVmean, SUVmax, and SUVpeak were evaluated. Sub-jective image ratings were generally superior in UHS compared to HS mode. At 0.5 MBq/kg, le-sion detectability decreased to 95% (HS) and 98% (UHS). SNR was comparable at 1.0 MBq/kg in HS (5.7±0.6) and 0.5 MBq/kg in UHS (5.5±0.5). With lower doses, there were negligible reductions in SUVmean and SUVpeak, whereas SUVmax increased steadily. Reducing [18F]FDG activity to 1.0 MBq/kg (HS/UHS) in a total-body PET/CT provides diagnostic image quality without statistical-ly significant changes in uptake parameters. UHS mode improves image quality, noise, and le-sion detectability compared to HS mode.

Solution combustion synthesis (SCS) is often utilized to prepare crystalline nanoparticles of transition metal oxides, in particular Mn oxides. The structure and composition of the final product depend on the conditions of the synthesis, in particular on the composition of metal precursors, its molar ratio to the fuel component, and the mode of heating. In the present work the study of chemical phenomena which may occur in the during SCS process has been studied for the conventional nitrate-glycine synthesis of Mn oxide, as well as for nitrate-citrate-glycine and nitrate-citrate-urea synthesis. In the case of nitrate-glycine synthesis, formation of a weak complex of Mn(II) and glycine provides the conditions of instantaneous SCS reaction upon heating, resulting in slight sintering of final oxide nanoparticles. However, partial hydrolysis of Mn precursor during slow solvent evaporation results in formation of mixture of oxides, namely MnO and Mn3O4. Formation of MnO is completely suppressed in the presence of ammonium citrate in the initial mixture, and pure Mn3O4 phase is obtained. SCS reaction in this case is slower, resulting in stronger sintering of the nanoparticles. The study of electrochemical properties of synthesized oxides demonstrated that the SCS with nitrate-citrate-urea mixture provides the highest charge capacitance in 1M NaOH: 130 F/g at 2 A/g. Impedance characterization of materials allowed to propose a tentative mechanism of degradation of electrode materials during the galvanostatic cycling.

Recent algorithmic-based research in the stock market has predominantly focused on ultra-high-frequency trading and index estimation. We developed an improved algorithm to address the need for a low-frequency, real-world trading model to build on the existing high hit-ratio and low maximum drawdown. We utilized established price indicators, Stochastic and Williams %R, and introduced a volume factor to increase the model's safety to enhance the model's performance. This improved algorithm demonstrated superior returns while maintaining high hit-ratio and low maximum drawdown. Specifically, we leveraged the existing algorithm to trade using 2X and 3X signals, incorporating volume data, the 52-week average, standard deviation, and other factors. The data set comprised SPY ETF price and volume from 2010 to 2023, covering over 13 years. Our enhanced algorithmic trading model outperformed both the benchmark and previous results, achieving a hit rate of over 90%, a maximum drawdown of less than 1%, an average of 1.5 trades per year, a total return of +519.3%, and an annualized return (AnnR) of +15.1%. The analysis demonstrates that the model's simplicity, ease of application, and comprehensibility can assist investors in making informed investment decisions albeit the past performance does not guarantee future returns.

Objectives: Valsalva maneuver is performed during strength physical exercises, because it stabilizes the torso through increased intra-abdominal pressure. By contrast, yoga practitioners are discouraged from Valsalva. Instead, they use ujjayi breath, which consists of unstopped breathing through the narrowed glottis. Methods: This study was an observational research performed in healthy participants. The aim of this study was to evaluate veins in the groin area during different types of breathing. We examined 10 healthy people in the standing body position during: a) normal breathing b) Valsalva maneuver c) ujjayi breath. We measured the cross-sectional areas of the femoral and the great saphenous veins in the proximity to the sapheno-femoral junction. Results: In comparison with normal breathing, there were only slight dilatations of examined veins during Valsalva and ujjayi. The cross-sectional area of femoral vein increased by 7-9% during Valsalva, and 2-4% during ujjayi; cross-sectional area of the great saphenous vein increased by 17-18% during Valsalva and 15-16% during ujjayi. In all participants the terminal and preterminal valves of the great saphenous vein were competent. However, Valsalva maneuver was associated with complete closure of the terminal valve, while during ujjayi breath this valve was opening and closing, following the breathing. Conclusions: In the standing body position both Valsalva and ujjayi breath have minimal effect on cross-sectional areas of the veins in the groin. On the other hand, ujjayi breath allows for undisturbed flow through the sapheno-femoral junction, while Valsalva interrupts this flow, with blood stagnation distally from the terminal valve.

Irregular female migration to Europe is a growing phenomenon, as more and more women are fleeing their countries of origin due to gender inequality and violence. During the migration process, women experience physical, psychological and social problems that affect their sex lives. The aim of our study is to describe and understand how irregular migrant wom-en living in humanitarian reception centers experience their sexuality at different stages of the migration process. This qualitative phenomenological study collected data through a sixteen in-depth interviews with irregular migrant women between January and February 2023. Data anal-ysis was carried out using ATLAS-ti 23.0 software, from which three themes were extracted: 1) The sexual reality of sub-Saharan women, 2) In search of a better life: take the risk or surrender, and 3) The migrant sexual revolution. The sexual reality of sub-Saharan women is subject to a complex normative order. The migratory process has severe consequences on migrant women's sex life. The sexual needs of irregular migrant women admitted to humanitarian reception cen-ters undergo a process of change that must be understood by healthcare providers in order to make improvements to care provision.

Broflanilide is a novel active ingredient from a unique insecticide class (IRAC Group 30) and was investigated as a control option against modern insecticide resistant strains of the common bed bug, Cimex lectularius. The susceptibility of technical grade broflanilide and efficacy of a broflanilide-based aerosol formulation (Earth Corp., Japan) were evaluated against five C. lectularius strains (MONH, SYD, DARL, PARRA, RIPPO). Results demonstrated that bed bugs had high susceptibility to broflanilide (RR50: SYD=1.22-fold, DARL=1.03-fold, PARRA=3.65-fold, RIPPO=2.77-fold), compared to the susceptible MONH strain. The aerosol showed high efficacy to adult bed bugs (97.5–100 % mortality to five strains after 24 hrs post-spray) and produced a notable decrease in egg hatch rates (MONH=9.7–23.4 %, PARRA=14.9–22.6 %). The aerosol also demonstrated high residual activity with 97.5–100% mortality in all five bed bug strains within 7 days exposure. The impact of different surface types upon aerosol residual efficacy was limited, although residues on a non-porous surface (tile) killed bed bugs slightly quicker than that on a porous surface (filter paper). The aerosol provided long residual activity to bed bugs, as 6-month-old residues were as equally efficacious to that of fresh residues. Bed bugs did not avoid surfaces treated with the aerosol. The high efficacy (including ovicidal efficacy), long residual activity, and non-avoidance of bed bugs on treated surfaces, demonstrated that broflanilide is highly suitable for modern bed bug management.

China is experiencing rapid urbanization. The focus on health issues has shifted from the treatment of diseases to passive or active prevention. Diseases caused by the deterioration of the urban environment, such as cardiovascular disease, diabetes, obesity and other chronic diseases and mental illness, have gradually become the main threat to public health. Studies have confirmed that urban green spaces (UGS) can help residents relieve mental stress, improve mood, reduce mental fatigue and restore attention, which has a positive effect on people's physical and mental health. In this study, the relationship between the quantity and quality factors of UGS and the physical and mental health of urban residents in Xihu District of Hangzhou is examined, and on this basis, UGS design strategies are proposed to promote the physical and mental health of residents. This study is of great significance for the future construction of UGS that are beneficial to the health of residents and the promotion of a healthy China and healthy city construction.

In large-capacity energy storage systems, instructions are decomposed typically using an equalized power distribution strategy, where clusters/modules operate at the same power and durations. When dispatching shifts from stable single conditions to intricate coupled conditions, this distribution strategy inevitably results in increased inconsistency and hastened system aging. This paper presents a novel differentiated power distribution strategy comprising three control variables: the rotation status, the operating boundaries for both Depth of Discharge (DOD) and C-rates (C) within a control period. The proposed strategy integrates an aging cost prediction model developed to express the mapping relationship between these control variables and aging costs. Additionally, it incorporates the multi-colony particle swarm optimization (Mc-PSO) algorithm into the optimization model to minimize aging costs. The aging cost prediction model consists of three functions: predicting health features (HFs) based on the cumulative charge/discharge throughput quantity and operating boundaries, characterizing HFs as comprehensive scores, and calculating aging costs using both comprehensive scores and residual equipment value. Further, we elaborated on the engineering application process for the proposed control strategy. In the simulation scenarios, this strategy prolonged the service life by 14.62%, reduced the overall aging cost by 6.61%, and improved module consistency by 21.98%, compared with the traditional equalized distribution strategy. In summary, the proposed strategy proves effective in elongating service life, reducing overall aging costs, and increasing the benefit of energy storage systems in particular application scenarios.

The thymus, a central lymphoid organ in animals serves as the site for T cell development, differentiation and maturation, vital to adaptive immunity. Thymus is critical for maintaining tissue homeostasis to protect against tumors and tissue damage. Overactive or prolonged immune response can lead to oxidative stress from increased production of reactive oxygen species. Heat stress induces oxidative stress and overwhelms the natural antioxidant defense mechanisms. The study objectives were to investigate the protective properties of astaxanthin against heat-induced oxidative stress and apoptosis in the chicken thymus, by comparing the growth performance and gene signaling pathways among three groups- thermal neutral, heat stress and heat stress with astaxanthin. The thermal neutral temperature conditions were 21-22°C and heat stress temperature was 32-35°C. Both heat stress groups experienced reduced growth performance, while the astaxanthin treated group showed a slightly lesser decline. The inflammatory response and antioxidant defense system were activated by the upregulation of the NF-kB, NFE2L2, PPARα, cytoprotective capacity and apoptotic gene pathways in the heat stress compared to the thermal neutral group. Conversely, expression levels were without significance between the thermal neutral and heat stress with antioxidant groups, suggesting astaxanthin antioxidant effectiveness to mitigate inflammation and oxidative stress damage.

Fatigue is a recognized concern in air traffic management, prompting international bodies like ICAO and EASA to advocate for Fatigue Risk Management Systems (FRMS). EU Regulation 2017/373, effective since January 2020, imposes specific requirements on air traffic service providers regarding controllers' fatigue, stress, and rostering systems, as part of safety management protocols. Despite active campaigns promoting fatigue awareness in air traffic control (ATC), there remains a need for standardized operational requirements. Eurocontrol recently published "Guidelines on fatigue management in ATC rostering systems" (April 23), aiming to facilitate the adoption of common fatigue operational standards. However, neither EU Regulation 2017/373 nor existing documentation specifies exact rostering criteria. Air Navigation Service Providers (ANSPs) typically derive these criteria from scientific literature, best practices, historical data, and legal and operational necessities. Yet, assessing and monitoring fatigue in operational settings can be complex and require long-term studies due to its multifaceted nature, spanning factors such as sleep quality, circadian rhythms, psychosocial influences, individual traits, and environmental conditions. The case studies reported in this paper represent an attempt to create an evidence-based protocol for fatigue risk monitoring in ATC operations, utilizing a non-invasive approach and collecting multidimensional data. The two case studies involved en-route and tower controllers from different ATC Centers, and the results underscore the importance of fatigue assessment in ATC and elucidates challenges in implementing fatigue monitoring within operational contexts.

The lack of tactile experience is a significant flaw in online product evaluation and purchase, but visual information can be utilized to compensate for tactile deficits. In this study, we constructed a mechanistic model of the role of tactile perceived diagnosticity on consumer purchase intention based on visual compensation based on mental imagery theory, innovativeness theory, and personal goals framework. We collected data from consumers (n=406) in the Chinese market and tested the research hypotheses using structural equation modeling. The findings suggest that visually compensated tactile perceptual diagnosticity promotes mental imagery and sensory similarity, which in turn affects purchase intention. Theoretically, this study enriches current explanations of online haptics by explaining the mechanisms by which haptic demonstration videos influence consumers' haptic evaluations and behavioral responses, as well as the moderating role of personal goals therein; practically offers advice for retailers seeking to build or expand their tactile marketing strategies.

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

Obesity during childhood has been associated with many important physiological and neurological health considerations. Specifically concerning are the associations between youth obesity and declines in mental health, as shown with increasing rates of adolescent depression and anxiety worldwide. The emergence of mental health disorders commonly arises during adolescent development, and approximately half the global population satisfy the criteria for at least one psychiatric disorder in their lifetime, suggesting a need for early intervention. Adolescence is critical time whereby brain structure and functions are not only negatively associated with obesity and declines in mental health, while also coinciding with significant declines in rates of physical activity among individuals in this age group. Physical activity is thus a prime candidate to address the intersection of obesity and mental health crises occurring globally. This review addresses the important considerations between physiological health (obesity, aerobic fitness, physical activity), brain health (structure and function), and mental wellbeing symptomology. Lastly, we pose a theoretical framework which asks important questions regarding the influence of physiological health on the association between brain health and the development of depression and anxiety symptoms in adolescence.

This study analyzed the levels of mental workload and the presence of burnout on a sample of fashion retailing workers from Spain and its relationship with the actual Covid-19 pandemic by exploring Covid-19 pandemic predictors of burnout and mental workload. We established a prospective cross-sectional design. Participants (n = 360) answered an online survey including questions about sociodemographic data, perception of Covid-19, CarMen-Q questionnaire (workload), and MBI (burnout syndrome). We obtained data throughout October-November 2020. The results showed that participants exhibit deep concern about the Covid-19 pandemic and its influence at the work level. Although the mental workload was near the middle point of the scale, participants showed moderate to high burnout levels, revealing that the sample is at risk of experiencing higher burnout levels over time as the pandemic and associated economic crisis continue. The multidimensional regression analysis results indicated that environmental changes, work overload, somatic symptoms, insomnia, negative job expectations, and uncertainty constituted significant mental workload predictors. Insomnia, somatic symptoms, and negative job expectations constituted significant predictors for burnout. In conclusion, the uncertainty at work derived from the Covid-19 pandemic is harming the psychological wellbeing of fashion retailing workers in Spain.

Background: Coronavirus disease 2019 (COVID-19) is an ongoing pandemic and life-threatening highly infectious disease. The people of Bangladesh are at high risk of COVID-19 and have already experienced various socio-economic, health and psychological (mental) consequences. Particularly, mental health problems are dominantly reported in the literature and should be controlled. The main objective of this epidemiological study is to assess the mental distress and identify its determinants using online-based survey. Such information is urgently needed to develop feasible strategies for Bangladesh. Methods: An online survey was conducted for this study from May 01 to May 05, 2020. A total of 240 respondents provided self-reported online responses. Respondent’s mental distress was measured by the General Health Questionnaire 12 (GHQ-12) and by the self-rated mental health (SRMH) question. Various kinds of statistical analyses ranging from simple to multivariable logistic recession were performed using SPSS 23.0. Results: About 31.3% and 48.3% of respondents were mentally distressed by GHQ-12 and SRMH question, respectively. Logistic regression analysis revealed that mental distress was significantly higher among those respondents, whose usual activity was affected by the coronavirus (OR = 6.40, 95% CI: 1.87 - 21.90, p<0.001) and whose financial stress was increased due to lockdown (OR = 2.12, 95% CI: 1.01 – 4.46, p<0.05) on GHQ-12. Female sex (OR = 1.97, 95% CI: 1.03 – 3.75, p<0.05) and respondents with poor mental health before the outbreak (OR = 3.38, 95% CI: 1.18 – 9.72, p<0.05) were also significantly affected by mental distress on SRMH. Conclusions: At least thirty percent of the respondents were found to be mentally distressed. Some of the study findings, particularly significant determinants, should be considered while developing strategies to reduce the burden of mental distress among study respondents or similar group in Bangladesh.

A “watch and wait” strategy, delaying treatment until active disease manifests, is adopted for most CLL cases; however prognostic models incorporating biomarkers have shown to be useful to predict treatment requirement. In our prospective O-CLL1 study including 224 patients, we investigated the predictive role of 513 microRNAs (miRNAs) on time to first treatment (TTFT). In the context of this study six well-established variables (i.e., Rai stage, beta-2-microglobulin levels, IGVH mutational status, del11q, del17p, and NOTCH1 mutations) maintained significant associations with TTFT in a basic multivariable model, collectively yielding a Harrell's C-index of 75% and explaining 45.4% of the variance in the prediction of TTFT. Concerning miRNAs, 73 out of 513 were significantly associated with TTFT in a univariable model; of these, 16 retained an in-dependent relationship with the outcome in a multivariable analysis. For 8 of these (i.e., miR-582-3p, miR-33a-3p, miR-516a-5p, miR-99a-5p, and miR-296-3p, miR-502-5p, miR-625-5p, and miR-29c-3p) a lower expression correlated with a shorter TTFT, whereas in the remaining eight (i.e., miR-150-5p, miR-148a-3p, miR-28-5p, miR-144-5p, miR-671-5p, miR-1-3p, miR-193a-3p, and miR-124-3p) the higher expression was associated with shorter TTFT. Integrating these miRNAs into the basic model significantly enhanced predictive accuracy, raising the Harrell’C index to 81.1% and the explained variation in TTFT to 63.3%. Moreover, the inclusion of the miRNA scores enhanced the Integrated Discrimination Improvement (IDI) and the Net Reclassification Index (NRI), underscoring the potential of miRNAs to refine CLL prognostic models and providing insights for clinical decision-making. In silico analyses on the differently expressed miRNAs revealed their potential regulatory functions of several pathways, including those involved in the therapeutic responses. To add a bio-logical context to the clinical evidence, a miRNA-mRNA correlation analysis revealed at least one significant negative correlation between 15 of the identified miRNAs and a set of 50 Artificial Intelligence (AI) selected genes, previously identified by us as relevant for TTFT prediction in the same cohort of CLL patients. In conclusion, the identification of specific miRNAs as predictors of TTFT holds promise for enhancing risk stratification in CLL to predict therapeutic needs. However, further validation studies and in-depth functional analyses are required to confirm the robustness of these observations and to facilitate their translation into meaningful clinical utility.

Fibromyalgia (FM), classified by ICD-11 with code MG30.0, is a chronic debilitating disease characterized by wide-spread pain, fatigue, cognitive impairment, sleep and intestinal alterations, among other. FM affects a large proportion of the world-wide population, with increased prevalence among women. The lack of understanding of its etiology and pathophysiology hampers the development of effective treatments. Our group had developed a manual therapy (MT) pressure-controlled custom manual protocol on FM showing hyperalgesia/allodynia, fatigue and patient’s quality of life benefits in a cohort of 38 FM cases (NCT04174300). With the aim of understanding the therapeutic molecular mechanisms triggered by MT, this study interrogated PBMC transcriptomes from FM participants of this clinical trial using RNAseq and RT-qPCR technologies. The results showed that the salt-induced kinase SIK-1 was consistently downregulated by MT in FM, correlating with improvement of patient symptoms. In addition, the study compared the findings in a non-FM control cohort subjected to the same MT protocol evidencing that the changes in SIK1 with MT only occurred in individuals with FM. This positions SIK-1 as a potential biomarker to monitor response to MT, and as a therapeutic target of FM, to be further explored by continuation studies.

Knowledge of clinical approaches and barriers in managing childhood myopia is limited. This study explores optometrists' knowledge, attitude, and practice towards childhood myopia. A 26-item survey was circulated online among practising optometrists in India. The questionnaire assessed the demographics, knowledge, self-reported clinical practice behaviour, barriers, source of information guiding their management, and extent of adult caregiver engagement for childhood myopia. Of 393 responses, a significant proportion of respondents (32.6%–92.4%) were unaware of the ocular complications associated with high myopia, with less than half (46.5%) routinely measuring axial length in clinical practice. Despite the improved awareness of emerging myopia management options, the uptake remains generally poor, with single-vision distance full correction spectacles (70.3%) being the most common mode of vision correction. Barriers to adopting emerging evidence are medico-legal concerns and the absence of clinical practice guidelines. Original research articles were the primary source of information supporting clinical practice. Most (>70%) respondents considered involving the adult caregiver in their child's clinical decision-making process. While practitioner knowledge, perspective, and practice are improving, childhood myopia management evidence is constantly evolving and remains inconclusive. Evidence-based practice guidelines and continuing education on myopia control might be helpful for practitioners in improving their clinical decision-making skills.

Background: Early risk stratification tools for COVID-19 patients were indicated but little is known about their ability to effectively detect clinical deterioration among COVID-19 patients. Objectives: To assess the prognostic accuracy of NEWS2 in predicting severe morbidity and mortality in hospitalization for COVID-19 patients. Methods: A prospective cohort study was performed among adult patients with a confirmed diagnosis of COVID-19 who were admitted to the inpatient units at COVID-19 Martyrs Medical Military Complex and Palestinian Red Crescent Society Hospital, located at Nablus, Palestinian Authority. NEWS2 scores were measured at admission, on 6, 12, 24, and 48 hours after their admission to the hospital using Receiver Operating Characteristic Curves (ROC). Results: Overall, 192 adult COVID-19 patients aged 25-94 years (mean=62.1, SD=13.9) were enrolled. Of those, 49.0% were males, 47.4% were vaccinated, and 53.6% were with diabetes. The mean NEWS scores during the patient’s hospital stay were excellent predictors of mechanical ventilation, admission to the ICU, and mortality, as indicated by an AUROC of 0.94 (95% CI: 0.88-1.00, P<0.001), 0.91 (95% CI: 0.87-0.96, P<0.001) and 0.96 (95% CI: 0.92-1.00, P<0.001), respectively. The classification of 192 patients into NEWS score categories indicated that 12.5% were classified as high-risk at admission. Conclusion: The NEWS2 had moderate sensitivity and specificity in predicting the deterioration of patients with COVID-19. Our findings support the utility of NEWS2 monitoring as a sensitive approach for initially assessing COVID-19 patients. It could be helpful to improve predictive performance by supplementing the score parameters with additional measures besides the clinical judgment.

The National Institute of Health Stroke Scale (NIHSS) is used worldwide to classify stroke severity as ‘mild’, ‘moderate’ or ‘severe’ based on neurological impairment. Yet stroke survivors argue that the classification of ‘mild’ does not represent the holistic experience and impact of stroke on their daily lives. In this observational cohort study, we aimed to identify different types of impairment among stroke survivors classified as mild. We used mild stroke survivors’ data from the START longitudinal stroke cohort (n=73) with measures related to sensorimotor, cognition, depression, functional disability, physical activity, work and social adjustment over 12 months. Given the multi-source, multi-granular and unlabelled nature of data, we utilised a structure-adapting, unsupervised machine learning approach, the Growing Self-organising Map (GSOM) algorithm to generate distinct clinical profiles. These diverse impairment profiles revealed that mild stroke survivors experience varying degrees of impairment and impact (cognitive, depression, physical activity, work/social adjustment) at different time points, despite the uniformity implied by their NIHSS-classified ‘mild’ stroke. This emphasises the necessity of creating a holistic and comprehensive representation of mild stroke survivors’ needs over the first-year post-stroke to improve rehabilitation and post-stroke care.

Diabetic foot ulcers (DFUs) significantly affect the lives of patients and increase the risk of hospital stay and amputation. We suggest a remote-monitoring platform for better DFU care. This system uses digital health metrics (scaled from 0 to 10, where higher scores indicate a greater risk of slow healing) to provide a comprehensive overview through a visual interface. The platform features smart offloading devices that capture behavioral metrics such as offloading adherence, daily steps, and cadence. Coupled with remotely measurable frailty and phenotypic metrics, it offers an in-depth patient profile. Additional demographic data, wound characteristics, and clinical parameters, such as cognitive function, were integrated, contributing to a comprehensive risk factor profile. We evaluated the feasibility of this platform with 124 DFU patients over 12 weeks; 39% experienced unfavorable outcomes such as dropout, adverse events, or non-healing. Digital biomarkers were benchmarked (0-10), categorized into low, medium, and high risk for unfavorable outcomes, and visually represented using color-coded radar plots. The initial results of case reports illustrate the value of this holistic visualization to pinpoint the underlying risk factors for unfavorable outcomes, including a high number of steps, poor adherence, and cognitive impairment. Although future studies are needed to validate the effectiveness of this visualization in personalizing care and improving wound outcomes, early results in identifying risk factors for unfavorable outcomes are promising.

Cigarette smoke (CS) is a major driver of many respiratory diseases including chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC). Tobacco causes oxidative stress, impaired phagocytosis of alveolar macrophages (AMs), and alterations in gene expression in the lungs of smokers. MicroRNAs (miRNAs) are small non-coding RNAs that influence several bi-ological processes and interfere with several regulatory pathways. The purpose of this study was to assess the effect of active CS on miRNAs expression in AMs obtained from bronchoalveolar lavage (BAL) of ever- or never-smoker subjects and patients with COPD or NSCLC. BAL specimens were collected from 43 sex-matched subjects to determine the expression of has-miR-34a-5p, 17-5p, 16-5p, 106a-5p, 223-5p, and 20a-5p before and after in vitro CS exposure by RT-PCR. In addition, bioin-formatic analysis of miRNAs target genes linked to inflammation was performed. Distinct and common miRNA expression profiles were identified in response to CS, suggesting their possible role in smoking-related diseases. It is noteworthy that, following exposure to CS, the expression levels of hsa-miR-34a-5p and 17-5p in both ever- or never-smokers, 106a-5p in never-smokers and 20a-5p in ever-smokers, shifted towards those found in individuals with COPD, suggesting them like a risk factor in developing this lung condition. Moreover, we identified miRNA targets involved in the immune system or AMs property regulation using in silico analysis. In conclusion, our study iden-tified miRNA signatures in AMs exposed to CS, indicating that CS is an important driver of epige-netic changes that contribute to the onset of various lung diseases.

Images are widely used in educational materials due to their ability to effectively convey complex concepts. However, unauthorized image use often leads to legal issues related to copyright infringement. To address this issue, we introduce a dual-module system designed specifically for educators. The first module, a copyright infringement detection system, leverages deep learning techniques to verify the copyright status of images. It employs a Convolutional Variational Autoencoder (CVAE) model to extract meaningful features from copyrighted images and compares them against user-provided images. If infringement is suspected, the second module, an image retrieval system, recommends alternative copyright-free images using a Vision Transformer (ViT)-based hashing model. Evaluation on benchmark datasets demonstrates the system's effectiveness, achieving a mean Average Precision (mAP) of 0.812 on the Flickr25k dataset. Furthermore, a user study with 65 teachers indicates high satisfaction levels, particularly in addressing copyright concerns and ease of use. Our system significantly aids educators in creating educational materials compliant with copyright regulations.

This work aims to study and analyze a hybrid power system for electric vehicles consisting of a dual low and high-rate lithium battery block and a fuel cell. In this configuration, the high-rate lithium battery powers the electric vehicle in high power demand processes like acceleration mode or on an uphill road; the low-rate battery operates at a low output power range, servicing the auxiliary systems and low power loads and the fuel cell supplies energy at intermediate power demand conditions, normal driving mode, constant velocity, or flat and downhill terrain. The dual power system improves global efficiency since every power unit operates optimally depending on driving conditions. Power sharing optimizes the lithium battery performance and fuel cell capacity, minimizing the size and weight of each energy system and enlarging the driving range. A comparative study between different lithium battery configurations and fuel cell shows an efficiency improvement of 31.4% for the hybrid dual battery block and fuel cell operating in low, high, and intermediate output power ranges, respectively. The study bases on a simulation process recreating current driving conditions for electric cars in urban, peripheral, and intercity routes. An alternative solution consisting of a hybrid system, fuel cell and a high rate lithium battery produces a 29 % power gain.

This article develops duality principles and related convex dual formulations suitable for the local optimization of non-convex primal formulations for a large class of models in physics and engineering. The results are based on standard tools of functional analysis, calculus of variations and duality theory. In particular, we develop applications to a Ginzburg-Landau type equation.

Abstract: The diffusion of competition under the coexistence of multi-generation products has become one of the important challenges faced by enterprises in their daily and sustainable operations. At the same time, the competition between different brands has intensified the difficulty and complexity of decision-making in the process of multi-generation product operation, Therefore, based on the Norton-Bass model diffusion process, this paper introduces two marketing variables, dynamic price and quality level, builds a multi-generation product diffusion model under the dual-brand competition, and analyzes the impact of the company's revenue on the launch time to market, pricing, quality or technical level. By using system dynamics (SD) method, From the perspective of strong brand and weak brand enterprises, the competition diffusion model is built and simulated. The simulation shows that: i) When enterprises have the same brand competitiveness, reducing the pricing level cannot obtain more revenue, but diminish the overall revenue of the industry; Raising the pricing level can get more revenue, but also improve the revenue of competitors. ii) When the competitive strength of enterprises is different, the strong brand tends to maintain a stable pricing on the basis of improving the quality level, or slightly raise the price. Weak brands tend to raise the pricing of new products significantly on the basis of improving the quality level. iii) The launch time to market decision of new product is influenced by the degree of product quality upgrade. Therefore, the frequency of releasing new products should trade-off against the degree of technological upgrading of product quality. This paper provides the theoretical basis and new insights for the new product launch and operation decision of enterprises.

Relay protection service is the most crucial service carried by the electric power communication network, which is directly linked to the safe operation of the power grid. In the route planning of power services, a route planning architecture for the power communication network is constructed in this paper, considering the operation and maintenance requirements, such as relay protection service overload (RPSO) and dual route. To minimize network risk variance, the problem of single-service route allocation is formulated by taking the factors into account such as service delay, link bandwidth utilization, and RPSO constraints. Based on $k$ shortest paths algorithm, a route planning scheme for the power services is proposed, which considers RPSO and risk balance, and a strategy for implementing multi-service route planning of the communication network is studied. The simulation results show that the proposed route planning strategy can effectively avoid relay protection service overload, reduce network risk variance, and balance network risk.

Localized surface plasmon resonance (LSPR) based sensors exhibit enormous potential in the areas of medical diagnosis, food safety regulation and environmental monitoring. While, the broadband spectral lineshape of LSPR hampers the observation of wavelength shifts in sensing processes, thus preventing their widespread applications in sensors. Here, we describe an improved plasmonic sensor based on Fano resonances between LSPR and Rayleigh anomaly (RA) in a metal-insulator-metal (MIM) meta-grating, which is constructed by silver nanoshells array, an isolation grating mask and a continuous gold film. The MIM configuration offers more freedoms to control the optical properties of LSPR, RA and the Fano resonance between them. Strong couplings between LSPR and RA form a series of narrowband reflection peaks (with a linewidth of ~20 nm in full width at half maximum (FWHM) and a reflectivity closing to 100%) within a LSPR based broadband extinction window in experiment, making the meta-grating promising for applications of high-efficiency reflective filters. While, a well-optimized Fano resonance between LSPR and RA by carefully adjusting the angles of incident light can switch such nano-device to an improved biological/chemical sensor with the figure of merit (FOM) large than 60 and capability for detecting the local refractive index changes caused by the bonding of target molecules on surface of the nano-devices. The figure of merit of hybrid sensor in detection of target molecules is 6 and 15 times higher than the simple RA and LSPR based sensors, respectively.

This article develops a duality principle and a related convex dual formulation suitable for a large class of models in physics and engineering. The results are based on standard tools of functional analysis, calculus of variations and duality theory. In particular, we develop applications to a model in non-linear elasticity.

The synergistic features of a three-component, photoinitiating system (A/B/C) based on the measured data and proposed mechanism of Liu et al. are analyzed. The co-initiators/additives B and C have dual-functions of : (i) regeneration of photoinitiator A, and (ii) generation of extra radicals for enhanced conversion efficacy (CE). The synergistic effects led to higher CE for both free radical polymerization (FRP) and cationic polymerization (CP). The CE of FRP has 3 terms due to the direct (tyep-I) coupling of the triplet state of A with the monomer (M) and the coupling of the two radicals, R and R', with M. The CE of CP has a transient state proportional to the effective absorption constant (b), the light intensity (I) and initiator concentration (A0), but a steady state is independent of the light intensity (I). For the CE of FRP, the contribution from radical R had two cases: (i) linear dependence on T=bIA0, or (ii) nonlinear square root dependence T0.5. The synergistic effects led to higher conversion of FRP and CP, consistent with the measured results. The theoretically predicted new features include: (i) co-initiator [C] which always enhances both FRP and CP conversions, and (ii) co-initiator [B] which leads to more efficient FRP, but it also reduces CP.

Inflammation associated endothelial dysfunction represents a pivotal contributor to atherosclerosis. Increasingly evidence has demonstrated that interleukin 1 receptor (IL1-R) / toll-like receptor (TLR) signaling participated in the development of atherosclerosis. Previous studies indicated the therapeutic potential of anti-inflammatory therapy in anti-atherosclerosis. The present study examined the effect of IL-1R-associated kinase 1 and 4 inhibitors (IRAK1/4i) in regulating endothelial dysfunction. IRAK1/4i showed little endothelial toxicity at concentrations from 1 to 10 μM. Inhibition of IRAK1/4 alleviated endothelial activation induced by LPS in vitro evidenced by attenuated monocyte adhesion to the endothelium. Mechanistically, blockade of IRAK1/4 ameliorated the transcriptional activity of NF-κB. Taken together, our findings demonstrated that dual inhibition of IRAK1 and IRAK4 attenuates endothelial dysfunction, suggesting pharmaceutical inhibition of IRAK1/4 might be a potential strategy to combat endothelial dysfunction and atherosclerosis.

Background: Oral hypoglycemic agents are typically the first-line treatment for type 2 diabetes mellitus (T2DM). This study examines the benefits of initiating insulin as the first-line therapy for newly diagnosed T2DM patients. Methods: A PubMed search using keywords ‘Type 2 Diabetes Mellitus’ and ‘Early STIIT’ included RCTs assessing beta cell function, insulin resistance, glycemic control, and lipid profiles. Revman 5.4.1 software was used for meta-analysis, with outcomes represented as mean difference (MD) and 95% confidence intervals (CI). Results: Significant reductions in fasting blood glucose (FBG: MD -4.75, 95% CI -7.07, -2.43), HbA1c (MD -1.84, 95% CI -3.01, -0.68), and postprandial glucose (PPG: MD -9.02, 95% CI -10.48, -7.56) were observed with early STIIT therapy compared to baseline. Beta cell function improved (HOMA-B: MD 53.70, 95% CI 27.78, 79.63) and insulin resistance decreased (HOMA-IR: MD -1.84, 95% CI -3.65, -0.04). Lipid profile improvements included reductions in total cholesterol (TC), triglycerides (TG), and LDL, with no change in HDL. BMI remained stable (MD -0.15, 95% CI -0.82, 0.51). Most patients achieved long-term remission and glycemic control without oral hypoglycemic agents. Conclusion: Early STIIT in newly diagnosed T2DM patients significantly reduces glycemic markers and maintains long-term glycemic control, preserving beta cell function. The therapy also improves lipid profiles, reducing TC, TG, and LDL. Initiating insulin as a first-line treatment shows promising results for glycemic control and overall metabolic health.

Lymphatic filariasis (LF) is a neglected tropical disease associated with poverty and poor environmental conditions. With the inclusion of vector control activities in LF surveillance actions, there is a need to develop simple methods to identify areas with higher mosquito density and consequent risk of W. bancrofti transmission. An ecological study was conducted in Igarassu, Metropolitan Region of Recife, Pernambuco, Brazil. The mosquitoes were captured in 2,060 houses distributed across 117 census tracts. The vector density index (VDI) was constructed, that measures the average number of lymphatic filariasis transmitting mosquitoes per number of houses collected in the risk stratum. Moreover, the social deprivation indicator (SDI) was constructed and was carried out through principal component factor analysis. The average number of female C. quinquefasciatus found in the high-risk stratum was 242, while the low-risk stratum had an average of 108. The overall VDI was 6.8 mosquitoes per household. The VDI for the high-risk stratum was 13.2 mosquitoes per household, while for the low/medium-risk stratum, it was 5.2. This study offers an SDI for the density of C. quinquefasciatus mosquitoes, which reduces the cost associated with data collection and allows for indicating priority areas for vector control actions.

Patients from regions without stem cell transplant (SCT) facilities often seek treatment abroad and return home for post-transplant care. While extensive data exists on GVHD and its risk factors, the prevalence of GVHD in international SCT patients returning to countries without transplant facilities, where multiple factors compromise post-transplant care, is not well documented. We screened 149 transplant recipients and analyzed data from 91 who received transplants abroad and were followed at our center from January 2019 to December 2022. This observational study used data from electronic medical records (EMR) and employed descriptive statistics, inferential tests, and relative risk calculations with forest plots to analyze GVHD prevalence and key risk factors. Of the recipients, 31.8% were residents from nine countries living in the UAE, and 67.2% were UAE citizens. Adults comprised 48.3% of the recipients, and 51.7% were pediatric. Hematological malignancies were the most common indication (49%), primarily in adults. Siblings were the majority of donors (52.6%), followed by related donors (23.09%), and unrelated donors (8.9%). Most (69.2%) received HLA-identical transplants followed by 21.9% who received haploidentical. Among adults, 62.2% developed GVHD, compared to 26% of pediatric patients. Recipients with related HLA-identical donors had a 50% GVHD prevalence, while those with unrelated identical donors had 71%. The overall GVHD prevalence was 50% among the 87.9% who received allogeneic SCTs. Despite favorable factors, GVHD prevalence remains high. Larger multicenter studies are needed to identify and assess the impact of contributing factors.

Mental Health Care Users (MHCUs) are admitted in general wards with medical and surgical conditions where non-psychiatric nurses are allocated to render services for medical and surgical conditions. Non-psychiatric nurses are expected to care for MHCUs in general wards regardless of their knowledge and skills which is against the Mental Health Care Act. The purpose of the study was to explore and describe the experiences of non-psychiatric nurses in car-ing for MHCUs admitted in general wards in Limpopo Province. Qualitative approach using explorative, descriptive, and contextual design was adopted for the study. Methodology included the setting, population, sampling, ethical con-siderations, and the measures to ensure trustworthiness. The study was conducted in four general hospitals of Limpopo Province, South Africa with mental health care wards, medical ward and surgical ward which were selected through simple random sampling. Semi structured Individual interviews were used to collect data from twenty professional nurses until data saturation. Data was analysed using Tesch’ s method. Ethical considerations were adhered to throughout the study. Themes that emerged after data analysis were: Managing MHCUs, Types of patient’s behaviour. The study concluded that professional nurses without psychiatry caring for MHCUs in general wards need training to provide holistic care.

Certain species of Mucorales have been identified as causative agents of mucormycosis, a rare yet often lethal fungal infection. Notably, these fungi exhibit intrinsic resistance to common azole drugs, which target lipids. Given the pivotal role of lipids in drug resistance and their contribution to the innate resistance to azoles, this study provides a comprehensive overview of key lipid classes, including sphingolipids (SLs), glycerophospholipids(GPLs), and sterols, in Rhizopus delemar 99-880, a well-characterized reference strain among Mucorales. Through high-throughput analysis involving the identification and quantification of intermediates, we have elucidated the biosynthetic pathways of SLs, PGLs, and sterols. Notably, the acidic SLs were not found probably because the acidic branch of the SL biosynthesis pathway terminates at α-hydroxy phytoceramides as evident by their high abundance. Intermediates in the neutral SL pathway incorporated higher levels of 16:0 fatty acid compared to other pathogenic fungi. A strikingly high phosphatidylethanolamine (PE)/phosphatidylcholine (PC) ratio was observed among GPLs. Ergosterol remains the major sterol, similar to other fungi, and our analysis confirms the existence of alternate ergosterol biosynthesis pathways. The total lipidomic profile of R. delemar 99-880 offers insights into its lipid metabolism and potential implications for studying pathogenesis and drug resistance mechanisms.

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

Background and Objectives: Peripheral vertigo is one of the most common symptoms for which patients are seen by a neurologist in the emergency room. Symptoms of peripheral vertigo can range from lightheadedness to an illusion of spinning. On average, vertigo is diagnosed for older patients as its predicting factors from medical history are yet to be determined. The objective of the study was to predict peripheral vertigo based on medical history and risk factors. Materials and Methods: A prospective case-control study at the Neurology Department of Lithuanian University Hospital was conducted. 71 patients diagnosed with vertigo and 43 controls was included. They completed questionnaires and underwent evaluation by neurologists or otolaryngologists, with statistical analysis performed using IBM SPSS Statistics. Results: 58% of vertigo patients were diagnosed with peripheral vertigo, with significant predictors including age (&gt;60), motion sickness, height intolerance, gastroesophageal reflux disease and dyslipidemia, leading to the development of a risk assessment table for the peripheral vertigo prediction. Conclusions: This study suggest that early identification of these predictors could enhance peripheral vertigo management, while further research with larger cohorts is needed to validate and expand upon these findings, emphasizing the importance of considering medical history and risk factors for predicting peripheral vertigo and improving patient care.

Abstract: The aim of this study was to compare the influence of corporate board characteristics on the extent of environmental disclosure quantity of listed firms in two leading emerging economies in Africa, South Africa (integrated reporting framework) and Nigeria (traditional reporting framework). Methods: The sample was comprised of 303 firms including environmentally sensitive companies purposively selected for content analysis study in South Africa (213) and Nigeria (90). We used both descriptive, multivariate and regression models to comparatively analyze the differences about corporate board characteristics as determinants of the extent of their environmental disclosure quantity. Results: The results reveal a more significant positive association between board characteristics and environmental disclosure in South Africa and less relevant association in Nigeria. Also, the results support that board independence arrangement may serve as bonding mechanisms in weak reporting environments, suggesting a substitutive relationship between board independence and the regulatory framework. Quiet revealing a board with environmental committee show a higher tendency to be ecologic transparent in both countries. However, in a traditional reporting framework, the environmental committee is not enough; its effect was insignificant and highly significant in the integrated reporting framework. Further revealed is the significant positive effect of industry membership influence on environmental disclosure. In all estimated models of South Africa sample show that 45% of environmentally sensitive industries significantly influence environmental disclosure, while 51% is environmentally polluting industries in Nigeria show less concern on environmental disclosure. Interestingly, Audit firm size (Big4) positively and statistically significantly associated with overall environmental reporting in both countries. The results are consistent with stakeholder theory, agency theory, institutional and legitimacy theory suggesting that a strong board size, independent members of the board with auditing experience, the active environmental committee in conjunction with solid audit reputation may reduce information asymmetry. Our findings will be helpful for policymakers and other regulators who are interested in environmental impact reporting.

During the COVID-19 pandemic, the term “behavioural fatigue” became the centre of policy debates in Great Britain. These debates involved deciding when to go into lockdown and whether behavioural interventions could be effective. Behavioural interventions can only succeed where people’s capabilities, opportunities, and motivations to perform target behaviours are supported. Our retrospective data analyses examine the relationships between people’s capabilities, opportunities, motivations, and behaviours, i.e., adherence to lockdown guidelines. Our cross-sectional analyses include 17,962 unique participants in Great Britain who completed a survey over the initial 30 days of the first lockdown (April 2020). We examine trends in responses to each scale and then the relationships between the scales using Granger’s causality test with tests for stationarity and cointegration. A mixture of increasing and decreasing trends were identified for capabilities and opportunities. Decreasing trends were identified for motivation and behaviour. Granger’s causality tests found that capability forecasts opportunity and behaviour and that motivation forecasts opportunity. The discussion reiterates that to realize and maintain behaviour changes, policies surrounding people's capabilities, opportunities, and motivations must continue to support target behaviours.

Fine dust causes various disorders, including cardiovascular, neurological, renal, reproductive, motor, systemic, respiratory, and cancerous diseases. Therefore, it is necessary to study functional materials to prevent these problems. In this study we used various methods, including quantitative PCR, flow cytometry, ELISA, and Alizarin O staining, to study the beneficial effects of erucic acid against fine dust. Erucic acid and erucic acid-induced exosomes (EIE) strongly suppress the attenuation of osteocytic differentiation and inflammation induced by fine dust. Erucic acid effectively suppresses inflammation in fibroblasts exposed to fine dust. Notably, despite exposure to fine dust, EIE promoted osteocytic differentiation in adipose-derived stem cells (ASC) and osteogenesis in macrophages, in addition to phagocytosis. Dramatic upregulation of RunX2 and BMP7 by EIE indicates that it is a strong activator of osteocytic differentiation in ASC and protects them from the effects of fine dust. Moreover, EIE induces immune activity and acts as an osteogenic trigger for macrophages. Therefore, this study suggests the potential use of erucic acid and erucic acid-induced exosomes (EIE) as biomaterials to prevent environment-borne diseases.

Today, issues related to people’s mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of the content and structure, describing experiences of study circles as a means of supporting participants' self-care and self-compassion. The overall design is a descriptive, QUAL+quan design, where quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one’s own and others' wellbeing, but not considered an alternative to psychiatric care, for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population, and a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders as well as the dissemination of study circles.

INTRODUCTION: This study focusses on diagnosis of stages of AD (Alzheimer’s disease) including MCI (Mild Cognitive Impairment) from two data modalities - gene expression and clinical data of ADNI (Alzheimer’s Disease Neuroimaging Initiative ) participants using multiclassification. The gene expression dataset is highly imbalanced and of HDLSS (high-dimensional and low-sample-size) characteristics. This is the only study where multiclassification based AD stage diagnosis is done to identify multiple stages of Alzheimer. We are able to achieve the best multiclassification result in both the modalities and identify new genetic biomarkers. METHODS: Combination of XGBoost and SFBS (“Sequential Floating Backward Selection”) methods is used to select features. We are able to select the most effective 95 gene probsets out of 49,386. For clinical study data, 8 most effective biomarkers could be selected using SFBS. For both genomic and clinical data, DL (‘Deep Learning’) classifier is used to identify stages - CN (Cognitive Normal), MCI (Mild Cognitive Impairment), AD (Alzheimer’s Disease / Dementia). Because of high data imbalance in genomic data, border line oversampling is used for model training and original data for validation. RESULT & DISCUSSION: With clinical data, we achieved ‘ROC AUC’ scores 0.97, 0.95, 0.94 for CN, MCI, Dementia stage respectively . We achieve ‘ROC AUC’ scores 0.75, 0.74, 0.70 for CN, MCI, Dementia stage respectively and 0.67 for both micro average F1 scores and micro weighted F1 score. This is the best result so far for AD stage diagnosis from gene expression profile data through multiclassification with ADNI data. Results reflect that our multiclassification model can efficiently handle the imbalanced data of HDLSS nature to identify samples of minority class. MAPK14, ZNF835, MID1, HLA-DQA1, TEP1 are some of the new genes found to be associated with AD risk. DRAXIN, HSPA12B, USP47 etc. are found to be AD preventive or suppressor.

Recent advancements in molecular diagnostics have highlighted the potential of circulating cell-free DNA (ccfDNA) as a biomarker in various diseases. This study aims to explore the role of ccfDNA in the early diagnosis, prognosis, and therapeutic monitoring of diseases, with a focus on oncology. We conducted a comprehensive review and analysis of current literature, combined with experimental approaches involving advanced genomic sequencing and bioinformatics techniques. Our research systematically characterizes the molecular composition of ccfDNA, including its origins, size distribution, and methylation patterns, across different disease states. Furthermore, we investigate the dynamics of ccfDNA release and clearance in the bloodstream, elucidating mechanisms that could influence its diagnostic accuracy. In the context of cancer, we analyze the correlation between tumor-derived ccfDNA and disease progression, response to therapy, and overall survival. Our findings indicate that ccfDNA holds promise as a non-invasive biomarker for early disease detection, real-time monitoring of treatment efficacy, and potentially, predicting relapse. This study contributes to the growing field of liquid biopsies and opens new avenues for personalized medicine, emphasizing the need for standardized protocols in ccfDNA analysis to maximize its clinical utility. The implications of our findings extend beyond oncology, suggesting potential applications of ccfDNA in other pathological conditions.

BackgroundIntracranial hemorrhage (ICH) in pregnancy, estimated at 1 in 10,000 cases, presents significant diagnostic challenges prenatally despite advanced imaging techniques such as ultrasound (US) and MRI. Detecting ICH is crucial for pregnancy management and future treatment decisions aimed at improving fetal survival and reducing brain damage. This report presents the diagnosis and outcomes of two cases of prenatal ICH.Cases presentationThe first case involves a 30-year-old pregnant woman with irregular prenatal care diagnosed with ICH at 32 weeks of gestation via US and MRI. She chose to continue the pregnancy, delivering a 3160g male infant at 36 weeks via cesarean section. Following NICU care including resuscitation and ventriculoperitoneal shunt placement, the infant was discharged. Subsequent examinations showed a reduction in ventricle size. In the second case, a 27-year-old woman taking acenocoumarol for a mechanical heart valve developed fetal subdural hemorrhage detected by US and MRI. She opted to terminate the pregnancy, resulting in a stillborn male infant weighing 1530g.ConclusionFetal ICH presents with varying severity and prognostic implications, diagnosed and graded using US. Fetal cranial MRI may help clarify the etiology. Management remains controversial, with termination of pregnancy potentially warranted in severe cases due to poor prognosis. Further research is needed to refine management and improve outcomes in fetal ICH.

Viral diseases pose a significant threat to tomato crops (Solanum lycopersicum L.), one of the world's most economically important vegetable crops. The limited genetic diversity of cultivated tomatoes contributes to their high susceptibility to viral infections. To address this challenge, tomato breeding programs must harness the genetic resources found in native populations and wild relatives. Breeding efforts may aim to develop broad-spectrum resistance against the virome. To identify the viruses naturally infecting 19 advanced lines, derived from native tomatoes, high-throughput sequencing (HTS) of small RNAs and validation by PCR and RT-PCR were used. Single and mixed infections with Tomato mosaic virus (ToMV), Tomato golden mosaic virus (ToGMoV), and Pepper huasteco yellow vein virus (PHYVV) were detected. The complete consensus genomes of three variants of Mexican ToMV isolates were reconstructed, potentially forming a new ToMV clade with a distinct 3' UTR. The absence of reported mutations associated with resistance-breaking to ToMV suggests that the Tm-1, Tm-2, and Tm-22 genes could theoretically be used to confer resistance. However, the high mutation rates and a 63 nucleotide insertion in the 3' UTR of Mexican ToMV isolates suggest the need to evaluate known resistance genes against these viral variants. The precise identification and characterization of viruses that naturally infect tomato germplasm could be used as a strategy for selecting the appropriate disease management and guiding breeding efforts.

Biliary tract cancers, including intrahepatic, perihilar, and distal cholangiocarcinomas, as well as gallbladder cancer, are a heterogeneous group of cancers with distinct molecular characteristics in each anatomic and pathological subtype. The pathological classification of BTC includes grossly classifiable growth patterns, such as mass-forming, periductal infiltrating, and intraductal growing. The small duct and large duct types of intrahepatic cholangiocarcinoma have been recently introduced in the WHO classification. Typical clinical presentations and various radiological, endoscopic, and molecular modalities for diagnosis are described in detail. To overcome the limitations of traditional tissue acquisition, new diagnostic modalities are being investigated. In fact, the treatment landscape is evolving rapidly owing to the emergence of distinct subgroups harboring unique molecular alterations with corresponding targeted therapies. In addition, we highlight the key points in the diagnostic process in real-world clinical practice for biliary tract cancer.

Background: Neonatal sepsis associated with severe morbidity and mortality defines the systemic condition arising from the bacterial, viral, fungal origin associated with hemodynamic and clinical alterations. Symptomatology can be different, from subclinical to severe, focal or systemic disease. The causal agent comes from maternal flora or can be of community/hospital origin. Material and method: Our retrospective study evaluated 121 newborns (both preterm and term), divided into three groups: early onset sepsis (35), late onset sepsis (39), and control group (47), from 0 to 28 days old. Blood samples and cultures were collected at admission, after 24 hours, and 72 hours. Results: The two-sample Wilcoxon signed rank test revealed a statistically significant difference between the initial and final measures of lactate dehydrogenase (LDH) and ferritin within the early onset sepsis (EOS) and late onset sepsis (LOS) groups. No significant differences were observed for those two variables within the control group. There were significant differences for first and last measurements of C-Reactive Protein (CRP) (p = 0.029), leukocyte count (p = 0.002), and platelets (TR) (p = 0.00001). Conclusions: Ferritin is a potential biomarker that can be associated with systemic response and sepsis in both cases of early and late onset sepsis.

Background: Frail elderly patients are exposed to suffering the consequences of heart diseases that are not managed timely such as receiving anticoagulation to prevent stroke associated to atrial fibrillation (AF). Referral to the cardiological outpatient department can be cumbersome as it often requires repeated visits. The aim of this project was to use AF as a showcase to develop and implement CardioShare, a shared-care model where primary care leads patient management, using an easy-to-use compact Holter monitor device with asynchronous remote support from cardiologists. Methods: This complex intervention has been developed during a feasibility phase, tested in a pragmatic cluster-randomization trial (primary care clinic as clusters) and its implementation potential evaluated with an escalation test. Mixed methods were used to evaluate the impact of the intervention, comprising quantitative observations, semi-structured interviews, and workshops. Results: Between February 2020 and December 2021, 314 patients (30% frail) were included of whom 75% had AF diagnosed/not found within 13 days. More than 80% in both groups avoided referral to cardiologists. Patients felt safe and primary care clinicians satisfied. In the escalation test, 58 primary-care doctors used CardioShare to manage 93 patients over three months with remote support from four hospitals in the Capital Region of Denmark. Conclusions: CardioShare was successfully implemented for AF evaluation in primary care.

The abnormal accumulation of cells in the human brain, if left untreated, may cause brain damage. Management and treatment of these tumours require an early and accurate diagnosis, while their prognostic characterisation can also be beneficial in the choice of care planning for the patient. CDSSs are being continuously developed and integrated into routine clinical practice as they assist clinicians and radiologists to deal with an enormous amount of medical data, reduce clinical errors, and improve diagnostic capabilities. They assist detection, classification, and grading of brain tumours as well as alerting physicians of requirement of change in treatment plans. The aim of this systematic review is to identify various CDSSs used in brain tumour diagnosis and prognosis, that rely on data captured by any imaging modality. Based on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, the literature search was conducted in PubMed and Engineering Village Compendex databases. This review examines various CDSS tool types, system features, techniques used, accuracy, and outcome, to provide the latest evidence available in the field of neuro-oncology. An overview of different types of CDSSs used to support clinical decision-making in the management and treatment of brain tumours, along with highlighting their benefits, challenges, and future perspectives has been provided.

Although initially conceived for high-risk patients who are ineligible for surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR) is now recommended in a wider spectrum of indications including young patients. However, as for SAVR, TAVR is also associated with a risk of infectious complications, namely prosthetic valve endocarditis (PVE). As the number of performed TAVR procedure increases, and despite the low incidence of PVE post TAVR, clinicians should be familiar with the associated risk factors and the clinical presentation. Whereas the diagnosis of native valve endocarditis can be straightforward applying the modified Duke criteria, the diagnosis of PVE is more challenging given its atypical symptoms, lower sensitivity of the criteria, and low diagnostic yield of conventional echocardiography. Delay in proper management can be associated with increased morbidity and mortality. Therefore, clinicians should have a high index of suspicion and initiate proper work-up according to the severity of illness, the underlying host, and the local epidemiology of the causative organisms. The most common causative pathogens are Gram-positive bacteria such as S. aureus, coagulase negative staphylococci, Enterococcus spp. and Streptococcus spp. (particularly the viridans group) and, less likely Gram-negative and fungal pathogens. The high prevalence of antimicrobial resistance complicates the choice of therapy. There remain controversies regarding the optimal management strategies including indications for surgical interventions. Surgical assessment is recommended early in the course of illness and surgical intervention should be considered in selected patients. As in other PVE, duration of therapy depends on the isolated pathogen, the host, and the clinical response. Since TAVR is a relatively new procedure, the outcome of TAVR-PVE is yet to be fully understood.

Contrapose the highly integrated, multiple types of faults and complex working conditions of aircraft Electro Hydrostatic Actuator (EHA), to effectively identify its typical faults, we propose a fault diagnosis method based on the fusion convolutional neural networks (FCNN). First, the aircraft EHA fault data is encoded by GADF to obtain the fault feature images. Then we build an FCNN model that integrates the 1DCNN and 2DCNN, where the original 1D fault data is the input of the 1DCNN model, and the feature images obtained by GADF transformation are used as the input of 2DCNN. Multiple convolution and pooling operations are performed on each of these inputs to extract the features, next these feature vectors are spliced in the convergence layer, and the fully connected layers and the Softmax layers are finally used to attain the classification of aircraft EHA faults. Furthermore, the multi-strategy hybrid particle swarm optimization (MSPSO) algorithm is applied to optimize the FCNN to obtain a better combination of FCNN hyperparameters; MSPSO incorporates various strategies, including an initialization strategy based on homogenization and randomization, and an adaptive inertia weighting strategy, etc. The experimental result indicates that the FCNN model optimized by MSPSO achieves an accuracy of 96.86% for identifying typical faults of the aircraft EHA, respectively higher than the 1DCNN and the 2DCNN about 16.5% and 5.7%. Additionally, the FCNN model improved by MSPSO has a higher accuracy rate when compared to PSO.

Background: Left ventricular hypertrophy (LVH) may be due to different causes, ranging from benign secondary forms to severe cardiomyopathies. Transthoracic Echocardiography (TTE) and ECG are the first level examination for LVH diagnosis. Cardiac magnetic resonance (CMR) defines accurately LVH type, extent and severity. Objectives: to evaluate the diagnostic and prognostic role of CMR in patients with TTE and/or ECG evidence of LVH. Methods: We performed CMR in 300 consecutive patients with echocardiographic and/or ECG signs of LVH. Results: Overall, 275 patients had TTE evidence of LVH with initial suspicion of hypertrophic cardiomyopathy (HCM) in 132 (44%), cardiac amyloidosis in 41 (14%), hypertensive LVH in 48 (16%), aortic stenosis in 4 (1%), undetermined LVH in 50(16%). The initial echocardiographic diagnostic suspicion of LVH was confirmed in 172 patients (57.3%) and changed in 128 patients (42.7%, p<0.0001): the diagnosis of HCM increased from 44% to 71% of patients; hypertensive and undetermined LVH decreased significantly (respectively to 4% and 5%). CMR allowed a diagnosis in 41 out of 50 (82%) with undetermined LVH at TTE. CMR also identified HCM in 17 out of 25 patients with apparently normal echo but with ECG criteria for LVH. Finally, the reclassification of the diagnosis by CMR was associated with a change of survival risk of patients: after CMR reclassification no events occurred in patients with undetermined or hypertensive LVH. Conclusions: CMR changed echocardiographic suspicion in almost half of patients with LVH. In the subgroup of patient with abnormal ECG, CMR identified LVH (particularly HCM) in 80% of patients. This study highlights the indication of CMR to better characterize the type, extent and severity of LVH detected at echocardiography and suspected with ECG.

Accurate lithium battery diagnosis and prognosis is critical to increase penetration of electric vehicles and grid-tied storage systems. They are both complex due to the intricate, nonlinear, and path-dependent nature of battery degradation. Data-driven models are anticipated to play a significant role in the behavioral prediction of dynamical systems such as batteries. However, they are often limited by the amount of training data available. In this work, we generated the first big data comprehensive synthetic datasets to train diagnosis and prognosis algorithms. The proof-of-concept datasets are over three orders of magnitude larger than what is currently available in the literature. With benchmark datasets, results from different studies could be easily equated, and the performance of different algorithms can be compared, enhanced, and analyzed extensively. This will expend critical capabilities of current AI algorithms, tools, and techniques to predict scientific data.

Liver cirrhosis is a chronic disease that is characterized by the presence of fibrosis and regeneration of nodules in the liver whose consequences are the development of portal hypertension and liver failure. Cirrhosis arises from a wide variety of chronic diseases, which progresses slowly after years or decades. Liver cirrhosis is a public health problem. It is usually associated with viral hepatitis, consumption of alcohol, metabolic syndrome, autoimmune processes, storage diseases, toxic substances, and medications. Cirrhosis is the fourteenth most common cause of death in adults throughout the world, the fourth in Europe and the ninth in the United States. The prevalence of this disease is underestimated because it is symptomatic it is not diagnosed in initial stages, and it usually goes to the decompensated stage at a rate of 5 to 7% per year. We review here the epidemiology, pathophysiology, etiology, and diagnosis of liver cirrhosis.

Smoking during pregnancy remains one of the most significant risk factors for poor birth outcomes. The Loma Linda University Health Comprehensive Tobacco Treatment Program (CTTP) is the largest maternal tobacco cessation program in San Bernardino County – the largest county in the contiguous US. CTTP is an eight week, incentivized, behavioral intervention for tobacco cessation for pregnant smokers. As part of program evaluation, we used a retrospective cohort design to assess smoking abstinence and to identify predictors of relapse/smoking after enrollment. Among CTTP cohort enrollees (n=233) from 2012-2013 we found: 1) a 28.4% 8 week point prevalence abstinence (PPA), and at a median of 9 months of follow-up after the PPA, 81.6% continued to indicate tobacco cessation, and 2) a high rate of relapse or loss to follow-up (56%). Our modeling of relapse/smoking after enrollment indicated that this was higher in young mothers, non-Hispanic mothers (White, Black), first/third trimester mothers, and rural mothers. The evaluation identified efficacy of the behavioral model at 8 weeks, but that relapse/smoking was occurring in disparity populations. Formative research is needed to expand the programmatic outreach and enrollment of mothers wanting to quit smoking.

Soil salinization is an essential risk factor for agricultural development as well as for food security, and how to obtain regional soil salinity information more reliably remains a priority problem to be solved. To improve the accuracy of the inversions for soil salinity, a new inversion model for soil salinity based on stacking integrated algorithm for learning was submitted for this work which took the prediction results of several basic models as new features and then trained a secondary model to fuse the prediction results of basic models. We compared and analyzed it against four machine learning regression models, namely, random forest (RF), back propagation neural network, support vector regression, and convolutional neural network. Findings indicated the stacking integrated learning regression model fitted better and had good stability, on the test set, the stacking integrated learning regression model showed a relative increase of 8.16% in R2, a relative decrease of 13.95% in RMSE, and a relative increase of 6.47% in RPD when compared to the RF model, which was the single most effective machine learning regression model, and the stacking model was able to achieve soil salinity inversion more accurately. The soil salinity in the oasis areas of the Manas River Basin tended to decrease from north to south in 2016 to 2020 from a spatial point of view, and it was reduced in April from a temporal point of view. The percentage of pixels with a high soil salinity content of 2.75–2.8 g/kg in the study area had decreased by 19.64% in April 2020 compared to April 2016. The innovatively constructed stacking integrated learning regression model improved the accuracy of soil salinity estimation on the basis of the superior results obtained in the training of the single optimal machine learning regression model. As a consequence, this model can provide technological backup for a fast monitoring and inversion of soil salinity as well as prevention and containment of salinization.

Synthetic biology uses engineering principles to redesign organisms and construct biological systems with specific functions, which is an important way to develop drugs, vaccines, biofuels, etc. In the process of transforming synthetic organisms, researchers need to conduct large-scale experiments for a long time, and many of these processes are manual and repetitive tasks, which results in the problems such as low throughput, low efficiency, and slow iteration. In addition, there are many experimental instruments and equipments required in the synthetic biology experiment process. The communication protocols between different instruments and equipments are not uniform, which seriously restricts the automation upgrade process of synthetic biology. To solve these problems, this paper put forward an integration technology based on the Object Linking and Embedding for Process Control Unified Architecture (OPC UA) to realize the interconnection of the synthetic biology automated casting platform and related instruments needed in synthetic biology process. The stability of the system is further designed and improved by using the concept of Triple Modular Redundancy. This helps the development of an efficient, stable and scalable automated casting platform for synthetic biology, which greatly improves the efficiency of synthetic biology experiments.

Aquaculture is expected to play a vital role in solving the challenge of sustainably providing the growing world population with healthy and nutritious food. Pathogen outbreaks are a major risk for the sector, so early detection and a timely response are crucial. This can be enabled by monitoring of pathogen levels in aquaculture facilities. This paper describes a photonic biosensing platform based on silicon nitride waveguide technology with integrated active components, which could be used for such applications. Compared to the state of the art, the current system presents improvements in terms of miniaturization of the Photonic Integrated Circuit (PIC), and the development of wafer level processes for hybrid integration of active components and for material-selective chemical and biological surface modification. Furthermore, scalable processes for integrating the PIC in a microfluidic cartridge have been developed, as well as a prototype desktop readout instrument. Three bacterial aquaculture pathogens (Aeromonas salmonicida, Vagococcus salmoninarum, and Yersinia ruckeri) were selected for assay development. DNA biomarkers were identified, corresponding primer-probe sets designed, and qPCR assays developed. The biomarker for Aeromonas was also detected using the hybrid PIC platform. This is the first successful demonstration of biosensing on the hybrid PIC platform.

Within the past few decades, thousands of experiments have been performed to characterize waste and biomass to estimate the bioenergy potential and product identification. There is a need to develop an integrated process model based on experimental literature, and simulation to obtain suitable products. In this study municipal solid waste (MSW) characterization and integrated process model have been developed to optimize final products in a reactor system. The process model has two modes R&amp;D and reactor control (RC) to obtain suitable products including bio-oil, char, and gases. A database was integrated based on thermokinetics, machine learning and simulation models to optimize product efficiency. The experimental data includes thermogravimetric analysis, Fourier transform Infrared Spectroscopy, Gas chromatography, and Mass spectrometry, which are linked with pyrolysis experimental setup. Feedstock-product mapping models were incorporated into the database along with the temperature, heating rates, elemental analysis, and final product concentration, which are utilized for pyrolysis reactor setup. Product feasibility is conducted based on lifecycle cost, affordability, and product efficiency. The present work will bridge the gap between experimental study and decision making based on obtained products at several experimental conditions around the world.

Building Information Modelling (BIM) is increasingly adopted in supporting Facility Management (FM). However, in the future perspective of efficiently encouraging the management of building estates, e.g. owned by public authorities or institutions, providing an effective integration between Building Information Models and Geographic Information Systems (GIS) becomes also essential. This contribution is therefore aimed at presenting a methodological framework integrating BIM and GIS environments by mainly taking advantage of open-source tools (e.g. QGIS and Dynamo) and non-proprietary data exchange formats like the COBie (Construction-Operations Building Information Exchange) international standard. Unlike what has been mainly proposed in the literature concerning BIM-GIS integration so far, the methodology presented in this paper does not provide for an integral transfer of BIM data to the GIS platform. The work led instead to the development of an effective bidirectional integration between the two informative systems, by properly relating them and allowing for an easy switch from one system database to the other. This integrated framework is intended to enable facility managers to easily visualize in the GIS platform, through queryable 2D and 3D maps, some relevant information from BIM to efficiently manage workspaces. At the same time, this hybrid informative system allows BIM practitioners to access and manage more detailed information stored in Building Information Models. The findings of experimental applications of the proposed methodological approach to the ex-Macciotta pediatric hospital, a healthcare building owned by the University of Cagliari, are finally presented and discussed.

One of the future challenges of increasing the harnessed solar power is efficiency using of CubeSat sides. One of the approaches is using integrated antenna systems with solar panels or payloads. This study proposes a new approach to the use of integrated antenna systems in remote sensing missions. In this approach, due to the integration of antenna system with payload (in our case, with camera), it is possible to achieve a significant increase in the power generation. Calculations are carried out for cases when the antenna system are integrated with the optical system (α = 0°), which implies that they use one plane, in the second case they are spaced at an angle of α = 90° and in the third case when they are directed to opposite sides (α =180°). In the case of α = 0°, where the camera and antenna module are aligned co-axially, there is no energy expenditure for CubeSat orientation. However, in the other two cases, energy is required for rotation and maintenance of the specified orientation throughout the entire duration of the satellite's flight over the ground station, amounting to 111.99 mW when α = 90° and 44.33 mW when α = 180°.

Abstract: With the continuous integration of various energy systems and the reform of energy trading marketization, the traditional power demand response can no longer meet the needs of multi-energy coupling. For the joint response problem of multi-energy, this paper proposes a comprehensive demand response optimization incentive model considering the user response characteristics, with the complete energy service providers and multiple users as the participants of the comprehensive demand response, to solve the response strategy for the optimal goal of all parties. The implementation architecture of integrated demand response and the electrothermal energy hub model is introduced first. Secondly, the integrated demand response collaborative optimization strategy of the integrated energy service providers and users is established, and the existence and uniqueness of the optimal solution are proved. Finally, the example analysis demonstrates that the proposed strategy can reduce the integrated energy service providers' response cost and user dissatisfaction under multiple scenarios.

The problem of blood delivery has been a critical concern in past decades. However, the unsteady behavior of blood donors, along with the uncertainties associated with demands in a crisis imposes several challenges for resource management. In this research work, we analyze the blood delivery behavior in a crisis modeled by coupled queues of patients and blood sources. Using Markovian modeling and results associated with G-network, we derive two critical probabilities, namely lack of unit of blood (unit of donations) or not having any storage capacity left to accept new donors' blood. We propose a closed-form solution to calculate the optimal blood storage size, and also we suggest sufficient conditions that guarantee the feasibility of the model. Finally, we conduct a sensitivity analysis to investigate the impact of model parameters on storage size and the proportion of time that storage is full.