In this work it is acknowledged that important attempts to devise an emergent quantum (gravity) theory require space-time to be discretized at the Planck scale. It is therefore conjectured that reality is identical to a sub-quantum dynamics of ontological micro-constituents that are connected by a single interaction law. To arrive at a complex system-based toy-model identification of these micro-constituents, two strategies are combined. First, by seeing gravity as an entropic phenomenon and generalizing the dimensional reduction of the associated holographic principle, the universal constants of free space are related to assumed attributes of the micro-constituents. Second, as the effective field dynamics of the micro-constituents must eventually obey Einstein’s field equations, a sub-quantum interaction law is derived from a solution of these equations. A Planck-scale origin for thermodynamic black hole characteristics and novel views on entropic gravity theory result from this approach, which eventually provides a different view on quantum gravity and its unification with the fundamental forces.

The article adds new policy insights to the way in which formal teaching methods of environmental stewardship education areas are evaluated in Tuvalu. We aimed to answer three questions: 1. What are the formal policies shaping environmental stewardship education in Tuvalu? 2. Are national educational and environmental policies mutually consistent? and 3. Are these national policies consistent with regional and global policies? These questions were addressed using a study of Tuvaluan online-available documentary assessments of national policies, frameworks, and curricula in conjunction with those obtained from the Education Department. Our findings revealed limitations and weaknesses regarding the provisions of environmental stewardship education at the national scale, including misaligned curricula, policy documents, and formal educational provisions with Tuvalu’s national environmental policy. We also found inconsistencies with regional and global policies such as the Pacific Islands Framework for Nature Conservation, the Framework for Resilient Development in the Pacific, and international strategic plans for biodiversity and climate change. These cross-scalar policy weaknesses and limitations highlight the need for the Tuvaluan government to align educational and environmental policies at different scales. We recommend a multi-pronged strategy where modes of informal environmental education can support and complement formal government policymaking on education and the environment.

We are introducing a highly efficient 48-channel ultrasound beamforming system ideal for ultrasound endoscopy applications. The system includes a transmitter and a receiver, which allow for low-area, high-resolution imaging acquisition. The transmitter uses a charge redistribution HV (high voltage) scheme to generate three-level pulses that actuate the transducer, implemented with the standard CMOS process for optimal cost and power savings. Meanwhile, the receiver features a sub-array structure and a delay generator that reduces area usage. To achieve high-resolution ultrasound imaging acquisition with low computational power, we developed the Shift Coherence Factor (SCF) algorithm, which is hardware-friendly. This approach delivers a lateral resolution over 20% better than the conventional delay and sum (DAS) algorithm, with a contrast ratio of over 30 dB. The system was implemented in a 180 nm standard CMOS process with an area of 24.98 mm2, power consumption of 8.23 mW per channel, achieving a delay resolution of 8.33 ns, and a low-area implementation of 0.52 mm2 per channel. The system offers high-quality imaging acquisition with minimal additional area and power consumption, which has great potential for 3D imaging or catheterized ultrasound systems.

The COVID-19 pandemic had a significant impact on the mental health of individuals globally, and primary healthcare (PHC) nurses play a critical role in providing mental healthcare services. However, limited research has explored the experiences of PHC nurses in providing mental healthcare services during the COVID-19 pandemic. This study explored the experiences of PHC nurses in providing mental healthcare services during the pandemic in Durban, South Africa. The aim was to identify the challenges faced by healthcare providers and the potential for innovative approaches to improve access to care. A qualitative, exploratory design guided the study, and data were collected through in-depth interviews with twelve PHC nurses purposively selected. Thematic analysis was used to analyse the data. Findings from interviews with primary healthcare nurses reveal that the pandemic exacerbated existing challenges, including medication adherence issues, fear and uncertainty among patients, vaccine hesitancy, decreased clinic visits, and the mental and emotional toll on both patients and healthcare workers. PHC nurses adapted their services by increasing outreach efforts, prioritising patient care, and utilising technology and non-governmental organisations’ (NGO) support. Challenges included reduced patient visits, complexities in healthcare provision, and lack of adequate support. Positive changes observed include increased mental health awareness among healthcare professionals and younger generations. Recommendations include implementing outreach and awareness campaigns, providing accurate information about COVID-19 and vaccinations, and promoting cultural sensitivity in mental healthcare provision.

Thrombosis is characterized by the pathological formation of fibrin clots within a blood vessel, leading to the obstruction of blood flow. Fibrinolytic enzymes from microorganisms have exhibited promising effects to dissolve clots in a more efficient and safe way. Then, the aim of this study was to evaluate the biomass and fibrinolytic enzyme production of Tetradesmus obliquus under autotrophic and mixotrophic conditions using different concentration of corn steep liquor (CSL). Different extraction and precipitating methods were tested, and the enzyme was purified by ion exchange chromatography. More advantageous culture condition was mixotrophic using 0.25% CSL, showing the highest values of biomass productivity (Px = 169.3 ± 44.36 mg∙L-1day-1) and specific growth rate (µmax = 0.17 ± 0.00 day-1), and significant fibrinolytic production (391.34 ± 40.03 U∙mg-1). Moreover, fibrinolytic activity was higher when extracted by homogenization and precipitated using acetone, which exhibited clear zone of fibrin degradation in the fibrinolytic plate assay. Additionally, the purified enzyme showed specific activity of 1176.90 ± 140.37 U∙mg-1 and molecular weight around 97 kDa. Finally, the enzyme has higher enzymatic activity than various fibrinolytic enzymes, and the obtained enzyme has potential to be developed as a therapeutic agent in thrombosis treatment. Additional studies are need to investigate the biochemical properties and biological profile of this enzyme.

Background and Objectives. To examine trends in the links between induced abortion and subsequent mental health problems for U.S. women approaching completed fertility. Materials and Methods. Panel data on a nationally-representative cohort of 3,842 ever-pregnant women assessed at mean ages of 15, 22, 28 and 37 years from the National Longitudinal Study of Adolescent to Adult Health (Add Health) were examined for pregnancy outcome-related mental health disorders, with extensive adjustment for confounders including sociodemographic dif-ferences, mental health history, and unwanted pregnancies. Outcomes were defined using pub-lished diagnostic criteria or validated index for depression, anxiety disorder, post-traumatic stress disorder (PTSD), and suicide ideation (affective problems); alcohol abuse, drug abuse, opioid abuse, and cannabis abuse (substance abuse problems); and summary counts of affective problems, substance abuse problems and total disorders. Results were adjusted for abortion under-reporting using cross-wave analysis. Results. The relative risk of mental health disorder with exposure to induced abortion followed an inverted “V” pattern as women aged to midlife, increasing from Wave III (age 22; IRR 1.41) to Wave IV (age 28; IRR 1.67), then dropping sharply by Wave V (age 37; IRR 1.20). The population at-tributable fraction of mental health disorder due to abortion dropped from 18.1% at Wave IV to 8.0% at Wave V. Unlike previous Waves, at Wave V mental health risk was more strongly reduced by exposure to childbirth (IRR 0.70, 95% CI .63, .78, p < .001). Reduced relative metrics at Wave V were not due to reduced prevalence of mental health disorders for ever-aborting women, which increased from Wave IV to Wave V by 1.7%, but increased much more, by 20.5%, for never-aborting women. Conclusion. At midlife approaching completed fertility, differential negative psychological out-comes for ever-aborting U.S. women remained elevated but reduced from younger ages.

Taking into consideration the arising resistance towards the currently available antimycobacterial, there is still an unmet need for the development of new chemotherapeutic agents to combat the infectious agent. This study presents the X-ray single-crystal analysis to verify the structure of leading sulfonyl hydrazone 3b, which have proven their potent antimycobacterial activity against Mycobacterium tuberculosis H37Rv with MIC value of 0.0716 μM, respectively, low cytotoxicity and very high selectivity indexes (SI=2216) and fully characterized by NMR and HRMS methods. Furthermore, this study assessed the ex vivo antioxidant activity, acute and subacute toxicity, and in vitro inhibition capacity against enoyl-ACP reductase of hydrazones 3a and 3b, as 3a was identified as the second leading compound in our previous research. Compared to isoniazid, compounds 3a and 3b demonstrated lower acute toxicity for intraperitoneal administration, with LD50 values of 866 and 1224.7 mg/kg, respectively. Subacute toxicity tests, involving the repeated administration of a single dose of the test samples per day, revealed no significant deviations in hematological and biochemical parameters or pathomorphological tissues. The compounds exhibited potent antioxidant capabilities, reducing malondialdehyde (MDA) levels and increasing reduced glutathione (GSH). Enzyme inhibition assays of the sulfonyl hydrazones 3a and 3b with IC50 values of 18.2 µM and 10.7 µM, respectively and molecular docking studies revealed enoyl acyl carrier protein reductase (InhA) as the possible target enzyme of the compounds to show their antitubercular activities. In conclusion, the investigated sulfonyl hydrazones display promising antitubercular drug-like properties and warrant further investigation.

In this paper, new types of M-fractional wave solutions of mathematical physics model named as truncated M-fractional (1+1)-dimensional non-linear simplified Modified Camassa-Holm model are achieved by applying the modified simplest equation (MSE), Sardar sub-equation and generalized Kudryashov techniques. The gained solutions containing dark, bright, periodic and mixed wave solitons. Effect of fractional order derivative is also discussed. Achieved wave solitons are verified by Mathematica tool. Few of the gained wave solitons are also described through 2-dimensional, 3-dimensional and contour graphs through Mathematica tool. The gained solutions are helpful for the further development of concerned model. Finally, these techniques are simple, fruitful and effective to deal with non-linear FPDEs.

In light of the current situation where no testing equipment is available for measuring thermal deformation of objects, this paper proposes a novel method for accurate and precise measurement. The method overcomes the limitations of previous approaches that relied on pitch angle. By utilizing the principle of biplane multiple reflections, a bivariate laser spot displacement analysis algorithm is devised to attain highly precise measurements of bivariate angles. Additionally, a temperature gradient comparison algorithm is introduced to calculate the indicator test results under specific temperature conditions. To validate the effectiveness and reliability of this method, a testing system is constructed and utilized. The results demonstrate that the thermal deformation angle change test achieves an impressive accuracy of 0.015″ and a rate of thermal deformation angle change of 0.3247″/°C. These values are in close agreement with the previously simulated analysis result of 0.359″/°C, with only a relative error of 9.55%. Therefore, the test results confirm the efficacy and reliability of this testing method along with the feasibility of the algorithm processing.

Estimating Forest growing stock volume (GSV) is crucial for forest growth and resource management, as it reflects forest productivity. National measurements are laborious and costly, however integrating satellite data such as optical, Synthetic Aperture Radar (SAR), and Airborne Laser Scanning (ALS) with National Forest Inventory (NFI) data and machine learning (ML) methods has transformed forest management. In this study, Random Forest (RF), Support Vector Regression (SVR), and Extreme Gradient Boosting (XGBoost) were used to predict GSV using Estonian NFI data, Sentinel-2 imagery, and ALS point cloud data. Four variable combinations were tested: CO1 (vegetation indices and LiDAR), CO2 (vegetation indices and individual band reflectance), CO3 (LiDAR and individual band reflectance), and CO4 (a combination of vegetation indices, individual band reflectance, and LiDAR). Across Estonia's geographical regions, RF consistently delivered the best performance. In the northwest (NW), RF achieved an R² of 0.63 and an RMSE of 125.39 m³/plot. In the southwest (SW), it achieved an R² of 0.73 and an RMSE of 128.86 m³/plot. In the northeast (NE), RF achieved an R² of 0.64 and an RMSE of 133.77 m³/plot, and an R² of 0.70 and an RMSE of 120.72 m³/plot was achieved in the southeast (SE). These results underscore RF's precision in predicting GSV across diverse environments, though refining variable selection and improving tree species data could further enhance accuracy.

This paper presents a novel game-theoretic model simulating the global artificial intelligence (AI) development race among nations. We introduce a dynamic system of equations that captures the complex interplay between a country's development level, investment strategies, market share, and the possibility of technological domination. The model incorporates key features of technological races, including returns subject to diminishing marginal utility, exponentially increasing costs, market dynamics, and strategic investment decisions based on relative market positions. Through Monte Carlo simulations, we analyze various scenarios of the AI race, focusing on the emergence of dominant players and the challenges faced by countries attempting to catch up. Our results indicate a tendency towards oligopolistic market structures, with a few countries achieving technological domination while others struggle to close the gap. The model provides insights into the potential trajectories of global AI development and the conditions under which technological leapfrogging might occur. These findings have implications for policymakers and researchers in understanding the dynamics of technological races and formulating strategies for national AI development.

The sub-economic dynamics studies the relationship between people's economic impulses and market behavior. Using Bourbaki structuralism as a philosophical consideration and quantum chromodynamics as a conceptual and modeling method, sub-economic dynamics theory is constructed. In this theory, we discuss the deep structure of the free market and analyze the errors in Mises' anthropological arguments. Sub-economic dynamics is the psychological basis of market dynamics. Guided by the preface, this paper is divided into six sections: (1) The Free Market and Impulse Flavor Charge, including topics such as the fate of the free market, the food chain and psychology, and the flavor charge of economic impulses; (2) The Nature of Economic Impulses, including topics such as the flavor and generation of impulses and counter-impulses, and the bound state of impulses and fractional market charges; (3) Freud's Color Charge Space and Spin, including topics such as the Pauli exclusion rule and color charge, and Freud's personality theory; (4) Consciousness and Gluons; (5) Gauge Transformations and SU(3) Symmetry Group; and (6) General Discussion.

It is widely believed that the dramatic transformation of the spherical outflows of AGB stars into the extreme aspherical geometries seen during the planetary nebula (PN) phase is linked to binarity and driven by the associated production of fast jets and central disks/torii. The key to understanding the engines that produce these jets and the jet-shaping mechanisms lies in the study of objects in transition between the AGB and PN phases. I discuss the results of our recent studies with high-angular-resolution (with ALMA & HST) and at high-energies (with GALEX, XMM-Newton & Chandra) of several such objects, which reveal new details of close binary interactions and high-speed outflows. These include two PPNe (the Boomerang Nebula and IRAS16342-3814), and the late carbon star, V Hya. The Boomerang is notable for a massive, high-speed outflow that has cooled below the microwave background temperature, making it the coldest object in the Universe. IRAS16342 is the prime example of the class of water-fountain PPNe (very young PPNe with high-velocity H₂O masers) and shows the signature of a precessing jet. V Hya ejects high-speed bullets every 8.5 years associated with the periastron passage of a companion in an eccentric orbit. I discuss our work on AGB stars with strongly-variable high-energy (FUV, X-ray) emission, suggesting that these objects are in the early stages of binary interactions that result in the formation of accretion disks and jets.

This paper reports aligned activities to promote energy and resource-efficient construction practice in Vietnam. First, the governance framework is introduced, including government decrees and technical standards. Then, a laboratory with building physics measurement technology is designed and partly set up at the local partner Vietnam Institute for Building Materials (VIBM), which can be used to determine the essential characteristic values required for the implementation of energy standards. The basis for the prioritization of the characteristic values are the requirements of the National technical regulation on energy efficient buildings of Vietnam – QCVN09:2017/BXD. Furthermore, basic characteristic values from international standards are described, which can also be used for calculations to optimize the energy consumption of buildings. In order to be able to carry out transient hygrothermal computer simulations, special characteristic values were also included. These are particularly useful for the research and development of new building materials and the evaluation of entire buildings in terms of thermal and moisture protection In order to communicate the material properties to the market and enable informed decision making by the stakeholders, a labeling system has been developed. Thereby, the practical means for implementing governance instruments are provided, and the related technical applications are supported.

We describe a vision for a national-scale heavy mineral (HM) map generated through automated mineralogical identification and quantification of HMs contained in floodplain sediments from large catchments covering most of Australia. The composition of the sediments reflects the dominant rock types in each catchment, with the generally resistant HMs largely preserving the mineralogical fingerprint of their host protoliths through the weathering-transport-deposition cycle. Heavy mineral presence/absence, absolute and relative abundance, and co-occurrence are metrics useful to map, discover and interpret catchment lithotype(s), geodynamic setting, magmatism, metamorphic grade, alteration or mineralization. Underpinning this vision is a pilot project, focusing on a subset of the national sediment sample archive, which is used to demonstrate the feasibility of the larger, national-scale project. We preview a bespoke, cloud-based mineral network analysis (MNA) tool to visualize, explore and discover relationships between HMs as well as between them and geological setting or mineral deposits. We envisage that the Heavy Mineral Map of Australia and MNA tool will contribute significantly to mineral prospectivity analysis and modeling here, particularly for technology critical elements and their host minerals, which are central to the global economy transitioning to a more sustainable, decarbonized paradigm.

The article obtains large deviation asymptotic for sub-critical communication networks modelled as signal-interference-noise-ratio(SINR) random networks. To achieve this, we define the empirical power measure and the empirical connectivity measure, as well as prove joint large deviation principles(LDPs) for the two empirical measures on two different scales. Using the joint LDPs, we prove an Asymptotic equipartition property(AEP) for wireless telecommunication Networks modelled as the subcritical SINR random networks. Further, we prove a Local Large deviation principle(LLDP) for the sub-critical SINR random network. From the LLDPs, we prove the large deviation principle, and a classical McMillan Theorem for the stochastic SINR model processes. Note that, the LDPs for the empirical measures of this stochastic SINR random network model were derived on spaces of measures equipped with the $\tau-$ topology, and the LLDPs were deduced in the space of SINR model process without any topological limitations. We motivate the study by describing a possible anomaly detection test for SINR random networks.

The Science-Sustainability poses an interdisciplinary paradox. On the one hand, the science for sustainability has increased in OECD economies in and in China as well as in the US in particular; on the other hand; the sustainability situation has worsened (Co2 emission has risen). On the face value, the adverse correlation shows a paradox. However, without explicating the science-sustainability relationship, it leads to a premature conclusion. In this study, we have drawn on three concrete questions for concrete answers. First, whether and how interdisciplinary sciences—energy science and environmental science—contribute to the sustainability. Second, whether and how the Sino-US inter-institutional analysis varies in the science-sustainability paradox. The empirical analysis from a panel data in the interdisciplinary and inter-institutional context show mixed patterns in three ways. First, the increase in the environmental science shows an improvement in the sustainability; the energy science shows a decline in the sustainability. Second, the Chinese environmental science has a comparative advantage to American environment science for the sustainability development, and the Chinese energy science has a comparative disadvantage to the US in the sustainability development. Third, the environmental science mediates the energy science in the science-sustainability relationships. Standing alone, the increase in the energy science harms sustainability; mediated by environmental science, it benefits sustainability. The study explains the adverse role of energy science in Jevons Paradox. The study also offers some policy paths for further research how capitalisms differently innovate, form strategies, and implement the practice.

Satellite altimetry is successfully developing during the past three decades for the sea level, ocean dynamics, coastal oceanography, planetary waves, ocean tides, wind and wave, ice cover, Earth’s gravity field, and climatology research. We propose a new essential add-on of satellite altimetry related to the peculiarities of the orbits of the Topex/Poseidon and Jasons’ satellite missions which were not mentioned before in the scientific publications. Derived subsets of “self-crossover” and “inter-crossover” points in sub-polar latitudes are discussed in detail in the context of water exchange, and wind-wave dynamics, and potential challenges to be solved. The relatively short time lags between measurements at these crossovers provide additional information on anomalies of magnitudes and directions of ocean currents, and characteristics of wind-driven waves. Resulting data snapshots with constant space and time intervals can be regarded as time series of virtual buoys, an analog of continuous buoy measurements of the sea level, wind speed, and wave height. Areas of the World Ocean where these specific crossovers occur are described in the context of water exchange, wind wave studies, and potential challenges to be solved. The value of these special crossovers for studies and monitoring of the sub-polar seas is illustrated by a case study.

This research aims to estimate the micro-motion (m-m) of ships. The problem of motion and m-m detection of targets is usually solved using synthetic aperture radar (SAR) along-track interferometry (ATI) which is observed employing two radars spatially distanced by a baseline extended in the azimuth direction. This paper is proposing a new approach where the m-m estimation of ships, occupying thousands of pixels, is measured processing the information given by sub-pixel tracking generated during the coregistration process of several re-synthesized time-domain and overlapped sub-apertures. The SAR products are generated splitting the raw data, according to a small-temporal baseline strategy, observed by one single wide-band staring spotlight (ST) SAR image. The predominant vibrational modes of different ships are estimated and results are promising to extend this application in performing surveillance also of land-based industries activities. Experiments are performed processing one ST SAR image observed by the COSMO-SkyMed satellite system.

Thanks to advanced semiconductor microfabrication technology, chip-scale integration and miniaturization of lab-on-a-chip components, silicon-based optical biosensors have made significant progress for the purpose of point-of-care diagnosis. In this review, we provide an overview of the state-of-the-art in evanescent field biosensing technologies including interferometer, microcavity, photonic crystal, and Bragg grating waveguide-based sensors. Their sensing mechanisms and sensor performances, as well as real biomarkers for label-free detection, are exhibited and compared. We also review the development of chip-level integration for lab-on-a-chip photonic sensing platforms, which consist of the optical sensing device, flow delivery system, optical input and readout equipment. At last, some advanced system-level CMOS-chip packaging examples are presented, indicating the commercialization potential for the low cost, high yield, portable biosensing platform leveraging CMOS processes.

Background: Open AI developed ChatGPT, a language model based on the GPT architecture, designed for text-based communication. Trained on diverse internet texts, ChatGPT generates contextually appropriate responses using machine learning. It understands input through analysis and context interpretation, generating coherent and contextually relevant responses. Interaction is possible through messaging platforms. Materials and Methods: In November 2023, we utilized ChatGPT 3.5, the default version at that time, to answer questions from the Italian National Residency Program Admission Tests (SSMs) of 2021, 2022, and 2023. The questions cover clinical, diagnostic, analytical, therapeutic, and epidemiological scenarios, sometimes accompanied by images. The study compared ChatGPT's answers to the official corrections on the Italian Ministry of University and Research (MUR) website. The scoring method used for evaluation was 1 point for correct answers, 0 points for unanswered questions, and -0.25 points for incorrect answers, reflecting the SSM test scoring system. Results: In summary, ChatGPT was tested with a total of 420 questions, 140 for each test. It achieved an overall accuracy of 80.48%, providing correct answers for 338 questions and incorrect answers for 82 questions. When faced with questions containing both text and images, it answered 55% correctly and 45% incorrectly. The model's performance varied over time, with an 82.14% accuracy rate in 2021 and 2022 (115 correct out of 140) and a 77.14% accuracy rate in 2023 (108 correct out of 140). Applying thisscoring method to the SSM test, ChatGPT would have scored 105 points in 2021 and 2022, and 100 points in 2023. Conclusions: ChatGPT has exhibited above-average performance in the last three SSM tests, highlighting its robust capability to interpret clinical scenarios and offer precise diagnostic and therapeutic guidance. Despite this, some limitations persist, notably the software's inability to interpret non-textual information.

This paper contains a comparative review of existing Zitterbewegung models. It attempts to synthesize them by offering a toy model containing an extra hypothesis of electromagnetic self-oscillation at the Fermi scale (10−15m). Inspired by Bell violation experiments, Zitterbewegung models and hydrodynamic walker studies, we revisit standing waves in quantum mechanics, echoing de Broglie-Bohm pilot wave theories. Starting with the electromagnetic self-oscillation hypothesis at the Fermi scale we propose an emergent and deductive hierarchical electron structure across multiple scales. The model spans Fermi, Compton (10−13m), Bohr (10−11m) and finally de Broglie (&gt;10−10m). At the Fermi scale, the hypothesis is one of "source-free chiral light", known as the "zilch", emerging as a self-oscillating electromagnetic field at the Schwinger limit. This self-interaction of retarded potentials due to real relativistic delays is a generic self-oscillation of Liénard-Wiechert potentials. This primary Fermi oscillation accounts for charge and mass at the Fermi scale. It generates secondary stable "auto-orbits" dynamics at the Compton scale, manifesting as observable spin and other quantum properties of the usual Dirac zitterbewegung models. These zitter models account for known electron characteristics, including mass, charge, spin and g/2 anomalous factors up to 9 digits precision. We explain the de Broglie wavelength through Doppler-shifted Compton-scale standing waves, in the tradition of de Broglie. The framework extends to electron-positron pair production at the Schwinger limit, described as a result of natural light focusing in non-homogeneous media, utilizing René Thom’s catastrophe theory. This offers a new perspective on baryogenesis and matter emergence from electromagnetic fields. We dub this toy model the "sub-standard" model of the electron.

Diagnostics is believed to drive about 70% of medical interventions, but this may not be true for all demographics. With more than 30% of the African population living in extreme poverty ($1.9 per day - 2022); and healthcare costs competing unfavorably against unbridled access to antibiotics and herbal concoctions, especially in Sub-Saharan Africa, how do you convince such a people to choose diagnostics first? More importantly, how do you design a medical device targeted at meeting the diagnostic needs of this demographic? In developing diagnostic devices for such a market, what is worth sacrificing? How dire is the need for advanced technologies in devices developed for such a demographic? These are questions that remain unaddressed by the technological breakthroughs and current research in medical device development, especially for infectious disease diagnostics. The objective of this paper is to underscore critical concerns which must be considered in the bid to successfully design medical diagnostic devices for Africa and perhaps, other limited-resource settings. It is also written as a suggestive guidance document for researchers whose interest is in the development of infectious disease diagnostic platforms for rural Africa and similar limited-resource environments.

A retrospective cohort study was performed to determine the likelihood of malignant stroke after mechanical thrombectomy via ASPECTS-PASS score(A-P score), a novel scoring system using ASPECT score and number of arterial-passes. This prediction score is designed to help clinicians take early measures. Malignant stroke is defined as a large MCA infarct with mass effect that develops during the first 5 days following presentation and is associated with approximately 80% mortality. Previous studies have shown an association of low ASPECTS and high number of passes with poor outcome.We performed a retrospective cohort analysis on 78 patients with anterior circulation stroke who underwent mechanical thrombectomy at our hospital. We analyzed the likelihood of developing malignant stroke post thrombectomy in the first 5 days following successful recanalization (TICI ≽ 2b). Malignant stroke is defined as severe symptoms secondary to edema as evidenced by midline shift, cistern engorgement, and hemorrhagic conversion with edema. Patients with ASPECTS of 0-5 were excluded. We used two variables to predict the outcome: ASPECT score and number-of-passes. We used the equation ASPECT score minus number-of-passes (A-P) to arrive at a single number to predict the risk of malignant stroke. A-P scoring scale ranged from 0-9. Our study showed a statistically significant inverse relationship of A-P score and risk of malignant stroke. Approximately 90% of patients with A-P score < 5 developed malignant stroke in our study. A-P score can help predict malignant stroke post thrombectomy even after successful recanalization. Thus, A-P score of ≤ 5 suggests very high risk. (A-P) Score can assist clinicians to take early measures, and thereby prevent worse outcomes.

The document sets out three differentiated proposals for the transport of medicines through RPAS with their respective regulations, adapted to different operational categories: open category, special category and military scope. In the open category, an economical and efficient solution is prioritized for urban and rural areas, complying with weight and height regulations, in addition to guaranteeing the stability and quality of medications during transportation. The special category allows more complex operations and in more adverse conditions, such as densely populated areas and long routes, incorporating advanced security measures and training for personnel. In the military field, RPAS are used in conflict zones and hard-to-reach areas, ensuring the safe and rapid delivery of medical supplies under extreme conditions. Success stories in different countries are highlighted, demonstrating significant improvements in delivery times and risk reduction for health personnel.