In this paper, we consider the generalized sextic functional equation \begin{align*} \sum_{i=0}^{7}{}_7 C_{i} (-1)^{7-i}f(x+iy) = 0. \end{align*} And by applying the fixed point theory in the sense of L. C\u adariu and V. Radu, we will discuss the stability of the solutions for this functional equation.

Introduction Emergency laparotomy is a surgical procedure associated with significantly higher mortality rates compared to elective surgeries. Awake laparotomy under neuraxial anaesthesia has recently emerged as a promising approach in abdominal surgery to improve patient outcomes. This study aims to evaluate the feasibility and potential benefits of using lumbar spinal anaesthesia as the primary anaesthetic technique in emergency laparotomies. Methods We conducted a case series involving 16 patients who underwent emergency laparotomy for bowel ischemia, perforation, or occlusion. Lumbar spinal anaesthesia was employed as the main anaes-thetic technique. We analysed patient demographics, clinical characteristics, intraoperative details, and postoperative outcomes. The primary outcome measures included the adequacy of postoper-ative pain control, the incidence of postoperative complications, and mortality rates. Results Among the 16 patients, adequate postoperative pain control was achieved, with only 2 patients requiring additional analgesia. Postoperative complications, including sepsis, wound dehiscence, and pneumonia, were observed in 7 patients (44%). The observed mortality rate was relatively low at 6% (1 patient). Notably, conversion to general anaesthesia was not necessary in any of the cases, and no early readmissions were reported. Discussion Our findings highlight the feasibility and potential benefits of using neuraxial anaesthesia in emergency laparotomies. The observed low mortality rate and the avoidance of conversion to general anaesthesia suggest that lumbar spinal anaesthesia may be a useful alternative in emer-gency settings. However, the occurrence of postoperative complications in 44% of patients indi-cates the need for cautious patient selection and close monitoring. Further research with larger sample sizes is warranted to fully elucidate the efficacy, safety, and potential impact of this tech-nique on patient outcomes in emergency laparotomies.

Older adults with obesity have an increased risk for cognitive decline and subsequent Alzheimer’s disease. Previous research has focused on the impact of individual nutrients and overall dietary patterns to improve cognitive function. The Brain and Body Health (BB-Health) study aims to demonstrate the feasibility of a multicomponent nutritional supplement (MCNS) and weight loss (WL) intervention for individuals with overweight and obesity who are not consuming a healthy diet. BB-Health is a parallel-group randomized placebo-controlled 2x2 factorial pilot trial comparing the MCNS, WL, and MCNS+WL with a Control group. Eligible participants are 55 to 85 years of age with a body mass index 27.0 to 39.9 kg/m2. Major exclusion criteria include type 2 diabetes, moderate or severe cognitive impairment, and self-reported healthy dietary pattern. The BB-Health feasibility trial is registered as NCT05542199 at clinicaltrials.gov. The BB-Health objectives are to report: 1) recruitment and enrollment, including pace and descriptive statistics of the study sample; 2) adherence to the administered interventions; 3) successful data collection and performance of outcome assessments, including evaluation of change in key outcomes over time that are powered for this pilot study; and 4) summary statistics on outcomes for use in planning a subsequent, larger trial. The outcomes of interest are age-sensitive cognitive assessments, cerebral hemodynamics, and related health parameters. All measurements are collected at baseline, 3-, 6-, and 12-month visits. If the BB-Health protocol demonstrates feasibility, the novel MCNS with and without a parallel WL intervention has potential to be administered in a confirmatory randomized trial to evaluate ability to prevent age-related cognitive decline and improve brain health. The BB-Health Feasibility Study could significantly contribute to our understanding of the influence of diet and weight management on cognitive health

Elizabethkingia anophelis is an opportunistic pathogen causing lifethreatening infections in humans, particularly in immunocompromised patients, neonates and elderly. Infections caused by this species are exceptionally challenging to treat due to its multiresistance to antimicrobials. We report a case of central line-associated bloodstream infection by E. anophelis in a 2.5-year-old girl with acute lymphoblastic leukemia successfully treated with a combination of piperacillin/tazobactam and amikacin. The literature was also reviewed on paediatric infections caused by E. anophelis. Accurate identification with MALDI-TOF, or using molecular techniques, is crucial because of varying susceptibilities among species. Early, accurate diagnosis and prompt effective treatment optimize outcomes.

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

M184V is a single-base mutation in the YMDD domain of reverse transcriptase (RT). The M184V resistance-associated mutation is related to virological unresponsiveness to lamivudine (3TC) and emtricitabine (FTC) and induces high-level resistance to these two antiretroviral agents. M184V is rapidly selected in the setting of non-suppressive antiretroviral therapy (ART) and accumulates in the HIV reservoir. There were continuous efforts to evaluate the impact of M184V mutation on the treatment outcomes in people with HIV (PWH). Since lamivudine remains an extensively used part of recommended antiretroviral combinations, M184V is commonly detected in patients with virological failure. ART guidelines do not recommend the use of drugs impacted by resistance-associated mutations as they have been confirmed to comprise a risk factor for virological failure. However, previous authors suggest that 3TC/FTC can remain active even in the presence of M184V. Obtaining the viral resistance profile for each individual both treated or ART-naïve is a key challenge for lifelong treatment management.Given the potential benefits of lamivudine in the ART combinations, the investigation of M184V remains of high interest for clinicians and researchers. This is a review of literature for the challenges in treating both naïve and experienced individuals carrying the M184V resistance mutation, including virological failure, virological suppression, and resistance to ART.

Predictive studies are essential to establish fundamental data for monitoring and controlling Xylella fastidiosa infections in our country. Limited knowledge exists about how Xylella fastidiosa interacts with the plant host's immune system, leaving numerous unanswered questions regarding Xylella fastidiosa biology and its interactions with national plant hosts. Key inquiries include understanding of how the plant immune system interfaces with Xylella fastidiosa in the xylem and identifying the specific or shared mechanisms underlying the susceptibility of different hosts. Factors such as the presence of insect vectors, abundance of host plants, and climate suitability play pivotal roles in Xylella fastidiosa dispersal. We recommend that countries identified with relatively high risk, like Portugal, undertake thorough individual risk analyses. The implementation of preventive measures and, if necessary, the enhancement of surveillance systems for early detection of Xylella fastidiosa in plants and insect vectors are crucial steps. Additionally, raising awareness is of equal importance to mitigate socioeconomic and ecological impacts on their ecosystems.

Atherosclerotic cardiovascular disease, a leading cause of morbidity and mortality worldwide, is a chronic inflammatory disease, linked to a state oxidative stress, with several well-identified culprits, of which low-density-lipoprotein cholesterol (LDL-C) and lipoprotein(a). No specific treatment is currently available to lower lipoprotein(a). It is, therefore, of paramount importance to identify nutritional factors that could lower lipoprotein(a). Growing evidence shows that although reducing saturated fatty acid (SFA) intake decreases LDL-C, it could increase lipoprotein(a). Optimal dietary recommendations may therefore differ depending on an in-dividual’s baseline lipoprotein(a) and LDL-C levels. Assessing the diet-induced true LDL-C response and net balance of these two atherogenic entities is difficult because LDL-C measurement is confounded by lipoprotein(a) cholesterol content. We have estimated, for the first time, the net atherogenic result of diet-induced variations of both LDL-C and lipoprotein(a), thanks to our new concept of LDLapoB risk equivalent=apoB+lp(a)x5 (in nmol/L). This is illustrated, via the rare case of a physician with very high lipoprotein(a) and hypobetalipoproteinemia. She experiences twice a considerable lipoprotein(a) increase (+32%, + 28mg/dL, + 67nmol/L) and higher LDLapoB risk equivalent (138mg/dL versus 123mg/dL) on a mediterranean diet, low in SFA. A reasonable SFA intake, despite causing marginal LDL-C increase, may be advisable in patients with high lipoprotein(a) who need personalized dietary recommendations.

With 500+ papers and 20+ books spanning many scientific disciplines, Mark Burgin has left an indelible mark and legacy for future explorers of human thought and information technology professionals. In this paper, I discuss his contribution to the evolution of machine intelligence using his general theory of information (GTI) based on my discussions with him and various papers I co-authored during the past eight years. His construction of a new class of digital automata to overcome the barrier posed by the Church-Turing Thesis, and his contribution to Super-Symbolic Computing with Knowledge Structures, Cognizing Oracles, and Structural Machines are leading to practical applications changing the future landscape of information systems. GTI provides a model for the operational knowledge of biological systems to build, operate, and manage life processes using 30+ trillion cells capable of replication and metabolism. The schema, and associated operations derived from GTI are also used to model a digital genome specifying the operational knowledge of algorithms executing the software life processes with specific purposes using replication and metabolism. The result is a digital software system with a super-symbolic computing structure exhibiting autopoietic and cognitive behaviors that biological systems also exhibit. We discuss here one of these applications.

To solve the benefit allocation problem between the subjects of the supply chain of general contracting projects. The Cobb-Douglas function is applied to establish the benefit distribution model when the two cooperate in the supply chain system, analyze the optimal benefit situation of one-time cooperation between the two parties under two modes of egoistic decision and collectivistic decision as well as the benefit distribution problem of multiple cooperation, and conduct numerical simulation to calculate the functional relationship between each decision variable and the contribution degree of the general contractor under different effort cost coefficients. The results show that：In the case of one-time cooperation between general contractors and subcontractors, regardless of the decision mode, the degree of effort of both parties is positively related to their own contributions and negatively related to each other's contributions; the overall benefit of the supply chain system is positively proportional to the degree of contribution of the general contractor and inversely proportional to the share of benefit distribution of the subcontractor; in multiple cooperation, the equilibrium result of both parties achieving Pareto optimality at each stage is that both parties choose to cooperate.

For more than half a century, Manfred Deistler has been contributing to the construction of the rigorous theoretical foundations of the statistical analysis of time series and more general stochastic processes. Half a century of unremitting activity is not easily summarized in a few pages. In this short note, we chose to concentrate on a relatively little-known aspect of Manfred's contribution which nevertheless had quite an impact on the development of one of the most powerful tools of contemporary time series and econometrics: dynamic factor models.

Worldwide, the prevalence of surgery under general anaesthesia has increased significantly, on one hand because of modern anaesthetic and pain control techniques, and on the other hand because of better diagnosis and increased complexity of surgical technique. Together with the development of new concepts in the surgical field, the attention of researchers and clinicians turned to minimizing the impact of surgical trauma and offering minimal invasive procedures. This fact is due to the recent discoveries in the field of cellular and molecular mechanisms, that have revealed a systemic inflammatory and pro-oxidative impact that not only lasts in the perioperative period, but also impacts the long term, contributing to more difficult recovery, increased morbidity, and mortality, and finally a negative financial impact. Detailed molecular and cellular analysis have shown an overproduction of inflammatory and pro-oxidative species, that are responsible for an augmentation of the systemic inflammatory status and more difficult postoperative recovery. Moreover, it was shown that there are a series of changes in certain epigenetic structures, the most important being the microRNAs. Based on these findings, a series of modern, targeted therapeutic approaches have been proposed, with the final goal of blocking these mechanisms and reducing the redox state. Recent studies carried out had a positive clinical impact regarding antioxidant therapy and have shown that it can be used in the perioperative period with beneficial clinical impact. This review describes and details the most important molecular and cellular mechanisms that impact the surgical patient undergoing general anaesthesia, and it presents a series of antioxidant therapies that can reduce systemic inflammation.

Herein is introduced a simple scalar field model derived from classical based kinetic energy, gravitational potential energy, and Special Relativity’s rest mass energy. By applying a classical orbit over the scalar field, relativistic effects are predicted. The scalar field is then applied to a classical model of the Hydrogen atom resulting in a relativistic effect equal to the binding energy of the Hydrogen atom. In addition, the model derives the fine structure constant due to the gravitational effect. The relativistic effects are then discretized in increments equal to the model’s gravitational induced constant. The discretization produces the Hydrogen atom spectral emissions and an angular moment equal to Planck’s reduced constant. The model is not presented as a replacement for current theory, rather it is for inspection and illustration of how a simplistic model may offer a fundamental bridge between the more complex, time proven theories of General Relativity and Quantum Mechanics.

The purpose of this study is to identify the different effects exerted by planting density and nitrogen fertilization on high-salinity Reclaimed Paddy Fields(RPF) and General Paddy Fields(GPF), and to find the amount of fertilization and the planting density suitable for the growth of forage rice in each paddy field. In both experimental locations, there was no significant change in the soil due to N treatment, but in the case of RPF, electrical conductivity(EC) decreased significantly from more than 5dS/m to up to 2.87dS/m during the yellow ripe stage due to the influence of floods and concentrated precipitation on the fields. In all soils, as both the amount of N treatment and the planting density increased, there was a proportional relationship in which the number of tillers and the dry weight also increased, with the occurrence of lodging also being increased. The dry weight, as expected, was 1.5 times higher at a planting distance of 10 cm, rather than 16 cm. In addition, in both locations N treatment led to an increase in the dry weight, but when N treatment reached 400kg/ha (2.0), the dry weight decreased instead. Moreover, although there was no clear difference in feed value according to N treatment, in RPF, neutral detergent fiber(NDF) was higher than 60%, RFV was less than 98, and TDN was also low, confirming that the quality of rice was higher in GPF.

Background: Histone deacetylases (HDACs) are implicated in carcinogenesis, and HDAC inhibitors (HDACis) are explored as a therapeutic tool in several tumors. The aim of this study was to evaluate the clinical significance of HDAC -2, -4, and -5 expression in epithelial ovarian carcinoma (EOC). Methods: HDAC-2, -4, and -5 immunohistochemical expression was examined in 92 EOC tissue specimens and was correlated with clinicopathological characteristics. Results: HDAC-2 was the most frequently (94.4%) expressed isoform, being marginally higher in serous tumors compared with other types (p=0,08). HDAC-5 was the less frequently expressed (28.1%), being positively associated with HDAC-4. HDAC-4 positivity was associated with lower FIGO-stage (p=0,045) and T-category (p=0.,043) and the absence of lymph node (p=0,05) or distant metastasis (p=0,09) in serous carcinomas. HDAC-2 positivity was correlated with absence of lymph node metastasis in serous tumors (p=0,045). On the contrary, HDAC-5 nuclear positivity was correlated with lymph node metastasis in the entire cohort (p=0,048). HDAC-4 positivity was marginally associated with favorable prognosis in serous carcinomas in univariate survival analysis (p=0,086), a correlation which was not significant in multivariate analysis. Conclusion: These findings suggest a differential expression of HDAC-2, -4 and -5, providing evidence for a potential role in the pathobiology of EOC.

The security of several fully homomorphic encryption (FHE) schemes depends on the intractability assumption of the approximate common divisor (ACD) problem over integers. Subsequent efforts on solving the ACD problem as well as its variants were also developed during the past decade. In this paper, an improved orthogonal lattice (OL) based algorithm, AIOL, is proposed to solve the general approximate common divisor (GACD) problem. The conditions for ensuring the feasibility of AIOL are also presented. Compared to the Ding-Tao’s OL algorithm, the well-know LLL reduction is used only once in AIOL, and when the error vector r is recovered in AIOL, the possible difference between the restored and the true value of p is given. The experimental comparisons towards the Ding-Tao’s algorithm and ours are also provided for validating our improvements.

Fruit quality is a critical factor in the produce industry, affecting producers, distributors, consumers, and the economy. High-quality fruits are more appealing, nutritious, and safe, boosting consumer satisfaction and revenue for producers. Artificial Intelligence can aid in assessing the quality of the fruit using images. This paper presents a general machine-learning model for assessing fruit quality using deep image features. The model leverages the learning capabilities of the recent successful networks for image classification called Vision Transformers (ViT). The ViT model is built and trained with a combination of various fruit datasets and learned to distinguish between good and rotten fruit images. The general model demonstrated impressive results in accurately identifying the quality of various fruits such as Apples (with a 99.50% accuracy), Cucumbers (99%), Grapes (100%), Kakis (99.50%), Oranges (99.50%), Papayas (98%), Peaches (98%), Tomatoes (99.50%), and Watermelons (98%). However, it showed slightly lower performance in identifying Guavas (97%), Lemons (97%), Limes (97.50%), mangoes (97.50%), Pears (97%), and Pomegranates (97%).

We evaluate the nested sum $\sum_{a_{n - 1} = c}^{a_n } {\sum_{a_{n - 2} = c}^{a_{n - 1} } { \cdots \sum_{a_0 = c}^{a_1 } {x^{a_0 } } } }$ where $a_n$ and $c$ are any integers and $x$ is a real or complex variable. Consequently, we evaluate multiple sums involving the terms of a general second order sequence, the Horadam sequence (W_j (a, b; p, q)), defined for all non-negative integers j by the recurrence relation W₀ = a, W₁ = b; W_j = pW_j−1 − qW_j−2 (j≥2); where a, b, p and q are arbitrary complex numbers, with p ≠ 0, q ≠ 0.

Different aspects in applying the nucleation theorem to the description of crystallization of liquids are analyzed. It is shown that, by employing the classical Gibbs' approach in the thermodynamic description of heterogeneous systems and assuming that the basic assumptions of classical nucleation theory commonly employed in application to crystallization hold, a general form of the nucleation theorem can be formulated valid not only for one-component but generally for multi-component systems. This result is taken then as the starting point for the derivation of particular forms of this theorem for the cases that the deviation from equilibrium is caused by variations of either composition of the liquid phase, temperature, or pressure. In this procedure, recently developed by us expressions for the curvature dependence of the surface tension, respectively, the dependence of the surface tension on pressure and/or temperature are employed. It is shown that the formulation of the nucleation theorem as proposed by Kashchiev [J. Chem. Phys. 76, 5098-5102 (1982)] holds also for multi-component systems as far as mentioned above assumptions are fulfilled. In the application of classical nucleation theory to crystallization processes it is assumed as one of its basic ingredients that the bulk properties of the critical clusters are widely identical to the properties of the newly evolving crystal phase. This assumption is, however, in general, it is not true. This limitation of the theoretical description can be overcome by the application of the generalized Gibbs approach for the specification of the dependence of the properties of critical crystal clusters on the degree of metastability of the liquid phase. Applying this method, it is demonstrated that a similar formulation of the nucleation theorem as derived based on classical nucleation theory holds true also in cases when a dependence of the state parameters of the critical clusters on the degree of deviation from equilibrium is appropriately accounted for.

Background: Iranian traditional medicine is a holistic school of medicine with a long prolific history. It describes numerous concepts and the relationships between them. However, no unified terminology has been proposed for the concepts of this medicine up to the present time. Considering the extensive use of concepts in the numerous textbooks written by the scholars over centuries, comprehending the totality of the terminology is obviously a very challenging task. To resolve this issue and overcome the obstacles, and code the concepts in a reusable manner, constructing an ontology of the concepts of Iranian traditional medicine seems a necessity.Methods: Makhzan al-Advieh, an encyclopedia of materia medica compiled by Mohammad Hossein Aghili Khorasani, was selected as the resource to create an ontology of Mizaj. The steps followed to accomplish this task included (1) compiling the list of classes for Mizaj; (2) arranging the classes in taxonomy; (3) determining object properties and their cardinalities; (4) specifying annotation properties including codes, labels, synonyms, and definitions for each concept; (5) reviewing the fields pertaining to Mizaj of all monographs in Makhzan al-Advieh. The ontology was created using Protégé with adherence to the principles of ontology development provided by the Open Biological and Biomedical Ontology (OBO) foundry. Results: Mizaj ontology was constructed with a final inclusion of 105 classes, three object properties, and 1078 axioms in the Iranian Traditional Medicine General Ontology database, IrGO, freely available at http://jafarilab.com/irgo/. An indented tree view and an interactive graph view using WebVOWL were used to visualize the ontology. All classes were linked to their instances in the UNaProd database to create a knowledge-base of Mizaj. Conclusion: We constructed an ontology-based knowledge base of ITM concepts of Mizaj in the domain of materia medica to help offer a shared and common understanding of this concept, enable reuse of the knowledge, and make the assumptions explicit. Extending IrGO will bridge the gap between traditional and conventional schools of medicine and help guide future research on new treatment options.

Understanding and addressing dehumanization in healthcare is crucial due to its profound impact on patient care, ethical implications on patient dignity and autonomy, and its potential to affect the psychological well-being of healthcare professionals. The primary aim of this study was to develop reliable and valid instruments measuring two different types of dehumanization, namely animalistic dehumanization (i.e., stripping one of their uniquely human characteristics) and mechanistic dehumanization (i.e., striping one of their human nature characteristics) among healthcare professionals. In a cross-sectional validation study among healthcare professionals, we developed and tested measures of both animalistic and mechanistic dehumanization, focusing on dehumanization of patients (hetero-dehumanization) and oneself (self-dehumanization), respectively. All measures were developed and validated based on a concept analysis, a literature review, and an appraisal of pre-existing scales. The research was conducted among 400 nurses and medical doctors employed in Greek public hospitals. Coefficient Validity Ratio results showed that 100% of items were acceptable for both measures. The newly developed hetero-dehumanization scale encompassed two-factors (factor 1: animalistic dehumanization, factor 2: mechanistic dehumanization, Cronbach’s alpha was equal to 0.86 for each measure). The self-dehumanization scale was a mono-factorial measure mechanistic dehumanization (Cronbach’s alpha = 0.97). Two validated measures of (self and hetero-) animalistic and mechanistic dehumanization measures were developed for the assessment of dehumanization among health professionals, which will form the basis for future research in this important scientific field.

Mechanical ventilation (MV), used in patients with acute lung injury (ALI), induces diaphragmatic myofiber atrophy and contractile inactivity, termed ventilator-induced diaphragm dysfunction. Phosphoinositide 3-kinase- (PI3K-) is crucial in modulating fibrogenesis during the reparative phase of ALI; however, the mechanisms regulating the interactions among MV, myofiber fibrosis, and PI3K- remain unclear. We hypothesized MV with or without bleomycin treatment would increase diaphragm muscle fibrosis through the PI3K- pathway. Five days after receiving a single bolus of 0.075 units bleomycin intratracheally, C57BL/6 mice were exposed to 6 or 10 mL/kg MV for 8 h after receiving 5 mg/kg of AS605240 intraperitoneally. In wild-type mice, bleomycin exposure followed by MV 10 mL/kg prompted significant increases in disruptions of diaphragmatic myofibrillar organization, transforming growth factor-1, oxidative loads, Masson’s trichrome staining, extracellular collagen levels, positive staining of -smooth muscle actin, PI3K- expression, and myonuclear apoptosis (P < 0.05). Decreased diaphragm contractility and peroxisome proliferator activated receptor- coactivator-1 levels were also observed (P < 0.05). MV-augmented bleomycin-induced diaphragm fibrosis and myonuclear apoptosis were attenuated in PI3K-γ-deficient mice and through AS605240-induced inhibition of PI3K- activity (P < 0.05). MV-augmented diaphragm fibrosis after bleomycin-induced ALI is partially mediated through PI3K-γ. Therapy targeting PI3K-γ may ameliorate MV-associated diaphragm fibrosis.

Sepsis is a serious disease that can lead to mortality. The etiology of the disease is connected to how the body as a host reacts toward microbes such as bacteria, viruses, and fungi invasion. Current research shows that during sepsis, the reaction toward microbe attacks takes two main phases. The first is known as a cytokine storm, while the second is a vicious cycle of pro-inflammatory responses followed by a strict anti-inflammatory response led by CD4+ Tregs. Various immunomodulatory therapies have been proposed to break the cycle of pro- and anti-inflammatory reactions to sepsis. However, clinical trials did not show promising results, indicating further research into the mechanism that Treg uses to inhibit proinflammatory reactions. We used next-generation sequencing (NGS) analysis of bulk RNA-seq and single-cell RNA-seq data to examine the exact molecular pathways used by Treg to inhibit the immune response in sepsis. Our approach identified ACOD1 (Aconitate Decarboxylase 1) as a primary mediator of Treg suppression of immune cells. We identified and validated CD36 as a downstream target of ACOD1. CD36 is a known metabolite regulator in Tregs. Taken together, our results indicate that targeting ACOD1 could prove valuable in regulating Treg function during sepsis.

We analyzed data of pediatric invasive fungal diseases of the central nervous system (CNS-IFDs) reported by five of total eight Pediatric Hematology-Oncology Departments in Greece for 15 years (2007-2022). A total of twelve patients (11 boys, median age: 9.5yrs range: 2-16) were reported suffering from CNS-IFDs. Underlying malignancy was acute lymphoblastic leukemia in 9/12, and acute myeloid leukemia, Ewing sarcoma and rhabdomyosarcoma in one each. Eleven patients presented with CNS-related symptoms (i.e seizures, headache, cerebral palsy, ataxia, hallucination, seizures, blurred vision, amaurosis). All patients had pathological MRI findings. Multifocal fungal disease was observed in 6/12 patients. Nine proven and three probable CNS-IFD cases were diagnosed. Causative pathogens in proven cases were Aspergillus spp. and Candida albicans (n=2 each), Mucor spp., Rhizopus arrhizus, Absidia spp., Fusarium oxysporum and Cryptococcus neoformans (n=1 each). Causative pathogens in probable cases were Aspergillus spp. (n=2) and Candida spp. (n=1). All patients received appropriate antifungal therapy (median duration: 69.5 days, range 19-364). Two patients underwent additional surgical treatment. Six patients admitted to ICU due to complications. Three patients (25%) died, two due to IFD and one due to underlying disease. Early recognition and prompt intervention of CNS-IFDs may rescue the patients and improve overall survival.

Acute and chronic respiratory diseases impose a significant economic and health burden. Distal small airway assessment requires invasive procedures such as a bronchoscopy and bronchoalveolar lavage. The Particles in Exhaled Air (PExA) device provides a non-invasive means of assessing small airways; it captures distal airway particles sized around 0.5-7m and contains particles of respiratory tract lining fluid (RTLF) that originate during airway closure and opening. The PExA device can measure particle count and mass according to particle size. Subsequent capture of particles in a thin membrane enables application of various analytical methods to assess a broad range of biomolecules including phospholipids, proteins, inflammatory profile, and other metabolites to characterise inflammation and diseases processes such as asthma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, lung cancer, and more recently acute infections such as COVID-19. PExA analysis provides a promising alternative to traditional investigative methods in the assessment, diagnosis, and management of respiratory conditions. By evaluating specific biomarkers in the RTLF associated with airway inflammation, PExA may offer a more accurate and comprehensive understanding of the molecular-level changes in the small airways of patients with acute and chronic lung diseases.

In solving the Collatz conjecture, it turns out that if we let all integers k be 6n, 6n+1, 6n+2, 6n+3, 6n+4, 6n+5, then we can solve the Collatz conjecture periodically. The Collatz conjecture states that for any positive integer P (initial value), if n is even, divide n by 2; if n is odd, repeat the rule of multiplying n by 3 and adding 1, which always converges to 1. One open problem has been proved by this paper. The authors hope to contribute to the mathematical community by presenting simple proofs of conjectures in the history of mathematics such as the Collatz conjecture.

The Theory of differences between elements explains the reasons for the differences in physical concepts between different elements, such as quantum physics and the Theory of general relativity, being explained through observations. Thus, it is possible to conclude from the observations that the differences are motivated by the reactions between the elements, by the composition of the elements, and by the influence of the spaces that promote losses and gains of characteristics; therefore, there is no general similarity between quantum physics and the general Theory of relativity. The study aims to understand the elements and their physical concepts that make up the Universe.

Background: General Practitioners (GP) have an important role in the prevention of suicidal behavior. The purpose of this study was to explore their views and experiences of identifying and assessing suicidal ideation. Methods: Ten GPs were recruited through convenience sampling, based on accessibility, interest and willingness to participate. In-depth interviews were carried out and results transcribed ver-batim. Aspects of experiences with suicidal patients emerged through the thematic analyses process. Results: The GPs described the varied clinical picture when patients presented in their office. How they identified depressive symptoms apart from originally somatic complaints, formed a trusting relationship and addressed suicide ideation. They described customized interventions as well as obstacles and factors that facilitated communication: time, own personal traits, pa-tient’s disclosure and organizational barriers. Conclusions: The levels of the suicidal process among patients in general practice vary greatly. GPs adjust their appraisals to profundity understand and intervene in order to prevent a crisis to escalate into subsequent suicidal behavior.

This article presents and discusses analytical data on the scientific publication record from 1910 to 2020 on two topics: "climate" and "climate change/global warming/climate emergency". The goal is to visualize how the publication record on these two topics has evolved over time, from different classification perspectives (year, country, source and organization). Three hypotheses are tested using data collected from Web of Science and various graphical representations of the data. It is found that research output related to the Earth’s contemporary changing climate overtook that of general climate research in 2011, and the publication ratio has been expanding in the last decade. There are significant differences in the publication countries and sources between the two topics, and conversely less significant differences in terms of organizations publishing these works. Differentiation factors that affect the level of research output and engagement on the climate challenge include: island versus landlocked nations, specialized versus general scientific journals, academic versus institutional organizations. The future of the publication records is discussed, such as the emergence of new terms to refer to the climate challenge, such as “climate emergency”.

The aim of the study was to examine the prevalence of suicide thoughts and -attempts during the early stage of the COVID-19 outbreak and examine factors associated with suicide thoughts in the general Norwegian population. A sample of 4527 adults living in Norway were recruited via social media. Data related to suicide thoughts and attempts, mental health variables, pandemic-related concerns and sociodemographic variables were collected. Associations with suicide thoughts were analyzed with logistic regression analysis. In the sample, 3.6 % reported suicide thoughts during the last month, while 0.2 % had attempted to commit suicide during the same period. Lower age (OR: 0.66, p < 0.001), daily alcohol use (OR: 3.29, p < 0.001), being in the risk group for COVID-19 complications (OR: 2.38, p < 0.01), and having economic concerns related to the pandemic (OR: 2.51, p < 0.001) were associated with having suicide thoughts. In addition to known risk factors, the study suggests that aspects specific to COVID-19 may be important for suicidal behaviors during the pandemic.

This paper derives measurement and identical principles, then makes the two principles into measurement and identical theorems of quantum mechanics, plus the three theorems derived earlier, we deduce the axiom system of current quantum mechanics, the general quantum theory no axiom presumptions not only solves the crisis to understand in current quantum mechanics, but also obtains new discoveries, e.g., discovers the velocities of quantum collapse and entanglement are instantaneously infinitely large. We deduce the general Schrȍdinger equation of any n particles from two aspects, and the wave function not only has particle properties of the complex square root state vector of the classical probability density of any n particles, but also has the plane wave properties of any n particles. Thus, the current crisis of the dispute about the origin of wave- particle duality of any n microscopic particles is solved. We display the classical locality and quantum non-locality for any n particle system, show entanglement origins, and discover not only any n-particle wave function system has the original, superposition and across entanglements, but also the entanglements are of interactions preserving conservation or correlation, three kinds of entanglements directly give lots of entanglement sources. This paper discovers, one of two pillars of modern physics, quantum mechanics of any n particle system is a generalization ( mechanics ) theory of the complex square root ( of real density function ) of classical statistical mechanics, any n particle system’s quantum mechanics of being just a generalization theory of the complex square root of classical statistical mechanics is both a revolutionary discovery and key new physics, which are influencing people’s philosophical thinking for modern physics, solve all the crisises in current quantum theories, quantum information and so on, and make quantum theory have scientific solid foundations checked, no basic axiom presumption and no all quantum strange incomprehensible properties, because classical statistical mechanics and its complex square root have scientific solid foundations checked. Thus, all current studies on various entanglements and their uses to quantum computer, quantum information and so on must be further updated and classified by the new entanglements. This and our early papers derive quantum physics, solve all crisises of basses of quantum mechanics, e.g., wave-particle duality & the first quantization origins, quantum nonlocality, entanglement origins & classifications, wave collapse and so on.Key words: quantum mechanics, operator, basic presumptions, wave-particle duality, principle of measurement, identical principle, superposition principle of states, entanglement origin, quantum communication, wave collapse, classical statistical mechanics, classical mechanics

Innovation in general education governance is one of the development trends not only in Vietnam but also in the world. This is also an important measure to change and improve the quality of education, especially expand autonomy of high schools and universities. The paper focuses on some main contents: overview of general education; the experiences of some countries in the implementation of the school administration model towards the school autonomy model so that give lessons for Vietnam’s education can be learned in the context of development conditions nowadays. The results in this work would be used to classify the schools into the various groups. The data also analysts on decision-making capability, on what we called an “index of school autonomy”, expressed the possible level of school-level decision-making.

The most important conclusion from this article is that from the General Theory of Relativity (GTR) do not result any gravitational waves, but just ordinary modulation of the gravitational field intensities caused by rotating of bodies. If the LIGO team has measured anything, it is only this modulation, rather than the gravitational wave understood as the carrier of gravity. This discussion shows that using too complicated mathematics in physics leads to erroneous interpretation of results (in this case, perhaps the tensor analysis is guilty). Formally, various things can be calculated, but without knowing what such analysis means, they can be attributed misinterpreted. Since the modulation of gravitational field intensities has been called a gravitational wave in contemporary physics, we have also done so, although it is misleading. In the article it was shown, that from the Newton’s law of gravitation resulted an existence of gravitational waves very similar to these, which result from the General Theory of Relativity. The article shows differences between the course of gravitational waves that result from Newton’s gravitation, and the course of gravitational waves that result from the General Theory of Relativity, which measurement was announced by the LIGO (Laser Interferometer Gravitational-Wave Observatory) [1], [2], and [5]. According to both theories, gravitational waves are cyclical changes of the gravitational field intensities. The article proposes a method of testing a laser interferometer for gravitational wave measurement used in the LIGO Observatory. Criticism of results published by the LIGO team was also presented.

The problem of optimal scheduling in a system with parallel queues and a single server has been extensively studied in the queueing theory. However, such systems have mostly been studied by assuming homogeneous attributes of arrival and service processes, or in heterogeneous case a Markov random process was usually assumed. In this paper, we explore the possibility of combining simulation and neural network paradigms for optimal scheduling in a heterogeneous system with an arbitrary inter-arrival and service time distributions. The service of any queue by the server is exhaustive. Further routing of the server after the queue has been emptied is as instructed by the trained neural network. Any change in the queue that currently has a server is accompanied by a switching cost. The simulated annealing optimization algorithm which is used to optimize the parameters of the neural network was adapted for numerically evaluated average cost function. A Markov decision problem was formulated for the corresponding markovian queueing system to verify the results of solving the optimization problem. In addition to comparing the actual values of the average cost, the parameter values of the neural network trained on the optimal control policy of the Markov model are also used to determine the domains of parameters required for the simulated annealing defined on a finite discrete domain. Numerical analysis shows the effectiveness of this approach. Moreover, a comparison of the results for different distributions illustrates the insensitivity of the optimal control policy to the shape of the distributions for the same two first moments. Thus, the optimal control policy for an exponential model can be used as a suboptimal one for the general system.

Density distribution function of classical statistical mechanics is generally generalized as a product of a general complex function and its complex Hermitian conjugate function, and the average of classical statistical mechanics is generalized as the average of the quantum mechanics. Furthermore, this paper derives three ones of the five axiom presumptions of quantum mechanics, e.g., deduces Schrȍdinger equation by two general ways, makes the three axiom presumptions into three theorems of quantum mechanics, not only solves the crisis to hard understand, but also gets new theories and new discoveries, e.g., this paper solves the crisis of the origin of the wave-particle duality, derives operators, eigenvalues and eigenstates, deduces commutation relations for coordinate and momentum as well as the time and energy, and discovers quantum mechanics is just a generalization ( mechanics ) theory of the complex square root of ( real density function of ) classical statistical mechanics. Quantum mechanics being just a generalization theory of the complex square root of classical statistical mechanics is both new physics and revolutionary discovery, which are affecting people’s deep philosophical thinking for modern physics development, solve all the crisises of quantum mechanics, quantum information and so on, and make quantum mechanics have scientific solid bases being checked and both no basic axiom presumption and no all the quantum strange incomprehensible properties, because classical statistical mechanics and the complex square root of classical statistical mechanics have the scientific solid bases being checked. In addition, this paper discovers the reason no taking the time derivative of space coordinates in Schrȍdinger equation. Therefore, this paper gives solution to the crisis of the first quantization origin, and mainly deduces quantum physics no all the quantum current strange incomprehensible properties.

Detection of virus in sample is an actual problem in biotechnology, virology, medicine using biosensor. History of problem dates back to middle of last century and is associated with development of an ion-sensitive solid-state device for neurophysiological measurements. Aim of work is theoretical investigation process of detection antibody+antigen (AB+AG) complexes using SOI-FET biosensor. On example of crystal with ten biosensors, estimates of probability detection AB+AG complexes influenza virus are made. In detection process, following four results are possible: – target complex is present in test sample, and it was correctly detected; – target complex is present in sample, but it was not detected; – target complex is absent in sample, but background particles are mistakenly detected as target complex; – target complex is absent in sample, background particles present in sample and are correctly detected as noise.

The right heart catheterisation constitutes the gold standard for pulmonary hypertension (PH) diagnosis. However, echocardiography remains a reliable, non-invasive, inexpensive, convenient, and easily reproducible modality not only for the preliminary screening of PH but also for PH prognosis. The aim of this review is to describe a cluster of echocardiographic parameters for the detection and prognosis of PH and analyse the challenges of echocardiography implementation in patients with suspected or established PH. The most important echocardiographic index is the calculation of pulmonary arterial systolic pressure (PASP) through the tricuspid regurgitation (TR). It has shown high correlation with invasive measurement of pulmonary pressure, but several drawbacks have questioned its accuracy. Besides this, the right ventricular outflow track acceleration time (RVOT-AT) has been proposed for PH diagnosis. A plethora of echocardiographic indices: right atrial area, pericardial effusion, the tricuspid annular plane systolic excursion (TAPSE), the TAPSE/PASP ratio, tricuspid annular systolic velocity (s′) and recently, can reflect the severity and prognosis of PH. Recent advances in echocardiography with 3-dimensional right ventricular (RV) ejection fraction, RV free wall strain and right atrial strain may further assist the prognostication of PH.

Abstract Background: Occipital neuralgia is a debilitating condition and traditional treatments often provide limited or temporary relief. Recently, ultrasound-guided hydrodissection of the greater occipital nerve (GON) has emerged as a promising minimally invasive approach. Objectives: To describe two novel ultrasound-guided hydrodissection with 5% dextrose for GON and discuss their advantages, disadvantages, and considerations. Methods: Two case reports are presented. Case 1 describes a lateral decubitus approach for hydrodissecting the GON between the semispinalis capitis (SSC) and obliquus capitis inferior (OCI) muscles. Case 2 details a cranial-to-caudal approach for hydrodissecting the GON within the SSC and upper trapezius (UT) muscles when the GON pass through these two muscles. Results: Both patients experienced significant and sustained pain relief with improvements in function and quality of life. Conclusions: Ultrasound-guided GON hydrodissection using 5% dextrose is a promising treatment for occipital neuralgia. The lateral decubitus and cranial to caudal approaches provide additional options to address patient-specific anatomical considerations and preferences.

INTRODUCTION: While postmenopausal osteoporosis management evolved in recent years, it nonetheless remains underdiagnosed and undertreated. Given that general practitioners are the keystone of patient screening and referral in France, the present study was conducted to assess their professional positioning in the management of postmenopausal osteoporosis. METHODS: The present is a qualitative study based on semi-directed interviews, carried out between July 2020 and February 2021, with randomly chosen Alsatian general practitioners. Interviews were conducted until data saturation. Consolidated criteria for qualitative research reporting grid was used as well as Nvivo software to categorize the datas. RESULTS: Twenty-three general practitioners (GPs) were interviewed. Study participants recognized that the investigation and treatment of osteoporosis begins at a primary care level, typically with the GP. While some initiated screening by prescribing bone mineral density (BMD) assessments, only few prescribed the associated laboratory assessment and spinal X-rays in search of curable osteopathy or vertebral fracture. For those GPs who do take the opportunity to initiate treatments for patients, there is an understanding that first line options often include calcium and vitamin D, at a “preventive” level. The interviewed physicians interacted mainly with gynecologists and rheumatologists. Fracture liaison services were widely acclaimed. Several barriers were identified in their care management. The absence of a defined role between specialists and the lack of communication between the latter were an additional highlighted barrier. CONCLUSION: This study sheds further light on the discrepancy between the means available to treat osteoporosis, and the modest impact of the care observed.

Anesthetics reduce cardiac functions and lower blood pressure (BP), potentially causing excessive BP reduction in dehydrated patients or those with heart conditions, such as coronary artery disease (CAD). Considering the increased prevalence of cardiovascular disease with age, anesthesiologists must be cautious about BP reduction during general anesthesia in older adults. In the present case, an undiagnosed CAD patient in a hypovolemic state experienced a significant systolic blood pressure drop to the 50s during propofol and sevoflurane anesthesia. Despite the use of vasopressors, excessive hypotension persisted, leading to anesthesia suspension. Subsequent cardiac examinations, including computed tomography heart angio and calcium score, and coronary angiogram, revealed a near total occlusion of the left main coronary artery and the formation of collateral circulation. After 5 days of hydration and anticoagulation medications and confirmation of normovolemic state, general anesthesia was attempted again and successfully induced; a normal BP was maintained throughout the surgery. Thus, it is important to conduct a thorough cardiac evaluation and maintain normovolemia for general anesthesia in older adults.

Karate is a martial art that originated in Japan It is characterized by its diverse techniques, including punches, kicks, strikes, and open hand techniques. Generally, karate practitioners shall execute techniques fast, with an impactful finishing towards the target. The present study aims to examine the effectiveness of customized gym sessions in enhancing the athletes’ general performance with a duration of 3-months’time. A total of 7 tests were monitored, i.e., anthropometric measurement, sit and reach test, stork balance stand test, T-test, counter movement jump, 20m sprint, and Yo-Yo endurance test. 4 male amateur athletes (state representative) that has practiced karate for at least 6 years, with at least 5 days training per week, were selected. The age ranges from 15 to 20 years old. The athletes were requested to have a proper rest (at least 7 hours sleeping time) five days before the actual test day. The results show that all athletes have at least maintained or improved stork balance for both legs. The balance improvement ranges from 0% up to 134.69%. However, both the T-test and 20m sprint test demonstrated a negative outcome. The time consumed to complete 20m is increased, which deteriorated the linear speed capability by 1.89% up to 8.93%. Also, 3 out of 4 athletes show that the T-test performance does not provide a satisfactory achievement. The agility of athletes was found to drop by 3.58% up to 10.60%. Interestingly, the athletes’ stamina was found to improve based on the VO2 max prediction and Yo-Yo test. The enhancement of VO2 max prediction and Yo-Yo test recorded as 0% - 7.53% and 9.09% - 20%, respectively. So far, there is no clear indicator on the flexibility of the athletes’ spine and length of the hamstring muscles, based on the sit and reach test. Short-term gym sessions with a duration of 3 months might improve the strength and body balance of athletes. However, the impact on the responsiveness and agility of athletes did not show any significant breakthrough. In future study, it is recommended that a large sample of participants should be included in the analysis.

Cholesterol is a lipid-derived substance found in lipoproteins and cell membranes. It is also one of the main sources for the production of bile acids, vitamin D, and steroid hormones. Today, foods are evaluated by consumers not only according to their taste and nutritional content but also according to their effects on consumer health. For example, many consumers choose foods according to their cholesterol level. The cholesterol in the food can directly affect the blood cholesterol level when consumed, which can lead to cardiovascular diseases. High levels of cholesterol can lead to diet-related human diseases such as cardiac arrest, paralysis, type II diabetes cerebral hemorrhage. In societies with high living standards, interest in and consumption of foods that lower or have low cholesterol levels have increased recently. Accordingly, efforts to increase the variety of foods with reduced cholesterol levels are on the rise. This has indirectly insulted in accurate measurement of cholesterol levels in blood and food being of great importance. Classical chemical, enzymatic, colorimetric, polarographic, chromatographic, spectrophotometric methods, and enzymatic, nonenzymatic, and electrochemical sensors and biosensors are used for the determination of cholesterol in foods. The purpose of this review is to reveal and explore current and future trends in cholesterol detection methods in foods. The review will summarize the most appropriate and standard methods for measuring cholesterol in biological components and foods.

The paper proposes a theoretical study that investigates the quantum effects on the gravity of black holes. The study utilizes a gravitational model that incorporates quantum mechanics derived from the classical-like quantum hydrodynamic representation. The research calculates the mass density distribution of quantum black holes, specifically in the case of central symmetry. The gravity of the quantum black hole shows contributions coming from the quantum potential energy, which is also sensitive to the presence of the background of gravitational noise. The additional energy, stored in the quantum potential fluctuations and constituting a form of dark energy, leads to a repulsive gravity in the weak gravity limit. This repulsive gravity overcomes the attractive classical Newtonian force at large distances of order of the intergalactic length.

Abstract This article examines the implementation of the Swedish national environmental quality objectives and discusses what can be learnt for the equivalent process for the set of global UN 2030 goals (SDGs), established in 2015. The empirical basis is a study on 50 large companies in Sweden and their use of these objectives in their policy formulation. The SDGs are crafted with a broader approach than the Swedish national environmental quality objectives. Therefore, the SDGs probably better reflect the agenda of the business community since they have a global character, cover the whole spectrum of important sustainability issues and provide a mutual agenda for the business community world-wide. More than 90 percent of the large companies in the study have explicitly committed themselves to the SDGs, only 1-2 years after they were published, whereas similar commitments hardly exist for the national environmental quality objectives, even 20 years after its establishment. A large majority of the large companies in this study know about the SDGs, have actively endorsed them, and started to adjust their activities accordingly. At the end, the results of these endorsements remain to be seen.

Single particle tracking (SPT) is a powerful class of methods for studying the dynamics of biomolecules inside living cells. The techniques reveal the trajectories of individual particles, with a resolution well below the diffraction limit of light, and from them the parameters defining the motion model, such as diffusion coefficients and confinement lengths. Most existing algorithms assume these parameters are constant throughout an experiment. However, it has been demonstrated that they often vary with time as the tracked particles move through different regions in the cell or as conditions inside the cell change in response to stimuli. In this work, we propose an estimation algorithm to determine time-varying parameters of systems that discretely switch between different linear models of motion with Gaussian noise statistics, covering dynamics such as diffusion, directed motion, and Ornstein-Uhlenbeck dynamics. Our algorithm consists of three stages. In the first stage, we use a sliding window approach, combined with Expectation Maximization (EM) to determine maximum likelihood estimates of the parameters as a function of time. These results are only used to roughly estimate the number of model switches that occur in the data to guide the selection of algorithm parameters in the second stage. In the second stage, we use change detection (CD) techniques to identify where the models switch, taking advantage of the off-line nature of the analysis of SPT data to create non-causal algorithms with better precision than a purely causal approach. Finally, we apply EM to each set of data between the change points to determine final parameter estimates. We demonstrate our approach using experimental data generated in the lab under controlled conditions.

ABSTRACT:This paper presents arguments for why it is important to include disability in the undergraduate medical curriculum. I, the first author am currently involved with my doctoral thesis proposal titled "Proposing clinician competency guidelines for the inclusion of disability in the undergraduate medical curriculum of South Africa. An exploratory study.” As part of my research, I conducted a literature search and developed arguments to strengthen the reasons why the research I propose in my thesis is necessary. It is important that I position myself in this research. I am a South African, Caucasian, female medical doctor, with an interest in physical rehabilitation medicine and I am a person with a physical disability. Although this research study will be conducted in South Africa, I am hopeful that the findings will be transferable to medical schools across the world.

AGI could arise within the next decades, promising a decisive strategic advantage. This paper discusses risks, associated with the development of AGI: destabilizing effects on strategic balance, underestimating risks in the interest of victory in the race, egoistically exploiting the huge benefits by a tiny minority. Further: Developed AGI could be beyond human control. Human goals could not be implemented and an intelligence explosion to superintelligence could take place leading to a total loss of control and power. If competition for AGI is non-transparent, secret, uncontrolled and not regulated, it’s possible that risks could not be managed and would lead to catastrophic consequences. The danger corresponds to that of nuclear weapons. It is crucial that the key actors of a possible AI Race agree at an early stage on the prevention and transparent regulation of a possible AI Race - similar to measures to secure strategic stability, on arms control measures, disarmament, and prevention of the proliferation of nuclear weapons. The realization that an uncontrolled AI race can lead to the extinction of humanity - this time even independent of human will – requires analogous measures to contain, prevent, regulate and secure an AI race within the framework of AGI development.

Background: Locally advanced rectal cancers (10-20%) can present with infiltration into adjacent viscera. R0 resections remain the key factor for better survival. Traditionally these cases have been managed with open surgery. There are some limitations of laparoscopic surgery in these case, which can potentially be overcome by robotic surgery. Objectives: To determine the feasibility and outcome results of robotic multi-visceral resection of stage T4 rectal carcinoma. Methods: Consecutive patients having locally advanced carcinoma of rectum, who undergone robotic multi-visceral resection as the primary treatment between 2015 -2018 were included, through our database which was maintained prospectively. All perioperative and intraoperative parameters were analyzed. Patient demographics, co-morbidities, preoperative imaging, endoscopic findings, operative data, histopathology results, postoperative hospital course and procedure related postoperative adverse events were noted and analyzed. Results: Twenty-one patients with the diagnosis of nonmetastatic locally advanced rectal cancers were operated with Robotic Si/X platform. The median body mass index was 28.5 kg/m2 (range 21-42). The mean blood loss during operation was 20 ml (range 5-200), and the mean duration of surgery was 280 min (range 240-430). The median hospital stay after operation was 6 days (range 4-25 days). On postoperative histopathology, R0 resection rate was 90.5% (19/21). Conclusions: The robotic multi-visceral en-bloc resection of stage T4 rectal carcinoma is technically feasible and oncologically safe. Advanced technical skills, accurate radiological staging and careful patient selection can allow the extension of minimal access surgery to this challenging group of patients.

Current theories of autoimmunity are diverse, sometimes contradictory, and suffer from incompleteness. Although substantial evidence exists that adaptive and innate immunity, sex, genetic predisposition, and the microbiome all play essential roles in autoimmune disease etiologies and pathogenesis, and that antigen processing is altered during disease induction, no existing theory integrates all of these factors through a single, coherent mechanism. In an attempt to focus the field on the need to elucidate such an integrative mechanism, I propose one possibility here that, if nothing else, helps to identify the nature of the problems that need to be addressed. My theory is that autoimmune diseases are induced by normal immunological responses to unique pairs of complementary antigens, at least one of which is a molecular mimic of a host target. Each antigen in the complementary pair induces a complementary immune response (T or B cell); although each immune response is idiotypic in origin, the antigenic complementarity results in what appears to be an idiotype-anti-idiotype relationship between the responses. Additionally, because of the antigenic complementarity, each immune response mimics one of antigens, abrogating the distinction between self and non-self. If at least one of the antigens mimics a host antigen, then the resulting immunological civil war spreads to a host tissue. Complementary antigens also alter antigen processing so that antigens that would normally be proteolytically digested are presented by the major histocompatibility complex (MHC) to T and B cell receptors inducing a cross-reactive immune response. The resulting civil war is supported by the innate immune system due to the complementarity of the initiating antigens.. Complementary antigens stimulate synergistic toll-like receptors (TLR) and/or nucleotide-binding oligomerization receptors (NOD) resulting in up-regulation of cytokine production and further stimulation of the adaptive immune response. Because the immune responses (e.g., antibodies) mimic the initiating antigens, this synergistic activation of innate immunity becomes chronic. Additionally, TLR and NOD function are highly sensitive to sex hormones, some becoming up-regulated and some down-regulated in the presence of either testosterone or estrogens. This sensitivity explains how sex modifies susceptibility to autoimmune diseases. Genetic mutations in TLR, NOD and MHC further alter antigen presentation and the degree to which antigens stimulate an immune response explaining how genetics also modifies susceptibility. Finally, sex hormones also alter the host microbiome, which in turn modulates autoimmune disease risk by shaping the immunological nature of self and by mediating susceptibility to microbial infection. Moreover, it appears that the microbiome camouflages itself from the immune system by mimicking the host antigenic repertoire; the mimicry between the antigens of the microbiome and the host results in selective attacks on microbiome constituents concomitant with any autoimmune attack on host tissues. This antigenic complementarity theory thereby integrates all major elements known to affect, or be affected by, autoimmune diseases and provides a set of testable implications.

Background: Patients with thromboembolic disease, prosthetic valves, or coagulation issues are commonly prescribed anticoagulants and antiplatelets. Although common professional oral hygiene might not represent a health concern for these patients, anticoagulant and antiplatelet medication might constitute a challenge for dentists and dental hygienists since possible prolonged bleeding might interfere with dental procedures. The aim of the present study was to investigate the bleeding time of different anticoagulants and antiplatelets during a professional hygiene session adapting the Ivy test to the oral environment; Methods: 93 consecutive patients undergoing professional oral hygiene were recruited. Debridement during oral hygiene was performed using ultrasonic mechanical instrumentation, and bleeding sites were assessed and treated with gentle pressure using sterile gauzes. The time for bleeding cessation was recorded. Patients were categorized into six groups based on their drug intake, Control: no anticoagulants or antiplatelets DTI: direct thrombin inhibitors (dabigatran) AntiXa: directa factor Xa inhibitors (endoxaban, apixaban, rivaroxaban) VKA: vitamin K antagonists (warfarin, acenocoumarol) SAPT: single anti-platelet therapy (acetylsalicylic acid or clopidogrel) DAPT: dual anti-platelet therapy (acetylsalicylic acid and clopidogrel). Bleeding time was measured in seconds and mean values were assessed among the different groups. Differences between groups were investigated with Kruskal-Wallis test followed by Dunn’s post-hoc correction for multiple comparisons or two-way ANOVA followed by Dunnett post-hoc; Results: Control patients presented the lowest bleeding time 50 sec, followed by AntiXa (98), SAPT (105), DTI (120), DAPT (190) and VKA (203). A statistically significant difference was present among control and DTI (p=0.004), VKA (p&lt;0.001), DAPT (p&lt;0.001). Conclusions: Based on the present outcomes, an increased risk of prolonged bleeding emerged in patients taking VKA and DAPT. However, bleeding did not interfere with the oral hygiene ses-sion The optimal period for dental treatment of these patients should be 2-3 hours before the next dose, without the need to temporarily suspend the medication.

It has been well established that hypertension is considered as a predominant risk factor for the development of cardiovascular diseases. Despite the link between hypertension and cardiovascular diseases, hypertension may directly affect the cardiac function leading in heart failure, mostly with preserved ejection fraction (HFpEF). There are echocardiographic findings indicating hypertensive heart disease (HHD) defined as altered cardiac morphology (left ventricular concentric hypertrophy, left atrium dilatation) and function (systolic or diastolic dysfunction) in patients with persistent hypertension irrespective of cardiac pathologies to which it contributes, such as coronary artery disease and kidney function impairment. In addition to classical echocardiographic parameters, novel indices, like speckle tracking of the left ventricle and left atrium, 3D volume evaluation, myocardial work in echocardiography may provide more accurate and reproducible diagnostic and prognostic data in patients with hypertension. However, their use is still underappreciated. An early detection and prompt therapy of HHD will greatly improve the prognosis. Hence, in the present review, we shed light on the role of echocardiography in the contemporary diagnostic and prognostic approach of HHD.

Abstract: Background: Viral hepatitis B and C (HBV and HCV) pose significant public health challenges globally, particularly in Nigeria, where access to healthcare and treatment affordability are major concerns. This study aims to identify sociodemographic and clinical predictors of health insurance coverage among patients with HBV and HCV in Nigeria. Methods: A cross-sectional facility-based study was conducted at two secondary hospitals in Nasarawa State, Nigeria. Par-ticipants included patients diagnosed with HBV, HCV, or both and are > 18 years old. Data were collected using a structured questionnaire covering sociodemographic and clinical information, health insurance details, and economic impact. Logistic multivariate regression analysis was used to analyze the relationship between sociodemographic/clinical variables and health insurance status. Results: Out of 295 participants included in the final analysis, 67.1% had health insur-ance, primarily covering hepatitis screening and vaccination. Being aged 31-45 years (adjusted Odds Ratio [aOR]: 5.72, 95% Confidence Interval [CI]: 1.4 - 23.28, p = 0.02), having post-secondary education (aOR: 11.73, CI: 4.09 - 33.66, p < 0.001), and being HIV-positive (aOR: 2.86, CI: 1.02 - 8.02, p = 0.046) were significant predictors of health insurance coverage. Being unemployed significantly reduced the likelihood of having health insurance (aOR: 0.04, CI: 0.01 - 0.11, p < 0.001).Conclusions: This study reveals high insurance coverage among patients seeking viral hepatitis services in Nasarawa state, Nigeria and provides critical insights into the sociodemo-graphic predictors of health insurance coverage. It also highlights the need for the expansion health insurance benefit package that covers for viral hepatitis diagnosis and treatment, espe-cially for the younger adults, unemployed and less educated populations. This should be followed with adequate budgeting and policy implementation monitoring efforts, which are crucial for Nigeria's journey towards universal health coverage and elimination of viral hepatitis.

This study aims to identify factors associated with anxiety levels of adults living in Singapore before the pandemic and during the COVID-19 outbreak. Data were collected using a cross-sectional web-based survey conducted from July to November 2020 accruing 264 eligible participants. Ordered logistic regression was used to assess Generalized Anxiety Disorder-7 (GAD-7), ranked as minimal (0-4), mild (5-9), moderate (10-14), and severe (15-21) before the pandemic and during the pandemic. About 74% of participants were female, 50% were aged 25-34, and 50% were married. The GAD-7 level went up from pre-pandemic for both moderate (from 12.5% to 16%) and severe GAD (from 2% to 11%). Alcohol consumption (AOR 1.79, 95% CI 1.04-3.06), loneliness (AOR 1.28, 95% CI 1.05-1.54), and difficulty in switching off social media (AOR 2.21, 95% CI 1.29-3.79) predicted increased GAD-7 levels. The quality of life (AOR 0.84, 95% CI 0.79-0.90) was significantly associated with decreased GAD-7 levels. The results heighten the awareness that early initiation of mental health support is crucial for the population in addition to the various financial support measures provided by the government as they are adapting to live with the COVID-19 pandemic.

We address the dynamics of two-dimensional Navier-Stokes models with infinite delay and hereditary memory, whose kernels are a much larger class of functions than the one considered in the literature, on a bounded domain. We prove the existence and uniqueness of weak solutions by means of Faedo-Galerkin method. Moreover, we establish the existence of global attractor for the system with the existence of a bounded absorbing set and asymptotic compact property.

With the development of general anesthesia techniques and anesthetic substances, brought new horizons for the expansion and improvement of surgical techniques. Nevertheless, more complex surgical procedures brought a higher complexity and longer duration for general anesthesia that led to a series of adverse events such as hemodynamic instability, under- or overdosage of anesthetic drugs, as well as an increased number of post-anesthetic events. In order to adapt the anesthesia according to the particularities of each patient, the multimodal monitoring of these patients is highly recommended. Classically, general anesthesia monitoring consists of the analysis of vital functions and gas exchange. Multimodal monitoring refers to the concomitant monitoring of the degree of hypnosis and the nociceptive-antinociceptive balance. By titrating anesthetic drugs according to these parameters, clinical benefits can be obtained, such as hemodynamic stabilization, reduction of awakening times, and the reduction of post-operative complications. Another important aspect is the impact on the status of inflammation and the redox balance. By minimizing inflammatory and oxidative impact one can achieve a faster recovery that will lead to both increased patient satisfaction and an increase in patient safety. The purpose of this literature review is to present the most modern multimodal monitoring techniques, respectively to discuss the particularities of each technique.

Pesticides have a vital contribution to the agricultural industry in Australia. However, pesticide applications may not always selective to its target organism. Exposure to pesticide has been associated with negative impacts to human health. One of the ways to reduce pesticide risk to the population and the environment is through government regulations. To put Australia pesticide regulations into perspective, comparisons were made between Australia and other nation’s pesticides regulations. The EU pesticide regulatory system was chosen for comparison with the Australian’s in the aspect of protecting the population from pesticide exposure. The comparison showed that the assessment to authorize a pesticide in Australia is based on the risk while in the EU, the assessment is based on the hazard of the pesticide. A registered active substance in Australia can be authorized for use indefinitely unless it is nominated for reconsideration while the period of registration of an active substance in the EU lasts for 10 years. In addition, no routine systematic chemical residue surveys are conducted in Australia for food commodities. The results highlight areas for improvement in the Australian pesticide regulatory system from the perspective of controlling undue exposure among the general population.

Technological advancements in the Internet of Things (IoT), unmanned aerial vehicles (UAVs), and novel technological tools have transformed disaster management practices from localized approaches to a global framework. These innovations necessitate a unified understanding and application of diverse methodologies at an international level, ensuring they are accessible and operational across different sectors. This integration is crucial not only for technical personnel but also for medical teams, who play a pivotal role in disaster response and management. By fostering a comprehensive grasp of these methods, we can enhance coordination, efficiency, and effectiveness in addressing disasters on a global scale. The authors aimed to provide a comprehensive overview of emerging techniques that are driving shifts in strategic approaches and treatment technologies. Recognized as a domain of continuous research and development, this overview, by necessity, remains an incomplete snapshot of an evolving field. It highlights the dynamic nature of technological and strategic advancements, underscoring the importance of ongoing investigation and innovation to stay abreast of current trends and future directions. The article also highlights the importance of international collaboration beyond societal and national boundaries A single paragraph of about 200 words maximum. For research articles, abstracts should give a pertinent overview of the work. We strongly encourage authors to use the following style of structured abstracts, but without headings: (1) Background: Place the question addressed in a broad context and highlight the purpose of the study; (2) Methods: briefly describe the main methods or treatments applied; (3) Results: summarize the article’s main findings; (4) Conclusions: indicate the main conclusions or interpretations. The abstract should be an objective representation of the article and it must not contain results that are not presented and substantiated in the main text and should not exaggerate the main conclusions.

On 11th March 2020, the World Health Organization declared COVID-19 as a pandemic. Vaccination programs have advanced greatly in the global health period, despite widespread anti-vaccination attitudes and misinformation. Vaccine hesitancy of COVID-19 vaccine is currently a major issue in Saudi Arabia. This cross-sectional study was carried out from June 25, 2021 to October 2021 in order to investigate the knowledge levels of acceptance and hesitancy of COVID-19 vaccine among Saudi’s nationals. The data was collected through a close-ended structured questionnaire from a total of 565 respondents. Overall, 78.41% respondents were female, 62.48% having university level education and 61.06% were unemployed. Majority of the participants 82.30% (n=465) think that Pfizer vaccine has the highest efficiency against COVID-19. Our study concludes that majority of the participants have satisfactory knowledge about COVID-19 vaccination. Concerns over vaccine components, effectiveness of vaccine and possible side effects are among the key causes for vaccine hesitancy.

Improving access to sexual health services is critical in light of rising sexually transmitted infections (STIs). We evaluated a Hub and Spoke model for improving access to sexual health services in three general practices in Victoria, Australia. The primary outcome was the impact on HIV and STI (chlamydia, gonorrhoea, syphilis) testing. Segmented linear regression analysis was conducted to examine the trends in the total HIV/STI tests before (from January 2019 to June 2020) and post-implementation (from July 2020 to July 2021). We evaluated the feasibility and acceptability of integrating this model into the general practices using semi-structured individual interviews. There was a statistically significant rise in testing for HIV and STIs in all general practices: post-implementation, there was an increase of an average of 11.2 chlamydia tests per month (p=0.026), 10.5 gonorrhoea tests per month (p=0.001), 4.3 syphilis tests per month (p=0.010), and 5.6 HIV tests per month (p=0.010). Participants reported increases in knowledge level and confidence in offering STI testing and managing more variety of sexual health cases. This study demonstrated the feasibility of implementing a hub and spoke model to enable GPs to deliver sexual health care with support from a sexual health specialist service.

Background: The COVID-19 among humans is spreading heavily and is largely impacting the mental health of the general population, students, and health care workers worldwide. Hence, this review aims to summarize the literatures addressing the impact of the COVID-19 pandemic on the mental health of the general population, students, and health care workers. Methods: Published articles concerning mental health of the general population, students, and health care workers related to the COVID-19 outbreak have been considered and reviewed. Results and Discussion: Mental health symptoms of stress, anxiety, and depression are common psychological reactions to the COVID-19 pandemic in the general population, students, and health care workers. This collectively influences daily behavior, economy, prevention strategies and decision making from policy makers and health organizations, weakening the strategies of COVID-19 control leading to more morbidity and mental health needs at the global level. Conclusion: There is a need for more evidence-based research from other affected countries, particularly in vulnerable populations such as children and adolescents, people of lower socioeconomic status, and those residing in rural areas, so that valid strategies can be developed and COVID-19 and outbreaks of similar types in the near future can be prevented.

Gastric inflammation-related disorders are commonly observed digestive system illnesses char-acterized by the activation of proinflammatory cytokines, particularly tumor necrosis factor-α (TNF-α). This results in the induction of cyclooxygenase-2 (COX-2)/prostaglandin E2 (PEG2) and matrix metallopeptidase-9 (MMP-9). These factors contribute to the pathogenesis of gastric in-flammation disorders. We examined the preventive effects of Lonicera japonica Thunb. ethanol ex-tract (Lj-EtOH) on gastric inflammation induced by TNF-α in normal GES-1 cells. The GES-1 cell line was used to establish a model that simulated the overexpression of COX-2/PGE2 and MMP-9 proteins induced by TNF-α, to examine the anti-inflammatory properties of Lj extracts. The re-sults indicated that Lj-EtOH exhibits significant inhibitory effects on COX-2/PEG2 and MMP-9 ac-tivity, attenuates cell migration, and provides protection against TNF-α-induced gastric inflam-mation. The protective effects of Lj-EtOH are associated with the modulation of COX-2/PEG2 and MMP-9 through activation of TNFR–ERK 1/2 signaling pathways as well as the involvement of c-Fos and nuclear factor kappa B (NF-κB) signaling pathways. Based on our findings, Lj-EtOH ex-hibits a preventive effect on human gastric epithelial cells. Consequently, it may represent a novel treatment for the management of gastric inflammation.

Cardiovascular morbidities are the main cause of mortality in pituitary disorders accruing either from hormonal excess or deficiency. Cushing disease is associated with various cardiovascular abnormalities;visceral obesity, insulin resistance, atherosclerosis, arterial hypertension, dyslipidaemia and hypercoagulability, structural and functional changes in heart, which do not seem to reverse completely even after remission. Acromegaly is related with insulin resistance, but also with structural and functional heart changes which consist acromegalic cardiomyopathy. Patients with prolactinomas demonstrate an aggravation of metabolic parameters, obesity, dysregulation of glucose and lipid metabolism and endothelial dysfunction. On the other hand, hypopituitarism and conventional hormonal replacement which is far from ideal contribute to an unhealthy metabolic status which leads to atherosclerosis and premature mortality. This review aims to update literature on cardiovascular risk and relevant morbidities in pituitary disorders.

Introduction/Aim: Central sensitivity to thyroid hormones refers to the sensitivity of the hypothalamic-pituitary-thyroid (HPT) axis to changes in circulating free thyroxine (fT4). The relationship between fT4 levels and iodine intake is complex. The aim of the present study was to assess central sensitivity to thyroid hormones in pregnancy against iodine intake. Materials & Methods: One thousand one hundred two blood and urine samples were collected from pregnant women (with a mean age+SD of 30.4+4.6 years) during singleton pregnancies; women with known/diagnosed thyroid disease were excluded. Specifically, TSH & fT4 and 24-hour urinary iodine excretion (UI) were measured in each trimester and at two months postpartum. The Thyroid Feedback Quantile-based Index (TFQI) was calculated to assess central sensitivity to thyroid hormones. For the statistical analysis of TFQI by time period, analysis of variance (ANOVA) was used, while Pearson's correlation was used to assess TFQI versus UI. Results: The mean TFQI index ranged from -0.06 (first trimester) to -0.07 (two months postpartum), while the corresponding UI was 141 and 172 μg/L, respectively. The TFQI-UI correlation was negative (Pearson r: -0.325, p: 0.04 and r: -0.399, p: 0.023), for UI values over 250 μg/L, in the first and the third trimester of pregnancy, respectively. Discussion: TFQI is a new index reflecting central sensitivity to thyroid hormones. Lower TFQI indicates higher sensitivity to thyroid hormones. In our sample TFQI was inversely related to iodine intake, in the first trimester of pregnancy (the critical period of organogenesis) and the third trimester (the critical period of fetal growth). Thus, the observed changes in TFQI may reflect different ways of central action of thyroid hormones, according to the phase of pregnancy. The negative association between maternal TFQI (indicative of central sensitivity to thyroid hormone) and urine iodine levels during the third trimester of pregnancy may reflect the combined influence of maternal and fetal thyroid function. Our results are intriguing and have the potential to enhance our comprehension of the changes in the HPT axis’ function via variations in central sensitivity to thyroid hormones and its interplay with nutritional iodine status during pregnancy.

(1) Background: The aim of the research was to present and emphasize the importance of magnetic resonance imaging (MRI) in diagnosing Achilles tendon (AT) ruptures by presenting case reports. (2) Materials and Methods: The sample of respondents included 7 patients (4 males and 3 females, 2 athletes and 5 non-athletes), aged 25 to 58 years, with AT injuries, who were examined and treated at the Institute for Treatment and Rehabilitation "Niška Banja", Niš, Serbia. Ankle examinations with MRI were conducted using the Esaote O-scan 0.3 T machine. The examinations were performed without the application of a paramagnetic contrast agent and without the use of anesthesia. Results: The MRI method's sensitivity and overall diagnostic accuracy were excellent, with 100% true positives. In our study, the method accurately detected the presence, location, and severity of AT injuries in all cases. MRI is an important and reliable method for detecting AT injuries, classifying them, monitoring the course of recovery, and assessing the effects of therapy. Conclusions: An unrecognized or delayed diagnosis of an AT injury can lead to chronic changes. Timely diagnosis (clinical examination, ultrasonography, magnetic resonance imaging) and appropriate treatment (conservative or operative) enable patients to return to normal activities, including sports. Unfortunately, the use of MRI is limited by restricted access and the cost of the examination.

Objective: Lower extremity ischemia-reperfusion injury (IRI) may occur with trauma-related vascular injury and various vascular diseases, during the use of a tourniquet, temporary clamping of the aorta in aortic surgery, and acute or bilateral acute femoral artery occlusion. Mitochondrial dysfunction and increased basal oxidative stress in diabetes may cause an increase in the effects of increased reactive oxygen species (ROS) and mitochondrial dysfunction due to IRI. It is of great importance to examine therapeutic approaches that can minimize the effects of IRI, especially for patient groups under chronic oxidative stress. Cerium oxide (CeO2) nanoparticles mimic the antioxidant enzymes and act as a catalyst that scavenges ROS. In this study, it was aimed to investigate whether CeO2 has protective effects on skeletal muscles in lower extremity IRI in mice with streptozocin-induced diabetes. Methods: A total of 38 Swiss albino mice were divided into six groups as follows: control group (group C, n=6), diabetes group (group D, n=8), diabetes-CeO2 (group DCO, n=8), diabetes-ischemia/reperfusion (group DIR, n=8), and diabetes-ischemia/reperfusion-CeO2 (group DIRCO, n=8). DCO and DIRCO groups were given doses of CeO2 0.5mg/kg intraperitoneally 30 minutes before the IR procedure. A 120-minute ischemia-120-minute reperfusion period with 100% O2 was performed. At the end of the reperfusion period, muscle tissues were removed for histopathological and biochemical examinations. Results: Total antioxidant status (TAS) levels were found to be significantly lower in group DIR compared with group D (p=0.047 and p=0.022, respectively). In group DIRCO and total oxidant status (TOS) levels were found to be significantly higher than in group DIR (p

Across decades of contemporary discussion on sustainable development, a core debate has concerned the relationship between the economic, social, and environmental dimensions of sustainability. In recent years, a debate on economic growth versus degrowth has been going on discussing whether economic growth can be sustainable in environmental terms and whether economic degrowth can be sustainable in social terms. This conceptual and theoretical article has used the Sustainability Window, or ‘SuWi’ method, to theoretically determine the sustainable window of economies, as upper and lower bounds of future change in GDP, that could be deemed in line with environmental and social sustainability. All theoretically possible scenario paths of development are considered by combining the economic, environmental, and social dimensions, with the environmental and social productivities of GDP. In moving to sustainability analysis through SuWi it is noted that only four of the logically possible scenario paths could be considered theoretically 'sustainable’, and only if adhering to strict conditions. Two of the hypothesised scenarios involve economic growth and two of economic degrowth. The approach, including calculation formulas, has many potential uses in providing analysis and support to 21st century sustainability policymaking, including the United Nations Sustainable Development Goals.

Linear programming formulations of forest ecosystem management (FEM) problems proposed in the 60s have been adapted and improved upon over the years. Generating management alternatives for forest management planning is a key step in building these models. Global forests are diverse, and a variety of models have been developed to simulate management alternatives. Climate change has made forest management calculations even more complex, requiring flexibility, diverse parameters, models, and methods. Despite this complexity, consistent concepts can be applied in developing management alternatives for forest management planning. This work describes iGen, a flexible forest prescription generator that applies the AI technique Rule-Based System (AI-RBS). iGen projects the state and associated inputs and outputs for a set of management units using rules from its knowledge base. An Inference Engine uses the rules to simulate a set of prescriptions in a tree-like graph structure. Without needing IT specialists, forest managers can describe the potential development of their forest through variables, rules, formulas, functions, and procedures. A key feature of iGen is that it is not limited to, adapted to, or focused on any specific region, landscape, forest condition, projection method, or yield function. Instead, it aims to maximize generality, enabling it to address a broad range of FEM problems. This article introduces iGen, explaining its concepts, structure, and algorithms through two FEM problems: natural regeneration with shelterwood harvests and plantation/coppice. For data and iGen source programs, visit github.com/…/iGen.

Geriatric decisional capacity assessment is a complex medico-legal activity that evaluates normal subjects involved in specific civil matter like wealth transfer, access to treatment or voluntary hospitalization. Our objective was to evaluate how geriatric extrajudicial capacity exams impacted a general psychiatric unit over a decade. We also assessed the value of a surrogate biomarker (neutrophils to lymphocyte ratio) as a screening factor in the capacity assessment process. 72 cases were assessed in one psychiatric unit over a decade (2009-2018). As population was fast ageing, the total number of capacity exams per year doubled in time. None of the subjects had an active diagnostic of severe cognitive impairment or active psychiatric disease. The percentage of subjects receiving an “absence of capacity” conclusion remained constant over time (approx. 20% of all cases). 81% of the subjects within this subgroup had a clinical diagnostic of mild cognitive impairment compared to 46% in the “presence of capacity” subgroup (p&lt;0.001). The surrogate biomarker neutrophils to lymphocyte ratio was significantly higher in the “absence of capacity” subgroup, mainly related to a cognitive impairment diagnostic. The ratio has to be validated by larger studies before to be included in the capacity assessment process as an early screening tool.

Hospital Pulau Pinang is the general hospital in Malaysia which targeting energy savings of 10% within five years from 2015 and other sustainability targets such as 3-star Energy Management Gold Standard and Green Building Certification. The targets are beneficial for the hospital itself to establish the Smart Building Program to improve its energy efficiency concurrent with the green policy of the Ministry of Health Malaysia and Sustainable Development Goals by the United Nations. This paper reviews the background of Hospital Pulau Pinang energy data , energy consumption trending, energy-saving trending, and energy conservation measures taken for the hospital from 2015 to December 2021.The yearly energy consumption baseline taken in 2016 was 27,496,731.00 kWh. It reduced significantly to 21,356,063 kWh in 2021 due to energy conservation measures. As a result, Hospital Pulau Pinang has achieved energy-saving about 16% at approximately RM7.3 million reduction in operational expenditure. The main objective of this paper is to provide further potential energy savings by studying the energy reduction by implementing solar photovoltaics using the simulation method. The simulation method can predict that Hospital Pulau Pinang can achieve another 5,130,000 kWh energy savings annually. This type of simulation has never been done before at a public hospital, and it will give further enhancing strategies to the Smart Building Program itself. Furthermore, the potential of smart building can be maximized to the next level by simulation, which helps the hospital energy committee make the potential decision on the energy-saving investment.

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

Fluid mechanics of flow in hydrophobic, rectangular microchannels with finite aspect ratios is of paramount importance. In such microchannels, not only the effect of the side walls should be taken into account, but also the classical assumption of no-slip boundary condition (BC) is no longer valid at the solid-liquid interface. Accordingly, slip flow can occur in microchannels fabricated from surfaces with low wetting conditions, hydrophobic surfaces. Determining the interactions of liquid molecules adjacent to solid surface is still a challenging issue, and it is especially important in small scale domains. Herein, the fluid mechanics of flow through rectangular hydrophobic microchannels has been reconsidered by taking into account the general Navier-slip BCs at the solid-liquid interface. For fully developed incompressible flow in microchannels at low Reynolds number, partial differential equation (PDE) of the momentum equation simplifies to the classical Poisson equation. Accordingly, by analytically solving the Poisson equations with general Navier-slip BCs, the most general forms of velocity distributions, flow rate, friction factor and Poiseuille number have been obtained.

Introduction Pharmacovigilance may detect safety issues after marketing of medications, and this can result in regulatory action such as direct healthcare professional communications (DHPC). DHPC can be effective in changing prescribing behaviour, however the extent to which prescribers vary in their response to DHPC is unknown. This study aims to explore changes in prescribing and prescribing variation among GP practices following a DHPC on the safety of mirabegron, a medication to treat overactive bladder (OAB). Methods This is an interrupted time series study of English GP practices from 2014-2017. NHS Digital provided monthly statistics on aggregate practice-level prescribing and practice characteristics (practice staff and registered patient profiles, Quality & Outcomes Framework indicators, and deprivation of the practice area). The primary outcome was monthly mirabegron items as a percentage of all OAB drug items. The exposure was a DHPC issued by the European Medicines Agency in September 2015. Variation between practices in mirabegron prescribing before and after the DHPC was assessed using the systematic component of variation (SCV). Multilevel segmented regression with random effects quantified the change in level and trend of prescribing after the DHPC. Practice characteristics were assessed for their association with a reduction in prescribing following the DHPC. Results This study included 7,408 practices. During September 2015, 88.9% of practices prescribed mirabegron and mirabegron composed a mean of 8.2% (SD 6.8) of OAB items. Variation between practices was classified as very high and the median SCV did not change significantly (p=0.11) in the 6 months after the September 2015 DHPC (12.4) compared to before (11.6). Before the DHPC, there was a monthly trend of 0.294 (95%CI, 0.287, 0.301) percentage points increase in mirabegron percentage. There was no significant change in the month immediately after the DHPC (-0.023, 95% CI -0.105 to 0.058) however there was a significant reduction in trend (-0.036, 95% CI -0.049 to -0.023). Higher numbers of registered patients and patients aged ≥65 years, and practice area deprivation were associated with having a significant decrease in level and slope of mirabegron prescribing post-DHPC. Conclusion Variation in mirabegron prescribing was high over the study period and did not change substantively following the DHPC. There was no immediate prescribing change post-DHPC, although the monthly growth did slow. Knowledge of the degree of variation in and determinants of response to safety communications may allow those that do not change prescribing to be provided with additional supports.

This study demonstrates the efficacy of structured pruning and architectural fine-tuning on the YOLOv7-tiny model for eye state detection, emphasizing optimization for real-time applications. Structured pruning significantly reduced the model's complexity and storage size while maintaining high detection accuracy, as evidenced by stable precision, recall, and [email protected] metrics across iterations. Further fine-tuning adjusted the model's width and depth, optimizing efficiency and processing speed without compromising performance. These optimizations yielded YOLOv7-tiny variants that are both computationally efficient and accurate, suitable for resource-constrained environments. The findings highlight the critical role of model optimization in deploying effective neural networks for specific detection tasks in real-time scenarios.

Abstract: This article aims to better understand the mechanisms that connect climate change perceptions and general willingness to engage in pro-environmental behavior using Spanish cross-sectional data (N = 403). To do this, we first developed and validated the General Willingness for Environmental Behavior Scale (GWEBS), which includes the classical approach of voluntarily doing new actions but also actions implying not doing things (degrowth) and actions forced by social constraints. The exploratory and confirmatory factor analysis showed a good fit for the one-factor structure, which had adequate validity based on their relationship with other variables. Additionally, the GWEBS distinguished between women and men, left- and right-oriented people, and people who belonged to pro-environmental groups and people who did not. In the second place, we tested the parallel mediator role of eco-anxiety and trust in science in the relationship between climate change perceptions and the GWEBS. The results showed that eco-anxiety, fully, and trust in science partially mediated such a relationship, making them crucial to mobilize the intention to act following the perception. This study contributes to our understanding of the psychological mechanisms that eventually drive pro-environmental behaviors and provides a clear direction for future research.

Nutraceuticals have taken the spotlight during the past two decades as evidenced by the exponential publications on them. Long a part of routine in Traditional Medicine Systems, the rise of their mainstream use globally raises both safety concerns and need for better understanding of efficacious dosing. We attempt to answer these questions in this preliminary scoping review by an analysis of current literature on nutraceutical use as a personalized or prescription medicine. Using Covidence, Rayyan, and manual searches of PubMed, 598 unique publications were selected. 32 are systematic reviews, of which we overview the scope. We also overview 30 papers that address adverse drug reactions. To obtain an unbiased landscape of the 598 papers, we analyzed keywords using multiple methods. Expectedly, the most frequent keywords were probiotics and vitamins. Unexpectedly and remarkably, among the highest keyword yield was ‘COVID’. Further exploring this aspect, we review 15 pertinent papers, that not only provide robust evidence for nutraceutical benefits as part of SARS-CoV-2 treatment, but also amplify the notion that nutraceuticals are protective. Overall, the strident note is that further robust targeted research is needed in order to reap the full benefits of nutraceuticals in a safe and efficacious manner.

Background: Current treatment for Chronic Kidney Disease (CKD) focuses on improving manifestations and delaying progression. Nutritional approaches play a crucial role in CKD management, and various supplements have become available. Ketoanalogues of amino acids (KA), calcum citrate, and inulin have been proposed as suitable supplements, yet their widespread use has been limited due to insufficient evidence. This study aimed to generate general guidance statements on the appropriateness of these supplements through a RAND/UCLA consensus process; Methods: A RAND/UCLA consensus panel was convened to evaluate the appropriateness of these supplements in different clinical scenarios. In this study, we present a subgroup analysis focusing on a panel of eleven clinical nephrologists from among the experts; Results: Supplementation of low protein diets (LPD) and very low protein diets (VLPD) with KA was considered appropriate to reduce manifestations and delay CKD outcomes, supplementation with calcium citrate is considered appropriate to reduce CKD manifestations, and supplementation with inulin is considered appropriate to delay CKD outcomes and manage comorbidities; Conclusions: Based on a combination of clinical experience and scientific evidence , the panel reached a consensus that KA supplementation of LPD and VLPD, calcium citrate, and inulin are appropriate in patients with CKD across various scenarios.

Background: In the landscape of thoracic surgery, innovation continually drives progress, offering novel approaches to address complex pathologies while prioritizing patient well-being. Dual-portal robotic-assisted thoracic surgery DRATS represents the next frontier in this evolution. In this report we describe our experience with the DRATS approach for segmentectomy with the indocyanine green intersegmental plane identification. Methods: We presented the case of a patient who underwent a DRATS lingulectomy and lymphadenectomy stations 5, 6, 7, and 10 using the daVinci Surgical System. Results: The patient's postoperative course was uneventful with chest tube was removed in second post operative day. The final pathological analysis confirmed a low-grade malignant potential adenocarcinoma, with main diameter of 1.1 cm, at 3 cm from lung margins. 12 nodes were removed, from station 5,6,7,10,11, all of the free of metastases. Conclusions: Our initial observations suggest that Dual-Portal Robotic-Assisted Tho-racic Surgery (DRATS) demonstrates notable feasibility.

Interprofessional collaboration between general practitioners (GPs) and community pharmacists (CPs) is central to implement antimicrobial stewardship (AMS) programs in primary care. This study aimed to design a GP-pharmacist antimicrobial stewardship (GPPAS) model in Australian primary care. A seven-component exploratory study was conducted since 2017 to 2021 to inform a GPPAS model. We generated both secondary and primary evidence through a systematic review, a scoping review, a rapid review, nationwide surveys of Australian GPs and CPs including qualitative components and a pilot study of a GPPAS model. All study evidence was synthesised, reviewed, merged and triangulated to design a prototype GPPAS model using a Systems Engineering Initiative for Patient Safety theoretical framework. Secondary evidence informed effective GPPAS interventions, and primary evidence captured interprofessional issues, challenges and future needs to implement GPPAS interventions by GPs and CPs. A GPPAS model framework involving GP-pharmacist team-based five GPPAS sub-models were successfully designed to foster AMS education, antimicrobial audits, diagnostic stewardship, delayed prescribing, and routine review of antimicrobial prescription by improved GP-CP collaboration. A GPPAS model could be used as a guide to collaboratively optimise antimicrobial use by GPs and CPs. Implementation studies on GPPAS model and sub-models are required to integrate GPPAS model into GP-pharmacist interprofessional care models in Australia.

This work is mainly focused on improving the differential evolution algorithm with the utilization of shadowed and general type 2 fuzzy systems to dynamically adapt one of the parameters of the evolutionary method. In this case, the mutation parameter is dynamically moved during the evolution process by using a shadowed and general type-2 fuzzy systems. The main idea of this work is to make a performance comparison between using shadowed and general type 2 fuzzy systems as controllers of the mutation parameter in differential evolution. The performance is compared with the problem of optimizing fuzzy controllers for a D.C. Motor. Simulation results show that general type-2 fuzzy systems are better when higher levels of noise are considered in the controller.

Background.Nurse gives professional nursing service to patients according to competence owned. Based on these services in the end of every year, nurses are given incentives for medical services as financial incentive. Purpose. To analyze the impact of competence training and incentives medical services’ distribution upon the achievement of nurse’s performances in General Hospital of W. Z. Johannes Kupang. Matterial and method. Observational survey research with cross sectional design. Population. Nurses in General Hospital of W. Z. Johannes Kupang. Technique. Total sampling technique with number of samples 183 respondents. Inclusive criteria of samples are willing to be interviewed, nurse’s status, permanent offices without limitation from particular working unit or poly in hospital. Independent variable: (1) competence training; (2) Incentives for medical services. Dependent variable; Nurse’s performance achievement. Variables are measured by using Lickert scale. Information are recorded through questionnaire. Analyzes using linier regression. Result. There are impacts of competence training (α=.000;ß=.489)and distribution of incentives for medical services(α=.012; ß=.152)upon nurse’s performances achievement in General Hospital of Prof.W. Z. Johannes Kupang. Conclusion.The training of nursing service status that could increase competences among nurses with affair incentives for medical services’ distribution simultaneously end up in the increasing of nurse’s performances achievement in a hospital

(1) Background: With the rising incidence of life expectancy, obesity, and tumours, understanding the incretory influence of adipose tissue in tumorigenesis becomes increasingly important. As the adipokines leptin and adiponectin are released by fat tissue, we aimed to analyse the expression of their respective receptors in tumours for which an association with obesity is epidemiologically hypothesized; (2) Methods: The expression of leptinR and adipoR1 were analysed in cohorts of renal cell cancer (n = 391), cervical cancer (n = 155), vulvar cancer (n = 107), and endometrial cancer (n = 90) by immunohistochemistry and correlated with clinicopathological parameters including survival times; (3) Results: Expression of leptinR was high in renal cell cancer (62.2% of cases), vulvar carcinoma (50%) and endometrial cancer (80.5% of tissue-samples). High expression was associated with favourable clinicopathological markers and longer overall survival times in renal cell cancer and vulvar cancer. AdipoR1 was only weakly expressed in all four tumor entities and did not show significant associations with clinicopathological parameters or prognosis; (4) Conclusion: High leptinR is a promising biomarker for favourable tumour outcome in renal cell carcinoma and vulvar carcinoma.

Medication non-adherence remains a substantial obstacle in asthma care, prompting the exploration of novel therapeutic modalities that prioritize rapid symptom relief, anti-inflammatory activity and facilitate patients’ compliance. This task is well served by a new form of therapy - inhaled triple-combination medications ICS/LABA/LAMA (inhaled glucocorticosteroid/long-acting beta2-agonist/long-acting muscarinic antagonist). The integration of three medications within a singular inhalation device culminates in the reduction of the effective dose of the principal therapeutic agent for asthma management, namely, ICS. This consolidation yields a dual benefit of minimizing the likelihood of adverse effects typically linked with ICS while concurrently optimizing bronchodilator efficacy. The accumulated evidence suggests that adding LAMA to a medium- or high-dose ICS/LABA results in a decrease of asthma exacerbations compared to medium- or high-dose ICS/LABA alone, accompanied by sustained enhancements in lung function parameters. We propose in adult patients experiencing suboptimal asthma control despite medium/high-dose ICS/LABA treatment - regardless of adherence to GINA-recommended strategies, such as MART therapy as a first-line approach or alternative second-line strategies - the preferred course for intensifying asthma therapy involves the addition of a LAMA, ideally in the form of SITT.

The composition of the gut microbiota varies among end-stage renal disease (ESRD) patients on the basis of their mode of renal replacement therapy (RRT), with notably more pronounced dysbiosis in those undergoing hemodialysis (HD). Interventions such as dialysis catheters, unstable hemodynamics, strict dietary restrictions, and pharmacotherapy significantly alter the intestinal microenvironment, thus disrupting the gut microbiota composition in HD patients. The gut microbiota may influence HD-related complications, including cardiovascular disease (CVD), infections, anemia, and malnutrition, through mechanisms such as bacterial translocation, immune regulation, and the production of gut bacterial metabolites, thereby affecting both the quality of life and the prognosis of patients. This review focuses on alterations in the gut microbiota and its metabolites in HD patients. Additionally, understanding the impact of the gut microbiota on the complications of HD could provide insights into the development of novel treatment strategies to prevent or alleviate complications in HD patients.

Oral lichen planus (OLP) is a chronic inflammatory mucosal disease, and an apparent cause has not been identified. OLP is refractory to treatment, and malignant transformation has been reported. Therefore, discovering effective drugs with few adverse effects over long-term administration is crucial. In this study, we established an in vitro OLP model to investigate the effects of Cepharanthin®, an alkaloid mixture derived from Stephania cephalantha Hayata. Four alkaloids from Cepharanthin® suppressed the expression of cytokine genes at various degrees in activated T cells. However, the effect of Cepharanthin® was limited. On the other hand, Cepharanthin® and four alkaloids suppressed the expression of various cytokine genes in human oral epithelial cells when stimulated with IL-β. In the OLP model, activated T cells increased the inflammatory gene expression in the epithelial cells, while Cepharanthin® suppressed their gene expression. Anti-inflammatory effect of Cepharanthin® was observed by protein dot blot. The effects of Cepharanthin®️ might be expressed through two aspects: its effect of mildly suppressing the activation of T lymphocytes and strongly suppressing the response of epithelial cells to inflammatory stimuli. The in vitro model established in this study could be a tool for elucidating the mechanisms of OLP pathogenesis and disease persistence.

Modified mRNAs (modRNAs) are an emerging delivery method for gene therapy. In particular, the modRNA-based COVID-19 vaccines have proven that modRNA is a safe and effective therapeutic tool. Moreover, modRNA has the potential to treat various human diseases including cardiac dysfunction. Acute myocardial infarction (MI) is a major cardiac disorder that currently lacks curative treatment options. MI is commonly accompanied by fibrosis and impaired cardiac function. Our group previously demonstrated that the matricellular protein CCN5 inhibits cardiac fibrosis (CF) and improves cardiac dysfunction. However, it remains elusive whether the early intervention of CF under stress conditions is beneficial or more detrimental due to potential adverse effects such as left ventricular (LV) rupture. To obtain acute CCN5 expression, we used modRNA-mediated gene transfer in a mouse MI model. To evaluate CCN5 activity, we established two independent experimental schemes: 1) preventive intervention and 2) therapeutic intervention. Cardiac function and structural changes were measured by echocardiography and magnetic resonance imaging. Finally, fibrosis and the underlying molecular pathway were analyzed by western blotting, quantitative real-time polymerase chain reaction, and immunohistochemistry. The modRNA-CCN5 gene transfer successfully ameliorated CF and enhanced cardiac function in both preventive and therapeutic interventions without LV rupture or any adverse cardiac remodeling. Conclusively, early intervention in CF by modRNA-CCN5 gene transfer is an efficient and safe therapeutic modality for treating MI-induced heart failure without adverse structural remodeling.

Pediatric onset multiple sclerosis (POMS), characterized by the onset of multiple sclerosis before the age of 18, is gaining increased recognition. Approximately 5 percent of MS cases manifest before the age of 18, with less than 1 percent occurring before the age of 10. Despite its rarity, pediatric MS exhibits distinct characteristics, with an association between younger age at onset and a comparatively slower disease progression. Despite this slower progression, individuals with POMS historically reach disability milestones at earlier ages than those with adult-onset multiple sclerosis. While various immunomodulatory agents demonstrate significant benefits in MS treatment, such as reduced relapse rates and slower accumulation of brain lesions on magnetic resonance imaging (MRI), the majority of disease-modifying therapies (DMTs) commonly used in adult MS lack evaluation through pediatric clinical trials. Current evidence is predominantly derived from observational studies. This comprehensive review aims to consolidate existing knowledge on the mechanisms of action, efficacy, safety profiles, and recommended dosages of available DMTs specifically in the context of pediatric MS. Furthermore, the review outlines recent advancements and explores potential medications still in developmental stages, providing a thorough overview of the current landscape and future prospects for treating POMS.

This paper discovers that current canonical variational principle and canonical Noether theorem of (in)finite freedom systems for different physics systems have neglected doublet extreme value processes of the general extreme value functional that both is derived by variational principle and is necessarily be taken in deriving all ( quantum ) physics laws in phase space, but which have not been done for over one century since Noether's showing her distinguished theorem, which lead to the crisis deriving all (quantum) physics laws (necessary) in phase space. We discover there is the hidden logic cycle that people assume canonical equations, and then they finally deduce canonical equations by the equivalent relation in the whole processes in all current references. We correct the current key mistake concepts that when physics systems take the variational extreme values, the appearing processes of the physics systems are real physics processes, otherwise, are virtual processes in all current references. The real physics should be what after taking the physics systems' variational extreme values, the physics systems' general extremum functional needs to further take the general extremum functional's minimum absolute extremum zero, otherwise, the appearing processes of physics systems still are virtual processes. Conservation current equations and conservation currents, in phase space, of general canonical variational principle and general canonical Noether theorem are, respectively, deduced for the first time. Using the general extremum functionals' doublet extreme value processes, the hidden logic cycle and the crisis in current canonical variational principle and current canonical Noether theorem are solved. Consequently, the new mathematical pictures, classical and quantum new physics in phase space and the new mathematical and physical doublet extremum processes for (in)finite freedom systems are discovered. General canonical variational principle and general canonical Noether theorem naturally are given, which would rewrite all the different sciences in phase space, as key tools of studying and dealing with them.

In schizophrenia, a single latent trait underlies psychosis, hostility, excitation, mannerism, negative (PHEMN) symptoms, formal thought disorders (FTD) and psychomotor retardation (PMR). Schizophrenia is accompanied by a breakdown of gut and blood-brain-barrier (BBB) pathways, increased tryptophan catabolite (TRYCAT) levels, bacterial translocation, and lowered natural IgM and paraoxonase (PON)1 activity. The aim of this study was to examine the factor structure of schizophrenia symptom domains and the biomarker correlates of these factors. We recruited 80 patients with schizophrenia and 40 healthy subjects and assessed the IgA/IgM responses to paracellular/transcellular (PARA/TRANS) ratios, IgA responses to TRYCATs, natural IgM to malondialdehyde and Gram-negative bacteria, and PON1 enzymatic activity.Direct Hierarchical Exploratory Factor Analysis showed a bifactorial oblique model with a) a general factor which loaded highly on all symptom domains, named overall severity of schizophrenia (“OSOS”); and b) a single-group factor (SGF) loading on negative symptoms and PMR. We found that 40% of the variance in the OSOS score was explained by IgA/IgM to PARA/TRANS ratio, male sex and education while 36.9% of the variance in SGF score was explained by IgA to PARA/TRANS, IgM to Gram-negative bacteria, female sex (positively associated) and IgM to MDA, and PON1 activity (negatively associated). Schizophrenia phenomenology comprises two biologically-validated dimensions, namely a general OSOS dimension and a single-group negative symptom dimension, which are associated with a breakdown of gut/BBB barriers, increased bacterial translocation and lowered protection against oxidation, inflammation and bacterial infections through lowered PON1 and natural IgM.

In this paper, we establish the necessary and sufficient conditions for solving a dual split quaternion matrix equation AXB=C, and present the general solution expression when solvability is achieved. As an application, we delve into the necessary and sufficient condition for the existence of Hermitian solution to this equation by using a newly defined real representation method. Furthermore, we obtain the solutions for the dual split quaternion matrix equations AX=C and XB=C. Finally, we provide a numerical example to demonstrate the findings of this paper.

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

Abstract: this study aimed to evaluate the benefits of applying 5 cmH2O of CPAP using a pediatric helmet during the recovery phase from general anesthesia in brachycephalic dogs. Brachycephalic dogs undergoing various surgical procedures were included in the study, and a total of 64 subjects were randomly assigned to receive either standard oxygen supplementation (NO-CPAP group) or oxygen supplementation combined with CPAP (CPAP group). The study evaluated arterial blood pH, blood gas partial pressures of O2 and CO2, arterial blood O2 saturation, and related parameters during recovery. The dogs were monitored, and helmet tolerance was assessed using predefined criteria. Of the initially assessed 69 dogs, 64 were enrolled, 32 in the CPAP group and 32 in the NO-CPAP group. Fifteen dogs in the NO-CPAP group were excluded based on predetermined criteria. The CPAP group showed significant improvements in PaO2, PaO2/FiO2, P(A-a)O2, F-Shunt, and respiratory rate compared to the NO-CPAP group (p < 0.001). The incidence of reintubation and helmet intolerance was higher in the NO-CPAP group (18% and 15.6%, respectively) than in the CPAP group (0%). This study highlights the potential benefits of incorporating CPAP, delivered through a pediatric helmet, in the perioperative management of brachycephalic dogs. Keywords: Brachycephalic; dog; CPAP; oxygenation; anesthesia

The patient's satisfaction level concerning hospitalization has certain particularities, related to the geographical area, medical/non-medical assistance, the age, incomes, morbidity and mortality of the population. The objective of this study is to emphasize the degree of patients' satisfaction, depending on the specialty of the hospitalization department: surgical, medical, oncological, psychiatry, and to evidence the factors influencing the reliability and accuracy of patients' answers, such as: the patient's health condition upon admission, the duration of the admission, the level of physical pain and the emotional state. Patients and methods: The research was conducted between April and December 2021 on patients hospitalized in two public hospitals from the north-west of Romania, both of them being independent Legal Entities: the Municipal Clinical Hospital of Oradea (MCHO) and the County Clinical Emergency Hospital of Oradea (CCEHO). Results: The lowest score of PSS recorded in these two analyzed public hospitals from the north-western of Romania was appointed for the Pharmaceutical availability of patients medical treatment (2.24), attitude of the staff (2.56) and the quality of nursing care offered (2.58). Conclusions: The hospital management’s focus has been set to improve the communication skills among medical staff, to evidence their compassion, politeness, and to ensure the availability of essential drugs.

Difference in two quantum states defined for a point in space time is represented by space time curvature and the superposition of these quantum states will affect the momentum of mass existed at that point. Analogy of the same with Einstein’s General relativity field equation and Einstein’s gravitational constant , indicated an equation containing ‘Hubble’s constant H , Einstein’s gravitational constant ‘H’ and Siva’s constant ‘K’. Its output is a quadratic equation. Solution to this quadratic equation predicted a fundamental force particle. This solution gives the diameter of that particle. From the fundamental principles, the diameter of this force particle gives the coupling constant of that fundamental force. Prediction and review of this particle may provide us new insights in to quantum physics and standard model of particle physics. From the first principles, it is discussed that this particle can be claimed as a force carrying particle of a fundamental force related to dark matter. This work has provided simple explanation to reconcile quantum nature of space time with smooth space time of General Relativity. This has demanded the necessity to introduce a new postulate in quantum mechanics which is beyond Hilbert space and Dirac notation. A new perspective of uncertainty principle in quantum mechanics has been elaborated.

We suggest that despite McLuhan’s claim not to have a theory of communication that in fact the body of his work does indeed constitute a theory of media and their effects which I have called his General Theory of Media (GToM) that also includes his Laws of Media (LoM). Both McLuhan’s GToM and his LoM are described. A comparison is made of three notions of law: i. McLuhan’s notion of law as used in his Laws of Media; ii. the notions of the Law in the legal sense and iii. the notion of law as formulated in scientific laws. McLuhan’s understanding of media is used to analyze some of the negative effects of social media suggesting that laws need to be formulated to prevent the misuse of social media that are antithetical to democracy and the invasion of the privacy of the individual users of these apps. McLuhan’s Laws of Media are then used to provide insights into the nature of scientific laws, the Law in the legal sense and his own Laws of Media.

This paper presents a new analytical method for obtaining new deformations compatibility equations or, new Saint-Venant’s identities, into the relative coordinate system with projected deformations by applying the hypothesis of the lineal shell theory in general flexion state. The method proposed generalizes the compatibility conditions established by A.L. Goldenveizer for the shell theory. On the other hand, the new equations include the deformations compatibility equations by other authors: Flügge, Saint-Venant, Love-Kirchhoff, Timoshenko, Goldenveizer, and Reissner-Mindlin. The results showed an increase of knowledge in general shell theory, and provide inverse and semi-inverse solutions, whose systems solution correspond to the hyper-statics degrees of the physical model, and not to their degrees of freedom.

The capacitated lot-sizing problem with product recovery (CLSP-RM) holds significant importance in reverse logistics but is notoriously complex (NP-hard). In this study, two techniques are introduced to confront this challenge. The first technique entails devising a linear optimization task that eliminates capacity limitations across a wide problem spectrum, yielding a remarkably accurate approximation of the optimal solution. This adaptable approach presents a potent alternative and holds potential for extension to diverse problem categories owing to its versatile nature. The second technique employs a simulation methodology utilizing Halton’s uniform random numbers to address the issue. This randomized production search method sidesteps considerations of production costs, inventory expenditures, and production order when determining production batches. The research’s novelty lies in its application of these techniques to the problem. The suggested methods undergo evaluation via a benchmark dataset of approximately 4200 instances, with comparison against solutions derived through the Gurobi solver. The results underscore the efficacy and resilience of the introduced methodology in tackling the CLSP-RM predicament.

Purpose – Extend the Blade Element Momentum Theory (BEMT) such that rotors with pronounced cone and axis angle (tilt or yaw) can be calculated. Derive an equation for the speed ratio (lambda) as a function of Tip Speed Ratio (TSR), radius, blade, cone and axis angle. This converts the BEMT into an Unsteady BEMT or UBEMT. Present the Wagner rotor as one such rotor geometry. --- Methodology – Literature review and calculations. --- Findings – The UBEMT can be used to calculate highly unconventional rotor geometries. --- Research Limitations – Although the aerodynamic coefficients used in the UBEMT are from measurements in steady flow conditions, they can be used with success. --- Practical Implications – Also conventional Horizontal Axis Wind Turbines (HAWT) with noticeable cone and axis angle should be calculated with the UBEMT. The accuracy of power calculations of these HAWTs can be slightly improved. --- Originality – Analytic equations for rotors with cone and axis angle have barely been discussed.

Research into professionalization in health and safety has recently gained in interest. Graduate training is one of the factors that determines or conditions the role of the safety professional, thus intervene in the professionalization process. This article is the result of a workshop and the discussions of nine academic directors of safety education programs about quality evaluation. This article introduces the issue with a historic overview of safety education, presents a synthesis of nine selected education programs, discusses quality evaluation of health and safety education programs, propose a quality evaluation frame and finally, proposes a process for designing a quality safety education program with an associated model of the learning objectives. The outcomes are interesting for everyone who is interested in health and safety education and quality evaluation and will give insights into how safety professionals are educated.

Background: given the various clinical manifestations that characterize coronavirus disease 2019 (COVID-19), the scientific community is constantly searching for biomarkers with prognostic value. Surfactant protein A (SP-A) and D (SP-D) play a crucial role in ensuring proper alveolar function and an alteration of their serum levels have been reported in several pulmonary diseases characterized by acute respiratory distress syndrome (ARDS) and pulmonary fibrosis. Consid-ering that such clinical manifestations can also occur during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we wondered if these collectins could act as prognostic markers. Methods: in this regard, serum levels of SP-A and SP-D were measured by enzyme immunoassay in patients with SARS-CoV-2 infection (n=51) at admission (T0) and after 7 days (T1) and compared with healthy donors (n=11). Results: SP-D increased in COVID-19 patients com-pared to healthy controls during the early phases of infection, while a significant reduction was observed at T1. Stratifying SARS-CoV-2 patients according to disease severity, increased serum SP-D levels were observed in severe compared to mild patients. Conclusions: In the light of these results SP-D, but not SP-A, seems to be an eligible marker of COVID-19 pneumonia and the early detection of SP-D serum levels could be crucial for a preventive clinical management.

Background: Critical states present scale-free dynamics, optimizing neuronal complexity. We explored electroencephalogram (EEG) criticality in amnesic Mild Cognitive Impairment (aMCI) patients with clinical improvement in working memory, verbal memory, verbal fluency and overall executive functions after the completion of a 6-month prospective memory training. (2) Methods: We compared “before” and “after” stationary resting-state EEG records of right-handed MCI patients (n = 17; 11 females), using the method of critical fluctuations and Haar wavelet analysis. (3) Results: Significant criticality enhancement was present in frontotemporal electrodes [mean dif: 0.10; Z = 7, p = .019] and isolated electrodes T6 [mean dif: 0.204; t (10) = - 2.3, p = .044] and F4 [mean dif: 0.0194; t (10) = - 2.82; p = .018]. (4) Conclusions: EEG criticality agreed with clinical improvement, consisting a possible monitoring biomarker in MCI and Alzheimer’s disease. Further evaluation is needed in patients under cognitive training or even drug-modifying therapies.