There is a great need to develop research-based models for supporting collaboration between educational institutions. Collaboration models are needed, for example, to assist the transition from lower educational level to higher education or from higher education to work life. In this research, collaboration was conducted through a joint upper-secondary school and university course that addressed global challenges by using a project-based learning approach. There is a shortage of research exploring students’ perceptions of collaboration. Therefore, the main purpose of this qualitative case study is to explore the relevance of the joint course for students and university students. The research was guided by the following research question: What kind of relevance did the students experience in the joint project-based learning course? The data was gathered using questionnaires, interviews, and reflective study reports. The data was analyzed via theory-based content analysis where research-oriented relevance model was used as the analysis framework. The analysis framework enabled categorizing experienced relevance on individual, vocational and societal dimensions. Altogether, the analysis produced 7 relevance categories for upper-secondary students and 9 for university students. According to the analysis, upper-secondary school students felt that the course offered the most on an individual relevance dimension whereas university students experienced the vocational relevance dimension most diverse. As the main conclusion, this research produced new insights on the experienced relevance of upper-secondary level and higher education cooperation from the students’ point of view. The acquired knowledge can be useful for everyone developing new cross-institutional cooperation models.

This cross-sectional study investigates the impact of Virtual Private Networks (VPNs) on Nigerians during the 2021 Twitter ban, prompted by the Nigerian government's suspension of Twitter operations following the deletion of a tweet by the President. The study aims to analyze the frequency and awareness of VPN and Twitter usage among Nigerians during the ban, addressing specific objectives. Employing a survey research method, data was collected from 400 respondents through online and offline questionnaires. Descriptive statistical tools were used for data analysis, revealing significant findings. Results indicate a substantial decrease in Twitter usage during the ban, with IPVanish emerging as the preferred VPN brand. The study also highlights an increase in VPN awareness post-ban, emphasizing the need for educational initiatives. The demographic analysis reveals a dominant age group of 21 to 25 among social media users. Overall, the research underscores the complex interplay between social media dynamics, VPN adoption, and demographic factors, emphasizing the importance of nuanced regulatory approaches and ongoing user education in Nigeria's online landscape.

This study employs molecular docking experiments to investigate the binding interactions of Hypericin with key proteins implicated in Alzheimer's disease (AD). Hypericin demonstrated a significant binding energy of -10.1 kcal/mol with ABAD (3-hydroxyacyl-CoA dehydrogenase type II). The analysis revealed multiple binding interactions, including hydrogen bonds with arginine 6, serine 7, and glutamic acid 140, as well as hydrophobic bonds involving leucine 11, aspartic acid 142, and aspartic acid 86. These findings illuminate the intricate molecular interactions between Hypericin and ABAD, suggesting its potential as a lead compound for further therapeutic development in the context of Alzheimer's disease. Additionally, a parallel docking investigation was conducted for Beta-secretase 1 (BACE1), a protein pivotal in the generation of beta-amyloid peptides—a hallmark of Alzheimer's disease. Inhibiting BACE1 activity is considered a promising therapeutic strategy for AD. Computational analyses suggest that Hypericin may serve as a potential inhibitor of BACE1. Molecular Docking results reveal a robust binding affinity between Hypericin and BACE1, supported by a significant binding energy score of -10.3 kcal/mol. Notably, both ABAD and BACE1 exhibit high binding affinity with Hypericin. This theoretical exploration provides an initial understanding of the intricate molecular pathways involved in Alzheimer's disease and proposes Hypericin as a potential therapeutic compound for mitigating its progression.

This study aimed to overcome the difficulty of conducting the horizontal-well cavity leaching test in the field and to investigate the long-term stability of the horizontal-well salt-cavity natural gas storage. The simulation test design is combined with the similarity theory to study the cavity expansion characteristics and the influence law of cavity leaching parameters. Through the design of a rubber hose connection, an integrated closed test system for multi-stage horizontal-well cavity leaching and brine drainage was built. The test system also realises the repeatable backward movement of the injection well during the test. A similarity simulation of the test design was carried out, and the test platform was constructed to carry out multi-stage horizontal-well leaching tests with a nitrogen cushion. In the horizontal-well leaching tests with a nitrogen cushion, the influence laws of the well spacing, flow rate and liquid level position on cavity expansion were investigated. Based on the morphological characteristics of the horizontal-well cavity, a numerical model of the horizontal-well salt cavity was developed, which reflects the real cavity morphology leached in the test. The long-term stability of the horizontal-well salt-cavity natural gas storage under different internal pressures was investigated through numerical simulation.

Energy communities are key actors in the energy transition since they optimally interconnect renewable energy capacities with the consumers. Despite versatile objectives, they usually aim at improving the self-consumption of renewable electricity within low voltage grids to maximize revenues. In addition, energy communities are an excellent opportunity to supply renewable electricity to regional and national energy systems. However, effective price signals have to be designed to coordinate the needs of the energy infrastructure with the interests of these local stakeholders. The aim of this paper is to demonstrate the integration of energy communities at the national level with a bottom-up approach. District energy systems with a building scale resolution are modelled in a mixed integer linear programming problem. The Dantzig-Wolfe decomposition is applied to reduce the computational time. The methodology lies within the framework of renewable energy hub, characterized by a high share of photovoltaic capacities. Both investments into equipment and its operation are considered. The model is applied on a set of five typical districts and weather locations representative of the Swiss building stock. The extrapolation to the national scale revealed a heterogeneous photovoltaic potential throughout the country. Present electricity tariffs promote a maximal investment into photovoltaic panels in every region, reaching an installed capacity of 67.2 GW and generating 80 TWh per year. Since the national PV capacity needed is forecast at 15.4 GW peak, coordinated investments between local and national actors are needed to prevent dispensable expenses. An uncoordinated design is expected to increase the total costs for residential energy systems by 43.2% and curtails 48.2% of local renewable electricity.

Physical properties like shape, volume and size affect the dynamics of biological systems. Along these lines, we focus on the topological properties of biological fluids and their biochemical and physiological outcomes. We take as a paradigmatic example the salivary fluid and describe how its topological features may affect the physiopathology of the oral cavity. Topological approaches assess the general properties of saliva, ignoring small-scale physical details such as density, flow rate, stiffness, viscosity. Specifically, the mucin aggregates scattered in the salivary fluid can be tackled in terms of topological holes, i.e., vortical clusters that modify the direction, flow, impulse, local rate-of-change and velocity of saliva. While the current methodological approaches are inclined to remove the effects of impurities assessing systems as homogeneous structures, we argue that the occurrence of mucins breaks up the salivary fluid’s homogeneity, leading to unexpected biophysical modifications. We suggest that every collected salivary sample is not reliable for accurate clinical and experimental investigation, since it displays highly local as well as variable chemical, physical and biological features, not reflecting the current physiological state of the oral cavity. Therefore, the assessment of a single salivary sample is not fully reproducible and cannot provide information about the biophysical, enzymatic and microbiological content of the whole saliva. In sum, the very topological features of the saliva - such as volume, shape, antipodal cells, vortex area, whirling fluid mass, segmentation, discretization, triangulation, node numbering - produce unnoticed biological consequences and network connectivity features with intriguing operational implications.

A paddle wheel aerator is developed in this research, which includes a wireless sensor network for measuring the water quality in the aquaculture of marine shrimp ponds. It can also move to the desired position to fill oxygen and measure water quality. A basic requirement is good standard water quality to prevent shrimp from epidemics and improve production. The water quality paddle wheel aerator applies a microcontroller and sensors to measure eight parameters of water quality. These water quality parameters are observed on the web application via an IoT module. The movement system of the water-quality paddle wheel aerator consists of a LiDAR, GPS, and remote RF signal. Each item of data is recorded immediately on the cloud server while the water-quality paddle wheel moves in the marine shrimp farm. The controlled paddle wheel aerator is harnessed automatically to enhance precisely the spatial monitoring resolution of the measurement system installed, which is needless for a multiple measurement system with high cost of investment. Also, farmers can access real data through the Line application. Hence, they are able to plan and control a good environment for aquaculture, preventing the occurrence of various epidemics and decomposing organic matter in the pond.

The burden of hypertension remains unacceptably high globally, particularly in low- and middle-income countries (LMICs). Workplace offer enormous potential as an idea setting for early detection and treatment of hypertension among the working class. Analysis of such a Workplace Screening Programme can reveal information about its potential impact. Machine learning techniques such as k-Means Clustering are untapped tools for such analyses. We set out to deploy this tool for the analysis of our university annual medical screening of workforce for hypertension. An anonymized dataset containing the demography and blood pressure measurements values obtained from staffs of different departments/units in an academic institution was obtained. The total number of samples or data points are 1, 723 in which the input dataset contains six features, including year category (2018, 2019, 2021,2022), Department/Unit (academic and non-academic), gender (male and female), while the target output is the blood pressure status (low, normal and high) respectively. Analysis of the dataset was carried out using machine learning techniques. In this retrospective analysis, it was observed that the mean age for this working class is 42 years old. Similarly, it was discovered that hypertension was prevalent among members of staff above the age of 40 irrespective of their gender or professional category (academic or non-academic). The analysis also revealed that there was a steady decline in the prevalence of hypertension from 2018 to 2022. From the research, it is evident that the adoption of machine learning techniques for periodic analyses of workplace health status screening initiative (especially for hypertension) is effective, feasible, and sustainable to diagnose and control hypertension among the working class.

Extravasation, the unintended leakage of intravenously administered substances, poses significant challenges in cancer treatment, particularly during chemotherapy and radiotherapy. This comprehensive review explores the pathophysiology, incidence, risk factors, clinical presentation, diagnosis, prevention strategies, management approaches, complications, and long-term effects of extravasation in cancer patients. It also outlines future directions and research opportunities, including identifying gaps in current knowledge and proposing areas for further investigation in extravasation prevention and management. Emerging technologies and therapies with the potential to improve extravasation prevention and management in both chemotherapy and radiotherapy are highlighted. Such innovations include advanced vein visualization technologies, smart catheters, targeted drug delivery systems, novel topical treatments, and artificial intelligence-based image analysis. By addressing these aspects, this review not only provides healthcare professionals with insights to enhance patient safety and optimize clinical practice but also underscores the importance of ongoing research and innovation in improving outcomes for cancer patients experiencing extravasation events.

Background: The clinical impact of withdrawal of sodium-glucose cotransporter 2 inhibitor (SGLT2i) on the all-cause readmission in patients with heart failure remains unknown. Methods: Consecutive 212 patients who were hospitalized for heart failure and received SGLT2i during the index hospitalization between February 2016 and July 2022 were evaluated. Of these, 51 patients terminated SGLT2i during or after their index hospitalization. The primary outcome was defined as an all-cause readmission rates/times. Results: Over a median of 23.2 months, an all-cause readmission occurred in 38 of 51 patients (74.5%) withdrawn from SGLT2i and 93 of 161 patients (57.8%) with continuation of SGLT2i (p = 0.099). The total number of all-cause readmissions per year was 0.97 [0-1.50] in patients withdrawn from SGLT2i and 0.50 [0-1.03] in patients with continuation of SGLT2i (p = 0.030). There was no significant difference in total medical cost (62,906 [502-187,246] versus 29,236 [7,920-180,305] JPY per month, p = 0.866) between both patient groups. Conclusions: Termination of SGLT2i may be associated with incremental all-cause readmission and no benefit in reducing total medical costs.

This study investigates the pivotal areas where Artificial Intelligence (AI) integration in healthcare warrants further exploration, leveraging insights from Boston Specialists, a forefront healthcare provider in AI adoption. Employing a qualitative case study approach, enriched by in-depth interviews and comprehensive literature reviews, we identify three main domains for potential AI expansion: scheduling efficiency, clinical documentation, and AI-driven medical research. Our results underscore the substantial enhancements AI brings to operational workflows and patient care, notably through improved scheduling systems, accuracy in medical documentation, and the facilitation of data-driven research methodologies. These findings suggest a critical need for healthcare institutions to further invest in AI technologies, focusing on these key areas to harness AI's full potential in personalizing care, optimizing efficiency, and advancing medical knowledge. The study concludes with a call for continued investigation into AI's integration within healthcare settings, emphasizing the importance of a supportive organizational infrastructure, ethical considerations, and data security in realizing AI's transformative impact on healthcare delivery and patient outcomes.

Cosmetic surgery is the subfield of plastic surgery that enhances appearance mainly for aesthetic reasons. Currently, cosmetic surgery interventions are highly considered appealing and popular all around the world. Several factors have contributed in this rapidly evolving field such as scientific and economic development, breaking down barriers and cultural norms, globalization, social media and mental disorders. Nowadays, the morality of cosmetic surgery is facing many dilemmas due to its benefits and drawbacks. It is proven that the advantages of cosmetic surgery include improved body confidence, mental health, and function. Additionally, aesthetic corrections can upscale the quality of life and create career opportunities for special targeted groups. Also, cosmetic surgery has a major impact in gender affirmation procedures. Although, herein we also describe the disadvantages of this widely developing field such as minor and major medical complications, potential postoperative risks and addiction in plastic surgeries associated with damaging economic issues. Lack in self-confidence, altered mental health status and ethical crisis consist another negative aspects of aesthetic surgery’s impact.

The aim of this review was to summarize the available literature regarding resident and medical student education utilizing the spaced repetition program Anki. This review enables current residents and medical students to recognize and utilize evidence-proven study techniques to increase learning efficacy. A systemic review of papers across all medical journals available on Pubmed was conducted to identify studies published without time constraints. The search was for (Anki) and (spaced repetition residency). Available outcome data was collected and discussed independently for students and residents. Many studies showed a statistically significant increase in exam performance associated with Anki use and high levels of satisfaction among residents and medical students. Further research is warranted to provide high-quality evidence of Anki’s applications and there is a need for exploration in additional residency specialties. Anki use has steadily increased with both medical students and residents. The application demonstrated consistent improvement on exam-based performance and was regarded highly by users. As burnout and time constrictions threaten educational workflow, Anki may serve as a powerful tool to improve the quality of learning. Further data needs to be collected and analyzed in specialties where Anki use may already exist.

ChatGPT is gaining widespread acceptance for its ability to generate natural language sentences in response to various inputs and is expected to become a supplementary tool for diagnosing and determining treatment policies in clinical settings. ChatGPT was used to evaluate its ability to perform clinical inference and accuracy in answering questions on the 117th Japanese National Medical Licensing Examination held in February 2023. The exam questions were manually inputted into ChatGPT's window, and the accuracy of ChatGPT's responses was determined based on answers provided by a preparatory school. ChatGPT provided answers for 389 out of 400 questions, and its overall correct answer rate was 55.0%. The correct answer rate for 5-choice-1, 5-choice-2, and 5-choice-3 were 57.8%, 42.9%, and 41.2%, respectively. The highest correct answer rate was for the compulsory exam (67.0%), followed by the specific knowledge exam (54.1%) and the cross category exam (47.9%). The correct answer rate for non-image questions was 56.2% and for image questions, it was 51.5%. The study suggests that ChatGPT has potential to support healthcare professionals in clinical decision-making in Japanese clinical settings, but caution should be exercised in interpreting and using the answers generated by ChatGPT due to room for improvement in performance.

Background: Health policy is a set of comprehensive principles and legislations that guide how healthcare should be effectively delivered in the community. Medical schools should prepare students to undertake managerial responsibilities by incorporating health policy in the curriculum to deal with the intricacies of healthcare systems and their clinical roles in their future professional careers. Objective: To examine medical students' perception at a Public University in Malaysia regarding teaching health policy and their participation in health policy roles. Material and Methods: A cross-sectional study using universal sampling was carried out among the medical students using a paper-based questionnaire to collect the data. Results: Most respondents opined their willingness to learn health policy (80.9%) and that teaching health policy (83.6%) should be compulsory for medical students. The respondents thought health policy should be introduced earlier in Year 1 or 2. The student scores on their knowledge regarding health policy and year of study were significantly associated with their involvement in the health policy roles in both the simple and multiple logistic regression. Both statistical tests reported higher participation in health policy roles with the higher year of study, though only Year 4 and 5 were significant in the simple logistic regression and only Year 5 in the multiple logistic regression compared to Year 1. On the other hand, age and type of admission show significant results only in the simple logistic regression, while the race was only significant at the multivariate level. Conclusion: This study demonstrated that most respondents showed their willingness to learn health policy, participate in the health policy programs, and recommend that health policy be considered an essential topic in the medical curriculum, which should be taught right from the first year of medical school. We recommend encouraging students’ participation in health policy activities.

The cannabis plant has been known for millennia for its properties such as textile fiber, food, recreational and medicinal use. Since the origin of its domestication in Asia, cannabis has been transported to the rest of the continents by merchants, nomads, settlers, and slaves, who have also carried with them valuable knowledge about its uses. Its medical use was one of the major contributions of this plant in the various civilizations through which it passed. This article aims to understand its origins, dissemination, and medical use over the years to the present day.

Background: Necrotizing enterocolitis (NEC) is one of the leading causes of death in newborns, however, little is understood of which patients can be treated medically or require surgery. The purpose of our study is to analyze the associated factors of surgically treated patients compared to patients requiring only medical treatment. Methods: Patients diagnosed with necrotizing enterocolitis over a period of 14 years in a single children’s hospital were retrospectively enrolled. Demographics and clinical data patients were collected and analyzed. Results: A total of 189 patients with NEC were included. Surgically treated patients had a lower gestational age (P = .018), body weight at birth (P = .034), and percentage of exclusive breast milk feeding (P= .001). They had increased comorbidity with respiratory distress syndrome (RDS) (P = .005), number of days of antibiotic use (P = .014), and length of hospital stay (P = .000). In multivariate logistic analysis, a lower percentage of exclusive breast milk feeding (OR = 0.366, 95% CI: 0.164-0.817) and a longer hospital stay (OR = 1.010, 95% CI: 1.001- 1.019) was associated with surgical NEC. Conclusion: Comparing medical and surgical NEC, a significantly lower percentage of surgical NEC patients were exclusively fed breast milk and their hospital stays were longer.

COVID-19 greatly challenges human beings in the health sector and leaves behind a large amount of medical waste that poses many potential threats to the environment. In this paper, we compiled relevant data released by official agencies and the media, and conducted data supplementation based on previous studies to calculate the net value of medical waste production in Hubei Province during COVID-19 with the help of a neural network model. Then, we reviewed the data related to the environmental impact of medical waste per unit and designed four scenarios to estimate the environmental impact of new medical waste generated during the epidemic. The results showed that at a medical waste generation rate of\ 0.\ 5\ kg/(\ bed\ \cdot\ d) COVID-19 resulted in a net increase in medical waste volume of about 3366.99 tons in Hubei Province. In the four scenario assumptions, if the medical waste brought by COVID-19 is completely incinerated, it will have a large impact on the air quality. If it is disposed by distillation sterilization, it will produce a large amount of wastewater and waste residue. Based on the results of the study, three policy recommendations are proposed in this paper: strict control of medical wastewater discharge, reduction and transformation of the emitted acidic gases, and attention to the emission of metallic nickel in exhaust gas and chloride in soil. These policy recommendations provide a scientific basis for controlling medical waste pollution.

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

Visible light photography diagnostic images are coloured ex vivo medical images popularly used in Dermatology and Endoscopy for diagnosis and monitoring. The need to protect the integrity of these images as well as associated patient data calls for techniques such as image steganography and watermarking. This research explores and compares the effect of watermarking on the YIQ and YCbCr colour transforms used in processing digital coloured images and video in recent times. Using a new spread spectrum watermarking algorithm, it was found that YIQ has better distortion performance than YCbCr in the order of 3dB while YCbCr had lower BER for accurate watermark retrieval and tamper detection in the order of 1.3 x 10-3.

Five years after the introduction of the Prescribing Safety Assessment (PSA) in the UK, the role pharmacists play to help prepare medical students for this challenge is uncertain. Our study explored pharmacists’ perceptions about their role in undergraduate medical training for the Prescribing Safety Assessment (PSA). Study participants were emailed a qualitative questionnaire aimed at ascertaining their current involvement in undergraduate medical education, particularly the preparation for PSA. Responses received were thematically-analysed. A total of 27 UK hospital pharmacists and 3 pharmacists from local education and training boards completed the questionnaire. Pharmacists were positive about their involvement in medical student training, recognising the added value they could provide in prescribing practice. However, respondents expressed concerns in relation to resource availability and the need for formal educational practice mentoring. This research highlights the potential value of pharmacists’ input into medical education and the need for a discussion on strategies to expand this role to maximise the benefit from pharmacist skill mix in teaching safe prescribing.

Traditional urban design often overlooks the synchronisation of human and ecological connectivities, typically favouring corridors for ecological continuity. Our study challenges this convention by introducing a computational design approach, Meta-Connectivity, leveraging the deep generative models performing cross-domain translation to integrate human-wildlife landscape connectivity in urban morphology amidst the planetary urbanisation. Utilising chained Pix2Pix models, our research illustrates a novel meta-connectivity design reasoning framework, combining landscape connectivity modelling with conditional reasoning based on deep generative models. This framework enables the adjustment of both human and wildlife landscape connectivities based on their correlative patterns in one single design process, guiding the re-materialisation of urban landscapes without the need for explicit prior ecological or urban data. Our empirical study in East London demonstrated the framework's efficacy in suggesting wildlife connectivity adjustments based on human connectivity metrics. The results demonstrate the feasibility of creating an innovative urban form in which the land cover guided by the connectivity gradients replaces the corridors based on simple geometries. This research thus presents a methodology shift in urban design, proposing a symbiotic approach to integrating disparate yet interrelated landscape connectivities within urban contexts.

This paper deals with the design and kinematic analysis of a novel mechanism for the elbow joint of an upper-limb exoskeleton, with the aim of helping operators, in terms of effort and physical resistance, in carrying out heavy operations. In particular, the proposed eight-bar el-bow joint exoskeleton mechanism consists of a motorized Watt I six-bar linkage and a suitable RP dyad, which connects mechanically the external parts of the human arm with the corre-sponding forearm by hook and loop velcro and thus, helping their closing relative motion for lifting objects during repetitive and heavy operations. This relative motion is not a pure rotation and thus, the upper part of the exoskeleton is fastened to the arm, while the lower part is not rigidly connected to the forearm, but through a prismatic pair which allows both rotation and sliding along the forearm axis. Instead, the human arm is sketched by means of a crossed four-bar linkage, which coupler link is considered as attached to the glyph of the prismatic pair, that is fastened to the forearm. Therefore, the kinematic analysis of the whole ten-bar mecha-nism, which is obtained by joining the Watt I six-bar linkage and the RP dyad to the crossed four-bar linkage, is formulated to investigate the main kinematic performance and for design purposes. The proposed algorithm has given several numerical and graphical results. Finally, a double-parallelogram linkage, as particular case of the Watt I six-bar linkage, was considered in combination with the RP dyad and the crossed four-bar linkage, by giving a first mechanical de-sign and a 3D printed prototype.

HIGHLIGHTS Special relativity has been successfully used to describe the behaviour of particles (Rossi & Hall, 1941), but there is no observation of special relativity in our world. On the contrary, there are at least two paradoxes based on special relativity: the twin paradox (Langevin, 1911) and Ehrenfest's paradox (1909). This paper is presenting a first experiment, based on Ehrenfest's paradox, where an effect of special relativity was expected but not observed. The validity of special relativity in our macro world will be questioned and an alternative will be offered. ABSTRACT After presenting the history of special relativity, the non-simultaneity of special relativity is questionned in our macro world. In addition, some incompatibilities between light clocks and the application of Lorentz transformation are presented. All this indicates some issues with special relativity which appears to be correct only for particles and would be invalid in our macro world. A new theory is presented based on an adaptation of special relativity; this new theory solves the anomalies and could be a solution to the twin paradox. This paper also presents a new experiment and its observation. The preliminary result shows that special relativity has no effect in our macro world and therefore supports the new theory. A lack of special relativistic effects has been observed in the universe (Davis et al., 2004); that is another observation where special relativity doesn't work. That second observation is also explained with the new theory.

This article examines the integration of artificial intelligence (AI) and robotic process automation (RPA) in financial accounting and management, underscoring their role in driving the digital transformation of corporate finance. It discusses the shortcomings of traditional financial processes and highlights the potential of AI and RPA technologies to enhance efficiency, accuracy, and cost-effectiveness. The paper also explores the limitations of RPA, such as its challenges in processing unstructured data and handling complex decision-making scenarios. Looking forward, it considers the future trends in AI and RPA, emphasizing the benefits of cloud technology in scaling automated systems and addressing associated challenges.

The periodontal ligament (PDL) is a complex connective tissue that connects the tooth root to the dental alveolar bone and plays crucial mechanical roles. PDL also exhibits regenerative roles and regulatory functions to maintain per-iodontium integrity and homeostasis. While PDL exposure to oral microbial pathogens is common, virtually nothing is known regarding viral infections of PDL. In particular, human herpes simplex virus type 1 (HSV-1) persistently infects the oral cavity through infections of the oral epithelium, connective tis-sue and neurons. While the oral spread of HSV-1 is generally asymptomatic, this virus has also been implicated in various oral pathologies. In this study, using a primary cell model derived from PDL (PDL-cells), and whole surgical fragments of PDL, we provide evidence supporting the efficient infection of PDL by HSV-1 and the promotions of cytopathic effects. Infection of PDL by HSV-1 was also associated with an acute innate inflammatory response, as il-lustrated by the production of the antiviral interferons and pro-inflammatory cytokines. Furthermore, this inflammatory response to HSV-1 was exacerbated in the presence of bacterial-derived products, such as peptidoglycans. This work therefore highlights the ability of HSV-1 to infect mesenchymal cells from PDL, suggesting that PDL may serve as a viral reservoir for the perio-dontal spread of HSV-1. Moreover, this raises questions about HSV-1 oral pathogenesis, as HSV-1-associated cytopathic and inflammatory effects may contribute to profound alterations of PDL integrity and functioning.

Epithelial barrier damage plays a central role in the development and maintenance of allergic inflammation. The rise in airways epithelial barrier permeability alters the tissue homeostasis and allows the allergen and other external agents penetration. Different factors contribute to barrier impairment, such as eosinophilic infiltrate and allergens proteases action: the eosinophilic cationic proteins and the allergens' proteolytic activity have a central role in contributing to epithelial damage. In the airways, the allergens proteases degrade the epithelial junctional proteins allowing the allergen penetration and the uptake by dendritic cells. The increase in allergen-immune system interactions induce the release of the alarmins and the activation of type 2 inflammatory pathways causing, or worsening, the main symptoms at skin, bowel and respiratory levels. We aim to highlight the molecular mechanisms underlying allergenic proteases-induced epithelial barrier damage and the role of immune response in allergic asthma onset, maintenance and progression. We further will explore clinical and radiological potential biomarkers of airways remodeling in allergic asthma patients.

Avian influenza viruses (AIVs) are highly contagious respiratory viruses of birds, lead-ing to significant morbidity and mortality globally and causing substantial economic losses to the poultry industry. Since their first isolation in 2013, the Asian-origin H5N1 highly pathogenic avian influenza viruses (HPAI) of clade 2.3.4.4b have undergone unprecedented evolution and re-assortment of internal gene segments and have spread to Asia, Europe, Africa, and America, caus-ing outbreaks in all the poultry categories. Novel epidemiological and pathobiological character-istics, distinct from other clades, are specific of clade 2.3.4.4b viruses. Wild waterfowl, the natu-ral reservoir of AIVs, are frequently found infected with clade 2.3.4.4b viruses, which can also cause high morbidity and mortality in these birds. The sustained clade 2.3.4.4b virus circulation in waterfowl has also led to virus infection in other wild bird species, with implications for the conservation of endangered species. Furthermore, clade 2.3.4.4b viruses have been isolated in var-ious wild and domestic mammals worldwide, and critical mutations related to virus adaptation to mammalian species have been identified, raising concerns about virus spillover to humans. The main clinical signs, and anatomopathological findings associated to clade 2.3.4.4b virus infection in birds and non-human mammals are hereby summarized.

: Microplastics and nanoplastics (MNPs) are becoming an increasingly severe global problem due to their widespread distribution and complex impact on living organisms. Apart from their environmental impact, the effects of MNPs on living organisms have also continued to attract attention. The harmful impact of MNPs has been extensively documented in marine invertebrates and larger marine vertebrates like fish. However, the research on the toxicity of these particles on mammals is still limited, and their possible effects on humans are poorly understood. Considering that MNPs are commonly found in food or food packaging, humans are primarily exposed to them through ingestion. It would be valuable to investigate the potential harmful effects of these particles on gut health. This review focuses on recent research exploring the toxicological impacts of micro- and nanoplastics on the gut, as observed in human cell lines and mammalian models. Available data from various studies indicate that the accumulation of MNPs in mammalian models and human cells may result in adverse consequences, in terms of epithelial toxicity, immune toxicity, and disruption of gut microbiota. The paper also discusses the current research limitations and prospects in this field, aiming to provide a scientific basis and reference for further studies on the toxic mechanisms of micro- and nanoplastics.

This paper is dedicated to examining dynamic dark energy models in the context of observational constraints and their implications for the universe's future. By integrating theoretical models with various observational data, we aim to provide a comprehensive view of how dynamic dark energy influences cosmic evolution and the universe's fate. This study tests these models against the latest observational evidence, including the Cosmic Microwave Background, supernovae, and large-scale structure surveys, to refine our understanding of the universe's accelerating expansion and the mysterious nature of dark energy.

In this preliminary investigation, a concise molecular docking study using the Pyrx program screened thousands of compounds against the active site of HIV-1 reverse transcriptase. The Virtual Screening library was employed to assess binding energetics scores, focusing on identifying candidates with high Vina Scores. Eight compounds, including Tetrophan, Imatinib, Amentoflavone, Alprazolam, Bilobetin, Bafetinib, Nilotinib, and Ginketin, emerged as promising candidates with significant binding energies.Recognizing compounds that strongly bind to HIV-1 reverse transcriptase holds potential for antiretroviral drug development in the fight against HIV infection. Subsequently, the study evaluated the toxicity properties of these candidates using pKCSM. Amentoflavone, a natural biflavonoid found in Ginkgo biloba and Nilotinib, a tyrosine kinase inhibitor, demonstrated lower overall toxicity profiles compared to other candidates. Further toxicity analysis using Pro-Tox-II revealed Amentoflavone's higher predictive LD50, lower toxicity class, and reduced probabilities of hepatotoxicity, carcinogenicity, mutagenicity, and moderate immunotoxicity compared to Nilotinib. While Nilotinib, a pharmaceutical drug, exhibited higher probabilities of adverse effects in these categories. In summary, Amentoflavone and Nilotinib present as promising candidates with lower toxicity concerns. Amentoflavone, as a natural substance, showcases a more favorable toxicity profile than Nilotinib, offering valuable insights for potential therapeutic applications.

A typical halogen-free flame-retardant (HFFR) formulation for electric cables may contain polymers, various additives, and fire-retardant fillers. In this study, composites are prepared by mixing natural magnesium hydroxide (n-MDH) with linear low-density polyethylene (LLDPE) and a few types of ethylene-octene copolymers (C₈-POE). Depending on the content of LLDPE and C₈-POE, we obtained composites with different crystallinity that affected the final mechanical properties. The nucleation effect of the n-MDH and the variations in crystallinity caused by the blending of C₈-POE/LLDPE/n-MDH were investigated. In the C₈-POE/LLDPE blend, we found a decrease in the crystallization temperature of LLPDE compared to pure LLDPE and an increase in the crystallization temperature of C₈-POE compared to pure C₈-POE. On the contrary, the addition of n-MDH led to an increase in the crystallization temperature of LLDPE. As expected, the increase in the crystallinity of the polyolefin matrix of composites led to higher elastic modulus, higher tensile strength, and lower elongation at break. Overall, these results show how to obtain the required mechanical features for halogen-free flame-retardant compounds for electric cable applications depending on the quantities of the two miscible components in the final blend.

Respiratory viral infections (RVI) are common reasons for healthcare consultations. The inpatient management of RVI consumes significant resources. From 2009-2014, we assessed the costs of RVI management in 4776 hospitalized chil-dren aged 0-18 years participating in a quality improvement program, where all ILI patients underwent virologic testing at the National Reference Centre followed by de-tailed recording of their clinical course. The direct (medical or non-medical) and indirect costs of inpatient management outside the ICU (“non-ICU”) versus management requiring ICU-care (“ICU”) added up to 2,767.14€ (non-ICU) vs. 29,941.71€ (ICU) for Influenza, 2,713.14€ (non-ICU) vs. 16,951.06€ (ICU) for RSV infections, and 2,767.33€ (non-ICU) vs. 14,394.02€ (ICU) for human rhinovirus (hRV) infections, respectively. Non-ICU inpatient costs were similar for all 8 RVI studied: Influenza, RSV, hRV, ade-novirus (hAdV), metapneumovirus (hMPV), parainfluenzavirus (hPIV), bocavirus (hBoV) and seasonal coronavirus (hCoV) infections. ICU-costs for Influenza however, ex-ceeded all other RVI. At the time of the study, Influenza was the only RVI with antivi-ral treatment options available for children, but only 9.8% of Influenza patients (non-ICU) and 1.5% of ICU-patients with Influenza received antivirals; only 2.9% were vac-cinated. Future studies should investigate the economic impact of treatment and pre-vention of Influenza-, COVID-19-, and RSV post vaccine introduction.

Costa Rica, renowned for its environmental sustainability, faces a pressing waste management crisis that threatens its ecological and public health achievements. This study provides a comprehensive analysis of Costa Rica's waste management challenges, focusing on urban areas like San José, where nearly half of the nation's waste is generated. Key issues include insufficient landfill capacity, a low recycling rate of 9.6%, and significant regional disparities in waste practices. Employing a hybrid modeling approach with Linear Regression and ARIMA models, the study forecasts CO2e emissions and waste minimization trends from 2024 to 2050, highlighting the critical role of public participation and innovative waste management strategies.The introduction of a Waste Management Innovation Index allows for a comparative analysis, positioning Costa Rica against global leaders like Germany and South Korea, and identifying areas where significant improvements are needed. The study also incorporates stakeholder perspectives to reveal the complex interplay of cultural, economic, and regulatory factors influencing waste management policies.Findings indicate that despite government initiatives like the Environmental Health Route and the National Circular Economy Strategy, success has been limited, particularly in rural areas. The study underscores the necessity of enhancing infrastructure, launching targeted public education campaigns, and adopting advanced technologies such as AI and blockchain to achieve sustainable waste management. Strategic recommendations are provided to help Costa Rica align its waste management practices with global standards.

This paper discusses the application of artificial intelligence in imaging omics, especially in cancer research. Imaging omics enables detailed analysis of spatial and temporal heterogeneity of tumours through high-throughput extraction of quantitative features from medical images such as MRI, PET, and CT. This paper focuses on applying PARKS systems to automate the recognition, segmentation, and extraction of image features, significantly enhancing the capabilities of clinical decision support systems (CDSS). The future direction is to establish a robust network infrastructure for radiology Medication-led Health care (RLHC) to facilitate the development and application of personalised treatment protocols, and to improve diagnostic accuracy, prognosis assessment, and treatment recommendations by uploading quantitative image features to a shared database and comparing them with historical images.

The analysis of aggregate data has received increasing attention in the statistical discipline over the past 20 years. Much of this attention has been focused on estimating the cells frequencies of a 2×2 contingency table given only the marginal totals; the analyses proposed have been received with missed reviews. More recently, the focus has shifted toward analysing the overall association structure rather than on the estimation of the cell frequencies. This article provides some insight int how informative the aggregate data of a single 2×2 contingency table is for assessing the association. The information contained in the margins of the table is quantified using the squared deviation of the expected cell frequencies over the possible range of values, where the row and column totals are known and fixed. The new measure we discuss to quantify this association is referred to as the aggregate informative index (AII) and is shown to be the standardized area under the squared deviation curve.

Complexity science studies physical phenomena that cannot be explained by the mere analysis of the single units of a system but requires to account for their interactions. A feature of complexity in connected systems is the emergence of mesoscale patterns in a geometric space, such as groupings in bird flocks. These patterns are formed by groups of points that tend to separate from each other, creating mesoscale structures. When multidimensional data or complex networks are embedded in a geometric space, some mesoscale patterns can appear respectively as clusters or communities, and their geometric separability is a feature according to which the performance of an algorithm for network embedding can be evaluated. Here, we introduce a framework for the definition and measure of the geometric separability (linear and nonlinear) of mesoscale patterns by solving the travelling salesman problem (TSP), and we offer experimental evidence on embedding and visualization of multidimensional data or complex networks, which are generated artificially or are derived from real complex systems. For the first time in literature the TSP’s solution is used to define a criterion of nonlinear separability of points in a geometric space, hence redefining the separability problem in terms of the travelling salesman problem is an innovation which impacts both computer science and complexity theory.

Instagram is a popular social media platform among youth, with over a billion active users worldwide. The platform allows users to share photos, videos, and stories and connect with friends and followers. Instagram has become a significant part of youth culture, with many young people spending a considerable amount of time on the app. According to Enterprise (2012:02), Instagram is a community shared among one member with other members from all over the world. This study examines the impact of Instagram on the physical and mental well-being of Indian youth. With the rapid proliferation of social media platforms in India, Instagram has emerged as a prominent influence on the lives and perceptions of young individuals. Studies have shown that using Instagram among youth can have positive and negative effects. On the positive side, Instagram can be a way for young people to express themselves, connect with others, and discover new interests. However, excessive use of the platform can also lead to negative outcomes, such as social comparison, anxiety, and low self-esteem. Instagram addiction among youth is a growing concern. Some young people may feel compelled to check their accounts frequently and may experience negative emotions if they are unable to do so. In extreme cases, excessive use of the platform can interfere with daily activities and relationships, leading to a negative impact on mental health. Parents and educators can play a role in helping young people manage their Instagram use. This can include setting limits on screen time, encouraging healthy online habits, and promoting offline activities and social interaction. Additionally, mental health professionals can offer support to young people who are struggling with addiction or other negative effects of Instagram use. This study explores the prevalence of Instagram dependency among Indian youth.

Product attribute extraction is an growing field in e- commerce business, with several applications including product ranking, product recommendation, future assortment planning and improving online shopping customer experiences. Under- standing the customer needs is critical part of online business, specifically fashion products. Retailers uses assortment planning to determine the mix of products to offer in each store and channel, stay responsive to market dynamics and to manage inventory and catalogs. The goal is to offer the right styles, in the right sizes and colors, through the right channels. When shoppers find products that meet their needs and desires, they are more likely to return for future purchases, fostering customer loyalty. Product attributes are a key factor in assortment planning. In this paper we present PAE, a product attribute extraction algorithm for future trend reports consisting text and images in PDF format. Most existing methods focus on attribute extraction from titles or product descriptions or utilize visual information from existing product images. Compared to the prior works, our work focuses on attribute extraction from PDF files where upcoming fashion trends are explained. This work proposes a more comprehensive framework that fully utilizes the different modalities for attribute extraction and help retailers to plan the assortment in advance. Our contributions are three-fold: (a) We develop PAE, an efficient framework to extract attributes from unstructured data (text and images); (b) We provide catalog matching methodology based on BERT representations to discover the existing attributes using upcoming attribute values; (c) We conduct extensive experiments with several baselines and show that PAE is an effective, flexible and on par or superior (avg 92.5% F1-Score) framework to existing state-of-the-art for attribute value extraction task.

Strong-aroma Baijiu is a traditional Chinese spirit distilled from grains that undergo solid-state fermentation. At the end of each fermentation cycle, a significant quantity of Huangshui accumulates at the bottom of the fermentation pit, constituting one of the primary by-products in the brewing process of strong-flavor liquor. In this report, the chemical component analysis of Huangshui obtained from a strong-flavor liquor factory revealed a diverse array of organic acids, alcohols, esters, starch, reducing sugars, amino acids, and other compounds present in Huangshui. Additionally, two specialized solid-state fermentation models were developed to investigate the formation process of Huangshui. Our findings demonstrate a positive correlation between the yield of Huangshui and the initial moisture content of fermented grains. It is concluded that Huangshui is the percolate produced during the solid-state brewing process of strong-flavor liquor, with its water content originating from the initial moisture of fermented grains.

Background/Objectives: Although the role of F-18 FDG PET/CT imaging is well established in oncology, its diagnostic value in routine monitoring for recurrent colorectal cancer (CRC) is still controversial. The aim was to evaluate the diagnostic value of FDG PET/CT in detecting recurrent CRC in correlation with CEA, CA 19-9 levels, and conventional imaging modalities (CIM). Methods: Between 2009 and 2023, we retrospectively studied 134 CRC patients referred for FDG PET/CT imaging on the suspicion of recurrence based on elevated CEA and/or CA 19-9, and/or equivocal radiological findings. According to the Institutional Tumor Board CRC protocol, after initial treatment which was dependent on TNM stage (neoadjuvant therapy, primary resection or adjuvant treatment), patients underwent a standard 5-year surveillance including CEA and CA 19-9 measurements, CIM, and colonoscopy every 6 months. The statistics including univariate and multivariable analyses were conducted using the IBM SPSS 20.0 statistical software. P-values <0.05 were considered statistically significant. Results: Recurrent CRC was confirmed in 54/134 (40.3%) patients with elevated tumor markers. FDG PET/CT shows high diagnostic performance in detecting recurrent CRC with sensitivity, specificity, PPV, NPV, and accuracy of 94.4%, 82.5%, 78.5%, 95.7%, and 87.3%, respectively. The CEA shows a high sensitivity of 98.1%, but both low specificity and accuracy of 15% and 48.5%, respectively. The sensitivity, specificity, and accuracy, for CA 19-9 and CIM for the correct diagnosis in CRC patients were: 44.4%, 67.5%, 58.2%, and 51.9%, 98.8%, 79.9%, respectively. The AUC for FDG PET/CT, elevated CEA levels, CIM, and elevated CA 19-9 levels was 0.885 (95% CI: 0.824-0.946; p<0.001), 0.844 (95% CI: 0.772-0.916; p<0.001), 0.753 (95% CI: 0.612-0.844; p<0.001); and 0.547 (95% CI: 0.442-0.652; p=0.358). Univariate analysis shows that both FDG PET/CT- and CIM-positive results were highly associated with CRC recurrence (p<0.001 and p<0.001, respectively), while gender, mucinous tumor type, presence of initial lymph node metastasis (N+), and presence of initial distant metastasis (M+) have no significance (p=0.211, p=0.158, p=0.583, and p=0.201, respectively). Our multivariate analysis shows that independent predictors for CRC recurrence are: positive FDG PET/CT scans (p<0.001), positive CIM results (p=0.001) and elevated CA19-9 levels (p=0.023). Although CA 19-9 was not detected as a statistically significant predictor in the univariate analysis (p=0.358), in a multivariate analysis it was recognized as a significant predicting factor in detecting CRC recurrence (p=0.023). Conclusions: FDG PET/CT shows a high diagnostic efficacy in CRC recurrence detection, in correlation with CEA levels, CA 19-9 levels, and CIM. This imaging modality should be routinely integrated into the postoperative follow-op in patients with elevated tumor markers.

A recent study revealed a persistent presence of the PP-Spike recombinant protein in 50% of individuals who received ModRNA injections, contrasting with unvaccinated controls, whether SARSCoV-2 infected or not, up to 187 days post-injection. The implications of these findings are discussed in the context of PP-Spike recombinant protein-induced hyperimmune/inflammatory reactions and thrombotic vasculitis as mechanisms to elucidate the serious side effects, long-term organ complications, and excess deaths observed after administering Covid ModRNA products. These results underscore the urgent need for a comprehensive reassessment of the risk-benefit profile of ModRNA injections, including an immediate halt in their use for any person, and a renewed emphasis on understanding and addressing their long-term effects on human health

Aim: the main aim of this study is to compare the onset of effectiveness of mental nerve block with lingual infiltration and inferior alveolar nerve block on patients visiting dental hospital for extraction of mandibular anterior teeth. Materials and methods: The study was set in a clinical setting. This was a randomized controlled double-blind cross study, where 25 subjects received two treatments at an interval of at least 1 week in a within a dental hospital.Inferior alveolar nerve block and lingual nerve block injection is given with 2mL lignocaine 2% with 1:2,00,000 epinephrine was administered for the right side. Mental nerve block along with lingual infiltration of the corresponding tooth was given with 2mL lignocaine 2% with 1:2,00,000 epinephrine was administered on the left side.Visual analogue scale (VAS) was used in this study, which consists of a scale with range of 0-10 pain severity on which 0 indicated absence of pain and 10 the worst pain possible. The patients were asked to give scores corresponding to his/her pain, after IANB, mental nerve block and lingual infiltration and these scores were recorde.Results: From the results we can see that patients gave scores between 3-4, stating that they had moderate pain during extraction after administration of IANB (54%) (graph 2) and VAS scores of 0-1 were given by patients, which is suggestive of no pain during extraction after administration of Mental nerve block and lingual nerve infiltration (62%)Conclusion: Within the limits of the study we can conclude that mental nerve block along with lingual infiltration is an effective way to completely and quickly anaesthetise the central incisor to the 1st premolar region.

Flavin-dependent monooxygenases (FMOs) have made substantial influence as catalysts for monooxygenation reactions, impacting diverse field such as drug metabolism, environmental studies, and natural product synthesis. Their application in biocatalysis boasts several advantages over conventional chemical catalysis, such as heightened selectivity, safety, sustainability, and eco-friendliness. In the realm of biomedicine, FMOs are pivotal in antibiotic research, modulating natural products, antimicrobial agents, and pathways involved in drug synthesis. They're also underscored as potential pharmaceutical targets, pivotal in disease progression and viable for therapeutic intervention. Additionally, FMOs play a substantial role in environmental science, especially in pesticide processing and plant vitality. Their involvement in biosynthesizing compounds like polyethers, tropolones, and ω-hydroxy fatty acids, with remarkable regio- and stereoselectivity, renders them indispensable in drug discovery and development. As our comprehension of FMOs' catalytic mechanisms and structures advances, coupled with cutting-edge biotechnologies like computational design and directed evolution, FMOs are poised to occupy an increasingly significant role in both scientific exploration and industrial applications.

Hund's rule of maximum multiplicity is a powerful empirical tool for determining the electron population of electronic shells. It was recently discovered that it is also the rule of minimum Shannon entropy. This study extends these findings to the Aufbau rule and discusses them from the perspective of emergent dimensionality, providing a monotonically increasing entropy function. We observed that some elements that violate the Aufbau rule have the same entropies in the actual and Aufbau electron configurations. On the other hand, lower entropies of all actual elements' configurations are associated with higher or equal numbers of unpaired electrons in these configurations compared to the Aufbau configurations. The only exception to this rule is palladium.

Introduction After the first use of infliximab in Crohn’s disease in 1995, the wide scale introduction of anti-tumour necrosis factor alfa (anti-TNF alfa) medications revolutionized the treatment of inflammatory bowel diseases (IBD’s). During the last two decades an increased number of molecules with multiple mechanisms of action were approved for the treatment of IBD with substantial increase of the costs of related to therapy. The increasing costs and access to therapy became a concern of payers and regulators but also for healthcare professionals. Biosimilars are biologic medical products that are highly structurally identical to their reference products and without any clinically meaningful differences in immunogenicity, safety or effectiveness. The introduction of biosimilars was seen as a way to provide a lower-cost alternative to the originator anti-TNF molecules and hence to increase treatment access and availability for patients. Material and methods This an observational, prospective study conducted in two IBD centers in Bucharest. The study included 53 patients, 27 male(M) and 26 female(F), diagnosed with UC or BC according to standard clinical,endoscopic, radiological, histological criteria that were non medically switched to a biosimilar. All patients completed at least the induction treatment with the originator adalimumab and they were clinically stable. After switch they received one of the market available biosimilars of Adalimumab(Hukyndra, Imraldi or Hyrimoz). For each patient, the following data were collected: age, sex, BC or UC diagnosis, previous and current therapy, clinical evolution, endoscopic scores as well as several biological markers. Aim The primary objective was the maintenance of clinical remission at twelve months after switching the original Adalimumab treatment to the biosimilar Adalimumab. The secondary objectives were to evaluate the presence of adverse effects and the treatment persistence at one year. Results In our population, there were 42 patients with Crohn's disease and 11 with ulcerative colitis who switched from the originator adalimumab to a biosimilar Adalimumab. The average age was 44,07 years old for patients with BC and 51,72 years old for patients with UC. No significant differences were found in terms of CF and CRP levels at 6 and 12 months after changing the originator biologic treatment to a biosimilar. Only one patient required changing the biological treatment, following the clinical and biological loss of response. The main adverse effect reported by patients was pain at the injection site. Of the 53 patients, only 2 patients reported pain at the injection site, but this was considered not significant because the patients had a BMI below 20 and they also reported the same symptom when administering the originator. One patient reported experiencing abdominal pain and rectal bleeding immediately after switch, but no recurrence was observed clinically and endoscopically. Conclusion: This observational study is the first carried out in Romania that shows that the after the non-medical switch, biosimilars of Adalimumab were as efficient as the originator Adalimumab in the clinical practice of patients with IBD. These results support that conclusion that the large-scale use of biosimilars does not significantly affect the effectiveness of the therapy and the safety of the patient.

Este estudio examina la implementación de redes bayesianas para el diagnóstico de afecciones respiratorias utilizando datos clínicos. Se analizaron 5725 registros de una clínica privada en Francia, obtenidos de Kaggle, centrándose en seis variables clave: glucosa en sangre, frecuencia cardíaca, saturación de oxígeno, presión arterial, temperatura y estado de salud del paciente. El objetivo era crear un modelo que mejorara la precisión y eficiencia en el diagnóstico de infecciones respiratorias. Se desarrolló una red bayesiana para modelar las interacciones fisiológicas en condiciones respiratorias, destacando la influencia de la glucosa en sangre en la oxigenación y la interacción entre la frecuencia cardíaca y la saturación de oxígeno. La mediana de la temperatura corporal fue de 38,18 °C y la mediana de la frecuencia cardíaca fue de 92,00 lpm. El modelo, basado en sólidos principios médicos, considera tanto los mecanismos patológicos directos como las respuestas compensatorias del cuerpo. Se utilizó Netica para la simulación y análisis del modelo, proporcionando una visualización clara de las probabilidades condicionales y las relaciones entre las variables. Los hallazgos demuestran que las redes bayesianas son herramientas efectivas para apoyar el diagnóstico de afecciones respiratorias, proporcionando una evaluación integral del estado de salud del paciente. La matriz de confusión reveló una precisión del 94%, una especificidad del 100% y una sensibilidad del 86,53%. Además, la calidad de la prueba para el estado "enfermo" mostró una sensibilidad de hasta el 98,49% y una especificidad de hasta el 98,85%, con un área bajo la curva ROC (AUC) de 0,9592. Estos resultados indican que el modelo tiene un alto rendimiento en la clasificación correcta de los casos de salud y enfermedad normales. Este enfoque tiene el potencial de mejorar la precisión y la eficiencia del diagnóstico, especialmente en entornos clínicos que requieren decisiones rápidas y precisas. Este estudio destaca la aplicación innovadora de las redes bayesianas en medicina respiratoria, ofreciendo una herramienta prometedora para mejorar el diagnóstico y el manejo de pacientes con afecciones respiratorias, y estableciendo una base para futuras investigaciones en el uso de métodos probabilísticos en el diagnóstico médico.

Robotic systems are increasingly being used in healthcare to improve patient care and support healthcare professionals. These robots are especially effective at performing repetitive tasks. In complex cancer cases, robots can enhance surgical precision and efficiency, resulting in reduced pain for patients and a lower risk of complications. Robot-assisted surgery offers high-quality 3D imaging, improved clarity, and increased efficiency. This review paper examines the application of Artificial Intelligence (AI) and robotic systems in the healthcare domain, specifically focusing on the interaction among operators, patients, and robots. The goal is to promote collaboration and improve healthcare provision through human-robot interaction. We considered already published articles by relevance, to identify the primary safety issues that need addressing for the integration of AI and robots in hospitals. Concluding with insights into understanding the focal points of social errors in Human-Robot Interaction (HRI) is crucial for mitigating these errors. While current technologies have reached a certain level of maturity, there are still numerous challenges in utilizing robot-assisted clinical practice, including technological, safety, clinical, financial, insurance, psychological, social, ethical, and legal issues. In addition, there is an urgent issue that needs to be addressed: the alignment of values in artificial intelligence, ensuring that AI systems reflect ethical principles and human values is crucial to avoid negative consequences such as bias, discrimination, and prejudicial decisions. Resolving this complex issue requires collaboration among clinical staff, researchers, programmers, and political decision-makers from various fields.

Suboptimal knowledge of clinical pharmacology, therapeutics, and toxicology (CPT) and poor-quality prescribing are threats to patient safety. Our previous national survey of medical faculty identified limited confidence in medical student graduates’ ability to prescribe safely and an interest in a national prescribing competence assessment. Given the in-person challenges posed by the restrictions related to the COVID-19 pandemic, we aimed to re-evaluate opinions and gauge interest in e-learning resources and assessments. Using public sources, a sampling frame of medical school leaders from all 17 Canadian medical schools, including deans, vice-deans, and program directors for clerkship, residency, and e-learning, were invited to participate in a cross-sectional survey. Survey questions were finalized after several rounds of testing and analyses were descriptive.Of 1448 invitations, 411 (28.4%) individuals reviewed the survey, and among them, 278 (67.6%) completed at least one survey question with representation from all schools. While more than 90% of respondents agreed that medical students should meet a minimum standard of prescribing competence, only 17 (7.9%) could vouch for their school meeting objectives in CPT and many had significant concerns about their own or other schools’ recent graduate prescribing abilities. Given the lack of local CPT eCurricula resources, there was strong interest in a national online course and assessment in CPT. Our national survey results suggest an ongoing inadequacy of medical trainees’ prescribing competence and provide a strong endorsement for both a national online CPT course and assessment during medical school.

Introduction: At the end of 2019 the Covid-19 pandemic caused a huge amount of restrictions across the world which affected teaching around the world as it was not prepared to move from traditional face-to-face to an online conversion overnight, so the aim of this paper is to determine the changes in undergraduate anatomy teaching strategies post-pandemic compared to pre-pandemic. Methods: A systematic review was conducted based on the PRISMA statement. Data were retrieved from the searches conducted in the different databases, and the articles to be retrieved were selected with the help of the Rayyan platform. Using the OPMER and JBI tools, the quality of evidence was assessed for the selection of the articles included in the review. Results: The teaching of medicine, specifically anatomy, presented serious problems due to the fact that throughout history it has been taught in the classroom by means of cadaveric dissection and when this ceased to be available, new methods arose through the use of digital resources to try to make up for the needs of the lack of dissection laboratories which lost a great deal of content in this restructuring, which have been improving with the passing of the courses taught and the development of new material that has been better adapted to the needs of the students. Discussion: The authors agree that in the future the best way to teach anatomy will continue to be face-to-face dissection without neglecting the strategies developed during this pandemic and to be taken if necessary to restructure curricula in the future to improve teaching.

Recently, Artificial Intelligence (AI)-based algorithms have revolutionized the medical image segmentation processes. Thus, the precise segmentation of organs and their lesions may contribute to an efficient diagnostics process and a more effective selection of targeted therapies as well as increasing the effectiveness of the training process. Thus, AI may contribute to the automatization of the image scan segmentation process and increase the quality of the resulting 3D objects, which may lead to the generation of more realistic virtual objects. In this paper, we focus on the AI-based solutions applied in the medical image scan segmentation, and intelligent visual-content generation, i.e. computer-generated three-dimensional (3D) images in the context of Extended Reality (XR). We consider different types of neural networks used with a special emphasis on the learning rules applied, taking into account algorithm accuracy and performance, as well as open data availability. This paper also attempts to summarize the current development of AI-based segmentation methods in medical imaging and intelligent visual content generation that are applied in XR. Finally, this paper concludes with possible developments and open challenges in AI application in Extended Reality-based solutions. Finally, the future lines of research and development directions of Artificial Intelligence applications both in medical image segmentation and Extended reality-based medical solutions are discussed.

Spinal deformity refers to a range of disorders that are defined by anomalous curvature of the spine and may be classified as scoliosis, lordosis, or kyphosis. Among these, scoliosis stands out as the most common type of spinal deformity in human beings, and it can be distinguished by abnormal lateral spine curvature accompanied by axial rotation. Accurate identification of spinal deformity is crucial for a person's diagnosis, and numerous assessment methods have been developed by researchers. Therefore, the present study aims to systematically review recent works on spinal deformity as-assessment for scoliosis diagnosis, utilizing image processing techniques. To gather relevant studies, a search strategy was conducted on three electronic databases (Scopus, ScienceDirect, and PubMed) between 2012 and 2022, using specific keywords and focusing on scoliosis cases. A total of 17 papers fully satisfied the established criteria and were extensively evaluated. Despite variations in methodological designs across the studies, all reviewed articles obtained quality ratings higher than satisfactory. Various diagnostic approaches have been employed, including artificial intelligence mechanisms, image processing, and scoliosis diagnosis systems. These approaches have the potential to save time and, more significantly, can reduce the incidence of human error. While all assessment methods have potential in scoliosis diagnosis, they possess several limitations that can be ameliorated in forthcoming studies. Therefore, the findings of this study may serve as guidelines for the development of a more accurate spinal deformity assessment method that can aid medical personnel in the real diagnosis of scoliosis.

Fractures of the talar neck and body are associated with spine fractures and scoliosis deformity, which affect cosmetic appearance and cause difficulty in ambulation. The implant design for talus surgery is thriving as a functional alternative in case of severe talar destruction, focusing on segmentation and reconstruction of the talus’s shape. However, manual segmentation of the talus is time-consuming and subjective. In this study we exploited the automatic segmentation framework to efficiently train a deep learning-based model to accurately segment the talus based on computed tomography imaging. We developed three model configurations with nnU-Net and investigated their Dice similarity coefficients (DSC) and 95% Hausdorff distances (HD95) for talus segmentation on a CT image dataset. The three configurations performed well (DSC > 0.95, HD95 < 0.6). When tested on the same samples, one of the configurations was more efficient while ensuring higher accuracy. We propose to focus on talus anatomic variations with increasing age based on this framework and apply it to clinical trials at the next stage.

: BACKGROUND: The prevalence of smoking among students is a growing concern, particular-ly among medical students. Being associated with stress, competitiveness, and various social in-fluences, smoking can have detrimental effects on self-esteem and self-efficacy and may create a vicious cycle that may contribute to students’ well-being and academic performance out-comes.METHODS: A cross-sectional study on 456 medical students was conducted via an online survey using structured questionnaires on socio-demographic characteristics, smoking habits, nicotine dependence, self-esteem, and self-efficacy. RESULTS: The prevalence of smoking was 31.1% The scores of self-esteem and self-efficacy were positively correlated with smoking habits (W1=0.957, W2=0.975, P<0.05). Students presented rather low smoking addiction with male stu-dents having slightly higher scores than female students on self-esteem and self-efficacy, mili-tary students had higher self-esteem scores than civilians with physical activity having a posi-tive correlation with non-smoking behavior. CONCLUSION: According to our results, self-esteem and self-efficacy were slightly positively correlated with smoking habits. Furthermore, there was no statistically significant association between other social factors and smoking. Our results may develop a theoretical basis for medical students’ psychological variables studying for further implementation of university educational programs and preventive interventions em-powering students towards an overall better quality of life, addressing, among others, smoking behaviors.

Chronic non-cancer pain is a highly debilitating condition affecting approximately 20% of the global population. Chronic pain may lead to significant physical disability, emotional distress, social isolation and financial burden. Whilst^. pharmacological therapies remain the cornerstone of pain management in non-cancerous chronic pain, factors including the current opioid epidemic have led to non-pharmacological techniques becoming a more attractive proposition. We explored the prevalence of medical device use and their treatment efficacy in non-cancer pain management. A systematic methodology was developed, peer reviewed and published in PROSPERO (CRD42021235384). Key words of medical device, pain management devices, chronic pain, lower back pain, back pain, leg pain and chronic pelvic pain using Science direct, PubMed, Web of Science, PROSPERO, MEDLINE, EMBASE, PorQuest and ClinicalTrials.gov. All clinical trials, epidemiology and mixed methods studies that reported the use of medical devices for non-cancer chronic pain management published between the 1^st of January 1990 and the 30^th of April 2022 were included. 13 studies were included in systematic review, of these 6 were used in the meta-analysis with 173 participants. Our meta-analysis for pain reduction in each study showed that transcutaneous electrical nerve stimulation combined with instrument-assisted soft tissue mobilization treatment and pulsed electromagnetic therapy produced significant treatment on chronic lower back pain patients. Pooled evidence revealed the use of medical device related interventions resulted in 0.7 degree of pain reduction under a 0-10 scale. Significant improvement in disability scores, with a 7.44 degree reduction in disability level compared to a placebo using a 50 score range was also seen. The application of medical devices in patients with chronic pain has gained popularity due to increasingly cost effective techniques, minimally invasiveness and greater awareness of risks associated with pharmacological management. Our analysis has shown that the optimal use of medical devices in a sustainable manner requires further extensive research, needing larger cohort studies with greater gender parity, in a more diverse range of geographical locations.

Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n=76) or control (n=69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points respectively (p&lt;0.05). The control group showed reductions of 1.5 and 1.2 points (p&lt;0.05). The difference in depression (HRDS) between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized effect size (SMD) was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. Limitations include the lack of blinding of study participants and a relatively small sample size.

Introduction. Covid-19 faced the world with serious health and socioeconomic issues. At the very beginning of the pandemics, the vaccine was considered by health authorities and the medical community the only way to curb the spread of the virus. One of the measures that have been proposed to increase vaccinations was the mandatory policy. The purpose of this study was to compare determinants of voluntary and mandatory vaccination among students of Albanian University. Methodology: This cross-sectional study by means of an online survey, was conducted among students enrolled in the private University “Albanian University”, Tirana, Albania during the last week of winter semester 7-14 Feb 2022. Results: 878 students participated in this study, among them 612 (69.7%) were females, 266 (30%) were males. 506 (57%) of the participants were enrolled in Medical Sciences (MS), 372(42.3%) were Non-Medical Science (Non-MS) group. 773 (88%) was vaccinated against Covid-19, 105 (11.8%) were not vaccinated. 466 (53%) reported voluntary vaccination, 412 (46.9%) reported mandatory vaccination. Among students that vaccinated voluntary 266 (57%) were from MS group, 200(42.9%) from Non-MS group. 237(57.5%) of students in mandatory vaccination group were from MS group, 175 (42.4%) from Non-MS. Conlusion. Vaccine safety and efficacy were hindering factors of vaccination. Also, based on the results of this study, the students felt encouraged to vaccinate by the academic staff. This clearly demonstrates that the staff does not lack the skills to enhance stu-dents' knowledge about the risk of infectious diseases and the importance of vaccination. Therefore, to influence as much as possible students’ attitude toward vaccination, comprehensive educational programs including modification of existing curricula should be considered.

Alzheimer’s disease has become a major concern in the healthcare domain as it is growing rapidly. Many researches have been conducted to detect it from MRI images through various deep-learning approaches. However, the problem of the availability of medical data and the privacy of the patients still exists. To mitigate this issue in Alzheimer’s disease detection, we have implemented the federated approach which is found to be more efficient, robust, and consistent compared to the conventional approach. For this, we needed deep excavation on various orientations of MRI images and transfer learning architectures. Then, we utilized the publicly available two datasets (OASIS, and ADNI), and designed various cases to evaluate the performance of the federated approach. In almost all of them, the federated approach achieved better accuracy and sensitivity. In distinguishing between two classes equally, the capability of the models was better in the found model when trained with federated approach compared to the conventional approach. In this approach. MobileNet, which is a low-cost transfer learning architecture, achieved the highest 95.24%, 81.94%, and 83.97% accuracy in OASIS, ADNI, and merged (ADNI+OASIS) test set, which was way higher than the achieved performance in Conventional approach. Moreover, in this approach, only the weights of the model were shared which keeps the original MRI images in their respective hospital or institutions, mitigating the privacy concern in the healthcare domain.

Innovation development in healthcare has paved the path towards the improvement in system efficiency, patient care and cost-effective healthcare services, increasing the overall efficiency of the healthcare system in a significant manner. Electronic medical record system has fostered interoperability and collaboration in healthcare departments by enabling different systems to exchange and use patient data. This trend has been accelerated dominantly by the pandemic, leading to increased use of telemedicine, referring specifically to the use of electronic communication to provide healthcare services remotely. Moreover, an increased prevalence towards the use of artificial intelligence and machine learning in healthcare has contributed effectively towards the rigorous and informed analysis of large amounts of data as well as to identify patterns or trends that may be useful for improving care delivery or identifying potential issues. A unified electronic medical record System that will generate competitive opportunities and success prospects with reference to enhanced interoperability in US healthcare departments, can contribute towards the improvement in the quality and efficiency of care by making it easier for healthcare providers to access and share patient information as well as reducing the risk of errors in effective patient care.

During the creation and integration of a health care system based on medical knowledge graphs, it is necessary to review and select the vocabularies and definitions that best fit the information requirements of the system being developed. This implies the reuse of medical knowledge graphs; however, full importation of knowledge graphs is not a tractable solution in terms of memory requirements. In this paper we present a modularization-based method for knowledge graph reuse. A case study of graph reuse is presented by transforming the original model into a lighter one.

This study is a cross-sectional survey involving physicians around Indonesia aimed to explore physician hesitancy to treat COVID-19 patients after experiencing COVID-19 infection coupled with associated occupational risk factors. The questionnaire was distributed via contact information from the Indonesian Physician Association database. Out of 383 participants, 25.6% suffered from moderate symptoms of COVID-19 and 2.9% were admitted for critical care. Hesitancy to treat suspected, probable, or confirmed COVID-19 patients was found in 20.3% of physicians. A higher hesitancy rate was found in older physicians and those with less experience in treating COVID-19 patients. Specialist trainees and those who work in public hospitals were physicians with the lowest hesitancy in treating COVID-19 patients. There is a significant hesitancy in treating COVID-19 patients among physicians who have suffered from COVID-19 which calls for further action by management and policy makers.

Convolutional neural network architectures have become increasingly complex, which has improved the performance slowly on well-known benchmark datasets in the recent years. In this research, we have analyzed the true need for such complexity. We have introduced G-Net light, a lightweight modified GoogleNet with improved filter count per layer to reduce feature overlaps and complexity. Additionally, by limiting the amount of pooling layers in the proposed architecture, we have exploited the skip connections to minimize the spatial information loss. The investigations on the proposed architecture are evaluated on three retinal vessel segmentation publicly available datasets. The proposed G-Net light outperforms other vessel segmentation architectures by reducing the number of trainable parameters..

Background: Emergency medical services (EMS) are the first health care contact for the majority of stroke patients. However, there is a lack of data on the current paramedics’ hospital-directed feedback and training needs across different health care settings. We aimed to evaluate paramedics’ prehospital stroke care knowledge, training needs, and current status of feedback on suspected stroke patients. Methods: We surveyed paramedics from the Vilnius region from September to November 2019, and compared the answers between the city and the district agencies. The questionnaire content included questions on paramedics’ demographic characteristics, prehospital stroke care self-assessment, knowledge on stroke mimics, stroke training needs, and the importance of hospital-directed feedback on suspected stroke patients. Results: A total number of 161 paramedics were surveyed, with more district paramedics rating their prehospital stroke care knowledge as inadequate (44.8% (95% confidence interval (CI) 32.8–57.6) vs 28.1% (95% CI 20.1–27.8), p = 0.028). In addition, more district paramedics indicated a need for additional stroke training (83.1% (95% CI 71.5–90.5) vs 69.8% (60.0–78.1), p = 0.043). However, respondents reported being the most confident while dealing with stroke (71.3%, 95% CI 63.8–77.7) compared to other time-critical conditions (p < 0.001). Vertigo (60.8%, 95% CI 53.0–68.0), brain tumours (56.3%, 95% CI 48.5–63.8), and seizures (54.4%, 95% CI 46.7–62.0) were indicated as the most common stroke mimics. Only 6.2% (95% CI 3.4–11.1) of respondents received formal feedback on the outcome of suspected stroke patients brought to the emergency department. Conclusion: A high proportion of paramedics self-perceive having inadequate stroke knowledge and an urgent need for further stroke training. The EMS staff indicate receiving an insufficient amount of feedback on suspected stroke patients, even though the usefulness is perceived to be paramount.

The success of total hip arthroplasty depends on the experience of the surgeon, and one of the ways the surgeon currently determines the final implant insertion depth is to listen to the change in audible pitch of the hammering sound. We investigated the use of acoustic vibration emissions as a novel method for insertion quality assessment. A non-invasive contact microphone-based measurement system for insertion depth estimation, fixation and fracture detection was developed using a simplified in vitro bone/implant (n=5). 2583 audio recordings were analysed in vitro to obtain energy spectral density functions. Out of the four main resonant peaks under in vitro conditions, broach insertion depth statistically correlates to increasing 3rd and 4th peak frequencies. Degree of fixation was also observed as higher goodness of fit (0.26-0.78 vs. 0.12-0.51 between two broach sizes, the latter undersized). Finally, however, the moment of fracture could not be predicted. A cadaver in situ pilot study suggests comparable resonant frequencies in the same order of magnitudes with the bone model. Further understanding of the signal patterns are needed for an early warning system diagnostic system for imminent fractures, bone damage, improving accuracy and quality of future procedures.

CVDs are a leading cause of death globally. In CVDs, the heart is unable to deliver enough blood to other body regions. Since effective and accurate diagnosis of CVDs is essential for CVD prevention and treatment, machine learning (ML) techniques can be effectively and reliably used to discern patients suffering from a CVD from those who do not suffer from any heart condition. Namely, machine learning algorithms (MLAs) play a key role in the diagnosis of CVDs through predictive models that allow us to identify the main risks factors influencing CVD development. In this study, we analyze the performance of ten MLAs on two datasets for CVD prediction and two for CVD diagnosis. Algorithm performance is analyzed on top-two and top-four dataset attributes/features with respect to five performance metrics –accuracy, precision, recall, f1-score, and roc-auc – using the train-test split technique and k-fold cross-validation. Our study identifies the top two and four attributes from each CVD diagnosis/prediction dataset. As our main findings, the ten MLAs exhibited appropriate diagnosis and predictive performance; hence, they can be successfully implemented for improving current CVD diagnosis efforts and help patients around the world, especially in regions where medical staff is lacking.

Nutraceuticals are combination of nutrients and pharmaceuticals and these are derived from various plants, microbes and animals too. The food products that are considered as nutraceuticals are categorised based on the availability in the market. It is a medical approach to improve health and remedy for illness. Nowadays there is an increase in shift towards use of nutraceuticals as its usage provides preventive therapies to various chronic diseases. Various natural nutraceuticals are based on extracts from Ginger, turmeric, garlic, amla, cinnamon, aloe vera etc. A wide variety of therapeutic values are provided by them such as anti-inflammatory, antibacterial, antifungal properties, allergy relief, antidiabetic and cardiovascular problems. India is in its infancy stage but have many emerging companies that are trying to meet the demand of growing population. Overall ‘Nutraceuticals’ has been known as a new era of well being, in which the food industry has become a main player.

Introduction: Travel-based continuing medical education (CME) has become a popular format for physicians looking to combine education with travel. Emergency Medicine Update Europe is a biennial accredited CME program combining high quality Emergency Medicine education with structured group activities including cycling, hiking and social activities. This unique design incorporates innovative educational practices but as a whole has not yet been evaluated. Methods: This was a participant observation-based, ethnographic-style case study of the Emergency Medicine Update Europe conference in Provence, France in 2015. Participant interviews and embedded observation methods were used to collect data. Data was then analyzed using thematic content analysis techniques. Results: We describe three phenomena from the data that we feel are highly influential in the success of the program and impact on learning. These include “social engagement and a sense of community”; “the value of a stimulating escape” and “the ‘flat’ faculty-learner relationships”. Discussion: These unique features, prioritized by participants, seem to be key to the apparent success of this model over more traditional CME approaches. To our knowledge this is the first empirical research in this area and improves our understanding of how to leverage these more sociologic components for more effective continuing medical education.

Demand for green technologies and energy is in continuous growth in the last years. Compact efficient antennas are crucial for energy harvesting portable systems. Small antennas have low efficiency. The efficiency of communication and energy harvesting systems may be improved by using efficient passive and active antennas. The system dynamic range may be improved by connecting amplifiers to the printed antenna feed line. Design, design considerations, computed and measured results of wearable meta-materials antennas with high efficiency for energy harvesting applications are presented in this paper. All antennas were analyzed by using 3D full-wave software. The antennas electrical parameters on human body are presented. The directivity and gain of the antennas with Split-ring resonators, SRR, is higher by 2.5dB than the antennas without SRR. The resonant frequency of the antennas with SRR is lower by 5% to 10% than the antennas without SRR.

This paper investigates the role of English language proficiency (ELP) as a measure of cultural integration on U.S. immigrant families’ economic integration, as measured by annual earnings, and health care market integration, as captured by annual medical care spending. Bayesian Markov Chain Monte Carlo (MCMC) estimation of a mixed bivariate ordered probit (MBOP) model of annual earnings and medical care spending is conducted using a nationally representative pooled cross-sectional sample data from the U.S. National Health Interview Surveys (NHIS). The results reveal that limited English proficiency is associated with lower marginal earnings propensities (-$44.83, -$50.66, and -$56.97), and higher marginal medical care spending propensities ($8.09, $6.09, and $4.32) for each of the three decreasing levels of ELP. Furthermore, we find a small yet statistically significant positive 7.2% correlation between immigrant families’ annual earnings and medical care spending propensities. Therefore investing to raise immigrants’ families ELP in the U.S. would not only contribute to more effective socio-economic integration, but also strengthen the U.S. workforce and economy for decades to come.

Cheating during examination is now day serious problem spatially in Ethiopia where many students sit in one class to exam. When cheating occurs in medical schools, it has serious consequences for human life, social values, and the economy. Even though, cheating on exams has existed in any department, with unknown reason, prevalence of cheater among 2^nd year laboratory students were high. So that assessing factors and improving cheating behavior of the students are mandatory to create competitive graduated students. To identify factors and to improve cheating behavior action research study design was conducted among 2^nd year medical laboratory student. Criterion sampling technique was used to selects sixteen cheater students among 2^nd year laboratory students. To gather necessary data, we used focus group discussions, individual interview, open-ended questionnaire and observation and collected information by using hand writing notes. During exam different cheating methods used by students like using a system of signals, writing on hands, desks and copy the other students answer. While the compelling reasons for cheating were like hard courses, hard exams, time pressure and fear of failure. To improve cheating behavior of the student’s different action strategies were taken like prepared exam by using code, arrangement sitting style during exam and sit with brainy students during class, reading and discussion. Most students were trying to done exam by themselves but their results are not good as previously. So that, we need more future action plan to avoid cheating behavior of the students. During, the next action plan we will be taken the remaining main action strategies and action evaluation we will be expected 50% of participants will be avoided their cheater behavior and done exam independently without forced by the environment.

For decades, sepsis research has been motivated by the idea of a dangerous overreaction of the immune system in sepsis. But is it true that the response to sepsis is dysregulated? This review surveys the history of sepsis trials and found that evidence for dysregulation does not exist in many of the physiologic mechanisms of sepsis. It is time to consider the alternative hypothesis, that sepsis traits are often functional, and do more harm than good. This review discusses the implications of this perspective for the future of sepsis research

In the last decades bioresorbable and biodegradable polymers have gained a very good reputation both in research and in industry thanks to their unique characteristics. They are, indeed, able to ensure high performances and biocompatibility, at the same time avoiding post-healing surgical interventions for devices removal. In the medical device industrial use of such biopolymers, it is widely known that product formulation and manufacturing need to follow specific procedures in order to ensure both proper mechanical properties and desired degradation profile. Moreover, also the sterilization method is crucial and its impact on physical properties is generally underestimated. In this work we focused our attention on the effect of different terminal sterilization methods on two commercially available poly(L-lactide-co-ε-caprolactone) with equivalent chemical composition (70% PLA and 30% PCL) and relatively similar initial molecular weight, but different chains arrangement and crystallinity. Results obtained show that crystallinity plays a key role, helping in preserving the narrow distribution of chains and, as a consequence, defined physical properties. These statements can be used as guidelines for a better choice of the most adequate biodegradable polymers in the production of resorbable medical devices.

Machine learning (ML) offers potential opportunities to enhance the learning, teaching and assessments within veterinary medical education including but not limited to assisting with admissions processes as well as student progress evaluations. The purpose of this primer is to assist veterinary educators in appraising and potentially adopting these rapid upcoming advances in data science and technology. In the first section, we introduce ML concepts and highlight similarities/differences between ML and classical statistics. In the second section, we provide a step-by-step worked example using simulated veterinary student data to answer a hypothesis driven question. Python syntax with explanations is provided within the text to create a random forest ML prediction model and within each step, specific considerations such as how to manage incomplete student records are highlighted when applying ML algorithms within the veterinary education field. The results from the simulated data demonstrate how decisions by the veterinary educator during ML model creation may impact the most important features contributing to the model. These results highlight the need for the veterinary educator to be fully transparent during the creation of ML models and future research is needed to establish guidelines for handling data not missing at random in medical education, and preferred methods for model evaluation.

The visual span refers to the number of letters readers can identify in a single fixation without using linguistic skills. Proponents of the visual span hypothesis postulate an influence of early visual processing on reading speed. Given the slowness of reading Arabic texts, the present work aims to study the development of the visual span and its effects on reading speed in the Arabic-speaking context. Thirty-four subjects participated in the study. The trigram task and the rapid serial visual presentation (RSVP) paradigm were used to estimate visual span size and reading speed. In line with our initial assumptions, the results showed a significant effect of grade level on reading speed (F(2,31) = 30.93, p<0.001), visual span size (F(2,31) = 20.57, p<0.001). In good alignment with previous work, our results show that visual span size could explain around 40% of the reading speed variability. Interestingly, our analyses revealed a narrowing of visual span size in our Arabic sample. The results of study 2, suggest that the poor performance in the trigram task is due to poor visual attention capacities in our Arabic readers

Although working memory (WM) is crucial for intellectual abilities, not much is known about its brain underpinnings, especially the structural connectivity. We used diffusion tensor imaging (DTI) to look across the whole brain for the white matter integrity correlates of the individual differences in the reading span (verbal WM capacity during reading) in healthy adults. Right-handed healthy native Russian speakers (N = 67) underwent DTI on a 3T Philips Ingenia scanner. Verbal WM was assessed with the Daneman-Carpenter reading span test (Russian version). Fractional anisotropy maps from each participant were entered into the group tract-based spatial statistics analysis with the reading span as a covariate; the results were TFCE-corrected. After taking into account effects of age, sex, education and handedness, reading span positively correlated with the white matter integrity in multiple sites: the body, the genu and the splenium of corpus callosum; bilateral corona radiata (anterior, posterior, and superior); bilateral superior longitudinal fasciculus; several tracts in the right hemisphere only, including the internal and external capsule; bilateral superior parietal and frontal white matter. Although the left hemisphere is central for verbal processing, we revealed the important role of the right hemisphere white matter for the verbal WM capacity. Our finding indicates that larger verbal working memory span may originate from additional processing resources of the right hemisphere.

Introduction:Lumbar radiculopathy, frequently triggered by disc herniation, affects around one in 50 young adults (30-55 ages), leading to significant impacts on quality of life. When conservative treatments fail to alleviate symptoms, surgical intervention such as discectomy is often pursued. Technological advancements have led to various minimally invasive techniques, promising improved outcomes. Our aim was to compare clinical outcomes of different techniques.Methods:We conducted a systematic search in PubMed using "lumbar disc hernia" and the meta-analysis filter. Inclusion criteria comprised meta-analyses focusing on lumbar disc herniation treatments, published in English. A rigorous selection process adhering to PRISMA guidelines ensured high-quality evidence extraction.Results:From 28,171 initial records, 31 meta-analyses involving 87,852 patients were included. Heterogeneity across the literature presented challenges, notably in study populations, surgical techniques, and research designs. Among the techniques evaluated, full-endoscopic lumbar discectomy (FELD) emerged as superior in various perioperative parameters, including Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI), operation time, and complications. Conversely, automated percutaneous discectomy (AUTD) consistently exhibited poorer outcomes, suggesting limited effectiveness compared to other techniques. Conclusion:Despite advancements, the heterogeneity observed in the literature underscores the need for standardized approaches in minimally invasive spinal surgery research. FELD stands out as a preferred technique, offering favorable outcomes across multiple parameters. Conversely, techniques like AUTD raise concerns regarding efficacy. Future research should aim for uniformity in methodologies to facilitate accurate comparisons and guide clinical decision-making.

The profile of secondary metabolites occurring in apple cuticular layer is not only characteristic for particular apple cultivar, but also dynamically reflects various external factors in growing environment. In this study, the possibility to authenticate apple samples based on analysis of their cuticular layer extracts was investigated. Ultra-high-performance liquid chromatography coupled to high resolution tandem mass spectrometry (UHPLC-HRMS/MS) was employed for obtaining metabolomic fingerprints. In total, 274 authentic apple samples, four cultivars harvested within the seasons 2020 to 2022 in the Czech Republic and Poland were analysed. The generated complex data processed by univariate and multivariate statistical methods enabled to build classification models for discrimination of apple cultivars as well as their geographical origin. The models showed very good performance in differentiation of Czech and Polish samples for three of four cultivars: ‘Gala’, ‘Golden Delicious’ and ‘Idared’, moreover, the validity of the models was verified over harvest seasons. The diagnostic markers, besides metabolites of triterpene biosynthetic pathway, mainly represented wax esters. ‘Jonagold’, which is known to be susceptible to mutations, was the only cultivar for which the unambiguous classification of geographical origin was not possible.

Suppose for n∈ ℕ, set A⊆ℝⁿ and function f∶A→ℝⁿ. If set A, using the Hausdorff outer measure, is measurable in the sense of Carathèodory; we want to find an extension of the expected value, w.r.t the Hausdorff measure, that's unique, finite and "natural" (defined on §2.3 & §2.4) for all f in a prevalent subset of ℝᴬ. The issue is current extensions of the expected value are finite for all functions in only a shy subset of ℝᴬ. The reason this issue wasn't resolved is mathematicians have not thought of the problem, focusing on application rather than generalization. Despite the lack of potential use, we'll attempt to solve the problem by defining a choice function---this shall choose a unique set of equivalent sequences of sets (Fₖ***) , where the set-theoretic limit of Fₖ*** is the graph of f; the measure Hʰ is the ℎ-Hausdorff measure, such for each k∈ℕ, 0 < Hʰ(Fₖ***) < +∞; and (fₖ*) is a sequence of functions where {(x,fₖ*(x))∶x∈ dom(Fₖ***)}=Fₖ***. Thus, the extended expected value of or E**[f,Fₖ***] is: ∀(ε>0)∃(N∈ℕ)∀(k∈N)(k≥N⇒1/Hʰ(dom(Fₖ***))∫dom(Fₖ*** )fₖ* dHʰ - E**[f,Fₖ***]<ε ) which should be unique, finite, and "natural" (defined on §2.3 & §2.4) for all f in a prevalent subset of ℝᴬ. Note we guessed the choice function using computer programming but we don’t use mathematical proofs due to the lack of expertise in the subject matter. Despite this, the biggest use of this research is the extension of the expected value is finite for "almost all" functions: this is easier to use in application when finding the "average" of functions covering an infinite expanse of space.

Cucurbitacin phytonematicides consistently suppress population densities of plant nematodes, but have no effect against bacteria, fungi and insects. This study investigates the mechanism through which cucurbitacin phytonematicides consistently exert nematicidal properties on nematodes. Post 72-h exposure of second-stage juveniles (J2) of Meloidogyne enterolobii to geometric concentration of Nemafric-BL phytonematicide, J2 total proteins were measured using TruspecCHNS Macro. Total proteins versus phytonematicide exhibited a negative quadratic relation (R² = 0.97), with the minimum total proteins achieved at x = 4.9% phytonematicide. Beyond the minimum, total proteins increased gradually, depicting the existence of both isoprenylation (breakdown) and farnesylation (biosynthesis) of total proteins. In conclusion, cucurbitacins and nematode cuticles are both chemically structured, which provides the mechanism through which the test chemicals consistently decrease population densities of plant nematodes.

The objectives of this paper are to investigate the tradeoffs between a physically constrained neural network and a deep, convolutional neural network and to design a combined ML approach ("VarioCNN"). Our solution is provided in the framework of a cyberinfrastructure that includes a newly designed ML software, GEOCLASS-image, modern high-resolution satellite image data sets (Maxar WorldView data) and instructions/descriptions that may facilitate solving similar spatial classification problems. Combining the advantages of the physically-driven connectionist-geostatistical classification method with those of an efficient CNN, VarioCNN provides a means for rapid and efficient extraction of complex geophysical information from submeter resolution satellite imagery. A retraining loop overcomes the difficulties of creating a labeled training data set. Computational analyses and developments are centered on a specific, but generalizable, geophysical problem: The classification of crevasse types that form during the surge of a glacier system. A surge is a glacial catastrophe, an acceleration of a glacier to typically 100-200 times its normal velocity. GEOCLASS-image is applied to study the current (2016-2024) surge in the Negribreen Glacier System, Svalbard. The geophysical result is a description of the structural evolution and expansion of the surge, based on crevasse types that capture ice deformation in six simplified classes.

Space exploration is an arduous journey, with future explorations extending in duration, increasing the risk for common space-related health issues such as bone density loss due to microgravity, impaired gut microbiota, cardiovascular ailments, and exposure to cosmic radiation. These ailments can be addressed using medicinal plants. Enhancing their efficacy entails employing gene editing to target specific secondary metabolite pathways associated with therapeutic properties. Moreover, gene editing can combine multiple medicinal properties from various plants, culminating in a singular 'superplant' with enhanced therapeutic benefits. This review discusses the current usage of medicinal plants in promoting human health during space travel, the application of gene editing technology in modifying medicinal plants and presents a vision for the utilization of gene-edited medicinal plants in space to mitigate the risk of various space-related health issues.

The purpose of this study is to analyze how global research cooperation patterns in the secondary battery industry have changed over recent years and to identify the evolution in the focus of research. To this end, network analysis was performed using the nationality information of the authors of a 10-year multinational joint research paper related to lithium-ion batteries. Furthermore, keyword analysis and topic modeling were performed using the abstract data from the study. The results of this study confirm that some countries that are not well-known in the field, such as Australia, Spain, and France, showed high centrality, compared with the level of cooperation scale. Additionally, six research topics were identified. According to a comparison over the first half of the decade, no difference was observed in the appearance of keywords indicating high energy density and conductivity with lithium, a key mineral. Keyword distribution was high for topics like battery charging and discharging in the first half of the decade, and for next-generation battery materials, such as solid electrolytes, lithium metal anodes, and lithium-sulfur batteries in the second. These results provide insights into the establishment of R&D cooperation strategies by countries and pre-planning by companies in the battery industry.

Stroke is a global leading cause of death and disability. Knowledge of related guidelines is crucial for Emergency Department (ED) staff, influencing early diagnosis and timely treatment. We investigated Greek-Cypriot ED healthcare professionals' (nurses and physicians) knowledge in recognizing and managing stroke. A descriptive cross-sectional study spanned November 2019 to April 2020, encompassing four private and seven public EDs in the Republic of Cyprus. The data were collected through a self-reported questionnaire developed by the research team, consisting of 37 questions. Eight questions focused on sociodemographic and employment characteristics, 28 assessed knowledge in stroke recognition and management (each item was equally weighted without deliberate prioritization), and one question addressed self-assessment of knowledge in stroke care. 255 nurses [Response Rate (RR): 74.1%] and 26 physicians (RR: 47.3%) completed the questionnaire. The average correct response rate was 12.9 out of 28 statements (SD: 4.2), with nurses and physicians scoring 12.6 (SD: 4.1) and 15.7 (SD: 4), respectively. Work experience significantly influenced stroke knowledge, with all groups demonstrating superiority over those with less than one year of experience. Participants with previous training scored an average of 1.45 additional correct answers while educational attainment did not significantly influence stroke knowledge. Investigating stroke knowledge among Emergency Department nurses and physicians in the Republic of Cyprus revealed significant deficits. The study stresses targeted interventions, including, education, yearly examinations, workshops with hands-on training, and repeated training, to address these gaps and enhance the overall stroke care capabilities of the healthcare professionals.

Astronauts in space are subject to a continuous bombardment of ionizing radiation. The Earth's magnetic field and the ISS shield some biologically damaging particles traveling through. Still, travel beyond low-Earth orbit and extravehicular activities are exceedingly more dangerous and there is a concern for the acute and late-occurring adverse health effects befalling astronauts. So, it is vital to consider the current tools and models used to describe and study the organic consequences of ionizing radiation exposure. It is equally important to see where these models may improve. This article reviews the historical development and current state of knowledge of radiation effects impacting astronauts in orbit. We explain the space radiation environment, cellular microenvironment, and how these may be incorporated in radiobiological models to aid in our understanding of the influence space travel may have on astronaut health. The topics discussed in this paper include a review of DNA damage and repair mechanisms and the numerical models that aim to explain the biological effects resulting from ionizing radiation damage. Historically, radiobiological models focused on how radiation damages nuclear DNA, built upon the hypotheses of Crowther and Lea in the 1940s and 1960s, and neglected other sub-cellular targets outside of nuclear DNA.

Abstract: This review addresses the complexities of type 1 diabetes (T1D)and its associated complications, with a par-ticular focus on diabetic retinopathy (DR). This review outlines the progression from non-proliferative to proliferative diabetic retinopathy and diabetic macular edema, highlighting the role of dysglycemia in the pathogenesis of these conditions. A significant portion of the review is devoted to technological advances in diabetes management, particu-larly the use of Hybrid Closed Loop systems (HCLS) and to the potential of open-source HCLS systems, which could be easily adapted to different patiens’needs using big data analytics and machine learning. Personalized HCLS algorithms that integrate factors such as patient lifestyle, dietary habits, and hormonal variations are highlighted as critical to reducing the incidence of diabetes-related complications and improving patient outcomes.

The objective of this study was to identify the key elements used by prehospital emergency physicians (EP) to decide whether or not to attempt advanced life support (ALS) in asystolic out-of-hospital cardiac arrest (OHCA). From 01.01.2009 to 01.01.2017, all adult victims of asystolic OHCA in Geneva, Switzerland, were retrospectively included. Patients with signs of "obvious death" or with a Do-Not-Attempt-Resuscitation order were excluded. Patients were categorized as having received ALS if this was mentioned in the medical record, or, failing that, if at least one dose of adrenaline had been administered during cardio-pulmonary resuscitation (CPR). Prognostic factors known at the time of EP's decision were included in a multivariable logistic regression model. 784 patients were included. Factors favourably influencing the decision to provide ALS were witnessed OHCA (OR=2.14, 95%CI1.43–3.20) and bystander CPR (OR=4.10, 95%CI2.28–7.39). Traumatic aetiology (OR=0.04, 95%CI0.02–0.08), age >80 years (OR=0.14, 95%CI0.09–0.24) and a Charlson comorbidity index greater than 5 (OR=0.12, 95%CI0.06–0.27) were the factors most strongly associated with the decision not to attempt ALS. Factors influencing the EP’s decision to attempt ALS in asystolic OHCA are the relatively young age of the patients, few comorbidities, presumed medical aetiology, witnessed OHCA and bystander CPR.

COVID-19 is a severe global problem, and AI can play a significant role in preventing losses by monitoring and detecting infected persons in early-stage. This paper aims to propose a high-speed and accurate fully-automated method to detect COVID-19 from the patient's CT scan images. We introduce a new dataset that contains 48260 CT scan images from 282 normal persons and 15589 images from 95 patients with COVID-19 infections. At the first stage, this system runs our proposed image processing algorithm to discard those CT images that inside the lung is not properly visible in them. This action helps to reduce the processing time and false detections. At the next stage, we introduce a novel method for increasing the classification accuracy of convolutional networks. We implemented our method using the ResNet50V2 network and a modified feature pyramid network alongside our designed architecture for classifying the selected CT images into COVID-19 or normal with higher accuracy than other models. After running these two phases, the system determines the condition of the patient using a selected threshold. We are the first to evaluate our system in two different ways. In the single image classification stage, our model achieved 98.49% accuracy on more than 7996 test images. At the patient identification phase, the system correctly identified almost 234 of 245 patients with high speed. We also investigate the classified images with the Grad-CAM algorithm to indicate the area of infections in images and evaluate our model classification correctness.

The detection and recognition of tables in image-based documents is a challenging and essential task for automated data extraction and anal- ysis. This paper introduces a methodology that utilizes Convolutional Neural Networks (CNNs) to address this problem. By harnessing the ro- bust visual recognition abilities of CNNs, the proposed method effectively detects and extracts tables from image-based documents. Additionally, an Encoder-Dual Decoder (EDD) architecture is employed to extract the textual content from table cells, enabling the transformation of visual data into structured, machine-readable formats. This structured data is then further processed using a Vector Space Model (VSM)-based language modeling technique for query-based table retrieval. The methodology’s accuracy is assessed by analyzing the spatial relationships between the extracted cells and comparing them against a pre-defined table structure. The results provide an evidence to the effectiveness of the proposed ap- proach, with an impressive 85% accuracy rate and a corresponding error rate of 15%. This accurate extraction and recognition of tables from image-based documents can significantly enhance applications in data analysis, information retrieval, and knowledge extraction.

Homeostasis and its interaction with gene expression in the development and maintenance of living systems is discussed in order to formulate a new method to diagnose and treat diseases on this causative level. This includes an inquiry into the unsolved homeostasis problems of: location (where in the cell are calculations performed?), communication (what language used?), identity (set of plans/hierarchy of set points?) and computational (mechanisms used to make necessary adjustments?). As these functions require the processing of vast amounts of information which is communicated at every level of organization including the mechanisms of epigenetics, different computer models are discussed, with examples for each; analog, digital and the possibility of quantum biological. Each one allows certain properties and cell functions to emerge. The difference between functional homeostasis and dysfunctional homeostasis is discussed with strategies to indirectly study them in terms of epigenetic signatures. Hormesis is discussed as a mechanism to reverse the epimutations, leading to a method of treatment to almost any chronic disease. These topics are discussed as being a whole interconnected system.

This study investigates the role of sustainable inventory management within supply chains, exploring strategies, benefits, challenges, and implications for organizations. Through qualitative research involving semi-structured interviews with supply chain professionals from diverse industries, key themes emerged. Sustainable practices such as green logistics, waste minimization, and ethical sourcing were identified as critical strategies to reduce environmental impact and enhance operational efficiency. Technological advancements, including AI, IoT, and blockchain, facilitate real-time monitoring, predictive analytics, and transparency, supporting data-driven decision-making in inventory management. Benefits include cost reduction, improved brand reputation, regulatory compliance, and risk mitigation, positioning organizations favorably in a competitive landscape shaped by environmental regulations and consumer expectations. Challenges such as cost constraints, regulatory complexities, and organizational inertia necessitate strategic investments, collaborative efforts, and leadership commitment to overcome. The study underscores the importance of integrating environmental, social, and economic considerations into supply chain practices to foster sustainability and resilience. Looking forward, the study advocates for a holistic approach to sustainable supply chain management, emphasizing innovation, stakeholder engagement, and capacity building. By aligning organizational values with societal expectations and regulatory frameworks, businesses can navigate complexities, drive positive environmental and social impacts, and achieve sustainable growth. This research contributes insights into current practices and future directions for sustainable inventory management, informing strategies that balance profitability with environmental stewardship and societal responsibility.

Major depressive disorder (MDD) and substance use disorder (SUD) are of immense medical and social concerns. Although significant progress on neuronal involvement in mood and reward circuitries has been achieved, only relatively recently the role of glia in these disorders have attracted attention. Detail understanding of the glial function in these devastating diseases could offer novel interventions. Here, following a brief review of circuitries involved in mood regulation and reward perception, specific contribution of the neurotrophic factors, neuroinflammation and gut microbiota to these diseases are highlighted. In this context, the role of specific glial cells (e.g., microglia, astroglia, oligodendrocytes and synantocytes) on phenotypic manifestation of MDD or SUD are emphasized. In addition, potential use of this knowledge in developing novel therapeutics is touched upon.

Telecoupling, interactions between social-ecological systems across large, often global, distances, drives negative impacts from the forest-based carbon market. Yet, these negative impacts have been underreported; and therefore, likely vastly underestimated. We identify how these unintended negative impacts may occur and provide recommendations for the forest-based carbon market to better account for externalities by prioritising positive social impact, expanding comprehensive ecological outcomes and improving transparency of investments. We call for a carbon market that is designed to account for its global interconnectedness.

The development of plant-based meat analogues has become a significant challenge for the food industry in recent years due to the increasing demand for sustainable and healthier proteins in the context of a global protein transition. Plant-based meat analogues imitate the visual, textural, and chemical properties of traditional meat products and are required to closely resemble meat to appeal to consumers. In addition, consumers demand natural, clean-label, and nutritional and healthy products. To address these challenges, the food industry must develop highly healthy, nutritious, and E-number-free meat analogue products. Understanding the functionality of each ingredient and its role in the food matrix is crucial to being a key player in the innovation of the meat analogues market. This review provides updated information on the primary ingredients utilized for the development of plant-based burger meat alternatives and their functionality. The key components of meat analogue burgers are outlined, including plant proteins, binding agents, fats and oils, flavorings, colorings, preservatives, fortificants, and clean-label considerations.

The hard open problem of finding the lower bound for the Fokker Planck Kolmogorov’s time-dependent controller parameter probability density function is addressed for the first time in literature in this work. This revolutionary exposition will put control theory and other related inter-disciplinary fields to a higher level towards contemporary control theory. Notably, based on the influential role of control theory in both engineering and industry, this paper will be of great value to all engineering and industry professionals who seek to know more about advanced trends within control theory settings. On the other remit of the spectrum, Fokker Planck Kolmogorov(FPK) equations are of high importance to physicists as well as mathematicians, based on their multiple applicability to multi-interdisciplinary fields of human knowledge, and beyond. So, this by default adds more taste and credibility to this study. Concluding thoughts are included at the end of the work along with a difficult outstanding problem and the direction of future work.

This work is the first in literature to tackle the difficult open problem of determining the upper bound and threshold theorem for the TDCDP (time-dependent controller parameter) of the (Fokker Planck Kolmogorov) probability density function. This revolutionary exposition will put control theory and other related inter-disciplinary fields to a higher level towards contemporary control theory. Notably, based on the influential role of control theory in both engineering and industry, this paper will be of great value to all engineering and industry professionals who seek to know more about advanced trends within control theory settings. On the other remit of the spectrum, Fokker Planck Kolmogorov(FPK) equations are of high importance to physicists as well as mathematicians, based on their multiple applicability to information theory, graph theory, data science, finance, economics, and beyond. So, this by default adds more taste and credibility to this study. This leads by nature to introducing a different flavor to this ground-breaking research by highlighting the impact of Fokker Planck Kolmogorov(FPK) to revolutionize crypocurrency,which have received its name because it uses encryption to verify transactions, a new debatable digital payment system that doesn't rely on banks to verify transactions. It’s a peer-to-peer system that can enable anyone anywhere to send and receive payments. The paper ends with closing remarks combined with some challenging open problems and the next phase of research.

This study aimed to evaluate the discrepancies between genetic and visual coat color assignment in the Sarcidano Horse and to elucidate potential reasons. Individual DNA from 90 Sarcidano Horses was used for genetic assignment of coat color to explore the correspondence with individual forms containing phenotypical traits. The MC1R exon 1 and ASIP exon 3 have been genotyped and sequenced to obtain a picture of the coat color distribution in this breed. Surprisingly, once we compared the genetic results with the individual forms reporting the phenotypic data for each subject, a certain degree of non-correspondence between the phenotypic and genetic data in relation to coat color emerged. From the genetic analysis, Chestnuts (n = 58) resulted the most common Sarcidano Horse (n = 58), followed by a quite large number of Blacks (n = 28) and a very small number of Bays (n = 4), whereas phenotypic distribution resulted in 38 Chestnuts, 40 Bays, only 2 Blacks, and 10 Grays (without the possibility of recognizing the true color they carried). Chestnut resulted a very representative coat color, while many horses that visually identified as Bays were genetically Blacks. This discrepancy, that could be due to a variety of individual and external factors, including age, time of year, living situation and dietary condition, suggesting the importance of accurate coat color identification to ensure adequate features registration and reliable prediction of offspring’s coat color.

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

Background: Thyroid nodules are common, affecting nearly 65% of the general population. While they are widespread, it's crucial to recognize that the majority of these nodules are not cancerous and can be effectively managed through careful monitoring. Thyroid ultrasound is commonly used to evaluate thyroid nodules owing to its low cost, wide availability and technical ease of application. In sonography, it's crucial to assess characteristics and vascular flow. Yet, conventional color and power Doppler ultrasound may not always effectively capture small vessels and low velocities due to their limitations. Superior Microvascular Imaging can display the blood flow of small vessels and low-velocity blood flow, which is difficult to visualize with conventional Doppler ultrasound. Meanwhile other thyroid scans, that utilize either [99mTc] pertechnetate or (18)F-fluorodeoxyglucose, can categorize nodules as hyperactive ('hot'), exhibiting normal activity ('warm'), or having reduced/no activity ('cold'). Thus, the main goal of screening and tracking thyroid nodules is to improve the management of potentially worrisome thyroid malignancies. Methodology: The study was conducted within the structural framework of a network meta-analysis, with the index tests being - SMI, Radionuclide Scanning and Color Doppler, and the general link between them being the reference gold standard. The data collection involved searching for all pertinent literature using PubMed, Google Scholar, and the Cochrane Library databases. The essential data was extracted following the application of specific inclusion and exclusion criteria.This meta-analysis included 7 RCTs with 1,152 patients for Radionuclide Scanning, 10 RCTs with 1,847 patients for SMI and 8 RCTs with 4,480 patients for Color Doppler. They were analyzed using the QualSyst tool and the risk of bias was evaluated by using QUADAS-2 analysis.The statistical software packages MetaDiSc 1.4, RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20) and Excel in Stata 14 were used to perform the statistical analyses. Result: According to the findings, the sensitivity for Radionuclide Scanning is calculated as 0.79 (range: 0.76 to 0.81) and specificity as 0.55 (range: 0.50 to 0.60) with a 95% confidence interval. The overall diagnostic odds ratio (DOR) for Radionuclide Scanning Is 10.54.Additionally, with a 95% confidence interval, SMI exhibits a sensitivity of 0.82 (with a range of 0.79 to 0.84) and a specificity of 0.86 (with a range of 0.84 to 0.88), while the overall DOR is approximately 25.73. Color Doppler demonstrates a calculated sensitivity of 0.71 (ranging from 0.69 to 0.74) and specificity of 0.81 (ranging from 0.79 to 0.83) with a 95% confidence interval, while its DOR is 13.48.Conclusion: As evidenced by this meta-analysis, blood flow dependent imaging techniques are superior in their abilities to be used as diagnostic tests, especially in conjunction with their use in detecting thyroid nodules. This study offers a starting point for delving deeper into the utilization of Radionuclide Imaging, Superior Microvascular Imaging and Color Doppler in diagnosing thyroid nodules in a clinical setting. Key Words: - Thyroid Nodule, Radionuclide Scanning, Superior Microvascular Imaging, Color Doppler Diagnosis, Sensitivity, Specificity, Diagnostic imaging

Background: An outbreak of Mpox disease caused by a mutant clade 1b virus (MPXV) in Kamituga area, South Kivu Province, DRC has rapidly grown to involve neighboring countries in this region. This now has the authorities worried, due to the limited supply of Mpox vaccines with emergence use licensure (EUL) available. As an emergency local response to this challenge, we set out to identify epitopes of clade 1b MPXV surface proteins as targets for the rapid research and development (R & D) of Mpox medical countermeasures. Methods: The H3L (OPG108–heparin binding protein) and A17L (OPG143–myristylated protein) were selected by virtue of their surface localization, stability and known role in MPXV host cell fusion entry. Within the immune epitope database analysis resource (IEDB-AR), surface accessibility, antigenicity and 3-D localisation (DiscoTope) we examined to identify > 9-nomer epitopes Results: Three (3) and six(6) candidate >9-nomer epitopes were derived for H3L and A17L surface fusion protein. Across all parameters, the two best identified epitopes were as follows:—H3L (28-HINDQKFDDVKDNEVMQEKR-47 and 236-YVEHDPRLVAEH-247) and A17L (104-QNEVTPEYIKDLKYATDYIA-123;) 270-KKDYLLGDSDSVAKCCSKTNTKHCPKIFNNNYKTEHC-290). Conclusions: These epitopes— alone, multiplexed (say as a nano-spiked virus-like particles, VLPs) or fused as a chimeric recombinants form immunogens for the rapid production of protein sub-unit vaccines. Inversely, derivative monoclonal antibodies (mAbs) from the same are precursors for therapeutic cocktails and or antigen, rapid diagnostic tests (RDT).

Additive Manufacturing (AM), commonly known as 3D printing, has revolutionized various industries, including the medical field. This technology enables the creation of complex structures layer by layer, offering unprecedented customization and precision. In medical applications, AM has proven transformative in producing patient-specific implants, prosthetics, and anatomical models, facilitating better surgical planning and outcomes. Additionally, it has shown promise in bioprinting, where cells and biomaterials are used to create tissue-like structures for regenerative medicine. The ability to rapidly prototype and manufacture medical devices reduces time and costs, and enhances personalized patient care. This abstract explores the diverse applications, benefits, and challenges of AM in the medical sector, highlighting its potential to revolutionize healthcare and improve patient outcomes.