Breast cancer is the most widespread malignancy in women from corner to corner of the world. Nanostructured lipid carrier (NLC) proved its efficacy in the treatment of cancer. NLC loaded with Imatinib (IMA) (NANIMA) was prepared and evaluated for in vitro efficacy in MCF-7 breast cancer cells. Hot homogenization method was used for the preparation of NANIMAs. Aqueous solution of surfactants (hot) was mixed with molten mixture of stearic acid and sesame oil (hot) under homogenization. The prepared NANIMAs were characterized and evaluated for size, polydispersity index, zeta potential, encapsulation efficiency, release studies, stability studies and MTT assay (cytotoxicity studies). The optimized NANIMA revealed particle size of 104.63 ± 9.55 d.nm, PdI of 0.227 ± 0.06 and EE of 99.79 ± 0.03. All NANIMAs revealed slow and sustained release behaviour. The surfactants used in the preparation of NANIMAs exhibited their effects on particle size, zeta potential, encapsulation efficiency, stability studies and release studies. The cytotoxicity studies unveiled 8.75 times increase in cytotoxicity for optimized NANIMA (IC50 = 6 µM) when compared with IMA alone (IC50 = 52.5 µM) on MCF-7 breast cancer cells. After this, NLC containing IMA possibly will be employed for the cure of breast cancer. A lesser amount of IMA loaded NLC will be sufficient than IMA alone for the treatment of breast cancer. Moreover, the patient will exhibit not as much of adverse effects as in case of IMA alone. Consequently, NANIMA could prove to be useful for effective therapeutic outcome in breast cancer treatment.

The aim of this study was to analyze surgical and refractive outcomes of XEN glaucoma implant (Allergan, an Abbvie company, Irvine, CA, USA), a minimally invasive surgical device for the treatment of refractory glaucoma. A retrospective chart review of eyes that received XEN Gel Stent placement from December 2014 to October 2019 was conducted. Intraocular pressure (IOP) change, best corrected visual acuity (BCVA), change in glaucoma medications, frequency of slit lamp revision procedures, and frequency of secondary glaucoma surgeries were the primary outcomes. Seventy-two subjects were included in the study: 32 (44%) males and 40 (56%) females. The mean follow-up time was 26.87 ± 15.33 months. The mean IOP before surgery was 24.82 ± 8.03 mmHg and decreased to 17.45 ± 5.84 mmHg at the end of the study, MD = -7.48, CI95 [-10.04; -4.93], p < 0.001. The mean decrease from baseline was 23%. Before surgery BCVA was 0.38±0.30 and at the end of the follow-up period it had improved to 0.47±0.37, MD = 0.09, CI95 [0.04; 0.13], p < 0.001. Additional procedures (fluorouracil injection, Bleb needling) were performed in 11/72 patients (15%). Further glaucoma surgery was necessary for 23.9%% of the patients. Implantation of XEN Gel Stent is both safe and effective for lowering IOP in refractory glaucoma patients.

Invasion ecology has a long tradition of searching for traits distinguishing alien invasive and non-invasive plants. Surprisingly, this approach has been so far poorly used to understand why some arable weeds are abundant and widespread while others are rare and narrowly distributed. In the present study, we focused on the characteristics of successful weeds occurring in maize fields, one of the most import crop worldwide. Two national weed surveys conducted in France were used to identify increasing and decreasing species based on 175 and 484 surveyed fields in the 1970s and the 2000s, respectively. Weed trait values related to regional frequency, local abundance and specialization to maize were identified with Phylogenetic Generalized Least-Squares (PGLS). We found a positive relationship between regional frequency and local abundance, i.e. the most widespread weeds were also locally more abundant. We highlighted that weeds with the C4 photosynthetic pathway and summer emergence were more abundant, more frequent and more specialized to maize crops. More generally, we highlighted two successful strategies: on the one hand, traits related to a general weediness syndrome with rapid resource acquisition (high SLA and Ellenberg-N) and high colonization capacity (seed longevity, fecundity and wind dispersal), on the other hand, traits related to specific adaptation to spring cultivation (thermophilous species with summer emergence, late flowering and C4 photosynthetic pathway). Deviations from the abundancy-frequency relationships also indicated that species of the Panicoideae sub-family, species with Triazine-resistant populations and neophyte species were more abundant than expected by their regional frequency. To some extent, it is therefore possible to predict which species can be troublesome in maize crops and use this information in weed risk assessment tools to prevent new introductions or favor early detection and eradication. This study showed how tools developed in functional and macro-ecology can be used to improve our understanding of weed ecology and to develop more preventive management strategies.

The activation of halogen bonding by the substitution of the pentafluorosulfanyl (SF5) group was studied using a series of SF5-substituted iodobenzenes. The simulated electrostatic potential values of SF5-substituted iodobenzenes, ab initio molecular orbital calculations of intermolecular interactions of SF5-substituted iodobenzenes with pyridine, and the 13C NMR titration experiments of SF5-substituted iodobenzenes in the presence of pyridine or tetra (n-butyl) ammonium chloride (TBAC) indicated the obvious activation of halogen bonding, although this was highly dependent on the position of SF5-substitution on the benzene ring. 3,5-Bis-SF5-iodobenzene was the most effective halogen bond donor followed by o-SF5-substituted iodobenzene, while the m- and p-SF5 substitutions did not activate the halogen bonding of iodobenzenes. The 2:1 halogen bonding complex of 3,5-bis-SF5-iodobenzene and 1,4-diazabicyclo[2.2.2]octane (DABCO) was also confirmed. Since SF5-containing compounds have emerged as promising novel pharmaceutical and agrochemical candidates, the 3,5-bis-SF5-iodobenzene unit should be an attractive fragment of rational drug design capable of halogen bonding with biomolecules.

The main objective of the study is to analyse time trends in excessive body weight (obesity, overweight) of Czech adolescents between 2002 and 2018 with regard to the socioeconomic status (SES) of adolescents’ families and to find SES-mediated correlates of adolescents’ obesity. A nationally representative sample of 29,879 adolescents (49.6% of them boys) aged 10.5-16.5 years was drawn from the Health Behaviour in School-aged Children cross-sectional, self-reported questionnaire surveys conducted in 2002, 2006, 2010, 2014, and 2018 in the Czech Republic. Across the quadrennial surveys from 2002 to 2018, we observed a clear increase in the prevalence of excessive body weight (overweight/obesity) in all SES categories of adolescents, which was most striking (p < 0.05) in adolescents with low SES (boys: +5.2/+7.5 percent points (p.p.); girls +6.3/+2.4 p.p.). When all the survey cycles were compared, the highest prevalence of overweight/obesity was evident in the low-SES adolescents in 2018, both in girls (14.9%/5.1%) and boys (20.4%/12.0%). The lower odds of obesity were significantly (p < 0.05) associated with regular vigorous physical activity, participation in organized sport. An unreasonable increase in the prevalence of obesity in adolescents with low SES suggests that national health-related and sports programmes have the least impact on children from low-SES families.

Nine 2-(1,2-benzothiazol-3-yl)-N-(4-oxo-2-phenyl-1,3-thiazolidin-3-yl) propanamides were designed and synthesized, combining benzisothiazole and 4-thiazolidinone in one frame. The aim of the study was to verify their effectiveness to contrast the inflammatory/oxidative process in which free oxygen and nitrite (ROS and RNS) radicals, advanced glycation products (AGEs), inflammatory cytokines and matrix metalloproteinases (MMPs) are involved. Docking studies of all the compounds were performed in order to explore their binding mode at the MMP-9 protein. An appreciable anti-inflammatory/wound healing effects of the tested compounds was highlighted. Derivative 23, bearing a 4-carboxyphenyl substituent at C2 of the 4-thiazolidinone ring, exhibited the highest activity, being able to inhibit MMP-9 at nanomolar level (IC₅₀ = 40 nM).

Cyclic vomiting syndrome (CVS) is a frequently disabling condition defined by severe, discrete, stereotypical episodes of nausea and vomiting. In our previous report [1], a candidate gene list was evaluated in a group of 80 unrelated participants with CVS with extensive genetic sequencing (whole exome/genome). Twenty-two good candidate genes for CVS association were identified, from which a cellular model of aberrant cation transport and energy metabolism was proposed. Herein, we present additional clinical information on those 80 participants, including eight case reports to highlight general principles and clinical practices. Our participants demonstrate substantial phenotypic and genotypic heterogeneity in CVS, including a propensity for specific co-morbidities in the participants and relatives, evolution towards episodes in which vomiting is less apparent, labeling with “non-organic” diagnoses, multiple genes, polygenic inheritance, and association with variants not designated as Pathogenic. Our case reports illustrate how genetic information can guide clinical management and argue to the high clinical utility of appropriate genetic testing and analysis in CVS. Expression profiling of our 22 candidate genes suggests an anatomical model in a unit defined by vagal afferents and adjacent cells. Our models are consistent with multiple current hypotheses of CVS and the efficacy of commonly-recommended treatments.

Background: Cancer patients require cross-professional care during the diagnosis and treatment periods. Therefore, methods for effectively carrying out case management are essential to tumor care. Purpose: To investigate the effects of using the community software LINE Official Ac-count on oral cancer case management. Methods: An experimental design was used; 100 patients were randomly divided into two groups by using a computer-generated random number table. The experimental group used LINE Official Account, which gave them self-care information, timely messages, and one-on-one health-care consultations. The control group followed standard healthcare practices. Results: The experimental group was satisfied with the self-care information provided by LINE Official Account (86.9%), patients regularly checked the self-care information (89.4%) and would check the information when receiving a push notification (54.3%). Ten patients used the one-on-one consultation(20.0%). LINE Official Account had a significant effect on the rate of participation in support groups. Generalized estimating equations indicated a significant difference between the two groups regarding the overall quality of life over 7 days (P = 0.023). Conclusion: Community software applications used in oncological case management can improve self-management and empower, also enable tracking of long-term follow-up effectiveness and reinforce the case manager’s role as a family therapist. Therefore, this study recommends that case manager systems be incorporated into mobile applications to increase the sustainable management, accessibility, effectiveness, and satisfaction of oncological management systems. This study also provides the value of Sustainable Development Goals (SDGs) with Good Health and Well-being, and decreased social withdrawal among patients with oral cancer.

Childhood diarrhea continues to be a major cause of under-five (U-5) mortality globally and in India. In this study, 1571 U-5 children residing in nine rural villages and four urban slums in Ujjain, India were included with the objective to use community participation and drug utilization research to improve diarrheal case management. The mean age was 2.08 years, with 297 (19%), children living in high diarrheal index households. Most mothers (70%) considered stale food, teething (62%), and hot weather (55%) as causes of diarrhea. Water, sanitation, and hygiene (WASH)-related characteristics revealed that most (93%) households had toilets, but only 23% of the children used them. The study identified ineffective household water treatment by filtration through cloth by most (93%) households and dumping of household waste on the streets (89%). The results revealed low community awareness of correct causes of diarrhea (poor hand hygiene, 21%; littering around the household, 15%) and of correct diarrhea treatment (oral rehydration solution (ORS) and zinc use, 29% and 11%, respectively) and a high antibiotic prescription rate by healthcare providers (83%). Based on the results of the present study, context-specific house-to-house interventions will be designed and implemented.

Reeling from the global supply chain crisis created by the COVID-19 pandemic, the maritime industry still faces multifaceted challenges for its sustainable survival. Those challenges include shifts in trade routes, congestion at major seaports, container shortages, volatility in fuel prices, the scarcity of skilled maritime labor, and potential technical glitches stemming from digitized maritime operations. To help the maritime industry handle these challenges, this paper identifies major drivers and deterrents that affect the efficiency of ocean carriers’ performances over time using two different versions of data envelopment analysis (DEA) models and the Malmquist Productivity Index (MPI). After evaluating the operating efficiencies of multinational ocean carriers across the globe over extended periods (pre- and post-pandemic periods), we developed a benchmark standard that can guide best-in-class sustainable maritime practices.

This qualitative study explores the intricacies of building sustainable supplier relationships in the e-commerce sector, focusing on best practices and strategic approaches. Through in-depth interviews with procurement managers, supply chain experts, and supplier representatives, the research identifies four critical themes: trust, technology integration, ethical practices, and performance measurement. Trust is found to be the foundation of effective supplier relationships, fostering open communication and collaboration, which are essential for addressing challenges and co-creating solutions. The integration of digital technologies such as supply chain management software, blockchain, and the Internet of Things significantly enhances transparency, decision-making, and operational efficiency, providing a competitive edge. Ethical practices, including adherence to fair labor standards and environmental sustainability, are increasingly crucial as consumer and regulatory expectations evolve, necessitating alignment between e-commerce companies and their suppliers. Performance measurement and continuous improvement are vital for maintaining quality and efficiency, with clear metrics and regular evaluations driving constructive feedback and optimization of supply chain processes. The study underscores the interdependence of these elements in fostering resilient and adaptable supplier relationships. The findings offer practical guidance for e-commerce businesses and suppliers, emphasizing the need for a holistic approach to supplier management that balances trust, technology, ethics, and performance. This approach not only enhances operational effectiveness but also ensures the long-term sustainability of supplier relationships in the dynamic e-commerce landscape. The research contributes to the theoretical understanding of supplier relationship management, providing a comprehensive framework for future studies and practical applications in the e-commerce industry.

Breast cancer (BC) is the most common invasive neoplasm and affects many women of working age. The return to work (RTW) of female survivors (BCSs) is associated with a better quality of life and longer survival. A tailored intervention to promote RTW was launched in 2022. A year later, the women were contacted to find out if RTW had occurred regularly and what their health conditions were compared to baseline. BCSs reported excessive fatigue, poor sleep quality, anxiety, depression and reduced work ability; these parameters had not improved significantly compared to baseline. Thematic analysis of the interviews confirmed the presence of personal, company and societal factors that could hinder or favor RTW. The interviews demonstrated that, even in an economically developed country that has provided numerous benefits for BCSs, protection is not always effective. Personalized intervention seems necessary to complete the process of reintegrating BCSs into their future working careers.

The development of modern genomic tools has sped up the breeding program of food crops. More recently, genomic resources are being developed for tropical forages and will be key resources for developing climate resilient high yielding forage varieties. In this study, we present a genome-wide association study for biomass yield and feed quality traits in buffel grass (Cenchrus ciliaris L. aka Pennisetum ciliare L.,). Genome-wide markers generated using the DArTSeq platform and mapped onto the reference genome of Setaria italica were used for the genome-wide association study. The results revealed several markers associated with biomass yield and feed quality traits. A total of 78 marker trait associations were identified with R2 values ranging from 0.138 to 0.236. The marker trait associations were distributed across different chromosomes. Of these associations, the most marker trait associations (23) were observed on Chr9, followed by Chr5 with 12. The fewest number of marker trait associations were observed on Chr4 with 2. In terms of traits, 17 markers were associated with biomass yield, 24 with crude protein, 26 with TDN, 14 with ADF, 10 with NDF and six with DMI. Twenty of the identified markers were associated with at least two traits. The identified marker trait associations provide a useful genomic resource for future improvement and breeding of buffel grass.

Reactions of picolinamides with 1,3-propanesultone in methanol followed by the treatment with ketones led to a series of previously unknown chemical transformations, yielding first pyridinium salts (2a-f) with a protonated endocyclic nitrogen atom and then heterocyclic salts (3a-j) containing a 4-imidazoline ring. The structures of intermediate and final products were determined by IR and 1H, 13C NMR spectroscopy and X-ray study. The effects of the ketone and alcohol structures on the product yield were studied by quantum-chemical calculations. The stability of salts 3a-j towards hydrolysis and alcoholysis makes them excellent candidates for the search of new types of biologically active compounds.

This study investigated the intersecting influence of socioeconomic status and cooking behavior on dietary habits using nationwide Japanese data. The study measured the frequency of balanced meals and breakfast intake as indicators of healthy eating habits and used subjective economic status, subjective spare time, and cooking behavior as the independent variables. It employed multivariate logistic regression analyses to elucidate the relationships among these variables. The results demonstrated that even among economically poor or time-constrained individuals, those preparing meals from ingredients were more likely to eat balanced meals and breakfast than those relying on commercial food or rarely cooking. This finding suggested that cooking behavior can mitigate disparity in healthful eating due to socioeconomic conditions. The study added new insights into the impact of combining socioeconomic status and cooking behavior on dietary habits, which highlights the potential of promoting cooking behaviors, such as teaching cooking skills, as a strategy for reducing socioeconomic dietary disparities.

This study aimed to explore the experiences of teachers in the recovery of educational skills. Specifically, ten teachers of Andap National High School are selected for the in-depth interview. This study employed a qualitative-phenomenological research design of which in-depth interview (IDI) was used in gathering the data. The study utilized phenomenological approach to study a particular phenomenon concerning the post-pandemic experiences of teachers in the implementation of the face-to-face classes. After gathering sufficient amount of data through the conduct of in-depth interviews, thematic analysis was used to analyse further the results and to check the disparities and similarities of all responses gathered. This was the time wherein responses were categorized and organized into themes. The findings of the study revealed that the challenges encountered of educational skills recovery were sources of learning materials, learning gaps, learners characteristics, difficulty with comprehension and lack of interest. It was also revealed that the most challenging teaching experiences in the recovery of educational skills were catching attention, learning gaps, communicating to students, need for remedial instruction, retroactive interference and difficulty in understanding English Language. They frequently have to quickly convert lesson material they had intended to teach in a classroom setting to any learning modality implemented. Further, adjust and learn new trend, provide opportunities to develop new skills, helps to manage stress, improved educational outcomes, become well-rounded teacher, networking and learning and continue doing responsibilities helped in these insights had in confronting challenges brought by the pandemic.

As medical care aiming to maintain the quality of life for elderly patients is increases, implant treatment for elderly patients is increasing worldwide. Therefore, we aimed to investigate implant stability and the reliability of different measuring devices according to implant placement site and duration in patients aged over 65 years. The study evaluated 60 implants in 60 patients aged ≥ 65 years. The implant placement sites were divided into six evenly distributed sections (n=10) i.e., maxillary right- posterior, A; maxillary anterior, B; maxillary left-posterior, C; mandibular right-posterior, D; mandibular anterior, E; mandibular left-posterior, F. Participants visited the hospital seven times: preoperatively, 1V; implant surgery, 2V; stitch removal, 3V; 1-month follow-up, 4V; 2-months follow-up, 5V; before final-restoration delivery, 6V; and after final-restoration delivery, 7V. The implant stability was evaluated with the Osstell Mentor (ISQ), Periotest M (PTV), and Anycheck (IST). The mean values of ISQ, PTV, and IST were analyzed (α=.05). ISQ, PTV, and IST results of 5V and 6V were significantly higher than those of 2V (P<.05). The lowest ISQ results occurred in E location at 5V and 6V (P<.05). In all mandibular locations, IST results of 7V were significantly higher than those of 2V, 3V, 4V, and 5V (P<.05). ISQ results were negatively correlated with PTV and positively correlated with IST, and PTV was negatively correlated with IST. By considering various factors that affect implant stability, the appropriate implant load application time was determined. This could help increase the implant success rate in elderly patients. And as a diagnostic device for implant stability for evaluation of osseointegration in elderly patients, Anycheck was also able to prove its relative reliability compared to Osstell ISQ Mentor and Periotest M.

Parkinson's Disease (PD) is a neurodegenerative disorder that affects the motor system of the human body. Currently, the available treatments are limited and often have undesirable side effects. In this context, the aim of this study was to develop a novel combinational formulation of Apomorphine and Quetiapine and evaluate its efficacy in a rat model of PD. The formulation was prepared using the solvent evaporation technique and characterized for its physicochemical properties. The in-vitro drug release was evaluated using the Franz diffusion cell method, and the pharmacokinetics of the combination was studied in rats. The behavioural and biochemical parameters were evaluated in the rats using the Rotarod, pole test, and biochemical assays. The results showed that the developed formulation had satisfactory physicochemical properties and exhibited sustained drug release. The pharmacokinetic studies showed that the combination exhibited a longer residence time than the individual drugs. The behavioural and biochemical parameters showed that the combination was effective in improving motor function and reducing oxidative stress. In conclusion, the developed Apomorphine and Quetiapine combination formulation showed promising results in improving motor function and reducing oxidative stress in rat model of PD. Further studies are required to evaluate the safety and efficacy of the developed formulation in humans.

Low-cost particulate matter (PM) sensors offer an excellent opportunity to improve our knowledge about this type of pollution. Their size and their cost, which support multi-node network deployment, along with their temporal resolution, enable them to report fine spatio-temporal resolution for a given area. These sensors have known issues across performance metrics. Generally, the literature focuses on the PM mass concentration reported by these sensors but some models of sensors also report particle number concentrations (PNC) segregated into different PM size bins. In this study, 8 units of each Alphasense OPC-R1, Plantower PMS5003 and Sensirion SPS30 have been exposed, under controlled conditions, to short-lived peaks of PM generated using two different combustion sources of PM, exposing the sensors to different particle size distributions to quantify and better understand the low cost sensors performance across a range of relevant environmental ranges. The PNC reported by the sensors were analysed. This study showed that there is added value in directly using the PNC reported by the sensors instead of the mass concentrations, which could aid the efforts to calibrate these sensors to a known accuracy. It demonstrated that all sensors tested here could track the fine temporal variation of PNC, that the Alphasense OPC-R1 could closely follow the variations of size distribution between the two sources of PM, and it showed that particle size distribution and composition are more impactful on the sensors measurement than relative humidity.

Background: Multiple system atrophy (MSA) is a rapidly progressive neurodegenerative disorder that has no curative treatment. Diagnosis is based on a set of criteria established by Gilman (1998 and 2008) and recently updated by Wenning (2022). We aim to determine the effectiveness of [123I]Ioflupane SPECT in MSA, especially at the initial clinical suspicion. Methods: Cross-sectional study of patients at initial clinical suspicion of MSA, referred for [123I]Ioflupane SPECT. Results: 139 patients (68 men, 71 women) were included, 104 being MSA-probable and 35 MSA-possible. MRI was normal in 89.2% while SPECT was positive in 78.45%. SPECT showed high sensitivity (82.46%) and positive predictive value (86.24), reaching maximum sensitivity in MSA-P (97.26%). Significant differences were found when relating both SPECT assessments in the healthy-sick and inconclusive-sick groups. We also found an association when relating SPECT to the subtype (MSA-C or MSA-P), as well as to the presence of parkinsonian symptoms. Lateralization of striatal involvement was detected (left side). Conclusions: [123I]Ioflupane SPECT is a useful and reliable tool for diagnosing MSA, with good effectiveness and accuracy. Qualitative assessment shows a clear superiority when distinguishing between the healthy-sick categories, as well as between the parkinsonian (MSA-P) and cerebellar (MSA-C) subtypes at initial clinical suspicion.

We investigate the effect of geopolitical risk on the returns of the Information Technology, Communication Services, and Consumer Staples sector firms within the S&P 500 index. We use the event study methodology and perform more than 17,000 regressions to provide empirical evidence at the sector level that geopolitical risk leads to different responses across these 3 sectors. The response of the Information Technology sector is negative for all event windows under study, except the one spanning 10 days prior to the geopolitical event and 10 days after. The Communication Services sector has positive returns as a result of geopolitical events for all event windows, except the one from the geopolitical event date and 5 days after. The Consumer Staples sector shows a negative impact on geopolitical risk for all event windows except the one from the geopolitical event date and 5 days after, demonstrating a negative correlation to the Communication Services sector.

Capturing complexity is both a conceptual and a practical challenge in palliative care. The HexCom model has proved to be an instrument with strong reliability and valid for describing the needs and strengths of patients in home care. In order to explore whether it is also perceived to be helpful in enhancing coordinated and patient-centered care at a practical level, a methodological study was carried out to assess the face validity of the model. Particularly, a Delphi method involving a group of 15 experts representing the full spectrum of healthcare professionals involved in palliative care was carried out. The results show that there is a high level of agreement, with a Content Validity Index-Item greater than 0.92 both with regard to the complexity model and the HexCom-Red, HexCom-Basic and HexCom-Clin instruments, and higher than 0.85 regarding the HexCom-Figure and the HexCom-Patient instruments. This consensus confirms that the HexCom model and the different instruments that are derived from it are valued as useful tools for a broad range of healthcare professional in coordinately capturing of complexity in healthcare practice.

Purpose: During the COVID-19 pandemic, the health care workers (HCWs) at the frontline have been largely exposed to infected patients, running an high risk of being infected by the SARS-CoV-2 virus. This study investigates the epidemiological, clinical and lifestyles characteristics that might play roles in the susceptibility of HCWs to COVID-19 in a hit Italian hospital. Methods:Demographic, lifestyle, work-related and comorbidities data of 1447 HCWs which underwent a nasopharyngeal swab for SARS-CoV-2 were retrospectively collected. For the 164 HCWs positive for SARS-CoV-2, data about safety in the workplace, symptoms and clinical course of COVID-19 were also collected. Cumulative incidence of SARS-CoV-2 infection was estimated. Risk factors for SARS-CoV-2 infection were assessed using a multivariable Poisson regression. Results: The cumulative incidence of SARS-CoV-2 infection among the screened HCWs was 11.33 (9.72-13.21). Working in a COVID-19 ward, being a former smoker (vs being a person who never smoked) and BMI were positively associated with SARS-CoV-2 infection, whereas being a current smoker was negatively associated with this variable. Conclusions: Assuming an equal accessibility and proper use of PPE of all the HCWs of our Hospital, the great and more prolonged contact with COVID-19 patients remains the crucial risk factor for SARS-CoV-2. Therefore, increased and particular care needs to be focused specifically on the most exposed HCWs groups, which should be safeguarded. Furthermore, in order to limit the risk of asymptomatic spread of SARS-CoV-2 infection, the HCWs mild symptoms of COVID-19 should be considered when evaluating the potential benefits of universal staff testing

Oiola archeological site, located in the mining complex of La Arboleda (Biscay, North Spain) was an important iron smelting center from the Roman Period to the Early Middle Ages and even in more current times (19th-20th centuries). Tap-slags and some plano-convex slags were identified as smelting slags. Samples were analyzed by optical microscopy, X-ray powder diffraction, scanning electron microscopy coupled with electron-dispersive spectroscopy and Raman microspectroscopy to perform a mineralogical and textural characterization. Additionally, thermogravimetric and thermodiffraction analyses were carried out to determine furnace operating temperatures. The mineral assemblage reflects furnace cooling rates and temperatures and the addition of quartz as the main flux to decrease the melting temperature of the iron ore. The comparison of slags from the Roman Period and the Early Middle Age allows to observe changes in the pyrometallurgical process through time.

The Sustainable Development Goals (SDGs) raise quality employability, gender equity in access to employment and increase coverage in education, however, in Colombia, high unemployment rates and informality of young people are risks of fulfilling these objectives. This is verified by a study with cohorts on access to employment, labor mobility and entry to quality occupations, through the use of probabilistic models. This study found that young people are less likely to be employed than adults, education has increased in the new generations and allowing them to enter a higher quality occupation, job segmentation and lack of experience of young people are the main cause of unemployment and Women are less likely to be employed than men and to do so in quality jobs. To comply with the SDGs, you must increase coverage in education, make a differential gender policy and expand programs as learners and insert dual education.

Suicide is a major public health concern in South Korea, and self-poisoning by pesticides is one of the common methods of suicide. Pesticide ban policies have been successful for suicide prevention; however, no studies have shown their effect according to occupational groups. The present study analyzed suicide and suicide by pesticide rates among South Korean workers age 15-64 in 2003-2017, their associations with occupational groups, and the impact of three major economic indices on these factors. Workers in the agriculture, forestry, and fishery industries have relative risks of 5.62 (95% CI: 5.54-5.69) for suicide overall and 25.49 (95% CI: 24.46-26.57) for suicide by pesticide. The real gross domestic product (RGDP) has a positive association with suicide overall only in the last five-year period investigated in this study, and the unemployment rate consistently has a positive association. The economic status and policy for suicide prevention affect suicide and suicide by pesticide rates differently among occupational groups and different time periods. Policy addressing suicidal risk for different occupational groups should be of concern in South Korea.

1) Background: The use of linked data in Semantic Web are promising approaches to add value to nutrition research. An ontology, which defines the logical relationships between well-defined taxonomic terms, enables linking and harmonizing research output. To enable the description of domain-specific output in nutritional epidemiology, we propose the Ontology for Nutritional Epidemiology (ONE) according to authoritative guidance for nutritional epidemiologic research; 2) Methods: First, a scoping review was conducted to identify existing ontology terms for reuse in ONE. Second, existing data standards and manuscript reporting guidelines for nutritional epidemiology were converted into ontology, and the terms used in the standards were summarized and listed separately in a taxonomic hierarchy. Third, the ontologies of the nutritional epidemiologic standards, reporting guidelines and the core concepts were gathered in ONE. Three case studies were illustrated for its potential applications. (i) annotation of existing manuscripts and data, (ii) ontology-based inference, and (iii) estimation of reporting completeness in a sample of nine manuscripts; 3) Results: Ontologies for “food and nutrition” (n=33), “disease and special population” (n=86), “data description” (n=21), “research description” (n=32) and “supplementary (meta) data description” (n=44) were reviewed and listed. ONE consists of 339 classes (79 new classes to describe nutrition data and 24 new classes to describe the content of nutrition manuscripts). The case studies demonstrated the application of ONE. 4) Conclusion: ONE is a resource to automate data integration, searching and browsing, and can be used to assess reporting completeness in nutritional epidemiology.

Cranioplasty (CP) is the main surgical procedure aimed at reproducing a structural or morphological defect of the skull. It has been shown that cranioplasty can be useful for patients with traumatic brain injury (TBI) to achieve functional cognitive and motor improvements. Here, we describe a patient with long-term severe TBI who recovered consciousness following delayed CP. We found that a delayed CP may result in a meaningful functional recovery with emergence from a minimally conscious state and recovery of functional communication, even more than a year after decompressive craniectomy. Delayed intervention is equally successful in promoting functional recovery in long-term TBI patients, as early CP has already shown.

The introduction of ventricular shunts dramatically changed the outcome and quality of life of hydrocephalic patients. However, shunt surgery continues to be associated with numerous adverse events. Headache is one of the most common complications after shunt operation. It is often over a prolonged duration, the symptoms resemble migraine, and pain does not respond to medication. We propose invasive peripheral nerve stimulation as a possible solution in the treatment of patients suffering from chronic headache associated with shunted hydrocephalus. A young woman with daily holocephalic headache with diffuse pain exacerbated by lying down. Imaging revealed panventricular enlargement and possible stenosis of the aqueduct. When a ventriculoperitoneal shunt was placed, clinical symptoms resolved. Nevertheless, she gradually exacerbated after a second valve replacement due to wound infection. Imaging revealed decompressed ventricles and appropriate shunt placement. The diagnosis of chronic post-intracranial disorder headache was set. Therefore, occipital nerve stimulation was applied and considering that the patient had not a total response, bilateral parietal stimulation was added. Three months after the combined PNS she experienced total remission of headache. Combined PNS eases refractory headaches much more than occipital nerve stimulation alone and could be considered as a solution for shunted hydrocephalus associated headache.

This paper proposes a Case-Based Reasoning (CBR) system to contribute to reinforce the sustainable performance of an environmental management system. The CBR system aims to support the decision-making process to select environmental management actions aimed at reducing risky trends of the environmental state of a region. The CBR system takes advantage of a set of situation-solution pairs called cases, which are stored in a memory and then retrieved as candidates to solve new problems. Situations in this work are represented by a set of risky trends of the following key environmental variables: CO2 emissions, Air-Quality, Loss of Vegetation Cover, Water Availability, and Solid Waste, whose combination damage the environmental state quality of a region. Meanwhile, solutions are represented by a set of environmental management actions. Similar situations to a given current situation are retrieved from the memory of cases and then their solutions are combined, through an adaptation mechanism, until the solution of the current problem is obtained. We used risky trends derived from real data related to the environmental states of a Mexican region to test the proposed CBR system. The results obtained provided insights into the potential of CBR systems to support the decision-making process to select environmental management actions aimed at reducing risky trends of current environmental states.

Background/objective: Tools to accurately and efficiently measure the dietary intake of Nigeria are lacking. We aimed to develop and assess the usability of a new online dietary assessment tool for Nigeria, myfood24 West Africa. Methods: We developed myfood24 West Africa database using data from existing food composition tables, back-of-pack labels of packaged foods and research articles. A 7-step approach was used: identified data sources, selected foods, processed/cleaned data, calculated nutrient content of recipes, created/allocated portion sizes, quality-checked database, and developed food accompaniments. To pilot myfood24 West Africa, we recruited 179 university staff living in Nigeria using a cross-sectional design; usability was assessed using a questionnaire that incorporated the System Usability Scale (SUS) and feedback session. Results: The database included 924 foods with up to 54 nutrients and 35 portion-size images allocated to foods. 60% of the data were sourced from the 2019 West Africa Food Composition Table, 17% from back-of-pack labels, 14% from the 2017 Nigeria Food Composition Table, 5% from generated recipes and 4% items from published literature. 30% (n=53) self-recorded their diet on their own and 1345 entries were made. The mean SUS score of 74 (95% CI: 68,79) indicated good usability. The feedback showed the tool was easy to use, educative, and included a variety of locally foods consumed. Conclusion: This new tool will enhance the dietary assessment of the Nigerian population. More work will cover more foods from other regions of Nigeria and West African countries.

Latent autoimmune diabetes in adults (LADA) is characterized by the presence of glutamate de-carboxylase autoantibodies (GADA). LADA has intermediate features between type 1 diabetes and type 2 diabetes. In addition, genetic risk factors for both types of diabetes are present in LADA. Nonetheless, evidence about the genetics of LADA in non-European populations is scarce. This study aims to perform a genome-wide association study with a phenome-wide association study of LADA in a southeastern Mexican population. We included 59 patients diagnosed with LADA from a previous study and 3121 individuals without diabetes from the MxGDAR/ENCODAT database. We utilized the GENESIS package in R to perform the GWAS of LADA and PLINK for the PheWAS of LADA features. Nine polymorphisms reach the nominal association level (1x10-5) in the GWAS. The PheWAS showed that rs7305229 is genome-wide associated with serum GADA levels in our sample (p=1.84x10-8). rs7305229 is located downstream FAIM2 gene; previous reports associate FAIM2 variants with childhood obesity, body mass index, body adiposity measures, lymphocyte CD8+ activity, and anti-thyroid peroxidase antibodies. Our findings reveal that rs7305229 affects the GADA levels in patients with LADA from southeastern Mexico. More studies are needed to determine if this risk genotype exists in other populations with LADA.

Background: Many risk-modifying factors affect cancer incidence and mortality rates. Solar UVB reduces cancer risk by producing vitamin D, which has many mechanisms to reduce risk of cancer incidence, progression, and metastasis. Obesity increases cancer risk through several mechanisms, including increased inflammation. Method and Materials. We present an ecological study (a type of observational study) of incidence and/or mortality rates for cancers during 2007–2016 of 17 anatomical sites with respect to solar ultraviolet-B (UVB) doses and obesity prevalence. Data were averaged for 12 geographical regions. Results: Solar UVB doses were significantly inversely correlated with incidence rates for three types of cancer for males. They were inversely correlated with mortality rates for five cancers for males and four for females. Obesity prevalence was directly correlated with mortality rates for three cancers for males and seven for females. Discussion: The ecological approach has certain limitations, such as its sensitivity only to regional variations in relation to specific risk-modifying factors. In this study, these limitations include numerous factors influencing cancer risk and the fact that the data are averaged across entire regional populations, which may not reflect individual risks. Despite this, the study reveals important correlations. Specifically, it found that solar UVB exposure is linked to a lower risk of certain cancers, while obesity is associated with an increased risk of some cancers in France. These findings are consistent with results from a similar study in the United States on cancer rates between 2016 and 2020. The association between obesity and cancer risk aligns with other observational studies. However, it is uncertain to what extent higher solar UVB exposure or elevated serum 25-hydroxyvitamin D levels might mitigate the impact of obesity on cancer risk. Reducing cancer mortality in France may be achievable through vitamin D supplementation and efforts to lower obesity prevalence.

Non-pharmaceutical interventions (NPIs), including social distancing, wearing personal protective equipment, and lockdown measures, have been at the forefront of outbreak control in nursing homes. We used a mixed methodology to assess which NPIs nursing homes in the canton of Geneva, Switzerland, followed for their staff and residents during the first wave of the pandemic, between March 1, 2020 and June 1, 2020. For the qualitative component, we interviewed the attending physicians and/or director of each nursing home. Based on in-vivo codes, NPIs for nursing home workers and residents in each nursing home were thematically classified as: maximally restrictive, moderately restrictive, and minimally restrictive. In the quantitative component, we calculated incident rate ratios (IRR) for infection between the three levels of COVID-19-related measures taken in these nursing homes. We found an equal distribution of maximally (n=4), moderately (n=4), and minimally (n=4) restrictive NPIs. The extent of restriction did not show to be significantly associated with the cumulative incidence of COVID-19 cases among residents (maximally restrictive IRR = 3.90, 95%CI 0.82-45.54, p = 0.184; moderately restrictive IRR = 3.55, 95%CI 0.75-41.42, p = 0.212 ; minimally restrictive IRR = reference). Variabilities in NPIs adopted by nursing homes, and the number of COVID-19 cases appear to be randomly affected.

The Ames/quantitative structure-activity relationship (QSAR) International Challenge Projects held during 2014–2017 and 2020–2022, evaluated the performance of various predictive models. Despite the significant insights gained, the rules allowing participants to select prediction targets introduced ambiguity in model performance evaluation. This reanalysis identified the highest-performing prediction model, assuming a 100% coverage rate (COV) for all prediction target compounds and an estimated performance variation due to changes in COV. All models from both projects were evaluated using balance accuracy (BA), Matthews correlation coefficient (MCC), F1 Score (F1), and the first principal component (PC1). After normalizing the COV, a correlation analysis with these indicators was conducted, and the evaluation index for all prediction models in terms of the COV was estimated. In total, 109 models, the highest estimated BA (76.9) at 100% COV was MMI-VOTE1, reported by Meiji Pharmaceutical University (MPU). The best models for MCC, F1, and PC1 were all MMI-STK1, also reported by MPU. All models reported by MPU ranked in the top four. MMI-STK1 was estimated to have F1 scores of 59.2, 61.5, and 63.1 at COV levels of 90%, 60%, and 30%, respectively. These findings highlight the current state and potential of the Ames prediction technology.

Hundreds of thousands of people living along the Yatsushiro Sea coast have been exposed to methylmercury from the contaminated water of the Chisso factory in Minamata. Methylmercury causes neurological deficits in the cerebrum and cerebellum, with symptoms of ataxia, dysarthria, and visual field constriction in severe cases, but the most common symptom of a milder disorder is somatosensory disturbance due to parietal lobe damage. We investigated the characteristics of the somatosensory disturbances in detail by studying subjective complaints, neurological findings, and quantitative sensory tests in 197 residents (63.2 ± 10.7 years old) from contaminated areas exposed to methylmercury from seafood and 130 residents (63.7 ± 9.3 years old) from control areas. The most commonly affected sensory modalities were superficial peripheral touch and pain in the extremities, followed by two-point discrimination and deep senses, and in the most severe cases, full-body sensory dysfunction and impairment of all sensory submodalities. Although the severity of the sensory submodalities correlated with each other, there was almost no correlation between the severity of these submodalities and indices of peripheral nerve conduction studies, suggesting that the primary cause of the sensory deficits was damage to the central nervous system. The health effects of chronic methylmercury toxicosis can be elucidated by a detailed examination of sensory deficits.

Coronavirus disease (COVID-19) has had devastating impacts on the global economy and public health. This study aimed to assess the level of COVID-19 vaccine acceptance, hesitancy, and associated factors among staff and students of the Federal University of Health Sciences Otukpo, Benue State, Nigeria. A web-based cross-sectional survey was conducted between November 2021 and April 2022, and data were collected and analyzed using descriptive and inferential statistics. Of the 150 completed and analyzed questionnaires, the majority of respondents (80.0%) were between 16 and 45 years old. The study found that 58.4% of participants indicated vaccine hesitancy, with skepticism about the vaccine's fast production/rollout and fear of vaccine side effects being the most common reasons for hesitation. Respondents' age, religion, and category were significant factors influencing vaccine acceptance and hesitancy (P < 0.05). The university community has a high level of awareness of COVID-19 but low vaccine acceptance, resulting in high levels of vaccine hesitancy. The study recommends that policymakers and public health officials should prioritize testing and vaccination for job categories with higher risk of exposure to COVID-19. They should provide accurate information about COVID-19 testing and vaccination and implement workplace-based testing and vaccination programs. These interventions can help to increase COVID-19 testing and vaccination uptake among the university community and mitigate the spread of COVID-19.

Job satisfaction has a strong impact on the intention to stay which is an important aspect to counter skills shortage in academic medicine. In an interview study combining qualitative and quantitative methods we investigated how the mental representation of working conditions influences job satisfaction and its impact on the intention to stay. In a first study chief physicians participated in interviews about job satisfaction in academic hospitals. Answers were segmented into statements, ordered by topics and rated according to their valence. In a second study assistant physicians (residents) during and after their training period talked about strength, weaknesses and potential improvements of working conditions. Again, answers were segmented, ordered, rated and used to develop a ‘job satisfaction scale’. In a third study, assistant physicians participated in a computer-led repertory grid procedure composing ‘mental maps’ of job satisfaction factors, filled in the job satisfaction scale and rated if they would recommend work and training in their clinic as well as their intention to stay. Comparing the interview results with recommendation rates and intention to stay show that a negative attitude is linked to high workload and poor career perspectives. A positive attitude towards work environment and high intention to stay are linked to sufficient personnel and technical capacities, reliable duty scheduling and fair salaries. The third study using repertory grids showed that the perception of current teamwork and future developments concerning work environment were the main aspects to improve job satisfaction and the intention to stay. The results of the interview studies were used to develop an array of adaptive improvement measure. The results support prior findings that job dissatisfaction is mostly based on generally known “hygiene factors” and whereas job satisfaction is due to individual aspects.

Passive and forced drinking harm was prevalent but less recognized in Chinese adolescents. We educated adolescents on such harm to reduce their intention to drink. Students (n=1244) from 7 secondary schools in Hong Kong participated in a video-based health talk on passive and forced drinking harm. Paired t-test was used to assess their change in knowledge of passive and forced drinking, health and social harm of drinking after the health talk. McNemar's chi-squared test and adjusted multivariable logistic regression (AOR) were used to assess their change in intention to drink and intention to quit. Students were less likely to drink (OR 0.29, 95% CI 0.19-0.42) and more likely to quit drinking (OR 3.50, 1.10-14.6) after the health talk. Increased knowledge of passive drinking was associated with less intention to drink (AOR 0.93, 0.90-0.97), increased knowledge of health harm (adjusted b 0.06, 0.05-0.08), and social harm of drinking (adjusted b 0.12, 0.10-0.16). Similar associations were observed in forced drinking (intention to drink: AOR 0.87, 0.79-0.96; health harm: adjusted b 0.16, 0.12-0.19; social harm: adjusted b 0.36, 0.28-0.43). We showed preliminary evidence that the health talk on passive and forced drinking reduced the intention to drink in adolescents.

Iron overnutrition has been implicated with higher risk of developing metabolic and cardiovascular diseases, including metabolic syndrome (MetS), while iron deficiency anemia exacerbates many underlying chronic conditions. Hemoglobin (Hb) concentration in the blood, which reflects a major functional iron (i.e., heme iron) in the body, may serve as a surrogate of iron nutrition status. We conducted sex-specific observational association studies where we carefully titrated the association between Hb deciles and MetS and its components among the Taiwanese Han Chinese (HC) from the Taiwan Biobank and Europeans of White ancestry from the UK Biobank, representing two large ethnicities. Our data show that at higher-than-normal levels of Hb, increasing deciles of Hb concentration were significantly associated with MetS across all sex subgroups in both ethnicities, with the highest deciles resulting in up to three times greater risks than the reference group [Taiwanese HC: OR=3.17 (95% CI, 2.75-3.67) for Hb >16.5 g/dL in men, OR=3.11 (2.78-3.47) for Hb >14.5 g/dL in women; European Whites: OR=1.89 (1.80-1.98) for Hb >16.24 g/dL in men, OR=2.35 (2.24-2.47) for Hb >14.68 g/dL in women]. The association between stronger risks and increasing Hb deciles was similarly observed with all metabolic components except diabetes. Here we found that both the highest Hb decile groups and contrarily the lowest ones, with respect to the reference, were associated with higher odds of diabetes in both ethnic groups [e.g., Taiwanese HC men: OR=1.64 (1.33-2.02) for Hb >16.5 g/dL, OR=1.71 (1.39-2.10) for Hb <13.5 g/dL; European Whites women: OR=1.39 (1.26-1.45) for Hb >14.68 g/dL, OR=1.81 (1.63-2.01) for Hb <12.39 g/dL]. These findings confirm that elevated Hb concentrations, a potential indicator of iron overnutrition, may play a role in the pathophysiology of MetS and metabolic components.

The incidence of Type 1 Diabetes (T1D) in the Arab world, particularly, oil and gas rich Gulf Cooperative Council (GCC) countries has more than doubled in the last twenty years. Therefore, there is a dire need for careful systematic familial cohort studies, especially in high-risk populations. Several immunogenetic factors affect the pathogenesis of the disease. Genes in the human leukocyte antigen (HLA) account for the major genetic susceptibility to the disease. The triggering agents initiate disease onset by destruction of pancreatic β-cells. The autoantibodies against glutamic acid decarboxylase (GADA), insulinoma antigen-2 (IA-2A), insulin (IAA), and zinc transporter-8 (ZnT-8A) comprise the most reliable biomarkers for T1D in both children and adults. Although three of the GCC countries, namely Kuwait, Saudi Arabia and Qatar are among the top 10 countries with high incidence rate of T1D, no proper diagnostic and prediction tools were applied in the region. Understanding the disease sequelae in a homogenous gene pool with high consanguinity in the GCC could help solve the challenges in understanding pathogenesis, as well as hasten the prevention of T1D. Arab states must incorporate T1D predictive and intervention policies on a war-footing basis to minimize the burden of this serious disease.

Ultrasonic measurements are used in civil engineering for structural health monitoring of concrete infrastructures. The late portion of the ultrasonic wavefield, the coda, is sensitive to small changes in the elastic moduli of the material. Coda Wave Interferometry (CWI) correlates these small changes in the coda with the wavefield recorded in intact, or unperturbed, concrete specimen to reveal the amount of velocity change that occurred. CWI has the potential to detect localised damages and global velocity reductions alike. In this study, the sensitivity of CWI to different types of concrete mesostructures and their damage levels is investigated numerically. Realistic numerical concrete models of concrete specimen are generated and damage evolution is simulated using the discrete element method. In the virtual concrete lab, the simulated ultrasonic wavefield is propagated from one transducer using a realistic source signal and recorded at a second transducer. Different damage scenarios reveal a different slope in the decorrelation of waveforms with the observed reduction in velocities in the material. Finally, the impact and possible generalizations of the findings are discussed and recommendations are given for a potential application of CWI in concrete at structural scale.

The aim of this study was characterization of some dairy drinks based on Milk Serum regarding major whey proteins (WP) and free amino acids (FAAs) using reversed phase high performance liquid chromatographic (RP-HPLC) methods. The studied WP, -lactalbumin (-La), bovine serum albumin (BSA), -lactoglobulin A (-Lg A) and -lactoglobulin B (-Lg B) were separated on Aeris XB-C18 column at 214 nm detection. The RP-HPLC method was validated by selectivity, linearity (R2 ≥0.99), sensitivity (LOQ, 1.35–10.08 µg mL−1), accuracy (recovery 96.79-103.07%) and precision (% RSD ≤ 4.13%). The total studied WP in studied dairy drinks varied between 1.42 and 3.047 g·L-1. The chromatographic profile of FAAs (aspartic acid, glutamic acid, serine, histidine, arginine, glycine, threonine, alanine, tyrosine, cysteine, tryptophan, methionine, valine, phenylalanine, isoleucine, leucine and lysine) was determined in lyophilized concentrate of Milk Serum by RP-HPLC using pre-column derivatization reaction with orthophthalaldehyde (OPA). The total studied FAAs in studied samples varied between 1.103 and 1.119 mg·g-1. Moreover, the Milk Serum showed bacteriostatic activity against two bacterial strains Escherichia coli and Staphylococcus aureus. The obtained results confirm that dairy drinks based on the Milk Serum constitutes a valuable sources of bioactive components with benefits for human healthy nutrition.

The present short communication aimed to determine the effects of vegetable cultivation on health. We conducted a qualitative study using responses to an open-ended question that was part of a survey on regional differences on vegetable intake. Participants in this study were residents of Gunma Prefecture, Japan, and were aged between 20–74 years. In the questionnaire, we asked: “Aside from increasing vegetable intake, how does vegetable cultivation affect your health?” We were able to categorize the answers into six subcategories related to physical health, mental health, and social well-being.

Genetic testing has expanded out of the research laboratory into medical practice and the direct-to-consumer market, and rapid analysis of the resulting genotype data can now have significant impact. We present a method for summarizing personal genotypes as ‘genotype fingerprints’ that meet these needs. Genotype fingerprints can be derived from any single nucleotide polymorphism (SNP)-based assay, and remain comparable as chip designs evolve to higher marker densities. We demonstrate that they support distinguishing types of relationships among closely related individuals and closely related individuals from individuals from the same background population, as well as high-throughput identification of identical genotypes, individuals in known background populations, and de novo separation of subpopulations within a large cohort through extremely rapid comparisons. While fingerprints do not preserve anonymity, they provide a useful degree of privacy by summarizing a genotype in a way that prevents reconstruction of individual marker states. Genotype fingerprints are therefore well-suited as a format for public aggregation of genetic information to support ancestry and relatedness determination without revealing personal health risk status.

1) Landsat operational land imager (OLI) data and consequent laboratory measurements were used to predict Chlorophyll-a (Chl-a) concentration and the trophic states for an inland lake within the East Kolkata Wetland, India; 2) The most suitable band ratio was identified by performing Pearson correlation analysis between Chl-a concentrations and possible OLI band and band ratios from the study points; 3) The results showed highest correlation coefficient from the band ratio OLI5/OLI4 with an R value of 0.85. The prediction model was then developed by applying regression analysis between the band ratio OLI5/OLI4 and Chl-a concentration of the study points. The reflectance ratios of the validation points were given as input on the prediction model and the model output was considered as predicted Chl-a values of the validation points to check the efficiency of the prediction model. The regression model between laboratory-derived Chl-a value and model-fitted Chl-a value of the validation points revealed a high correlation with an R² value of 0.78. Trophic State Index (TSI) of the lake was also calculated from laboratory-derived Chl-a value and model-fitted Chl-a value of the validation points. The study presented a high correlation of TSI determined from predicted data with TSI from laboratory reference data (R = 0.88). The TSI values of the lake ranged from 65 to 75 which indicate that the lake is appeared to be eutrophic to hypereutrophic conditions. 4) This empirical study showed that Landsat 8 OLI imagery can be effectively applied to estimate Chl-a levels and trophic states for inland lakes.

Background: Active case finding for TB was implemented in selected sixty high TB burden wards of Kolkata, India. Community volunteers called TOUCH agents (TAs) identified and referred presumptive TB patients (PTBPs) to health facilities for TB diagnosis and treatment. We aimed to describe the ‘care cascade’ of PTBPs identified during July to December, 2018 and to explore the reasons for attrition as perceived by TAs and PTBPs. Methods: An explanatory mixed methods study with quantitative phase of cohort study using routinely collected data followed by descriptive qualitative study with in-depth interviews was conducted. Results: Of the 3, 86,242 individuals enumerated, 1132 (0.3%) PTBPs were identified. Only 713 (63.0%) PTBPs visited referred facility for TB diagnosis. TB was diagnosed in 177 (24.8%) and the number needed to screen for one TB was 2,183 individuals. The potential reasons for low yield were stigma and apprehension about TB, distrust about TA, wage loss for attending health facilities and substance abuse among PTBPs. Conclusion: The yield of ACF was suboptimal with low PTBP identification rate and high attrition rate. Interviewing each individual for symptoms of TB and supporting PTBPs for diagnosis through sputum collection and transport can be adopted to improve the yield.

Lotions with or without 28% ascorbyl glucoside arginine complex (AGAC) were applied twice daily for 24 weeks in a double‐blind half‐face study of 27 Japanese females with solar lentigos (SLs). Pigmentation scores were evaluated using a photo‐scale and skin colors were assessed using a color difference meter and a Mexameter. Treatment with the test lotion elicited a significant decrease in pigment scores at 24 weeks compared to week 0; with a significant decrease in pigment scores at 24 weeks compared to the placebo lotion‐treated SLs. In the test lotion‐treated SLs; the L values and melanin index (MI) significantly (p<0.0001) increased and decreased; respectively; at 12 and 24 weeks of treatment compared to week 0. Comparisons of increased L (△L) values or decreased MI (△MI) values between test and placebo lotion‐treated SLs demonstrated that the test lotion‐treated SLs had significantly higher △L or △MI values than the placebo lotion‐treated SLs both at 12 and 24 weeks of treatment. The sum of our results strongly indicates that AGAC is distinctly effective in ameliorating the hyperpigmentation levels of SLs at a visibly recognizable level by the subjects without any hypo‐pigmenting effects or skin irritation.

Most shear tests are performed as standard three- or four-point bending tests, i.e., on one-way simply supported specimens subjected to concentrated loads. The major disadvantage is that these conditions usually do not correspond to the support and load condition of real structures. Structural members such as beams or slabs, are often multi-span components and subjected to distributed loads. As a consequence, the complex shear behavior, including crack kinematics, shear transfer mechanisms, and shear capacity, is studied almost only simply supported members with concentrated load. Positive impacts on the shear behavior resulting from continuous systems and distributed loads are thus neglected in the derivation of calculation models and in the development of design specifications. To incorporate the effect of continuous members and distributed loading conditions, more experimental investigations are necessary. Therefore, a total of 16 bending shear tests on CFRP reinforced concrete members without shear reinforcement were carried out. The tests specimens were tested as simply supported beams or as simply supported beams with loaded cantilever to simulate the continuous system with concentrated and distributed loads. Furthermore, the shear slenderness was varied by using different span lengths and degrees of restraint in the systems with intermediate support. All test specimens were made of high-strength concrete and were reinforced with a multilayer grid-like CFRP reinforcement in longitudinal direction. There was no shear reinforcement installed in the investigated shear span. This paper focuses the influence of the support conditions and load arrangements on crack development as well as on shear strength.

Abstract There is no research that combines behavioural and fMRI research approaches to investigate the mediating and moderating effects of working memory, verbal IQ, visuospatial and verbal reasoning on students’ performance of maths and science. This paper investigates all these multiple relationships between working memory (WM), verbal IQ, visuospatial and verbal reasoning with performance in maths and science accuracy. The multimethod research consists of a behavioural survey and a fMRI neuroscience investigating the interactive and multiple relationships of all cognitive processing independent variables (IVs) with the dependent variables (DVs) of maths and science performance. Using structural Equation Modelling (SEM) and Warp Partial Least Squares (Warp PLS) analytical approach, the research discusses the findings of both, the behavioural and fMRI data. The adolescent sample (N=34) for the behavioural and fMRI study, was recruited from consenting schools in London, UK, and consisted of equal numbers of girls and boys between 11-15 years old. The hypothesised behavioural SEM model predicted positive relationships between all the independent variables (IV) of visuospatial matrix reasoning (VSMatAR), verbal analogical reasoning (VerbAR), verbal working memory (VWM), visuospatial working memory (VSWM) and verbal IQ, with performance in maths and science accuracy. The findings support all hypotheses except two and identifies verbal IQ, Verbal WM and VerbAR as the three strongest predictors of maths and science accuracy. The neuroscience fMRI data identified four brain regions of interest, namely, the bilateral DLPFC, Parietal, Temporal and pre-supplementary motor area (PSMA) as being most relevant to maths and science outcomes. The hypothesised fMRI SEM, produced mixed results which supported some of the hypothesised relationships between the IVs of verbal AR and VSMatrix AR associations with all four brain regions and in turn the associations with maths and science performance. The paper makes two original contributions, firstly, by testing the hypothesis that Verbal WM mediates the independent variables’ effects on maths and science outcomes. And secondly, by using Warp PLS to test the SEM (behavioural and fMRI) models’ multiple non-linear interactions simultaneously between the IVs with the DVs of maths and science accuracy. The Warp PLS testing of all IVs and DVs produced some interesting new insights regarding the relationships between Verbal analogical reasoning, which are deemed important to assist academics and educational practitioners in improving maths and science performance of adolescent students. The combination of behavioural and neuroscience fMRI data provides more reliable empirical evidence regarding the multiple interactive influences impacting maths and science performance for adolescents.

Computer and Smart Device-assisted Learning (CSDL) has gained increasing attention from educational researchers and practitioners in recent years. However, it remains controversial whether student can benefit from CSDL and what moderator could affect the impact of CSDL. Within the specific context of Korea, where the interest in digital education is steadily increasing, the number of empirical studies exploring the causal effect of CSDL remains relatively scarce. The primary objective of this empirical study was to investigate the impact of CSDL on students' academic achievement in Korea. To achieve this objective, a two-way fixed effect model was employed, utilizing a panel dataset spanning three years derived from the 'Korean Education Longitudinal Study 2013'. The findings revealed a significant positive impact of CSDL on students’ Mathematics achievement. Notably, higher income levels, increased availability of computer resources provided by schools, and the implementation of more individualized education were identified as factors that moderate the effect of CSDL on students' achievement levels in Korean and English subjects. These findings underscore the need for an approach that optimizes the educational benefits of CSDL by considering subject-specific characteristics. Furthermore, this study highlights the importance of allocating educational resources, such as computers and smart devices, and integrating individualized educational activities within the classroom environment.

Oral and parenteral delivery of first-line anticonvulsant Valproic cid (VA) are associated with serious adverse effects, high hepatic metabolism, high clearance, and low bioavailability in brain. GastroPlus program was used to predict in vivo performance of immediate (IR) and sustained release (SR) products in human. HSPiP software predicted excipients with maximum possible miscibility of the drug. Based on GastroPlus and HSPiP program, various excipients were screened for experimental solubility study and prepared cationic nanoemulsions and respective gels for nasal to brain delivery. These were characterised for size, size distribution, polydispersity index, zeta potential, morphology, pH, % transmittance, drug content, and viscosity. In vitro drug release, ex vivo permeation profile (goat nasal mucosa), and penetration studies were conducted. Result showed that in-vivo oral drug dissolution and absorption were predicted as 98.6 mg and 18.8 mg, respectively from both tablets (IR and SR) at 8 h using GastroPlus. The drug access to the portal vein was relatively predicted high in IR (115 mg) as compared to SR (82.6 mg). Plasma drug concentration-time profile predicted was in good agreement with published reports. The program predicted duodenum and jejunum as the prime site of drug absorption and no effect of nanonization on Tmax for sustained release formulation. Hansen parameters suggested suitable selection of excipients. The program recommended for nasal to brain delivery of the drug using cationic mucoadhesive product. The optimized stable CVE6 was associated with optimal size (113 nm), low PDI (0.26), high zeta potential (+34.7 mV), high transmittance (97.8%), and high strength (0.7 %w/w). In vitro release and ex vivo permeation of CVE6 were found to be substantially high as compared to anionic AVE6 and respective gels. Penetration study executed high fluorescence intensity with CVE6 and CVE6-gel as compared to suspension and ANE6 which may be attributed to electrostatic interaction between mucosal membrane and nanoglobules. Thus, cationic nanoemulsion and respective mucoadhesive gel are promising strategy for delivery of VA to brain through intransal administration for the treatment of seizure and convulsion.

The shear factor of ore drawing is one of the important factors affecting the formation of underground debris flow, and it has an important contribution to the formation of underground debris flow. The purpose of this paper is to study the effect of mining shear factor on underground debris flow in natural caving method. Based on the research background of the underground debris flow in Plan copper mine, this paper analyzes the characteristics of the slurry material structure of the underground debris flow, the influence of drawing shear factor on formation mechanism of underground debris flow is analyzed. The results show that the slurry of the underground debris flow in Plan mine is not only a pseudoplastic fluid but also a thixotropic fluid. It is indicated that once there is shearing force in drawing, it will deform, and its viscosity will decrease with the increase of shear rate and time. It is considered that the shear force produced by the flow of ore particles first produces shear action on the paste in the shear boundary region of ore drawing, it is reduced in viscosity and increased in fluidity, so that its “Activation” and then become a flowable paste, along with the bulk ore flow through the mouth. The continuous ore drawing process will continuously shear the new moraine slurry in the ore drawing channel and continuously “Activate” the moraine slurry in the ore drawing channel, finally, a certain scale and destructive down-hole debris flow accident. This paper is the first to study the effect of ore drawing shear factor on the formation mechanism of underground debris flow. It not only broadens the research field of debris flow, but also fills up the deficiency of systematic research on underground debris flow, and provides theoretical guidance for the prevention and control of underground debris flow.

Background and Objectives: Mucilaginous substances from plant extracts are known to be able to support the lubricating effect of hyaluronic acid (HA) in dry eye disease (DED). In this pilot study, the combined lubricating effect of HA and mallow extract (Malva sylvestris L.) in patients with DED was assessed. Materials and Methods: 20 patients at 5 ophthalmological practices in Italy were treated with eye drops, containing HA and mallow extract on the one hand, and with eye drops containing HA only, on the other hand, in a two-period crossover design. As primary endpoints, the tear film breakup time (TBUT), the reduction of lissamine green staining of the ocular surface (Oxford Scheme, OS), and the safety and efficacy assessment by the ophthalmologists were evaluated. As secondary variables, the patient symptom score, the ocular surface index (OSDI), and the satisfaction, preference and efficacy judgement by the patients were evaluated. All data were analysed descriptively in addition to an exploratory analysis of the target variables. Results: Both products were well tolerated. There were no statistically significant differences, with regard to the TBUT, OS and OSDI, between both treatments. Anyway, the efficacy and safety assessments by the ophthalmologists and the patients showed results in favour of the combined product. Conclusion: The addition of mallow extract to HA containing eye drops enhances the treatment of DED at least with respect to subjective measurements. Further assessments will have to be done to prove and explain this observation in terms of measurable parameters, e.g. markers for inflammatory cytokines.

Cervical cancer is mostly diagnosed cancer of women worldwide and the second most common cancer among middle-aged women in Bangladesh. Knowledge and perception of women are considered one of the major components of prevention strategy. We carried out this survey to assess the existing knowledge level of students and their perception to the role of vaccination in preventing cervical cancer. The participants were female undergraduate students studying Public Health in a university in Chattogram city of Bangladesh. A total of 275 female students were interviewed through prescribed questionnaire possessing questions on basic information of cervical cancer, its causal agent, risk factors, prevention methods, and vaccination. We marked the responses of participants with zero for wrong answer and one for every correct answer and ranked the knowledge level of students. The mean age of study participants was 20.68 years. In total, 69.1% students possessed poor knowledge whereas, 30.9% had good knowledge. The country of students has significant association with their level of knowledge. Most of the students got information on cervical cancer from traditional media (49.8%) and doctor (30.9%) and the effect of these two sources was statistically significant on the knowledge level of students. Students mostly identified vaccination (21.1%) and Gynecological examination (14.39%) as preventing methods. However, 65.5% of them acknowledge that vaccines cannot prevent this cancer and 33.4% believe in different risks of vaccine. Although students have heard of cervical cancer the overall knowledge was insufficient and perceived negative concepts about cancer vaccine. Therefore, we recommend the initiation of educational programs on basic reproductive health and health seeking behaviour targeting young women to successfully control and prevention of this life-threatening health problem.

Ensembles of Species Distribution Models (SDMs) represent the geographic ranges of pathogen vectors by combining alternative analytical approaches and merging information on vector occurrences with more extensive environmental data. Biased collection data impact SDMs, regardless of the target species but no studies have compared the differences in the distributions predicted by the ensemble models when different sampling frameworks are used for the same species. We compared Ensemble SDMs for two important Ixodid tick vectors, Amblyomma americanum and Ixodes scapularis in mainland Florida, USA, when inputs were either convenience samples of ticks, or collections obtained using the standard protocols promulgated by the U.S. Centers for Disease Control and Prevention. The Ensemble SDMs for the convenience samples and standard surveys showed only a slight agreement (Kappa = 0.060, A. americanum; 0.053, I. scapularis). Convenience sample SDMs indicated A. americanum and I. scapularis should be absent from 34.5% and 30.9% of the state where standard surveys predicted the highest likelihood of occurrence of the respective vectors. Ensemble models from standard surveys predicted 81.4% and 72.5% (A. americanum and I. scapularis) of convenience sample sites. Omission errors by standard survey SDMs, of the convenience collections, frequently were associated with adjacency to at least one SDM or errors in geocoding algorithms that failed to correctly locate convenience samples. These geocoding errors emphasize commonly overlooked needs to explicitly evaluate and improve data quality for vector survey data used in spatial models.

The doctoral defense, which is an essential requirement for the doctoral degree, is considered to have three dimensions: the scholarly dimension, the emotional (affective) dimension, and the cultural dimension. In this work, I explore the link between sociodemographic factors and students’ perception of the doctoral defense. In particular, I focus on gender, ethnicity, and age at time of defense, as well as current position, and field of study. To address the influence of these aspects on the affective dimension of the doctoral defense, I first reviewed the literature on these socio-demographic aspects as well as the affective dimension of the defense. I then carried out an international survey on doctoral defenses, defense formats, and students’ perceptions and analyzed the 204 completed surveys for this study using quantitative and qualitative methods. The analysis included cross-correlations between students’ perceptions and the studied sociodemographic aspects. The main results of these analyses are that gender affects various aspects of the students’ perception of the doctoral defense and long-term perception, and that female candidates experience more issues with their committee. Ethnicity is important as well, although the participations of non-white respondents in this survey was limited. The influence of age at the defense is limited, and only for the youngest and oldest age groups I observe some differences in perception. There is no relation between current position and perception of the candidates during the defense. Finally, field of study is correlated for various aspects of student perception, committee issues, and long-term perception. The conclusion of this work is that socio-demographic aspects, and in particular gender, ethnicity, and field of study, influence how doctoral candidates experience their defense.

The Covid-19 pandemic has severely tested the mental health of frontline health care workers. A repeated cross-sectional study can provide information on how their mental health evolved during the various phases of the pandemic. The intensivists of a COVID-19 hub hospital in Rome were investigated with a baseline survey during the first wave of the pandemic in April 2020 and were contacted again in December 2020, during the second wave. 152 of the 205 eligible workers responded to an online questionnaire designed to measure procedural justice, occupational stress (effort/reward imbalance), sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and turnover intention. Workers reported a further increase in workload and compassion fatigue, which had already risen during the first wave, and a marked reduction in the time devoted to meditation and mental activities. A low level of confidence in the adequacy of safety procedures and the need to work in isolation, together with an increased workload and lack of time for meditation were the most significant predictors of occupational stress in a stepwise linear regression model. Occupational stress was, in turn, a significant predictor of insomnia, anxiety, low job satisfaction, burnout, and intention to leave the hospital. The number of workers manifesting symptoms of depression increased significantly to exceed 60%. Action to prevent occupational risks and enhance individual resilience cannot be postponed.

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

Downregulated microRNA-142-3p signaling contributes to the pathogenesis of endometriosis [1] [2], an invasive disease where the lining of the uterus grows at ectopic locations, by yet incompletely understood mechanisms. Using bioinformatics and in vitro assays, this study identifies cytoskeletal regulation and integrin signaling as two relevant categories of miR-142-3p targets. qPCR revealed that miR-142-3p upregulation in St-T1b cells downregulates ROCK2, CFL2, RAC1, WASL and ITGAV. qPCR and Western-blotting showed miR-142-3p effect on WASL and ITGAV was significant also in primary endometriotic stroma cells. Luciferase reporter assays in ST-T1b cells then confirmed direct regulation of ITGAV and WASL. On the functional side, miR-142-3p upregulation significantly reduced ST-T1b cell size, the size of vinculin plaques, migration through fibronectin-coated transwell filters and the ability of ST-T1b and primary endometriotic stroma cells to contract collagen I gels. These results suggest that miR-142-3p has a strong mechanoregulatory effect on endometrial stroma cells and its external administration reduces the invasive endometrial phenotype. Within the limits of an in vitro investigation, our study provides new mechanistic insights into the pathogenesis of endometriosis and provides a perspective for the development of miR-142-3p based drugs for inhibiting invasive growth of endometriotic cells.

The advantageous location, port clusters, strong economic strength, developed financial system, rational and orderly urban division of labor and modern industrial system of Guangdong-Hong Kong-Macao greater bay area provide sustainable driving force for innovation activities in this region. This paper selected the Gini-coefficient, first degree index and concentration index to measure the spatial pattern characteristics of innovation output in Guangdong-Hong Kong-Macao greater bay area. The results show that the innovation output presented a spatial pattern of center-periphery in the study region with Shenzhen and Guangzhou as the dual centers and engines of innovation and Dongguan and Foshan as the main innovative areas. Further empirical analysis of the impact of various factors on innovation output in the study region found that R&D expenditure, the number of R&D personnel, the level of economic development and industrial structure all have significant promoting effects on innovation output. Accordingly, this paper put forward countermeasures and suggestions to promote the innovative development of Guangdong-Hong Kong-Macao greater bay area and build a world-class scientific and technological innovation bay area.

Background: The prognostic value of erythrocyte levels of the n-6 fatty acids (FAs) for total mortality and cardiovascular disease (CVD) outcomes remains an open question. Methods: We examined CV outcomes and death in 2500 individuals in the Framingham Heart Study Offspring cohort without prevalent CVD (mean age 66 years, 57% women) as a function of baseline levels of different length n-6 FAs (18 carbon, 20 carbon and 22 carbon) in the erythrocyte membranes. Clinical outcomes were monitored for up to 9.5 years (median follow up, 7.26 years). Cox proportional hazards models were adjusted for a variety of demographic characteristics, clinical status and RBC n-6 and long chain n-3 FA content. Results: There were 245 CV events, 119 CHD events, 105 ischemic strokes, 58 CVD deaths, and 350 deaths from all causes. Few associations between either mortality or CVD outcomes were observed for the n-6 FAs, with those that were observed becoming non-significant after adjusting for n-3 FA levels. Conclusions: Higher circulating levels of the marine n-3 FA levels are associated with reduced risk for incident CVD and ischemic stroke and for death from CHD and all-causes, however in the same sample, little evidence exists for association with n-6 FAs. Further work is needed to identify a full profile of FAs associated with cardiovascular risk and mortality.

Agriculture is the backbone of Kenya’s economy, supporting up to 80% of the rural livelihoods. Kenya’s export horticulture is currently the leading Agriculture subsector in Kenya has evolved from small-holder farming to agro-industrial large-scale export farming dominated by multinational companies. It is regarded as an agro-industrial food system based on the economies of scale producing for mass markets outside of the production area. Much of the food consumed from this food system has undergone multiple transformations and been subject to a host of formal and informal insitutions (rules, regulations, standards, norms and values). An Anthropological study of export horticulture in Northwest Mount Kenya was carried out utilizing qualitative data collection methods in Northwest Mount Kenya region. Data was coded and analysed thematically based on grounded theory approach. The study described the institutional settings of export horticulture from an emic perspective as changing and defining the operations of the food system access and management of common pool resources, namely water and land. With the agro-industrial food system competing for these scarce resources in a semi-arid zone, there is potential for conflict and also reduced production and overall benefits to the different actors in the study area.

Electrical storm (ES) is defined as the presence of at least three episodes of sustained ventricular tachycardia or ventricular fibrillation within 24 hours. This patient had a previously known arterial hypertension, type II diabetes mellitus, and chronic kidney disease and has presented to the Emergency Department (ED) with symptoms of retrosternal chest pain lasting for several hours prior. The initial 12-lead electrocardiogram revealed ST segment elevation in the anterior leads (V1-V6). Emergent coronary angiography revealed an acute occlusion of the proximal left anterior descending artery (pLAD) and percutaneous coronary intervention was performed with successful implantation of one drug-eluting stent in the pLAD. On the day 8 of hospitalization, patient developed a refractory ES for which he received 50 DC shocks and did not respond to multiple lines of antiarrhythmic medications. Due to a failure of medical therapy, we decided to implant a temporary pacemaker and initiate ventricular overdrive pacing (VOP) that was successful in terminating ES. Following electrical stabilization, the patient underwent a successful ICD implantation. This case demonstrates that VOP can contribute to hemodynamic and electrical stabilization of a patient that suffers from refractory ES and this treatment modality might serve as a temporary bridge to ICD implantation.

Introduction: Diagnosing and managing Borrelia miyamotoi disease (BMD) is challenging due to its symptom overlap with Lyme disease (LD) and the lack of reliable laboratory diagnostics for BMD. This case study demonstrates the use of phage-based PCR (phb-PCR) to identify B. miyamotoi in a patient who had been bitten by ticks. Case presentation: A female patient aged 46 presented with joint and muscle pain, myalgic encephalomyelitis/chronic fatigue syndrome, and cognitive impairment after multiple tick bites in Europe. The patient was assessed for LD at the National Reference Centre in Strasbourg using Enzyme-linked immunosorbent assay (ELISA) and immunoblot. Additional diagnostics involved screening for Bartonella and Anaplasma antibodies using indirect immunofluorescence, and tests for antinuclear antibodies to check for autoimmune conditions. All serological and immunological tests yielded negative results. However, the phb-PCR identified B. miyamotoi. Consequently, the patient received treatment for BMD with a regimen of intravenous ceftriaxone, oral azithromycin, and additional intravenous vitamin and mineral therapy. Post-treatment evaluations showed significant improvements in pain levels, cognitive abilities, and fatigue. Conclusion: This case highlights the importance of direct diagnostic methods like phb-PCR for identifying BMD when serological tests fail. Clinicians should consider B. miyamotoi testing for accurate and timely management of complex TBDs.

Management of resistant Tuberculosis (TB) can be extremely difficult, especially in case of novel unpredicted complications. In this report, we present a case of a 48-year-old patient with pre-extensive-drug-resistant-(XDR)-TB who received a treatment regimen including Pretomanid, Bedaquiline, Linezolid, Cycloserine and Amikacin and died due to myocarditis. Acquired resistance to first- and second-line drugs developed due to previous poor adherence to medication. The clinical presentation of the patient, along with her initial ultrasonographical, electrocardiogram (ECG) and laboratory examinations, were typical for acute myocarditis, however, the patient was considered unstable and further investigation with Magnetic Resonance Imaging (MRI), pericardiocentesis and endomyocardial biopsy were not performed. To our knowledge, this is the first case of myocarditis in such a patient, the clinical features of which set a high suspicion of drug-induction that could be attributed to the treatment regimen that was administered. Clinicians who manage cases of drug-resistant TB should be aware of this, newly reported, potentially lethal, adverse event.

Background: The lateral antebrachial cutaneous nerve (LACN) is the terminal sensory branch of musculocutaneous nerve and is rarely entrapped or injured. This study describes the electrodiagnostic (EDX) findings and etiologies of LACN neuropathy. Methods: This is a review of 49 patients with pain and/or paresthesia of the forearm who underwent EDX studies. The diagnosis of LACN neuropathy was based on clinical and sensory conduction abnormalities. Results: The most common etiology of LACN neuropathy was iatrogenic injury in 30 (61.2%) patients, primarily due to biceps tendon repair at the elbow (11 [36.7%]) and phlebotomy (5 [16.7%]. Fifteen (30.6%) patients sustained a non-iatrogenic injury at the proximal forearm/elbow, consisting of 6 (60%) laceration injuries and 5 (33.3%) stretch injuries. Four (8.2%) patients comprised the “other” etiology category, including 2 mass lesions causing LACN compression. Pain, paresthesia, and/or numbness in the LACN distribution were reported in 33 (67.3%), 27 (55.1%), and 23 (46.9%) patients, respectively. Hypoesthesia was detected in 45 (91.8%) patients, and dysesthesia in 7 (14.3%). The sensory nerve action potentials (SNAPs) of the LACN on the symptomatic side were absent in 44 (89.8%) patients. Of the 5 patients whose SNAPs of the LACN were detected, all had a decreased amplitude and 2 had increased sensory latency. Conclusion: The most common etiology for LACN neuropathy in this series was iatrogenic injury; repair of biceps tendon at the elbow was the most frequent provoking cause. Protection of the LACN during surgical procedures at the elbow and forearm is vital to prevent iatrogenic injury.

Violence against healthcare workers (HCWs) is a widespread, underreported and inadequately prevented problem. Only a few companies have efficient systems for assessing the extent of the phenomenon. In 2005, the health surveillance service of a public health company introduced a system that monitored violence experienced by HCWs by means of three items from the Violent Incident Form (VIF), integrated with departmental in-depth analyses using the participatory ergonomics group technique. In 2005, the annual rate of physical assaults was 8.2%, that of threats 12.0%, while the harassment rate was 19.6%. Over the past twenty years of observation (2005-2024), the percentage of workers who reported experiencing a physical attack in the previous year at their periodic medical examination, has fluctuated between 5.8% and 11.1%, except for the years 2020 and 2021 when, during the COVID-19 pandemic, the rate was 3.9% and 3.2%, respectively. During the same pandemic period, the annual threat rate that ranged from 9.4% to 20.1%, dropped to 7.7%, while the prevalence of harassment, that was between 13.5 and 19.6, fell to 7.2%. HCWs believe that (i) limiting visitor access (ii) a better balance of the demand for services and (iii) a better attitude towards HCWs were the causes of the reduced rate of violence during the pandemic. Recording the violence experienced during health surveillance is an economical, reliable and sustainable risk assessment method.

In the fast-changing world of software development, the protection of software products has emerged as an imperative requirement. This paper presents a new way to increase the maturity of development teams to reach the highest level of software security. Based on these, the framework uses the Fuzzy Analytic Hierarchy Process (Fuzzy-AHP) to systematically evaluate and enhance the people maturity of software development projects. The essence of the fuzzy logic and AHP technique interaction is to handle the uncertainty and complexity of human factors and team dynamics in the evaluation framework. Using the decision-making model allows the project managers and stakeholders to determine the appropriate areas for improvement and develop the right strategies and actions to nurture a secure and mature development culture. The paper identifies 24 human success factors (HSFs) and human security vulnerabilities (HSVs) and 38 practices for addressing these HSFs and HSVs. Furthermore, we discuss the local and global ranks of each HSF and HSV practice and categorize the identified practices into 9 categories to determine the ranks and weight of each category. Based on collected data, FAHP prioritized these practices; the category “C4: Skill Development and Stakeholder Engagement” is ranked highest at rank-1 and possesses the most significant weight of 0.12435. Similarly, the highest global weight is 0.051506, and the global ranked (rank-1) HSF and HSV practice is “P15: Hands-On Practice and Stakeholder Communication”. Research evidence and case discussions show how the described framework assists in building secure software development (SSD) practices, which can be considered evidence of the application of team maturity to improve cybersecurity in organizations. Additional research directions include improving the framework, especially using highly developed learning techniques and applying the framework to other forms of development.

This qualitative study explores the multifaceted strategies organizations employ to build resilient supply chains through effective procurement risk management. Conducted over a six-month period in 2024, the research involved semi-structured interviews with 25 industry professionals from sectors including manufacturing, retail, healthcare, and technology, alongside document analysis and case studies. The study identifies four key themes: risk identification and assessment, supplier relationship management, digitalization in risk management, and strategic resilience practices. The findings reveal that organizations face diverse risks, including supplier, supply market, and external environmental risks, necessitating comprehensive risk assessment methodologies. Supplier relationship management emerges as a critical factor in mitigating risks, with practices such as regular audits, collaborative risk management, long-term partnerships, and supplier diversification being crucial. The adoption of digital technologies like predictive analytics, blockchain, advanced analytics, and artificial intelligence enhances risk management capabilities, providing data-driven insights and fostering transparency. Strategic resilience practices, including inventory buffering, flexible sourcing, redundancy, and scenario planning, are essential for maintaining supply chain continuity amidst disruptions. The study underscores the importance of an integrated and proactive approach to procurement risk management that leverages robust assessment, strong supplier relationships, digital tools, and strategic planning. These findings contribute to a deeper understanding of how organizations can effectively manage procurement risks and build resilient supply chains in a dynamic global environment. The insights offer valuable guidance for procurement professionals and organizational leaders in developing resilient and adaptable supply chain strategies to navigate the complexities of today's market.

Abstract: This article reports the results of an ecological study of cancer incidence rates by state in the US for the period 2016-2020. The goals of this study were to determine the extent to which solar UVB doses still reduced cancer risk compared to findings reported in 2006 for cancer mortality rates for the periods 1950–1969 and 1970-1794 as well as cancer incidence rates for the period 1998–2002 and to determine which factors were recently associated with cancer risk. The cancer data for non-Hispanic white (European American) men and women were obtained from the Centers for Disease Control and Prevention. Indices were obtained for solar UVB at the surface for July 1992, and alcohol consumption, and diabetes and obesity prevalence near the 2016–2020 period. Lung cancer incidence rates were also used in the analyses as a surrogate for smoking, diet, and air pollution. The cancers for which solar UVB is significantly associated with reduced incidence are bladder, brain (males), breast, corpus uteri, esophageal, gastric, non-Hodgkin’s lymphoma, pancreatic, and renal cancer. Lung cancer was significantly associated with colorectal, laryngeal, and renal cancer. Diabetes was also significantly associated with breast, liver, and lung cancer. Obesity prevalence was significantly associated with breast, colorectal and renal cancer. Alcohol consumption was associated with bladder and esophageal cancer. Thus diet has become a very important driver of cancer incidence rates. The role of solar UVB in reducing risk of cancer has been reduced due to people spending less time outdoors, wearing sunscreen that blocks UVB but not UVA radiation, and population increases in overweight and obesity, which lowers 25-hydroxyvitamin D concentrations and generates systemic inflammation, a risk factor for cancer. The dietary approach that would reduce the risk of diabetes, obesity, lung cancer, and, therefore cancer, would be one based mostly on whole-plants and restrictions on red and processed meats and ultraprocessed foods. Solar UVB exposure for a few minutes before applying sunscreen and taking vitamin D supplements would also help reduce risk of cancer.Keywords: alcohol consumption; cancer incidence;

Quality of life (QoL) assessments are integral to cancer care, yet their effectiveness in providing essential information for supporting survivors varies. This study aimed to elucidate key indicators of QoL among colorectal cancer survivors from the perspective of healthcare professionals, and to evaluate existing QoL questionnaires in relation to these indicators. Two studies were conducted: a Delphi study to identify key QoL indicators and a scoping review of questionnaires suitable for colorectal cancer survivors. Fifty-four healthcare professionals participated in the Delphi study's first round, with 25 in the second. The study identified two primary QoL domains (Physical and Psychological) and 17 subdomains deemed most critical. Additionally, a review of 12 questionnaires revealed two instruments assessing the most important general domains. Findings underscored a misalignment between existing assessment tools and healthcare professionals' clinical priorities in working with colorectal cancer survivors. To enhance support for survivors' QoL, efforts are needed to develop instruments that better align with the demands of routine QoL assessment in clinical practice.

We aimed to evaluate the association between daily dietary calcium intake and the risk of cardiovascular disease (CVD) in postmenopausal women using data from the Korean National Health and Nutrition Examination Survey (KNHANES). This cross-sectional study included 12,348 women aged 45–70 years who had reached natural menopause. They were classified into three groups according to daily dietary calcium intake: &lt; 400 mg, 400–800 mg, and &gt;800 mg. The risks of CVD, stroke, angina, and myocardial infarction were assessed in each group. Further, we performed subgroup analysis according to the post-menopause duration (≤10 vs. &gt;10 postmenopausal years). We performed logistic regression analysis with adjustment for age, menopausal age, income, urban area, education, insulin use, body mass index, hypertension, diabetes mellitus, dyslipidemia, high alcohol intake, smoking, exercise, oral contraceptive use, and hormonal therapy use. Calcium intake level was not significantly associated with the risk of CVD in the total population and the ≤10 postmenopausal years subgroup. However, in the &gt;10 postmenopausal years subgroup, daily calcium intake &gt;800 mg was associated with significantly decreased risks of all CVD (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.11–0.64), stroke (OR, 0.06; 95% CI, 0.01–0.42), and myocardial infarction (OR, 0.27; 95% CI, 0.11–0.64). Our findings suggest that a dietary calcium intake of &gt;800 mg/day decreases the risk of CVD events in women who have been menopausal for &gt;10 years.

Augmented reality (AR) provides an opportunity for mobile fitness applications to show users real-time feedback on their current fitness activity. For such applications, it is essential to accurately track the user’s current fitness activity using available mobile sensors, such as inertial measurement units (IMUs). Convolutional neural networks (CNNs) have been shown to produce strong results in different time series classification tasks, including the recognition of activities of daily living. However, fitness activities can present unique challenges to the human activity recognition task (HAR), including greater similarity between individual activities and fewer available data for model training. In this paper, we evaluate the applicability of CNNs to the fitness activity recognition task (FAR) using IMU data and determine the impact of input data size and sensor count on performance. For this purpose, we adapted three existing CNN architectures to the FAR task and designed a fourth CNN variant, which we call the scaling fully convolutional network (Scaling-FCN). We designed a preprocessing pipeline and recorded a running exercise data set with 20 participants, in which we evaluated the respective recognition performances of the four networks, comparing them with three traditional machine learning methods commonly used in HAR. On our data set, all CNN architectures significantly outperformed traditional machine learning methods, reaching up to 97.14±1.36% classification accuracy on the test set for ResNet. Whereas a reduced input data size invariably led to a performance loss, removing specific sensors improved the performance of all CNN architectures, with our Scaling-FCN reaching the highest accuracy of 99.86±0.11%. Our results suggest that CNNs are generally well suited for fitness activity recognition, and noticeable performance improvements can be achieved if sensors are dropped selectively.

(1) Background: Most patients with mycosis fungoides (MF), a form of cutaneous T-cell lym-phoma (CTCL), develop relapsed/refractory (R/R) disease following front-line systemic therapy. This report describes treatment patterns and outcomes from the subpopulation with R/R MF. (2) Methods: This observational, retrospective, cohort study analysed patient records (1984–2016) from 27 clinical sites in Eurpe. Outcomes included treatments received, response to first-, second- and third-line treatment, overall survival (OS), and progression-free survival (PFS). (3) Results: Of 104 patients with MF, 100 received second-line and 61 received third-line therapy. Median (range) times from start of first-line therapy to first R/R MF and from first to second R/R MF were 11.2 (0.3–166.5) and 13.5 (0.0–174.6) months, respectively. Second-and third-line treatment options varied and comprised systemic therapies (85% and 79% of patients, respectively), radio-therapy (32% and 34%, respectively) and topical therapies (48% and 36%, respectively). Median (95% confidence interval [CI]) OS from the diagnosis of first R/R MF was 11.5 (6.5–not reached [NR]) years and was higher with non-chemotherapy (NR) versus chemotherapy (6.5 years); es-timated median PFS (95% CI) from the time of first R/R MF was 1.3 (1.0–2.1) years. (4) Conclu-sion: High rates of R/R disease were observed after second- and third-line treatments in this re-al-world cohort, with longer median OS in patients receiving non-chemotherapy versus chemo-therapy. Following the standard management of MF and using recently approved targeted therapies can help improve patient outcomes in advanced-stage MF.

Arrhythmic sudden cardiac death (SCD) has an annual prevalence of 1 per 1000 while 75% of the victims suffer from ischemic and 10% from non-ischemic or hypertrophic cardiomyopathy. Altogether, these three entities account for more than 80% of the total SCD victims. Guidelines for implantable cardiac defibrillators are still dominated by LVEF<30% from the MADIT II study. In terms of arrhythmic risk stratification, the PRESERVE-EF study restored in clinical practice the two-step arrhythmic risk stratification approach based on Electrocardiographic non-invasive risk factors (NIRFs) guiding to electrophysiological study. In our times with the multiple cardiac imaging methods and artificial intelligence applications availability, this two-step approach based on integrated arrhythmia mechanisms detection, emerges as an efficient SCD risk stratification paradigm for these three entities but also for the patients with congenital heart disease.

This research paper presents an enhanced economic load dispatch (ELD) approach using the Teaching-Learning-Based Optimization (TLBO) algorithm for 10 thermal units, examining the impact of Plug-in Electric Vehicles (PEVs) in different charging scenarios. The TLBO algorithm is utilized to optimize the ELD problem, considering the complexities associated with thermal units. The integration of PEVs in the load dispatch optimization is investigated, and different charging profiles and probability distributions are defined for PEVs in various scenarios, including overall charging profile, off-peak charging, peak charging, and stochastic charging. These tables allow for the modeling and analysis of PEV charging behavior and power requirements within the power system. By incorporating PEVs, additional controllable resources are introduced, enabling more effective load management and grid stability. The comparative analysis showcases the advantages of the TLBO-based ELD model with PEVs, demonstrating the potential of coordinated dispatch strategies leveraging PEV storage and controllability. This paper emphasizes the importance of integrating PEVs into the load dispatch optimization process, utilizing the TLBO algorithm, to achieve economic and reliable power system operation while considering different PEV charging scenarios.

Fungal plant diseases are a major threat to food security worldwide. Current efforts to identify and list loci involved in different biological processes are more complicated than originally thought, even when complete genome assemblies are available. Despite numerous experimental and computational efforts to characterize gene functions in plants, about ~ 40% of protein-coding genes in the model plant A. thaliana are still not categorized in the Gene Ontology Biological Process (BP) annotation. In non-model organisms, such as sunflower (Helianthus annuus), the number of BP term annotation is far fewer, ~22%. In the current study we performed gene co-expression network analysis using eight terabytes of public transcriptome datasets and performed expression-based functional prediction to categorize and identify loci involved in the response to fungal pathogens. We were able to construct a reference gene network of healthy green tissue (GreenGCN) and a gene network of healthy and stressed root tissues (RootGCN). Both networks achieved robust high quality scores on the metrics of guilt-by-association and selective constraints versus gene connectivity. We were able to identify eight modules enriched in defense functions, of which, two out of the three modules in the RootGCN were also conserved in the GreenGCN, suggesting similar defense-related expression patterns. We identified 16 WRKY genes involved in defense related functions and 65 previously uncharacterized loci now linked to defense response. In addition, we identified and classified 122 loci previously identified within QTL or near candidate loci reported in GWAS studies of disease resistance in sunflower linked to defense response. In all, we have implemented a valuable strategy to better describe genes within specific biological processes.

Oestrogen receptor expression in breast cancer (BC) cells is a marker of high cellular differentiation and allows the identification of two BC groups (ER-positive and ER-negative) that, although not completely homogeneous, differ in biological characteristics, clinical behaviour and therapeutic options. The study, based on three publicly available EWAS datasets, focuses on the comparison between these two groups of breast cancer using an epimutation score. The score is calculated not only based on the presence of the epimutation but also on the deviation amplitude of the methylation outlier value. For each dataset, we performed a functional analysis based first on the functional gene region of each annotated gene (we aggregated the data per gene region TSS1500, TSS200, first-exon, body-gene identified by the information from the Illumina Data Sheet) and then we performed a pathway enrichment analysis through the REACTOME database based on the genes with the highest epimutation score. Thus, we blended our results and found common pathways for all three data sets. We found that a higher and significant epimutation score due to hypermethylation in ER-positive BC is present in the promoter region of the genes belonging to the SUMOylation pathway, the NOTCH pathway, the IFN-$\gamma$ signalling pathway and the deubiquitination protease pathway; while a higher and significant level of epimutation due to hypomethylation in ER-positive BC is present in the promoter region of the genes belonging to the ESR-mediated pathway. The presence of this state of promoter hypomethylation in the ESR-mediated signalling genes is consistent and coherent with an active signalling pathway mediated by oestrogen function in the group of ER-positive BC. SUMOylation and NOTCH pathways are associated with BC pathogenesis and have been found to play distinct roles in the two BC subgroups. We speculated that the altered methylation profile may play a role in regulating signalling pathways with specific functions in the two subgroups of ER-BC.

Promoting the use of solar energy resources has always faced the challenges of instability and supply-demand mismatch. The key to solving these issues is to efficiently store and utilize solar energy resources using high-performance heat storage devices. This study designed a high-performance shell-and-tube phase change thermal storage device and established a numerical model using ANSYS software to summarize the device's dynamic melting law. To verify the accuracy of the numerical simulation, a performance testing platform for the phase change thermal storage device was built to investigate the impact of factors such as inlet water temperature, inlet water flow rate, type of heat storage, and initial temperature of the device, and to reveal the change law of the device's performance. The results show that the inlet water temperature has the most significant impact on the device's heat storage and release performance. When the device's heat storage or release is used for heating, changing the inlet water flow rate has a weak and limited effect on the device's performance. However, when the device's heat release is used to provide domestic hot water, increasing the makeup water temperature and reducing the inlet water flow rate can significantly improve the device's effective heat release. Furthermore, based on the experimental validation of the model's correctness, this study further simulated and studied the impact of different factors on the device's heat storage process to optimize its structural design and provide technical references for the device's actual operation and installation. The results show that the placement of fins has a negligible effect on the performance of the heat storage device while reducing the fin spacing and increasing the fin thickness can significantly improve the melting efficiency of the phase change material (PCM). Additionally, the heat storage characteristics of the device are significantly better in the vertical installation mode than in the horizontal installation mode. This study provides theoretical guidance and technical references for the design and use of phase change thermal storage devices.

ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome) is a chronic, complex, heterogeneous disease that affects millions and lacks both diagnostics and treatments. Big data, or the collection of vast quantities of data that can be mined for information, has transformed the understanding of many complex illnesses like cancer (1,2) and multiple sclerosis (3,4), by dissecting heterogeneity, identifying subtypes, and enabling the development of personalized treatments. It is possible that big data can reveal the same for ME/CFS. Solve M.E. developed and launched the You + ME Registry to collect longitudinal health data from people with ME/CFS, people with Long COVID (LC) and control volunteers using rigorous protocols designed to harmonize with other groups collecting data from similar groups of people. The Registry is an invaluable resource because it integrates with a symptom tracking app, as well as a biorepository, to provide a robust and rich dataset that is available to qualified researchers. Accordingly, it facilitates collaboration that may ultimately uncover causes and help accelerate the development of therapies.

The COVID-19 pandemic has severely tested the physical and mental health of health care workers (HCWs). The various stages of the epidemic have posed different problems; consequently, only a prospective study can effectively describe the changes in the workers’ health. This repeated cross-sectional study is based on a one-year investigation (spring 2020 to spring 2021) of intensive care physicians in one of the two COVID-19 hub hospitals in Central Italy. Changes in their work activity due to the pandemic were studied anonymously together with their perception of organizational justice, occupational stress, sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and intention to quit. In May-June 2021, one year after the baseline, doctors reported an increased workload, isolation at work and in social life, lack of time for physical activity and meditation and compassion fatigue. Stress was inversely associated with the perception of justice in safety procedures and directly correlated with work isolation. Occupational stress was significantly associated with anxiety, depression, burnout, dissatisfaction, and intention to quit. Procedural justice was significantly associated with happiness. Doctors believed vaccinations would help control the problem; however, this positive attitude had not yet resulted in improved mental health. Doctors reported high levels of distress (73%), sleep problems (28%), anxiety (25%), depression (64%). Interventions to correct the situation are urgently needed.

Compounds with tyrosinase inhibitory efficacy could be effective as depigmenting agents. Although a large number of natural and synthetic tyrosinase inhibitors have been reported, few of them are used as skin-whitening agents due to poor activity and safety concerns. 3-(2,4-Dihydroxyphenyl)propionic acid (DPPA), a naturally occurring compound isolated from Ficus carica, was previously discovered as a moderate tyrosinase inhibitor. In this study, the structure-activity relationship study of DPPA was conducted. Compound 3g, with the 2,4-resorcinol subunit and terminal hydrophobic di-butylamino group, was identified with low nanomolar enzymatic IC₅₀ value. Additionally, compound 3g could effectively reduce melanin levels in B16-F10 melanoma cells treated with α-melanocyte-stimulating hormone (α-MSH) without affecting cell viability and proliferation. All these results indicated that compound 3g could be considered as a promising candidate for the treatment of diseases associated with hyperpigmentation.

Full-scale/model test comparison studies to validate the traditional ABL wind tunnel simulation technique are reviewed. According to the literature review, notable discrepancies between full-scale measurement results and model test results were observed by most performed comparison studies, but the causes of the observed discrepancies were not revealed in a scientific way by those studies. In this regard, a new research scheme for future full-scale/model test comparison studies is proposed in this article, which utilizes the multiple-fan actively controlled wind tunnel simulation technique. With the new research scheme, future full-scale/model test comparison studies are expected to reasonably disclose the main problems with the traditional ABL wind tunnel simulation technique, and the technique can be improved correspondingly.

We introduce linear probing hashing schemes that construct a hash table of size $n$, with constant load factor $\alpha$, on which the worst-case unsuccessful search time is asymptotically almost surely $O(\log \log n)$. The schemes employ two linear probe sequences to find empty cells for the keys. Matching lower bounds on the maximum cluster size produced by any algorithm that uses two linear probe sequences are obtained as well.

AbstractBackground: Maternal health service (MHS) use is a key strategy to reduce maternal mortality. However, the existing evidence is scarce to design efficient intervention strategies in Ethiopia. Thus, we aimed to explore community members and health care providers' perceptions of MHS, and barriers, and facilitators of MHS use in southern Ethiopia. Methods: A phenomenological qualitative study was conducted from November 14-30, 2022, in the northern zone of the Sidama region. Sixteen in-depth interviews, nine focus group discussions, and 15 key informant interviews were done with 112 study participants. A maximum variance sampling method was used to select study participants. Data coding and analysis were done using MAXQAD 2020 software and presented in narratives. Results: Communities have positive perceptions and good practices of skilled antenatal care (ANC) and health facility delivery (HFD), but lack awareness of postnatal care (PNC) services and schedules. Some have experienced negative interactions with health care providers, health facilities, and ambulance drivers. The main identified barriers to ANC use were lack of awareness of ANC benefits, distance from a health facility, costs associated with ANC use, long waiting time, lack of access to road, and women being busy with different household chores. Distance from health facility, costs associated with HFD use, unpredicted labour, lack of an ANC visit, lack of a birth preparedness plan, and non-dignified care were the main barriers to HFD. The major identified barriers to PNC use were home delivery, lack of awareness of PNC service and schedule, and socio-cultural beliefs. The main identified facilitators of MHS use were previous experience and fear of obstetric complications, health extension workers and women’s development teams, and pregnant women's forum.Conclusions: Rural women still encounter several challenges when using MHS, even though communities have positive perceptions and good practices of skilled MHS. Bad experiences mothers faced in health facilities, challenges associated with the costs of MHS use, poor awareness of service, and unpredictable labour continued to be basic barriers to MHS use. Intervention approaches should consider inter-sectoral collaboration to address barriers at the community and health facility levels. The programs must emphasize the transportation arrangements during unpredictable labour, the needs of poor mothers, and women who have poor awareness of MHS at the community level.

Clinical trials often involve new substances characterized or developed for a specific pathology or class of pathologies. At other times, a clinical trial is observational; in other words, a known sub-stance has a range of effects on a given cohort of subjects. The types of trials are different and complex, and often, young clinical novice and the inexperienced researchers may struggle to evaluate how to proceed correctly. In this paper, we aim to create a mini-guide for beginners in clinical trials and provide elements for designing a clinical trial. Our intention is to highlight where to find the materials and how to adapt, even in the absence of sponsors, so that even the most inexperienced and under-resourced researcher can gain an understqanding of the complexi-ty of the process andaddress it appropriately. We do not claim to be exhaustive or cover all ele-ments, but rather, we aim to create a checklist. With this approach, starting discussioms about the experimental phases of the drug and concluding with the clinical trial, we aim to assist those facing this challenging "world."

Successful implementation of antibiotic stewardship programs (ASP) requires a well-structured approach involving all stakeholders. Despite embracing key responsibilities, nurses’ role remains poorly defined, preventing consistent engagement. We conducted a scoping survey to assess knowledge, attitude and perception of nurses towards nurse-led initial sepsis risk evaluation using the sepsis risk calculator (SRC) of newborns admitted to the mother-baby unit. Single-center, cross-sectional study. Study link was sent to all full-time nurses in mother-baby unit. Survey centered around knowledge of unit’s ASP and attitude and perception towards nurse-led initial sepsis risk evaluation. 89% response rate. 100% agreed that SRC reduced antibiotic use and 66% felt nurse-led sepsis risk evaluation will enhance nurse involvement, but this was offset by extra burden of work (66%) and low confidence in differentiating stable from clinically unstable infants (46%). Other facilitating factors included greater nurse/patient ratio (100%), targeted education (89%) and incorporation of the SRC into EMR (78%). Only 11% were willing to serve as champions for it. There was no significant correlation to age or experience however, greater number of fresh grads were interested in championing this effort. Our study identifies a need for strong foundation of knowledge and greater nurse/patient ratio as two main factors for improving nurse-led use of the SRC. Multi-site studies scoping barriers to nursing involvement for successful implementation of ASPs are necessary.

The crystals, C11H4BrF5N2S, (I), 1-((4-bromothiophen-2-yl)methylene)-2-(perfluorophenyl)hydrazine and C12H6BrF5N2S, (II), 1-((4-bromo-5-methylthiophen-2-yl)methylene)-2-(perfluorophenyl)hydrazine are molecules with two rings and hydrazone part like a centre of the molecule. The compounds have been synthesized and characterized by elemental, spectroscopic (¹H-NMR) analysis. The crystal structures of the solid phase were determined by single crystal X-ray diffraction method. They crystallize in the monoclinic space group with Z = 4 and Z = 2 molecules per unit-cell. The compound (I) crystallizes as a racemate in the centrosymmetric space group and the compound (II) crystallizes as a non-racemate in the non-centrosymmetric space group. The “absolute configuration and conformation for bond values” were derived from the anomalous dispersion (ad) for (II). The crystal structures are revealed diverse non-covalent interactions such as intra- and interhydrogen bonding, π-ring···π-ring, C-H···π-ring and they were investigated. The expected stereochemistry of hydrazones atoms C7, N2 and N1 were confirmed for (I) and (II). The hole molecule of the (I), and (II) possesses “a boat conformation” like a 6-membered ring. The results of the single crystal studies are reproduced with the help of Hirshfeld surface study and Gaussian software.

The acylation of unsymmetrical N-benzylbispidinols in aromatic solvents without external base led to formation of supramolecular gels, which possess different thickness and stability depending on the substituents in para-positions of benzylic group and nature of acylating agent as well as on the nature of the solvent used. Structural features of the native gels as well as of their dried forms were studied by complementary techniques including FT IR- and ATR-spectroscopy, AFM, TEM, SEM, SAXS. Structures of the key crystalline compounds were established by X-ray diffraction. Analysis of obtained data allowed speculating on the crucial structural and condition factors that governed the gel formation. The most important factors were: (i) absence of base, either external or internal; (ii) presence of HCl; (iii) presence of carbonyl and hydroxyl groups to allow hydrogen bonding; (iv) presence of two (hetero)aromatic rings at both sides of the molecule. The hydrogen bonding involving amide carbonyl, hydroxyl at 9th position and, very probably, ammonium N-H+ and Cl- anion appear to be responsible for the formation of infinite molecular chains required for the first step of gel formation. Subsequent lateral cooperation of molecular chains into fibers occured, presumably, due to the aromatic pi-pi-stacking interactions. sc-CO2 drying of the gels gave rise to aerogels morphology different from that of air dried samples.

Myocardial infarction, more commonly known as heart attack, is a huge health problem around the world. It is a result of inadequate blood supply to certain parts of the heart and death of heart muscle cells in that region. Although it has been around for a long time, newer and newer ways of probing myocardial infarction is being followed. Bioinformatics and Systems Biology are relatively recent fields to try to give new insights into myocardial infarction. Following the footsteps of others, this in silico study has tried to chime in on the investigation into myocardial infarction. The study began with the gene expression omnibus dataset uploaded to the NCBI from a whole-genome gene expression analysis carried out at Mayo Clinic in Rochester, Minnesota. From the dataset, differentially expressed genes following first-time myocardial infarction were identified and classified into up-regulated and down-regulated ones. Gene Set Enrichment Analysis (GSEA) was carried out on the up-regulated genes which were statistically significant and corresponded with the NCBI generated annotations. Protein-Protein Interaction Network for these genes was constructed. GSEA revealed 5 transcription factors, 5 microRNAs and 3 pathways significantly associated with them. From the Protein-Protein Interaction Network, 6 key proteins (hub nodes) have been identified. These 6 proteins may open a new window of opportunity for the discovery/design of new drugs for mitigating the damage caused by myocardial infarction.

Metalloproteinases are zinc-dependent endopeptidases that function as primary effectors of tissue remodelling, cell-signalling, and many other roles. Their regulation is ferociously complex, and is exquisitely sensitive to their molecular milieu, making in vivo studies challenging. Phenanthroline (PhN) is an inexpensive, broad-spectrum inhibitor of metalloproteinases that functions by chelating the catalytic zinc ion, however its use in vivo has been limited due to suspected off-target effects. PhN is very similar in structure to phenanthrene (Phe), a well-studied poly aromatic hydrocarbon (PAH) known to cause toxicity in aquatic animals by activating the aryl hydrocarbon receptor (AhR). We show that zebrafish are more sensitive to PhN than Phe, and that PhN causes a superset of the effects caused by Phe. Morpholino knock-down of the AhR rescues the effects of PhN that are shared with Phe, suggesting these are due to PAH toxicity. The effects of PhN that are not shared with Phe (specifically disruption of neural crest development and angiogenesis) involve processes known to depend on metalloproteinase activity. Furthermore these PhN-specific effects are not rescued by AhR knock-down, suggesting that these are bona fide effects of metalloproteinase inhibition, and that PhN can be used as a broad spectrum metalloproteinase inhibitor for studies with zebrafish in vivo.

Bovine respiratory disease (BRD) is a major health problem within the global cattle industry. This disease has a complex aetiology, with viruses playing an integral role. In this study, metagenomics was used to sequence viral nucleic acids in the nasal swabs of BRD affected cattle. Viruses detected included those well known for their association with BRD in Australia (bovine viral diarrhea virus 1), as well as viruses known to be present but not fully characterised (bovine coronavirus) and viruses that have not been reported in BRD affect cattle in Australia (bovine rhinitis, bovine influenza D, and bovine nidovirus). Nasal swabs from a case control study were subsequently tested for 10 viruses and the presence of at least one virus was found to be significantly associated with BRD. Some of the more recently detected viruses had inconsistent association with BRD. Full genome sequences for bovine coronavirus, a virus increasingly associated with BRD, and bovine nidovirus were complete. Both viruses belong to the Coronaviridae family, which are frequently associated with disease in mammals. This study has provided greater insights into the viral pathogens associated with BRD and highlighted the need for further studies to elucidate more precisely the roles viruses play in BRD.

The oral microbiome is a diverse and complex ecosystem essential for maintaining oral and systemic health. Our study is the first to define the oral microbial community in Egyptian young adults and investigate the effects of natural antimicrobials on the oral microbiome. SuperMint (SM) is a proprietary blend of peppermint, Japanese mint, bergamot mint, and spearmint essential oils encapsulated in a tiny soft beadlet. This work aimed to evaluate the effects of SM beadlets on the oral microbiome. This study recruited twenty healthy participants. A baseline investigation of the oral microbiome of the selected participants was performed by collecting saliva and swab samples before treatment. Treatment included chewing four SM beadlets twice a day for 7 days, and then post-administration saliva and swab samples were collected at the end of treatment. The oral microbiome samples were analyzed by high-throughput amplicon sequencing of 16S rRNA gene fragments, and the community composition was determined. The results showed that the abundance of some microbial genera and families decreased after using SM, including Prevotella, Streptococcus, Neisseria, and Haemophilus. However, some genera showed inconsistent patterns. We also found that the subject's gender and SM usage were significantly associated with diverse microbial composition. The results suggest that SM treatment decreased the abundance of several bacteria associated with halitosis and periodontal diseases, such as Actinomyces and Streptococcus. Furthermore, Corynebacterium species increased while Streptococcus decreased after SM usage. More research is needed to fully understand the antimicrobial effects of mint oils and their potential applications in maintaining good oral health.

Background: Pediatric Rapid Response Teams (RRTs) are expected to significantly lower pediatric mortality in healthcare settings. This study evaluates RRTs' effectiveness in decreasing cardiac arrests and unexpected Pediatric Intensive Care Unit (PICU) admissions. Methods: A quasi-experimental study (2014-2017) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, involved 3,261 pediatric inpatients, split into pre-intervention (1,604) and post-intervention (1,657) groups. The intervention entailed pediatric specialists collaboratively managing acute decompensations following set protocols. Results: RRT was activated 471 times, primarily for respiratory distress (29.30%), sepsis (22.30%), clinical anxiety (13.80%), and hematological abnormalities (6.7%). Family concerns triggered 0.1% of activations. Post-RRT implementation, unplanned PICU admissions significantly reduced (RR = 0.552, 95% CI 0.485-0.628, P < 0.0001), and non-ICU cardiac arrests were eliminated (RR = 0). Patient care improvement was notable, with a -9.61 coefficient for PICU admissions (95% CI: -12.65 to -6.57, P < 0.001) and a -1.641 coefficient for non-ICU cardiac arrests (95% CI: -2.22 to -1.06, P < 0.001). Sensitivity analysis showed mixed results for PICU admissions, while zero-inflation Poisson analysis confirmed a reduction in non-ICU arrests. Conclusions: The deployment of pediatric RRTs is associated with fewer unexpected PICU admissions and non-ICU cardiopulmonary arrests, indicating improved PICU management. Further research using robust scientific methods is necessary to conclusively determine RRTs' clinical benefits.

Treatment of tendinopathies with multipotent mesenchymal stromal cells (MSCs) is a promising option in equine and human medicine. However, conclusive clinical evidence is lacking. The purpose of this study was to gain insight into clinical treatment efficacy and to identify suitable outcome measures for larger clinical studies. Fifteen horses with early naturally occurring tendon disease were assigned to intralesional treatment with allogeneic adipose-derived MSCs suspended in serum or with serum alone by block randomization (dosage adapted to lesion size). Clinicians and horse owners remained blinded to the treatment during 12 months (7 horses per group) and 18 months (7 MSC- and 5 control-group horses) of follow-up including clinical examinations and diagnostic imaging. Clinical inflammation-, lameness- and ultrasonography scores improved more over time in the MSC-group. The lameness score difference significantly improved in the MSC- compared to the control-group after 6 months. In the MSC-group, 5 out of 7 horses were free of re-injuries and back to training until 12 and 18 months. In the control-group, 3 out of 7 horses were free of re-injuries until 12 months. These results suggest that MSCs are effective for treatment of early phase tendon disease and provide a basis for a larger controlled study.

This cross-country four-year longitudinal study investigated the development of processing speed throughout primary school education. The analyses were conducted on data collected from 441 schoolchildren in Grades 1, 2, 3 and 4 (aged 6.42 to 11.85 years) in the Kyrgyzstan and Russia. Mixed effects growth modeling was applied to estimate average and individual growth trajectories for processing speed at two cross-country samples. Latent class growth modeling was conducted to identify different types of growth trajectories for processing speed and to compare the distribution of the types within the analyzed samples. According to the results, processing speed significantly increases across primary school years. The trajectory is characterized by nonlinear changes with more intensive growth between Grades 1 and 2, which later slows down until Grade 4. There were no significant cross-country differences in the initial score of processing speed or developmental changes in processing speed across primary school years. The development of processing speed is described by a model with three quadratic growth types but minimally differs. It is concluded that in both samples, the development of processing speed may be characterized by homogeneity, with the most intensive growth from Grade 1 to Grade 2 and subsequent linear improvement until Grade 4.

In New Orleans, Louisiana the population’s poor baseline health led to its establishment as an early epicenter for severe acute COVID-19. Antici-pating future outbreaks of COVID-19 and other respiratory viruses, we need to identify correlates of outcome, from real clinical experience. 89 patients were recruited into the ClinSeqSer acute COVID-19 longitudinal observational study, from the beginning of the outbreak in March to July 2020. Patients admitted for acute COVID-19 were enrolled in person. The cohort is unique as it is 68% Black, 53% female, of average age of early 60s, and prevalence of obesity and hypertension respectively of 55% and 83%. The outcomes are: 53% severe (20% fatal, 33% non-fatal) and 47% non-severe, with severe defined as death or requiring mechanical ventila-tion or high flow oxygen. Obesity and admit systolic blood pressure (SBP) >140mmHg are each associated with severe outcome and, despite respective sensitivity of 71% and 76%, specificity ~66% for both, and ac-curacy of 60% and 70% by ROC analysis, would likely provide useful predictors of outcome in critically stressed health care systems. We discuss pathophysiologic hypotheses to explain why high admit SBP is observed only in half of patients with pre-COVID hypertension and is associated with severe outcome.

The article studies the Venetsiansky (Hydropark) Island (the Dnipro River, Kyiv, Ukraine) landscape structure applying the genetic landscape science method and the European landscape classification (LANMAP) approach. The aim of the article is to determine the best way to study the river islands landscapes analyzing the Venetsiansky Island landscape structure by the both methods. Methodology. The genetic landscape science method consists in the next steps: 1) the island’s territory information collecting; 2) the preliminary landscape map creating; 3) field study; 4) the final landscape map creating. The LANMAP method consists on: 1) the climate study; 2) the altitude study; 3) the parent material study; 4) the land cover study. The results. The genetic landscape science method demonstrates that the Venetsiansky Island is not a landscape, but a structural part of the landscape – the tract. The LANMAP study reveals that the Venetsiansky Island is naturally homogeneous, but land cover differs. The conclusion. The both methods’ study shows that the river island cannot be the entire landscape by the natural criteria, but only the part of it. The genetic landscape science explores the landscape forming while the LANMAP reveals the current state of the landscape.

The World Health Organization has developed the Integrated Care of Older People (ICOPE) strategy, a program based on the measurement of intrinsic capacity (IC) as “the composite of all physical and mental attributes on which an individual can draw”. Multicomponent interventions appear to be the more effective approach to enhance IC and to prevent frailty and dependence, being adapted physical activity is the preventive intervention that has shown more evidence in the treatment of frailty and risk of falls. The present study aims to describe the development of a multi-domain group-based intervention addressed to frail older people living in the community aimed to improve and/or maintain intrinsic capacity by means of promoting physical activity, healthy nutrition, and psychological wellbeing in frail older people. We used the GUIDED checklist to describe the development process of AMICOPE (Aptitude Multi-domain group-based intervention to improve and/or maintain IC in frail Older PEople). The intervention was built upon the ICOPE framework and it is described with Template for Intervention Description and Replication (TIDieR) guidelines and it includes dietary advice, cognitive stimulation strategies, medication review, goal setting, and activities to strengthen social support and manage depressive symptoms, as well as strength, balance and flexibility exercise using the Vivifrail program. The study represents the first stage of the UK Medical Research Council framework for developing and evaluating a complex intervention. The next step should be carrying out a feasibility study for the AMICOPE intervention, and in a later stage, assessing the effectiveness in a randomized controlled trial.