The small intestinal villus is covered with a thick layer of mucus that is secreted by goblet cells and functions primarily to first barrier from damage by toxic substance. Recent studies showed that goblet cells and mucins involved in complex immune function. Lipopolysaccharide (LPS) is widespread in the housing of livestock, which can induce bacterial infection symptoms and immunological stress within a short of time. Therefore, we aimed to study the effects of long-term exposure to different doses of LPS on intestinal mucus layer and immune barrier. The result showed that mucus layer thickness and goblet cell functions were significantly increased after low doses of LPS. The intestinal mucosal barrier can block the bacteria of the lumen, but LPS can penetrate this barrier into the blood, putting the body in a state of chronic low-grade inflammation and reducing the body’s immune function. However, after long-term exposure to high doses of LPS, a large number of lysosomes in goblet cells caused loss of function, and mucus layer thickness was significantly decreased. A large amount of LPS stuck to the mucus, leading to normal LPS and inflammatory cytokines level of plasma. The intestinal tissue morphology was damaged, and a number of immune cells were necrosis in the intestine. Collectively, long-term exposure to low doses of LPS lead to chronic low-grade inflammation in the body. Long-term exposure to high doses of LPS can be directly linked to the severity of the immunosuppression in the body.

Background: Glioblastomas (GBM) is generally burdened, to date, by a dismal prognosis, although Long Term Survivors have a relatively significant incidence. Our specific aim was to determine the exact impact of many surgery-, patient- and tumor-related variable on Survival parameters. Methods: The surgical, radiological and clinical outcomes of patients have been retrospectively reviewed for the present study. All the patients have been operated on in our Institution and classified according their Overall Survival in LTS (Long Term Survivors) and STS (Short Term Survivors). A thorough Review of our surgical series was conducted to compare the oncologic results of the patients in regards to 1. Surgical , 2. Molecular, and 3.Treatment related features. Results: A total of 177 patients were included in the final cohort. Extensive statistical analysis by means of univariate, multivariate and survival analyses disclosed a survival advantage for patients presenting a younger age, a smaller lesion and a better functional status at presentation. From the Histochemical point of view, Ki67(%) was the strongest predictor of better oncologic outcomes. A stepwise analysis of variance outlines the existence of 8 prognostic subgroups according to the molecular patterns of Ki67 overexpression and EGFR, p53 and IDH mutations. Conclusions: On the ground of our statistical analyses we can affirm that the following factors were significant predictors of survival advantage: KPS, Age, Volume of the lesion, Motor disorder at presentation, a Ki67 overexpression. A fine molecular profiling is feasible to precisely stratify the prognosis of GBM patients.

In this study, 6 residents of a long-term care facility were asked to try on Virtual Reality glasses and report their first experiences with Virtual Reality. The results show that Virtual Reality is of great interest to elderly residents of in-patient long-term care facilities. The wearing period was longer than expected and no symptoms of cyber sickness occurred. For the residents it was exciting to explore the virtual environments. Austrian destinations, nature scenes in the mountains and forests but also trips to the zoo, the museum, in churches or even densely populated areas like shopping streets or train stations would be places for the residents, they would like to explore virtually. Far-off destinations such as Rio de Janeiro or the Caribbean are more of an exception. Biographically relevant places such as the parental home or the location of their wedding were not named. Concerning the usability, an adjustment of the VR glasses is necessary for a longer-term use in any case.

HPV vaccine induces a herd immunity effect in genital warts when a large number of the population is vaccinated. That aspect should be taken into account when devising new vaccine strategies, like vaccination at older ages or male vaccination. Therefore it is important to develop mathematical models with good predictive capacities. We devised a sexual contact network that was calibrated to simulate the Spanish epidemiology of different HPV genotypes. Through this model we simulated the scenario that occurred in Australia in 2007, where 12-13 year-old girls where vaccinated with a three-dose schedule of a vaccine containing genotypes 6 and 11, that protect against genital warts, and also a catch-up program in women up to 26 years of age. Vaccine coverage were 73 % in girls with three doses and with coverage rates decreasing with age until 52 % for 20-26 year-olds. A fast 59 % reduction in the genital warts diagnoses occurred in the model in the first years after the start of the program, similar to what was described in the literature.

Bioactive compound profiles in organic and conventional sweet basil were analyzed by HPLC, and the enzymatic status and antioxidant status of plants cultivated with the two systems were also examined. Unique chemical compound locations in the basil leaves were also estimated by fluorescence microscopy. The experiment was conducted from 2019-2021. Organic and conventional basil samples were obtained directly from the largest Polish herb producers. The results showed that the chemical structures of organic and conventional basil leaves are different. Not only cultivation method but also experimental year had a significant impact on the antioxidants content in basil leaves. Organic basil contained significantly more dry matter (11.97 g 100 g-1 FW) compare to conventional one (10.54 g 100g-1 FW) and showed a higher tendency for total phenolic (5.24 mg g -1 DW) concentrations than conventional basil (4.99 mg g-1 DW). The higher bioactive compound content reflects the antioxidant activity ( 61.0%, 54.33% and 46%) in organic basil compare to conventional 46.87%, 38.055 and 39.24%), respectively to analysis method (ABTS, DPPH and FRAP), as well catalase activity (39 µmol H2O2 min-1 mg-1) in organic compare to conventional (23.19 µmol H2O2 min-1 mg-1) of examined basil plants. The obtained results are a very unique and could be used by herbs producers as a key for q high quality basil production.

The soil microbial community serves as a crucial indicator for assessing soil fertility and health. The composition and activity of soil microorganisms reflect the soil's well-being and its ability to provide proper nutrients for crops. Fertilization plays a prominent role in enhancing soil fertility, and novel types of fertilizers, such as stabilized fertilizers with nitrification/urease inhibitors and coated fertilizers, have gained popularity in rice and maize cultivation. However, the long-term effects of these stabilized and coated urea fertilizers on soil chemical properties, microbial di-versity and community structure, as well as nitrogen cycling functional genes, remain unclear. Therefore, it is essential to investigate the impact of extended use of stabilized and coated urea fertilizers on soil fertility and microbiota in rice paddy fields. This research will provide scientific and theoretical support for the development and promotion of stabilized and coated urea ferti-lizers. To examine the effects of long-term application of these stabilized and coated urea fertilizers on soil chemical properties and microorganisms in rice paddy fields, soil samples were collected from brown soil rice paddy fields treated with various urease and nitrification inhibitors, stable urea, sulfur-coated urea (SCU), and resin-coated urea (PCU). The study revealed that 16 years of long-term use of conventional urea nitrogen fertilizer led to a considerable reduction in soil TP. On the other hand, NBPT and conventional urea fertilizers, when applied for an extended period, significantly increased soil organic matter (SOM). Moreover, except for HQ and NBPT+DMPP, the prolonged application of new urea fertilizers also signifi-cantly enhanced soil total potassium (TK). Notably, among all the treatments, PCU treatment had higher values for various soil chemical properties. In the case of SCU fertilizer used in brown soil rice paddy fields, it resulted in a significant decrease in soil pH over time. However, this change in pH did not affect the population of ammonia-oxidizing bacteria (AOB), as it was primarily in-fluenced by soil available nitrogen. DMPP, HQ+DCD, NBPT+DMPP, SCU, and PCU significantly reduced the copy number of bacterial 16S rRNA genes in the soil, with the coated urea fertilizers (SCU and PCU) having a greater impact. The long-term use of stabilized urea fertilizers containing HQ significantly reduced the bacterial community in rice paddy soil. Conversely, HQ+DCD stable urea fertilizer significantly increased the population structure and abundance of Basidiomycota fungi while decreasing the population structure and abundance of Rozellomycota fungi. DMPP stabilized urea fertilizer notably increased the population structure and abundance of Ascomycota fungi while decreasing the population structure and abundance of Rozellmycota and Chytridiomycota fungi. Further-more, HQ stabilized urea fertilizer significantly reduced the population structure and abundance of Chytridiomycota fungi. It is important to note that SCU fertilizer is not suitable for long-term application in neutral to slightly acidic meadow brown soil with a background pH. On the other hand, stable urea fertilizers and resin-coated urea fertilizers containing HQ, NBPT, DCD, DMPP, and their combinations are suitable for long-term application in neutral to slightly acidic meadow brown soil.

Here we investigated the longer-term effect of Ncald-ASOs by additional i.c.v. bolus injection at PND28. Two weeks after injection of 500 µg Ncald-ASO in wild-type mice, NCALD was significantly reduced in brain and spinal cord and well tolerated. Next, we performed a double-blinded preclinical study combining low-dose SMN-ASO (PND1) with 2x i.c.v. Ncald-ASO or CTRL-ASO (100 µg at PND2, 500 µg at PND28). Ncald-ASO re-injection significantly ameliorated electrophysiological defects and NMJ denervation at 2 months. Moreover, we developed and identified a nontoxic and highly efficient human NCALD-ASO that significantly reduced NCALD in hiPSCs-derived MNs. This improved both neuronal activity and growth cone maturation of SMA MNs, emphasizing the additional protective effect of NCALD-ASO treatment.

Background. Type 2 diabetes mellitus (T2DM) is becoming a major global health concern, especially in poorer nations. The high prevalence of obesity and the ensuing diabetes I attributed to rapid economic progress, physical inactivity, consumption of high-calorie foods, and changing lifestyles. Objectives. We investigated the role of interleukins-10 , 19 and 22 with varying levels of obesity in T2DM in the Asir region of Saudi Arabia. Materials and methods. 170 confirmed T2DM patients and a control group were enrolled. The demographic data, serum levels of IL-10, IL-19, and IL-22, and biochemical indices were assessed in patients and control groups by standard procedures. Results. T2DM patients were divided into four groups: A (normal body weight), B (Overweight), C (obese), and D (highly obese). Both male and female T2DM subjects in Group A showed significant decreases in IL-10 levels as compared to controls; however, there were insignificant changes in IL-10 levels in Groups C and D. T2DM patients in groups C and D, in both males and females, depicted very significant (p 0.001) increases in IL-19 levels as compared to controls and group A. Patient groups A to D displayed a progressive elevation of Il-22 levels irrespective of gender, although significant alterations were seen only in groups B to D, with p 0.05 for group B and p 0.01 for groups C and D respectively, as compared to healthy controls. Conclusions. IL-10 showed a strong relationship with T2DM in males with varying degrees of obesity, but females depicted relatively higher IL-10 levels in obese and highly obese groups, pointing to a protective phenomenon. IL-19 levels showed significant increases in all four groups, irrespective of gender. IL-22 appears to be unrelated to T2DM per se but shows an association with varying degrees of obesity.

Background/Aim: microRNAs (miRNAs) are key regulators of both physiological and pathophysiological mechanisms in diabetes and gastrointestinal (GI) dysmotility. Our previous studies have demonstrated the therapeutic potential of miR-10a-5p mimic and miR-10b-5p mimic (miR-10a/b mimics) in rescuing diabetes and GI dysmotility in murine models of diabetes. In this study, we elucidated the safety profile of a long-term treatment with miR-10a/b mimics in diabetic mice. Methods: Male C57BL6 mice were fed a high-fat, high-sucrose diet (HFHSD) to induce diabetes and treated by five subcutaneous injections of miR-10a/b mimics for a 5-month period. We examined the long-term effect of the miRNA mimics on diabetes and GI dysmotility, including an assessment of cancer risk as well as liver and colon inflammation using cancer and inflammatory biomarkers. Results: HFHSD-induced diabetic mice subcutaneously injected with miR-10a/b mimics monthly for 5 months exhibited a marked reduction in fasting blood glucose levels with restoration of insulin and significant weight loss, improved glucose and insulin intolerance, and restored GI transit time. In addition, the miR-10a/b mimic treated diabetic mice showed no indication of risk for cancer development and inflammation induction in the liver, colon, and blood for the 5 months post injections. Conclusion: This longitudinal study demonstrates that miR-10a/b mimics, when subcutaneously administered in diabetic mice, effectively alleviate diabetes and GI dysmotility for 5 months with no discernible risk for cancer or inflammation in the liver and colon. The sustained efficacy and favorable safety profiles position miR-10a/b mimics as promising candidates in miRNA-based therapeutics for diabetes and GI dysmotility.

This study evaluated the effects of replacing zinc bacitracin with a symbiotic diet on the biochemical profile, liver development, and Clostridium perfringens presence in laying hens at 90 weeks of age. A total of 198 Dekalb–White hens were assigned to six experimental diets: MBM (corn, soybean meal, and meat and bone meal), BAC (MBM + 0.05% zinc bacitracin), and SIMC (MBM + 0.1% symbiotic), provided from day 1 to 90 weeks. Additional treatments, SIMR and SIMP, received symbiotics from weeks 6 and 17, re-spectively. At 90 weeks, blood and tissue samples were analyzed. Results showed that symbiotic-treated hens had 20% heavier livers (P < 0.01) and lower concentrations of uric acid, total proteins, AST, ALT, and LDH (P < 0.01) compared to BAC-treated birds. Phosphorus, triglycerides, and HDL levels were better in symbiotic groups. C. perfringens counts and antibiotic resistance (ampicillin, erythromycin, aminoglyco-sides, lincomycin, tetracycline, bacitracin) were significantly higher in BAC groups (P < 0.01). Symbiotic supplementation improved intestinal health, reduced pathogenic bacterial colonization, and enhanced liver function compared to continuous antibiotic use, especially when administered from early life stages.

Agro-waste fibres for polymer composite reinforcement have gained increased interest in industry and academia as a more sustainable alternative to synthetic fibres. However, natural fibre composites (NFC) hygroscopicity is still an issue that needs to be solved. This work investigates how prolonged exposure to water affects the properties of the polypropylene (PP)--based injection moulded composites reinforced with different contents of rice husk (rh) and olive pit (op) fibres. Both rh and op composites became more hydrophilic with increased fibre charge due to the affinity of cellulose and hemicellulose OH groups. Meanwhile, lignin contributes to the protection of the composites from thermo-oxidative degradation caused by water immersion. The PPrh composites had a higher saturation water content of 1.47% (20 wt.% rh) and 2.38 (30 wt.% rh) in comparison to PPop composites with absorption of 1.13% (20 wt.% op) and 1.59% (30 wt.% op). Tensile elastic modulus has slightly increased, at the cost of increased saturated composites' rigidity, in composites with 30% rh and op fibre content (up to 13%) while marginally decreasing (down to 8%) in PP30%op compared to unsaturated counterparts. A similar trend was observed for the flexural modulus, enhanced up to 18%. However, rh and op composites with 30% fibre content ruptured in bending, highlighting their fragility after hydrolytic ageing.

In orthopedics, bone drilling is a crucial part of a surgical method commonly carried out for internal fixation in bone fracture treatment. The primary purpose of bone drilling is the creation of holes for screw insertion to immobilize fractured parts. The bone drilling task depends on the orthopedist and surgeon’s high level of skill and experience. This paper aimed to provide a summary of previously published review studies in the field of bone drilling. This review paper also presents a comprehensive review of the application of machine learning for bone drilling and as a future direction for the automation system. This review can also help medical surgeons and bone drillers understand the latest improvements through parameter selection and optimization strategies to reduce bone damage in bone drilling procedures. Apart from the review study, bone drilling vibration data collected in the University laboratory experiment is also presented in this study. The vibration data consist of three different layers of femur cow bone which are processed and classified using several machine learning methods. LSTM is, used in the bone drilling classification study to prove that the layers of the bone drilling are associated with the vibration signal and can be classified and predicted using the machine learning method.

This research was to examine the impacts of long-term rice-crayfish coculture systems(RS) on soil nutrients, carbon pools, and rice yields in paddy fields , aiming to establish a scientific basis for the sustainable development of RS in the northern region of Zhejiang. The results showed that the change from rice monoculture (CK) to RS resulted in a 24.99% increase in the 5-year average of soil ammonium nitrogen(AN), while the soil nitrate nitrogen(NN), available potassium(AK), and available phosphorus content(AP) decreased by 28.02%, 16.05%, and 28.76% respectively. Moreover, the total organic carbon(TOC), easily oxidizable organic carbon(EOC), dissolved organic carbon(DOC), and microbial biomass carbon(MBC) decreased by 2.45%, 8.82%, 35.31%, and 65.84% respectively. Correlation analysis showed that there was a significant positive correlation between NN, EOC and MBC in the RS. In terms of rice yield, 5-year average of rice yield in RS has decreased by 8.4% compared to CK.The average yield of planting early-maturing varieties of rice was reduced by 13.16%, while the average yield of planting late-maturing varieties of rice was reduced by 6.00%. In conclusion, enhancing water and nutrient management and cultivating late maturing rice varieties are essential strategies for achieving the sustainable development of RS in northern Zhejiang.

In this paper, the Shannon entropy measure was used to assess changes in precipitation and temperature conditions. Due to the short, low-volume sequences of precipitation and temperature data analysed, a bootstrap method was used in the procedure for calculating Shannon entropy. The analysis used minimum and maximum values of monthly precipitation totals and monthly mean temperatures for 377 catchments distributed across the globe. A 110-year data series from 1901 to 2010 was analysed. Entropy values for the estimated parameters of the generalised extreme value distribution (GEV) were calculated for the adopted data. Entropy value calculations were performed for the left-hand constraint, based on minimum values, and for the right-hand constraint, based on maximum values. The applicability of Shannon's entropy measure in the analysis of climate change was demonstrated by allowing the degree of disorder and complexity of the distributions describing climate variables in the form of precipitation and temperature to be measured. This made it possible to obtain information on the directions of changes occurring with regard to minimum and maximum values in the field of monthly precipitation and mean temperatures in the analysed catchments. The study demonstrated the existence of Shannon entropy trends. The evaluation of entropy trends for precipitation and temperature sequences was performed using non-parametric tests. Mann -Kendall tests at the 5% significance level were used for trend analyses. The Pettitt test was performed to determine the point of change in trend for the rainfall and temperature data. The performed analysis was supported by graphical presentations.

In-depth insights into the profound impacts of climate change and human activities on water resources are garnered through the dynamic changes in surface water, a crucial aspect of effective water resource management and the preservation of aquatic ecosystems. This paper introduces an innovative approach employing the random forest algorithm for the systematic extraction and monitoring of surface water at large regional or national scales. This method integrates spectral bands, spectral indices, and digital elevation model data, offering a novel perspective on this critical task. A data filling model is proposed to mitigate the impact of missing data due to cloud cover. Leveraging the capabilities of the Google Earth Engine (GEE), detailed information on surface water dynamics during the rainy and dry seasons in the Yangtze River Basin (YRB) from 1991 to 2021 is extracted using Landsat time series imagery. The analysis encompasses spatial-temporal variation characteristics and trends, with a specific focus on the intricate interplay between the areal extent of surface water and hydro-meteorological factors in each sub-basin of the YRB. Importantly, this includes considerations of potential groundwater contributions to surface water. Key findings from our research include: (1) Achieving a remarkable overall accuracy of 0.96 ± 0.03 in obtaining reliable surface water datasets with the support of GEE. (2) Identifying significant trends, such as a noteworthy increase in rainy season surface water bodies (+248.0 km2·yr−1) and a concerning decrease in surface ice/snow cover during both rainy and dry seasons, with change rates of −39.7 km2·yr−1 and −651.3 km2·yr−1, respectively. (3) Uncovering the driving mechanisms behind these changes, revealing positive correlations between the areal extent of rainy season surface water bodies and precipitation, as well as negative correlations between surface ice/snow cover area and average surface skin temperature. It is crucial to note that these driving factors exhibit variation among secondary river systems, underscoring the complexity of surface water dynamics. Furthermore, comparative analyses with existing surface water products are conducted, contributing to a deeper understanding of the advantages and uncertainties inherent in our proposed extraction method. The proposed method for large-scale surface water extraction not only enhances the monitoring of spatio-temporal surface water dynamics in the YRB but also provides valuable insights for the sustainable utilization and protection of water resources, considering the potential role of groundwater in supplementing surface water.

Outcome of redo-mitral valve replacement in the small mitral annulus with the use of the chimney technology is not well documented. From 2019 to 2020, 77 consecutive patients underwent redo-mitral valve replacement with the use of the chimney technology because of a small mitral annulus. To evaluate heart structural integrity and clinical outcomes, postoperative clinical data and echocardiograms were examined. Mean age was 56.7 ± 15.98 years. All patients underwent mitral valve surgery of which 62 were mitral valve replacements, 7 mitral valve repairs, and 8 double valve replacements. Preoperative Mitral valve mean gradient was 18.07 ± 9.40 mmHg. Postoperative mitral prosthesis size 28.51 ± 1.22 mm. The median increment of mitral size enlargement was 4 (0, 6) valve sizes. Mean mitral gradient coming out of the operating room was 10.34 ± 2.12 mmHg and at follow-up echocardiogram performed at 3 years after the procedure was 10.36 ± 1.70 mmHg. One-year survival was 93.3%, while 4-year survival was 89.3% with no reoperation. Use of the chimney technology in small mitral valve re-mitral valve replacement results in larger valve sizes. Moreover, the mean gradients over the mitral valve are acceptable intraoperatively and over time.

Biomass storage is an essential requirement in the supply chain of bio-refineries and power plants. This research aims to evaluate the influence of long-term outdoor storage (1 year) of baled rockrose (Cistus laurifolius L.) shrub biomass on biofuel´s quality, pre-treatment processes and on combustion emissions in an industrial boiler. The raw material was obtained from different rockrose shrublands in North-center Spain. 233 tWM (tones of wet matter) of biomass were used to produce biofuels (30 mm milled biomass and Ø 8 mm pellets) in the pre-treatment pilot plants at CEDER-CIEMAT. The combustion tests were conducted in an industrial moving grate boiler with a thermal power of 50 MWth, in a 17 MWe power plant. Outdoor storage improved some quality biofuels parameters, mainly the reduction in ash content, what allowed to classify 30 mm milled material as class I1 (ISO 17225-9:2022) and pellets as class I3 (ISO 17225-2-2021). No significant differences were observed in the total specific mass flow and energy consumptions in the pre-treatment processes. The combustion tests had similar results, being the emissions below the limits established in the Directive (EU) 2015/2193. The results obtained indicated that 1-year outdoor store of rockrose-baled biomass under Mediterranean conditions was feasible for its subsequent use as biofuel.

The time-dependent behavior and long-term stability of deep-buried tunnels in soft rocks have received lots of considerations in tunnel engineering and allied sciences. To better explore and deepen the engineering application of rock creep, extensive research studies are still needed, although fruitful outcomes have already obtained in many related investigations. In this article, the Weilai Tunnel in China’s Guangxi province is studied taking its host rocks as the main research object. In fact, aiming at forecasting the time-varying deformation of this tunnel, a novel elasto-visco-plastic creep constitutive model with two variants is proposed, by exploiting the typical complex load-unload process of rock excavation. The model is well validated and good agreements are found with the relevant experimental data. Moreover, the time-dependent de-formation rules are properly established for the surrounding rocks, by designing two new closed-form solutions based on the proposed creep model and the Hoek-Brown criterion. The convergence deformations calculated from the closed-form solutions conform well to the on-site monitoring data. In only 27 days after excavation, the creep deformation of the Weilai tunnel overtakes 400 mm, which is enormous. To guarantee the long-term stability of this tunnel, a ro-bust support scheme and its long-term monitoring with appropriate remote sensors are strongly suggested.

Laparoscopic partial nephrectomy (LPN) after hyperselective embolization of tumor vessels (HETV) in a hybrid operating room (HOR) that combines traditional surgical equipment with advanced imaging technology, is a non-clamping surgical approach to treat localized kidney tumors that have shown promising short-term results. The aim of this study was to evaluate the long-term oncological and functional outcomes of this procedure. All consecutive patients treated for a localized kidney tumor by LPN after HETV between May 2015 and October 2022 in a single academic institution were included in the study. Clinical, pathological and biological data were collected prospectively in the uroCCR database. We evaluated perioperative data, postoperative complications, surgical margin and modification of renal function after surgery. We included 245 patients. Median tumor size was 3.2 (2.5-4.4) cm. The R.E.N.A.L. complexity was low, medium and high for 104 (43.5%), 109 (45.6%) and 26 (10.9%) patients, respectively. Median LPN time was 75 (65 -100) min and median blood loss was 100 (50-300) mL. Surgical postoperative complications occurred in 56 (22.9%) patients with 17 (5.7%) major complications. The median preoperative Glomerular Function Rate (GFR) was 90.5 (77-101.8) mL/min and the median GFR variation at 6 months was -7.5 (-15- -2) mL/min. Malignant tumors were present in 211 (86.1%) patients and 12 (4.9%) patients had positive surgical margins. After a median follow-up of 27 (8-49) months, 20 (8.2%) patients had a tumor recurrence and 4 (1.6%) died from cancer. The use of a HOR to perform LPN after HETV is a safe and efficient non-clamping approach to treat localized kidney tumors.

Supply Chain Management (SCM) encompasses a wide variety of decision-making problems that affect business and supply chain performance as a whole. Since most of these problems involve uncertainty and hesitation on the part of Decision Makers (DMs), various studies have emerged recently that present SCM applications of techniques based on Hesitant Fuzzy Linguistic Term Sets (HFLTSs) and HFLTS extensions. Given the relevance of this subject and the lack of literature review studies, this study presents a systematic review of HFLTS and HFLTS extension applications to SCM decision-making problems. In order to answer a set of research questions, the selected papers have been classified in accordance with a group of factors that are pertinent to the origins of these studies, SCM, HFLTSs, and decision-making. The results demonstrate that the Source and Enable processes have been studied with greater frequency, while the most common problems have to do with supplier selection, failure evaluation, and performance evaluation. The companies of the automotive sector and Sustainable SCM and Green SCM strategies predominate in the analyzed studies. Even though most of the studies use techniques based on HFLTSs, we have identified applications of seven distinct HFLTS extensions, with Double Hierarchy Hesitant Fuzzy Linguistic Term Sets and Probabilistic Linguistic Term Sets being the most utilized. The identification of gaps in the literature presents avenues for future studies focused on innovative applications, integrations of techniques, comparisons of techniques, group decision-making, and validation procedures for new models. The results of this study offer a panorama of the state of the art in regard to this subject and can help researchers and practitioners develop new studies which involve the use of methods that employ HFLTSs and HFLTS extensions in SCM decision-making problems.

This paper has a twofold objective. The first aim is to present a comprehensive bibliographical analysis of journal articles and book chapters on fuzzy-random option pricing (FROP) over the WoS and SCOPUS databases. It follows PRISMA criteria and takes special care of developments in continuous time. Thus, we described the principal findings about the research streams, outlets and authors of this topic and lets us suggest further research. The second contribution is motivated by the fact that the bibliographical revision has identified a lack of developments on equilibrium models on the yield curve. This question motivates extending Vasicek’s yield curve equilibrium model to introduce fuzziness in the parameters that govern interest rate movements (speed of reversion, equilibrium short-term interest rate, and volatility). Likewise, this paper develops an empirical application on the term structure of fixed income public bonds with the highest credit rating in the Euro area.

Background: To compare the clinical efficacy of Japas osteotomy of the middle foot and first metatarsal sequence osteotomy in treating children with cavovarus foot deformity. Methods: A retrospective analysis was performed on the clinical effect of cavovarus foot surgery from January 2012 to January 2019. Thirty light and medium cavovarus foot cases underwent osteotomy based on soft tissue release. Among them, 16 cases of 22 feet underwent first metatarsal sequence osteotomy, and 14 cases of 21 feet underwent middle foot Japas osteotomy. Ankle-posterior foot (Wicart) scoring system was used to evaluate the good and good rates of the two surgical methods. X-ray films were taken before and after the last follow-up in a standing weight-bearing position, and Meary Angle, Hibb Angle, and Pitch Angle were measured to compare the clinical efficacy of the two surgical methods in correcting the light and medium-cavovarus foot deformity.Results: (1) All patients were followed up for an average of 30 months. There was no significant difference in Meary, Hibb, and Pitch Angle between first metatarsal osteotomy and middle foot Japas osteotomy before surgery, indicating that the severity of malformation was similar between the two groups. (2) The Meary, Hibb, and Pitch Angle of the last follow-up were compared between the two groups (P>0.05), which showed no statistical significance, indicating that the two surgical methods had similar effects on cavovarus deformity correction. (3) At the most recent follow-up, there was no statistically significant difference between the two groups regarding the percentage of patients who achieved an excellent or good Wicart score; for the first metatarsal osteotomy group, the rate was 87%, and for the Japas osteotomy group was 90%; the Fisher test p>0.05 indicates that the postoperative excellent and good rates of the two treatments are comparable.II (4) Comparison of operation time and intraoperative blood loss between the two groups, P<0.05, showed statistically significant differences, indicating that the first metatarsal osteotomy had obvious advantages over Japas osteotomy operation time and intraoperative blood loss. Conclusions: There is no significant difference in postoperative efficacy between first metatarsal osteotomy and Japas osteotomy for light and medium-cavovarus with the apex of the deformity located at the medial cuneus or navicular cuneiform joint. However, the intraoperative blood loss and operative time of first metatarsal osteotomy are superior to Japas osteotomy of the middle foot, and the trauma to children is less. Therefore, the first metatarsal osteotomy can be considered a surgical procedure.

This study aimed to investigate the prevalence, location, and characteristics of new-onset chronic pain by using a new definition in long-term survivors after discharge from a tertiary emergency center. We conducted a single-center ambidirectional cohort study from January to May 2022. A survey of patients was conducted by postal mail 2-2.5 years since their discharge from a tertiary emergency center. We used the Brief Pain Inventory to investigate chronic pain parameters, and the painDETECT questionnaire to investigate neuropathic pain. Patient information during hospitalization was collected retrospectively from medical records. The survey was sent to 78 patients, 63 (81%) of whom responded and were included in the analysis. Nine of the 63 patients (14%) had new-onset chronic pain. Of these, six (67%) had chronic pain of moderate or severe intensity which interfered with daily life. The most frequent location of chronic pain was the ankle/foot (n=4, 44%). Neuropathic pain was present in four (44%) patients with new-onset chronic pain. New-onset chronic pain may occur for up to 2-2.5 years after discharge from a tertiary emergency center, and this may interfere with daily life. Therefore, a follow-up system for chronic pain is warranted.

(1) Background: This work aimed to conduct the first comparative study providing long-term data about patient reported outcome measures as well as donor-site scar assessment and aesthetic evaluation of the reconstructed breasts in patients with DIEP versus PAP flap breast reconstruction. (2) Methods: This prospective, single-center, matched cohort study included a total of 36 patients after DIEP and PAP flap breast reconstruction. Evaluation was done using the Breast-Q and POSAS questionnaire as well as the Breast Aesthetic Scale for cosmetic analysis by four plastic surgeons. (3) Results: Post-operative Breast-Q evaluation revealed no significant differences between both patient groups for the categories physical well-being donor-site, physical well-being breast and satisfaction with the breast. Scar evaluation of the donor-site region showed equivalent results for the thigh and the abdomen concerning the overall opinion of patients and observers. There was no significant difference between both methods of reconstruction for all aspects of breast aesthetics. (4) Conclusions: Similar results of donor-site morbidity, scar quality and aesthetic outcome of the breast in both the DIEP and PAP patient group have been demonstrated. Hence, in cases suitable for both types of reconstruction, the decision can be based on factors such as patients’ lifestyle, leisure activities and preferences.

This study aims to verify the time-variant feature of American ginseng (AG) continuous cropping obstacles and to explore the factors impeding continuous cropping. We verified the feature with a plant-soil feedback pot experiment and then investigated the factors by comparing the properties of control soils that had not been previously used for growing ginseng (CS) with those of soils with a 10-year-crop-rotation cycle following the growth of AG (RS). It’s found that the survival rate of AG in RS was lower than that in CS. The RS had lower pH, available potassium content, and urease activity. Additionally, p-coumaric, p-hydroxybenzoic, vanillic, caffeic, and cinnamic acid levels were lower in RS than in CS, but salicylic acid levels showed the opposite pattern. RS had higher Rhodanobacter and lower Acidothermus, Sphingomonas relative abundances in bacterial community. It’s also found that many bacteria were substantially correlated with phenolic acids and soil physiochemical properties. Results indicate that even after 10-year crop rotation, the negative effects of prior continuous cropping of AG has not been eliminated. The growth of AG can be affected negatively with deterioration of soil physicochemical properties and with lower levels of phenolic acids which promote pathogen reproduction. Probiotics reduction also weighs. Moreover, biotic factors are interrelated with abiotic ones. Therefore, it can be inferred that the comprehensive change of soil properties is the main obstacle for continuous cropping.

Age-related hearing loss (ARHL) is the most common sensory disorder in the elderly. It is associated with aging and hair cell death due to oxidative stress-induced mitochondrial dysfunction. Although transgenic mice and long-term cultures for induction of aging have been used to study ARHL, there are presently no ARHL animal models stimulated by intermittent environmental change for aging. In this study, an ARHL animal model was established by inducing continuous oxidative stress to promote short-term aging of cells, determined based on the expression of the hearing loss-induced phenotype and aging related factors in the short term. The incidence of hearing loss was significantly different among the groups subjected to intermittent hypoxic environment, high-fat diet (HFD), and injection with D-galactose. Continuous oxidative stress and HFD were factors that accelerated cellular aging. Increase in UCP2 affected oxidative stress and mitochondrial dysfunction. CDH23, SLC26A4, KCNQ4, Myo7a, and Myo6, which are ARHL-related factors, were modified by oxidative stress in cells of the hearing organ. We found that intermittent hypoxic, HFD, and galactose injection accelerated cellular aging in the short term. Thus, we anticipate that the development of this hearing loss animal model, which reflects intermittent environmental changes, will benefit future research on ARHL.

People who suffer a mild traumatic brain injury (mTBI) have heterogeneous symptoms and disease trajectories, which make it difficult to precisely diagnose and assess complications long-term. Insufficient information is available regarding how to precisely diagnose and assess mTBI. This study identified and compared deficits in cognitive, psychosocial, visual functions, and balance performance between college students with and without histories of mTBI. Global DNA methylation ratio (5-mC%) in blood was also compared as a peripheral epigenetic marker. Twenty-five volunteers participated in this pilot study, including 11 mTBI cases (27.3% females; mean age of 28.7 years, SD=5.92) and 14 healthy controls (64.3% females; mean age of 22.0, SD=4.13). All the participants were assessed for cognitive (by NIH toolbox—executive function, memory, and processing speed), psychological (by PROMIS—depression, anxiety, and sleep disturbances), visual function (by King-Devick and binocular accommodative tests), postural balance performance (by a force plate), and blood 5-mC% (global methylation) levels. Students with mTBI reported significantly poorer episodic memory, severe anxiety, and more sleep disturbance problems. They also had higher blood 5-mC% level (all p’s<.05). No significant differences were found in visual function and postural balance. These findings validate changes in cognitive, psychosocial, and global DNA methylation long after mTBI.

The aim of this study of patients with chronic kidney disease (CKD) is to assess the safety of daily consumption of walnuts on the physiological levels of phosphorous, potassium, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23), and to assess the short-term benefits of this intervention on risk factors associated with cardiovascular events. This led us to perform a prospective, randomized, cross-over, pilot clinical trial examined 13 patients with chronic kidney disease (CKD). Subjects were randomly assigned to a diet of 30 g of walnuts per day or the control diet. After 30 days, each group was given a 30-day washout period, and then switched to the alternate diet for 30 days. Urinary and serum levels of phosphorous and potassium, multiple vascular risk factors, and urinary inositol phosphates (InsPs) were measured at baseline and at the end of the intervention period. Our results showed that the walnut dietary supplement led to reduced blood pressure, LDL cholesterol, and serum albumin, but had no effect on the physiological levels of phosphorous, potassium, PTH, and FGF23. This is the first report to show that daily consumption of walnuts by patients with CKD does not alter their physiological levels of phosphorous, potassium, PTH, and FGF23. Consequently, this dietary supplement may prevent cardiovascular events in patients with CKD.

Reducing sedentary behaviours can help prevent non-communicable diseases, particularly among young adolescents with long term illnesses or disabilities (LTID). Much of young people’s voluntary sedentary time is related to screen-time behaviours (STBs) such as TV viewing, playing computer games, and using the computer for other activities. Although public health data on adolescents’ STB is growing, information about adolescents with LTID is currently lacking in a European context. The purpose of this study is to compare time on STBs between adolescents with and without LTID in European Countries through the HBSC 2013/14 study. Young adolescents (n = 61,329; boys 47.8%) from 15 European countries reported the time spent on TV viewing, playing computer games, and using the computer for other purposes on weekdays and the weekend. STBs were dichotomised based on international recommendations of less than 2 h per day, and Chi-square tests of independence were performed to investigate differences. STB time was combined to produce a sum score as dependent variable in multiple analysis of covariance with age and family affluence as covariates. There were statistically significant differences in computer gaming among boys and other computer use among girls for both weekdays and weekends, whereby adolescents with LTID reported higher use. In addition, both boys and girls with LTID spent more time on STBs than their same sex peers without LTID (Boys, F = 28.17, p < 0.001; Girls, F = 9.60, p = 0.002). The results of this study indicate a need for preventive strategies to address high levels of STB among young adolescents with LTID and reduce the risk of poor health outcomes associated with higher levels of sedentary behaviour.

Using assembly theory, we investigate the assembly pathways of binary strings of length N formed by joining bits present in the assembly pool and the strings that entered the pool as a result of previous joining operations. We show that the string assembly index is bounded from below by the shortest addition chain for N, and we conjecture about the form of the upper bound. We define the degree of causation for the minimum assembly index and show that for certain N it features regularities that can be used to determine a shortest addition chain. We show that a string with the smallest assembly index for N can be assembled by a binary program of length equal to this index if the length of this string is expressible as a product of Fibonacci numbers. We conjecture that there is no binary program that has a length shorter than the length of the string having the largest assembly index for N that could assemble this string. The results confirm that four Planck areas provide a minimum information capacity that corresponds to a minimum thermodynamic (Bekenstein-Hawking) entropy. Knowing that the problem of determining the assembly index is at least NP-complete, we conjecture that this problem is NP-complete, while the problem of creating the string so that it would have a predetermined largest assembly index is NP-hard. The proof of this conjecture would imply P ≠ NP, since every computable problem and every computable solution can be encoded as a finite binary string. Once the new information is assembled by a dissipative structure or by a human, it is subject to the 2^nd law of thermodynamics, and nature seeks to optimize its assembly pathway.

In mountain-gorge areas, the rock creep is the critical process for high rock slopes failure. During long-term rock creep, slopes might encounter earthquakes and form further creep after earthquakes. This complex mechanical response process can easily lead to the slope failure. Based on a high rock slope in the Nujiang River Basin, this paper analyzes deformation characteristics and dynamic response characteristics by using FLAC3D software, considering combined effects of multiple earthquakes and long-term creep. Results show that when the amplitude increases, the shear strength of the slope decreases and the risk of instability increases under combined actions of creep and earthquakes. Earthquakes promote the development of creep and induce the accumulation of damage on the slope surface and in the slope. The delayed effect becomes more pronounced as the slope height increases. We need to consider deformation differences of the slope further. The ground motion response on the slope surface is stronger than those in the slope, with the peak occurring at the top of the slope. Earthquakes have a greater impact on the middle and top of the slope surface, where cumulative damage and crack development begin. Reinforcement should be considered in these two places. Vertical earthquake has a great effect on the dynamic response. The phenomenon of slope resonance leads to a larger MPGA in the vertical direction than in the horizontal direction. Nonlinear and damping characteristics of the slope and the frequency of seismic waves cause the MPGA to decrease with the increase of amplitudes. This study could promote the development of high rock slope failure mechanism and provide references for the prevention of landslides in the Nujiang River Basin.

Backgorund and Objectives: In this study, we aimed to evaluate and compare the changes in visual and structural outcomes in patients with intravitreal aflibercept (IVA)-resistant neovascular age-related macular degeneration (nAMD) switched to either intravitreal brolucizumab (IVBr) or intravitreal faricimab (IVF) injections in a clinical setting. Materials and Methods: This obser-vational clinical study included 20 eyes of 20 patients switched to brolucizumab and 15 eyes of 14 patients switched to faricimab for aflibercept-resistant nAMD. We measured the structural outcome (central macular thickness (CMT)) and the visual outcome (best-corrected visual acuity (BCVA); logMAR) as follows: just before the most recent IVA injection (B0), one month after the most recent IVA injection (B1), just before the first IVBr or IVF injection (A0), one month after (A1) and three months after (A3) the first IVBr or IVF injection. Results: BCVA showed significant im-provement at A1 (0.25 ± 0.34) and at A3 (0.19 ± 0.24) compared to A0 (0.38 ± 0.35) in IVBr group (p = 0.0156, p = 0.0166, respectively). CMT (μm) was significantly thinner at A1 (IVBr; 240.55 ± 51.82, IVF; 234.91 ± 47.29) and at A3 (IVBr; 243.21 ± 76.15, IVF; 250.50 ± 72.61) compared to at A0 (IVBr; 303.55 ± 79.18, IVF; 270.33 ± 77.62) in IVBr group (A1; p = 0.0093, A3; p = 0.0026) and in IVF group (A1; p = 0.0161, A3; p = 0.0093). There was no significant difference in BCVA and CMT improvement observed between two groups at any time point (p > 0.05 for all). Conclusion: Switching from aflibercept to either brolucizumab or faricimab has a significant anatomical ef-fect on eyes with aflibercept-resistant nAMD and both treatments appear to be effective short-term treatment options. There is a trend towards greater visual improvements and reductions in CMT with brolucizumab.

Background. Transcatheter edge-to-edge repair (TEER) is a safe and effective treatment in symptomatic patients with mitral regurgitation (MR). We aimed to investigate the short-term impact of mitral TEER on left ventricular (LV) performance and identify echocardiographic prognostic indicators. Methods. Seventy-eight patients with severe MR (organic and functional etiologies) were included retrospectively. All patients had a baseline and short-term echocardi-ography after TEER and were followed up for the primary composite endpoint (heart failure hos-pitalization and cardiovascular death) over a median period of 13 months. Results. A significant decrease in left ventricular ejection fraction (LVEF), all myocardial work indices (except global wasted work), and left atrial reservoir were observed after TEER. Additionally, there was an im-provement in the pulmonary artery systolic pressure and tricuspid annular plane systolic excur-sion/pulmonary artery systolic pressure (TAPSE/PASP) ratio. 34% of all patients presented the primary composite endpoint. A TAPSE/PASP ratio post-TEER < 0.47 (HR: 4.76, p-value = 0.039), and left atrial reservoir post-TEER < 9.0% (HR: 2.77, p-value = 0.047) were independently associ-ated with the primary endpoint. Conclusions. Echocardiography post-TEER reflects impairment in ventricular performance due to preload reduction and right ventricular to pulmonary artery coupling improvement. Short-term echocardiography after TEER identifies high-risk patients who could benefit from a close clinical follow-up.

Functional ankle instability (FAI) results from multiple ankle sprains, causing a perceived sense of joint instability due to muscle and ligament imbalances. Neuromuscular training (NMT) is employed to enhance ankle stability in individuals with FAI. The study included 24 male university students with FAI, who underwent ankle NMT on three surfaces. OpenSim musculoskeletal model analyzed the effects on ankle muscle activity, kinetics, and kinematics. Utilizing repeated measures analysis of variance (ANOVA) and one-dimensional statistical non-parametric mapping (SNPM1d) to identify distinctions between training surfaces. NMT on foam cushion (FC) significantly enhanced tibialis anterior (TA) and gastrocnemius medial (GM) activation during walking compared to level-ground (LG) and artificial turf (AT) (p&lt;0.05). However, no differences observed for peroneus longus (PL), gastrocnemius lateral (GL), and peak ankle plantarflexion (PF). During jogging and fast running, post FC training increased TA, PL, GM, GL activation, and peak ankle PF moment (p&lt;0.05). Additionally, post FC training, subtalar mobility was significantly reduced (p&lt;0.05), and ankle joints exhibited greater dorsiflexion (DF) angles during jogging and fast running (p&lt;0.05). Consequently, selecting FC for short-term ankle NMT proves more advantageous in enhancing ankle stability among individuals with FAI, yielding a more positive impact on FAI improvement.

Water deficit (drought) is still one of the most important stress factors affecting not only yields, but also production quality. Breeders are focusing on breeding cultivars and crop lines that are more resistant to water shortages. In addition to breeding, for example, for the size of the roots and changes in the color of the leaves, focus on changing the morphotype i.e. long chaff, multirowed ear. It is predicted that wheat genotypes with a morphotype change should be more drought tolerant. Therefore, our research focused on the study of changes in the physiological parameters of wheat (cv. ´Bohemia´) with a changed morphotype (genotypes ´284-17´ [long chaff] and genotype ´29-17´ [multirowed ear]) in relation to exposure to drought. Pigment content, photosynthesis and transpiration rate, water potential were measured in plants irrigated and affected by water deficit. Water deficit was shown to have a statistically significant effect on transpiration rate, photosynthetic rate, water potential and total chlorophyll content. Furthermore, the influence of the genotype on the observed parameters and on the effect of water deficit was demonstrated. Due to the fact that cv. ´Bohemia´, increases during such periods of transpiration, so for this reason it is not suitable for dry areas. Genotype ́29-17 ́ appears promising with respect to drought resistance.

Due to the intermittency and fluctuation of photovoltaic (PV) output power, a high proportion of grid-connected PV power generation systems has a significant impact on power systems. Accurate PV power forecasting can alleviate the uncertainty of the PV power and is of great significance for the stable operation and scheduling of the power systems. Therefore, in this study, a feature rise-dimensional (FRD) two-layer ensemble learning (TLEL) model for short-term PV power deterministic forecasting and probability forecasting is proposed. First， based on the eXtreme Gradient Boosting (XGBoost), Random Forest (RF), CatBoost, and Long-short-term memory (LSTM) models, a TLEL model is constructed utilizing the ensemble learning algorithm. Meanwhile, the FRD method is introduced to construct the FRD-XGBoost-LSTM (R-XGBL), FRD-RF-LSTM(R-RFL), and FRD- CatBoost - LSTM (R-CatBL) models. Subsequently, the above models are combined to construct the FRD-TLEL model for deterministic forecasting, and perform probability interval forecasting based on quantile regression(QR). Finally, the performance of the proposed model is demonstrated with a real-world dataset. By comparing with other models, the proposed model displays better forecasting accuracy for deterministic forecasting and reliable forecasting intervals for probability forecasting, and good generalization ability in the datasets of different seasons and weather types.

Inflammatory activation within the brain was linked to a decrease in cognitive abilities, however the molecular mechanisms implicated in the development of inflammatory-related cognitive dysfunction and its prevention are poorly understood. This study compared responses of hippocampal transcriptomes 3 months after the striatal infusion of lipopolysaccharide, alone (LPS; 30 µg) resulting in memory loss, or with dexamethasone (DEX; 5 mg/kg intraperitoneal) pretreatment, which abolished the long-term LPS-induced memory impairment. After LPS alone, a significant elevation in the expression of immunity/inflammatory-linked genes, including chemokine (Cxcl13), cytokines (Il1b, Tnfsf13b), and major histocompatibility complex (MHC) class II members (Cd74, RT1-Ba, RT1-Bb, RT1-Da, RT1-Db1) was revealed. DEX pretreatment did not change expression of these genes, but significantly affected expression of genes encoding ion channels, primarily calcium and potassium channels, regulators of glutamate (Slc1a2, Grm5, Grin2a) and GABA (Gabrr2, Gabrb2) neurotransmission which enriched in such GO biological processes as “Regulation of transmembrane transport”, “Cognition”, “Learning”, “Neurogenesis”, and “Nervous system development”. Taken together, the data suggest that: (1) pretreatment with DEX did not markedly affect LPS-induced prolonged inflammatory response; (2) DEX pretreatment can affect processes associated with glutamatergic signaling and nervous system development, possibly involved by that in the recovery of memory impairment induced by LPS

Electrical energy demand increase does evolve rapidly due to several socioeconomic factors such as industrialization, population growth, urbanization and of course the evolution of modern technologies in this 4th industrial revolution era. Such rapid increase in energy demand introduces a huge challenge in power system. Such has paved way for network operators to seek for alternative energy resources other than the conventional fossil fuel system. Hence, the penetration of renewable energy into the electricity supply mix has evolved rapidly in the past three decades. However, the grid system has to be well planned ahead to accommodate such increase in energy demand in the long run. Transmission Network Expansion Planning (TNEP) is a well ordered and profitable expansion of power facilities that meets the expected electric energy demand with an allowable degree of reliability. This paper proposes a TNEP model that minimises the network reinforcements, operational costs and costs of renewable energy penetrations, while satisfying the increase in demand. The problem is formulated as a mixed integer linear programming (MILP) problem. The developed model has been tested in several IEEE test systems in multi-period scenarios. The paper also carried out a detailed derivation of the new non-negative variables in terms of the power flow magnitudes, the bus voltage phase angles and the lines’ phase angles for proper mixed integer variables’ decomposition techniques. Moreover, this paper tends to provide additional recommendation in terms of which particular year (within 20 years of planning period) can the network operators install new line(s), new corridor(s) and/or additional generation capacity to the respective existing power networks. Such is achieved by running incremental periods simulations from base year through the planning horizon. The results show the efficacy of the developed model in solving the TNEP problem with a reduced and acceptable computation time even for large power grid system.

The creep response of commercially pure titanium was investigated in air at 550, 600 and 650°C, to assess the effect of oxidation on the mechanical response. Experiments demonstrated that exposure at high temperature produced a marked reduction of the minimum creep rate under a given applied stress. Microhardness measurements showed that a hardened zone forms in proximity of the surface, due to oxygen penetration into metal. A simplified composite-model was then used to describe the creep response. In this model, the sample consisted of two zones, the hard case, enriched in oxygen, and the soft pure-titanium core, both creeping with similar strain rates. Calculation led to an estimation of the dependence of the minimum creep rate on stress and temperature for the hard high-oxygen zone. The simplified composite-model here presented gave an excellent description of experimental creep data for pure titanium tested in air and also provided a reliable picture of the effect of oxidation on complex Ti-alloys.

The global demand for energy has been steadily increasing due to population growth, urbanization, and industrialization. Numerous researchers worldwide are striving to create precise forecasting models for predicting energy consumption to manage supply and demand effectively. In this research, a time-series forecasting model based on multivariate multilayered long short-term memory (LSTM) is proposed for forecasting energy consumption and tested using data obtained from commercial buildings in Melbourne, Australia: the Advanced Technologies Center, Advanced Manufacturing and Design Center, and Knox Innovation, Opportunity, and Sustainability Center buildings. This research specifically identifies the best forecasting method for subtropical conditions and evaluates its performance by comparing it with the most used methods at present, including LSTM, bidirectional LSTM, and linear regression. The proposed multivariate multilayered LSTM model was assessed by comparing mean average error (MAE), root-mean-square error (RMSE), and mean absolute percentage error (MAPE) values with and without labeled time. Results indicate that the proposed model exhibits optimal performance with improved precision and accuracy. Specifically, the proposed LSTM model achieved a decrease in MAE by 30%, RMSE by 25%, and MAPE by 20% compared to the LSTM method. Moreover, it outperformed the bidirectional LSTM method with a reduction in MAE by 10%, RMSE by 20%, and MAPE by 18%. Furthermore, the proposed model surpassed linear regression with a decrease in MAE by 2%, RMSE by 7%, and MAPE by 10%. These findings highlight the significant performance increase achieved by the proposed multivariate multilayered LSTM model in energy consumption forecasting.

Multivariate predictive analysis of the Stream-Water (SW) parameters (discharge, water level, temperature, dissolved oxygen, pH, turbidity, and specific conductance) is a pivotal task in the field of water resource management during the era of rapid climate change. The highly dynamic and evolving nature of the meteorological and climatic features have a significant impact on the temporal distribution of the SW variables in recent days making the SW variables forecasting even more complicated for diversified water-related issues. To predict the SW variables, various physics-based numerical models are used using numerous hydrologic parameters. Extensive lab-based investigation and calibration are required to reduce the uncertainty involved in those parameters. However, in the age of data-informed analysis and prediction, several deep learning algorithms showed satisfactory performance in dealing with sequential data. In this research, a comprehensive Explorative Data Analysis (EDA) and feature engineering were performed to prepare the dataset to obtain the best performance of the predictive model. Long Short-Term Memory (LSTM) neural network regression model is trained using over several years of daily data to predict the SW variables up to one week ahead of time (lead time) with satisfactory performance. The performance of the proposed model is found highly adequate through the comparison of the predicted data with the observed data, visualization of the distribution of the errors, and a set of error matrices. Higher performance is achieved through the increase in the number of epochs and hyperparameter tuning. This model can be transferred to other locations with proper feature engineering and optimization to perform univariate predictive analysis and potentially be used to perform real-time SW variables prediction.

The glucose-insulin regulatory system and its glucose oscillations is a recurring theme in the literature because of its impact on human lives, mostly the ones affected by diabetes mellitus. Several approaches were proposed, from mathematical to data-based models, with the aim of modeling the glucose oscillation curve. Having such a curve, it is possible to predict, when injecting insulin in type 1 diabetes (T1D) individuals. However, the literature presents prediction horizons no longer than 6 hours, which could be a problem considering their sleeping time. This work presents Tesseratus, a model that adopts a multi-agent approach to combine machine learning and mathematical modeling to predict the glucose oscillation up to 8 hours. Tesseratus uses the pharmacokinetics of insulins and data collected from T1D individuals. Its outcome can support endocrinologists while prescripting daily treatment for T1D individuals, and provide personalized recommendations for such individuals, to keep their glucose concentration in the ideal range. Tesseratus brings pioneering results for prediction horizons of 8 hours for nighttime, in an experiment with seven real T1D individuals. It is our claim that Tesseratus will be a reference for classification of glucose prediction model, supporting the mitigation of short- and long-term complications in the T1D individuals.

As the problem of traction injuries to brachial plexus is a common one and of high socio-economic significance, the analysis of the surgical outcomes in patients with this pathology is significant for neurosurgery, neurology, traumatology-orthopedics, and rehabilitation. The aim of the research is to compare the short-term outcomes of using various surgical methods for managing patients with closed traction injuries of brachial plexus. Material and methods. The research involved 61 patients with closed traction injury of brachial plexus divided into two groups homogeneous in sex, age and severity of their neurological deficit: Group I – 33 patients who underwent microsurgical neurolysis, Group II – 28 patients who underwent microsurgical neurolysis combined with one-level electrostimulation. The dynamic assessment of clinical and functional status of upper limbs was performed using scale methods and electrophysiological monitoring. Results. The research revealed a more evident recovery of the upper limb function in Group II patients suggesting the method of microsurgical neurolysis combined with electrostimulation to be preferable in case of closed traction injuries to brachial plexus. Conclusion. The combination of microsurgical neurolysis with one-level electrostimulation improves the short-term outcomes of surgical treatment in patients with closed traction injuries of brachial plexus due to a sooner decrease in pain in postoperative period, and positive dynamics of clinical and electrophysiological parameters.

Satellite-based Normalized Difference Vegetation Index (NDVI) time-series data are useful for monitoring the changes of vegetation ecosystems in the context of global climate change. However, there are currently no ideal NDVI datasets that reconcile long-term series with high spatial resolution. Here, we have developed a simple and novel data downscaling algorithm based on the coefficient of variation (CV) statistics, which combines the detailed spatial features of MODIS data with the long-term temporal information of AVHRR data. The proposed data fusion method helps generate a global monthly NDVI database that has a 250 m-resolution and covers the long period of 1982−2018. We evaluated the accuracy of the fused data against MODIS NDVI using the metrics of Root Mean Square Error (RMSE), Mean Absolute Error (MAE), and Pearson’s correlation coefficients (R). Validation suggests a high performance of the downscaling algorithm and a high accuracy of the new NDVI database. We further applied the downscaled data to monitor NDVI changes of various vegetation types and in areas having high vegetation heterogeneity, and we obtained stable results similar to MODIS data. The whole data downscaling and validation processes were completed on the Google Earth Engine platform, and here we provide a code for users to easily get the data for any part of the world. The downscaled global-scale NDVI time series has high potential in monitoring the temporal and spatial dynamics of the terrestrial ecosystems under changing environments.

One of the key challenges of stock trading is the stock prices follow a random walk process, which is a special case of a stochastic process, and are highly sensitive to new information. A random walk process is difficult to predict in the short-term. Many linear process models that are being used to predict financial time series are structural models that provide an important decision boundary, albeit not adequately considering the correlation or causal effect of market sentiment on stock prices. This research seeks to increase the predictive capability of linear process models using the SPDR S\&P 500 ETF (SPY) and the CBOE Volatility (VIX) Index as a proxy for market sentiment. Three econometric models are considered to forecast SPY prices: (i) Auto-Regressive Integrated Moving Average (ARIMA), (ii) Generalized Auto Regressive Conditional Heteroskedasticity (GARCH), and (iii) Vector Autoregression (VAR). These models are integrated into two technical indicators, Bollinger Bands and Moving Average Convergence Divergence (MACD), focusing on forecast performance. The profitability of various algorithmic trading strategies is compared based on a combination of these two indicators. This research finds that linear process models that incorporate the VIX Index do not improve the performance of algorithmic trading strategies.

It is crucial to forecast the water demand accurately for supplying water efficiently and stably in a water supply system. In particular, accurately forecasting short-term water demand helps in saving energy and reducing operating costs. With the introduction of the Smart Water Grid (SWG) in a water supply system, the amount of water consumption is obtained in real time through an advanced metering infrastructure (AMI) sensor, which can be used for forecasting the short-term water demand. The models widely used for water demand forecasting include the autoregressive integrated moving average, radial basis function-artificial neural network, quantitative multi-model predictor plus, and long short-term memory. However, there is a lack of research on assessing the performance of models and forecasting the short-term water demand by applying the data on the amount of water consumption by purpose and the pipe diameter of an end-use level of the SWG demonstration plant in each demand forecasting model. Therefore, in this study, the short-term water demand was forecasted for each model using the data collected from the AMI, and the performance of each model was assessed. The Smart Water Grid Research Group installed ultrasonic-wave-type AMI sensors in the block 112 located in YeongJong Island, Incheon, and the actual data used for operating the SWG demonstration plant were adopted. The performance of the model was assessed by using the residual, root mean square error (RMSE), normalized root mean square error (NRMSE), Nash–Sutcliffe efficiency (NSE), and Pearson correlation coefficient (PCC) as indices. The water demand forecast was slightly underestimated in models that employed the assessment results based on the RMSE and NRMSE. Furthermore, the forecasting accuracy was low for the NSE due to a large number of negative values; the correlation between the observed and forecasted values of the PCC was not high, and it was difficult to forecast the peak amount of water consumption. Therefore, as the short-term water demand forecasting models using only time and the amount of water consumption have limitations in reflecting the characteristics of consumers, a water supply system can be managed more precisely if other factors (weather, customer behavior, etc.) influencing the water demand are applied.

Natural circulation loop (NCL) systems are buoyancy-driven heat exchangers that are used in various industrial applications. The concept of passive heat exchange in NCL systems is attractive, because there is no need for an externally driven equipment (e.g., a pump) to maintain the fluid circulation. However, relying on buoyancy as the sole driving force may lead to several potential difficulties, one of which is generation of (possibly) time-varying nonlinearities in the dynamical system, where a difference in the time scales of heat transfer and fluid flow causes the flow to change from a steady-state regime to either an oscillatory regime or a flow-reversal regime, both of which are undesirable. In this paper, tools of symbolic time series analysis (e.g., probabilistic finite state automata (PFSA)) are proposed to identify selected regimes of operation in NCL systems, where the underlying principle is built upon the concept of pattern classification from measurements of fluid-flow dynamics. The proposed method is shown to be capable of identifying the current regime of operation from the initial time response under a given set of operational parameters. The efficacy of regime classification is demonstrated by testing on two data sets, generated from numerical simulation of a MATLAB SimuLink model that has previously been validated with experimental data. The results of the proposed PFSA-based classification are compared with those of a hidden Markov model (HMM) that serves as the baseline.

Dynamic laser speckle is applied as a reliable sensor of activity in all sort of material. Traditional applications are based on a time rate that is usually higher than 10 frames-per-second (FPS). Even in drying processes, where there is a high activity in the first moments after the painting and a slow activity after some minutes or hours, the process is based on the acquisition of images in a time rate that is the same in both moments of high and low activity. In this work, we present an alternative approach to follow the drying of paint and the other processes related to restauration of paintings that takes long-term to reduce the activity. We illuminated, using three different wavelength lasers, an accelerator (Cyclododecane) and a varnish used in restauration of paintings and monitor them at long-term drying using an alternative fps, comparing the results to the traditional method. The work also presents a way to do the monitoring using a portable equipment. The results present the feasibility to use the portable device and show the improvement in the sensitivity of the dynamic laser speckle to sense long-term process regarding the drying of Cyclododecane and Varnish used in restauration.

Background: Recent studies suggest an association between long-term air pollution, diet, and health outcomes, but there are limited studies on how short-term air pollution affects dyslipidemia in particular. We aimed to investigate this association with modified fruit and vegetable consumption.Methods: The Cardiovascular Disease Association Study (CAVAS) included 8,779 participants between 2007 and 2016. Particulate matter (PM_2.5) and nitrogen dioxide (NO₂) levels were estimated using community multiscale air quality models. Short-term air pollution exposure was defined as a moving average over a lag time from “lag 1 days” to “lag 14 days.” Fruit and vegetable intake was categorized into 'total vegetables (TV),’ 'non-salted vegetables (NSV),' 'salted vegetables (SV),' 'fruits (F),' 'non-salted vegetables + fruits (NSVF),' and 'total vegetables + fruits (TVF).' Dyslipidemia was defined by total cholesterol ≥240 mg/dl, LDL cholesterol ≥160 mg/dl, HDL cholesterol <40 mg/dl, serum triglycerides ≥200 mg/dl, or physician-reported dyslipidemia.Results: Higher short-term PM_2.5 concentrations were associated with an increased risk of dyslipidemia (odds ratio (OR) = 1.012, 95% CI: 1.003, 1.020 for a lag of 14 days). High PM_2.5 groups (≥23.3 μg/m³) with a higher TV intake (≥186.1 g/day) were associated with a decreased risk of dyslipidemia (OR = 0.88, 95% CI: 0.78, 0.99). Additionally, high PM_2.5 groups (≥23.3 μg/m³) with a higher intake of SV (≥110.6 g/day) were associated with a decreased risk of dyslipidemia (OR = 0.86, 95% CI: 0.76, 0.97). Conclusion: Our study suggests that vegetable consumption is an important dietary factor for attenuating risk of dyslipidemia associated with short-term air pollution exposure.

Fragile X syndrome (FXS) is an intellectual developmental disorder characterized, inter alia, by deficits in short-term processing of neural information such as sensory processing and working memory. The primary cause of FXS is the loss of fragile X messenger ribonucleoprotein (FMRP), which is profoundly involved in synaptic function and plasticity. Short-term synaptic plasticity (STSP) may play important roles in functions that are affected by FXS. Recent evidence points to a crucial involvement of presynaptic calcium sensor synaptotagmin-7 in STSP. However, how the loss of FMRP affects STSP and synaptotagmin-7 have been insufficiently studied. Further-more, males and females are affected differently by FXS, but the underlying mechanisms remain elusive. The aim of the present study is to investigate possible changes in STSP and the expres-sion of synaptotagmin-7 along the hippocampus of adult males and females in the Fmr1 knock-out (KO) rat model of FXS. We found that paired-pulse ratio and frequency facilita-tion/depression, two forms of STSP, as well as the expression of synaptotagmin-7, are normal in adult KO males, but paired-pulse ratio is increased in the ventral hippocampus of KO females. Furthermore, we found no gender-related but robust region-dependent difference in STSP. AM-PA receptors are similarly expressed in the two hippocampal segments of the two genotypes and in both genders. Also, basal excitatory synaptic transmission is higher in males compared with females. Interestingly, we found more than twofold higher levels of synaptotagmin-7, not syn-aptotagmin-1, in the dorsal compared with the ventral hippocampus in males of both genotypes and in wild type females. These results point to the susceptibility of the female ventral hippo-campus to FMRP loss. Importantly, the different levels of synaptotagmin-7 that parallel the higher score of synaptic facilitation in the dorsal vs ventral hippocampus suggest that synapto-tagmin-7 may play a pivotal role in defining the striking difference in STSP along the long axis of the hippocampus.

The rise in prevalence of obesity in women of reproductive age in both developed and developing countries might propagate intergenerational cycles of detrimental effects on metabolic health, contributing to substantial economic burden on society. Placental lipid metabolism might be disrupted by maternal obesity, which possibly affects the life-long health of the offspring. Here, we investigated placental lipid metabolism and handling from women with pre-gestational obesity as a sole pregnancy complication and compared to placental responses of lean women. Open profile and targeted lipidomics were used to assess placental lipids and oxidized products of docosahexahenoic acid (DHA), neuroprostanes, and arachidonic acid (AA), isoprostanes. Placental fatty acid transporters FABP1, FABP3 and endothelial lipase protein were measured. Despite no signs of overall alterations in lipid content, increased contents of DHA, AA, DHA-derived neuroprostanes and AA-derived isoprostanes and decreased content of FABP1 protein were found in placentas from obese women. Multivariate analyses suggested that these oxidised fatty acids are associated with maternal and placental inflammation and also with birth weight. These results might shed light on the molecular mechanisms associated with altered fatty acid metabolism and lipid handling in maternal pre-gestational obesity, placing these oxidized fatty acids as novel mediators of placental function.

Computational methods are essential to support and advance nuclear technologies due to the hazards of handling and analysing highly radioactive materials such as spent nuclear fuel (SNF). However, many such methods, including those thatcan predict SNF compositions and decay heat parameters, require expensive, proprietary software, alongside significant programming experience and computational power for utilisation, severely limiting availability of data and hampering research throughput. Although some datasets are available, many are incomplete or only cover certain fuel systems for older reactor types. Research investigating new methods for SNF recycling, for example, requires compositional and decay heat data for fuel systems not covered by extant data, though analogous source data may be available. With this in mind, we have developed a simple, accessible, and flexible method for extrapolation of isotopic, elemental, and decayheat compositions for SNF at discharge and following decay storage before recycling, based on an extant dataset. This semi-empirical method uses physical and mathematical first principles and can be performed using software accessible to all researchers. This provides outputs accurate to within 1% of reference values interpolated within the range of available data for isotopic compositions, with sensible extrapolations at higher burnups beyond those reported, withoverall elemental outputs accurate to within 0.1%of expected totals. In this publication, we present the developmental methodology, some sample data, the present limitations, and options for future development and expansion of functionality.

Background/Objectives: Intervertebral disc degeneration is the most common cause of low back pain (LBP) and lumbosciatica is a major challenge to healthcare systems worldwide. ''For years, ozone therapy has been used with excellent results in intervertebral disc disease and in patients with LBP, thanks to its anti-inflammatory and pain-relieving action.'' At the other side, the repair effect fulfilled by porcine collagen, is a novelty to approach this pathology. In vitro studies have demonstrated the positive action of porcine collagen in extracellular matrix remodeling and homeostasis These tissue changes, associated with LBP, may suggest an indication for combined ozone/collagen treatment in patients with LBP. However, no studies have been reported regarding this combination of treatments. Methods: The present work compared two treatment groups (each of 10 LBP patients): A) Oxygen-Ozone Therapy (OOT) vs. B) OOT plus porcine collagen type 1 injections (COL I). Pain intensity and physiological function were assessed by the numerical rating scale (NSR) method. The Roland-Morrison questionnaire was used to assess disability. Patient data were acquired before, during and at six months of follow-up. Significant differences were assessed by ANOVA and T-Student test. Results: The analyses revealed significant statistical differences comparing the two arms, where, the OOT COL I treatment demonstrated a booster efficacy in pain, while the questionnaire revealed a reduction in disability. Conclusions:. The combination of these two therapies could be effective for the management of LBP. However no studies have been reported in literature regarding this therapeutic combination.

A significant challenge encountered in mmWave and Sub-terahertz systems used in 5G and 1 the upcoming 6G networks is the rapid fluctuation in signal quality across various beam directions. Extremely high-frequency waves are highly vulnerable to obstruction, making even slight adjustments in device orientation or the presence of blockers capable of causing substantial fluctuations in link quality along a designated path. This issue poses a major obstacle because numerous applications with low-latency requirements necessitate precise forecasting of network quality from many directions and cells. The method that is proposed in this research demonstrates an avant-garde approach for assessing the quality of multi-directional connections in mmWave systems by utilizing the Liquid Time Constant network (LTC) instead of the conventionally used Long Short-Term Memory (LSTM) technique. The method’s validity was tested through an optimistic simulation involving the monitoring of multi-cell connections at 28 GHz in a scenario where humans and various obstructions were moving arbitrarily. The results with LTC are significantly better than those obtained by conventional approaches such as LSTM. The latter resulted in a test Root Mean Squared Error (RMSE) of 3.44 dB, while the former, 0.25 dB, demonstrating a 13-fold improvement. For better interpretability and to illustrate the complexity of prediction, an approximate mathematical expression is also fitted to the simulated signal data using Symbolic Regression.

Background: Despite continuous improvements in revascularization techniques, refractory angina without potential revascularization options remains a relevant clinical issue with significant impact on patient’s quality of life. Recently, a novel device, the Coronary Sinus Reducer (CSR), has been introduced into clinical practice as a therapeutic option for patients with disabling angina pectoris. In this single-center, observational study, we evaluated the mid-term (3-month) safety and efficacy of the CSR in a real-world cohort. Methods: The study population consisted of 55 patients with refractory angina without potential revascularization options, predominantly men (87.3%) with a high cardiovascular risk factor burden and advanced angina (baseline CCS angina class 3.15 ± 0.6). In terms of procedure safety, all patients underwent successful device deployment with only one periprocedural complication. Results: At the 3-month follow-up we observed statistically significant improvement in angina control measured CCS class and SAQ-7 Total questionnaire along with increased abolition of physical limitation – 6-MWT (233.3 ± 107.1 vs 305.2 ± 126.8; p&lt;0.0001). Additionally, we observed significant improvement in terms of quality of life measurements SF-36, the EQ-5D-5L questionnaire, and the EQ-VAS. Conclusions: Our real-world data suggest that CSR implantation is a relatively safe procedure and appears to be particularly effective in relieving angina symptoms and improving quality of life in subjects with refractory angina.

Cattle slurry is an important nitrogen source for maize on dairy farms. Slurry injection is an effective measure to reduce ammonia emissions after field application, but with higher risk of nitrous oxide emission than surface application. This study compared soil mineral nitrogen dynamics and nitrous oxide emissions with two ways of application. First, traditional injection at 25 cm spacing between rows followed by ploughing (called “non-placed slurry”), and second, injection using a new so-called goosefoot slurry injector that placed the slurry in ploughed soil as a c. 30 cm broad band at 10 cm depth below maize crop rows with 75 cm spacing (named “placed slurry”). Furthermore, the effect of treating slurry with the nitrification inhibitor 3,4-dimethylpyrazole phosphate (DMPP) in Vizura® was tested with both application methods. The field experiment was conducted on a sandy loam soil in a temperate climate. Both nitrous oxide emissions, and the dynamics of soil mineral nitrogen, were monitored for eight weeks after slurry application and seeding of maize using static chambers. The level of nitrous oxide emissions was higher with non-placed compared to placed slurry, mainly due to higher emissions during the first four weeks. That might be due to higher rates of nitrification rate and in turn stimulation of denitrification process. In both placed and non-placed slurry treatments, Vizura® caused higher soil ammonium concentrations and lower nitrate concentrations, particularly from 3 to 8 weeks after slurry application. The final level of soil nitrate was similar with and without the nitrification inhibitor, but higher with placed compared to non-placed slurry. Adding Vizura® to non-placed slurry reduced nitrous oxide emissions by 70 % when compared to placed slurry. Surprisingly, there was a non-significant trend towards higher cumulative emissions from placed slurry with the nitrification inhibitor compared to untreated slurry, which were due to higher emissions in the last part of the monitoring period (5-7 weeks after slurry application). Possibly degradation of the nitrification inhibitor, and nitrification activity inside the slurry band as the soil dried, promoted nitrous oxide emissions by this time. In summary, placement of untreated slurry in a broad band under maize seeds reduced nitrous oxide emissions compared to non-placed slurry with more soil contact. A comparable reduction was achieved by adding a nitrification inhibitor to non-placed slurry. The pattern of nitrous oxide emissions from placed slurry treated with the inhibitor was complex and requires more investigation.

Abstract: Sickle cell disease (SCD) is an autosomal recessive monogenic disorder caused by a homozygous mutation in the β-globin gene, which leads to erythrocyte sickling, hemolysis, vaso-occlusion and sterile inflammation. Oral l-glutamine administration has been shown to reduce the frequency of pain crisis in SCD patients, however, the long-term effect of l-glutamine in SCD remains to be determined. To understand the long-term effect of l-glutamine administration in SCD liver we used quantitative liver intravital microscopy and biochemical analysis in humanized SCD mice. We here show that chronic l-glutamine administration reduces hepatic hemoglobin-heme-iron level, but fails to ameliorate ischemic liver injury. Remarkably, we find that this failure in resolution of hepatobiliary injury and persistent liver fibrosis is associated with reduced expression of hepatic Kupffer cells post l-glutamine treatment. These findings establish the importance to investigate the long-term effects of l-glutamine therapy on liver pathophysiology in SCD patients.

Background: The prognostic impact of non-cardiac comorbidities can vary in relation to the left ventricular ejection fraction (EF) in patients with ST-elevation myocardial infarction (STEMI). The aim was to analyze prevalence and long-term prognostic impact of non-cardiac co-morbidities in patients with reduced and preserved EF following STEMI. Method: 3115 STEMI patients undergoing primary PCI were divided in two groups: reduced EF <50% and preserved EF≥50%. Follow-up period was 8 years. Results: Preserved EF was present in 1726 (55.4%) patients and reduced EF was present in 1389 (44.5%) patients. Non-cardiac comorbidities were more frequent in patients with reduced EF as compared with patients with preserved EF (38.9% vs 27.4%, respectively, p<0.001). Lethal outcome was registered in 240 (17.2%) patients with reduced EF and in 40 (2.3%) patients with preserved EF, p<0.001. Diabetes and CKD were independent predictors for 8-year mortality in patients with preserved EF while in patients with reduced EF only CKD was independently associated with 8-year mortality. Conclusion: In the present study the prevalence of non-cardiac comorbidities is similar in patients with reduced and preserved EF after STEMI, but only DM and CKD are independently associated with long-term mortality.

Most studies on the association of in utero exposure to cigarette smoking and childhood overweight or obesity (OWO) were based on maternal self-reported smoking data and few were based on objective biomarkers. In this study, we evaluated the associations between self-reported and biomarkers of in utero exposure to cigarette smoking with risk of childhood OWO. We analyzed data from 2351 mother-child pairs in the Boston Birth Cohort, a US low-income minority cohort that enrolled children at birth and followed prospectively up to age 18 years. In utero smoking exposure was measured by maternal self-report and by maternal and cord plasma cotinine and hydroxycotinine metabolites. We assessed the individual and joint associations of each smoking exposure measure and maternal OWO with childhood OWO using multinomial logistic regressions. We used nested logistic regressions to investigate the childhood OWO prediction performance when adding maternal and cord plasma biomarkers as input covariates on top of self-reported data. Our results demonstrated that in utero cigarette smoking exposure defined by self-report and by maternal or cord metabolites were consistently associated with increased risk of long-term child OWO. Adding maternal and cord plasma biomarker information to self-reported data improved the prediction accuracy of long-term child OWO risk.

Soil organic carbon (SOC) is an essential condition for soil health and a potential sink for greenhouse gases. SOC dynamics in a long-term field experiment with mineral and organic fertilization on loamy sand Podzol in Vladimir Region, Russia, was traced with the dynamic carbon model RothC since 1968 until the present time. During this period, C stock increased 21% compared with the initial level in the treatment with the application of manure in an average annual rate of 10 t·ha-1. The model was also used to forecast SOC changes until 2090 for two contrasting RCP4.5 and RCP8.5 climatic scenarios. Until 2090, the steady growth of SOC stocks is expected in all compared treatments for both climate scenarios. This rate of growth was the highest until 2040, decreased in 2040-2070 and increased again in 2070-2090 for RCP4.5. The highest annual gain was within 21-27‰ under RCP4.5 and 16-21‰ in 2020-2040 in 0-20 cm soil layer. The expected accumulation of C allows increasing current C stock 1.6-1.7 times for RCP4.5 and 2.0-2.2 times for RCP8.5 scenario. Modelling demonstrated potentially more favourable conditions for SOC stability in arable Podzols than in Retisols in Central Russia in the 21st century.

Grain production and storage are major components in food security. In the ancient times, food security was achieved through gathering of fruits, grains, herbs, tubers, and roots from the forests by individual households. Advancements in human civilization led to domestication of crops and a need to save food for not only a household, but the nation. This extended need for food security led to establishment of national reservoirs for major produces and this practice varies greatly in different states. Each of the applied food production, handling and storage approaches has got its benefits and challenges. In sub-Saharan Africa, several countries have a public funded budget to subsidize production costs, to buy grains from farmers and to store the produce for a specific period and/or until the next harvests. During the times of famine, the stored grains are later given free to the citizens. If there is no famine, the grain is sold to retailers and/or processors (e.g., millers) who later sell it to the consumers. This approach works well if the produce (mainly grain) is stored under conditions that do not favor growth of molds, as some of these could contaminate the grain with toxic and carcinogenic metabolites called mycotoxins. Conditions that alleviate contamination of grains are required during production, handling and storage. Most of the grain is produced by smallholder farmers under sub-optimal conditions, which make vulnerable to colonization and contamination by toxigenic fungi. Further, the grain is stored in silos at large masses, where it is hard to monitor the conditions at different points of these facilities, and hence it becomes vulnerable to additional contamination. Production and storage of grain under conditions that favor mycotoxins poses major food health and safety risks to humans and livestock who consume the grain. This concept paper focuses on how establishment of local grain production and banking system (LGPBS) could enhance food security and safety in East Africa. The concept of LGPBS provides an extension of advisory and finance support within warehouse receipting system to enhance grain production under optimal conditions. The major practices at the LGPBS, and how each could contribute to food security and safety are discussed. While the concept paper gives more strength on maize production and safety, similar practices could be applied to enhance safety of other grains in the same LGPBS.

Both cementless and cemented stems have exhibited favorable long-term outcomes in total hip arthroplasty. Nonetheless, in elderly patients, cemented hips offer an advantage because of their reduced risk of periprosthetic fractures. The present study aimed to assess the initial outcomes of 28 patients who underwent unilateral cemented total hip arthroplasty utilizing the calcar-guided A2 stem (Artiqo GmbH, Lüdinghausen, Germany). Various types of antibiotic-loaded cement were employed. Demographic data, comorbidities, and standardized clinical assessment tools, including the Harris Hip Score, were utilized during the follow-up. Radiographic assessments included preoperative, postoperative, and follow-up imaging to evaluate subsidence, osteolysis, and bone resorption. The results indicated that among the 28 patients, 5 withdrew consent, and 2 patients passed away from unrelated causes. Additionally, one prosthesis was explanted because of undersizing of the cement stopper, resulting in an inadequate cement mantle. As a result, 20 patients underwent a 1-year follow-up, revealing noteworthy enhancements in clinical scores, with no instances of radiolucent lines or osteolysis. In summary, our short-term experience with this particular cemented short-stem design yielded promising results, exhibiting excellent functional outcomes and no aseptic loosening attributable to the stem. Further clinical studies and registry data are essential to corroborate these findings.

Carbon monoxide (CO) is a colorless, odorless gas emitted from carbon fuel combustion. In this study we monitored indoor carbon monoxide (CO) levels for 120 homes over three seasons in the North Denver metropolitan region as part of an environmental justice initiative to quantify health and social well-being impacts from a major freeway construction upgrade nearby. Urban outdoor CO levels are typically very low (less than 1 ppm in Denver) due to air pollution control strategies and technologies implemented over the past several decades. However, people can still be exposed to higher than outdoor levels of CO in their homes due to the operation of indoor appliances that use carbon fuels such as natural gas. Our data show that ~10% of the homes had consistent daily average levels of CO above 3.5 ppm and 24-57% of the homes showed peaks greater than 9 ppm. While much higher levels can result in CO poisoning and fatalities, these lower levels of CO have been associated with adverse health impacts, especially pregnant women, and sensitive populations. Our results highlight the need for increasing awareness regarding CO exposures in homes with gas appliances and motivate the transition from non-electrified homes toward electrification.

This brief report presents a comparative analysis to examine differences in the mean dose of nitrate supplementation between studies with positive and negative results on exercise performance. Protocols of at least six days that had positive results used lower nitrate doses (~7.7 mmol), whereas those with negative results used higher doses (~10.2 mmol), showing a statistically significant difference (p < 0.05). These findings suggest long-term supplementation with higher doses (~10.2 mmol) may not improve exercise performance. Further research is essential to understand the underlying mechanisms.

Abstract: Thermostability of vaccines, particularly enveloped viral vectored vaccines, remains a challenge for their delivery wherever needed. Freeze-drying of viral vectored vaccines is a prom-ising approach but remains challenging due to the water removal process from the outer and in-ner parts of the virus. In the case of enveloped viruses, freeze-drying induces increased stresses on the envelope, which often leads to inactivation of the virus. In this study, we design a method to freeze-dry a recombinant Vesicular Stomatitis Virus (VSV) expressing the SARS-CoV-2 spike glycoprotein. Since the envelope of VSV is composed of 50% lipid and 50% protein, the formula-tion study focused on both the protein and lipid portions of the vector. Formulations were pre-pared primarily using sucrose, trehalose, and sorbitol as cryoprotectants; mannitol as a lyopro-tectant; and histidine as a buffer. Initially, the infectivity of rVSV-SARS-CoV-2 and cake stability were investigated at different final moisture contents. High recovery of the infectious viral titer ( 0.5 to 1 log loss) was found at 3-6% moisture content with no deterioration of the freeze-dried cakes. To further minimize infectious viral titer loss, the composition and concentration of the ex-cipients were studied. An increase from 5 to 10% of both cryoprotectants and lyoprotectant, to-gether with the addition of 0.5% gelatin, resulted in the improved recovery of infectious virus titer and stable cake formation. Moreover, the secondary drying temperature of the freeze-drying pro-cess showed a significant impact on the infectivity of rVSV-SARS-CoV-2. The infectivity of the vector declined drastically when the temperature was raised above 20°C. Throughout a long-term stability study, formulations containing 10% sugar (sucrose/trehalose), 10% mannitol, 0.5% gelatin, and 10 mM of histidine showed satisfactory stability for six months at 2-8°C. The development of this freeze-drying process and the optimized formulation minimizes the need for a costly cold chain distribution system.

Background Few data exist on comparative long-term outcomes of severe aortic stenosis (AS) patients with different flow-gradient patterns undergoing transcatheter aortic valve implantation (TAVI). This study sought to evaluate the impact of pre-TAVI flow-gradient pattern on long-term clinical outcomes after TAVI and assess changes in left ventricular ejection fraction (LVEF) of different subtypes of AS patients following TAVI. Methods Consecutive patients with severe AS undergoing TAVI in our institution were screened and prospectively enrolled. Patients were divided in four subgroups according to pre-TAVI flow/gradient pattern: (i) low flow - low gradient (LF-LG): stroke volume indexed (SVi) ≤ 35ml/m2 and mean gradient (MG) < 40mmHg), (ii) normal flow - low gradient (NF-LG): SVi > 35ml/m2 and MG < 40mmHg, (iii) low flow - high gradient (LF-HG) : SVi ≤ 35ml/m2 and MG ≥ 40mmHg and (iv) normal flow - high gradient (NF-HG): SVi > 35 ml/m2 and MG ≥ 40mmHg. Transthoracic echocardiography was repeated at 1-year follow-up. Clinical follow-up was obtained at 12 months, and yearly thereafter until 5-year follow up was complete for all patients. Results A total of 272 patients with complete echocardiographic and clinical follow-up were included in our analysis. Their mean age was 80±7 years and the majority of patients (N=138, 50.2%) were women. 62 patients (22.8% of the study population) were distributed in LF-LG group, 98 patients (36%) were LF-HG patients, 95 patients (34.9%) were NF-HG, while 17 patients (6.3%) were NF-LG. There was a greater prevalence of comorbidities among LF-LG AS patients. One-year all-cause mortality differed significantly between the four subgroups of AS patients (log rank p: 0.022) and was more prevalent among LF-LG patients (25.8%) compared to LF-HG (11.3%), NF-HG (6.3%) and NF-LG patients (18.8%). At 5-year follow-up, global mortality remained persistently higher among LF-LG patients (64.5%) compared to LF-HG (47.9%), NF-HG (42.9%) and NF-LG patients (58.8%) (log rank p: 0.029). At multivariable Cox hazard regression analysis, baseline SVi (HR: 0.951, 95% C.I.; 0.918 – 0.984), the presence of at least moderate tricuspid regurgitation at baseline (HR: 3.091, 95% C.I: 1.645 - 5.809) and at least moderate paravalvular leak (PVL) post-TAVI (HR: 1.456 , 95% C.I.: 1.106 - 1.792 ) were significant independent predictors of late global mortality. LF-LG patients and LF-HG patients exhibited a significant increase in LVEF at 1-year follow-up. A lower LVEF (p<0.001) and a lower Svi (p<0.001) at baseline were associated with LVEF improvement at 1 year. Conclusions Patients with LF-LG AS have acceptable 1-year outcomes with significant improvement in LVEF at 1-year follow-up, but exhibit an exceedingly high 5-year mortality following TAVI. The presence of low transvalvular flow and at least moderate tricuspid regurgitation at baseline and significant paravalvular leak post-TAVI were associated with poorer long-term outcomes in the entire cohort of AS patients. The presence of a low LVEF or a low SVi predicts LVEF improvement at 1-year.

Abstract: (1) Background: Post-COVID syndrome is defined as symptoms that occur simultane-ously with or after COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people’s long-term quality of life (QoL) following COVID-19 infection. The aim of this cross-sectional study was to investigate long-term QoL after COVID-19 among employees of the St. Josef Hospital in Paderborn, Germany, and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on QoL and global health status were collected in the following four domains: physical health, mental health, social relationships, and environment. (3) Results: The response rate was 73.84% (923/1250). Furthermore, 63.45% of hospital staff respondents reported at least one persistent symptom after COVID-19 infection, leading to significant differences in QoL. Pre-existing conditions, persistent symptoms, and disability after COVID-19 infection, as well as high BMI, no partnership, and low educational level were found to significantly contribute to long-term low QoL. (4) Conclusions: Obesity, lack of partnership, and a low level of education were independent risk factors for lower QoL post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are re-quired to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.

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

Abstract: Agriculture uses plastic products for containers, packaging, tunnels, drip irrigation tub-ing, mulches. Large amounts of plastics are used as mulches on the soil surface for vegetable pro-duction (tomato, cucumber, watermelon, strawberry, vine) to reduce the weed competition, in-crease water and fertilizer use efficiency and enhance crop yield. Portugal uses around 4,500 t/year of polyethylene plastic to cover approximately 23,000 ha of agricultural land and only a small amount is recovered for recycling or secondary uses because of dirt with soil, vegetation, pesticide and fertilizers. Cleaning and decontaminating polyethylene mulch are costly and commercial technology is often not accessible nor economically viable in the current economic Portuguese situation. Most plastic mulch is composed of polyethylene that degrades slowly and produces a large quantity of residues in soil with negative impact in the environment. In the present study, the effects of long-term cultivation of blueberry using green 100% high density polyethylene mulch, in the south Portugal were evaluated for soil chemical and biological changes. High density green plastic mulch did not contaminate the topsoil with di(2-ethylhexyl) phthalate and heavy metals, buttotal nitrogen and organic carbon concentrations, electric conductivity and microbial activity were reduced in the planting row compared with bare soil, without mulching. Further-more, the presence of plastic mulch did not affect negatively the presence of nematodes, and the Rhabditida (bacterial feeders) increased in the planting and covered row.

Background: Carers (or care partners) of adults in LTC contribute substantially to the health and well-being of their loved ones by providing physical care, emotional support, and companionship. Despite their critical role, little is known about how caregivers have been impacted by the pandemic. The purpose of this study was to explore the lived experiences of caregivers of people living in long-term care (LTC) homes during the initial phases of the COVID-19 pandemic and potential supports and resources needed to improve caregivers’ quality of life.Design: An interpretive descriptive approach that incorporated photovoice method was used. Methods: Using purposive sampling strategy, six family carers in Ontario, Canada were recruited between September and December 2021. Over a four-week period, caregivers took pictures depicting their experience of the pandemic that were shared in a virtual focus group. Visual and text data were analyzed using thematic analysis with an inductive approach.Findings: Caregivers expressed feelings of frustration, confusion, and joy. Emerging themes included: (i) feeling like a “criminal” amidst visitor restrictions and rules; (ii) experiencing uncertainty and disappointment in the quality of care of long-term care homes; (iii) going through burnout; and (iv) focusing on small joys and cherished memories.Conclusions: The combination of visual and textual methods provided unique insight into the mental distress, isolation, and intense emotional burdens experienced by caregivers during the pandemic. Impact: Our findings underscore the need for LTC organizations to work in unison with caregivers to optimize the care of residents and support mental health of caregivers.

Chlorhexidine digluconate (CHX) has shown the ability to significantly reduce inflammation and marginal bone loss (MBL) at 1-year follow-up but limited data exists regarding its long-term efficacy in peri implant stability. The objective was to compare the long-term effects of a placebo gel (16 patients in Group A) or a 0.20% CHX gel (15 patients in Group B) used at each previous surgical and prosthetic stage. Follow-ups were conducted in 2022, investigating by biological, radiological, clinical, mechanical evaluation the long-term effects. Data were statistically analyzed. The research achieved a 96.7% implant success rate over five years, but 41.9% of patients didn't attend annual oral hygiene check-ups. The average MBL was 1.04 ± 0.39 mm, with no significant differences between the two groups. Notably, patients who attended regular periodontal check-ups experienced significantly less MBL than those who didn't (p &lt;0.05). At five years, the effects of CHX were reduced, with both groups showing moderate bone loss. The results suggest early disinfection could enhance both short and long-term outcomes. In fact, patient with initial minor MBL preserve this advantage also at 5 years of follow-up. Additionally, the data underscore the importance of annual check-ups in early detection and management of biological and mechanical complications.

A block-diagonal fuzzy neural network for short-term load forecasting is proposed. DBD-FELF consists of fuzzy rules with consequent parts that are neural networks with internal recurrence. These networks have a hidden layer which consists of pairs of neurons with feedback connections between them. The overall fuzzy model partitions the input space in partially overlapping fuzzy regions, where the recurrent neural networks of the respective rules operate. The partition of the input space and determination of the fuzzy rule base is performed by use of Fuzzy C-Means clustering algorithm and the RENNCOM constrained optimization method is applied for consequent parameter tuning. The electric load time-series of the Greek power system is examined, and hourly-based forecasting for the whole year is performed. The performance of DBD-FELF is tested via extensive experimental analysis and the results are promising, since an average percentage error of 1.18% is attained, along with an average yearly absolute error of 76.2 MW. Moreover, DBD-FELF is compared with Deep Learning, fuzzy and neurofuzzy rivals, such that its particular attributes are highlighted.

This study numerically evaluated the long-term and stable trends of meandering channel planform at different mean annual subcritical flows based on a depth-averaged linearized meander evolution model. The calculation cases included an idealized sine-generated meander with moderate max-deflection angle and a typical natural meander - Jiyun River (in China). Within the increase of the selection of the mean annual width-depth ratio in a certain scope, the results showed some specific phase characteristics of channel centerline evolution: (1) the meander straightening trend became weaker in phase 1 (B/H ≤ 16.5) and gradually turned into the meander developing trend in phase 2 (B/H ≤ 27) with the overall immunity to flow magnitude; (2) the symmetric development form along the transverse direction perpendicular to the flow average direction was broken starting from the downstream tail in phase 3 (B/H ≤ 28.9), meantime accompanied by the highlight of flow effects when the mean annual B/H exceeded 28; (3) in phase 4 (B/H ≤ 29.5), there occurred obvious incipience and jump process of the channel sensitivity responding to flow when the selected B/H crossed 29.3, which were very similar to the transition process from the laminar flow to turbulent flow. Besides, the initial sinuosity and curvature-ratio indicator could contribute much to the channel evolutionary state, as demonstrated in the comparison between natural Jiyun River case and the correspondingly idealized sine-generated meander case with the same level of mean annual B/H. This research provides innovation spaces for deeper meander mechanism exploration and effective riparian management.

Working memory refers to the capability of the nervous system to selectively retain short-term memories in an active state. The long-standing viewpoint is that neurons play an indispensable role and working memory is encoded by synaptic plasticity. Furthermore, some recent studies have shown that calcium signaling assists the memory processes and the working memory might be affected by the astrocyte density. Over the last few decades, growing evidence has also revealed that astrocytes exhibit diverse coverage of synapses which are considered to participate in neuronal activities. However, very little effort has yet been made to attempt to shed light on the potential correlations between these observations. Hence, in this article we will leverage a computational neuron-astrocyte model to study the short-term memory performance subject to various astrocytic coverage and we will demonstrate that the short-term memory is susceptible to this factor. Our model may also provide plausible hypotheses for the various sizes of calcium events as they are reckoned to be correlated with the astrocytic coverage.

Being hospitalized is a threatening and stressful experience for many children. From a psychological point of view, children may experience increased feelings of anxiety and fear that can negatively interfere with behavioral, cognitive, and emotional outcomes. To limit these impacts on children's well-being and mental health, interventions that could contribute to protecting the emotional domain of hospitalized children are welcomed. The present research reported a single-setting case study intervention to evaluate the impact of educational play-based activity with a CoderBot robot in a pediatric short-term recovery ward (N=61). The methodology included multiple sources of data (i.e., children, parents, nurses), observations on the field, and a sequential (quantitative-qualitative) mixed-method approach to data analysis. Results supported the idea that robot-based activities were associated with increased participant well-being (particularly positive emotions). The conclusions of this pilot study discuss the strengths, limitations, and further developments of using robots with hospitalized children.

In horses, there is an increasing interest in developing long-lasting drug formulations, with bi-opolymers as viable carrier alternatives in addition to their use as scaffolds, suture threads, screws, pins, and plates for orthopedic surgeries. This communication focuses on the prolonged biocompatibility and biodegradation of PLA, prepared by hot pressing at 180 ºC. Six samples were implanted subcutaneously on the lateral surface of the neck of one horse. The polymers remained implanted for 24 to 57 weeks. Physical examination, plasma fibrinogen, and the mechanical noci-ceptive threshold (MNT) were performed. After 24, 28, 34, 38, and 57 weeks, the materials were removed for histochemical analysis using hematoxylin-eosin and scanning electron microscopy (SEM). There were no essential clinical changes. MNT decreased after the implantation procedure, returning to normal after 48h. A foreign body response was observed by histopathologic evalua-tion up to 38 weeks. At 57 weeks, no polymer or fibrotic capsules were identified. SEM showed surface roughness suggesting a biodegradation process, with an increase in the average pore di-ameter. As in the histopathological evaluation, it was not possible to detect the polymer 57 weeks after implantation. PLA showed biocompatible degradation and these findings may contribute to future research in the biomedical area.

The population dynamics of Hazel Grouse was studied by presence/ absence recording at stationary sites along fixed routes (110 km) during 1972-2019 in the central part of the Bohemian Forest (Šumava, Czech Republic). The 100-km² study area covered altitudes between 600 m (Rejstejn) and 1,253 m a.s.l., (mount Sokol). Our data base contained indices of Hazel Grouse occupancy: positive sites/ controlled sites for a yearly increasing number of Hazel Grouse occurrence sites (N = 134) for 48 years. We used a loglinear Poisson-regression method to analyze the long-term population trend for Hazel Grouse in the study area. In the period 1972 to 2006 we found a stable Hazel Grouse population (p = 0.83). From 2006-2007 to 2019, the population index dropped (-3.8% per year, p &lt; 0.05) for the last 13 years. This decline is assumed to be influenced by habitat loss due to succession resulting in older, more open forest stands, by strongly increasing forestry and windstorm “Kyrill” followed by clear cutting, bark-beetle damage, and removal of pioneer trees in spruce plantations, which diminished buds and catkins, the dominant winter food. The influence of disturbance by increasing touristic activities and/or predation is discussed. Our results could help to optimize conservation efforts for Hazel Grouse in the Bohemian Forest.

Background: The associations between long-term exposure to particulate matters (PM) in residential ambiance and obesity are comparatively less elucidated among young adults. Methods: Using 2017 Community Health Survey data with aged 19−29 participants in 25 communities, Seoul, the relationship between obesity and long−term PM10 levels of living district was examined. We defined obesity as overweight (25≤BMI&lt;30) or obese (30≤BMI) using Body Mass Index (BMI) from self-reported anthropometric information. Analysis was conducted sampling weighted logistic regression models by fitting municipal PM10 levels according to individual residence periods with 10 years and more residing in a current municipality. Socio-demographic factors were adjusted over all models and age−specific effect was explored among aged 19–24 and 25–29. Results: Total study population are 3,655 [men 1,680 (46.0%) and aged 19–24 1,933 (52.9%)] individuals. Among the communities with greater level of PM10; 2001–2005, associations with obesity were increased for overall with residence period; 10 years ≤ [Odds ratio, OR 1.071, 95% Confidence interval (CI) 0.969–1.185], 15 years ≤ [OR 1.118, 95% CI 1.004–1.245], and 20 years ≤ [OR 1.156, 95% CI 1.032–1.294]. However, decreased associations were detected for PM10; 2006–2010, and age–specific effects were modified according to the residence period. Conclusions: Although currently PM10 levels are decreasing, higher levels of PM10 exposure at the residential area during the earlier life-time may contribute in increasing obesity among young adults.

Background: Most sepsis patients died during their first episode and the long-term survival post discharge was low. Major adverse cardiovascular events and repeated infections were regarded as the major causes in such conditions. No definite medications were proven to effectively improve the long-term outcome. We aimed to examine the benefit of statins on the long-term outcome of survived sepsis patients. Methods: Between 1999 and 2013, a total of 220,082 patients with the first episode of sepsis hospitalization were included and 134,448 ones (61.09%) survived to discharge. The survived patients who subsequently had statins use of >30 cumulative defined daily doses (cDDDs) post discharge were defined as the statin users. After propensity score matching of 1:5, a total of 7,356 and 36,780 survived patients were retrieved as the study (statin-users) and comparison cohort (non-statin users), respectively. The main outcome was the long term survival post discharge. HR with 95% CI was calculated using the Cox regression model to evaluate the effectiveness of statins with further stratification analyses according to cDDDs. Results: The study cohort, that is, the statin users had an adjusted HR of 0.29 (95% CI, 0.27-0.31) in long term mortality rate compared with the comparison cohort. For statin users with the cDDDs of 30–180, 180–365, and >365, the adjusted HRs were 0.32, 0.22, and 0.16, respectively, (95% CI, 0.30-0.34, 0.19-0.26, and 0.12-0.23, respectively) compared with the non-statin users (defined as statins use <30 cDDDs post discharge), and the P for trend <.0001. In the sensitivity analysis, after excluding the survived patients who died within three and six months post discharge, the adjusted HR of statins use remained significant (0.35, 95% CI 0.32-0.37 and 0.42, 95% CI 0.39-0.45, respectively). Conclusions: Statins decreased the long-term mortality post sepsis. Further randomized control trial deserved to be conducted to confirm this observation.

A low-cost data logging platform is presented for environmental monitoring projects that provides long-term operation in remote or submerged environments. Three premade “breakout boards” from the open-source Arduino ecosystem are assembled into the core of the platform. The components are selected based on low-cost and ready availability, making the loggers easy to build and modify without specialized tools, or a significant background in electronics. Power optimization techniques are explained. The platform has proven to be highly reliable, and capable of operating for more than a year on standard AA batteries. The flexibility of the system is illustrated with two ongoing field studies recording drip rates in a cave, and water flow in a flooded cave system.

Aim: To evaluate the clinical findings of glucose 6 phosphate dehydrogenase(G6PD) and pyruvate kinase(PK) deficiency in prolonged jaundice. To determine whether systemic-immune-inflammation index(SII), neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio (PLR) can be used in the diagnosis of neonatal prolonged jaundice. Methods: In full term neonates with hyperbilirubinemia who were admitted to Medicine Hospital between January 2019 and January 2024 with the complaint of jaundice, 167 infants with a serum bilirubin level above 10 mg/dL, whose jaundice persisted after the 10th day, were included in the study. Results: G6PD was negatively correlated with NLR, SII, age, and Hct. There was a negatively poor correlation between G6PD and NLR and a negatively moderate correlation between G6PD and SII when adjusted for age and Hct. PK showed no significant correlation with G6PD, NLR, PLR, SII, age, and Hct. A linear relationship was observed between G6PD and SII and NLR. Conclusions: NLR and SII can be easily calculated in the evaluation of prolonged jaundice in G6PD deficiency has a considerable advantage. NLR and SII levels may contribute by preventing further tests for prolonged jaundice and regulating its treatment. It may be useful to form an opinion in emergencies and in the early period.

(1) Background: CTA has validated the use of pericoronary adipose tissue (PCAT) attenuation as a credible indicator of coronary inflammation and plays a crucial role in coronary artery disease (CAD). This study aimed to evaluate the long-term effects of high-dose statins on PCAT attenuation at coronary lesion sites and changes in plaque distribution; (2) Methods: Our prospective observational study included 52 patients (mean age 60.43) with typical chest pain, a low-to-intermediate likelihood of CAD, and documented atheromatous plaque through CCT. We utilized advanced features of the CaRi-Heart® and syngo.via Frontier® systems to assess coronary plaques and changes in PCAT attenuation; (3) Results: Changes in plaque morphology were investigated, revealing significant alterations. Notably, in mixed plaques, calcified portions increased (p &lt; 0.0001), while non-calcified plaque volume (NCPV) decreased (p = 0.0209). PCAT attenuation generally decreased after one year and remained low, indicating reduced inflammation in the following arteries: LAD (p = 0.0142), LCX (p = 0.0513), and RCA (p = 0.1249). The CaRi-Heart® risk also decreased significantly (p = 0.0041). Linear regression analysis demonstrated a correlation between increased PCAT attenuation and higher volumes of NCPV (p &lt; 0.0001, r = 0.3032) and lipid-rich plaque volume (p &lt; 0.0001, r = 0.3281); (4) Conclusions: Our study provides evidence that high-dose statin therapy significantly reduces CAD risk factors, inflammation, and plaque vulnerability, as evidenced by the notable decrease in PCAT attenuation, a critical indicator of plaque progression.

Postoperative headaches (POH) following retrosigmoid microsurgery for ves-tibular schwannoma (VS) can significantly diminish patients' perceived health benefits (PHB). A survey of 101 VS patients, utilizing the Rostock Headache Compendium, Glasgow Benefit Inventory, Ten-Item Personality Inventory (TI-PI-G), and German pain processing questionnaire (FESV), revealed that almost half experienced POH, leading to a markedly reduced overall PHB compared to those without POH. This decrease in PHB was linked to higher levels of pain-related helplessness, depression, anxiety, and anger. Positive associations were found between PHB and action-planning competence, cognitive restruc-turing, and experience of competence. Personality traits, particularly low emo-tional stability and openness, were associated with pain-related psychological impairment. Interestingly, hearing loss and facial paresis did not impact PHB. The study underscores the influence of pain-related mental interference and coping strategies on PHB in long-term POH patients, suggesting a role for personality traits in their pain management. The findings advocate for short-term psychological interventions, emphasizing adaptive coping mecha-nisms like cognitive restructuring, to enhance PHB in VS patients post-microsurgery.

Chronic Low Back Pain (CLBP), defined as pain persisting for at least 12 weeks, is a significant public health issue, with prevalence intensifying due to an ageing global population, amassing approximately 619 million cases in 2020 and projected to escalate to 843 million by 2050. Given the multitude of therapeutic modalities available for CLBP, this research sought to ascertain their respective efficacies in ameliorating pain and disability. We specifically scrutinized Multidisciplinary Biopsychosocial Rehabilitation (MBR) among adults enduring non-specific low back pain for over 12 weeks, excluding acute pain conditions and pre-study surgical interventions. MBR is an approach encompassing various modalities, including exercise, behavioral therapies, educational programs, and work conditioning aspects, necessitating a comprehensive Network Meta-Analysis (NMA) to fully grasp the extensive scope of its impact. The constructed network comprised diverse MBR modalities (behavioral, educational, and work conditioning) alongside exercise therapy (ET), minimal intervention, and usual care, serving as controls with pain and disability as outcomes. Through the analysis of 4,619 initially identified studies, 93 were included, encompassing a total of 8,059 participants. The NMA conducted substantiated that both ET and MBR modalities were notably effective in alleviating CLBP, with education-oriented MBR emerging as the most efficacious for pain mitigation and behavior-focused MBR for disability reduction. Nevertheless, the discerned differences amongst the treatments were minimal and uncertain, highlighting that no modality was definitively superior to the others. The analysis revealed low global and local inconsistency within the network, underscoring the reliability of the observed outcomes. Given the intricate nature of CLBP, embodying various facets, our findings advocate for a combined therapeutic approach to optimize treatment efficacy. Nonetheless, the presence of high study heterogeneity and potential biases necessitates cautious interpretation of the results, prompting future research.

Ozonated sunflower oil (OSO) is well known functional oil with its antioxidant, antimi-crobial, anti-allergic, and skin-moisturizing properties. However, studies on the effects of OSO on high-cholesterol diet (HCD)-induced metabolic disorders have been scarce. In the current study, we aimed to determine the anti-inflammatory effects of OSO on lipid me-tabolism in adult hypercholesterolemic zebrafish and its embryo. Microinjection of OSO (final 2%, 10 nL) into zebrafish embryos under presence of carboxymethyllysine (CML, 500 ng) protected acute embryo death upto 61% survival, while sunflower oil (final 2%) showed much less protection around 42% survival. The microinjection of OSO was more effective than SO to inhibit reactive oxygen species (ROS) production and apoptosis in the CML induced embryo toxicity. Intraperitoneal injection of OSO under presence of CML protected acute death from CML-induced neurotoxicity with improved hepatic inflamma-tion, less detection of ROS and interleukin (IL)-6, and lowering blood total cholesterol (TC) and triglyceride (TG), while SO-injected group did not protect the CML-toxicity. Long-term supplementation of OSO (final 20%, wt/wt) with HCD for 6 months resulted higher sur-vivability than HCD alone group or HCD+SO group (final 20%, wt/wt) with significant lowering of plasma TC and TG levels. The HCD+OSO group showed the least hepatic in-flammation, fatty liver change, ROS, and IL-6 production. In conclusion, short-term treat-ment of OSO by injection exhibited potent anti-inflammatory activity against acute neuro-toxicity of CML in zebrafish and its embryo. Long-term supplementation of OSO in diet also revealed the highest survivability and blood lipid-lowering effect through potent an-ti-oxidant and anti-inflammatory activity.

This prospective study provides data on long-term humoral immunogenicity of a heterologous off-label vaccine regimen combining the adenoviral vectored ChAdOx1 nCoV-19 from Astra-Zeneca (ChAd) with the mRNA-1273 vaccine from Moderna (m1273) in comparison to two different homologous mRNA vaccine schedules. Of the 316 COVID-19 naïve adult health care workers (HCW) included to complete a survey on vaccine-associated symptoms (VAS), 197 had received the homologous BNT162b2 mRNA vaccine from Pfizer/BioNTech (BNT/BNT), 76 the homologous m1273/m1273, and 43 the heterologous ChAd/m1273 vaccine regimen. Concentration of antibodies against SARS-CoV-2 spike protein in plasma 5-7 months after the second vaccine dose was higher in the m1273/m1273 and ChAd/m1273 than the BNT/BNT vaccine group. The frequency of systemic VAS after first vaccine dose was 86% after ChAd compared to 35% and 39% after BNT and m1273, respectively (p &lt; 0.0001), and after second vaccine dose highest (89%) in the m1273/m1273 group (p &lt; 0.001). Individuals with systemic VAS achieved higher levels of antibodies irrespective of vaccine regimen. In conclusion, VAS serve as a strong predictor of long-term humoral immune response, and the heterologous ChAd/m1273 vaccine regimen provides an at least equal long-term humoral immune response compared with the standard vaccine regimens used in Denmark.

Surgical methods for treating spasmodic torticollis include denervation and myotomy (DAM) of the affected muscles, and deep brain stimulation (DBS). This study reports on the long-term efficacy, prognostic factors, safety, and hospitalization costs following these two procedures. We collected data from 94 patients with spasmodic torticollis, of whom 41 and 53 were treated with DAM and DBS, respectively, from June 2008 to December 2020 at the Chinese People’s Liberation Army General Hospital. We used the Tsui scale and the global outcome score of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) to evaluate the preoperative and postoperative clinical condition in all patients. We also determined the cost of hospitalization, prognostic factors, and serious adverse events following the two surgical procedures. The mean follow-up time was 68.83 months (range = 13–116). Both resection surgery and DBS showed good results in terms of Tsui (Z = -5.103, P = 0.000; Z = -6.210, P = 0.000) and TWSTRS scores (t = 8.762, P = 0.000; Z = -6.308, P = 0.000). Compared with the DAM group, the preoperative (47.71, range 24–67.25) and postoperative (18.57, range 0–53) TWSTRS scores in the DBS group were significantly higher (Z = -3.161, P = 0.002). We found no correlation between prognostic factors and the patient age, gender, or disease duration for either surgical procedure. However, prognostic factors were related to the length of the postoperative follow-up period in the DBS surgery group (Z = -2.068, P = 0.039; Z = -3.287, P = 0.001). The mean hospitalization cost in the DBS group was 6.85 times that found in the resection group (Z = -8.284, P = 0.000). The total complication rate was 4.26%. We found, both resection surgery and DBS, showed good results in the patients with spasmodic torticollis. Although DBS had a greater impact on the quality of life and the degree of pain relief, it was more expensive. Prognostic factors were related to the length of the postoperative follow-up period in patients who underwent DBS surgery.

Electrolyzed water, which mainly contains hypochlorous acid, is widely used because of its strong microbicidal effects, biosafety, and eco-friendliness. For frequent use in intraoral treatments, we focused on neutral electrolyzed water (NW) produced using two-stage electrolysis and investigated its storage stability. For standard-concentration NWs with free available chlorine concentration (ACC) of 25, 35, and 50 mg/L and high-concentration NWs (100, 200, 300, 500, and 1000 mg/L), changes in the pH, oxidation-reduction potential, and ACC during 126 days of storage and the bactericidal efficacies were examined. Storage under non-shaded conditions at room temperature (LRT) and a higher ACC substantially altered the properties of the NW. NW (≤ 300 mg/L) had a pH of 5.9–7.3 even after storage under LRT; however, NW with higher ACC (500 and 1000 mg/L) had a pH ˂ 5.5, critical for human enamel), even under shaded and refrigerated conditions (SLW). Only NW (25 mg/L) stored under LRT exhibited the lowest ACC (5 mg/L), indicating a decreased bactericidal effect. When stored for use in intraoral treatments, NWs should be prepared with an ACC of 25–300 mg/L and stored in SLW. If diluted NW is used, the ACC should be checked and appropriately diluted every time.

Electric vehicles are in focus and growing, with new adoptions every day. Its wide use represents a new scenario and challenge for the electrical power system due to the high charge storage requirements. Predicting these loads using artificial neural networks proves to be a very efficient tool for solving time series. This work uses a multilayer perceptron network through supervised backpropagation training with Bayesian regularization to improve generalization, reducing overfit- ting errors. In this research, the aggregation of the actual consumption of 200 homes and 348 plug-in electric vehicles is used in the training and forecasting process, and to validate the method developed, MAPE was used. Short-term forecasts were made considering the year’s four seasons, predicting the next 24 hours of total aggregate demand from homes and vehicles. The methodology presented significant and relevant results using hybrid training for the problem, with the potential to be applied in the real world.

Recent studies, typically using patient cerebrospinal fluid (CSF), have suggested that different autoantibodies (Aabs) acting on their respective receptors, may underlie neuropsychiatric disorders. The NR1 subunit of the N-methyl-D-aspartate receptor (NMDAR) has been identified as a target of anti-NMDAR Aabs in a number of central nervous system (CNS) diseases including encephalitis and autoimmune epilepsy. However, the role or the nature of Aabs responsible for effects on neuronal excitability and synaptic plasticity is yet to be established fully. Patient-derived anti-NMDAR Aabs have been shown to bind to specific regions within the NR1 subunit; here, peptide immunisation was used to generate Aabs against selected specific NR1 extracellular sequences. ‘Protein A’ purification was used to obtain total IgG and further peptide purification used to obtain a greater percentage of NMDAR-target specific IgG Aabs. Binding and specificity of these anti-NMDAR Aabs was determined using a range of methodologies including enzyme-linked immunosorbent assay, immunocytochemistry and immunoblotting. Functional effects were determined using different in vitro electrophysiology techniques: two-electrode voltage-clamp in Xenopus oocytes and measures of long-term potentiation (LTP) in ex vivo hippocampal brain slices using multi-electrode arrays. We show that anti-NMDAR Aabs generated from peptide immunisation had specificity for NR1 immunisation peptides as well as target-specific binding to the native protein. Anti-NMDAR Aabs had no clear effect on isolated NMDARs in an oocyte expression system. However, we show that peptide-purified anti-NMDAR Aabs prevented the induction of LTP at Schaffer collateral-CA1 synapses in ex vivo brain slices. Our data demonstrate that anti-NMDAR Aabs cause synaptic NMDAR hypofunction at a network level. This work provides a solid basis to address outstanding questions regarding anti-NMDAR Aabs mechanisms of action and, potentially, development of therapies against CNS diseases.

Provenance trials provide a valuable opportunity to evaluate the impact of extreme events on growth and wood properties. In this study, we have evaluated 81 Norway spruce provenances, tested in three provenance trials established in the Romanian Carpathians in 1972. The response to drought of the Norway spruce provenances – resistance, recovery, resilience, and relative resilience, has been examined, as well as the relationship between climate and growth, and the correlations between wood traits, the coordinates of origin and drought resilience indices. In each provenance trial, there were significant differences between provenances and years regarding wood widths and latewood percentage (LWP). Regarding the drought extreme events, the years when it occurred in all three provenance trials were 2000 and 2003. Significant differences between provenances for at least one drought resilience index have been found in all provenance trials, for the year 2000. By using subperiods of 25 years, changes in the relationship between climate and growth have been observed. Several provenances with high radial growth and good resistance and/or recovery have been identified. Provenances that performed better in common garden experiments could be used in assisted migration even beyond the current natural range.

Introduction: Congenital heart defects (CHD) are the most frequent group of major congenital anomalies, accounting for almost 1% of all births. They comprise a very heterogeneous group of birth defects in terms of their severity, clinical management, epidemiology and embryologic origins. Taking this heterogeneity into account is an important imperative to provide reliable prognostic information to patients and their caregivers, as well as to compare results between centers or to assess alternative diagnostic and treatment strategies. The Anatomic and Clinical Classification of CHD (ACC-CHD) aims to facilitate both the CHD coding process and data analysis in clinical and epidemiological studies. Objectives: 1) To describe the long-term childhood survival of newborns with CHD and 2) To develop and validate predictive models of infant mortality based on the ACC-CHD. Materials and Methods: This study is based on data from a population-based, prospective cohort study: Epidemiological Study of Children with Congenital Heart Defects (EPICARD). The final study population comprised 1881 newborns with CHD after excluding cases that were associated with chromosomal and other anomalies. Statistical analysis included non-parametric survival analysis and flexible parametric survival models. The predictive performance of models was assessed by Harrell’s C index and the Royston-Sauerbrei R2 with internal validation by bootstrap. Results: The overall 8-year survival rate for newborns with isolated CHD was 0.96 [0.93- 0.95]. There was a substantial difference between the survival rate of the categories of ACC-CHD. The highest and lowest 8-year survival rates were 0.995 [0.989-0.997] and 0.34 [0.21-0.50] for “interatrial communication abnormalities and ventricular septal defects” and "functionally univentricular heart", respectively. Model discrimination as measured by Harrell’s C was 87% and 89% for the model with ACC-CHD alone and the full model, which included other known predictors of infant mortality, respectively. The predictive performance as measured by R2 was 45% and 50%, for the ACC-CHD alone and the full model. These measures were essentially the same after internal validation by bootstrap. Conclusion: The ACC-CHD classification provided the basis of a highly discriminant survival model with good predictive ability for the 8-year survival of newborns with CHD. Prediction of individual outcomes remains an important clinical and statistical challenge.

The power system has rapidly grown and expanded over the past decades and has been experiencing major changes and challenges. The increase in energy demand and the modern advancements in the smart grid, such as solar and wind energies and electric vehicles, have led to complexity and complications for utilities. A further layer of complexity and difficulty was added by the rapid expansion of behind-the-meter (BTM) photovoltaic (PV) systems with various designs and characteristic features. The rapid increase and the invisible solar power (BTM) have led to fluctuations in power grid stability and reliability and to inefficiency. Accurate forecasting of load generation will help to assure optimal planning, minimize the negative effects of the PV systems, and minimize the operational and maintenance costs. The authors propose a solution that uses combinations of K-means clustering with neural network machine learning models, AMI real-world PV load generation, and weather data to forecast the generation load at customer locations to achieve a 2.49% error between actual and predicted generation load.

Atopic dermatitis (AD), a T2 inflammatory skin condition, is widely recognized as one of the most prevalent chronic and recurrent skin disorders. One of the most effective therapy for treating moderate-to-severe AD is Dupilumab, a monoclonal antibody that blocks both IL-4 and IL-13 signaling. At the same time, no comprehensive analysis of cytokines profile was made in AD patients undergoing Dupilumab therapy. The primary objective of our research was to examine the levels of main cytokines to better understanding systemic immune response in AD and to identify potential biomarkers of the effectiveness of Dupilumab treatment. AD patients demonstrated significant clinical improvements one year after initializing of Dupilumab therapy. We identified 16 cytokines that showed major difference between Dupilumab-treated patients and patients without Dupilumab therapy. Six cytokines showed correlation with AD severity and the efficacy of Dupilumab therapy. Jointly revealed cytokines could potentially predict the effectiveness of Dupilumab treatment and help to choose the precision target therapy in AD patients as well.

With an increasing concern for global warming, there have been many attempts to reduce greenhouse gas emissions. About 30 % of total energy has been consumed by buildings and much attention has been paid to reducing building energy consumption. While there are many ways of reducing building energy consumption, accurate energy consumption prediction becomes more significant. As mechanical systems are the most energy-consuming components in the building, the present study developed the energy consumption prediction model for a direct-fired absorption chiller by using the ANN technique for the short term. The ANN model was optimized and validated with the actual data collected through a BAS. For the optimization, the numbers of input variables and neurons, and the data size of training were applied. By changing these parameters, the predictive performance was analyzed. In sum, the outcome of the present study can used to predict the energy consumption of the chiller as well as improve the efficiency of the energy management. The outcome of the present study can be used to develop a more accurate prediction model with a few datasets in that it can improve the efficiency of building energy management.

In this paper, a systematic literature review is presented, through a survey in the main digital databases, about modelling methods for Short-Term Load Forecasting (STLF) for hourly electricity demand for residential electricity and to realize the performance evolution and impact of the Artificial Intelligent (AI) in STLF. With these specific objectives, it was developed a conceptual framework on the subject, a systematic review of the literature based on scientific publications with high impact and a bibliometric study directed to the scientific production of AI and STLF. The review of research articles over a 10-year period, which takes place between 2012-2022, uses the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) method. This research resulted in more than 300 articles, available in 4 (four) databases: Web of Science, IEEE Xplore, Scopus and Science Direct. The research was organized around 3 (three) central themes, which were defined through keywords: STLF, Electricity, Residential and their corresponding synonyms. 334 research articles were analyzed and identified the year of publication, journal, author, geography by continent and country and the area of application. Of the 334 documents found in the initial research and after applying the inclusion/exclusion criteria, which allowed delimiting the subject addressed in the topics of interest for analysis, 37 (thirty-seven) documents are in English (25 are journal articles and 12 are conference papers). The results point to a diversity of modelling techniques and associated algorithms. The corresponding performance is measured with different metrics and, therefore, cannot be compared directly. Hence, it should be desirable to have a unified data set together with a set of benchmarks with well-defined metrics for a clear comparison of all the modelling techniques and the corresponding algorithms.

Medium-Long term impacts of Antiretroviral drugs on arterial blood pressure in people living with HIV in Malawi.SAGNO Jean Bpatiste², Loenardo Palombi¹ , Giuseppe Liotta¹, Victor T Tolno², Sangare H Mamary², Jere Haswel ².1= University of Tor vergata Roma, 2= Dream Health center MalawiKey Words: HIV, hypertension ABSTRACTIntroduction: We aimed to explore the medium-long term impacts of Anti-Retroviral Treatment (ART) on Hypertension in a sample of HIV-positive in Malawi. Methodology: This was a retrospective case control study carried out at DREAM health Centre in Blantyre/Malawi on patients who were enrolled from 2005 to 2019, Information about age, gender, blood pressure, ART regimen, BMI, CD4 count, Viral load, Biochemistry, hemoglobin, marital status, education level, survival and period on ARVs were retrieved from data base from 01/01/2006 to 31/12/2015.. In total, we enrolled (alive and on HAART)1350 patients > 18 years (mean age: 43.4 and the SD was ±10.7 with 1031 (65.9%) females and 534 (34.1%) males who were taking (or have taken) ARVs for more than 6 months at the date of enrollment and who were not affected by hypertension or potentially related diseases like Renal failure at the enrollment. The mean observation time, from the HAART initiation was 77 months per person (SD±40). Results: The sample was made up by two groups of patients, 675 who developed hypertension and 675 who did not, with similar age and gender composition. Among patients with hypertension, 30/675 (4.4%) developed a stage 3 hypertension, 154 a stage 2 (22.8%) and 491 a stage 1 (72.8%). Hypertension stages were not associated to statistic significant differences of age and/or gender ( p=0.422, p=0.281 respectively). At baseline, patients who developed hypertension showed higher hemoglobin, higher CD4 count and lower VL ( P<0.001). Patients on AZT-based regimen and TDF based regimen were at high risk to develop hypertension while PI-based regimen was protective to hypertension (P<0.001). In a multivariate analysis, factors independently associated to Hypertension were higher CD4 count and Body Mass Index at the visit date, while Baseline Viral Load and PI-Including regimes were protective factors. Education level was inversely associated with risk of hypertension, while being married was associated of risk of hypertension (p<0.001). Mortality rate among hypertensive patients was 1.6% for those treated for hypertension against the 3.6% for those not treated. Conclusion: this study shows a protective action of PI-including regimens compared with AZT based regimen that is associated to an increased risk of hypertension. Factors related to a better general health status are associated to an higher risk of hypertension as well as lower education, older age and male gender. Treatment should be started as soon as Hypertension stages 2-3 are reached and control by behavioral factors is no longer effective.

Background:Peripheral neuropathy (PN) can result in either partial or complete loss of distal sensation resulting in an increased fall risk. Walkasins^® uses a shoe insert to detect the magnitude and direction of sway and sends signals to a leg unit that provides sensory balance cues. The objective of this case report is to describe the long-term influence of the Walkasins^® lower limb sensory neuroprosthesis on balance and gait for an individual with diabetic PN.Case Description:A fifty-one-year-old male with a 3-year history of PN and a 10-year history of type II diabetes mellitus was fitted with Walkasins^® and utilized the shoe inserts 8-10 hours/day for more than 1 year. Although, vibration and tactile thresholds were severely impaired at his 1^st metatarsophalangeal joint and the lateral malleolus bilaterally he could perceive tactile stimuli from the Walkasins^® above the ankles.Outcomes:Following Walkasins^® use, his Activities-specific Balance Confidence Scale (ABC) scores improved from 33% to 80%. His mean Vestibular Activities of Daily Living (VADL) scores decreased from 3.54 to 1. His Functional Gait Assessment (FGA) scores increased from 13/30 to 28/30 and his miniBESTest scores improved from 15/28 to 26/28. Gait speed increased from 0.23 m/sec to 1.5 m/sec. The patient described a decrease in pain and cramping throughout his lower extremities and an increase in function.Discussion:Gait and balance improved with the use of the Walkasins^® and participation in the Neuro Wellness Program. This improvement suggests that the use of sensory substitution devices, such as the Walkasins^®, may replace sensory deficits related to gait and balance dysfunction experienced by patients with PN. Further research is needed to determine if other patients will have a similar response and what the necessary threshold of sensory function is to benefit from use of the Walkasins^®.

Background: The coronavirus disease-19 (COVID-19) has spread globally with more than 80,000 people infected, and nearly 3000 patients died. Currently, we are in an urgent need for effective treatment strategy to control the clinical deterioration of COVID-19 patients. Methods: The clinical data of 10 COVID-19 patients receiving short-term moderate-dose corticosteroid (160mg/d) plus immunoglobulin (20g/d) were studied in the North Yard of The First Hospital of Changsha, Hunan from January 17^th to February 27^th, 2020. Epidemiological, clinical, laboratory, radiological findings were analyzed. Results: After treatment with combination of low-dose corticosteroid (40-80mg/d) and immunoglobulin (10g/d), patients’ lymphocyte count (0.88±0.34 vs 0.59±0.18, P<0.05), oxygenation index including SPO₂ (94.90±2.51 vs 90.50±5.91, P<0.05) and PaO₂/FiO₂ (321.36±136.91 vs 129.30±64.97, P<0.05) were significantly lower than pre-treatment, and CT showed that the pulmonary lesion deteriorated in all patients. While after treatment of short-term moderate-dose corticosteroid plus immunoglobulin, patients’ APACHE Ⅱ score (9.10±6.15 vs 5.50±9.01, P<0.05), body temperature (37.59±1.16 vs 36.46±0.25, P<0.05), lymphocyte count (0.59±0.18 vs 1.36±0.51, P<0.05), Lactate dehydrogenase (419.24±251.31 vs 257.40±177.88, P<0.05), and C-reactive protein (49.94±26.21 vs 14.58±15.25, P<0.05) significantly improved compared with post-treatment with low-dose therapy. In addition, oxygenation index including SPO₂ (90.50±5.91 vs 97.50±1.18, P<0.05), PaO₂ (60.47±14.53 vs 99.07±34.31, P<0.05), and PaO₂/FiO₂ (129.30±64.97 vs 340.86±146.72, P<0.05) significant improved. Furthermore, CT showed that pulmonary lesions obviously improved in 7 patients. After systematic therapy, 4 out of 10 COVID-19 patients recovered and discharged. Conclusions: Short-term moderate-dose corticosteroid plus immunoglobulin is effective for reversing the continued deterioration of COVID-19 patients who failed to respond to the low-dose therapy. Funding: This work was supported by the Innovative Major Emergency Project Funding against the New Coronavirus Pneumonia in Hunan Province (Dr. Ji-Yang Liu, number 2020SK3014; Dr. Yuan-Lin Xie, number 2020SK3013).

High fat-diet (HFD) feeding is known to induce metabolic dysregulation, however less is known on its impact in promoting the hypercoagulable state. The current study aimed to evaluate platelet-monocyte aggregate (PMA) formation following short-term HFD feeding. This is particularly important for understanding the link between inflammation and the hypercoagulable state during the early onset of metabolic dysregulation. To explore such a hypothesis, mice were fed a HFD for 8 weeks, with body weights as well as insulin and blood glucose levels monitored on weekly basis during this period. Basal hematological measurements were determined and the levels of spontaneous peripheral blood PMAs were assessed using whole blood flow cytometry. The results showed that although there were no significant differences in body weights, mice on HFD displayed impaired glucose tolerance and markedly raised insulin levels. These metabolic abnormalities were accompanied by elevated baseline PMA levels as an indication of hypercoagulation. Importantly, it was evident that baseline levels of monocytes, measured using the CD14 monocyte marker were significantly decreased in HFD-fed mice when compared to controls. In summary, the current evidence shows that in addition to causing glucose intolerance, such as that identified in a prediabetic state, HFD-feeding can promote undesirable hypercoagulation, the major consequence implicated in the development of cardiovascular complications.