Atrial fibrillation (AF) is a common arrhythmia associated with various risk factors and significant morbidity and mortality. This article presents findings from a study involving 115 patients with permanent AF. The study examined demographics, risk factors, associated pathologies, complications, and anticoagulant therapy. The results showed a slight predominance of AF in males, with the highest incidence in individuals aged 75 and above. Common risk factors included arterial hypertension, dyslipidaemia, diabetes mellitus type 2, and obesity. Comorbidities such as congestive heart failure, mitral valve regurgitation, and pulmonary disorders were prevalent among the patients. Major complications included congestive heart failure, stroke, and myocardial infarction. Thromboembolic and bleeding risk assessment using CHAD2DS2-VASc and HAS-BLED scores demonstrated a high thromboembolic risk in all patients. The majority of patients were receiving novel oral anticoagulants (NOACs) before admission, while NOACs were also the most prescribed antithrombotic therapy at discharge. The study highlights the importance of risk factor management and appropriate anticoagulant therapy in AF patients to reduce complications and improve outcomes.

Red raspberry fruit production is increasing worldwide due to the growing consumer interest in foods with high antioxidant properties. However, raspberries are very perishable fruit with a short shelf life. Chitosan applications have shown promising results in promoting the storage of different berry fruit. This work aimed at analysing the effects of chitosan applied in pre- and/or post-harvest on the quality and antioxidant properties of raspberry fruit during the cold storage and room temperature conditions (i.e., 6 d at 4 °C and 3 d at 20 °C, respectively). Pre-harvest chi-tosan applications reduced fruit weight loss during cold storage and room temperature condi-tions but also reduced fruit decay at room temperature conditions. Furthermore, pre-harvest treatments with chitosan increased the total phenol and anthocyanin contents and promoted the highest total antioxidant activity with respect to other treatments. Of note, after the cold storage, post-harvest chitosan application drastically reduced the development of fungi that cause fruit decay, thus minimizing the potential risk of mycotoxin production. Overall, this study demon-strates that applications of chitosan in pre-harvest are sufficient to ensure the goal of maintaining and/or increasing the quality and antioxidant properties of fruit during cold storage and room temperature conditions.

Suboptimal health status (SHS) is a state between health and disease, has several associated factors, although, its underlying mechanism is still unclear. This study aimed to investigate the status of SHS and its associated factors of high school students in three areas of China (Shanxi, Guangzhou, and Tibet). A multidimensional sub-health questionnaire of adolescent (MSQA) is used to evaluate SHS. Among 1461 respondents, females proportion 56.47% was higher than males 43.53% where SHS was higher in Shanxi followed by Tibet and then Guangzhou. The rural area, grade, lack of sleep, home visit in a week, lack of exercise, a heavy burden of study, smoking, drinking, and fewer friends were the risk factors of SHS, while, families living status, seeking help and extroversion were the protective factors. SHS is significantly associated with different influencing factors. For comprehensive prevention and control measures, reduce the risk factors and enhance the protective factors.

The [PSI⁺] nonsense-suppressor determinant of Saccharomyces cerevisiae is related to formation of heritable amyloids of the Sup35 (eRF3) translation termination factor. [PSI⁺] amyloids have variants in amyloid structure and in the strength of suppressor phenotype. Appearance of [PSI⁺], its propagation and manifestation depend primarily on chaperones. Besides chaperones, the Upf1/2/3, Siw14 and Arg82 proteins restrict [PSI⁺] formation, while Sla2 can prevent the [PSI⁺] toxicity. Here, we identify two more non-chaperone proteins involved in [PSI⁺] detoxification. We show that simultaneous lack of the Pub1 and Upf1 proteins causes lethality of [PSI⁺] cells with a strong, but not with weak suppressor phenotype. This lethality results from excessive depletion of the Sup45 (eRF1) termination factor due to its sequestration into Sup35 polymers. We also show that Pub1 acts to restrict excessive Sup35 prion polymerization, while Upf1 interferes with Sup45 binding to Sup35 polymers. These data allow considering the Pub1 and Upf1 proteins as a novel [PSI⁺] detoxification system.

Interferon regulatory factor 5 (IRF5) is known to be involved in the innate immune response and pro-inflammatory cytokines. However, the roles of IRF5 in immune responses in Malabar grouper (Epinephelus malabaricus) have not been extensively explored. In this study, IRF5 gene was identified and characterized from M. grouper. The full-length IRF5 cDNA consisted of a 5’ terminal untranslated region (5’-UTR) of 289 bp and a 3’-UTR of 542 bp, an open reading frame (ORF) of 1500 bp encoding a polypeptide of 499 amino acids with a predicted molecular mass of 56.28 kDa and isoelectric point (pI) of 5.2. The putative MgIRF5 protein consists of four important conserved domains: a helix DNA-binding domain (DBD) at the N-terminus, a middle region, an IRF association domain (IAD) and a virus activated domain (VAD) at the C-terminus. Sequence alignment and phylogenetic analysis showed that highest sequence similarity of IRF5 was observed between the IRF5 genes from Oplegnathus fasciatus and Miichthys miiuy. The mRNA transcripts of IRF5 were detected in a wide range of tissues types from healthy M. grouper with highest expression in muscle, liver and skin. After treatment with poly (I: C), it was significantly up-regulated in spleen and liver tissues. When infected with NNV, the expression level of MgIRF5 was up-regulated in spleen and head kidney and their transcriptional responses to IRF5 increased in the grouper kidney cells. This approach suggests that MgIRF5 is important in the underlying mechanism of the innate immune responses against antiviral response.

In engineering practice, various types of information data are affected by many factors during the collection process. For example, information data measurement errors are caused by equipment performance and the working environment. During the transmission of detection information, the signal distortion caused by energy loss and signal interference causes unpredictable detection errors in the collected information data. Through the study of fractional calculus theory, it was found that it is suitable for studying nonlinear, non-causal, and non-stationary signals, and has the dual functions of improving detection information and enhancing signal strength. Therefore, under the influence of many factors, we applied the fractional difference algorithm to the field of information data processing. Multi-sensor detection data fusion algorithm based on the fractional partial differential equation was adopted to establish its online detection data. A multi-sensor detection data fusion algorithm based on a fractional partial differential equation is established, which effectively fuses the information data detection errors caused by various influencing factors and greatly improves the detection accuracy of information data. The effectiveness of this method is proved through its application in an experiment.

International data suggests that exposure for nature is beneficial for mental health and well-being. The restrictions related to Covid-19 pandemic have created a setting that allows us to investigate the importance of greenness exposure on mental health during a period of increased isolation and worry. Based on 2060 responses from an online survey in the Stockholm County, Sweden, we investigated: 1) weather the Covid-19 pandemic changed peoples’ life-style and nature-related habits, and 2) if peoples’ mental health differed depending on their exposure to greenness. Neighbourhood greenness levels were quantified by using the average Normalized Difference Vegetation Index (NDVI) within 50m, 100m, 300m, and 500m buffers surrounding the participant’s place of residence. We found that the number of individuals that reported that they visited natural areas “often” was significantly higher during the pandemic than before the pandemic. Higher levels of greenness surrounding one’s location of residence were in general associated with higher mental health/wellbeing and vitality scores, and less symptoms of depression, anxiety, and perceived and cognitive stress, after adjustments for demographic variables and walkability. In conclusion, the results from the present study provided support to the suggestion that contact with nature may be important for mental health in extreme circumstances.

The supposition is that the usage of fibrin rich in leukocytes and platelets advanced (A-PRF) in ulcerative osteomyelitis of the diabetic foot allows rehabilitation from this critical illness. In this investigation, the focus was to normalize the use of PRF in patients with osteomyelitis not amputated, to use this second generation platelet concentrate as a regeneration enabler. The researchers submitted and utilized A-PRF membranes (1300 g × 8 min) in 7 patients (all diabetics) with osteomyelitis and cutaneous injury for 6 months. The membranes, in combination with the supernatant fluid produced by stress, have been integrated into the skin lesion down to the bone after surgical debridement. The advancement of the lesions after some period of time has been analyzed. All seven subjects had a Probe-to-Bone positive assay; MRI indicated a cortico-periosteal coagulation and/or foci of cortico-spongeous osteolysis contiguous to the lesion. Gram-positive bacterium were identified in our procedures in 52% of cases. Gram+ Cocci, for example, S. Aureus (15.6%), S. Hemolytic (12.1%), S. Viridans (7.1%), and Gram-negative Bacteria, for example, Pseudomonas (10.6%), Proteus (7.8%), Enterobacter (5.7%) are present. Candida Albicans is active in 2.8%. The blood count shows no relevant differences. To date, cutaneous lesions have cured in 6 of the seven subjects treated (one patient for more than five years) without any evidence of infection or recurrence. The results obtained on our subjects indicate that PRF membranes may be a therapeutic option in this problematic disease.

Desertification is a global environmental and socio-economical issue threatening humanity's survival and development. The Shiyang River Basin ecosystem is vulnerable and prone to desertification. In addition, establishing the quantitative analysis of desertification driving factors and understanding their relative contribution, separately or combined, is still an unresolved problem. The present study applied geographic information system (GIS) techniques and a geographic detector model to quantify desertification spatial extent and driving mechanisms. This research utilized Fractional Vegetation Cover (FVC) to elucidate desertification spatial heterogeneity. The 30 years Coefficient of Variation (CV) of the Normalized Difference Vegetation Index (NDVI) was a dependent variable and indicator of ecosystem terrestrial conditions; Elevation, near-surface air temperature, precipitation, wind velocity, land cover change, soil salinity, road buffers, waterway buffers, and soil types were independent variables. The results showed that 89.41% of the total area is under desertification risk, where 20.99% is extremely desertified, 34.45% is severely desertified, 12.05% is moderately, and 21.92% is slightly desertified. The results from the Geodetector model showed that Power Determinant (PD) values ranged between 0.004 and 0.270. Elevation and soil types had the highest contributing factors with PD values of 0.270 and 0.227, whereas precipitation, soil salinity, the buffer of the waterway, and wind velocity played a moderate role with PD values of 0.146, 0.117, 0.107, and 0.071. Near-surface air temperature, road buffer, and land cover dynamics exhibited lower impact with PD values of 0.028, 0.013, and 0.004. In most cases, investigating the interaction between driving factors resulted in a mutual or non-linear enhancement. There was an apparent linear and mutual enhancement between elevation and soil salinity, precipitation, and soil types with values of 0.3513, 0.3232, and 0.3204, respectively. In addition, there was a mutual enhancement between soil salinity and soil types with a value of 0.2962. On the other hand, a non-linear enhancement was observed between Elevation and near-surface air temperature (0.3116), Elevation and Land cover dynamics (0.2759), soil types and near-surface air temperature (0.2687), land cover dynamics and soil types (0.234), precipitation and near-surface air temperature (0.2248), precipitation and wind velocity (0.2248), and between land cover dynamics and precipitation (0.223). This research revealed irrefutable evidence that environmental factors might be the primary drivers of ecosystem disturbance, provided the basis for the environmental footprint of desertification mechanism, and might be a cornerstone for future policy on ecological restoration sustainability in the Shiyang River Basin.

Cardiovascular disease (CVD) is considered to be one of the leading health issues in Thailand. CVD not only contributes to an increase in the number of hospital admissions year on year but also impacts on the rising health care expenditure for the treatment and long-term care of CVD patients. Therefore, this study is aimed at examining the impacts of risk reduction strategies on the number of CVD hospital admissions, Disability-Adjusted Life Years (DALYs) and the costs of hospitalisation. To estimate such impacts a CVD cost-offset model wasapplied using a Microsoft Excel spreadsheet. The number of the mid-year population was classified by age, gender and the CVD risk factor profiles from the recent Thai National Health Examination Survey (NHES) IV. This survey was chosen as the baseline population. The CVD risk factor profiles included age, gender, systolic blood pressure, total cholesterol, and smoking status. The Asia-Pacific Collaborative Cohort Study (APCCS) equation was applied to predict the probability of developing CVD over the next eight-year period. Estimates on the following were obtained from the model: (1.) the CVD events both fatal and non-fatal; (2.) the difference between the projected number of deaths and the actual number of deaths in that population; (3.) the number of patients who are expected to live with CVD; (4.) the DALYs from the estimated number of fatal and non-fatal events; (5.) the cost of hospital admissions. Four CVD risk strategy scenarios were investigated as follows: (1.) the do nothing scenario; (2.) the optimistic scenario; (3.) achieve the UN millennium development goal; and (4.) the worst-case scenario. The findings showed that over the next eight years there are likely to be 3,297,428 recorded cases of CVD; 5,870,049 cases of DALYs; and, approximately ฿57,000 million, ($1.9 billion), is projected as the total cost of hospital admissions. However, if the current health policy can reduce the levels of risk factors as defined in the optimistic scenario or such policy meets the specifications of the UN millennium development goal,there would be a significant reduction in the number of hospital admissions. These are estimated to be a reduction of 522,179 male and 515,416 female cases. With these results it is expected that health care costs would save approximately ฿9,000 million, ($298.3 million), for CVD and 900,000 million of DALYs over the next eight years. However, if there is an upward trend in the risk factors as predicted in the worst-case scenario, then there will be an increase of 428,220 CVD cases; consequently, DALYs cases may rise by 766,029 while the hospitalisation costs may increase by approximately ฿7,000 million, ($232.1 million). Based on our findings, reducing the levels of CVD risk factors in the population will drastically reduce: (1.) the number of CVD cases; (2.) DALYs cases; and (3.) health care costs. Therefore it is recommended that the health policy should enhance the primary prevention programs which would be targeted at reducing the CVD risk factors in the population.

The variation of river hydrologic process can not only reflect the impact of natural factors, but also the impact of human activities. The purpose of this study is to reveal the change trend of the hydrologic regime of the Yellow River and its response to ecological protection in the river basin. Based on the daily water and sediment observation data of representative gauging stations in the middle and lower reaches of the Yellow River, it was analyzed the variation trend of the annual and monthly runoff and suspended sediment load (SSL), and monthly mean runoff, suspended sediment transport rate (SSTR), sediment inflow coefficient, and hydrological regime in decadal average of the gauging stations during the period 1960-2019. The results show that the variation of annual runoff and SSL, as well as the monthly mean runoff and SSTR in decadal average, has a significant decreasing trend in the 1960’s-1990’s, which was mainly in response to the gradual implementation of ecological protection measures such as afforestation, grass planting, terrace construction, and check dam construction, etc. in the basin. In 2000’s and 2010’s, the annual runoff increased, while the SSL increased slightly. This was a response to the implementation of new river management measures such as ensuring the ecological water demand of the lower reaches and scouring the riverbed by manually regulated clear water discharged from the Xiaolangdi Reservoir. In the same time, the monthly mean runoff and SSTR for the flood season (Jun.-Oct.) decreased remarkably, while the process curve of the monthly mean discharge and sediment concentration, changed from a clockwise loop to a counterclockwise loop in the river reach below the Xiaolangdi dam. This was a comprehensive response to the environmental protection measures in the Yellow River basin, in which the construction and operation of the Xiaolangdi Reservoir played a key role. This study can provide reference for river basin management.

This purpose was to compare the ability of body shape index (ABSI) and body roundness index (BRI) with waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body adiposity index (BAI) to predict metabolic risk. The cross-sectional study was conducted in 17,360 Chinese subjects (were aged 18-95 years old) who escaped cardiovascular disease (CVD) or diabetes. Biochemical and anthropometric variables were measured by trained staff. Receiver operating characteristic curve (ROC) and optimal cutoff values of obesity indices were recruited to compare the predictive ability for metabolic risk factors. The mean age of subjects was 53.7(13.1) years, 41.6 % were males. Within young group (<60 years), the areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to similarly predict high metabolic risk in males (0.74 vs. 0.74 vs. 0.73 vs. 0.73 vs. 0.73) and in females (0.73 vs. 0.73 vs. 0.71 vs. 0.73 vs. 0.73), while the approximate predictive ability were only acquired in males (0.73 vs. 0.73 vs. 0.70 vs. 0.73 vs. 0.73) within elder group (≥60 years). The optimal cut-off values of BRI for high metabolic risk were calculated in males (<60 y: 3.49 vs. ≥60 y: 3.46) and females (<60 y: 3.47 vs. ≥60 y: 3.60). Meanwhile, BRI displayed a strong prediction to elevated BP and elevated TG in males (AUC = 0.64; AUC = 0.70) and to elevated BP, elevated TG and elevated SUA in females (AUC = 0.67; AUC = 0.69; AUC =0.70). BRI was able to similarly predict high metabolic risk compared to WC, BMI, WHR, WHtR and BAI, while ABSI was not. Moreover, BRI revealed specific predictive ability for elevated BP, elevated TG and elevated SUA.

The decline in Pinus sylvestris var. mongolica in the introduction area has had a high profile in recent years. For the ecological restoration, management and silvicultural design of Mongolian pines in the introduction area, it is necessary to conduct a comprehensive and in-depth study on the ecological adaptation mechanism of Mongolian pines in provenances. The ecological process of water and nutrient accumulation as well as the influence of environmental factors on the photosynthetic physiology are the key to revealing the ecological adaptation mechanism of Mongolian pines. According to the differences of climate in the distribution area of Mongolian pines, sampling sites were set up, the effects of environmental factors on leaf δ13C and the relationship between leaf δ13C and nutrient content were analyzed. The results showed that leaf δ13C values were ranging from - 29.7 ‰ to - 23.76 ‰. The ecological stoichiometry, including LC (522.81 mg·g-1), LN (16.04 mg·g-1), LP (1.19 mg·g-1) and L-N:P (13.56), indicated that leaf photosynthesis and water use efficiency is greatly affected by environmental conditions, Mongolian pines had strong ability of carbon fixation, and its growth was obviously restricted by nitrogen. Although there was no significant correlation between δ13C with stoichiometric parameters in leaf, photosynthesis was the key link in the process of carbon fixation. It also showed that Pinus sylvestris var. mongolica was a stomatal limited plant. Leaf δ13C had significant correlation with climatic factors. VPD is the dynamic factor affecting the photosynthetic physiological process in leaves. Air and soil moisture are the dominate factors affecting the leaf stomatal conductance and determines leaf δ13C value, while other factors indirectly affect leaf δ13C by its impact on relative humidity or soil water content. Soil phosphorus content affected by clay is a key factor affecting soil water availability and soil nutrient cycling. Photosynthetic process in leaf is the dynamic process affecting the nutrient accumulation.

Background/Purpose: In recent times, Sub-Sahara Africa (SSA) had been rated by the World Health Organization, (WHO), as the most malaria endemic region in the world. Evidence synthesis of the risk factors associated with malaria among children aged under-five in SSA is urgently needed. This would help to inform decisions that policy makers and executors in the region need to make for the effective distribution of scare palliative resources to curb the spread of the illness. This scoping review is aimed to identify studies that have used multivariate classical regression analysis to determine risk factors associated with malaria among children under-five years old in SSA. Methods/Design: The search terms followed PICOTS, (Population, Intervention, Comparator, Outcome, Timing, Setting), and were used in searching through the following databases: PubMed, MEDLINE, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, and MeasureDHS. The databases were searched for published articles from January 1990 to December 2020. Results: Among the 1154 studies identified, only thirteen (13) studies met the study’s inclusion/exclusion criteria. Narrative syntheses were performed on the selected papers to synchronise the various risk factors identified. Factors ranging from child-related, (age, birth order and use of bed net), parental/household-related, (maternal age and education status, household wealth index) and community-related variables, (community wealth status, free bed net distribution), were some of the identified significant risk factors. Conclusion: It is timely to have a synthesis of risk factors that influence the malaria status of children under-five in SSA. The outcome of the review will increase the knowledge of the epidemiology of morbidity that will form the basis for designing efficient and cost-effective distribution of palliatives and controls of malaria in SSA.

Background: In 1962, Susser and Stein observed that the mortality rates of peptic ulcers in England and Wales increased markedly in the 1910s, maintained at a high level during the 1910s-1940s, and began to decline steadily since the early 1950s. They termed this epidemic pattern a birth-cohort phenomenon, but its mechanism has never been elucidated. Susser and Stein speculated that the occurrences of extraordinary social environmental factors roughly fit the fluctuations, but the role of environmental factors in peptic ulcers has never been identified. Objectives: This study aims to elucidate the mechanism of the birth-cohort phenomenon of peptic ulcers and identify the role of environmental factors in the disease. Methods: Starting from an etiology identified recently, this study uses the two inverse operations in calculus, differentiation, and integration, to analyze the existing data. First, a fluctuation curve in the birth-cohort phenomenon is differentiated into multiple annual mortality rates caused by individual environmental factors. Second, these annual mortality rates are integrated to reproduce the fluctuation curve in the birth-cohort phenomenon. Results: The differentiation reveals a parallel relationship between the psychological impacts of environmental factors and the mortality rates of peptic ulcers, whereas the integration reproduces a representative fluctuation curve in the birth-cohort phenomenon. The successive occurrences of multiple social environmental factors from the 1910s to 1940s maintained the increase in mortality rates, while the sustained improvements in living environments explained the steady decline of the mortality rates from the early 1950s. Conclusion: The parallel relationship suggests a causal role of environmental factors in peptic ulcers, whereas the reproduction of a representative fluctuation curve indicates that multiple environmental factors caused the birth-cohort phenomenon by Superposition Mechanism. Significantly, this study challenges the current reductionist approach used to study disease in modern medicine by demonstrating the effectiveness of an opposite methodological concept focused on integration.

In recent years, the high-frequency abnormal price fluctuations of small-scale agricultural products have been detrimental to market stability. The traditional method based on statistical data of production factors can no longer accurately predict abnormal price fluctuations. Taking scallions as a case, the paper identifies price influencing factors from massive network information, and analyzes the causes and changing characteristics of price fluctuations from four perspectives: market supply, economic environment and market sentiment, and attention. Initially, the study employs an LDA topic model to extract factors from online sentiment data over the past four years, including market supply and demand, economic conditions, related agricultural prices, and market attention. Subsequently, using the SO-PMI algorithm to expand domain-specific lexicons and employing semantic and sentiment analysis with syntactic parsing, the study aims to improve the accuracy of sentiment quantification in text analysis. Furthermore, cointegration and Granger causality tests validate the significant impact of these factors on scallion price fluctuations, mitigating spurious regression issues. Finally, by employing a TVP-VAR model, the study compares the impulse responses and shock magnitudes of various factors in different time and spatial dimensions. It also delves into the mechanisms of heterogeneous impacts and trends in scallion prices, considering the corresponding socio-economic context and public sentiment events within specific time windows, thereby providing valuable decision-making insights for the healthy development of agricultural markets.

The contribution of genetic and environmental factors to the pathophysiology of cerebral aneurysms in monozygotic twins is under-reported and presents ambiguous arguments. The morphology and hemodynamics of neurovascular arteries in a pair of monozygotic twins (MTs) were investigated to reveal the underlying mechanisms. Four arterial models were reconstructed for the twin A-right brain and left brain, twin B-left brain, and B-left brain without anterior cerebral arteries based on preclinical scanned information. Subsequently, the dimensions, configurations and outlined curves of the three-perspective geometries were compared between the MTs. Adopting an in-vitro validated numerical cerebral aneurysm model, hemodynamic patterns were investigated and compared in the MT models, respectively. Morphological comparisons of the MTs show the size and shape of cerebral arteries exist significant differences, despite of the expected genetic similarities. These differences can be attributed to variations during embryological development and external environmental influences. Qualitatively and generally, numerical results indicate the MTs have some hemodynamic similarities (e.g., time-averaged pressure (TAP) distributions (~13400 Pa), and oscillatory shear index (0~0.49), but present significant differences in specific local arteries due to morphological variances. Specifically, the difference in the volumetric blood flow rate in corresponding arteries between the MTs is from 16% (smallest) in anterior choroidal artery (AChA) to 221% (largest) in the ophthalmic artery (OphA), varying with specific compared arteries. Also, the registered hemodynamic indicators, such as the maximum time-averaged wall shear stress (TWSS) (53.6 Pa vs. 37.8 Pa), and different local OSI distributions were observed between the MTs. The findings revealed that morphological variations in MTs could be generated by embryological and environmental factors, thus assuming they share the identical morphology in cardiovascular and neurovascular systems may lead to significant misevaluations in hemodynamics quantifications and further lesions.

Historic sites are important components of every city's cultural history because they preserve rich historical knowledge and distinctive values passed down from previous generations to the present. Due to the progress of urbanization and modernization, many historic sites face pressure from damage and transformation. In this paper, a method for assessing cultural heritage damage was developed to measure the extent of spatial damage in historic sites. Using sample data obtained in Xiyang, Qixian, and Xiaoyi, all historic cities in Shanxi Province, Mainland China, and combined weights were estimated using the Delphi technique and the CRITIC weight method. Following this, the Spatial Damage Degree Model (SDDM) based on K-means cluster analysis and K-nearest neighbor (KNN) classification was developed. The findings show that the model efficiently solves the problem of assessing spatial damage levels in historic sites. Through multiple linear regression analysis, it was shown that the damage to historic sites was predominantly caused by three factors: natural erosion, construction damage, and planning and policy. SDDM was used to calculate the spatial damage levels of historic sites, allowing conservators to fully comprehend the features and concerns related to historic sites. As a result, more scientific and rational preservation approaches may be developed, improving the efficiency of historic site restoration and conservation and encouraging the sustainable development of urban and rural heritage.

As we know, the economy of science is to achieve optimal gains using scarce resources. Similarly, a problem where economies of the world are trying to resolve it is the issue of how to achieve an optimal economic contribution from limited tourism resources. According to the fact that global studies and statistics indicate that good governance is considered as the most important factor in developing countries and is considered as a strong governance of the development and as Information and Communication Technology (ICT) is effective in the interactions and economic and social exchanges of any society, it is the link between the tourism industry and the technology under the form of a robust tool and utilitarian in the tourism process called E-tourism can play a significant role. Therefore, the aim of this study was to investigate the effect of network Readiness Index and good governance on income from tourism industry. In this study, data and information about 14 selected countries were collected from Southwest Asia in the annual period of 2016-2011 in the form of panel data and the proposed model was used and estimated by the generalized torques system method. The estimated results of the model indicate that both hypotheses have a positive and significant impact on the amount of Network Readiness Index in the income of tourism industry, as well as the positive and significant effect of the index the amount of income from the tourism industry is confirmed, and their impact has been positive and significant, as well as exchange rate variables, revenue and commercial openness, also have a positive and significant effect on revenues of the tourism industry.

Based on our interest in properties of human movement, we investigated Japanese GPS data, and arrived at the following three observations: 1) there is a strong correlation between the area of polygons created by human movement trajectories and their perimeters; 2) short-distance movement trajectories less than 5 km tend to enclose a large area like a circle; 3) long-distance movement trajectories over 5 km tend to be straight. We also clarified the following four observations on individual attributes and external factors related to long-distance movements: 1) women tend to travel more linearly than men; 2) linearity is stronger on weekends and national holidays in areas with a large theme park; 3) linearity is weaker on weekends and holidays in areas with many historical tourist attractions; 4) these variations are created by people visiting such areas. These properties should be incorporated when modeling the movement trajectories of humans.

In the foodservice industry, clients judge not only the product standard but also the service quality they receive during their restaurant experience. Therefore, when the importance of the dining experience is strongly regarded by consumers in terms of intellectual and motivational attributes, they are happier to suggest the establishment to others. The main objective of this research is to study the influence of different service quality factors in restaurants and their impact on customer satisfaction. This research is also undertaken to evaluate the identification of important factors for the restaurant industry and the levels of service quality among customers satisfaction with the services offered by restaurants in India. As factor analysis, correlation, and regression research, this study was conducted using a modified IBM SPSS Statistics 24 and AMOS instrument among the 630 randomly selected customers. A weighted mean was used to describe the levels of service quality and customer satisfaction. Multiple regressions were used to determine the predictors of customer satisfaction. The results reveal the main 12 service quality factors, which are: 1. Process-related factors: system for take-away orders, order tracking system, and time for food preparation 2. People-related factors: focus on customers' special requests, peer group influence, and making you feel special. 3. Physical Environment: Walking Space, Architecture of the Restaurant, and Signals for Direction 4. Performance-related factors: food served at an appropriate temperature; food presentation; portion size of food in the restaurant. The researchers have developed one model on service quality factors that is described in the research paper.

Background: Human papillomavirus is a common pathogen that infects the skin and mucosal epithelium, is transmitted sexually; causes condylomas or squamous cell carcinomas. Two (16 and 18) of the 150 HPV serotypes are oncogenic types. Studies have been done on the infection by oncogenic human papillomavirus 16/18 and associated factors are found to be very limited in Ethiopia. Objective: This study aimed to assess the prevalence of oncogenic human papillomavirus infection (HPV 16/18) and associated factors among women. Methods: An institutional-based cross-sectional study was conducted among 337 women screened for cervical cancer in two hospitals in East Gojjam Zone from February to April 2021 G.C. Four BSc-qualified nurses who worked in the chosen hospitals collected the data using pretested questionnaire and an HPV test (OncoE6TM Cervical Test) specific to HPV16/18 in cervical swabs. Descriptive analysis was performed to determine the prevalence and a multivariate logistic regression model was used to identify the associated factors of HPV16/18 infection. Finally, statistical significance was declared at P < 0.05.Results: The prevalence of HPV infection was 14.2% (95% CI: 10.7% -18.1%). The mean age of the respondents was 36.7±9.1 years. Women with the age group of 55-65 years (AOR = 7.91, 95% CI: 1.95-32.09), early initiation of sexual intercourse (AOR = 5.36, 95% CI: 1.58-18.13), history of sexually transmitted infection (STI) (AOR = 3.52, 95% CI: 1.27-9.72), human immunodeficiency virus (HIV) positive status (AOR = 6.8, 95% CI: 1.99-23.54), and number of lifetime sexual partners (AOR = 4.37, 95% CI: 1.15-17.3) were important independent factors associated with the presence of oncogenic HPV infection. Conclusion and Recommendation: We found a relatively low prevalence of high-risk HPV infection. Age, early initiation of sexual intercourse at less than 18 years, STI of women, being HIV seropositive, and a number of sexual partners were important factors for high-risk HPV infection. Women aged > 46 years, women with early initiation of sex, a history of STI, being HIV positive, and a history of multiple sexual partners should be encouraged to be screened and vaccinated for HPV infection. Wider-ranging studies are also needed in HPV-infected women in association with the cervical lesion.

This literature review was aimed to identifying the opportunistic bacterial pathogens that can be transmitted by contaminated food and represent a current threat for patients particularly suscep-tible to infections because of underlying conditions or predisposing factors. The analysis was focused on recent case or outbreak reports, and systematic reviews published in years 2019 - 2023 and resulted in sorting 24 bacterial groups comprising genera or species able to cause a variety of systemic or invasive infections if ingested with food or drinking water. These included both bacteria known to cause mild infections in immunocompetent persons and bacteria considered innocuous that are used in food fermentation or as probiotics. No recent cases from dietary routes were reported for bacteria of critical importance as nosocomial pathogens and widely occurring in food products, primarily, Acinetobacter baumanii and Klebsiella pneumoniae. However, the very first sources of their introduction in the clinical environment still need to be estab-lished. In many instances, risky dietary habits such as eating raw fish, seafood, raw meat, unpasteurized milk and derived products or the lack of control on fermentation processes led to the reported illnesses, pointing out to the necessity to improve the hygiene of production and consumer’s awareness of risks.

Bone morphogenetic protein (BMP) and platelet-derived growth factor (PDGF) are known to regulate and stimulate osteogenesis, both proteins playing an important role in bone homeostasis, constituting good candidates for osteoporosis´ treatment. Herein we aim to evaluate the effects of recombinant human BMP-7 (rhBMP7) and PDGF-BB (rhPDGF-BB) in oophorectomy-induced osteoporosis in rats. To this end, 40 Sprague-Dawley rats were submitted to oophorectomy surgery and treatments were started at the 100th day after the surgery, when all animals showed signs of osteoporosis. These peptide growth factors were applied intravenously once or twice a week and animals were followed for a total of five weeks. Two weeks after the end of the treatments, the animals were euthanized, the tissues were collected and Alkaline Phosphatase, X-ray, micro-CT and histology were assessed. The results indicate that the most promising treatments are: 20 µg/kg PDGF-BB + 30 µg/kg BMP-7 2x/week and 30 µg/kg BMP-7 2x/week, presenting an increase of 15% (p&lt;0.05) and 13% (p&lt;0.05) in bone volume fraction and 21% (p&lt;0.05) and 23% (p&lt;0.05) in trabecular number, respectively. In conclusion, rhPDGF-BB and rhBMP-7 are capable of inducing an increase in bone volume and density in this osteoporotic animal model, constituting interesting candidates for osteoporosis treatment.

In the wake of the rapid deployment of Small Modular Reactors (SMRs), this study aims to enhance the efficiency, reliability, and safety of SMR operations through a deeper understanding of human factors in their interaction within digital control room systems. Recognizing the pivotal role of human understanding in this new era of nuclear power, we employed electroencephalogram (EEG)-based monitoring to provide an unparalleled real-time view into operators' cognitive states. By interfacing detailed human models, informed by EEG metrics, with specific operational tasks, we recreate potential operational scenarios using an SMR simulator and capture intricate human responses therein. Our results elucidated the intricate relationship between EEG-derived data and human performance shaping factors, indicating a marked correlation between certain EEG patterns and operational efficiencies. Conclusively, these findings underscore the potential of EEG monitoring not only as a diagnostic tool but as an instrumental aid in the design and operation of future SMR digital control rooms. The insights derived offer a roadmap for the development of practical strategies, ensuring more effective and safer SMR operations.

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP based Swiss COPD cohort, and develop a statistical model for predicting exacerbation. Methods: In a questionnaire-based COPD cohort, demographic and medical data were recorded for 24 months. Data set was split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and the overall performance was validated. A nomogram was created to facilitate the clinical use of the model. Results: Of the 229 COPD patients analyzed, 77% of patients had no exacerbation during the follow-up. The best subset in the training dataset found that lower forced expiratory volume, high scores on the MRC dyspnoea scale, exacerbation history, being on combination therapy of LABA+ICS or LAMA+LABA at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) was 0.75 for one or more exacerbations. Calibration was accurate (predicted 0.34 exacerbations vs observed 0.28 exacerbations). Conclusion: Nomograms built from these models can assist clinicians in the decision-making process of their COPD care.

Youth is the essential entrepreneurial force for every country's social, political, and economic development. Urban youth make up about 34.27 percent of the population in Ethiopia. The youth unemployment crisis is one of the serious challenges that Ethiopia is facing nowadays, and it should be mentioned in the nation's public discourse. Therefore, the main objective of this study is to specify the socioeconomic and demographic factors that influence urban youth unemployment in the Somali Regional State, specifically in Jigjiga, Degahbour, Kebridahar, Gode, and Dollo Ado towns. Both primary and secondary data sources were employed. A multi-stage sampling technique has been used to select 385 sample respondents from the total population of the study. This study found that almost 63% of youth in the study area were unemployed, and a large number of unemployed youths live in Jigjiga and Dollo Ado Towns as compared to other city administrations. The econometric model's findings indicate that factors like gender, education level, work experience, access to credit, access to information, time applied for job vacancy, active job seeker, social network (network with clan elders, government officials, businessmen, and other friends), and residence in Jigjiga and Gode town have a significant association with the likelihood of youth unemployment in the Somali regional state. Therefore, this study recommends that the regional government and local city administration should develop effective policies and strategies to address the underlying causes of gender inequality, improving access and quality of education, supporting freshman graduates to find jobs, providing access to credit and job vacancies, ensuring fair and free job competition, and managing youth migration for job seeking.

BRICS-Plus (Brazil, Russia, India, China, South Africa, and 30 other countries) is a group of 35 countries with emerging economies making up more than half of the world’s population. We explored epidemiological trends of cardiovascular disease (CVD) mortality attributable to modifiable risk factors and its association with period and birth cohort effects and sociodemographic index (SDI) across BRICS-Plus by using joinpoint regression and age-period-cohort (APC) modeling from 1990 to 2019. Between 1990 and 2019, the all-ages CVD deaths increased by 85.2% (6.1 million to 11.3 million) across BRICS-Plus. The CVD ASMR attributable to dietary risks and smoking significantly decreased across BRIC-Plus countries, with some exceptions. However, four-fifth of BRIC-Plus countries observed a remarkable increasing trend of high body mass-index (BMI)-related CVD deaths in particular among younger adults (25-49 years). Early birth cohorts and individuals aged greater than 50 years showed a higher risk of CVD mortality. Both China-ASEAN FTA and Mercosur regions stand out for their successful sociodemographic transition, with a significant reduction in CVD mortality over the study period. Singapore and Brazil achieved great progress in CVD mortality reduction and the other BRICS-Plus countries should follow their lead in adopting public health policies and initiatives into practice.

Drought is one natural disaster with the greatest impact worldwide. Southern Africa (SA) is susceptible and vulnerable to drought due to its type of climate. In the last four decades, droughts have occurred more frequently, with increasing intensity and impacts on ecosystems, agriculture and health. The work consisted of a systematic literature review on the drought regime’s characteristics in the SA, under current and future climatic conditions, conducted on the Web of Science and Scopus platforms, using the PRISMA2020 methodology, with usual and appropriate inclusion and exclusion criteria to minimize/eliminate the risk of bias, which lead to 41 documents published after the year 2000. The number of publications on the drought regime in SA is still very small. The country with the most drought situations studied is South Africa and the fewer studies are Angola and Namibia. The analysis revealed that the main driver of drought in SA is the ocean-atmosphere interactions including the El Niño Southern Oscillation. The documents used drought indices, evaluating drought descriptors for some regions, but it was not possible to identify one publication that reports the complete study of the drought regime, including the spatial and temporal distribution of all drought descriptors in SA.

Several studies have shown that the traditional way of learning is not optimal when we aim to improve ICT users’ actual privacy behavior. In this research, we present a literature review of the theories that are followed in other fields to modify human behavior. Our findings show that the cognitive theory and the health belief model present optimistic results. Further, we examine various learning methods and we conclude that experiential learning is advantageous compared to other methods. In this paper aggregate the privacy behavior determinant factors found in the literature and we use the cognitive theory to we synthesize a theoretical framework. The proposed framework can be beneficial to educational policy makers and practitioners, such as public and private schools, and universities. Also, our framework provides a fertile ground for more research on experiential privacy learning and privacy behavior enhancement.

This paper presents the goals and components of a quantitative energy balance assessment framework to define PEDs flexibly in three important contexts: the context of the district's density and RES potential, the context of a district's location, induced mobility and the context of the dis-trict's future environment and its decarbonized energy demand or supply. It starts by introducing the practical goals of this definition approach: achievable, yet sufficiently ambitious to be inline with Paris 2050 for most urban and rural Austrian district typologies. It goes on to identify the main design parts of the definition: system boundaries, balancing weights and balance targets and argue how they can be linked to the definition goals in detail. In particular we specify three levels of system boundaries and argue their individual necessity: operation, including everyday mobili-ty, including embodied energy and emissions. It argues that all three pillars of PEDs, energy effi-ciency, onsite renewables and energy flexibility can be assessed with the single metric of a prima-ry energy balance when using carefully designed, time-dependent conversion factors. Finally, it is discussed how balance targets can be interpreted as information and requirements from the sur-rounding energy system, which we identify as a "context factor". Three examples of such context factors, each corresponding to the balance target of one of the previously defined system bounda-ries operation, mobility and embodied emissions are presented: Density (as a context of opera-tion), sectoral energy balances and location (as a context for mobility) and an outlook of a person-al emission budgets (as a context for embodied emissions). Finally, the proposed definition framework is applied to seven distinct district typologies in Austria and discussed in terms of its design goals.

Today, the world is undergoing a major investment cycle in infrastructure, which is vital for the development and prosperity of countries and society. Management deficiencies in infrastructure projects are well known and some of them concerns weak engagement of project stakeholders. Importance of stakeholder engagement as the key success factors for infrastructure projects is recognized. However, the literature gives very few answers how this process manifests in projects. Some scholars concluded that it is a complex and undertheorized management process which necessitates more empirical research. The research questions seek to identify how practitioners perceive the stakeholder engagement, who implements activities and processes related to engagement and in what way, which organizational aspects influence the process and how success is achieved in infrastructural projects. Interviews were conducted with eight experienced experts who participated in a whole series of (complex) infrastructure projects. The interviews examined all aspects of the engagement of stakeholders in detail, and a thematic analysis was carried out. Based on the analysis, success/failure factors related to the stakeholder engagement process were defined. As a result, a framework model for engaging stakeholders and achieving success in infrastructure projects is presented, which is based on three management levels and three levels of project success.

This study analysed through the perspective of networks the association between physical activity (PA), sedentary behaviour (SB), and cardiovascular risk factors in overweight low-income schoolchildren from the perspective of complex systems. Methods: The sample consisted of 41 overweight children between 6 and 10 years old (56% girls). PA and SB were analysed by accelerometer, and the measures of cardiovascular factor risk were: anthropometric and hemodynamic measurements, body fat, lipid profile and glucose, cardiorespiratory fitness (CRF), left ven-tricular mass (LVM), and Sokolov-Lyon. Network analysis with Boot-strap-1000 was performed to analyze the association between PA, SB and the cardiovascular risk factors. Results: Moderate to vigorous PA was positive related with Waist circumference (WC; 0.499), HDL-C (0.307), and CRF (0.276), and negatively associated with BMI (-0.251) and Fat (-0.341). For SB, positive associations were seen with WC (0.326), CRF (0.296), LVM (0.250) and Sokolov (0.215). Adicionalment, the centrality indicators highlighted WC as the most important variable in the network. Conclu-sion: Interventions that aim to mitigate the harmful effects of obesity on cardiovascular risk factors in overweight children should consider WC as an important variable in of system.

Human Adenovirus (HAdV) infection occurs in 14-16% of patients in the early months after pediatric hematopoietic cell transplantation (HCT) and this correlates with a higher risk to develop HAdV disease and overall 6-month mortality. The main risk factors for HAdV infection are T-cell depletion of the graft by ex vivo CD34+ selection or in vivo use of alemtuzumab or anti-thymocyte serum, the development of grade III-IV graft versus host disease (GVHD), the type of donor (unrelated donor, cord blood, haploidentical or HLA mismatched parent) and severe lymphopenia (< 0.2 x 109/L). The prevention of HAdV disease is based on early intervention with antivirals in the asymptomatic patient when the permitted viral load threshold on blood (> 102-3 copies/ml) and/or on the stool (109 copies/g stool) is exceeded. Cidofovir, a monophosphate nucleotide analog of cytosine, is the primary drug for preemptive therapy, used at 5 mg/kg/week for 2 weeks followed by 3-5 mg/kg every 2 weeks. The alternative schedule is 1 mg/kg every other day (three times/week). Enhancing virus-specific T-cell immunity in the first months post-HCT by donor-derived or third-party-derived virus-specific T cells represents an innovative and promising way of intervention applicable both in prevention and therapeutic setting.

In West Africa, research on the hepatitis E virus (HEV) is barely covered despite the recorded outbreaks. The still low level of access to safe water and adequate sanitation is one of the main factors of HEV spread in developing countries. HEV infection induces acute or sub-clinical liver diseases with a mortality rate ranging from 0.5 to 4%. The mortality rate is more alarming (15 to 25%) among pregnant women, especially in the last trimester of pregnancy. Here, we conducted a multicentric socio-demographic and seroepidemiological survey of HEV in Senegal among pregnant women. A total of 1,227 consenting participants attending antenatal clinics responded to our questionnaire. Plasma samples were collected and tested for anti-HEV IgM and IgG by using the WANTAI HEV-IgM and IgG ELISA assay. HEV global seroprevalence was 7.9% with 0.5% and 7.4% for HEV IgM and HEV IgG, respectively. One participant's sample was IgM/IgG positive, while four were declared indeterminate to anti-HEV IgM as per the manufacturer's instructions. From one locality to another, the seroprevalence of HEV antibodies varied from 0 to 1% for HEV IgM and from 1.5 to 10.5% for HEV IgG. The data also showed that seroprevalence varied significantly by marital status (p&lt;0.0001), by the regularity of income (p=0.0043) and by access to sanitation services (p=0.0006). These data could serve as a basis to setup national prevention strategies focused on socio-cultural, environmental and behavioral aspects for a better management of HEV infection in Senegal.

The cause and prevention of recurrent aphthous stomatitis (also called aphthous ulcers or canker sores) are still unknown. This may be due in part to ignorance of the risk factors present in susceptible people. In this systematic review (PROSPERO record #CRD42019122214), we show that most of the risk factors for the disease are single nucleotide genetic polymorphisms in genes related to the functioning of immune system (TLR4, MMP9, E-selectin, IL-1 beta and TNF-alpha). Single nucleotide genetic polymorphisms do not constitute a modifiable risk. This indicates that, at least in part, susceptibility to recurrent aphthous stomatitis is hereditary, and that these factors cannot be modified.

The Mediterranean diet represents one of the most studied dietary patterns, however, there is no single tool for measuring the grade of adherence and no single criteria to adapting these indices to pregnant women. We characterized the adherence to the Mediterranean diet (MDA) of pregnant women participating in the NELA cohort and identified the sociodemographic determinants and lifestyle habits associated with a higher risk of a low MDA. Maternal diet during gestation was assessed by a validated Food Frequency Questionnaire (FFQ) (n=665). We estimated Relative Mediterranean Diet score (rMED), Alternative Mediterranean Diet score (aMED) and Alternate Healthy Index-2010 (AHEI-2010). Multivariate regression models were performed to identify the sociodemographic and lifestyle factors associated to each index. Mothers with lower age and more previous deliveries had a greater probability of low MDA (P &lt;0.05). Only, for aMED index, mothers with university education and / or who practiced 2 or more hours per week sport activities had a lower probability of a low MDA (P &lt;0.01). These results may be useful in order to design intervention strategies and dietary recommendation for pregnant women.

Breast cancer (BC) is the most frequent form of malignancy and the second only to lung cancer as common cause of cancer-causing deaths in women. Notwithstanding many progresses in the field, metastatic BC has a very poor prognosis. As therapies are becoming more personalized to meet patients‘ needs, a better knowledge of the molecular biology leading to the disease unfolds the possibility to project more precise compounds or antibodies targeting definite alteration at the molecular level expressed in cancer cells of patients or as antigens on the surface of cell membranes. Fibroblast growth factor receptor (FGFR) is a druggable target -which is activated by its own ligands -namely the Fibroblast Growth Factors (FGFs). This pathway provides a vast range of interesting molecular targets pursued at different levels of clinical investigation. Herein we provide an update on the knowledge on genetic alterations of the receptors in breast cancer, their role in tumorigenesis and the most recent drugs against this particular receptor to treat the disease.

The main moto of this study is to examine and study on behavior of Software Quality Assurance (SQA) issues of project stakeholders in a Scrum environment and their consequences. This inductive case study identifies SQA principles relevant to Meeting User Expectations. The Stakeholders in the Scrum project having lack of Concrete Guidance on Scrum’s SQA approaches, methods, and techniques. The insufficiency of concrete guidelines in Scrum needs a management squad to develop concepts that can include implementing practices from other methodologies and wisely modifying the system structure to incorporate the practices adopted, ensuring improvement in the processes, and creating a shared ownership environment. Through explaining the incompleteness of Agile approaches with special attention to the lack of concrete instructions in Scrum, the study uses techniques to customize literature and advocate for Scrum’s versatility. The study uses strategies to adapt literature and argue for Scrum’s simplicity by illustrating the incompleteness of Agile approaches with special attention to the lack of concrete instructions in Scrum methodology.

In the recent years, conducted businesses have been increasingly expected to obtain more sustainable forms, with many added determinants. Indeed, sustainability-related entrepreneurship still faces complex choices among conventional entrepreneurial factors while being urged to consider three main pillars of sustainability. Thus, this work is focused on the development of a sustainability-related entrepreneurship by reflecting the sustainable needs of an entrepreneurship. Due to the fact that it is not clear for the sustainability-related entrepreneurship what the valuable and most influential factors stimming its development are, the detection of the underpinning building blocks that properly adapting within each factor and how these factors correlate with each other become a major motivation of this work. Therefore, this paper aims to conduct an attempt to identify comprehensive set of SE (Sustainable Entrepreneurship) factors providing a structural overview in making insights into the factors/determinants of SE. It assists researchers and entrepreneurs in obtaining clear informative pictures about SE factors. The applied research methodology is based on a systematic literature review which is conducted using the PRISMA methodology, simultaneously ensuring repetitiveness and lack of bias in this process. To retrieve and condense the immense amount of bibliographic information, a bibliometric analysis is adopted to perform in co-occurrence analysis of keywords determining SE factors and detailed different forms of distribution analysis. The expected outcome is to provide the classification schema of applied keywords in sustainable entrepreneurship literature as part of a comprehensive literature review, which is presented in order to uncover, classify and systematize the current research. As a result, a co-word matrix of high frequency keywords of SE factors is also established. It offers a feasible path of investigation for researchers aiming to build a consistent body of knowledge about sustainable entrepreneurship, by providing a conceptualization and systematization that can be applied across the many contexts in which sustainable entrepreneurship is expressed, for example sustainable actions and sustainable development contexts. The present research aims to yield a successful attempt of identifying comprehensive set of SE factors, as well as to establish a co-word matrix of high frequency keywords of SE factors. Providing a macroscopic overview of the main factors of SE in the form of conceptualization of the proposed construct will capture the unique organizational characteristics of sustainable enterprises and facilitate the research into capability building, innovation and competitive advantage in sustainable enterprises. It supports both researchers and entrepreneurs in shaping up and refining future research activities and investments in line with the policy of SE.

Disease related malnutrition (DRM) is prevalent in hospitals and is associated with increased care needs, prolonged hospital stay, delayed rehabilitation and death. Nutrition care process related activities such as screening, assessment and treatment has been advocated by scientific societies and patient organizations but implementation is variable. We analyzed the cross-sectional nutritionDay database for prevalence of nutrition risk factors, care processes and outcome for medical patients. In 59126 medical patients included between 2006-2015 the prevalence of recent weight loss (45%), history of decreased eating (48%) and low actual eating (53%) was more prevalent than low BMI (8%). Each of these risk factors was associated with a large increase in 30 days hospital mortality. Nutrition care processes increases slightly with presence of risk factors but never done in more than 50% of patients. Only a third of patients not eating in hospital receive oral nutritional supplements or artificial nutrition. We suggest that political action should be taken to raise awareness and formal education on all aspects related to DRM for all stakeholders, to create and support responsibilities within hospitals, and to create adequate reimbursement schemes. Collection of routine and benchmarking data is crucial to tackle DRM.

Cachexia is a complex metabolic syndrome characterized by loss of skeletal muscle, leading to a significant weight loss that impacts patient morbidity and mortality. Given the complexity of gene regulatory networks that control gene expression, our objective was to perform an integrative mRNA and miRNA profiling to identify genetic programs that capture essential mechanistic details that promote muscle atrophy in cancer cachexia. Here, we used RNA sequencing to analyze miRNAs and mRNAs expression profiles in tibialis anterior (TA) muscles of the Lewis lung carcinoma model of cancer cachexia. In addition, we compared these findings with RNA-Seq data from C2C12 myotubes treated in vitro with the cachectic factors tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ). Extracellular matrix (ECM) alterations were validated by picrosirius staining, western blot, and fractal dimension analyses. We found 1,008 mRNAs and 18 miRNAs differentially expressed in cachectic mice. This set of genes was associated with the ECM, proteolysis, and inflammatory response. Enrichment analysis of transcriptional factor binding sites revealed activation of the atrophy-related transcriptional factors: NF-κB, Stat3, AP-1, and FoxO. Furthermore, the integration of mRNA and miRNA expression profiles identified post-transcriptional regulation by miRNAs of genes involved in ECM organization, cell migration, transcription factors binding, ion transport, and FoxO signaling pathway. C2C12 myotubes treated with TNF-α and IFN-γ similarly down-regulate subsets of ECM genes, including collagens. Our integrative analysis of miRNA-mRNA co-profiles comprehensive characterized regulatory relationships of molecular pathways and revealed miRNAs targeting ECM-associated genes in cancer cachexia. We also confirmed in C2C12 myotubes that changes in ECM-associated genes are dependent on inflammatory signaling of the cytokines TNF-α and IFN-γ.

HD-Zip proteins are unique to plants, and contain a homeodomain closely linked to a leucine zipper motif, which are involved in dimerization and DNA binding. Based on homology in the HD-Zip domain, gene structure and the presence of additional motifs, HD-Zips are divided into four families, HD-Zip I–IV. Phylogenetic and bioinformatics analysis of HD-Zip genes using transcriptomic and genomic datasets from a wide range of plant species indicate that the HD-Zip protein class was already present in green algae. Later, HD-Zips experienced multiple duplication events that promoted neo- and sub-functionalizations. HD-Zip proteins are known to control key developmental and environmental responses, and a growing body of evidence indicates a strict link between members of the HD-Zip II and III families and the auxin machineries. Interactions of HD-Zip proteins with other hormones such as brassinolide and cytokinin have also been described. However, it is striking that among the genes regulated by REV, a HD-Zip III protein playing a key role in apical development, are genes that mediate ABA signaling. Furthermore, HAT1 and HAT3, two HD-Zip II proteins involved in key developmental processes, repress ABA biosynthesis and signaling, indicating an essential role of these factors in adjusting development to changing environment.

Identification of costs drivers and their influence level on building development costs play a key role in the development of construction models and improve the efficiency and effectiveness of any project. Forty-five indicators influencing building development costs in New Zealand are explored by literature review and pilot interviews. These indicators are grouped into seven categories. The determination and ranking of the cost drivers are carried out by a questionnaire survey distributed to key professionals working in New Zealand’s construction industry. Structural equation modeling (SEM) software was employed for analysis of the collected data. One of the key advantages of this powerful software is to provide the p-value according to the structure of the research model. Findings of this study indicate that the property market and construction industry factor, statutory and regulatory factor, and socio-economic factor are major factors affecting building development costs in New Zealand.

Plant growth and productivity are hindered by abiotic stresses. Crop productivity and the ecosystem are suffering due to climate change and harmful farming practices. We urgently need to use environment-friendly techniques like Arbuscular Mychorriza Fungi (AMF) to improve crop productivity. It is a well-established fact that AMF are effective bio-fertilizers. It is believed that AMF injections can increase plant resilience to stressors like heat,metals, salt, drought, and extreme temperatures. AMF aids in enhancing tolerance mechanisms and safeguarding essential metabolic pathways. AMF, as natural root symbionts, give plants important inorganic nutrients, helping them grow better, produce more, and acclimatize even under stress. AMF acts as a bio-fertilizer, boosting plants’ ability to adjust to different environments. Thus, researchers need to conduct further studies on how AMF promotes crop quality and productivity. This review describes the current understanding of AMF’s impact on host plants at their different growth stage, their benefits, applications, and the significance of plant nutrient relationships with AMF.

Circulating miRNA-451a has recently emerged as an important biomolecule with potential clinical values as a diagnostic marker for several diseases. However, to be used as such, it is critical to accurately assay miRNA-451a in the clinic. Yet, pre-analytical factors that can affect such an error-free clinical assay of miRNA-451a have not been explored. This study aimed at investigating several of these pre-analytical factors that may affect the accurate quantification of miRNA-451a in human blood samples. We initially evaluated miRNA-451a levels in red blood cells (RBCs), white blood cells (WBCs), platelets, and plasma by droplet digital PCR (ddPCR). Next, we quantified miRNA-451a levels in whole blood or plasma stored at different temperatures for different time periods by ddPCR and used hemolyzed plasma samples to study the effects of hemolysis on plasma miRNA-451a concentration. We found that WBCs and platelets contain trace amounts of miRNA-451a and that about 99.9% of miRNA-451a in the blood are localized in RBCs. Hemolyzed plasma showed 58.5-fold increase in miRNA-451 concentration as compared to non-hemolyzed plasma. Importantly, plasma stored at room temperature (RT) or 4ºC showed a steady statistically significant decrease in miRNA-451a levels over a 7-day period whereas plasma samples stored at -20 or -80ºC for up to 7 days showed stable miRNA-451a levels. Together, our data indicate that hemolysis and blood storage at RT or 4ºC may have significant negative effects on the levels of circulating miRNA-451a.

(1) Background: This paper details the development process of two assistive technology products (ATs) implemented in the PAID project, aiming to promote the social, educational, and labor inclusion of people with disabilities across 10 municipalities of Antioquia, Colombia. (2) Methods: Applying Design Thinking (DT) methodology, including stages of empathizing, defining, ideating, prototyping, and testing, alongside a demographic study where specific needs of people with disabilities (PwDs) were identified. (3) Results: As a result, the construction process of two specific cases of assistive technology products (ATs) is detailed, including finite element simulation, mechanical testing, and delivery to end-users. Additionally, workshops for assistive product fabrication conducted in select municipalities of the project are highlighted. (4) Conclusions: the information gathered guided the development of the ATs, focusing on their features on accessibility and ease of replication. The primary objective is to facilitate the participation of PwDs in educational environments, thus promoting inclusion and accessibility. This article describes the results of two of these ATs; however, it is worth noting that this process was performed for 112 ATs delivered through the duration of the project.

contaminated sites located in each school district. Previous studies showed that various environmental factors, such as exposure to toxic substances negatively impacts human health depending on their concentration and occurrence. Therefore, the study aims to use Geographical Information System (GIS) technology and secondary data on IEP numbers of each school district, chemical occurrence in contaminated sites, and demographic data to conduct a correlational analysis. The secondary data obtained from school districts and contaminated sites from Iowa Department of Natural Resources Facility Explorer were populated in ArcMap 10.5 (a GIS software) for generating maps and data to conduct statistical analysis. The contaminants were categorized into metals, polyaromatic hydrocarbons (PAH), and solvents with weighing factors as 1, 0.5, and 0.25. A total of 1 Superfund site and 39 CERCLA sites were identified as contaminated sites for this study. The majority of contaminants were heavy metals such as lead, arsenic, mercury, and cadmium. The mean toxic score of all contaminated sites combined was 13.4 (sd 14.4). The correlational analysis between the IEP numbers from each school districts and toxic scores from the contaminated sites was positive indicting that increased toxic score increased the number of students enrolled in the IEP program (F=23.7, p<0.0001). The correlational analysis between toxic score and demographics indicated some interesting results. Children under the age of 10 were living in areas with high toxic score and the showed mild correlation (p<0.00052). Similarly, higher number of black population resided in areas with high toxic score (p=0.0032) than the white population (p<0.0001). The result also indicated that children enrolled in IEP were predominantly among the black population (p<0.0001). The correlational analysis between household income and poverty percentage of people residing near the contaminated area indicated that people had low average household income (p=0.0002) and high poverty percentage (p=0.0203) residing in areas with higher toxic score. Regarding the educational status, less number of people with post graduate degree (p<0.0001) resided in areas with high toxic score and more number of people with no degree (p<0.0001) resided in areas with high toxic score. Finally, the study showed the increasing trend of eligible children enrolling in free and reduced lunch programs with increasing toxic scores (p=0.0012) and IEP levels (p=0.0416). This study emphasize on developing multiple exposure to correlate environmental factors contributing to the negative health outcome on people.

The levels of informatization, automation, and intelligence are continuously improving; however, the risks due to the increased design and operational complexity of ship systems are increasing. Large-scale ship accidents occur for various reasons. Existing accident analysis methods that examine marine accidents from the perspective of causal one-to-one correspondence have limitations in systematically analyzing complex marine risks when identifying their causes for the prevention of similar accidents. This study focuses on a systematic causality analysis of the factors related to human errors in marine accidents that may occur during the arrival and departure of mega container ships. In particular, a representative case of the Milano Bridge crane contact accident at Busan New Port is considered. To explore the complex organizational–technical, human–technical, and organizational–human relationships relevant to this case, human factors (seafarer, pilot, etc) that are closely related to the linked causes were analyzed using the functional resonance analysis method. This study aims to reduce human error and prevent marine accidents including pilotage.

Precipitation gauges are critical for measuring precipitation rates at regional and global scales and are often used to calibrate precipitation rates estimated from other instruments such as satellites. However, precipitation measured at the gauges is affected by gauge-undercatch that is often larger for solid precipitation. In the present work, two popular gauge-undercatch correction factors are assessed: one utilizes a dynamic correction model and is used in the Global Precipitation Climatology Centre (GPCC) Monitoring product and the other one employs a fixed climatology and is used in the Global Precipitation Climatology Project (GPCP) product. How much the choice of correction factors can impact the total estimate of precipitation was quantified over land at seasonal, annual, regional, and global scales. The correction factors are also compared as a function of the environmental variables used in their development, among those are near-surface air temperature, relative humidity, wind speed, elevation, and precipitation intensity. Results show that correction factors can increase the annual precipitation rate based on the gauges by ~9.5 % over the global land (excluding Antarctica), although this amount can vary from ~6.3% (in boreal summer) to more than 10% (in boreal winter), depending on the season and the method used for gauge-undercatch correction. Annual variations of correction factors can also be large, so the use of the fixed climatology correction factors requires caution. Given their magnitudes and differences, selection of appropriate correction factors can have important implications in refining the water and energy budget calculations.

The increasing demand for high-quality livestock products dictates to develop approaches to assessing the composition of the fatty acids (CFAs) and amino acids (CAAs) in animal tissues. The review considers the following issues: chromatographic methods for the determination of CAAs and CFAs of pig tissues; factors influencing the CAAs and CFAs of pig tissues; methods of regulating CAAs and CFAs of pork using nutritional factors; the effect of CAAs and CFAs on formation of meat properties. The main methods for determining CAAs or CFAs are the ion-exchange or gas chromatography, respectively. The total FA amount and individual FAs have significant effects on the tenderness, taste, color and juiciness of pork meat (due to the different melting points of particular fatty acids, formation of lipid oxidation products during cooking, etc.). Muscle proteins of pigs with regulated fatness differ also in CAAs (decreasing by increase in “pork fat” and decrease in the protein’s amount. The significance of this review is also determined by high popularity of pork in Russia and in a number of other countries of the world.

Objective: Application of ERA methods to investigate the atmospheric pollution and built environment factors influencing lung cancer incidence rate in Chinese women. Methods: Lung cancer incidence rate among Chinese women at 339 cancer registries were obtained from the China Cancer Registry Annual Report 2017, air quality and built environment data were obtained from the Greenpeace and China Construction Yearbook. After multiple covariates variables were eliminated, an exploratory regression analysis was performed using the world standardized population incidence rate as the dependent variable. Air quality and built environment factors as the independent variable. Results: Shandong Peninsula, Hebei and Liaoning are high incidence rate areas of female lung cancer in China, with significant regional aggregation. In addition to air quality factors such as industrial smoke emission data, the association between built environmental factors such as urbanization rate, development LUI, population density and greening coverage of built-up areas and female lung cancer incidence rate is statistically significant. Conclusion: In addition to air quality factors, urban spatial factors can also significantly affect respiratory health. The LUI is positively while urbanization rates and population density are negatively correlated with the incidence rate of lung cancer. The role of green space for respiratory health has not been proven. In addition, there is little relationship between income and health, and similar findings are found for indicators such as the public transportation and roads network.

In Taiwan, colorectal cancer is ranked second and third in terms of mortality and cancer incidence, respectively. In addition, medical expenditures related to colorectal cancer are considered to be the third highest. While advances in treatment strategies have provided cancer patients with longer survival, potentially harmful second primary cancers can occur. Therefore, second primary colorectal cancer analysis is an important issue with regard to clinical management. In this study, a novel predictive scheme was developed for predicting the risk factors associated with second colorectal cancer in patients with colorectal cancer by integrating five data mining classification techniques, including support vector machine, random forest, multivariate adaptive regression splines, extreme learning machine, and extreme gradient boosting. In total, 4,287 patients in the datasets provided by three hospital tumor registries were used. Our empirical results revealed that this proposed predictive scheme provided promising classification results and the identification of important risk factors for predicting second colorectal cancer based on accuracy, sensitivity, specificity, and area under the curve metrics. Collectively, our clinical findings suggested that the most important risk factors were the combined stage, age at diagnosis, BMI, surgical margins of the primary site, tumor size, sex, regional lymph nodes positive, grade/differentiation, primary site, and drinking behavior. Accordingly, these risk factors should be monitored for the early detection of second primary tumors in order to improve treatment and intervention strategies.

Crop plants should be resilient to climatic factors in order to feed ever-increasing populations. Plants have developed stress-responsive mechanisms by changing their metabolic pathways and switching the stress-responsive genes. The discovery of plant transcriptional factors (TFs) as key regulators of different biotic and abiotic stresses have opened up new horizons for plant scientists. TFs perceive the signal and switch certain stress-responsive genes on and off by binding to different cis-regulatory elements. The above 50 species of plant TFs have been reported in nature. DREB, bZIP, MYB, NAC, Zinc-finger, HSF, Dof, WRKY, and NF-Y are important with respect to biotic and abiotic stresses whereas the role of many TFs is yet to explore. In this review, we summarize the role of different stress-responsive TFs with respect to biotic and abiotic stresses. Further, challenges and future opportunities linked with TFs for developing climate-resilient crops are also elaborated.

Missense mutations in the LRRK2 gene were first identified as a pathogenic cause of Parkinson’s disease (PD) in 2004. Soon thereafter, a founder mutation in LRRK2, p.Gly2019Ser (rs34637584), was described, and it is now estimated that there are approximately 100,000 people worldwide that carry this risk variant. While the clinical presentation of LRRK2 parkinsonism has been largely indistinguishable from sporadic PD, disease penetrance and age at onset can be quite variable. In addition, its neuropathological features span a wide range from nigrostriatal loss with Lewy body pathology, lack thereof, or atypical neuropathology including a large proportion of cases with concomitant Alzheimer’s pathology, hailing LRRK2 parkinsonism as the "Rosetta stone" of parkinsonian disorders. These differences may result from interactions between LRRK2 mutant protein and other proteins or environmental factors that modify LRRK2 function, and thereby influence pathobiology. This review explores how potential genetic and biochemical modifiers of LRRK2 function may contribute to the onset and clinical presentation of LRRK2 parkinsonism. We review, which genetic modifiers of LRRK2 influence clinical symptoms, age at onset, and penetrance, what LRRK2 mutations are associated with pleomorphic LRRK2 neuropathology, and which environmental modifiers can augment LRRK2 mutant pathophysiology. Understanding how LRRK2 function is influenced and modulated by other interactors and environmental factors –either increasing toxicity or providing resilience- will inform targeted therapeutic development in the years to come. This will allow developing disease-modifying therapies for PD and LRRK2-related neurodegeneration.

The increasing number of registered road crashes involving cyclists during the last decade, and the high proportion of road crashes resulting in severe injuries and fatalities among cyclists constitutes a global issue for community health, urban development, and sustainability. Nowadays, the incidence of many risk factors for road crashes of cyclists remains largely unexplained. Given the importance of this issue, the present study has been conducted with the aim of determining relationships between infrastructural, human factors and safety outcomes of cyclists. Objectives: This study aimed, first, to examine the relationship between key infrastructural and human factors present in cycling, bicycle-user characteristics, and their self-reported experience with road crashes. And second, to determine whether a set of key infrastructural and human factors may predict their self-reported road crashes. Methods: For this cross-sectional study, a total of 1064 cyclists (38.8% women, 61.2% men; M = 32.8 years of age) from 20 different countries across Europe, South America and North America, participated in an online survey composed of four sections: demographic data and cycling-related factors, human factors, perceptions on infrastructural factors, and road crashes suffered. Results: The results of this study showed significant associations between human factors, infrastructural conditions and self-reported road crashes. Also, a logistic regression model found that self-reported road crashes of cyclists could be predicted through variables such as age, riding intensity, risky behaviors, and problematic user/infrastructure interactions. Conclusions: The results of this study suggest that self-reported road crashes of cyclists are influenced by features related to the user and their interaction with infrastructural characteristics of the road.

For children born with congenital heart defects (CHD), extracorporeal life support may be necessary. This study aimed to investigate the outcomes of children on extracorporeal membrane oxygenation (ECMO), focusing on various risk factors, including the type of CHD. The study was conducted as a retrospective single-center analysis at the Children's Hospital Zurich. All patients with CHD who required ECMO (veno-arterial or veno-venous) between 2009 and 2019 were included. Among the 88 patients, 36 (41%) had a single ventricle heart defect while 52 (59%) had a biventricular heart defect. Out of the total patients, 25 (28%) survived, with 7 (8%) having a single ventricle heart defect and 18 (20%) having a biventricular heart defect. Statistical analysis with a p-value of 0.19 revealed no significant difference in survival rates between the two groups. At the one-year follow-up, all children who survived to discharge were still alive. The rate of complications on ECMO was higher in children with a single ventricle (odds ratio [OR] 1.57, 95% confidence interval [CI] 0.67 - 3.7). The occurrence of a second ECMO run was more frequent in patients with a single ventricle compared to those with a biventricular physiology (22% vs. 9.6%). Although the study did not identify a significant difference in survival rates, it did indicate that patients with a single ventricle faced a higher risk of complications during ECMO and a greater likelihood of requiring a second ECMO run.

Disordered eating is a serious health concern globally. The etiology is complex and multidimensional and differs somewhat for each specific eating disorder. Several risk factors have been identified which include psychological, genetic, biochemical, environmental, and sociocultural factors. Poor body image, low self-esteem, teasing, family dynamics, and exposure to media images have also been identified as risk factors. While it is enticing to consider a single behavioral risk factor, doing so fails to consider the documented environmental, social, psychological, biological, and cultural factors that contribute to the development of an eating disorder in a multidimensional and complex integration that is undoubtedly unique to everyone. Focusing only on any one factor without taking the complex etiology into account is remiss. For example, it has been suggested that the use of dietary supplements may lead to eating disorders, despite a lack of evidence to support this conjecture. Therefore, the purpose of this review is to examine the evidence-based risk factors for eating disorders and discuss why connecting dietary supplements to eating disorder etiology is not supported by the scientific literature and may interfere with treatment. Established, effective prevention and treatment approaches for eating disorders should be the focus of public health initiatives in this domain.

The human immunodeficiency virus 1 (HIV-1) viral protease (PR) is one of the most studied viral enzymes, and approval of drugs targeting its catalytic activity opened the door to the develop-ment of highly active antiretroviral therapy (HAART). Despite the fact that its crucial role in viri-on maturation is well characterized, an increasing body of research is starting to focus on its abil-ity to cleave host cell proteins, based on recent advances in proteomics and genomics technologies. Such findings are apparently in contrast with the dogma of HIV-1 PR activity being restricted to the interior of nascent virions, and suggest catalytic activity within the host cell environment. Given the limited amount of PR present in the virion at the time of infection, it is tempting to specu-late that such events mainly occur during viral late gene expression, mediated by newly synthe-sized Gag-Pol polyprotein precursors, rather than at a very early stage of infection, before pro-viral integration. Among cellular targets of HIV-1 PR, three major clusters can be identified: pro-teins involved in viral and cellular translation, those controlling cell survival, and restriction fac-tors responsible for innate/intrinsic antiviral responses. Indeed, by cleaving host cell translation initiation factors HIV-1 PR can impair cap-dependent translation, thus promoting IRES-mediated translation of late viral transcripts and viral production, while by targeting several apoptotic fac-tors it modulates cell survival, thus promoting immune evasion and viral dissemination. Addi-tionally, HIV-1 PR counteracts restriction factors incorporated in the virion that would otherwise interfere with nascent virus vitality. Thus, HIV-1 PR appears to modulate host cell function at dif-ferent times and locations during its life cycle, to ensure efficient viral persistency and propaga-tion. This kind of PR-mediated host cell modulation is found in a plethora of different viruses and HIV-1 is no exception, and although we are far from having a complete picture, it is clear that the PR has a multifaceted role in interfering with host machineries to better suit viral replication, and is a field that needs to be explored further.

Objective: This study aimed to examine the relationship between health structure disparities and hospitalizations and deaths among the pediatric population in different regions. Method: The study employed an ecological time series design, utilizing population-based secondary data ob-tained from DATASUS, from the Brazilian Ministry of Health. The data included in this study encompassed the population aged zero to 19 years, health establishments, physicians working in health establishments, hospitalizations, and deaths related to Morbidities listed in the Interna-tional Classification of Diseases. The focus was explicitly on individuals diagnosed with Cere-bral Palsy and other paralytic syndromes. The data for this study were gathered from January 2018 to December 2021. TABNET was used for data collection, and Excel for tabulation and anal-ysis. Results: Analysis of health structure data across regions revealed notable disparities, par-ticularly in the North and Northeast regions, compared to other regions. These discrepancies prompted a decision to conduct a comparative assessment between these regions and the rest of the country. Conclusion: In the North region, a significant 50% difference in hospitalizations based on residence versus a place of care was observed for individuals with Cerebral Palsy and other paralytic syndromes, indicating the necessity for relocation to access appropriate medical treatment.

The paper presents the most comprehensive and large-scale study to date on how students perceive the impacts of the COVID-19 crisis on various aspects of their lives on a global level. With a sample of 30,383 students from 62 countries, the study reveals that amid the worldwide lockdown and transition to online learning students were most satisfied with the support provided by teaching staff and their universities’ public relations. Still, deficient computer skills and the perception of a higher workload prevented them from perceiving their own improved performance in the new teaching environment. Students were mainly concerned about issues to do with their future professional career and studies, and experienced boredom, anxiety and frustration. The pandemic has led to the adoption of particular hygienic behaviours (e.g. wearing masks, washing hands) and discouraged certain daily practices (e.g. leaving home, shaking hands). Students were also more satisfied with the role played by hospitals and universities during the epidemic compared to the government and banks. The findings also show that students with selected socio-demographic characteristics (male, part-time, first level, applied sciences, lower living standard, from Africa or Asia) were generally more strongly affected by the pandemic since they were significantly less satisfied with their academic work/life. Key factors influencing students' satisfaction with the role of their university are also identified. Policymakers and higher education institutions around the world may benefit from these findings while formulating policy recommendations and strategies to support students during this and any future pandemics.

Background: Urinary tract infection (UTI) is one of the commonest bacterial infections among reproductive age females. Untreated UTI in reproductive age female is associated with sexual dysfunction, cystitis, pyelonephritis and Pelvic inflammatory disease. At present, the antimicrobial resistance emergency has quadrupled worldwide and poses a serious threat to the treatment of patients. Thus, this study aimed to determine bacterial profile, antibiotic susceptibility pattern and associated risk factors of urinary tract infection among reproductive age females attending the Logbaba District Hospital Methods: A hospital-based cross-sectional study was conducted from January – July, 2023. Convenient sampling was employed to recruit 259 reproductive age females. Sociodemographic and risk factors information were obtained using a well-structured questionnaire. Mid-stream urine was collected and inoculated on cystine lactose electrolyte deficient media. Isolates were identified using API 20. Antibiotic sensitivity testing was performed using modified kirby-bauer susceptibility testing technique. Multivariate logistic regression model was used to assessed risk factors. A p-value < 0.05 was considered as statistically significant. Results: The overall prevalence of UTI among reproductive age females was 82/259 (31.66%). Symptomatic and asymptomatic patients reported a prevalence of 50/121(41.32%) and 32/138 (23.19%), respectively. Ages ranging from 21-30 years (AOR: 2.53 ,95% CI 1.32 – 4.43, p=0.006) and 31 – 40 years (AOR: 0.19 , 95% CI: 0.14- 0.54; p <0.0001), student (AOR: 1.8, 95% CI: 1.21 - 2.75; p = 0.010), history of UTI (5.34, 95% CI = 1.86 - 18.15; p = 0.03), symptomatic (AOR = 2.86, 95% CI1.78 - 4.67, p <0.0001) and secondary education (AOR: 0.13, 95% CI 0.08 - 0.32; p<0.0001) were predictors to UTI. Klebsiella Pneumoniae was the most frequent species 27 (32.9%), follow by E coli 22(26.8%), Staphylococcus aureus 16 (19.5%), CONS 8 (9.8%), Proteus mirabilis 6 (7.3 %) and Pseudomonas aeruginosa 3(3.7%). Majority of the isolates were sensitive to cefotaxime (87.80%), imipenem (85.7%), vancomycin (79.27%), Ofloxacillin (76.83%), Ceftriaxone (75.61%), Ciprofloxacin (74.39%), Gentamicin (71.95%) and Doxycycline (69.51%), and resistant to Amoxicillin (51.22%), cotrimoxazole (47.56%) and Azithromycin (31.71%) , All the isolates were multidrug drug resistant (100%) and Klebsiella Pneumoniae and E coli were the most multidrug drug resistant species Conclusion: In the present study, the prevalence of urinary tract infection among reproductive age females was high and considerably a high proportion of multidrug resistance was observed. This result will have a significant impact on the selection of appropriate antimicrobial agents for the treatment of urinary tract infection in the study area.

Cyanobacteria (blue-green algae) may rapidly propagate under favorable conditions, forming dense blooms. As water blooms deteriorate, blue-green algae can generate potent toxins, potentially harmful to companion animals, wildlife, and even humans. One widely recognized cyanobacterial toxin is microcystin. This algal toxin has been implicated in surface waters globally, increasing liver cancer and/or disease risk amongst those who depend on sources prone to microcystin contamination. Interestingly, no study looked at weather conditions when connecting liver health outcomes to freshwater cyanotoxins. The purpose of this study was to determine if climate was an important determinant of liver mortality and total microcystins at the ecological level. Secondary data was used to evaluate the proposed hypothesis. Environmental data (CDC WONDER) and toxin data (USEPA) were used in multivariate regression analysis. Mean daily sunlight and total microcystins were significant predictors of age-adjusted chronic liver disease and cirrhosis death rates. Mean annual precipitation and mean daily max temperature were non-significant predictors. This study demonstrated how microcystins in combination with climate may increase liver mortality. The results can prompt others to study environmental exposures of terminal liver diseases, guiding environmental health and the water industry of human survival needs.

Taking a DNA-sequence, a word with letters/bases A, T, G and C, as the relation between the generators of an infinite group $\pi$, one can discriminate two important families: (i) the cardinality structure for conjugacy classes of subgroups of $\pi$ is that of a free group on $1$ to $4$ bases and the DNA word, viewed as a substitution sequence, is aperiodic. (ii) The cardinality structure for conjugacy classes of subgroups of $\pi$ is not that of a free group, the sequence is generally not aperiodic and topological properties of $\pi$ have to be determined differently. The two cases rely on DNA conformations such as A-DNA, B-DNA, Z-DNA, G-quadruplexes, etc. We found a few salient results: Z-DNA, when involved in transcription, replication and regulation in a healthy situation implies (i). The sequence of telomeric repeats comprising $3$ distinct bases, most of the time, satisfies (i). For $2$-base sequences in the free case (i) or non free case (ii), the topology of $\pi$ may be found in terms of the $SL(2,\mathbb{C})$ character variety of $\pi$ and the attached algebraic surfaces. The linking of two unknotted curves --the Hopf link-- may occur in the topology of $\pi$ in cases of biological importance, in telomeres, G-quadruplexes, hairpins and junctions, a feature we already found in the context of models of topological quantum computing. For $3$- and $4$ base sequences, other knotting configurations are noticed and a building block of the topology is the $4$-punctured sphere. Our methods have the potential to discriminate potential diseases associated to the sequences.

Background: In March 2020, a COVID-19 outbreak associated with the Falles Festival in Borriana, Spain, led to significant infections. Methods: In June 2022, we conducted a cross-sectional follow-up study of 473 socially engaged adults aged 18 to 64, examining the cumulative experience after SARS-CoV-2 infection and vaccination responses. Data included demographic details, lifestyle habits, medical history, infection records, and vaccinations from a population-based vaccine registry. Blood samples were analyzed for SARS-CoV-2 antibodies and cellular immunity. We employed a doubly robust inverse weighted probability analysis to estimate the booster vaccine dose's impact on long COVID prevalence and symptom count. Results: 28.1% of participants met the WHO criteria for long COVID, with older individuals showing higher rates. Not complying with long COVID criteria associated with factors including O blood group, higher occupational status, physical activity, three vaccine doses, strong SARS-CoV-2-S-reactive IFNγ‐producing‐CD8+ response, and infection during the Omicron period. Conversely, increased age, high or low social activity, underlying health conditions, a severe initial COVID episode, and reinfection associated with higher long COVID likelihood. A booster dose, compared to one or two doses, reduced long COVID risk by 74% (95% CI: 56.4% to 91.7%) and symptom count by 55.2% (95% CI: 31.6% to 78.7%). Conclusion: Long COVID was prevalent in a significant portion of those who contracted COVID-19, underscoring the need for sustained follow-up and therapeutic strategies. Vaccinations, notably the booster dose, had a substantial beneficial effect on long-term infection outcomes, affirming the vaccination’s role in mitigating SARS-CoV-2 infection consequences.

Failure to meet the deadlines for the implementation of investment and construction projects is a problem in all countries of the world, and leads to unstable activity of construction companies. The article studies the most important destabilizing factors affecting the main indicator of sustainable activity of construction companies-the duration of the implementation of an investment and construction projects. To determine and assess the impact of destabilizing factors on the duration of implementation of selected investment and construction projects, a survey was conducted, in which a number of customers, consultants and contractors involved in construction projects took part. Questionnaires developed on the basis of a cluster sample were sent to respondents, 48 responses were received in response to the assessment of destabilizing factors. To analyze the received and grouped information, structural equation modeling using the Smart-PLS program was used. As a result of modeling, a number of results were obtained, the most important of which are the identification of the main reasons that lead to an average (20% - 50%) increase in the duration of projects in the construction sector. The most significant were: the lack of an appropriate procurement program for materials; inefficient scheduling by contractors and instability of construction production; poor-quality processing of incoming information and untimely deci-sion-making due to changes in projects during their implementation. Destabilizing factors con-tribute to an increase in the duration of construction sector projects, which leads to time overruns, cost overruns, and an increase in the negative impact on the overall use of resources. As a result of the study, a set of recommendations was formed, the most important of which is the use of possible compensatory measures that can allow construction companies to eliminate the risks of disrupting construction deadlines for sustainable activities. These compensatory measures include: - recommendations to customers of the construction project; - recommendations to contractors; - recommendations to the consultant. Moreover, the control of destabilizing factors that can cause delays, the improvement of contracts and the precise and clearer definition of all elements of the project can help to reduce the duration of construction, and will allow companies to maintain sustainable activities in the construction industry.

Open-plan office (OPO) layouts emerged to allow organizations to adapt to changing workplace demands. We explore the potential for OPOs to provide such adaptive capacity to respond to two contemporary issues for organizations: the chronic challenge of environmental sustainability, and the acute challenges emerging from the great COVID-19 homeworking experiment. We apply a socio-technical systems perspective and green ergonomics principles to investigate the relationship between an OPO environment and the occupants working within it. In doing so, we consider the relevant technical and human factors such as green technology and employee green behavior. We also consider how a green OPO might provide non-carbon benefits such as improving occupant wellbeing and supporting the emergence of a green organizational culture. Our investigation highlights several avenues through which an OPO designed with green ergonomic principles could benefit occupants, the organizations they work for, and the natural environment of which they are a part and on which they depend. We find reason to suspect that green OPOs could play an important role in sustainable development; and offer a research agenda to help determine whether in fact OPOs are another example of how going green is good business.

Dynamic behavior of coaxial axisymmetric planar cracks in the transversely isotropic magneto-electro-elastic (MEE) material in transient in-plane magneto-electro-mechanical loading is studied. Magneto-electrically impermeable as well as permeable cracks are assumed for crack surface. In the first step, considering prismatic and radial dynamic dislocations, electric and magnetic jumps are obtained through Laplace and Hankel transforms. These solutions are utilized to derive singular integral equations in the Laplace domain for the axisymmetric penny-shaped and annular cracks. Derived Cauchy singular type integral equations are solved to obtain the density of dislocation on the crack surfaces. Dislocation densities are utilized in computation of the dynamic stress intensity factors, electric displacement and magnetic induction in the vicinity tips of crack tips. Finally, some numerical case studies of a single and multiple cracks are presented. The effect of system parameters on the results is then discussed.

The present study investigates the decision-making process of investors on the Pakistan Stock Exchange with regard to portfolio construction, explicitly focusing on the incorporation of ESG concerns. The present study employed SmartPLS and structural equation modeling (SEM) to quantitatively assess data received from a sample of 393 out of 400 respondents. Based on the available data, investors participating in the Pakistan Stock Exchange are notably impacted by ESG aspects. The findings of this study hold significance for emerging economy firms, regulators, and investors, both in terms of theoretical and practical ramifications. The study's findings demonstrate a clear indication of investors' significant emphasis on ESG matters. Furthermore, it provides valuable insights for stakeholders who are involved in the ever-evolving realm of sustainable finance within developing countries

This article presents a state-of-the-art literature review to understand people’s perceptions and opinions of Autonomous Vehicles (AVs) and the factors that influence AV adoption. A strategic literature search was conducted to select articles for this review. Most of the articles were published within the last five years and they used a household questionnaire survey to collect data. Mostly, they used statistical and econometric methods to evaluate the factors that affect people’s intentions to adopt AVs. The results show that psychological factors often appear as the most important internal factors of people’s willingness to adopt AVs. Additionally, other internal factors such as the socioeconomic profile of individuals and their household, and knowledge and familiarity with AV technologies would affect AV adoption tendencies. User attributes also indirectly affect AV adoption by influencing the psychological factors of users. We identify several critical external factors such as opportunities (e.g., safety and security, low congestion, energy use) and challenges (e.g., system failure, privacy breach, and legal issues), while another influential group includes transportation factors (e.g., travel mode, distance, and time), urban form (e.g., urban/rural, density, land use diversity), affinity to new technology, and the institutional regulatory environment. We discuss some recommendations for policy makers, auto industries, and private stakeholders to formulate policies and strategies to increase market share of AVs. Finally, we identify some limitations of previous studies and provide a blueprint for future research on AV adoption.

The inaugural AIDS Program in Brazil was established in São Paulo in 1983, with the Instituto Adolfo Lutz appointed for laboratory assistance. Subsequently, research on HIV infections and HIV/HTLV (HIV/HTLV-1 and HIV/HTLV-2) co-infections were conducted. This narrative review focuses on studies from the Immunology Department (1983–2017) that significantly influenced AIDS diagnosis or provided epidemiological data such as prevalence rates, sex, age, and risk factors. Ten studies, encompassing over 8,000 individuals, are discussed. During 1983–1985, nearly all AIDS cases were attributed to homosexual/bisexual men aged 31 years old. Subsequently, heterosexual men and women emerged as risk groups owing to intravenous drug use (IDU) and/or unprotected sexual intercourse with AIDS patients or multiple partners per year. From 1985 onwards, vertical transmission led to child infections. HIV/HTLV co-infection rates decreased over time, initially associated with male IDU, and in the 2010s, with females, IDU, and individuals aged &gt;40 years. Trends in HIV and HIV/HTLV co-infections among younger men and women (&lt;30 years of age) were observed from 2015–2017. The changing characteristics and risk groups for HIV and HIV/HTLV co-infections over the years underscore the necessity for ongoing public policies to prevent retrovirus transmission, particularly among adolescents and young adults.

Objective: The primary objective of this study was to develop a logistic regression model to predict post-operative in-hospital mortality rates for patients undergoing emergency cardiac surgeries, with the aim of improving predictive accuracy over traditional risk assessment tools and enhancing patient outcomes and clinical decision-making. Methods: Data were collected from 4,855 patients who underwent emergency cardiac surgeries at a tertiary hospital between 2008 and 2017. The analysis incorporated demographic, anthropomet- ric, and clinical factors, including the ASA classification, emergency status, and various preoperative laboratory values. A logistic regression model was developed, and the Elixhauser Comorbidity Index was calculated using standard ICD-10 codes for its comprehensive assessment of comorbidities. Model performance was evaluated using metrics such as AUROC, AUPRC, accuracy, precision, recall, and F1 score. Results: The logistic regression model demonstrated strong predictive performance, with an AUROC of 0.939 and an AUPRC of 0.350. Key pre-operative factors identified included emergency operation status, ASA classification, and preoperative prothrombin time. The model significantly outperformed the traditional ASA classification system, which showed an AUROC of 0.524 and an AUPRC of 0.010. These findings suggest a substantial improvement in predicting post-operative mortality. Conclusion: The logistic regression model significantly improves the prediction of post-operative mortality in emergency cardiac surgeries compared to the ASA classification system. These findings highlight the potential of incorporating comprehensive pre-operative factors into predictive models to enhance clinical decision-making and patient outcomes. Implementing such models in routine clinical practice could lead to more accurate risk assessments, better resource allocation, and improved patient care.

The conserved cyanobacterial protein PipX is part of a complex interaction network with regulators involved in essential processes that include metabolic homeostasis or ribosome assembly. Because PipX interactions depend on the relative levels of their different partners and of the effector molecules binding to them, in vivo studies are required to understand the physiological significance and contribution of environmental factors to regulation of PipX complexes. Here we have used the NanoBiT complementation system to analyse regulation of complex formation in Synechococcus elongatus between PipX and each of its two best characterized partners, PII and NtcA. Our results confirm previous in vitro analysis on regulation of PipX-PII and PipX-NtcA complexes by 2-oxoglutarate and on regulation of PipX-PII by the ATP/ADP ratio, showing the disruption of PipX-NtcA complexes by increased levels of ADP-bound PII in Synechococcus elongatus. The demonstration of a positive role of PII on PipX-NtcA complexes under the initial response to nitrogen starvation or the impact of a PipX point mutation on the activity of PipX-PII and PipX-NtcA reporters are further indications of the sensitivity of the system. This study reveals additional regulatory complexities in the PipX interaction network, opening the way to future research in cyanobacteria.

Introduction: Neoadjuvant chemotherapy in breast cancer offers the possibility to facilitate breast and axillary surgery, it is a test of chemosensibility in vivo with significant prognostic value and may tailor adjuvant treatment according to response. Material and Methods: a retrospective single institution of 482 stage II and III breast cancer patients treated with neoadjuvant chemotherapy based on anthracycline and taxans plus antiHEr2 in those Her2 positive cases. Survival was calculated at 5 and 10 years. Kaplan Meier with log rank test were calculated for difference according to TNM, pathological and molecular surrogated subtype, TILs cut-off 20%, response to chemotherapy and the presence of vascular invasion. Results: In the univariate those factors that influenced long-term patient outcome were TNM (p=0.000); pathologic subtype (p=0.003); Tils cut off 20%; achieving pCR (p=0.000), RCB (p=0.000) and vascular invasion (p=0.000). After a mean follow up of 126 months, Luminal tumors presented a substantial difference of survival rates calculated at 5 or 10 years (81.2% compared to 74.7%) whereas for TNBC was 75.3 and 73.5, respectively. The greatest difference was seen according to response those patients with pCR presented a 10yDDFS of 95.5 vs 72.4% for those patients without pCR. This difference was especially meaningful in TNBC were 10y DDFS according to the RCB 0 to 3 was 100%, 80.6%, 69% and 49.2% respectively. Patients with a special bad prognosis in our series were lobular carcinomas with 10y DDFS of 42.9% vs 79.7%, p= 0.001 for ductal carcinomas; and those patients with vascular invasion at the surgical specimen with a 10yDDFS of 59.2% vs 83.6, p=0.,000 for those patients without vascular invasion. Conclusion: long-term outcomes after neoadjuvant chemotherapy can help patient and clinician make well-informed decisions.

GeneVac-B® was recently licensed in Burkina Faso and is widely used for population vaccination. This study aimed to evaluate the immune response in people fully vaccinated against hepatitis B with the GeneVac-B® vaccine in Burkina Faso under actual conditions of use. This cross-sectional study included individuals fully vaccinated with GeneVac-B®. For each consenting participant, sociodemographic and clinical data were collected using a structured questionnaire. Approximately 4 mL of whole blood was collected for immunological (anti-HBs, HBsAg, anti-HCV and anti-HIV) and biochemical (blood glucose, total cholesterol, and triglycerides) testing. The anti-HBs titer was used to determine the immune response. A total of 392 participants were included in the study. The mean age was 35.5±15 years. Approximately 56.1% had been previously exposed to HBV. Three hundred eighty (380) participants had an anti-HBs titer ≥ 12 mIU/mL, a seroprotection rate of 96.9%, and 12 had a titer &lt; 12 mIU/mL, a nonresponse rate of 3.1%. Among the nonresponders, 11 (11/12; 91.7%) had high total cholesterol levels (&gt; 240 mg/dL), and 8 (8/12; 66.7%) were older than 40 years of age. The results showed an excellent immune response to GeneVac-B® in our study population. However, age &gt; 40 and high total cholesterol appear to be factors associated with nonresponse.

Transcription factors (TFs) are crucial in modulating gene expression and sculpting cellular and organismal phenotypes. The identification of TF-target gene interactions is pivotal for comprehending molecular pathways and disease etiologies but has been hindered by the demanding nature of traditional experimental approaches. This paper introduces a novel web application, utilizing the R programming language, which predicts TF-target gene relationships and vice versa. Our application integrates the predictive power of various bioinformatic tools, leveraging their combined strengths to provide robust predictions. It merges databases for enhanced precision, incorporates gene expression correlation for accuracy, and employs pan-tissue correlation analysis for context-specific insights. The application also enables the integration of user data with established resources to analyze TF-target gene networks. Despite its current limitation to human data, it provides a platform for exploring gene regulatory mechanisms comprehensively. This integrated, systematic approach offers researchers an invaluable tool for dissecting the complexities of gene regulation, with the potential for future expansions to include a broader range of species.

This review explores the multifaceted role of multimillets in promoting a healthy lifestyle, focusing on their processing challenges, nutritional values, nutraceutical properties, antinutritional factors, and the emergence of biofortified varieties in India. Millets, known for their resilience and adaptability, present both opportunities and challenges in processing, demanding innovative solutions. Their rich nutritional profile, including high fiber, essential minerals, and antioxidants, contributes significantly to a balanced diet. The nutraceutical potential of millets further underscores their therapeutic properties, offering preventive measures against lifestyle-related health issues. However, the presence of antinutritional factors necessitates careful consideration. Biofortified millet varieties in India have emerged as a promising solution to enhance micronutrient content, addressing malnutrition concerns. This review synthesizes current knowledge, providing insights into the diverse aspects of multimillets and their pivotal role in fostering a healthier lifestyle in India.

Helicobacter pylori (H. pylori) is a Gram-negative bacterium that colonizes the gastric mucosa and is associated with various gastrointestinal disorders. H. pylori is a pervasive pathogen, infecting nearly 50% of the world's population, and presents a substantial concern due to its link with gastric cancer, ranking as the third most common cause of global cancer-related mortality. This review article provides an updated and comprehensive overview of the current understanding of H. pylori infection, focusing on its pathogenesis, diagnosis, and treatment strategies. The intricate mechanisms underlying its pathogenesis, including virulence factors and host interactions, are discussed in detail. Diagnostic methods, ranging from traditional techniques to advanced molecular approaches, are explored, highlighting their strengths and limitations. The evolving landscape of treatment strategies, including antibiotic regimens and emerging therapeutic approaches, is thoroughly examined. Through a critical synthesis of recent research findings, this article offers valuable insights into the contemporary knowledge of Helicobacter pylori infection, guiding both clinicians and researchers toward effective management and future directions in combating this global health challenge.

Hepatitis E virus (HEV) is a zoonotic foodborne virus with an annual infection prevalence of 20 million human cases, which seriously affects public health and economic development in both developed and developing countries. To better understand the epidemiology of HEV in the Centre of Portugal, a cross-sectional study was conducted from 2016 to 2023 with sera samples from wild ungulates. The seroprevalence and risk factors for HEV seropositivity were evaluated in the present study. Specifically, antibodies against HEV were determined by a commercial enzyme-linked immune-sorbent assay (ELISA). Our results show that in the 650 sera collected from 298 wild red deer and 352 wild boars from Portugal, 9.1% red deer (95% confidence interval [CI]: 6.312.9%) and 1.7% wild boar (95% CI: 0.63.3%) were positive for antibodies to HEV. Regarding age, the seropositivity in juvenile wild ungulates was 1.3% (95% CI: 0.273.72%) and 7.2% in adults (95% CI: 4.910.11%). Logistic regression models investigated risk factors for seropositivity. The odds of being seropositive was 3.6 higher in adults than in juveniles (95% CI: 1.7218.11%) and the risk was 4.2 higher in red deer than in wild boar (95% CI: 1.64–10.69%). Both wild ungulate species were exposed to HEV. The higher seroprevalence in red deer suggests that this species may have a major contribution to the ecology of HEV in the Centre of Portugal. Further research is important to understand how wildlife affects the epidemiology of HEV infection in Portugal.

African swine fever has damaged the foundation of China’s hog industry, caused a serious decline in hog production, highlighted the contradiction between supply and demand in the pork market, and led to major economic and social impacts. This study measured the industrial resilience of 31 Chinese provinces which faced the African swine fever shock and its spatial and temporal differentiation characteristics from 2018-2021 in terms of the two dimensions of resistance and recoverability. Using Geodetector, the study explored the key factors influencing the resilience of China’s hog industry. The results showed that 2018-2019 and 2020-2021 were the resistance and recovery periods of the hog industry under the African swine fever shock, respectively, with poor resilience characterizing the resistance period and improved resilience exemplifying the recovery period. At the early stage of the African swine fever outbreak, Tianjin, Shanxi, Guangxi and Yunnan had robust resistance in the hog industry, and the slaughter rate, economic level, mortality rate, carcass weight and culling rate showed the highest explanation for the resistance. At the most severe stage of the outbreak, the resistance of the hog industry in all provinces was generally poor, and the slaughter rate, per capita consumption and scale level showed the highest explanation for the resistance. In the period of rapid recovery of hog production, the recoverability of each province was very strong, and the industrial structure, culling rate, economic level and resource carrying capacity showed the highest explanation for the recoverability. In the reasonable adjustment period of hog production capacity, the recoverability based on the breeding sow inventory in 13 provinces, including Henan, Shandong and other large hog breeding provinces, was negative, and the scale level, slaughter rate, per capita consumption and resource carrying showed the highest explanation for the recoverability. It is recommended to take measures to enhance the resilience of the hog industry, strengthen the prevention and control of hog epidemics, improve the monitoring and early warning mechanism, and strive to enhance the ability of the hog industry to cope with major animal epidemics.

The response of boreal vegetation to global warming has shown a weakening trend over the last three decades. However, in previous studies, models of vegetation activity responses to temperature change have often only considered changes in mean daily temperature (Tmean), with the diurnal temperature range (DTR) being neglected. The goal of this study is to evaluate the temporal trends of the relationships between two temperature factors (Tmean and DTR) and vegetation activity across the boreal regions on both annual and seasonal timescales, by simultaneously employing satellite and climate datasets. We found that the interannual partial correlation between growing season (GS) NDVI and Tmean (RNDVI−Tmean) showed a significant decreasing trend over the last 34 years. At the seasonal scale, RNDVI−Tmean shows a significant upward trend in the spring, while in the summer and autumn, RNDVI−Tmean exhibits a significant downward trend. The temporal trend characteristics of the partial correlation between NDVI and DTR (RNDVI−DTR), at both the GS and seasonal scales, are fully consistent with RNDVI−Tmean. The area with a significant decrease in GS RNDVI−Tmean and RNDVI−DTR accounted for approximately 44.40% and 41.21% of the boreal region with the 17-year moving window, respectively. In stark contrast, the area exhibiting a significant increasing trend in GS RNDVI−Tmean and RNDVI−DTR accounted for only approximately 14.65% and 13.59% of the boreal region with the 17-year moving window, respectively. With respect to the seasonal patterns of RNDVI−Tmean and RNDVI−DTR, the area with a significant upward trend in spring was greater than that with a significant downward trend. Nevertheless, more areas had a significant downward trend of RNDVI−Tmean and RNDVI−DTR in summer and autumn than had a significant upward trend. Overall, our research reveals a weakening trend in the impact of temperature on vegetation activity in the boreal regions, and contributes to a deeper understanding of the vegetation response to global warming.

(1) Background: This paper investigates the epidemiological risk related to temperature before and during COVID-19 in Italy; (2) Methods: Deaths in 2015-2019 and temperatures were correlated. Excess and COVID-19 deaths were examined to estimate the relationships with temperatures; (3) Results: Annual deaths were higher during the cold months (+45,000, SD = 4,700, S = 21). The scenario worsened during COVID-19. Mortality was higher during minimum temperature periods, although the curve moderately rose in the warmest months (r = -0.75, 95% CI = [-0.87; -0.56], S = 23). COVID-19 deaths showed a decreasing seasonality. Monthly excess deaths during COVID-19 were high (+4,200, IQR = [2,800; 8,000], S = 28) with a doubt of seasonality. COVID-19 mortality was correlated with regional latitude (r = 0.86, 95% CI = [0.68; 0.94], S = 20). Discrepancies between COVID-19 and excess deaths were found. The exposed population was subject to aging; (4) Conclusions: The epidemiological risk in Italy is seasonal and geographically dependent. Low and very high temperatures can lead to mortality peaks. Therefore, COVID-19 and any other epidemiological risk must be evaluated in light of this evidence. Health systems need to be strengthened during cold and extremely hot periods. Future research should investigate these phenomena at the causal level.

During the progression from ductal carcinoma in situ (DCIS) to invasive breast cancer (IBC), cells have to overcome the physically restraining basement membrane (BM) which compartmentalizes the epithelium from the stroma. Since the extracellular matrix (ECM) of the epithelial and stromal compartment is biochemically and physically distinct from one another, the progression demands a certain degree of cellular plasticity being essentially required for a primary tumor to become invasive. The Epithelial-to-Mesenchymal Transition depicts such a cell program equipping cancer cells with features allowing for dissemination from the epithelial entity and stromal invasion on the single-cell level. Here, we investigated the reciprocal interference between an altering tumor microenvironment and the EMT-phenotype in vitro. BM-typical collagen IV and stroma-typical collagen I coatings were applied as provisional 2-D matrices. Pro-inflammatory growth factors were introduced to improve tissue mimicry. Whereas the growth on coated surfaces did only slightly affect the EMT-phenotype, the combinatorial action of collagen with growth factor TGF-β1 induced prominent phenotypic changes. However, the EMT-induction was independent of the collagen type and cellular accessibility for EMT-like changes was strongly cell line dependent. Summarizing the entire body of data, we computed an EMT-phenotyping model that was used to decide on cellular EMT-status and estimate EMT-like changes. We confirmed that miR200c-mediated reversion of mesenchymal MDA-MB-231 cells is reflected by our EMT-phenotype model emphasizing its potential to predict the therapeutic efficacy of EMT-targeting drugs in the future.

Based on its large surface area and covering the whole human body, the skin body’s largest organ and its main function is protection. Injuries and wound healing involving the skin offer valuable lessons shared with and of relevance to other organ systems and the diseases that impact them. Arguably the most complex human body process, wound healing is a multifaceted process that involves multiple cells and the extracellular matrix (ECM), with each component playing a specific role in the different stages of the healing process. Importantly, studies indicate that cells with stem cell-like properties are present within many of the human tissues and play key roles in case of tissue and cellular injury. Cell-to-cell and cell-to-ECM interactions are salient in wound healing subsequent to an injury. Microenvironment related factors and the variations therein including hypoxia or the abundance of oxygen, the presence/absence of growth factors and cytokines add to the complexity of the wound healing process and impact cell function and result in compromised or enhanced wound healing. This expert review critically examines the advances in biochemical and analytical tools that are enable the analysis of numerous cells and molecules within the wound microenvironment, revealing great cellular heterogeneity as well as novel molecular targets of importance to enhance wound healing. In a broader angle, we emphasize the ways in which wound healing is significant in the search for perfect skin after injury and in many common complex human diseases including cancer. In all, wound healing is a centrepiece of integrative biology research and applications in medicine as well as dermatology as discussed in this review.

Several recent epidemiological studies attempted to identify risk factors for Alzheimer's disease. Age, family history, genetic factors (APOE genotype, Down syndrome), physical activity, and a low level of schooling are significant risk factors. In this review, we summarize the known psychosocial risk factors for the development of Alzheimer's disease in Down syndrome patients and their association with neuroanatomical changes in the brains of people with Down syndrome. We completed a comprehensive review of the literature on PubMed, Google Scholar, and Web of Science about psychosocial risk factors for Alzheimer's disease, for Alzheimer's disease in Down syndrome, and Alzheimer's disease in Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. Alzheimer's disease causes early pathological changes in Down syndrome patients, especially in the hippocampus and corpus callosum. The field needs more data about the neuroanatomical changes during childhood, how they change with increasing age, and the presence or absence of psychosocial risk factors. Further neuroimaging and psychosocial assessment-focused research is needed to understand the mechanisms leading to Alzheimer's disease at an early age and create more sensitive and relevant clinical, memory, and reasoning assessments for people with Down syndrome.

Background: In Arizona Helicobacter pylori prevalence of infection among Navajo adults is about 62% and gastric cancer incidence rate is 3-4 times higher than that of the non-Hispanic White population. Aim: The aim of this study was to estimate the prevalence of specific H. pylori virulence factors (cagA and vacA) among Navajo patients undergoing and their association with gastric disease. Methods: Virulence genes, cagA and vacA, in H. pylori were investigated in gastric biopsies from 96 Navajo patients over age 18 who were undergoing esophagogastroduodenoscopy. Biopsies from the antrum and fundus were used for molecular characterization to determine cagA type and number of EPIYA motifs and presence of alleles in the signal (s) and medium (m) regions of the vacA gene. Results: H. pylori infection was found in 22.9% of the biopsy samples. The cagA gene amplified in 57.6% of samples and showed a predominant “Western cagA” type, with the EPIYA-ABC motif (45.4%), most prevalent. The vacA allele s1bm1 was the most prevalent (54.5%). Conclusions: H. pylori genotypes were predominantly cagA Western-type and ABC EPIYA motifs. The vacA s1bm1 genotype was the most prevalent and seemed to be associated with gastritis. American Indian/Alaska Native populations are at higher risk for gastric cancer. It is important to identify genotypes of H. pylori and virulence factors involved in the high prevalence of H. pylori and associated disease among the Navajo population.

Diabetes and chronic kidney disease (CKD) are a major public health burden in low-and-middle-income countries. This study aimed to explore factors associated with CKD in patients with type 2 diabetes (T2D) in Bangladesh. A cross-sectional study was conducted among 315 adults with T2D presenting at the outpatient department of Bangladesh Institute of Health Sciences (BIHS) hospital between July 2013 to December 2013. CKD was diagnosed based on estimated Glomerular Filtration Rate using the ‘Modification of Diet in Renal Disease’ equations and presence of albuminuria estimated by the albumin-to-creatinine ratio. Multivariate logistic regression analysis was used to determine the factors associated with CKD. The overall prevalence of CKD among patients with T2D was 21.3%. In the unadjusted model Factors associated with CKD were: aged 40-49 years (OR: 5.7, 95% CI: 1.3-25.4), age 50-59 years (7.0, 1.6-39), age ≥60 years (7.6, 1.7-34); being female (2.2, 1.2-3.8), hypertensive (1.9, 1.1-3.5) and household income between 128.2-256.4 US$ (2.9, 1.0-8.2) compared with income ≤128.2$. However, after adjustment of other covariates, only duration of hypertension and household income (128.2-256.4 US$) remained statistically significant. There is a need to implement policies and programs for early detection and management of hypertension and CKD in T2D patients in Bangladesh.

Background: Colorectal cancer (CRC) is one of the most prevalent diseases and the second leading cause of death worldwide. However, the relationship between CRC and cerebrovascular-specific mortality (CVSM) remains elusive and less is known about the influencing factors associated with CVSM in CRC. Here, we aimed to analyze the incidence as well as the risk factors of CVSM in CRC. Methods: Patients with a primary CRC diagnosed between 1973 and 2015 were identified from Surveillance Epidemiology and End Results database with follow-up data available until 31 December 2016. Conditional standardized mortality ratios were calculated to compare the incidence of CVSM between CRC patients and the general US population. Univariate and multivariate survival analyses with a competing risk model were used to interrogate the risk factors for CVSM. Results: A total of 563298 CRC individuals were included. The CVSM in CRC patients was significantly higher than the general population in all age subgroups. Among competing causes of death in patients, the cumulative mortality caused by cerebrovascular-specific diseases steadily increased during study period. While age and surgery positively influenced CVSM on both univariate and multivariate analyses, male patients and those who had radiotherapy, chemotherapy, more recent year (2001-2015) of diagnosis as well as multiple primary or distant tumors experienced a lower risk of CVSM. Interpretation: Our data suggest a potential role for CRC in the incidence of CVSM and also identify several significant predictors of CVSM, which may be helpful for risk stratification and therapeutic optimization of cerebrovascular-specific diseases in CRC patients.

This study examined the tail dependency structure of sovereign credit risk and three global risk factors in BRICS countries using copulas approach, which is known for its ability to provide the “true” tail correlation based on the correct marginal distribution. The empirical results show that global market risk sentiment comoves with sovereign CDS spreads across BRICS countries under extreme market events, with Brazil having the highest co-dependency followed by China, Russia, and South Africa. Furthermore, oil price volatility is the second biggest risk factor correlated with sovereign CDS spreads for Brazil and South Africa while exchange rate risk exhibits very small co-dependence with sovereign CDS spreads under extreme market conditions dominated by tail events. On the contrary, exchange rate risk is the second largest risk factor co-moving with China and Russia’s sovereign CDS spreads while oil price volatility exhibits the lowest co-dependence to CDS in these countries. Between oil price and currency risk, evidence of single risk factor dominance is found for Russia where exchange rate risk is largely dominant. These results suggest that BRICS policymakers might consider financial sector regulations that mitigate risks spill-over such as targeted capital controls when markets are distressed.

The Simplified Spherical Harmonic (SPN) approximation was first introduced as a three-dimensional (3-D) extension of the plane-geometry Spherical Harmonic (PN) equations. A third order SPN (SP3) solver, recently implemented in the Nodal Expansion Method (NEM), has shown promising performance in the reactor core neutronics simulations. This work is focused on the development and implementation of the transport corrected interface and boundary conditions in NEM SP3 solver, following recent published work on the rigorous SPN theory for piecewise homogeneous regions. A streamlined procedure has been developed to generate the flux zero and second order/moment discontinuity factors (DFs) of the generalized equivalence theory to eliminate the error introduced by pin-wise homogenization. Moreover, several color set models with varying size and configuration are later explored for their capability of generating DFs that can produce results equivalent to that using the whole-core homogenization model for more practical implementations. The new developments are tested and demonstrated on the C5G7 benchmark. The results show that the transport corrected SP3 solver shows general improvements to power distribution prediction compared to the basic SP3 solver with no DFs or only zero order/moment DFs. The complete equivalent calculations using the DFs can almost reproduce transport solutions with high accuracy. The use of equivalent parameters from larger size color set models show better prediction in the whole-core calculations. By coupling different color set models DFs can offer the best accuracy at both eigenvalues and power distributions.

Background/Purpose: Over the last two decades, malaria has remained a major worldwide public health concern, especially in the developing countries leading to high morbidity and mortality among children. Nigeria is the world most burdened malaria endemic nation, contributing more than a quarter of global malaria cases. This study determined the prevalence of malaria among children 6-59 months in Nigeria, and the effects of individual and contextual factors. Methods: The study utilized data from 2018 Nigeria Demographic and Health Survey (NDHS) involving a weighted sample size of 10,185 children who were tested for malaria using rapid diagnostic test (RDT). Given the hierarchical structure of the data set, such that children at level-1 are nested in community at level-2, and nested in states and Federal Capital Territory (FCT) at level-3, multilevel mixed effect logistic regression models were used for the analysis. Results: The proportion of children 6-59 months of age in Nigeria that had malaria fever positive as assessed by RDTs was 35.5% (3,418/10185), (CI: 33.9-37.1). Kebbi State had the highest proportion of children 6-59 months who were malaria positive, 77.6%, (CI: 70.2-83.5), followed by Katsina State, 55.5%, (CI: 47.7-63.1). The Federal Capital Territory (FCT), Abuja had the proportion of 29.6%, (CI: 21.6-39.0), malaria positive children of 6-59 months of age. Children between the age of 48 and 59 months were 2.68 times more likely to have malaria fever than children 6-11 months of age (AOR=2.68, 95% CI: 2.03-3.54). Also, children from the rural area (AOR= 2.12, 95% CI: 1.75-2.57), were more likely to suffer from malaria infection compare with children from urban area. Conclusion: The study identified some individual and contextual predictors of malaria among children in Nigeria. These factors are areas that need to be considered for policy designs and implementations toward control and total elimination of malaria-related morbidity and mortality among children in Nigeria.

Type-2 diabetes mellitus (T2DM) have been strongly associated with single nucleotide polymorphisms (SNPs) in the TCF7L2 gene. This study investigated the association between rs12255372, rs7903146 and T2DM in a Ghanaian population. A case-control study design was used for this study. A total of 106 T2DM patients and 110 control participants were selected. Basic data collected included body mass index, blood pressure and socio-demographics. Fasting blood samples were collected and used for serum lipid analysis, HbA1c, plasma glucose estimation and DNA extraction. Common and allele-specific primers were designed for genotyping using the Modified Tetra-Primer Amplification assay. Associations were evaluated using logistic regression models. The rs7903146 risk variant was significantly associated with 2.16 vs 4.06 increased odds for T2DM in patients <60 years vs ≥60 years. Both rs7903146 and rs12255372 are significantly associated with increased odds of T2DM in women, overweight/obese; T2DM negative family history (T2DM-NFH) and low-HDL-C. In a multivariate model, rs7903146 but not rs12255372 was significantly associated with 2.18, 5.01 and 2.25 increased odds of T2DM, under the codominant, recessive and additive model, respectively (p<0.05). The association between rs7903146 and rs12255372 with T2DM is more highly associated in a subgroup- women and those with T2DM-NFH, yet have cardiometabolic risk.

Risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not well-defined in resident physicians and fellows (trainees). We aimed to identify sociodemographic, occupational and community factors associated with SARS-CoV-2 infection among trainees during the first wave of the coronavirus disease 2019 (COVID-19) pandemic in New York City (NYC). In this retrospective cohort study, we administered an electronic survey between June 26 and August 31, 2020 to trainees at the Mount Sinai Health System in NYC to assess risk factors for SARS-CoV-2 infection between February 1 and June 30, 2020. We used Bayesian generalized linear mixed effect regression and structural equation models to examine associations. SAR-CoV-2 infection was determined by self-reported IgG antibody and reverse transcriptase-polymerase chain reaction results and confirmed with laboratory results. Among 2354 trainees invited to participate, 328 (14%) completed the survey and reported test results. The cumulative incidence of SARS-CoV-2 infection was 20.1%. Assignment to medical-surgical units (odds ratio [OR], 2.51; 95% CI, 1.18-5.34), and training in emergency medicine, critical care and anesthesiology (OR, 2.93; 95% CI, 1.24-6.92) were independently associated with infection. Deployment to care for unfamiliar patient populations was protective against infection (OR, 0.16; 95% CI, 0.03-0.73). Community factors were not significantly associated with infection after adjustment for occupational factors. Our findings may inform tailored infection prevention strategies for trainees responding to the COVID-19 pandemic.

The present study is aimed to determine the predicting role of objective (lifestyle) and subjective factors of middle-aged women’s psycho-emotional health such as their attitude towards parents, attachment and separation types. Women who are overloaded with professional and family roles have high stress level, their indicators of psychological well-being and emotional level decrease when they have to give everyday care to their elderly parents. (2) Methods: Sample consists of 146 women aged 38 to 56 ( =41.1, ó=3.5), married (70.5%) and divorced (29.5%), having children of 14-28 years old; giving everyday care to elderly parents for more than 1.5 yrs. Some live separately (62.3 %), or have to cohabitate with parents (37.7%). All women evaluate their life situation as difficult and manifest signs of high psycho-emotional stress. We used methods adapted for the Russian-speaking sample: getting socio-demographic information, an interview; Attachment style and Interpersonal Guilt Questionnaires (study 1); Psychological Separation Inventory, Purpose-in-Life Test, projective methods of incomplete sentences and metaphors` analysis (study 2), mathematical statistics. (3) Results: A number of factors and indicators of women`s psycho-emotional health decrease in the situation of role overload have been identified. Among the factors there are four main types of women’s attitudes towards parents: strong (anxious), distancing, ambivalent, normative closeness, predicting low indicators of psycho-emotional health: dependence on the others` opinions and feedbacks in making decisions, a lack of meaningfulness of life; reduced sense of control over life are showing the decrease. Anxiety about future and neurotic symptoms (increased demands on oneself, irritability, reduced emotional background) distinguish these respondents. (4) Conclusions: The study confirms that middle-aged Russian women`s psycho-emotional health depends on contextual factors (difficult role-overloaded lifestyle) and factors integrating women`s attitudes towards parents, attachment and separation types. Among the most important risk factors there are a difficult life situation, conflict separation type and gilt.

The three-dimensional printing of scaffolds is an interesting alternative to the traditional techniques of periodontal regeneration. This technique uses computer assisted design and manufacturing after CT scan. After 3D modelling, individualized scaffolds are printed by extrusion, selective laser sintering, stereolithography, or powder bed inkjet printing. These scaffolds can be made of one or several materials such as natural polymers, synthetic polymers, or bioceramics. They can be monophasic or multiphasic and tend to recreate the architectural structure of the periodontal tissue. In order to enhance the bioactivity and have a higher regeneration, the scaffolds can be embedded with stem cells and/or growth factors. This new technique could enhance a complete periodontal regeneration. This review summarizes the application of 3D printed scaffolds in periodontal regeneration. The process, the materials and designs, the key advantages and prospects of 3D bioprinting are highlighted, providing new ideas for tissue regeneration.

Low levels of physical activity (PA) and sedentarism are associated with the onset of different pathologies and health problems. Regular physical activity has been linked with being beneficial to the health of the general population. Within this framework of analysis, the aim of the present study is to analyse the existing association between the time spent doing physical activity and the expressed motives for doing so, from which the first innovative aspect of the paper emerges: the use of the time spent doing PA as a study variable of the phenomenon. The data analysed come from the latest special Eurobarometer survey about the sport and physical activity done in Europe. Using an exploratory factorial analysis and a structural equations model, we were able to find a six-dimensional factorial model that explains the reasons for doing PA, demonstrating that there is no relationship between the reasons for and time spent doing PA. Therefore, motivation is not a variable that explains the time spent doing PA and another type of variable must be used to explain the phenomenon if PA is to be incentivised.

Nigeria is the most populous country in the African continent. The aim of this study was to analyze risk factors for COVID-19 prevalence and deaths in all 6 geopolitical regions and 37 states in Nigeria. We analyzed the data retrieved from various sources, including Nigeria CDC, Nigeria National Bureau of Statistics, Unicef-Nigeria multiple indicator cluster survey and the Institute of Health Metrics and Evaluation, University of Washington. We examined 4 clinical risk factors (prevalence of TB, HIV, smoking and BCG vaccination coverage) and 5 sociodemographic factors (age ≥65, population density, literacy rate, unemployment and GDP per capita). Multivariate modeling was conducted using generalized linear model. Our analysis showed that the incidence of confirmed COVID-19 cases differed widely across the 37 states, from 0.09 per 100,000 in Kogi to 83.7 in Lagos. However, more than 70% of confirmed cases were concentrated in just 7 states: Lagos, Abuja, Oyo, Kano, Edo, Rivers and Delta. Case mortality rate (CMR) per million population also varied considerably, with Lagos, Abuja and Edo having CMR above 9. On bivariate analysis, higher CMR correlated positively with GDP and to a lesser extent with TB and population density. On multivariate analysis, which is more definitive, states with higher HIV prevalence and BCG coverage had lower CMR, while high GDP states had a greater CMR. This study indicates that COVID-19 has disproportionately affected certain states in Nigeria. Population susceptibility factors include higher economic development but not literacy or unemployment. Death rates were mildly lower in states with higher HIV prevalence and BCG vaccination coverage.

Many studies were done in the development of drought stress-tolerant transgenic plants, including crop plants. Rice is considered to be a vital crop target for improving drought stress tolerance. Much transgenic rice showed improved drought stress tolerance was reported to date. They are genetically engineered plants that are developed by using genes that encode proteins involved in drought stress regulatory networks. These proteins include protein kinases, transcription factors, enzymes related to osmoprotectant or plant hormone synthesis, receptor-like kinase. Of the drought stress-tolerant transgenic rice plants described in this review, most of them display retarded plant growth. In crop crops, plant health is a fundamental agronomic trait that can directly affect yield. By understanding the regulatory mechanisms of retarded plant growth under drought stress, conditions are necessary precursors to developing genetically modified plants that result in high yields.

Tight regulation of gene transcription is essential for normal development, tissue homeostasis and disease-free survival. Enhancers are distal regulatory elements in the genome that provide specificity to gene expression programs and are frequently misregulated in cancer. Recent studies examined various enhancer-driven malignant dependencies and identified different approaches to specifically target these programs. In this review, we describe numerous features that make enhancers good transcriptional targets in cancer therapy and discuss different approaches to overcome enhancer perturbation. Interestingly, a number of approved therapeutic agents such as cyclosporine, steroid hormones, and thiazolidinediones actually function by affecting enhancer landscapes by directly targeting very specific transcription factor programs. More recently, a broader approach to targeting deregulated enhancer programs has been achieved via Bromodomain and Extraterminal (BET) inhibition or perturbation of transcription-related cyclin-dependent kinases (CDK). One challenge to enhancer-targeted therapy is proper patient stratification. We suggest that monitoring of enhancer RNA (eRNA) expression may serve as a unique biomarker of enhancer activity that can help to predict and monitor responsiveness to enhancer-targeted therapies. A more thorough investigation of cancer-specific enhancers and the underlying mechanisms of deregulation will pave the road for an effective utilization of enhancer modulators in a precision oncology approach to cancer treatment.

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-age women. Women with PCOS are at higher risk of pregnancy complications including gestational diabetes (GDM). The prevalence of PCOS and GDM varies according to the diagnostic criteria used. The mechanism for the occurrence of GDM in women with PCOS is still unclear. Materials &amp; Methods- A systematic search of the electronic database was done using keywords like PCOS, and GDM to include studies between April 2008 and March 2023 where uniform diagnostic criteria were used. Studies were excluded with high-risk of bias after the assessment of bias, and meta-analysis was done with relative risks and confidence intervals. Results &amp; Discussion-Out of 1896 search results, 95 were selected for full-text. The quality of the studies was scrutinized and a total of 28 studies were included as they fulfilled the inclusion criteria. The incidence of GDM in women with PCOS was found to be 10.55 % (2.9- 54.9%) from pooled data involving 1,280,245. The prevalence of PCOS in women diagnosed with GDM was found from pooled data of 36,351 women in retrospective studies to be 2.47% (1.5- 50.1%). Selection predominantly included cohort studies, most commonly from China. The meta-analysis reported the risk of GDM is higher in women with PCOS than in those without PCOS (HR: 1.59, 95% CI: 1.27–1.91, p &lt; 0.001). Family history of diabetes, ethnicity, pre-pregnancy BMI, insulin resistance, gestational weight gain, use of assisted reproductive techniques, and multifetal gestation were the risk factors for GDM in women with PCOS. Conclusion- The prevalence of GDM in patients with PCOS is high, but the causality is complex. The newer predictive models are promising in clarifying the causative relationships, yet use various parameters at different cut-offs. There is a need for the development of universally acceptable parameters for the early prediction of GDM in women with PCOS.