Introduction: Uganda has got the highest prevalence rate of malaria among the risk groups compared to other parts of the world. In addition, Uganda bears a particularly large burden from the disease which is limited by a lack of reliable data, but it is clear that the prevalence of malaria infection, incidence of disease, and mortality among pregnant women all remain very high. According to the Iganga DHIS2 Jan-May report, a higher number of pregnant women received Intermittent Preventive Treatment one (IPT1) and the numbers dropped for IPT2 and IPT3. The district is also referral point of the greater Busoga region and has got several challenges towards malaria control. The study aimed at assessing the uptake of Intermittent Preventive Treatment and the prevalence of malaria among pregnant women in Iganga district so as to generate evidence for scaling up appropriate interventions for IPT uptake among pregnant women. Methods: The research was a retrospective study using secondary data to assess the uptake of IPT and prevalence of malaria for financial year 2019/2020 in nine Public Health Centre IIIs and one Public Health Centre IV. In this study IPT was defined as the administration of a curative dose of an effective antimalarial drug to all pregnant women without testing for presence of malaria parasite and at least three doses as recommended. Secondary data from HMIS was obtained and analyzed to assess the uptake of IPT services and the prevalence of malaria among pregnant women was determined using proportions. Results: The study found that of 6,672 women who received the first dose of IPT-SP, 1671 (25%) of the women received less than 2 doses of IPT and 46% of pregnant women received more than 2 doses of IPT. The study showed that a total of 3,435 pregnant women tested positive for malaria which brings the prevalence to 50%, and being highest among pregnant women aged 20-24 years at 50%. Conclusions: The study showed that the uptake of IPT was relatively low among lower age groups with a relatively high prevalence of malaria among the same age group. This calls for all stakeholders (DHO, MOH, Iganga District, NGOs e.t.c) urgent attention thus to ensure mass sensitization about malaria and IPT importance with IEC and ITN distribution, early diagnosis and treatment, giving incentives to ANC attending mothers, control of the vector.

Abstract: The aim of this study was to evaluate the effects of solids accumulation on greenhouse gas (GHG) emissions, substrate, plant growth and performance of a horizontal flow (HF) treatment wetland (TW) planted with Phragmites australis (Cav.) Trin. ex Steud. sub sp. australis. The study was carried out in an eight-year-old full-scale HF-TW located in the Mediterranean region (Sicily, Italy). To collect data inside the HF unit, nine observation points (besides the inlet and the outlet) along three 8.5 m long transects (T1, T2, and T3) were identified. The first transect (close to the inlet zone) showed hydraulic conductivity (Ks) reduction of about one order of magnitude higher than the other two. Results highlighted GHG emissions increasing during the summer when temperature and solar radiation were higher than in the rest of the year. Carbon dioxide (CO2) emis-sions decreased from T1 to T3, with maximum monthly values in T1 (21.4 g CO2 m-2 d-1) about double with respect to T2 (12.6 g CO2 m-2 d-1) and T3 (10.7 g CO2 m-2 d-1) observed in July. The CO2 seasonal trend was similar to that of P. Australis growth. Theoretical me-thane (CH4) emissions followed the trend of volatile solids (VS), which was about 3.5 and 4 times in T1 to T2 and T3. The highest CH4 emissions in T1 were probably due to anaerobic bacteria (methanogens) that proliferated in the waterlogged, anoxic part of TW. The pore-clogging affected the chemical oxygen demand (COD) removal efficiency which de-creasing from T1 to T3 for the observation period. Notwithstanding this behaviour, the final effluent quality was very satisfactory with the average value of COD removal efficiency above 90%.

Management of synchronous colorectal cancer with liver metastases (SCLM) is still on debate, regarding timing, indications and complications of the 3 strategies: classic approach (first tumor resection), simultaneous resection and reverse approach (liver first). A retrospective single-centre evaluation of synchronous approach was accomplished, focusing on surgical technique, indications and perioperative complications. Between 2017 and 2020, 31 SCLM patients benefited from synchronously colorectal and hepatic approach: segmental colectomies/rectal resections, simultaneously with liver metastasectomies (associated with radiofrequency ablation). Post-therapeutic imaging monitoring was performed from every 3 to 6 months. There were no perioperative complications related to the combination of the two procedures, low morbidity and zero postoperative mortality. The follow-up period was from 10 to 40 months: 13 patients had no evidence of recurrence, 10 patients had hepatic metastases in regression, 4 of them had signs of peritoneal carcinomatosis and 4 patients showed progression of liver disease; all patients were on chemotherapy. During follow-up 4 patients died. Experience shows that the simultaneous approach of recto-colic and hepatic resections in colo-rectal cancers is a safe procedure, with low morbidity, the limits being dictated by the size of the liver metastases. The results at long-distance must be drawn by further consistent trials.

Rheumatoid arthritis (RA) is a chronic, systemic, abnormal inflammatory immune response. It is characterized by the involvement of the synovium and multiple organs and the destruction of joints and articular cartilage. Over the past 30 years, several promising novel compounds and antibodies have been developed for the treatment of RA. The introduction of new drugs and precision medicine for all forms of RA raises several issues related to access to novel treatments by patients, optimal regimen selection, cost-effectiveness, prognosis monitoring and outcome surveillance, particularly with regarding to the development of low drug response rates, drug resistance and adverse side effects. Tremendous attention has been given to the identification of optimized drug combinations for the treatment of RA, particularly in early high-risk vulnerable and early individuals. Addressing these issues requires novel therapeutic approaches with new mechanisms and the establishment of accurate guidelines for drug selection, drug recombination, and non-chemical therapeutic efforts. In this study, we reviewed the most exciting recently established or ongoing novel drugs and methods according to the clinical trial database maintained by the United States National Library of Medicine and discussed the trends in RA drug development and challenges in the treatment, providing a reference significant for the accurate treatment of RA and the research direction in the future.

Influence of the volute design parameters on the stable operating range and the performance of a centrifugal compressor was investigated experimentally for the following design conditions. The volute casing surface roughness was changed from 0 to 200 µm in five steps and tested. The axial distance between the casing and the diffuser cascades (clearance) was varied in five steps as C/b₂ = 1.2, 2.4%, 3.6%, 4.8%, and 6% relative to the impeller exit width. The radial distance from the impeller blade exit to the diffuser vane inlet in (vaneless space radius) in six steps as C/r₂ = 1.03, 1.05, 1.07, 1.09, 1.11, and 1. 13 relatives to the rotor outlet radius. The volute outlet geometry of a symmetric and tangent with different area ratios from 0.4 to 0.9. Finally, the compressor has been tested experimentally with different pinched vaned diffuser distances relative to the impeller exit width of bp/b2 =1, 0.98, 0.96, 0.94, 0.92, and 0.9. These testes were carried at different compressor operating conditions, and the time variations of the static pressure were recorded using five high-frequency response pressure transducers. A hot-wire anemometer is used to measure the compressor flow rate. The rotating stall and surge at the vaneless zone after the impeller exit can be detected by analyzing the fluctuations of pressure signals and the power spectrum density by using the Fast Fourier Transformation analysis. The experimental results indicated that the compressor with volute casing surface roughness of 100mm gives about 10.9% enhancements in the stable operating and 1% in pressure rise coefficient. The best axial distance between the diffuser vanes and the casing is 2.4% of the impeller blade height and the compressor in this design gives about 12.4% improvements in the stable working range. The compressor with radial vaneless distance of 1.056 gives improvements of about 16.6% in the surge margin, 2% in the pressure recovery and 4% in pressure rise coefficients. The compressor with a pinched diffuser of b/bp of 0.98 gives an improvement of 20.8% in surge point.

The opioid epidemic is an ongoing public health crisis, and the United States health system is overwhelmed with increasing numbers of opioid-related overdoses. Methocinnamox (MCAM) is a novel mu-opioid receptor antagonist with an extended duration of action and potential to reduce the burden of the opioid epidemic through overdose rescue and could treat opioid use disorder (OUD) long-term. We compared the efficacy and effects of MCAM to the current treatments available to treat OUD including naloxone, naltrexone, methadone, and buprenorphine which have their own limitations including short duration of action, patient non-compliance, and diversion. A literature review was conducted using PubMed and Google Scholar databases covering the history of the opioid epidemic, pain receptors, current OUD treatments and the novel drug MCAM. MCAM could potentially be used as both a rescue and long-term treatment for opioid misuse. This is due to its pseudo-irreversible antagonism of the mu opioid receptor, abnormally long duration of action of nearly two weeks, and the possibility of using kappa or delta opioid receptor agonists for pain management during OUD treatment. MCAM’s novel pharmacokinetic and pharmacodynamic properties open a new avenue for treating the opioid crisis.

Bare titania and metal promoted TiO2 catalysts were employed in the treatment of nitrates, which are ubiquitous pollutants of wastewater. The results show that the process can be carried out under visible light (from white light LED lamp) and, in the best case, 23.5% conversion of nitrate was obtained over 4 hours with full selectivity towards N2 by employing 0.1 mol% Ag/TiO2 prepared by flame spray pyrolysis. Moreover, the performance was worse when testing the same catalysts with tap water (11.3% conversion), due to the more complex composition of the matrix. At last, it was found that the photoreduction of nitrate can be effectively performed in combina-tion with the photo-oxidation of ammonium without loss in the activity, opening to the possi-bility to treat highly polluted wastewater with a single process. The latter treatment employs the two contaminants simultaneously as electron and holes scavengers, with very good selectiv-ity, in a completely new process that we may call Photo-Selective Catalytic Reduction (Pho-to-SCR).

Since the first generation of 7xxx superhard aluminum alloy was investigated in 1930, hitherto the fifth generation aluminum alloy materials with high comprehensive properties such as high static strength, high strength, heat resistance, high toughness, damage resistance, low density and low quenching sensitivity have been improved and developed. This paper reviews the progress of 7xxx aluminum alloy materials in composition, microstructure, properties, preparation methods, heat treatment strengthening and applications from 2014 to 2021. The effect of adding trace elements on microstructure and properties of 7xxx series alloy and the problems existing in aging precipitation characteristics and reinforcement mechanism are discussed. The future development direction of 7xxx superhard aluminum alloy is prospected by optimizing heat treatment technological, adding appropriate trace elements to alloy and controlling alloy microstructure.

Multi-modal Motion-assisted Memory Desensitization and Reprocessing Therapy (3MDR), an interactive, virtual-reality assisted, exposure-based intervention for PTSD, has shown promising results for treatment-resistant Posttraumatic Stress Disorder (TR-PTSD) among military members (MMs) and Veterans in Randomized Controlled Trials. Previous research has suggested that emotional regulation (ER) and emotional dysregulation (ED) may be factors which are correlated with symptom severity and maintenance of TR-PTSD. This embedded mixed-methods pilot study (n=9) sought to explore the impact of 3MDR on ER and ED of MMs and Veterans. Difficulties in Emotional Regulation Scale (DERS-18) data was collected at baseline, prior to each session, and at 1 week, 1 month and 3 months post-intervention and analyzed using a Wilcoxon signed-ranks test. Qualitative data collected from sessions, debriefs, and follow-up interviews were transcribed and descriptively analyzed. Results demonstrated statistically significant decreases in DERS-18 scores from pre-intervention to post-intervention at each timepoint. Qualitatively, participants perceived improvements in ER within specified DERS-18 domains. We describe how 3MDR’s unique and novel approach may address ED through cognitive-motor stimulation, narration, divergent thinking, reappraisal of aversive stimuli, dual-task processing, and reconsolidation of traumatic memories. Further investigation is underway to better understand the underlying neurobiological mechanisms by which 3MDR addresses ER and PTSD.

Human displacement is on the rise globally, and the increase in the burden of tuberculosis (TB) is also attributed to migrations worldwide. A significant number of such displacement occur in regions with considerably higher areas of TB burden. Displacements may delay in TB diagnosis and treatment, which possibly will lead to TB transmission among healthy individuals. In this study, we assessed the association of existing determinants after a protracted internal displacement of people with the delay in TB diagnosis and treatment outcomes. A cross-sectional study was conducted on internally displaced TB patients registered at selected health facilities in three urban districts of Pakistan from March 2019 to February 2020. The univariate and multivariate logistic regression model was used to assess the delay in diagnosis and treatment outcomes. IDPs with delay in initiation of treatment beyond 30 days were at high possibility of unsuccessful TB treatment outcomes (adjusted odds ratio AOR,2.60; 95% CI 1.06-6.40). Analysis of factors that affect health seeker behavior and timely treatment showed a significant association (p<0.05) in-between age group 55-65 years (AOR, 2.66; 95% CI 1.00-7.07), female patients (AOR, 2.42; 95% CI 1.21-4.81), visited non-formal health provider (AOR, 8.81; 95% CI 3.99-19.46), self-medication (AOR, 2.72; 95 % CI 1.37-5.37), poor knowledge of TB (AOR, 11.39; 95% CI 3.31-39.1), and perceived stigma (AOR, 8.81; 95% CI 3.99-19.4). Prolong delay in treatment was associated with unfavorable treatment outcomes among IDPs, more specifically. As migrants and IDPs are more likely to experience an interruption in care due to overall exclusion from social and health care services. Therefore, it is imperative to understand the barriers in providing public health care services, particularly in preventing and treating TB.

Background: Laryngopharyngeal reflux (LPR) is a common disease in otolaryngology characterized by an inflammatory reaction of the mucosa of the upper aerodigestive tract caused by digestive refluxate enzymes. LPR has been identified as etiological or favoring factor of laryngeal, oral, sinonasal or otological diseases. In this case-series, we reported atypical clinical presentation of LPR in patients presenting in our clinic with reflux. Methods: A retrospective medical chart review of 351 patients with LPR treated in the European Reflux Clinic in Brussels, Poitiers and Paris was performed. In order to be included, patients had to report atypical clinical presentation of LPR, consisting of symptoms or findings that are not described in reflux symptom score and reflux sign assessment. The LPR diagnosis was confirmed with 24-hour hypopharyngeal-esophageal impedance pH-study and patients were treated with a combination of diet, proton pump inhibitors and alginates. The atypical symptoms or findings had to be resolved from pre- to posttreatment Results: From 2017 to 2021, 21 patients with atypical LPR were treated in our center. The clinical presentation consisted of recurrent aphthosis or burning mouth (N=9), recurrent burps and abdominal disorders (N=2), posterior nasal obstruction (N=2), recurrent acute suppurative otitis media (N=2), severe vocal fold dysplasia (N=2), and recurrent acute rhinopharyngitis (N=1), tearing (N=1), aspirations (N=1) or tracheobronchitis (N=1). Abnormal upper aerodigestive tract reflux events were identified in all of these patients. Atypical clinical findings resolved and did not recur after an adequate anti-reflux treatment. Conclusion: LPR may present with various clinical presentations including mouth, eye, tracheobronchial, nasal or laryngeal findings, which may all regress with an adequate treatment. Future studies are needed to better specify the relationship between LPR and these atypical findings through analyses identifying gastroduodenal enzyme in the enflamed tissue.

This study aims to identify an optimal heat-treatment parameter set for an additively manufactured AlSi10Mg alloy in terms of increasing the hardness and eliminating the anisotropic microstructural characteristics of the alloy in as-built condition. Furthermore, the influence of these optimized parameters on the fatigue properties of the alloy investigated. In this respect, microstructural characteristics of an AlSi10Mg alloy manufactured by Laser-Based Powder Bed Fusion in non-heat-treated and heat-treated conditions were investigated. Their static and dynamic mechanical properties were evaluated, and fatigue behavior was explained by a detailed examination of fracture surfaces. Much of the microstructure in the non-heat-treated condition was composed of columnar grains oriented parallel to the build direction. Further analysis revealed a high fraction of pro-eutectic α-Al. Through heat-treatment, the alloy was successfully brought to its peak-hardened condition, while eliminating the anisotropic microstructural features. Yield strength and ductility increased simultaneously after heat-treatment, which is due to the relief of residual stresses, preservation of refined grains, and introduction of precipitation strengthening. The fatigue strength, calculated at 10^7 cycles, improved as well after heat-treatment and finally detailed fractography reviled that a more ductile fracture mechanism has happened in the heat-treated condition compared to the non-heat-treated condition.

Doxorubicin, a member of the anthracycline family, is a common anticancer agent often used as a first line treatment for the wide spectrum of cancers. Doxorubicin-based chemotherapy, although effective, is associated with serious side effects, such as irreversible cardiotoxicity or nephrotoxicity. Those often life-threatening adverse risks, responsible for the elongation of the patients' recuperation period and increasing medical expenses, have prompted the need for creating novel and safer drug delivery systems. Among many proposed concepts, polymeric nanocarriers are shown to be a promising approach, allowing for controlled and selective drug delivery simultaneously enhancing its activity towards cancerous cells and reducing toxic effects on healthy tissues. This article is a chronological examination of the history of the work progress on polymeric nanostructures, designed as efficient doxorubicin nanocarriers, with the emphasis on the main achievements of 2010-2020. Numerous publications have been reviewed to provide an essential summation of the nanopolymer types and their essential properties, mechanisms towards efficient drug delivery, as well as active targeting stimuli-responsive strategies that are currently utilized in the doxorubicin transportation field.

The disastrous 2017 fire season in Portugal lead to widespread recognition of the need for a paradigm shift in forest and fire management. We focused our study on Alvares, a parish in central Portugal which had 60% of its area burned in 2017, with a large record of historical. We evaluated how different fuel treatment strategies can reduce wildfire hazard in Alvares, through i) a fuel break network with different priorities and ii) random fuel treatments resulting from stand-level management intensification. To assess this, we developed a stochastic fire simulation system (FUNC-SIM) that integrates uncertainties in fuel distribution over the landscape. If the landscape remains unchanged, Alvares will have large burn probabilities in the north, northeast, and center-east areas of the parish that are very often associated with high fire line intensities. The different fuel treatment scenarios decreased burned area between 12.1-31.2%, resulting from 1%-4.6% increases in annual treatment area, and reduced 10%-40% the likelihood of wildfires larger than 5000 ha. On average, simulated burned area decreased 0.22% per each ha treated, and effectiveness decreased with increasing area treated. Overall, both fuel treatment strategies effectively reduced wildfire hazard and should be part of a larger, holistic and integrated plan to reduce the vulnerability of the Alvares parish to wildfires.

The efficiency of microbial inactivation in water is highly dependent on the type of treatment technology used as well as the characteristics of the water to be treated. Wastewater from poultry slaughterhouses carries a significant number of microorganisms posing threat to humans and the environment in general. Therefore, the treatment of poultry slaughterhouse wastewater requires the use of appropriate purification systems with high removal efficiency for microbial agents. In this study, the performance of an integrated treatment plant with electrolysis, ultrafiltration, and ultraviolet radiation as the principal treatment units is investigated in terms of microbial inactivation from poultry slaughterhouse wastewater. In this case, Total microbial number, Total coliform bacteria, Thermo-tolerant coliform bacteria, Pathogenic flora, including Salmonella coliphages, Spores of sulfite-reducing clostridia, Pseudomonas aeruginosa, and Staphylococcus aureus Enterococcus were studied. About 63.95% to 99.83% of the microbes were removed by the EC treatment unit, as well as 99.86% to 100% removal efficiency was achieved after the combined treatment. However, the Pseudomonas aeruginosa was the only microbial agent detected in the final effluent after the combined treatment. The phenomenon suggests that an upgrade to the treatment plant may be required to achieve 100% removal assurance for Pseudomonas aeruginosa.

The efficiency of microbial inactivation in water is highly dependent on the type of treatment technology used as well as the characteristics of the water to be treated. Wastewater from poultry slaughterhouses carries a significant number of microorganisms posing threat to humans and the environment in general. Therefore, the treatment of poultry slaughterhouse wastewater requires the use of appropriate purification systems with high removal efficiency for microbial agents. In this study, the performance of an integrated treatment plant with electrolysis, ultrafiltration, and ultraviolet radiation as the principal treatment units is investigated in terms of microbial inactivation from poultry slaughterhouse wastewater. In this case, Total microbial number, Total coliform bacteria, Thermo-tolerant coliform bacteria, Pathogenic flora, including Salmonella coliphages, Spores of sulfite-reducing clostridia, Pseudomonas aeruginosa, and Staphylococcus aureus Enterococcus were studied. About 63.95% to 99.83% of the microbes were removed by the EC treatment unit, as well as 99.86% to 100% removal efficiency was achieved after the combined treatment. However, the Pseudomonas aeruginosa was the only microbial agent detected in the final effluent after the combined treatment. The phenomenon suggests that an upgrade to the treatment plant may be required to achieve 100% removal assurance for Pseudomonas aeruginosa.

Laryngopharyngeal reflux (LPR) is a prevalent disease in the general population and may have acute or chronic clinical presentation. LPR may be misdiagnosed in primary care medicine regarding the lack of gastroesophageal reflux disease symptoms and the lack of findings at the gastrointestinal endoscopy. Depending on the physician field of expertise and experience, LPR may be clinically over- or under-diagnosed. The management of LPR is possible in primary care medicine but primary care physician has to consider some red flags that requires to address the patient to otolaryngologist or gastroenterologist. The use of patient-reported outcome questionnaire such as reflux symptom score-12 and the consideration of some oral and pharyngeal findings visualized through the mouth opening may help the primary care physician to evaluate the LPR findings at the diagnosis time and throughout treatment. In this review, we provide a practical algorithm of management of LPR for primary care physician or other specialists that cannot perform fiberoptic examination. In this algorithm, physician has to exclude some confounding conditions such as allergy or other causes of pharyngolaryngitis and red flags. Physician may prescribe an empirical treatment based on diet and behavioral changes with or without medication, depending on the complaint severity of the patient. In case of prescription of medication, proton pump inhibitors and alginate have to be considered in association to protect the upper aerodigestive tract mucosa from acid, weakly acid and alkaline pharyngeal reflux events.

Coronavirus that is also known as COVID-19 disease is produced by SARSCoV-2. This causative agent is highly contagious and can cause potentially fatal pneumonia worldwide with serious public health concerns. In the beginning among infected individuals, most of them were those who were mainly shown to the wet animal market in a big city of China known as Wuhan. So, it was suggested that this was almost certainly the zoonotic source of COVID-19illness. The transitional source of origin and their mode of transmission to humans were not known obviously. Conversely, from human to human rapidly transformation have been confirmed generally. Currently, there is no availability of FDA approved clinically antiviral drugs and/or vaccines to be used against the COVID-19. Afterward, SARS-CoV and MERS-CoV, the occurrence of SARS-CoV-2 has been manifested as the third sketch of an enormously pathogenic coronavirus into human population globally. In this review, we provide a brief overview of the history of COVID-19 in Pakistan up-to 18^th weeks after beginning, current situation, epidemiology, and its impact on the human population. Moreover, we focused on physiological variation during the incubation period, genome analysis of SARS-CoV2, supportive treatment approaches, and safety measures in the Pakistani population, which may be supportive for combating the risk of COVID-19 epidemic. We also reviewed the future approaches for the development of therapeutic interventions and vaccines to cope with the COVID-19 epidemic.

Modern day civilization is dependent on energy generation by fossil fuels. But the major drawback of using fossil fuels is environmental pollution. Microalgae are potential candidate for production of various products of interest, such as proteins, mini food, pigments and triglycerides that can be converted into biofuels. Lignocellulosic feedstocks are the most abundantly available raw material of plants that can serve as a promising feedstock for cultivating bacteria, fungi, yeasts and microalgae to produce biofuels and other value-added products. Owing to the abundant availability of these low/no cost substrates, can be utilized as feedstocks for cultivating microalgae to generate biogas/biodiesel. Likewise, there is much room to exploit defatted algal biomass to be used as animal/fish feed and oil producing/accumulating genes knowledge in future to produce high and good quality biodiesel and biogas.

The effect of retrogression re-aging treatment (RRA) on corrosion behavior of 7055 Al-Zn-Mg alloy were studied. Results provides the corrosion resistance could be greatly improved by RRA. After the RRA treatment, the isolated precipitates occurred on grain boundaries (GBs) and the low angle grain boundaries (LAGBs) presented a larger fraction compared to the single-stage peaking aging. The samples after RRA treatment also show better corrosion resistance than the single-stage peak aging. The results of electrochemical impedance spectroscopy (EIS) show that impedance spectrum is consisted of semi-infinite layer diffusion impedance and stagnant Weber impedance. The semi-infinite layer diffusion impedance corresponded a limited retention layer on the electrode surface. In corrosion process, Weber impedance corresponded to stagnant layer of corrosion products generated by the anode branches. The RRA sample has the high Rf and low Cf, Cp values, and the corrosion current density of the RRA samples is ten times less than the single-stage peak aging samples with the 10% hardness losing.

Objective: To describe outcomes of patients with coronavirus disease 2019 (COVID-19) in the outpatient setting after early treatment with zinc, low dose hydroxychloroquine, and azithromycin (the triple therapy) dependent on risk stratification. Design: Retrospective case series study. Setting: General practice. Participants: 141 COVID-19 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the year 2020. Main Outcome Measures: Risk-stratified treatment decision, rate of hospitalization and all-cause death. Results: Of 335 positively PCR-tested COVID-19 patients, 127 were treated with the triple therapy. 104 of 127 met the defined risk stratification criteria and were included in the analysis. In addition, 37 treated and eligible patients who were confirmed by IgG tests were included in the treatment group (total N=141). 208 of the 335 patients did not meet the risk stratification criteria and were not treated. After 4 days (median, IQR 3-6, available for N=66/141) of onset of symptoms, 141 patients (median age 58 years, IQR 40-67; 73% male) got a prescription for the triple therapy for 5 days. Independent public reference data from 377 confirmed COVID-19 patients of the same community were used as untreated control. 4 of 141 treated patients (2.8%) were hospitalized, which was significantly less (p<0.001) compared with 58 of 377 untreated patients (15.4%) (odds ratio 0.16, 95% CI 0.06-0.5). Therefore, the odds of hospitalization of treated patients were 84% less than in the untreated group. One patient (0.7%) died in the treatment group versus 13 patients (3.5%) in the untreated group (odds ratio 0.2, 95% CI 0.03-1.5; p=0.16). There were no cardiac side effects. Conclusions: Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset with the used triple therapy, including the combination of zinc with low dose hydroxychloroquine, was associated with significantly less hospitalizations and 5 times less all-cause deaths.

The Corona Virus Disease 2019 (COVID-19) outbreak is becoming pandemic with the highest mortality in people with associated comorbidities. These RNA viruses containing four structural proteins usually use spike protein to enter the host cell. It has been demonstrated that Angiotensin Converting Enzyme 2 (ACE2) ,as a part of renin-angiotensin-aldosterone system (RAAS), acts as a host receptor for the virus which is the main target of therapeutic approaches. However, medications acting on RAAS can lead to serious complications especially in people with diabetes and hypertension. To avoid this, other potential treatment modalities should be used in COVID-19 patients with associated comorbidities.

Background: On Dec 19, 2019, the public health department of China reported that an outbreak of pneumonia was caused by a novel Coronavirus. The virulence of the new virus COVID-19 was much greater than either the SARs and MERSs viruses and on March 11, 2020, the World Health Department (WHO) declared a worldwide pandemic. Understanding the pathophysiology of virulence of the SARS-COV-2 virus is absolutely necessary for understanding the transmission, virulence factors, reduce risk factors, clinical presentation, predict outcomes of the disease and provide guidance for any current or future treatment protocols. Methodology: A comprehensive PubMed search was performed during December 20, 2019 and April 03, 2020, utilizing the words: Wuhan Virus, COVID-19, SARs coronavirus, ACE2, S-protein, virulence, clinical presentation, epidemiology, genome, treatment, structure, MERs, pathogenesis and/or pathology alone and in combination with other terms. Each paper was evaluated by three content experts for quality, reproducibility, credibility and reputation of the journal. Results: The SARS-COV-2 virus is much more virulent than either the SAR’s or MER’s virus and its ability to cause serious disease inversely corresponds to the person’s ability to produce T-cells which declines linearly with age. The ACE2 receptor binding site does not vary among different ethnic groups but do in ACE-2 expression levels. This variance in expression level may explain for different infectivity rates among men and women and predict and explain different susceptibilities to infection by different ethnic groups. Furthermore, by understanding the underlying pathophysiology one can explain and provide guidance to the clinical effectiveness of any treatment. Conclusions: The underlying pathophysiology of COVID-19 explains not only the virulence, and clinical presentation, but, explains at a molecular level the comorbidity risk factors such as hypertension, sex, and age. Ethnic and anatomic expression patterns of ACE-2 and associated pathophysiology suggests that Native Americans and Asians may be particularly susceptible to this disease.

We present the AI-discovered aetiology of COVID-19, based on a precise disease model of COVID-19 built under five weeks that best matches the epidemiological characteristics, transmission dynamics, clinical features, and biological properties of COVID-19 and consistently explains the rapidly expanding COVID-19 literature. We present that SARS-CoV-2 implements a unique unbiased survival strategy of balancing viral replication with viral spread by increasing its dependence on (i) ACE2-expressing cells for viral entry and spread, (ii) PI3K signaling in ACE2-expressing cells for viral replication and egress, and (iii) viral-non-structural-and-accessory-protein-dependent immunomodulation to balance viral spread and viral replication. We further propose the combination of irinotecan (an in-market topoisomerase I inhibitor) and etoposide (an in-market topoisomerase IIinhibitor) could potentially be an exceptionally effective treatment to protect critically ill patients from death caused by COVID-19-specific cytokine storms triggered by sepsis, ARDS, and other fatal comorbidities.

A novel mathematical model is developed to calculate the temperature distribution on the surface and bulk of a steel plate under the laser hardening process. The model starts with the basic heat equation then it is developed into a volumetric form and is connected to the various solid existing phases. The proposed model is based on three influencing parameters of the laser hardening process which are the velocity of the laser spot and irradiation time. The results are compared with the available experimental data reported in the literature. The volumetric model provides an assessment of temperature distribution in both the vertical and horizontal axis. Laser irradiation at sufficiently high fluence can be used to create a solid-state phase change on the surface. Primary calculations show that the temperature profile has a Gaussian distribution in horizontal x and y-axis and presents an exponentially decreasing in the horizontal and vertical depth directions.

Honey is a complex sweet food stuff with well-established antimicrobial and antioxidant properties. It has been used for millennia in a variety of applications, but those most noteworthy include treatment of surface wounds, burns and inflammation. A variety of substances in honey have been suggested as the key component to its antimicrobial potential; polyphenolic compounds, hydrogen peroxide, methylglyoxal and bee-defensin 1. These components vary greatly across honey samples due to botanical origin, geographical location and the individual bee. The use of medical grade honey, Medihoney and Revamil, in the treatment of surface wounds and burns has been seen to improve the healing process, reduce healing time, reduce scarring and prevent microbial contamination. Therefore, medical grade honeys should be used for these treatments and reduce the demand for antibiotic usage. In this review, we aim to outline the constituents of honey and how they affect the antibiotic potential of honeys in a clinical setting.

Statins prevent cardiovascular diseases, yet their use is limited by the muscle disturbances they cause. Rarely, statin-induced myopathy is autoimmune, but more commonly it is due to direct muscle toxicity. Available evidence suggests that statin-induced creatine deficiency may be a major cause of this toxicity, and that creatine supplementation prevents it. Statins inhibit guanidinoacetate methyl transferase (GAMT), the last enzyme in the synthesis of creatine, thus they decrease its intracellular content. Such decreased content could cause mitochondrial impairment, since creatine is the final acceptor of the phosphate group of adenosine triphosphate (ATP) at the end of mitochondrial oxidative phosphorylation. Decreased cellular synthesis of adenosine triphosphate (ATP) would follow. Accordingly, ATP synthesis is decreased in statin-treated cells. In vitro, creatine supplementation prevents the opening of mitochondrial permeability transition pore caused by statins. Clinically, creatine administration prevents statin myopathy in statin-intolerant patients. Additional research is warranted to hopefully confirm these findings. However, creatine is widely used by athletes with no adverse events, and has demonstrated to be safe even in double-blind, placebo-controlled trials of elder individuals. Thus, it should be trialed, under medical supervision, in patients who cannot assume statin due to the occurrence of muscular symptoms.

Shanghai is experiencing water supply problems caused by heavy pollution of its raw water supply, deficiencies in its treatment processes and water quality deteoriation in the distribution system. However, little attention has been paid these problems of water quality in raw water, water treatment and household drinking water. Based on water quality data we show that the raw water sources of the Huangpu River and the Changjiang (Yangtze River) estuary are polluted by microbes (TBC), eutrophication (TP, TN and NH3-N), heavy metals (Fe, Mn and Hg) and organic contamination (chemical oxygen demand [COD], detergent and volatile phenols [VP]). The average concentrations of these contaminants in the Huangpu River are almost double that of the Changjiang estuary forcing a rapid shift to the Changjiang estuary for raw water. In spite of filtering and treatment, TN, NH3-N, Fe, COD and chlorine maxima of the treated water and drinking water still exceed the Chinese National Standard (GB5749). We determine that the relevant threats from water source to household water in Shanghai are: 1) eutrophication arising from highly concentrated TN, TP, COD and algal density in the raw water; 2) increasing salinity in the river estuary, especially at the Qingcaosha Reservoir (currently the major freshwater source for Shanghai); 3) more than 50% of organic constituents and by-products remain in treated water; 4) bacteria and turbidity increase in the course of water delivery to users. The analysis presents an holistic assessment of the water quality threats to metropolitan Shanghai in relation to the city’s rapid development.

Major depressive disorder (MDD) is a common mental disorder, which results in seriously impaired condition in the patients and great global disability burden. In light of its quite diverse etiologies, comorbidity with many other diseases, and complex underlying pathology, it has been a great challenge to understand the physiological basis of MDD, which may be a complex of related diseases, rather than a single one. In addition to the partial understanding of MDD, the individual heterogeneities among patients may render the development of a universal treatment an elusive goal. But studying how each of currently available treatments affects the disease can generate useful information to stratify patients into different subtypes for individualized treatments. In this case report, we present the first report of repeated success of using meditation as the only treatment of MDD, compared to initial success but no remission with other conventional antidepressants on the same patient. We hypothesized that the short but continuous natural pain during one-hour meditation sittings has the therapeutic effect to treat depression in the case of this patient and potentially others with MDD. This special opportunity of eliminating tremendous heterogeneity among different individuals has enabled us to probe deeply into the potential mechanism of depression treatments and the complex physiology of depression itself, both of which have likely profound implications in the treatment of other MDD patients as well. More importantly, this case report helps us dissect one specific component of meditation for its long-known and well-established benefit against depression.

Proper management of water is a challenge for every individual but especially for companies. Nowadays also legislation obliges companies to clean the wastewater before being discharged into municipal public sewer especially if they use some chemicals or oily elements in their production process. Construction of the wastewater cleaner depends directly on the way of pollution, the amount of contaminated water and the energy demand of the cleaning process. The paper deals with the construction of the wastewater cleaner, which is based on the technology of electro-flotation for the treatment of water contaminated with disperse colorants. The experimental work as well as the modelling using the statistical methods proved the suitability of the chosen technology. Also, each colour combination requires a specific time period for the water treatment. The authors determined the time interval for cleaning the wastewater that was polluted with yellow colour to 33 minutes. Finally, the wastewater cleaner that is based on the electro-flotation technology was included in the company’s reverse logistics system.

The improvement of mechanical properties of cantala fiber and its composites. Treatments including alkali, silane, and the combination of both were carried out to modify the fiber surface. The influence of chemical treatments on fiber properties such as the degree of crystallinity and tensile strength was investigated. A variety of short cantala fiber reinforced rHDPE composites were produced by hot press, and the effect of fiber treatment on the flexural strength of composites was observed. SEM observations also carried out to highlight these changes. The result shows that alkali treatment improves tensile strength and tensile modulus of alkali treated fiber (NF12) which was predicted as a result of the enhancement of the cellulose crystallinity. In contrast, the tensile strength and tensile modulus of silane (SF05) and alkali-silane treated fiber (NSF05) decreased compared to untreated fiber (UF) which is caused by the addition of amorphous material. The tensile strength of alkali-silane treated fiber (NSF05) was lower than alkali treated fiber (NF12), but the composites prepared with NSF05 showed the highest increment of flexural strength of 25.9%. This may be due the combination of alkali and silane treatment helped in the better formation of fiber-matrix interface adhesion.

This paper investigates the evolution of microstructures and precipitations of an ultra-low iron alloy 625 subjected to long term aging treatment by scanning electron microscope (SEM) and X-ray diffraction(XRD). Use ASTM G28A acid Fe3(SO4)2 erosion to represent intergranular corrosion weightlessness and corrosive morphology. The result shows that alloy at 750C by aging treatment for 40h, precipitated γ'' phase in the grain boundary. In high density area of γ'' phase, occurs γ'' phase to δ phase degeneration transformation by aging treatment for 200h and the needle-like δ phase becomes more with time prolonged. And γ'' phase degenerated to δ phase completely until treated for 1000h. The sample which has aging treatment tends to have intergranular corrosion and mainly because alloy element spreading leads to dilution area and grain boundary precipitated phase, plus interlaced δ phase’s dissolving, which makes sample grain particle fall off and this results in apparent weightlessness. The weightlessness rate(WLR) is related with precipitated volume score. With aging sensitization time change, can be described by Johnson-Mehl-Avrami equation, i.e.: $WLR=44.32\left[1-\text{exp}\left(-\frac{t}{10.99}\right)\right]+44.62\left[1-\text{exp}\left(-\frac{t}{327.8}\right)\right]+1.267\left(mm/a\right)$

The scratch test consists in pushing a tool across the surface of a material at a given penetration depth or applied load. It has several applications in Science and Engineering including strength testing, damage and quality control of thin films and coatings. Despite numerous attempts in scientific literature, the application of scratch test to characterizations of fracture properties remains a heavily controversial topic. Therefore, this investigation arises as an experimental study in order to assess the fracture toughness using scratch test. A study on the effect of cryogenic treatment, performed after tempering, on fracture toughness, via scratch test experiments, of different tool steels has been made. A laboratory investigation on AISI D2, AISI M2 and X105CrCoMo18 steel confirms the possibility of increasing the fracture toughness by carrying out the cryogenic treatment after the usual heat treatment

Coronavirus disease 2019 (COVID-19), can manifest with ocular symptoms. These symptoms can be divided into isolated events attributed to COVID-19 and those occurring in multisystem inflammatory syndrome in children (MIS-C), a newly diagnosed disease entity associated with COVID-19 infection. Currently, the literature lacks specific guidelines and treatment regimens for COVID-19 ocular symptoms, especially in children.

Treatment efficacy for age-related macular degeneration relies on early diagnosis and precise determination of the disease stage. It involves analyzing biomarkers in retinal images, which can be challenging when handling a large flow of patients and compromise the quality of healthcare services. Clinical decision support systems offer a solution to this issue by employing intelligent algorithms to recognize biomarkers and specify the age-related macular degeneration stage through the analysis of retinal images. However, different stages of age-related macular degeneration may exhibit similar biomarkers, complicating the application of intelligent algorithms. This paper introduces an approach to overcome these challenges using hybrid and hierarchical classification. By leveraging the hybrid structure of the classifier, we can effectively manage issues commonly encountered with medical data sets, such as class imbalance and strong correlations between variables. The modifications to the intelligent algorithm proposed in this work for staging age-related macular degeneration resulted in an increase in average accuracy, sensitivity, and specificity by 20% compared to initial values. The Cohen’s Kappa coefficient used for consistency estimation between the regression model and expert assessments of the intermediate class severity was 0.708, indicating a high level of agreement.

This research investigates the transformative role of digital health solutions in tackling climate-related health challenges. The study underscores the potential of digital health innovations to empower individuals and communities, fostering resilience and collective action in addressing the health impacts of climate change. By enhancing the accessibility of critical health information and enabling real-time responses, these digital tools not only mitigate immediate risks but also contribute to long-term public health strategies. The findings highlight the importance of integrating digital health solutions into broader climate health initiatives, demonstrating their capacity to bridge gaps in public health infrastructure, especially in vulnerable populations. This research calls for continued investment and innovation in digital health technologies as a vital component of global efforts to combat the growing challenges posed by climate change

Background: Numerous risk factors have been recognized as significant contributors to outdoor workers' heat stress and the risk of heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers' safety, health, and well-being remain under-researched. With climate change increasing temperatures, assessing heat stress among construction workers is imperative. Objective: To identify the barriers and facilitators influencing the safety of natural gas construction workers and evaluate an implemented heat stress intervention. Methods: In the summer of 2023, two semi-structured interviews and six focus groups were conducted with twenty-one stakeholders at a Texas natural gas construction site. Results: Key facilitators include employee preparedness, use of employer-provided resources, hydration logs, and real-time communication tools. Contrarily, the barriers include daily work schedules, access to dehydrating beverages, and generational differences with the non-implementation of mandatory rest breaks. The heat stress program was perceived as effective, surpassing recommended guidelines. Conclusion: To advance construction workers’ safety, health, and well-being, both employee involvement and employer management are needed, along with no-cost accessible resources. Additionally, implementing a required routine rest break and comprehensive heat stress education, particularly for older workers, will significantly promote safety and safe work practices in hot environments.

Background and Objectives: The trends in metabolic dysfunction-associated steatotic liver disease (MASLD) and related metabolic dysfunctions in Japan is unknown. Thus, we aimed to clarify the trends of these before the novel coronavirus disease 2019 pandemic in Japan. Materials and Methods: We included Japanese individuals aged 25-79 years who underwent health examinations at our center. We analyzed anthropometry, lifestyle-related disease, and nutritional intake in relation to MASLD trends from 2010-2019. Results: The prevalence of MASLD increased in all ages and body mass index (BMI) classes, reaching 30.3% in males and 16.1% in females, with MASLD accounting for 75% of steatotic liver cases and more than half of all type 2 diabetes mellitus (T2DM) and high waist circumference (HWC) cases. The increase in the prevalence of MASLD was due to an increase in that of steatotic liver itself, and there was no increase in the prevalence of other factors, such as overweight, T2DM, hypertension, and dyslipidemia. The prevalence of glucose metabolic disorders (GMDs) and hypertension decreased. National nutritional data showed an increase in energy intake, total fat, saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids, which correlated with a decrease in GMDs. Salt intake also decreased, which correlated with hypertension. The MASLD group had a higher prevalence of all related metabolic factors than the non-MASLD group, especially HWC, T2DM, and hyperlipidemia. Conclusion: The prevalence of MASLD increased with that of steatotic liver, regardless of age or BMI. A relationship between increased dietary fat, increased steatotic liver, and decreased GMDs was suggested.

Premenstrual syndrome (PMS) continues to impact the health outcomes and emotional well-being of reproductive-age women, globally. Several studies have provided conflicting evidence concerning the role of dietary approaches in improving PMS symptoms. Accordingly, this study aimed to evaluate the possible influence of a healthy diet and motivational strategies on PMS symptoms and health-related quality of life among Omani adolescents. This open-label, randomized, prospective controlled trial was conducted in two randomly selected secondary schools, in Al Seeb Willayah, in Muscat region. Adolescents with PMS symptoms, who were at grade 10 or 11, aged 16 years or above, had regular menstrual cycles and not known to have psychiatric disorder, were included in this study. Participants in the intervention group received an individual face-to-face dietary consultation and motivational phone consultation. The health outcomes, including the PMS symptoms in both groups, and quality of life, were recorded via a daily record of severity of problems questionnaire (DRSP) and the 14-item Self-Reporting-Based Perceived Stress Scale tools, respectively. The primary outcome was the differences in the mean premenstrual symptom scores between the two groups. Secondary outcomes included the quality of life and stress levels of participants. The study period was from 1 February and ended 30 June 2021. SPSS was used to analyze the data and intention-to-treat analysis was utilized.A total of 72 adolescents with PMS were randomized to the intervention and control groups (n=36 each). Both groups were similar at baseline (P-value&gt;0.05). No significant association was found between healthy-diet and PMS symptoms (P-value&gt;0.05). In addition, no significant association was found between healthy-diet and quality of life at follow-up (P-value=0.216). The outcomes of this study refuted any possible relationships between healthy diet and PMS symptoms. Accordingly, dietary consultations may not facilitate the clinical management of PMS symptoms in adolescent females.

Introduction: The primary objective of researchers in the biology of ageing is to gain a comprehensive understanding of the ageing process while developing practical solutions that can enhance the quality of life for older individuals. This involves a continuous effort to bridge the gap between fundamental biological research and its real-world applications. Purpose: In this narrative review, we attempt to link research findings concerning the hormetic relationship between neurons and germ cells, and translate these findings into clinically relevant concepts. Methods: We conducted a literature search using PubMed, Embase, PLOS, Digital Commons Network, Google Scholar and Cochrane Library from 2000 to 2023, analyzing studies dealing with the relationship between hormetic, cognitive, and reproductive aspects of human ageing. Results: The process of hormesis serves as a bridge between the biology of neuron-germ cell interactions on one hand, and the clinical relevance of these interactions on the other. Details concerning these processes are discussed here, emphasizing new research which strengthens the overall concept. Conclusions: This review presents a scientifically and clinically relevant argument, claiming that maintaining a cognitively active lifestyle may decrease age-related degeneration, and improve overall health in ageing.

The concept of ecosystem services (ESs) provides a valuable approach to communicate societies' dependence on natural ecosystems, assisting in the evaluation of measures to protect vegetation in watersheds that promote water-related ESs. Vegetation cover and land use are important factors related to the capacity of ecosystems to provide soil loss regulation and sediment retention services, which are highly relevant for sediment management in watersheds draining into reservoirs with multiple water uses. This study aims to assess the relationship between potential changes in land use and land cover and the sediment retention service provided by riparian vegetation in a watershed draining into a hydroelectric reservoir in the Brazilian Cerrado. Sediment load was selected as a physical variable that affects different water uses in reservoirs, with these uses being dependent on the quality or quantity of stored water. Scenarios were analyzed to represent landscape reconfigurations from a baseline condition in order to account for the recovery of riparian vegetation by the agricultural sector, as foreseen in the Brazilian Forest Code. To map and quantify variations in annual sediment retention, the InVEST model was used, which allows estimating an integrated response of the drainage basin to large-scale land use changes over time and space. The results show that for the drainage basin of the Corumbá IV Hydroelectric Power Plant (HPP), the recovery of riparian areas occupied by annual crops has the potential to generate greater benefits to water use in the reservoir. In the studied catchment area, 14% of the total vegetation deficit in riparian areas is occupied by crops, while 86% is occupied by pastures. This highlights the buffering role of riparian vegetation as an effective practice for managing sediment flows originating from sheet erosion in agricultural landscapes. The methodology employed in this study allows for the quantification and mapping of the effects of soil and water conservation measures in river basins. This enables the prioritization of sectoral efforts for the restoration of native vegetation, considering the highest returns in benefits perceived by water users affected by sediment input in reservoirs. The study's results reinforce the importance of conserving vegetation in riparian areas and their surroundings for sediment retention, highlighting the role of these areas as assets in providing water-related ecosystem services.

The objective of this study was aimed to study the sensory processes of the “human-computer interaction” model when classifying visual images with an incomplete set of signs based on the analysis of early, middle, late and slow components of event-related potentials (ERPs). 26 healthy subjects (men) aged 20-22 years were investigated. ERPs in 19 monopolar sites according to the 10/20 system were recorded. Discriminant and factor analysis were applied. The component N450 is the most specialized indicator of the perception of unrecognizable (oddball) visual images. The amplitude of the ultra-late components N750 and N900 is also higher under conditions of presentation of the oddball image, regardless of the location of the registration points. The results of the study are discussed in the light of the paradigm of the P300 wave application in brain-computer interface systems, as well as with the peculiarities in brain pathology. Promising directions for the development of studies of the “Brain Computer Interface” (BCI) P300 systems are to increase the throughput of information flows. To extend the application of the P300 ERPs to multiple modalities, the underlying physiological mechanisms and responses of the brain for a particular sensory system and mental function must be carefully examined.

Healthy life style is associated with decreased risk of chronic kidney disease (CKD) and mortality in the general population. However, there is no definitive evidence on the benefits of physical activity and other health-related behaviors in the early-stage CKD. This study aimed to explore the association between health-related behaviors and end-stage renal disease (ESRD) and mortality in the early stages of CKD. The National Health Insurance Service (NHIS) database from January 1st, 2009 to December 31st, 2016 was used to screen 83,470 subjects with early stage CKD. Cox proportional hazard regression analysis was used to evaluate the association between health-related behaviors and ESRD and death. Kaplan-Meier curves for mortality and ESRD were plotted according to the physical activity, smoking status and alcohol consumption pattern. Risk of death decreased significantly in subjects who engaged in sufficient physical activity (adjusted Hazard Ratio (HR) 0.73; 95% CI: 0.64-0.83; p < 0.001). Risk of ESRD and death increased significantly in the current smoker with adjusted HR of 1.44 (95% CI: 1.06-1.95; p < 0.02) and 1.61 (95% CI: 1.44-1.80; p < 0.001) respectively. Therefore, systematic interventions to encourage physical activity and smoking cessation need to be actively considered in the early stages of CKD.

A practical method is presented to estimate rare earth elements (REE) concentrations in magmatic vapour phase (MVP) in equilibrium with water-saturated granitic melts based on empirical fluid-melt partition coefficients of REE (k_P^REE). The values of k_P^REEcan be calculated from a set of new polynomial equations linking to the chlorine molality (m_Cl^v) of the MVP associated with granitic melts, which are established via a statistical analysis on the existing experimental dataset. These equations may be applied to the entire pressure range (0.1 to 10.0 kb) within the continental crust, suggesting that light REEs behave differently in magmatic fluids, i.e. either being fluid compatible with higher m_Cl^v or fluid incompatible with lower m_Cl^v values. In contrast, heavy REEs are exclusively fluid incompatible and partition favourably into granitic melts. Consequently, magmatic fluids tend to be rich in LREE relative to HREE, leading to REE fractionation during the evolution of magmatic hydrothermal systems. Maximum k_P^REEvalue for each element is predicted and presented in a REE distribution diagram constrained by the threshold of m_Cl^v. REE contents of the granitic melt is approximated by whole-rock analysis, so that REE concentrations in the associated MVP would be estimated from the value of k_P^REE given chemical equilibrium retains. Two examples are provided respectively, to show the use of this method as a REE tracer to fingerprint the source of ore-fluids responsible for the Lake George intrusion-related Au-Sb deposit in New Brunswick (Canada), and for the Bakircay Cu-Au (-Mo) porphyry systems in northern Turkey.

The present study aimed to analyze novel mechanisms underlying Nrf2-mediated anti-apoptosis in periodontal ligament stem cells (PDLSCs) in the periodontitis oxidative microenvironment. We created an oxidative stress model with H2O2-treated PDLSCs. Herein, we used real-time PCR, western blotting, TUNEL staining, fluorogenic assay and transfer genetics to confirm the degree of oxidative stress and apoptosis as well as the Nrf2 function. Surprisingly, we demonstrated that with up-regulated ROS and MDA levels, the effect of oxidative stress was obvious under H2O2 treatment. Anti-oxidative molecules were changed after the H2O2 exposure, whereby the anti-oxidative signaling of Nrf2 was activated with the increase of its downstream effectors, HO-1, NQO1 and γ-GCS. Additionally, the apoptosis levels gradually increased with oxidative stress and changes in the caspase-9, caspase-3, Bax and c-Fos levels, but not with caspase-8 and down-regulated Bcl-2. The enhanced antioxidant effect could not resist the occurrence of apoptosis. Furthermore, Nrf2 overexpression effectively improved the anti-oxidative levels and increased cell proliferation. At the same time, overexpression effectively restrained TUNEL staining and decreased the molecular levels of caspase-9, caspase-3, et al, but not that of caspase-8. By contrast, silencing the expression Nrf2 levels had the opposite effect. Collectively, Nrf2 alleviates PDLSCs via its effects on anti-oxidative and anti-intrinsic apoptosis by the activation of anti-oxidative enzymes.

Objective: To evaluate whether primary tumor treatment provides a survival benefit in uveal melanoma by comparing patients who declined treatment (Natural History Study, NHS) with those who received treatment in the Collaborative Ocular Melanoma Study (COMS) for medium-sized choroidal melanomas. Methods: A retrospective cohort study was conducted using reverse-engineered individual-level survival data from cumulative all-cause mortality curves in the original COMS and NHS publications. Censoring patterns were estimated from numbers at risk and descriptive statistics. To ensure a conservative approach, a Bonferroni-corrected significance level of 0.017 was applied. Further, if the Cox regression hazard ratio for all-cause mortality, the unadjusted risk ratio for death at 8 years, and the 95% confidence intervals (CIs) of the Kaplan-Meier curves did not indicate a smaller survival difference for the resulting data than reported in the original studies, we iteratively adjusted the NHS cohort data by reducing the 8-year cumulative mortality by one percentage point until these criteria were met. Results: Kaplan-Meier analysis revealed significantly higher cumulative mortality in the NHS cohort compared to the COMS cohort (Log-rank P = 0.012). When restricting the analysis to the first 8 years to account for unclear censoring patterns beyond this period, the NHS cohort still demonstrated worse survival (P = 0.008). Sensitivity analysis varying censoring times by ±25% over 1,000 iterations confirmed worse survival in the NHS cohort in 100% of cases. Conclusions: Patients who declined primary tumor treatment had significantly worse survival than those who received treatment. These findings support the hypothesis that primary tumor treatment confers a survival benefit in uveal melanoma.

Background/Objectives: With breast cancer (BC) survival improving due to optimized therapy, enhancing quality of life has become increasingly important. Both diagnosis and treatment, with their potential side effects, pose risks to mental well-being. Our study aimed to analyze the incidence and potential risk factors for mental disorders in BC patients. Methods: This retrospective analysis used claims data from AOK Baden-Wuerttemberg, including 11,553 BC patients diagnosed via ICD code C50 between 2010 and 2020 and 31,944 age-matched controls. Patients with mental disorders in the 12 months prior to diagnosis were excluded. Mental disorders were categorized into eight groups based on ICD codes: anxiety, obsessive-compulsive disorder, adjustment disorder, dissociative disorder, hypochondriac disorder, affective disorder, mania, and other neuroses. Results: Mental disorders were significantly more common in BC patients than in controls (64.2% vs. 38.1%, p<0.01, OR 2.91). In particular, hypochondriac, anxiety, affective, and adjustment disorders occurred significantly more often in BC patients. No differences were found for mania, bipolar disease, other neuroses, obsessive-compulsive- and dissociative disorder. Furthermore, endocrine therapy was associated with psychological comorbidities (OR 1.69, p<0.001), while primarily metastasized patients (Stage C) had a lower risk than adjuvant patients in stage A (OR 0.55, p<0.0001). Regarding surgical treatment, mastectomy patients showed lower rates of mental illnesses (61.2%) than those with breast-conserving treatment (71.6%) or especially breast reconstruction (78.4%, p<0.01). Breast reconstruction was also associated with more hypochondriac (p<0.01) and adjustment disorders (p<0.01). Conclusions: So, BC patients experience significantly more mental disorders than controls, particularly, when treated with endocrine therapy and breast reconstructive surgery.

Wheat straw (WS) is a promising substrate for biogas production by anaerobic digestion (AD) due to its high carbohydrate content. An estimated 0.603 million t yr-1 of WS are generated from wheat production systems in South Africa. This is equivalent to an energy potential of 11 PJ. Despite, WS is still undervalued as a bioenergy resource in South Africa due to its structural complexity and low nitrogen content. WS disposal methods, such as use in livestock bedding, burning and burying into the soil, inter alia, are not sustainable and may contribute to global warming and climate change. Commercialization of the AD of WS needs to be further developed and promoted. Pre-treatment (i.e. physical, chemical, biological and hybrid methods) and anaerobic co-digestion (AcoD) are novel strategies that can support the conversion of WS into biogas and other value-added products. Current and future research should focus on optimizing pre-treatment and AcoD conditions towards industrialization of WS into valuable products. This paper focuses on the potential use of WS for biogas production by AD in South Africa. The aim is to create information that will promote research and development, and encourage policy makers and stakeholder participation and investment in WS biogas technology.

In machining, there is a constant effort to achieve the expected roughness of the machined surface while maintaining the life of the cutting tool during its operation. The methods used for extending machinability characteristics can be applied due to cooling and lubrication. One of the latest, but not new, targeted cooling techniques have become cryogenic treatment, which uses substances that exhibit extremely low-temperature values of about 123 K. This is a very environmentally friendly technique compared to the current standardized cooling and lubricating fluids. The main task of such cooling is to change the properties of the workpiece so that it exhibits the properties of a brittle material. Bringing the workpiece structure in this way can result in easier material separation through the chip. In the article, the obtained test results can approximate the behavior of various materials during cryogenic cooling.

This study explores the development and characterization of ceramic rod reinforced TWIP (Twinning Induced Plasticity) steel matrix composites, fabricated using a lost foam casting process. The incorporation of ceramic rods aims to enhance the mechanical properties of TWIP steel, which is known for its excellent plasticity. Mechanical testing demonstrated a significant improvement in flexural strength and ductility, with the composite exhibiting over double the strength of the unreinforced TWIP steel. Heat treatment at 500°C for 60 minutes further enhanced these properties, increasing the composite's flexural strength to 1023 MPa and improving its ductility. The observed improvements are attributed to the synergistic effects of the hard ceramic reinforcement and the ductile matrix, as well as the microstructural modification conferred by heat treatment. These findings suggest that ceramic rod reinforced TWIP steel composites are promising materials for applications requiring a combination of high strength and ductility.

Pancreatic cancer is a serious and aggressive type of cancer that affects the digestive system and has a low chance of survival. Although traditional treatment methods have achieved some efficacy, the survival rate of patients remains low. Therefore, exploring novel treatment strategies is important. This article looks at the research done on bioactive compounds and plant extracts for treating pancreatic cancer. Bioactive compounds, such as naringenin and ziyuglycoside II, have significant anticancer activity and exert anti-pancreatic-cancer effects by inducing cell apoptosis, inhibiting the cell cycle, and blocking signaling pathways. Plant extracts, such as epigallocatechin-3-gallate and resveratrol, also demonstrate good anti-pancreatic cancer activity and inhibit tumor growth and metastasis. Additionally, the combined application of bioactive compounds and plant extracts may result in improved therapeutic effects. This article aims to provide a theoretical basis for the application of bioactive compounds and plant extracts in the treatment of pancreatic cancer and to help guide future medical research and practice.

Groundnut is an important cash crop and a diet component for rural households in sub-Saharan Africa. However, Aflatoxin contamination remains a barrier to promoting groundnut-based food products as food levels above maximum limit (ML) can adversely affect human health. Three objectives were set, namely, (i) to characterize the post-harvest operations and risk factors affecting aflatoxin contamination, (ii) to assess aflatoxin incidence in on-farm stores and, iii) to assess agronomic practices that can be integrated to improve yield and reduce aflatoxin contamination. The average aflatoxin levels in on-farm stores were 11.3-16.4μg/kg, in which the proportions of ML were 25.7% at 4μg/kg, 56.3% at 15μg/kg, and 80% at 20μg/kg (~5-7 months after harvest). The application of Aflasafe® resulted in safe or no aflatoxin contamination across the locations. Significant hazards identified during postharvest operations include intermittent rain at harvest and drying (6.5), insect pests attacks after harvest (6), prolonged harvest to stripping interval (6.6), drying on bare ground (6.2), storing on bare floor (6.9), use of poorly efficient shelling machines (6.5), and re-use of rejected nut (6.1). This study provides solutions to minimize aflatoxin risk if appropriate technologies (e.g. improved variety, fertilizer, rhizobia inoculant, and Aflasafe®) and policies are deployed.

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

This paper explores the feasibility of applying Bayesian statistical methods to study the distortion patterns induced by carburizing heat treatment. By establishing posterior and predictive distribution models for torsion bar dimensions, we aim to accurately understand and predict the expansion behavior, thus enhancing control over carburizing-induced dimensional changes. Bayesian methods allow for the integration of prior knowledge and real-time data, providing a more comprehensive understanding of the distortion phenomena. This approach not only improves the precision of dimensional predictions but also contributes to optimizing the overall manufacturing process, ensuring that the torsion bars meet the rigorous standards required for high-performance applications in demanding industrial environments.

Telomeres, located at the ends of each chromosome play a vital role in determining cellular fate and aging. Accelerated shortening of telomeres may also result in accelerated aging and occurrence of age-related degenerative diseases. Anti-aging treatments may help in increasing the telomere length along with improving quality of life, reducing dependency for daily life activities, increasing life expectancy and reducing the risks associated with aging. In this study, we evaluated the effect of anti-aging integrative therapy in 36 individuals. The treatment included a combination of HBOT, ozone therapy, colon hydrotherapy, etc. Telomere length was used as a biomarker for objectively quantifying the outcome of the treatment. The effect of treatment was also assessed on various aging symptoms. At the end of the treatment, it was found that that 97.22% individuals showed an increase in telomere length with an average increase of 0.43 Kbp and 94.44% individuals showed reduced biological age with an average decrease of 3.8 years. These improvements were statistically significant. Improvements were also recorded in the majority of the symptoms. No major adverse events were observed. These results indicate that antiaging integrative therapy has the potential to reverse aging symptoms, cellular aging and improve quality of life.

Uveal melanoma (UM) poses a significant clinical challenge due to its high metastasis rate and poor prognosis. Melatonin, noted for its anti-cancer properties in various malignancies, including cutaneous melanoma, shows promise in UM treatment. This study aimed to evaluate melatonin receptor expression in primary UM and its association with UM-related mortality and prognostic factors. Immunohistochemical analysis of 47 primary UM tissues showed low expression of MTNR1A and MTNR1B receptors, with MTNR1A significantly higher in patients who succumbed to UM. Analysis of TCGA data from 80 UM patients revealed RNA expression for MTNR1A, RORα, and NQO2, but not MTNR1B or GPR50. Higher MTNR1A RNA levels were observed in patients with a BAP1 mutation, and higher NQO2 RNA levels were noted in patients with the epithelioid tumor cell type. However, Kaplan-Meier analysis did not show distinct survival probabilities based on receptor expression. The study concludes that UM clinical samples express melatonin receptors, suggesting a potential mechanism for melatonin's anti-cancer effects. Despite finding higher MTNR1A expression in patients who died of UM, no survival curve differences were observed. Further research is needed to explore additional mechanisms of melatonin’s oncostatic effects, including its antioxidant properties and immune modulation.

(1) Background: São Paulo, Brazil, exhibits high mortality rates from pediatric solid tumors. This study analyzed the survival trends of patients aged 0-19 diagnosed with the state's five most prevalent solid tumors between 2000-2022. (2) Methods: An epidemiological, descriptive study utilized data from the Oncocentro Foundation of São Paulo, classified according to the International Classification of Childhood Cancer. The time between the first consultation and diagnosis, between diagnosis and treatment initiation, and patient survival were assessed using the Pe-to-Peto test. (3) Results: Analysis involved 11,067 cases: 53.5% male, with 89.6% diagnosed via microscopic confirmation. Tumor distribution comprised 34.3% central nervous system, 21.1% bone, 18.6% soft tissue, 14.2% germ cell, and 11.9% retinoblastomas. Main treatments included surgery with chemotherapy (26.5%), surgery alone (20.5%), and chemotherapy alone (15.6%). The average time between consultation and diagnosis was 22.94 ± 69.93 days, significant for treatments and recurrences, except for germ cell tumors (p=0.0178). The time between diagnosis and treatment was 25.46 ± 39.71 days, not significant for germ cell tumor treatments (p=0.0793). (4) Conclusions: Survival curves varied among neoplasm groups, with patients experiencing delays beyond recommended times, despite advanced healthcare services in the state.

Modeling the reaction time required for the removal of chemical oxygen demand (COD) from wastewater is important because can be an indicator of harmful pollutants that may pose risks to human health.. Here, we evaluate the use of an inverse artificial neural network (ANNi) to optimize the removal of COD from aqueous herbicide solutions using sonophotocatalysis as the treatment process.. This algorithm takes the operating conditions as input and estimates the optimal reaction time to reach the required effluent COD. This model was validated by comparison with both experimental measurements and simulated analysis, resulting in low error (0.5%), high Pearson correlation (R2 = 0.9956), and short computing time (less than one minute). The results for the proposed methodology (ANNi-GAs) were efficient and attractive in a reasonable way providing a satisfactory picture of the relationships between the optimal input parameters. Such parameters control the degradation process of herbicides online and can be used to predict the behavior of COD removal, thus taking actions to reduce the impact of aqueous treatment with alazine and gesaprim herbicides on aquatic, soil biota, and human health. Therefore, this technique constitutes a promising framework for predicting the environmental impact of herbicides within a tolerable degree of error.

Background: There are limited evidence-based data to guide treatment recommendations for breast cancer (BC) patients ≥ 80 years (P80+). Identifying and addressing unmet needs are critical. Aims: Advocate-BREAST80+ compared the needs of P80+ vs. patients < 80 years (P80-). Methods: In 12/2021, a REDCap survey was circulated electronically to 6,918 persons enrolled in the Mayo Clinic Breast Disease Registry. The survey asked about concerns and satisfaction with multiple aspects of BC care. Results: 2,437 participants responded (35 % response rate); 202 (8.3%) were P80+. P80+ were less likely to undergo local regional and systemic therapies vs. P80- (p

Cultural heritage is a fundamental part of the society’s identity, and its conservation is of great relevance as it transcends time and memory. To minimize its deterioration, cultural heritage has traditionally undergone diverse preservation and maintenance treatments and the attention of researchers to develop new and innovative methods for state diagnosis and protection treatments has been increasing in the recent decades. Therefore, in this study, a literature review using a bibliometric analysis and LDA methodology was conducted to systematically map scientific research outputs on cultural heritage conservation and protection. Data was retrieved from the Scopus database and the annual publications, countries, most-cited publications, authors, institutions, and keywords have been comprehensively analyzed, leading to the detection of research trends. Findings show an increasing number of studies in this field in the last decades, particularly since 2010. Italy, home to the largest number of UNESCO heritage sites, is the most prolific country. Most of the studies are related to metal, paper and stone as substrate to be protected. Significant progress has been made in understanding the deterioration processes through precise diagnosis and the development of innovative treatments for protection. In this sense, latest trends have been detected such as the use of non-invasive techniques for diagnosis and the use of nanotechnology and nature-based treatments for the conservation treatments.

Invasive fungal disease causes high morbidity and mortality among immunocompromised patients. Anti-fungal drug resistance and cytotoxicity highlight the need for effective antifungal therapeutics. In this study, the antifungal potential of the ethanolic extract of Anacardium occidentale (Cashew Leaf) leaves were evaluated against Candida albicans and C. auris. The antifungal activity was tested by the broth microdilution method and growth kinetic test. To further explore its antifungal action mode, spectrofluorophotometry, confocal microscopy and scanning and transmission electron microscopy were performed, Additionally, heterozygous knockout strains associated with resistance to oxidative stress were included in the study. We found that A. occidentale could inhibit the proliferation and growth of C. albicans at concentrations of 62.5 and 125 μg/mL. the doubling time was also drastically affected, going from 2.8 hours to 22.5 hours. Which was also observed in C. auris. The extract induced the accumulation of intracellular reactive oxygen species (ROS), resulting in endoplasmic reticulum stress and mitochondrial dysfunction, while it did not show cy-totoxicity or hemolytic activity at the concentrations evaluated. Our work preliminarily elucidated the po-tential mechanisms of A. occidentale against C. albicans on a cellular level and might provide a promising op-tion for the design of a new treatment for invasive candidiasis

Background/Objectives: This study aims to investigate the influence of root canal morphology and various treatment variables on the outcomes of root canal treatments (RCT) in mandibular second molars, assessed through cone-beam computed tomography (CBCT) imaging. Methods: A total of 150 CBCT images were examined, comprising 100 cases of persistent endodontic infections and 50 from previously treated root canals with normal apices in mandibular second molars. CBCT was utilized to evaluate root canal configuration, the radiographic quality of coronal restorations and treated canal systems, and the presence of periapical lesions. Statistical analyses were performed to explore correlations between these factors. Results: The presence of a C-shaped root canal configuration did not demonstrate a significant correlation with periapical lesions (p=0.05). Factors influencing endodontic treatment outcomes included the presence of missing canals (p=0.018), underfilling or overfilling (p=0.045), and inadequate coronal restoration (p=0.006). The presence of a missing canal was identified as the variable most significantly associated with periapical lesions (OR=3.103). Leaky canals were more commonly observed in C-shaped root canals (p&lt;0.001). Conclusions: Regardless of the root canal morphology of mandibular second molars, successful RCT depends on thorough disinfection to eliminate any untreated canals, precise three-dimensional filling of the canals at the correct working length, and a securely sealed coronal restoration to prevent leakage.

The purpose of this review is to provide an overview of brain arteriovenous malformations (AVMs) and focus on their management. The therapeutic options differ in each case depending on the location, size, and adjacent anatomical content of the AVM. The surgical resection by microsurgery is the preferred therapeutic option for a small and superficial AVM not related to an eloquent area (e.g., Spetzler-Martin grades I and II). On the other hand, when facing a very large AVM (e.g., Spetzler-Martin grades IV and V), the conservative and symptomatic treatment remains the most common management option due to the high risk-benefit ratio of any intervention. The management of AVMs with features between these two extremes (e.g., Spetzler-Martin grade III) remains less stablished. Stereotactic radiosurgery usually is the option for deep and small AVMs. Embolization has been usually considered before surgery for occlusion of deep arterial supplies of an AVM or to decrease its nidus size. Young patients and AVMs with compact nidus are features that weight in favor of a surgical approach. For the minority of cases that have the AVM diagnosed before bleeding the most common recommendation is to treat conservatively and particularly to avoid embolization. In summary, surgery is the gold-standard approach to cure an AVM and the choice for small AVMs located in non-eloquent area and with superficial venous drainage; large AVMs are mostly treated conservatively; the treatment of AVM with intermediate features is tailored, chosen with the guidance of classification systems, and encompasses radiosurgery and pre-operative embolization.

Nano- and microparticles are increasingly widely used in biomedical research and applications, particularly as specific labels and targeted delivery vehicles. Silica has long been considered the best material for such vehicles, but it has some disadvantages limiting its potential, such as the proneness of silica-based carriers to spontaneous drug release. Calcium carbonate (CaCO3) is an emerging alternative, being easily available, cost-effective, biocompatible material with high porosity and surface reactivity, which makes it an attractive choice for targeted drug delivery. CaCO3 particles are used in this field in the form of either bare CaCO3 microbeads or core/shell microparticles representing polymer-coated CaCO3 cores. In addition, they serve as removable templates for obtaining hollow polymer microcapsules. Each of these types of particles has its specific advantages in terms of biomedical applications. CaCO3 microbeads are primarily used due to their capacity for carrying pharmaceutics, whereas core/shell systems ensure better protection of the drug-loaded core from the environment. Hollow polymer capsules are particularly attractive because they can encapsulate large amounts of pharmaceutical agents and can be so designed as to release their contents in the target site in response to specific stimuli. This review focuses first on the chemistry of the CaCO3 cores, core/shell microbeads, and polymer microcapsules. Then, systems using these structures for the delivery of therapeutic agents, including drugs, proteins, and DNA, are outlined. The results of systematic analysis of available data are presented. They show that the encapsulation of various therapeutic agents in CaCO3-based microbeads or polymer microcapsules is a promising technique of drug delivery, especially in cancer therapy, enhancing drug bioavailability and specific targeting of cancer cells while reducing side effects. To date, research in CaCO3-based microparticles and polymer microcapsules assembled on CaCO3 templates has mainly dealt with their properties in vitro, whereas their in vivo behavior still remains poorly studied. However, an enormous potential of these highly biocompatible carriers for in vivo applications is undoubted. This last issue is addressed in depth in the Conclusion and Outlook sections of the review.

Previous studies suggested that trauma-focused cognitive behavior therapy (TF-CBT) is effective in reducing symptoms of post-traumatic stress disorder (PTSD) and depression in children and adolescents. However, the effects of app-assisted TF-CBT-based interventions in psychiatric clinics compared to treatment-as-usual (TAU) are under-explored. The purpose of this study was to reveal the added value of the app-assisted TF-CBT-based intervention as an add-on to TAU. The digitalized measures of the Child and Adolescent Trauma Screen (CATS), The Adolescent Dissociative Experience Scale (A-DES), Short Moods and Feelings Questionnaire (SMFQ), PTSD Checklist (PCL-5), and Children's Post-Traumatic Cognitions Inventory (CPTCI) were applied at baseline and post-treatment. The app-assisted TF-CBT-based group participants started with higher levels of negative alterations in cognition and mood compared to TAU participants but at post-treatment, no significant differences were observed between the app-assisted TF-CBT and TAU groups. Within the app-assisted TF-CBT group, post-treatment scores were significantly lower in post-traumatic stress symptoms, intrusion symptoms, alterations in arousal and reactivity, overall post-traumatic cognitions, and belief in being "a fragile person in a scary world”. Within the TAU group, post-treatment scores were notably lower just in dissociation and intrusion symptoms. The study suggests that app-assisted TF-CBT-based intervention can be effective in addressing specific trauma-related symptoms. The findings imply the necessity for screening for traumatic experiences, incorporating trauma-informed care, implementation of TF-CBT into treatment protocols, utilization of app-assisted interventions, tailoring interventions to individual needs, and comprehensive assessment and monitoring of treatment progress.

Traumatic pneumothorax (PTX) occurs in up to 50% of patients with severe polytrauma and chest injuries. Patients with traumatic PTX with clinical signs of tension physiology and hemodynamic instability are typically treated with an urgent decompressive thoracostomy, tube thoracostomy, or needle decompression. There is recent evidence that non-breathless patients with hemodynamically stable traumatic PTX can be managed conservatively through observation or a percutaneous pigtail catheter. We present here a 52-year-old woman who presented to the emergency department with 55 mm traumatic PTX. Following aspiration of 1500 ml of air, clinical improvement was immediately observed, allowing the patient to be discharged shortly thereafter. In hemodynamically stable patients with posttraumatic PTX, without specific risk factors or oxygen desaturation, observation or simple needle aspiration can be a reasonable approach. We aimed in this article to review the available literature on needle aspiration and conservative treatment of traumatic pneumothorax. A total of 12 studies were selected out of 190 articles on traumatic PTX, where conservative treatment versus chest tube decompression was compared. Our case report demonstrated that even a large PTX in a hemodynamically stable patient without other risk conditions, can be successfully treated conservatively with simple needle aspiration to avoid tube thoracostomy complications.

Molecular analysis of growing teratoma syndrome has not been extensively studied. Here, we report a 14-year-old boy with a growing mass during treatment for a mixed germ cell tumor of the pineal region. Tumor markers were negative; thus, growing teratoma syndrome was suspected. A radical resection via the occipital transtentorial approach was performed, and histopathological examination revealed a teratoma with malignant features. Methylation classifier analysis confirmed the diagnosis of teratoma, and DMRT1 loss and 12p gain were identified by copy number variation analysis, potentially elucidating the cause of growth and malignant transformation of the teratoma. The patient remains in remission after intense chemoradiation treatment as a high-risk germ cell tumor.

Background and Objectives: To evaluate the effectiveness and safety of balloon pulmonary angio-plasty in patients with inoperable chronic thromboembolic pulmonary hypertension in Vilnius Pulmonary Hypertension Referral centre and provide comparative analysis with other centres. Materials and Methods. This study included all balloon pulmonary angioplasty procedures per-formed between 2019 and 2024 in a single tertiary centre. Invasive haemodynamic parameters and clinical variables were assessed at baseline, at the end of invasive treatment, and at the con-clusion of follow-up (average 8.6 months) following the last balloon pulmonary angioplasty. Ad-ditionally, respective literature review was performed. Results. Twenty-six patients with inoper-able chronic thromboembolic pulmonary hypertension were enrolled. The mean age of the pa-tients was 61.6 (40-80) years. Each patient underwent an average of 4.2 (1-9) procedures. Fol-low-up data were available for 12 patients. Mean pulmonary arterial pressure decreased by 38.8% (p

Conventional MRI sequences are standard methods to monitor patients with brain tumors but have significant limitations especially after irradiation. Currently, the role of FET-PET in radiotherapy of glioblastoma is emerging, starting from target definition, response assessment and in distinguishing progression from post-irradiation changes. Recently a PET RANO criteria have been published providing optimal strategy for treatment evaluation with amino-acid PET. Earlier, a PET/RANO group reported contribution of PET imaging to radiotherapy planning and monitoring in glioma patients. Also, increasing evidence have showed advantages of amino-acid PET vs. RANO MRI for prediction of overall survival. In this narrative review we aimed to summarize published data on FET-PET based treatment response assessment to radiotherapy and focused on details in protocols.

Red mud (RM), a bauxite residue, contains hazardous radioactive wastes and alkaline material and poses severe surface water and groundwater contamination risks, necessitating recycling. Pretreated RM can be used to make adsorbents for water treatment. However, its performance is affected by many factors, resulting in a nonlinear correlation and coupling relationship. This study aimed to identify the best formula for an RM adsorbent using a mathematical model that examines the relationship between 11 formulation types (e.g., pore-assisting agent, component modifier, and external binder) and nine properties (e.g., specific surface area, wetting angle, and Zeta potential, among others). This model was built using a back-propagation neural networks(BP) based on single-factor experimental data and orthogonal test data. The model trained and predicted the established network structure to obtain the optimal adsorbent formula. The RM particle adsorbents had a pH of 10.16, specific surface area(BET) of 48.92 m2·g−1, pore volume of 2.10 cm3·g−1, compressive strength(ST)) of 1.12 KPa, and 24-h immersion pulverization rate(η_m) of 3.72%. In the removal of total phosphorus in flotation tailings backwater, it exhibited a good adsorption capacity (Q)and total phosphorous removal rate(η) of 48.63 mg·g−1 and 95.13%, respectively.

Abstract: Cervical cancer, which is the fourth most common malignancy and the fourth greatest cause of cancer-related deaths in women globally, continues to be a serious issue for global health. Despite advancements in treatment techniques, particularly the implementation of concomitant chemoradiation therapy, predicting the prognosis of locally advanced cervical cancer, especially for stage III, remains challenging. In recent years, neoadjuvant chemotherapy (NACT) has gained interest as a viable treatment strategy. The objective of this review paper is to scrutinize the clinical data and outcomes associated with NACT in the management of stage 3 cervical cancer. Electronic databases were used to perform a comprehensive literature search, and research up to 2023 were included. The findings suggest that NACT followed by irradiation may have advantages such as lowering tumor size, pelvic architectural distortion, and subclinical distant metastases, therefore enhancing radiation delivery. However, several studies have produced conflicting findings, raising questions regarding toxicity and finding no appreciable survival benefit over radiation alone. NACT followed by radical surgery has demonstrated more promising outcomes compared to surgery alone in terms of increasing rates of overall survival (OS) and progression-free survival (PFS). Additionally, NACT has been associated with decreased tumor growth, parametrial infiltration, nodal, metastases, and vascular space invasion. These findings suggest adjuvant radiation treatment. Although the overall survival rate has been markedly increased by concomitant chemoradiation treatment, metastatic disease continues to be a major factor in the death rate from cervical cancer. Therefore, improving outcomes in locally advanced cervical cancer requires investigating novel systemic treatments, such as NACT. The study also emphasizes how crucial it is to research factors like cisplatin dose-intensity and cycle lengths in order to maximize NACT's efficacy. To prevent the need for subsequent treatments and cumulative toxicity, more study should concentrate on patient selection for NACT followed by surgery.

Increasing research has indicated a strong association between identity functioning and eating disorder (ED) symptomatology. However, a detailed investigation of identity throughout ED treatment is lacking. The present longitudinal study examined identity in inpatients with an ED and explored its co-development with ED symptomatology throughout treatment. At admission (Wave 1), 110 women with an ED (Mage=21, SD=6.08, range:14-45) participated, of whom 83.64% participated during treatment (Wave 2) and 55.45% at discharge (Wave 3). Questionnaires on identity synthesis, identity confusion, identity processes, and ED symptomatology were completed. Latent growth curve modeling was used to address the research questions. Throughout treatment, a decrease in identity confusion and an increase in identity synthesis and adaptive identity processes were found. Accordingly, increases in identity synthesis and identification with commitment were related to general decreases in drive for thinness and body dis-satisfaction. Similarly, such decreases in ED symptoms were related to general decreases in identity confusion and ruminative exploration. The present study points to an increase in identity functioning throughout treatment, and longitudinal associations between identity functioning and ED symptomatology were found. Helping the patient to decrease ruminative exploration and to increase identification with previously made life commitments seem important in ED treatment.

A simple model is developed for membrane fouling, taking into account two main fouling phenomena: cake formation, due to attached solids onto the membrane surface and pores clogging, due to retained compounds inside the pores. The model is coupled with a simple anaerobic digestion model for describing the dynamics of an Anaerobic Membrane BioReactor (AnMBR). In simulations, we investigate its qualitative behavior: it is shown that the model exhibits satisfying properties in terms of flux decrease due to membrane fouling. Comparing simulation and experimental data, the model is shown to predict quite well the dynamics of an AnMBR. The simulated flux best fits the experimental flux with a correlation coefficient r2=0.968 for the calibration data set and r2=0.938 for the validation data set. General discussions are given on possible control strategies to limit fouling and optimize the flux production. We show in simulations that these strategies allow one to increase the mean production flux to 33 L/(h.m2), whereas without control it was 18 L/(h.m2).

Technical components should be produced sustainably and are subject to growing demands in terms of durability and reliability. To meet these expectations, the development of thermochemical processes is auspicious. Titanium alloys, which have a comparatively high gas solubility, allow temporary hydrogen (H) loading, often called thermo hydrogen treatment (THT). THT causes lattice deformation and reduces the β transformation temperature. These effects enable an adjustment of the microstructure, which improves the mechanical properties as compared to those produced conventionally. Furthermore, the process is applicable to complex geometries that cannot be surface hardened by mechanical surface treatment techniques. The investigation presented intends to realize a local microstructure gradient in additively via laser-powder bed fusion (L-PBF) manufactured cylindrical Ti–6Al–4V specimens by changing the distribution and morphology of strengthening precipitates as well as the β grain size depending on the distance to the surface, which should improve the material fatigue properties. To evaluate the mechanical properties of such THT-induced microstructure gradients, the resulting change in fatigue life in the LCF and HCF range was determined by stress-controlled cyclic deformation tests. Besides, the resulting microstructure was characterized by means of XRD and TEM. In addition to the additively manufactured and thermo hydrogen treated cylindrical specimens, conventionally produced tube-like specimens were thermo hydrogen treated and examined. For the THT-induced microstructure gradients, numerically simulated H concentration profiles as well as experimentally determined hardness profiles were used for the evaluation of the THT process. The study shows that H-loading at 500°C and H-degassing at 750°C, followed by aging at 550°C, allows the establishment of a microstructure gradient that shows an 8% improvement in fatigue properties compared to a reference condition without THT. The reason for this improvement is an increased volume fraction secondary alpha phase in the near-surface area of the specimens. Moreover, the results show that the process is applicable a tube-like specimen with varying wall thicknesses.

Wound healing is rarely seen as a problem in healthy individuals; however, under certain pathophysiological conditions, this process can be impaired, leading to the emergence of chronic wounds, which are themselves a serious public health problem. This work aimed to review the most important and recent literature on the use of metallic nanoparticles, in this case those produced from plant extracts, and their application as healing agents. For this, we firstly provided an insight into the pathophysiology of the wound healing process and then the main routes for obtaining metallic nanoparticles. The methodology of synthesis, which is part of the so-called green synthesis, has been the subject of several studies reporting the use of medicinal plants as subtracts for the production of different nanoparticles (of silver, gold, and zinc). Additionally, their use as wound healing agents is close related with biological properties such as antimicrobial, anti-inflammatory, and healing. Finally, we addressed in vitro and in vivo studies reporting the efficiency of metallic nanoparticles synthesized with plant extracts and applied in different pharmaceutical forms on the wound healing process. Based on these satisfactory results, we verified that metallic nanoparticles are potential therapeutic alternatives when compared to the traditional synthetic healing agents, thus foreseeing the production of new drugs in the pharmaceutical market.

Locally Advanced Breast Cancer (LABC) is a complex disease that requires a multidisciplinary approach. Neoadjuvant Chemotherapy (NAC) is usually performed in order to achieve loco-regional radical resection; although its importance in the multidisciplinary approach to LABC is well recognised, a small number of patients show Progressive Disease (PD). No standard Salvage Treatment (ST) has been defined and different strategies can be adopted, such as second line systemic therapies, radiation therapy, and surgery. Herein a case of LABC in PD during NAC is reported with a literature review, with the aim of highlighting the importance of a tailored multidisciplinary treatment in each patient.

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.

The catalytically inactive caspase-8-homologous protein, c-FLIP, is a potent antiapoptotic protein highly expressed in various types of cancers. c-FLIP competes with caspase-8 for binding to the adaptor protein FADD (Fas-Associated Death Domain) following Death Receptors (DRs) activation by the ligands of the TNF-R family. As a consequence, the extrinsic apoptotic signaling pathway involving DRs is inhibited. Inhibition of c-FLIP activity in tumor cells might enhance DR-mediated apoptosis and overcome immune and anticancer drug resistance. Based on an in silico approach, the aim of this work was to identify, new small inhibitory molecules able to bind selectively to c-FLIP and block its anti-apoptotic activity. Using a homology 3D model of c-FLIP, an in silico screening of 1880 compounds from the NCI database (National Cancer Institute) was performed. Nine molecules were selected for in vitro assays, based on their binding affinity to c-FLIP and their high selectivity compared to caspase-8. These compounds selectively bind to the Death Effector Domain 2 (DED2) of c-FLIP. We have tested in vitro the inhibitory effect of these 9 molecules using the human lung cancer cell line H1703 overexpressing c-FLIP. Our results showed that 6 of these newly identified compounds efficiently prevent FADD/c-FLIP interactions in a molecular pull-down assay, as well as in a DISC Immunoprecipitation assay. Overexpression of c-FLIP in H1703 prevents TRAIL-mediated apoptosis, however, combination of TRAIL with these selected molecules signifi-cantly restored TRAIL-induced cell death by rescuing caspase cleavage and activation. Altogether, our findings indicate that new inhibitory chemical compounds efficiently prevent c-FLIP recruit-ment into the DISC complex, thus restoring caspase-8 dependent apoptotic cascade. These results pave the way to design new c-FLIP inhibitory compounds that may serve as anticancer agents in tumors overexpressing c-FLIP.

Endovascular therapy (EVT) has revolutionized the management of acute ischaemic strokes with large vessel occlusion, with emerging evidence suggesting its benefit also in large infarct core volume strokes. In the last 2 years, 4 randomised controlled trials have been published on this topic - RES-CUE-Japan-LIMIT, ANGEL-ASPECT, SELECT2 and TENSION, with overall results showing that EVT improves functional and neurological outcomes compared to medical management alone. This review seeks to summarise the recent evidence presented by these 4 trials and highlight some of the limitations of our current understanding on this topic.

This article discusses the fabrication of pullulan/polyvinyl alcohol (PVA) and PVA blends as carrier polymers for drug delivery. This study utilized coaxial electrospinning to encapsulate doxorubicin (DOX), a common anticancer drug, within nanofibers, which helped mitigate the adverse effects of DOX on normal cells. The study also demonstrated that the coaxial electrospinning technique using PVA/pullulan cores was effective in inhibiting the attachment and proliferation of HeLa cells, a type of cervical cancer cell. The use of pullulan/PVA and PVA blends as carrier polymers in conjunction with coaxial electrospinning could provide a safe and effective drug delivery system for the treatment of cervical and other solid malignancies. The study concluded that nanofibers showed promising results in inhibiting the growth of HeLa cells, indicating their potential as safe and effective drug delivery systems for treating cervical cancer and other solid malignant tumors.

Statistical analysis of mechanical properties of thin-walled samples (~500 microns) obtained by selective laser melting from AlSi10Mg material and subjected to heat treatment for 1 hour at temperatures from 260 °C to 440 °C (step of aging temperature change 30 °C) has shown that the maximum strain hardening in the stretching diagram section from yield strength to tensile strength is achieved at the heat treatment temperature equal to 290 °C. At carrying out of correlation analysis statistically significant positive correlation between deformation corresponding to yield strength and the sum of heights of the largest protrusions and depths of the largest depressions of the surface roughness profile within the basic length of the sample (Rz) and the full height of the surface roughness profile (Rmax) was established. It was found that the reason for the correlation is the presence of cohesive states between the extreme values of the surface roughness profile that persist along the entire length of the specimen.

Modification of Scots pine sapwood (Pinus sylvestris L.) with heterocyclic compounds, imidazole and succinimide, was investigated. Pressure-impregnation with aqueous solutions containing imidazole, imidazole + citric acid, succinimide, succinimide + citric acid, and citric acid + sorbitol (CIOL®) at 5%, 10%, and 15% solid content was followed by oven-curing at 220 °C for 1 hour. Mass changes during treatment steps, bending properties, and anti-swelling efficiency (ASE) were examined. Results indicate that solid concentrations within the range of 5% to 10% were optimal. Results seem to show there are two differing mechanisms in the modification of imidazole and succinimide, respectively. Mass loss due to the heat treatment was highest in imidazole-treated specimens, whereas it remained low and concentration-independent in succinimide-treated specimens. ASE after three cycles reached 31% for imidazole-treated specimens and improved to 38% with the addition of citric acid. For succinimide, ASE increased from 17% to 41%. Bending properties generally showed improvement, except for succinimide + citric acid and CIOL®, which displayed a reduced modulus of rupture. Chemical analyses are warranted to fully understand the reaction mechanisms of the treatments. Imidazole treatment's positive effects are suggested to stem from a thermal reaction between the chemical and wood, indicated by substantial mass loss during leaching and specimen darkening. Succinimide and citric acid might exhibit polymerization with each other and wood components, akin to the CIOL® process. Further research should delve into reaction mechanisms and the impact of imidazole and succinimide on biological durability.

Oil agents produced from degreasing treatment of synthetic fibers are typical pollutants in printing and dyeing wastewater, which may cause large-scale environmental pollution without proper treatment. How to purify oily dye wastewater with low cost is a key problem at present. In this study, the biochar microspheres with oil removal ability were prepared deriving from waste bamboo chips using hydrothermal method. The structure of biochar microsphere was regulated by the activation and modification processes. The biochar microspheres were characterized and their adsorption behaviors for oily dye wastewater were explored. The results showed that the adsorption efficiency of biochar microspheres for oily dye wastewater (DTY) was improved significantly after the secondary pyrolysis and lauric acid grafting reaction. The maximum COD removal quantity of biochar microspheres for DTY was 889 mg/g with removal rate of 86.06% in 30 min. Besides, the kinetics showed that the chemisorption was the main adsorption manner. The application of biochar microspheres can decrease the costs of oily wastewater treatment and avoid environmental pollution.

Colorectal cancer is the third most common disease and the second most common cause of death in the world. The drug for second-line treatment depends on the drugs used in first-line treatment and biomarker status. As biomarkers, the RAS gene, BRAF gene, and dMMR/MSI-H, TMB-H, and HER2 statuses have been established in clinical practice, and the corresponding molecularly targeted therapeutic agents are selected based on biomarker status. Given the frequency of biomarkers, it is assumed that when patients move on to second-line treatment, an angiogenesis inhibitor is selected in many cases. For second-line treatment, three angiogenesis inhibitors, bevacizumab (BEV), ramucirumab (RAM), and aflibercept (AFL), are available, and one of them is combined with cytotoxic agents. These three angiogenesis inhibitors are known to inhibit angiogenesis through different mechanisms of action. Although no useful biomarkers are established for selecting angiogenesis inhibitors, previous biomarker studies have suggested that angiogenesis-related factors such as VEGF-A and VEGF-D might be predictors of therapeutic efficacy of angiogenesis inhibitors. These biomarkers are measured as protein levels in plasma and are considered to be hopeful biomarkers. We consider that the rationale for selecting among these three angiogenesis inhibitors should be clarified to benefit patients.

Treating clubfoot in walking age children is debated, despite studies showing that using Ponseti casting principles can correct the mid-foot effectively. We aimed to explore techniques and approaches for management of older children with clubfoot and identify areas of management consensus. A mixed-methods cross-sectional electronic survey on delayed presenting clubfoot (DPC) was sent to 88 clubfoot practitioners (response rate 56.8%). We collected data on decision-making, casting, imaging, orthotics, surgery, re-currence, rehabilitation, multidisciplinary care and contextual factors. The quantitative data were analysed using descriptive statistics and the qualitative data were analysed using conventional content analysis. Many respondents used the Pirani score and some used the PAVER score to aid deformity severity assessment and correctability [1,2]. Ponseti casting principles were consistently applied with a stepwise approach. Con-textual factors influenced the timing of the treatment, the decision to treat a bilateral deformity simultaneously, and casting intervals. Differences were seen around orthotic usage and use of tibialis anterior tendon transfer following full correction. The survey identified consensus areas in overall principles of management for delayed presenting clubfoot and implementation of Ponseti principles, indicating these principles are well recognized as a multidisciplinary approach for older children with clubfoot. Some dif-ferences in approach may reflect different economic or social contexts. The principles can be adapted well for different geographical and healthcare contexts.

Novel effluent treatment solutions for dangerous organic pollutants are crucial worldwide. In recent years, chemical reduction using noble metal-based nanocatalysts and NaBH4, a reducing agent, has become common practice for eliminating organic contaminants from aquatic environments. We suggest a straightforward approach to synthesizing magnetic cellulose nanocrystals (CNC) modified with magnetite (Fe3O4) and silver nanoparticles (Ag NPs) as a catalyst for organic contamination removal. Especially, Ag NPs were decorated on the CNC surface without reducing agents or stabilizers by reducing AgNO3. XRD, FE-SEM, TEM, EDX, VSM, BET, and zeta potential tests characterized the Ag/Fe3O4/CNC nanocomposite. The nanocomposite's catalytic activity was tested by eliminating 4-nitrophenol (4-NP) and organic dyes methylene blue (MB) and methyl orange (MO) in an aqueous solution at 25 oC. The Ag/Fe3O4/CNC nanocomposite reduced 4-NP and decolored these hazardous organic dyes in short time (2 to 5 min) using a tiny amount of catalyst (2.5 mg for 4-NP and 15 mg for MO and MB). The magnetic catalyst was removed and reused three times without losing catalytic activity. This work shows that the Ag/Fe3O4/CNC nanocomposite can chemically reduce harmful pollutants in effluent for environmental applications.

Bisphenol A is a remarkable chemical compound for its many applications mainly in the plastics industry, but also for its toxic effects on the environment and human health. BPA (4,4-isopropylidenediphenol) is an anthropogenic compound, moderately soluble in water (120 – 300 mg/l) at room temperature, and highly soluble in alkaline solutions, ethanol and acetone. BPA can bioconcentrate, bioaccumulate and biomagnify through food webs until it reaches humans. To prevent this, effective strategies are sought to allow its removal from the environment, through physico-chemical or enzymatic methods, advanced oxidation, adsorption and biodegradation, ultrasonic degradation. This article shows a comparative study regarding adsorption of BPA on Active carbon and zeolitic tuff, ZTC. In this paper, the characterization of the zeolitic tuff Rupea adsorbent, was carried out from an elemental and mineralogical point of view, pore size and elemental distribution, using SEM, EDAX, and XRD analysis. The pore size varies from 30 nm to 10 µm, atomic ratio Si/Al≥4, and the 80 % of mineralogical composition represent Ca Clinoptilolite zeolites Ca Clinoptilolite zeolite ((Na1.32K1.28Ca1.72Mg0.52)(Al6.77Si29.23O72)(H2O)26.84). Also, a comparative study of the adsorbtion capacity of bisphenol A from synthetic solutions on activated carbon type - Norit GAC 830 W, GAC, as well as on Clinoptilolite-type zeolitic tuff, ZTC, Rupea, was carried out. The experiments were carried out at a temperature of 20 ºC, a pH of 4.11; 6.98 and 8.12, and ionic strength being assured using KCl of 0.01 M, and 0.1 M. The adsorption capacities of GAC and ZTC tend to 115 mg/g and 50 mg/g respectively, at 8.12 pH and ionic strength of 0 M. The Langmuir mathematical model most faithfully describes the adsorption equilibrium of BPA. The maximum adsorption capacity for both adsorbents increases with increasing pH, and decreases with increasing ionic strength.

Objective: To evaluate the effect of care bundles on treatment compliance and intestinal barrier function in patients with refractory septic shock in the intensive care units (ICUs). Methods: In this retrospective study, the clinical data of 94 patients with refractory septic shock admitted to our hospital between June 2020 and April 2022 were collected. Patients with routine nursing were included in the routine group, and those with care bundles were assigned to the care bundles group, with 47 cases in each group. Outcome measures included nursing efficiency, treatment compliance, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHE II) score, intestinal barrier function, inflammation factor level, treatment outcome and complications. Results: Care bundles resulted in significantly higher nursing efficiency and treatment compliance versus routine care (P<0.05). Patients receiving care bundles showed significantly higher SOFA scores and APACHE II scores than those receiving routine care (P<0.05). Intestinal fatty-acid binding protein (I-FABP), diamine oxidase (DAO), lactate, endotoxin, and intestinal dysfunction scores in the care bundles group were significantly lower than those in the conventional group after treatment (P<0.05). Care bundles were associated with significantly lower levels of procalcitonin (PCT) and hypersensitive C-reactive protein (hsCRP), shorter time to symptom relief, ICU treatment time, and duration of mechanical ventilation, and lower 28-d morbidity and mortality versus routine care (P<0.05). Patients in the care bundles group had a significantly lower incidence of complications than those in the routine group (P<0.05). Conclusion: Care bundles effectively enhance treatment compliance, improve intestinal barrier function and treatment outcomes, reduce the inflammatory response, and decrease the risk of SOFA score, APACHE II score, and complications in patients with refractory septic shock.

Objective: To evaluate the effect of care bundles on treatment compliance and intestinal barrier function in patients with refractory septic shock in the intensive care units (ICUs). Methods: In this retrospective study, the clinical data of 94 patients with refractory septic shock admitted to our hospital between June 2020 and April 2022 were collected. Patients with routine nursing were included in the routine group, and those with care bundles were assigned to the care bundles group, with 47 cases in each group. Outcome measures included nursing efficiency, treatment compliance, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHE II) score, intestinal barrier function, inflammation factor level, treatment outcome and complications. Results: Care bundles resulted in significantly higher nursing efficiency and treatment compliance versus routine care (P<0.05). Patients receiving care bundles showed significantly higher SOFA scores and APACHE II scores than those receiving routine care (P<0.05). Intestinal fatty-acid binding protein (I-FABP), diamine oxidase (DAO), lactate, endotoxin, and intestinal dysfunction scores in the care bundles group were significantly lower than those in the conventional group after treatment (P<0.05). Care bundles were associated with significantly lower levels of procalcitonin (PCT) and hypersensitive C-reactive protein (hsCRP), shorter time to symptom relief, ICU treatment time, and duration of mechanical ventilation, and lower 28-d morbidity and mortality versus routine care (P<0.05). Patients in the care bundles group had a significantly lower incidence of complications than those in the routine group (P<0.05). Conclusion: Care bundles effectively enhance treatment compliance, improve intestinal barrier function and treatment outcomes, reduce the inflammatory response, and decrease the risk of SOFA score, APACHE II score, and complications in patients with refractory septic shock.

The study's objective was to assess the impact of Mediterranean diet/lifestyle interventions for weight loss on Positive airway pressure (PAP) adherence, Body mass index (ΒΜΙ), sleepiness, and blood pressure measurements (BP) in patients with obstructive sleep apnea (OSA). We designed a randomized, controlled trial, including overweight and obese patients with moderate-to-severe OSA, randomized to standard care (SCG, n=37) and Mediterranean diet group (MDG, n=37). SCG received healthy lifestyle advice, while MDG underwent a 6-month behavioral intervention aiming to enhance weight loss and adherence to Mediterranean diet. PAP adherence, BMI, Epworth Sleepiness Scale (ESS) and BP measurements were evaluated pre- and post-intervention. Post-intervention PAP use was higher in MDG compared to SCG (6.1 vs 5.4, p=0.02). Diet/lifestyle intervention was one of the most significant predictive factors for PAP adherence (OR = 5.458, 95% CI = 1.144-26.036, p=0.03). The SCG demonstrated a rise in BMI, while the MDG displayed a decline (0.41 vs -0.75, p=0.02). The MDG also demonstrated a substantial reduction in adjusted SBP (-5.5 vs 2.8, p=0.014) and DBP (-4.0 vs 2.5, p=0.01). Ultimately, incorporating a dietary/lifestyle intervention with standard care yields superior PAP adherence, BMI, and BP measurements in contrast to standard care alone, underscoring the potential benefits of allocating increased time and support within the MDG group. Trial registry: ClinicalTrials.gov; No.: NCT05881824; URL: www.clinicaltrials.gov.

Globally, gastric cancer is a major cause of cancer mortality, with a 5-year survival rate of 32% for locally advanced and metastatic gastric cancer. This systematic literature review summarized the clinical, safety, and humanistic outcomes associated with systemic regimens given as first line therapy for locally advanced and metastatic gastric cancer. The search included articles published in English in PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and the American Society of Clinical Oncology meeting library, from inception to April 2022. Phase II and III randomized controlled trials conducted among western populations diagnosed with stage III and IV locally advanced and metastatic gastric cancer were included. Two investigators independently reviewed the studies, conducted data extraction, and assessed risk of bias in accordance with PRISMA guidelines. Twenty-four randomized controlled trials totaling 8,705 patients were included. Median overall survival ranged from 5.0-13.1 months, median progression-free survival ranged from 2.0-7.7 months, and objective response ranged from 13.0-64.1%. Two studies reported higher quality of life outcomes. Grade 3 and 4 adverse events were reported in most studies. Improvement in clinical outcomes can be seen in recently published randomized controlled trials for locally advanced and metastatic gastric cancer.

The cast grains of the 7055 aluminum alloy were refined by adding Sm + Er, and the proper heat treatment procedure was utilized to further precipitate the rare earth phase in order to increase the alloy's strength and toughness. The grain size, microstructure and phase were characterized by optical microscopes (OM), Scanning electron microscopy - energy spectrum (SEM-EDS), XRD diffractometer (XRD). The macroscopic hardness, yield strength and tensile strength of alloy materials were measured by hardness meter and universal electronic tensile machine. The results shown that the as-cast sample and the heat treatment sample all exist Al10Cu7Sm2 and Al8Cu4Er rare earth phase; But after heat treatment, the volume percentage of the rare earth phase dramatically increased and the dispersion was more unified. When 0.3wt.%Sm and 0.1wt.%Er were added, the grain size could be refined to 53μm. With the increase of the total content of rare earth elements, the refining effect first increased and then decreased. Under 410 oC solid solution for 2h + 150oC aging for 12h, the macroscopic hardness, yield strength, tensile strength and elongation of 0.3wt.%Sm + 0.1wt.%Er+7055 as-cast sample were 155.8HV, 620.5Mpa, 658.1Mpa, and 11.90%, respectively.

Within this paper, a machine learning algorithm is used to investigate the importance of certain setpoints and parameters in the filtration processes of a large-scale water treatment facility. Previously, a model for the filtration process based on Run-to-Run Control was proposed and tested against sample data from the treatment plant, but it was quickly found that such a model was incompatible for successfully computing setpoints of operation which minimize the energy cost of running the filtration systems. The machine learning model described herein is an attempt to elucidate the importance of the available data on the filtration systems and to identify the most important variables that influence the filtration run time.

The aim of this study was to investigate the potential of converting potato peel waste into bio ethanol using an in-house produced multi-enzyme preparation. To achieve this, a variety of pre-treatment strategies, including thermal, chemical, and thermo-chemical methods, were applied to the potato peels. These included boiling for 30 and 60 min, steam at varying pressures and times, and different concentrations of chemicals such as H2SO4, HNO3, CH3COOH, HCl, NaOH, Ca(OH)2, KOH, NH3, and H2O2, either alone or in combination with steam. The pre-treated potato peels were then enzymatically hydrolyzed using a crude multi-enzyme cocktail derived from solid-state fermentation of wheat bran by a natural variety of Aspergillus niger P-19, containing cellulases, hemicellulases, pectinase, and amylases. The most effective pre-treatment combination was found to be 3% H2SO4 followed by steam under pressure and enzymatic hydrolysis using the crude multi-enzyme preparation. This combination resulted in the highest yield of reducing sugars (141.04 ±12.31 g/l) with a 98.49% carbohydrate conversion at a 20% substrate loading, giving an ethanol yield of 43.2 g/l. Furthermore, supplementing the medium with peptone, (NH4)(H2PO4), and ZnSO4 at 0.1%w/v each with 22% and 24% solid, respectively, resulted in appreciable yields of 51.67 and 54.75 g/l, further enhancing the ethanol yield.

In the recent years, biochar has emerged as a remarkable biosourced material for addressing global environmental, agricultural, biomedical, and energy challenges. However, the performances of biochar rest in part on finely tuning its surface chemical properties, intended to obtain specific functionalities. In this review, we tackle surface treatment of biochar with silane and other coupling agents such as diazonium salts, titatantes, ionic/non-ionic surfactants, as well as nitrogen-containing (macro)molecules. We summarize the recent progress achieved mostly in the last five years, and correlate the nature and extent of functionalization to eye catchy end applications of the surface engineered biochar.

This article reports on the comparative study of the hot deformation behaviour of virgin (steel A) and rejuvenated heat treatment creep-exhausted (steel B) P91 steels. Hot uniaxial compression tests were conducted on the two steels at the deformation temperature range of 900°C-1050°C and a strain rate range of 0.01-10s-1 to 0.6 strain using Gleeble® 3500 equipment. The results showed that the flow stress largely depends on the deformation conditions. The flow stress for the two steels increased with an increase in strain rate at a given deformation temperature and vice versa. The flow stress-strain curves exhibited a dynamic recovery as the softening mechanism. The material constants determined using Arrhenius constitutive equations were: stress exponent was: steel A (5.76) and steel B (6.67), and the apparent activation energy was: steel A (473.1 kJ mol-1) and steel B (564.5 kJmol-1). From these results, steel A exhibited better workability than steel B. Statistical parameters analyses showed that the flow stress for the two steels had a good correlation between the experimental and predicted data. Pearson’s correlation coefficient (R) was: steel A (0.97) and steel B (0.98). The Average Absolute Relative Error (AARE) values were: 7.62% (steel A) and 6.54% (steel B). The study shows that the Arrhenius equations can effectively describe the flow stress behaviour of P91 steel, and this method is applicable to the industrial metalworking process.

Cempo Ireng (Oryza sativa L. var. Cempo Ireng) is one of the black rice variety in Indonesia that consumed as functional food, not as a staple food because of the black rice contains anthocyanin pigment which has beneficial to human health. High concentration of anthocyanin reaching 393.93 ppm cause black color in the pericarp layer of Cempo Ireng which make this variety as an antioxidant source, low glycemic index, and free of gluten, leading to have higher price in the rice market. However, most of the farmers are not cultivate Cempo Ireng due to the longer vegetative phase up to 150 days compared to the white rice varieties which only takes 90 days, the taller phenotype of Cempo Ireng cause problems in cultivation, and also the purple color of Cempo Ireng attract birds and earhead bug (Leptocorisa oratorius) to feed on black rice caryopsis that cause severe yield loss. Transgenic methods, mutation technique, intensification systems, and physical treatment have been applied in Cempo Ireng to overcome those lack characteristics. In the future, Cempo Ireng also has a big potential to become a parent in cross breeding program because of the positive characters. The aim of this review is to describe the potential of Cempo Ireng in rice breeding program for improving food sustainability.

We investigated whether a functional insertion/deletion (I/D) polymorphism of angiotensin-converting enzyme (ACE) influenced antipsychotic treatment. At baseline, and after 8 weeks of treatment with various antipsychotic medications, we assessed patients’ Positive and Negative Syndrome Scale (PANSS) scores, PANSS factors, and metabolic syndrome-related parameters (fasting plasma lipid and glucose levels, and body mass index). A total of 186 antipsychotic-naïve first-episode psychosis patients or nonadherent chronic psychosis individuals (99 males and 87 females) were genotyped by polymerase chain reaction analysis. The ACE-I/D polymorphism was significantly associated with changes in PANSS psychopathology only (p < 0.05). Compared to ACE-II homozygous males, ACE-DD homozygous and ACE-ID heterozygous males manifested significantly greater decreases in PANSS positive score, PANSS excitement factor, and PANSS cognitive factor. ACE-DD homozygous females manifested higher decreases in PANSS depression factor compared to ACE-II homozygous and ACE-ID heterozygous females. The polymorphism’s effect size was estimated as moderate to strong, while its contribution to the PANSS psychopathology ranged from ~5.4–8.7%, with the lowest contribution observed for PANSS positive score changes and the highest for PANSS depressive factor changes. Our results indicated that ACE-I/D polymorphism had a statistically significant but weak gender-specific impact on psychopathology data and showed no association between ACE-I/D polymorphism and metabolic syndrome-related parameters.

Acute myeloid leukemia (AML) is a hematological malignancy that predominantly affects the elderly. Prognosis declines with age. For those who cannot tolerate intensive chemotherapy, historically established treatment options have been hypomethylating agents (HMAs), low dose cytarabine (LDAC), and best supportive care (BSC). As the standard of care evolves for those unfit for intensive chemotherapy, there is a need to understand established treatment pathways, clinical outcomes and healthcare resource utilization in Canada. The CURRENT study was a retrospective chart review of AML patients not eligible for intensive chemotherapy who initiated first-line treatment between 1 January 2015 and 31 December 2018. Data were collected from 170 Canadian patients treated at six hematology centers, of whom 118 received systemic therapy and 52 received BSC as first-line treatment. Median overall survival was 8.58 months and varied from 2.96 months for BSC to 13.31 months for HMAs. Over 80% of patients had at least one outpatient visit, and 67% of patients receiving systemic therapy and 71% of those receiving BSC had at least one admission to hospital, during their first line of therapy. A total of 96 (81.4%) patients receiving first line systemic therapy and 39 (75.0%) of those receiving first line BSC had at least one red blood cell or platelet transfusion. These findings highlight the unmet need for novel therapies for patients ineligible for intensive chemotherapy.

Cognitive rehabilitation is useful for many after traumatic brain injury (TBI), but we lack critical knowledge about which patients benefit the most from different approaches. Advanced neuroimaging techniques have provided important insight into brain pathology and systems plasticity after TBI and have potential to inform new practices in cognitive rehabilitation. In this study, we aimed to identify candidate structural brain measures with relevance for rehabilitation of cognitive control (executive) function after TBI. Twenty-eight patients (9 female, mean age 40.5 (SD = 13.04) years) with moderate/severe TBI (>21 months since injury) that participated in a randomized controlled cognitive rehabilitation trial (NCT02692352) were included in the analyses. Regional brain volume was extracted from T1-weighted MRI scans before treatment using tensor-based morphometry. Both positive and negative associations between treatment outcome (everyday cognitive control function) and regional brain volume were observed. The most robust structural brain measures with relevance for improvement in function were observed in midline fronto-parietal regions, including the anterior and posterior cingulate cortices. The study pro-vides proof of concept and valuable insight for planning future studies focusing on neuroimaging in cognitive rehabilitation after TBI.