This paper presents a new methodology to derive and analyze strategies for a fully decarbonized urban transport system which combines conceptual vehicle design, a large-scale agent-based transport simulation, operational cost analysis, and life cycle assessment for a complete urban region. The holistic approach evaluates technical feasibility, system cost, energy demand, transportation time and sustainability-related impacts of various decarbonization strategies. In contrast to previous work, the consequences of a transformation to fully decarbonized transport system scenarios are quantified across all traffic segments, considering procurement, operation and disposal. The methodology can be applied to arbitrary regions and transport systems. Here, the metropolitan region of Berlin is chosen as a demonstration case. First results are shown for a complete conversion of all traffic segments from conventional propulsion technology to battery electric vehicles. The transition of private individual traffic is analyzed regarding technical feasibility, energy demand and environmental impact. Commercial goods, municipal traffic and public transport are analyzed with respect to system cost and environmental impacts. We can show a feasible transition path for all cases with substantially lower greenhouse gas emissions. Based on current technologies and today’s cost structures our simulation shows a moderate increase in total systems cost of 13-18%.

1) Background: Capturing patients’ medical histories significantly influences clinical decisions. Errors in this process lead to clinical errors, increase costs and dissatisfaction among physicians and patients. Physicians in developing countries are overloaded with patients and cannot always follow the proper history-taking procedure. The challenges are acknowledged; however, a comprehensive understanding of the status and the remedies remained unexplored. 2) Objective: This paper aims to investigate the workload, history-taking challenges, and the willingness of the physicians to accept digital solutions. 3) Methods: A cross-sectional online survey was conducted on 104 physicians across Bangladesh, featuring 22 questions regarding their professional environment, workload, digitization status of health records, challenges in history-taking, and attitudes toward adopting digital solutions for managing patient histories; 4) Results: 92.67% of the physicians face workloads, 88.46% struggle in medical history-taking, and only 4.81% use digital medical records. About 70% struggle to complete the necessary history-taking steps, emphasizing the urgent need for solutions. An AI-based Smart Health Gantt Chart (SHGC) system has been introduced for their instant feedback. 93.27% of physicians expressed their willingness to use such a system. 5) Conclusions: The proposed SHGC has the potential to enhance healthcare efficiency in developing nations, benefit physicians, and improve patient-centered care.

BACKGROUND: Over the past few years, there has been an increasing interest to view the diagnosis of Familial hypercholesterolemia (FH) through the lens of the biopsychosocial model. However, other than a few epidemiological surveys, there is a dearth of studies from emerging economies that have examined FH using the biological, psychological and socio-environmental facets of the aforementioned model. AIM. The three aims of the current study were as follows: (i) to examine the psychosocial status among patients with genetically confirmed FH, (ii) to compare the intellectual capacity and cognitive outcomes with a reference group, and (iii) to examine the relationship between health literacy and cognitive functioning. METHOD: Consecutive FH patients referred to the lipid clinic at a tertiary care center for an expert opinion were recruited into this study, conducted from September 2019 to March 2020. Information regarding psychosocial functioning, health literacy, quality of life, and affective ranges were surveyed. Indices of current reasoning ability (attention and concentration, memory, and executive functioning) were compared with an age-matched reference group. The current hypothesis also explored the impact of FH on health literacy and cognition. RESULT: A total of 70 participants out of 106 (response rate: 66.0%) initially agreed to participate. However, 18 out of 70 dropped out of the study, yielding a final total of 52 FH patients. With 27 (51.9%) males and 25 (48.1%) females, the mean participant age stood at 37.2 years (SD=9.2), ranging from 21 to 52 years of age. In the psychosocial data, thirty-two percent (n=17) of them had anxiety (HADS≥ 8), and twenty-five percent (n=13) had depressive symptoms (HADS≥ 8). The performance of the FH patients was significantly impaired compared to the control group on the indices of current reasoning ability and all domains of cognitive functioning. In univariate analysis conducted to compare cognitive functioning with health literacy status, only indices of attention and concentration emerged as being significant. CONCLUSION: To date, there are only a few studies employing the biopsychosocial paradigm to investigate the FH population. The current study indicates that the FH population is marked by an impediment in almost all of the core features that are characteristically assessed by the biopsychosocial approach.

The multidimensionality of chronic pain forces us to look beyond isolated pain assessment such as pain intensity, which does not consider multiple key parameters, particularly in patients suffering from post-operative Persistent Spinal Pain Syndrome (PSPS-T2). Our ambition was to provide a novel Multi-dimensional Clinical Response Index (MCRI), including not only pain intensity but also functional capacity, anxiety-depression, quality of life and objective quantitative pain mapping assessments, the objective being to capture patient condition instantaneously, using machine learning techniques. Two hundred PSPS-T2 patients were enrolled in a real-life observational prospective PREDIBACK study with 12-month follow-up and received various treatments. From a multitude of questionnaires/scores, specific items were combined using exploratory factor analyses to create an optimally accurate MCRI; as a single composite index, using pairwise correlations between measurements, it appeared to better represent all pain dimensions than any other classical score. It appeared to be the best compromise among all existing indexes, showing the highest sensitivity/specificity related to Patient Global Impression of Change (PGIC). Novel composite indexes could help to refine pain assessment by changing the physician’s perception of patient condition on the basis of objective and holistic metrics, and by providing new insights to therapy efficacy/patient outcome assessments, before ultimately being adapted to other pathologies.

Cisplatin (CDDP) is a platinum-based drug effective against various cancers, including lung, bladder, prostate, ovarian, esophageal, stomach, and cervical cancer and malignant lymphoma. It plays a central role as the first choice in current anticancer therapy. However, CDDP causes serious side effects, such as neurological disorders, myelosuppression, and renal damage, because it is a small molecule indiscriminately distributed in normal tissues. Therefore, it is very important to prevent or attenuate CDDP toxicity. We hypothesized that liposomalization of CDDP could alleviate serious side effects. Therefore, this study aimed to evaluate the safety and efficacy of CDDP liposomes. A patient with multiple recurrent liver metastases from metastatic nasal carcinoma was administered CDDP liposomes with consent. Magnetic resonance imaging showed that the patient remained stable-diseased; however, no apparent side effects were observed, and blood draw data showed no worsening of renal function. Patients undergoing partial pancreatectomy and jejunoileal biliary anastomosis for biliary tract cancer who consented to receive CDDP liposomes demonstrated a partial response on angiographic computed tomography; however, they showed slight fatigue. To our knowledge, the present study is the first in Japan to suggest that liposomalization of CDDP may have anticancer effects while alleviating renal damage and bone marrow suppression.

Remaining service life (RSL) of pavement, as a sign of future pavement performance, has always received growing attention from pavement engineers. The RSL describes the time from the moment of pavement inspection until such a time when a major repair or reconstruction is required. The conventional approach to determining RSL involves using non-destructive tests. These tests, in addition to being costly, interfere with traffic flow and compromise users' safety. In this paper, surface distresses of pavement have been used to estimate the pavement’s RSL in order to eliminate the aforementioned problems and challenges. To implement the proposed theory, 105 flexible pavement segments were taken from Shahrood-Damghan Highway (Highway 44) in Iran. For each pavement segment, the type, severity, and extent of surface damage and pavement condition index (PCI) were determined. The pavement RSL was then estimated using non-destructive tests include Falling Weight Deflectometer (FWD) and Ground Penetrating Radar (GPR). After completing the dataset, the modeling was conducted to predict RSL using three techniques include Support Vector Regression (SVR), Support Vector Regression Optimized by Fruit Fly Optimization Algorithm (SVR-FOA), and Gene Expression Programming (GEP). All three techniques estimated the RSL of the pavement by selecting the PCI as input. The Correlation Coefficient (CC), Nash-Sutcliffe efficiency (NSE), Scattered Index (SI), and Willmott’s Index of agreement (WI) criteria were used to examine the performance of the three techniques adopted in this study. In the end, it was found that GEP with values of 0.874, 0.598, 0.601, and 0.807 for CC, SI, NSE, and WI criteria, respectively, had the highest accuracy in predicting the RSL of pavement.

A revitalized practice of natural philosophy can help people to live a better life and promote a flourishing ecosystem. Such a philosophy is natural in two senses. First, it is natural by seeking to understand the whole of nature, including mental phenomena, In particular, a comprehensive natural philosophy should address the phenomena of sentience by embracing first- and second-person methods of investigation. Moreover, to expand our understanding of the world, natural philosophy should embrace a full panoply of explanations, similar to Aristotle’s four causes. Second, such a philosophy is natural by being grounded in human nature, taking full account of human capacities and limitations. Future natural philosophers should also make use of all human capacities, including emotion and intuition as well as reason and perception, to investigate nature. Finally, since the majority of our brain's activities are unconscious, natural philosophy should explore the unconscious mind with the aim of deepening our relation to the rest of nature and enhancing well-being.

There are no theorems (proven theories) in the biological sciences. We propose that the 3 31 nt minihelix tRNA evolution theorem be universally accepted as one. The 3 31 nt minihelix theorem completely describes evolution of type I and type II tRNAs from ordered precursors (RNA repeats and inverted repeats). Despite diversification of tRNAome sequences, statistical tests overwhelmingly support the theorem. Furthermore, the theorem relates the dominant pathway for the origin of life on Earth, specifically, how tRNAomes and the genetic code may have coevolved. Alternate models for tRNA evolution (i.e., 2 minihelix, convergent and accretion models) are falsified. In the context of the pre-life world, tRNA was a molecule that via mutation could modify anticodon sequences and teach itself to code. We relate the clearest history to date of the chemical evolution of life on Earth. From analysis of tRNA evolution, ribozyme-mediated RNA ligation was a primary driving force in evolution of complexity during the pre-life to life transition on Earth.

We consider the financial planning problem of a retiree wishing to enter a retirement village at a future uncertain date. The date of entry is determined by the retiree's utility and bequest maximisation problem within the context of uncertain future health states. In addition, the retiree must choose optimal consumption, investment, bequest and purchase of insurance products prior to her full annuitisation on entry to the retirement village. A hyperbolic absolute risk-aversion (HARA) utility function is used to allow necessary consumption for basic living and medical costs. The retirement village will typically require an initial deposit upon entry. This threshold wealth requirement leads to exercising the replication of an American put option at the uncertain stopping time. From our numerical results, active insurance and annuity markets are shown to be a critical aspect in retirement planning.

Several studies have shown that physical activity (PA) is related to physical and mental health. Yet, there are few studies on the frequency of PA as it relates to health and a healthy lifestyle. The purpose of this study was to investigate the relationship between the frequency of practicing different types of physical activities (dependent variables), living a healthy lifestyle (BMI, smoking and alcohol consumption), physical health (sum of all doctor visits except psychiatrists) and mental health (a sum of visits to psychiatrists) at different ages (independent variables). We fo-cused on three types of PA: (1) medium to high-intensity aerobic exercises; (2) low to medium intensity relaxing and stretching exercises, (3) outdoor leisure PA. 9,617 participants (ages: 19 -81) were included in the study (with health registries over a period of 10 years prior to a cross-sectional survey). Descriptive statistics and multinomial logistic regression on frequencies of three types of PA and factors related to health and healthy lifestyles, as well as age and sex, were performed in this study. The results indicate that a higher frequency of practicing PA had a higher probability of association with the following factors: lower BMI, less or non-smoking behavior (types 1 & 3); higher education (types 1 & 2); higher age (types 2 & 3) and better physical health (type 1). Occasional (practicing sometimes) PA, type 2, was positively associated with poorer mental health (higher number of psychiatrist visits). Women were more likely to practice PA type 2, and men – PA types 3 & 1. Conclusion: In general, a higher frequency of PA is related with better health and healthy life styles; with the exception of PA type 2 that is related to poorer mental health.

Spinal Cord Stimulation (SCS) is an effective and validated treatment to address chronic refractory neuropathic pain in Persistent Spinal Pain Syndrome-Type 2 (PSPS-T2) patients. Surgical SCS lead placement is traditionally performed under general anesthesia due to its invasiveness. In parallel, recent works have suggested that Awake Anesthesia (AA), consisting in Target Controlled Intra-Veinous Anesthesia (TCIVA), could be an interesting tool to optimize lead anatomical placement using patient intra-operative feedback. We hypothesized that combining AA with Minimal Invasive Surgery (MIS) could improve SCS outcomes. The goal of this study was to evaluate SCS lead performance (defined by the area of pain adequately covered by paraesthesia generated via SCS), using an intraoperative objective quantitative mapping tool, and secondarily to assess pain relief, functional improvement and change in quality of life with a composite score. We analyzed data from a prospective multicenter study (ESTIMET) to compare the outcomes of 115 patients implanted with MIS under AA (MISAA group) or General Anesthesia (MISGA group), or by Laminectomy under General Anesthesia (LGA group). All in all, MISAA appears to show significantly better performance in terms of patient pain coverage, as well as improved secondary outcomes. One step further, our results suggest that MISAA combined with intra-operative hypnosis could potentialize patient intraoperative cooperation and could be proposed as a personalized package offered to PSPS-T2 patients eligible for SCS implantation in highly dedicated neuromodulation centers.

"Redesigning Education: A Transformative Approach" outlines comprehensive strategies for re-forming educational systems from primary to secondary levels to promote holistic student de-velopment. Traditional educational models fail to address diverse learning needs and cultivate critical thinking, creativity, and emotional intelligence. This study introduces innovative approaches such as personalized education through AI, wellness schools, professional skill development programs, and social and emotional learning (SEL) integration. The methodology includes an extensive literature review of contemporary educational books, peer-reviewed articles, and case studies from highly developed European countries, ensuring that the proposed strategies are grounded in credible and current research. Key reforms include continuous professional development for teachers, enhanced teacher training and support, comprehensive counseling services, and robust support systems for students. Strengthening school-family collaboration and promoting multiculturalism through inclusive policies and cultural events are emphasized. Additionally, upgrading school infrastructure to create safe and welcoming learning environments is essential for student prosperity. The proposed educational reforms aim to create an inclusive, innovative, and supportive learning environment, ensuring students thrive academically, emotionally, and socially. By integrating these comprehensive reforms, the study seeks to develop effective educational systems that foster student well-being and excellence, equipping future generations for success in a rapidly evolving world.

The Late Heavy Bombardment Period (4.1 to 3.8 billion years ago) of heightened impact cratering activity on young Earth is likely the driving force for the origin of life. During the Eoarchean, asteroids such as carbonaceous chondrites delivered the building blocks of life and water to early Earth. Asteroid collisions created innumerable hydrothermal crater lakes in the Eoarchean crust which inadvertently became the perfect cradle for prebiotic chemistry. These hydrothermal crater lakes were filled with cosmic water and the building blocks of life. forming a thick prebiotic soup. The unique combination of exogenous delivery of extraterrestrial building blocks of life, and the endogenous biosynthesis in hydrothermal impact crater lakes very likely gave rise to life. A new symbiotic model for the origin of life within the hydrothermal crater lakes is here proposed. In this scenario, life arose around four billion years ago through five hierarchical stages of increasing molecular complexity: cosmic, geologic, chemical, information, and biological. During the prebiotic synthesis, membranes first appeared in the hydrothermal crater lakes, followed by the simultaneous origin of RNA and protein molecules, creating the RNA/protein world. These proteins were noncoded protein enzymes that facilitated chemical reactions. RNA molecules formed in the hydrothermal crater basin by polymerization of the nucleotides on the montmorillonite mineral substrate. Similarly, the initial synthesis of abiotic protein enzymes was mediated by the condensation of amino acids on pyrite surfaces. The regular wet-dry cycles within the crater lakes assisted further concentration, condensation, and polymerization of the RNAs and proteins. Lipid membranes randomly encapsulated amino acids, RNA, and protein molecules from the prebiotic soup to initiate a molecular symbiosis inside the protocells, this led to the hierarchical emergence of several cell components. As the role of protein enzymes became essential for catalytic process in the RNA/protein world, Darwinian selection from noncoded to coded protein synthesis led to translation systems and the genetic code, heralding the information stage. In this stage, the biochemical pathways suggest the successive emergence of translation machineries such as tRNAs, aaRS, mRNAs, and of ribosomes for protein synthesis. The molecular attraction between tRNA and amino acid led to the emergence of translation machinery and the genetic code. tRNA is an ancient molecule that created mRNA for the purpose of storing amino acid information like a digital strip. Each mRNA strand became the storage device for genetic information that encoded the amino acid sequences in triplet nucleotides. As information became available in the digital languages of the codon within mRNA, biosynthesis became less random and more organized and directional. The original translation machinery was simpler before the emergence of the ribosome than that of today. We review three main concepts on the origin and evolution of the genetic code: the stereochemical theory, the coevolution theory, and adaptive theory. We believe that these three theories are not mutually exclusive, but are compatible with our coevolution model of translations machines and the genetic code. We suggest biosynthetic pathways as the origin of the translation machine that provided the framework for the origin of the genetic code. During translation, the genetic code developed in three stages coincident with the refinement of the translation machinery: GNC code with four codons and four amino acids during interactions of pre-tRNA/pre-aaRS /pre-mRNA, SNS code consisting of 16 codons and 10 amino acids appeared during the tRNA/aaRS/mRNA interaction, and finally the universal genetic code evolved with the emergence of the tRNA/aaRS/mRNA/ribosome machine. The universal code consists of 64 codons and 20 amino acids, with a redundancy that minimizes errors in translation. To address the question of the origin of the biological information system in the RNA/protein world, we converted letter codons into numerical codons in the Universal Genetic Code Table. We developed a software called CATI (Codon-Amino Acid-Translator-Imitator) to translate randomly chosen numerical codons into corresponding amino acids and vice versa, gaining insight into how translation might have worked in the RNA/protein world. We simulated the likely biochemical pathways for the origin of translation and the genetic code using the Model-View-Controller (MVC) software framework, and the translation machinery step-by-step. We used AnyLogic software to simulate and visualize the evolution of the translation machines and the genetic code. We conclude that the emergence of the information age from the RNA/protein world was a watershed event in the origin of life about four billion years ago.